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a CITY SECRETARY l
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NOv 201 PROFESSIONAL SERVICESAGREEMENT
a ov ofF35w�� Trion Group, a division of Marsh &McLennan Agency LLC
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a�[ OFESSIONAL SERVICES AGREEMENT ("Agreement") is made and entered into
Q 4 een the CITY OF FORT WORTH (the "City" or "Client"), a home rule municipal
corporation of the State of Texas, acting by and through its duly authorized Assistant City Manager,
and Trion Group, a division of Marsh & McLennan Agency LLC, a Delaware limited liability company
("Consultant," "MMA" or"Trion"), acting by and through its duly authorized Vice President of Sales &
Marketing. City and Trion are each individually referred to as a "party" and collectively referred to as
the"parties."
CONTRACT DOCUMENTS:
The Contract documents shall include the following:
1. This Agreement for Professional Services
2. Exhibit A—Statement of Work plus any amendments to the Statement of Work
3. Exhibit B—Price Schedule
4. Exhibit C—Signature Verification Form
5. Exhibit D—Compensation 'sclosure
6. Appendix 1: Business Associat eement
1. ,SCOL PY SERVICES.
Consultant hereby agrees to provide comprehensive consulting services regarding the City's
Pharmacy Benefits Program. Core services include, but are not limited to: preparing plan specifications,
soliciting qualified providers, negotiating agreements, evaluating and monitoring plan performance,
preparing actuarial studies, performing strategic planning, recommending plan-structure changes to
maximize plan savings, monitoring compliance requirements, ensuring market competitiveness for the
City's health and welfare pharmacy plans. Attached hereto and incorporated for all purposes incident to
this Agreement is Exhibit "A," Statement of Work, more specifically describing the services to be
provided hereunder.
2. TERM.
This Agreement shall commence on November 1, 2016 and shall expire on October 31, 2019, unless
terminated earlier in accordance with the provisions of this Agreement (the "Initial Term"). This
Agreement may be extended for up to two(2)additional periods of one year each by signed,written mutual
agreement of the parties(each a"Renewal Term").
3. COMPENSATION.
During the Initial Term, Consultant shall be compensated in accordance with the provisions of this
Agreement and the Payment Schedule attached as Exhibit L°B," which is incorporated for all purposes
herein. Consultant shall not perform any additional services for the City not specified by this Agreement
unless the City requests and approves in writing the additional costs for such services. The City shall not
be liable for any additional expenses of Consultant not specified by this Agreement unless the City first
approves such expenses in writing.
In the event this Agreement is extended for one or more Renewal Terms, 'tf e0MCjAUqjERWft
Consultant shall earn commissions as full and complete compensation for Core S rft kslog-agT
Pharmacy Benefits Consulting FT.WOWo Mo
renewal process, the parties will negotiate and agree to a not-to-exceed amount for Special Services to be
provided during each Renewal Term.
4. TERMINATION.
4.1 Notwithstanding anything to the contrary in this Agreement, this Agreement may only be
terminated as follows:
a) Non-Renewal. If the City or Trion gives notice of its intention not to renew at
least sixty (60) days prior to the end of the then-current term, this Agreement shall automatically
terminate on the last day of such term.
b) Breach. In the case of a material breach of the Agreement, the non-breaching
party may provide the breaching party with sixty (60) days prior written notice specifying the nature of
the alleged breach. If the breach is not cured to the reasonable satisfaction of the non-breaching party
within sixty (60) days of the date of such notice, the non-breaching party may, at its option immediately
terminate this Agreement in its entirety by providing written notice to the breaching party.
C) Bankruptcy. Either party may terminate this Agreement immediately upon written
notice to the other party in the event the other party becomes insolvent or enters into bankruptcy or other
reorganization proceedings.
d) Non-appropriation of Funds. In the event no funds or insufficient funds are
appropriated by the City in any fiscal period for any payments due hereunder, City will notify
Consultant of such occurrence, and this Agreement shall terminate on the last day of the fiscal period
for which appropriations were received without penalty or expense to the City of any kind whatsoever,
except as to the portions of the payments herein agreed upon for which funds shall have been appropriated.
4.2 Obligations on Termination or Expiration Generally.
In the event that this Agreement is terminated prior to the Expiration Date, the City shall
pay Consultant for services actually rendered up to the effective date of termination, and Consultant
shall continue to provide the City with services requested by the City and in accordance with this
Agreement up to the effective date of termination.
Within sixty(60)days following the effective date of termination,Trion shall return to the City or
destroy all City Information(as defined below).
4.3 Obligations on Termination for Breach.
Upon termination of this Agreement by Trion due to a breach, the City shall immediately pay
Trion any and all fees or other amounts due under this Agreement including (A) any agreed upon deferred
fees, commissions and carrier paid fees earned through the effective date of the termination and (B) the
amount that would have been due from the termination date through the end of the then-current term. The
foregoing shall not limit in any way any other remedies available to Trion pursuant to this Agreement or
applicable law.
Upon termination of this Agreement by the City due to a breach,Trion shall no longer be entitled to
any fees, commission, or carrier paid fees on or after the effective date of termination. The foregoing shall
not limit in any way any other remedies available to the City pursuant to this Agreement or applicable law.
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5. DISCLOSURE OF CONFLICTS AND CONFIDENTIAL INFORMATION.
Consultant hereby warrants to the City that Consultant has made full disclosure in writing of
any existing or potential conflicts of interest related to Consultant's services under this Agreement. In
the event that any conflict of interest arises after the execution of this Agreement, Consultant hereby
agrees immediately to make full disclosure to the City in writing. Consultant, for itself and its officers,
agents and employees, further agrees that it shall treat all information provided to it by the City as
confidential (City Information) and shall not disclose any such information to a third party without the
prior written approval of the City. Consultant shall store and maintain City Information in a secure
manner and shall not allow unauthorized users to access, modify, delete or otherwise corrupt City
Information in any way. Consultant shall notify the City promptly if the security or integrity of any City
Information has been compromised or is believed to have been compromised.
6. RIGHT TO AUDIT.
Consultant agrees that the City shall, until the expiration of three (3) years after final payment
under this Agreement, have access to and the right to examine at reasonable times any directly
pertinent books, documents, papers and records of the consultant involving transactions relating to this
Agreement at no additional cost to the City. Consultant agrees that the City shall have access
during normal working hours to all necessary Consultant facilities and shall be provided adequate
and appropriate work space in order to conduct audits in compliance with the provisions of this
section. The City shall give Consultant reasonable advance notice of intended audits.
7. INDEPENDENT CONTRACTOR.
It is expressly understood and agreed that Consultant shall operate as an independent contractor
as to all rights and privileges granted herein, and not as agent, representative or employee of the City.
Subject to and in accordance with the conditions and provisions of this Agreement, Consultant shall
have the exclusive right to control the details of its operations and activities and be solely responsible
for the acts and omissions of its officers, agents, servants, employees, contractors and subcontractors.
Consultant acknowledges that the doctrine of respondeat superior shall not apply as between the City,
its officers, agents, servants and employees, and Consultant, its officers, agents, employees, servants,
contractors and subcontractors. Consultant further agrees that nothing herein shall be construed as the
creation of a partnership or joint enterprise between City and Consultant.
8. LIABILITY AND INDEMNIFICATION.
CONSULTANT SHALL BE LIABLE AND RESPONSIBLE FOR ANY AND ALL
PROPERTY LOSS, PROPERTY DAMAGE AND/OR PERSONAL INJURY(INCLUDING DEATH)
TO ANY AND ALL PERSONS, OF ANY KIND OR CHARACTER, WHETHER REAL OR
ASSERTED, TO THE EXTENT CAUSED BY THE GROSS NEGLIGENT ACT(S) OR
OMISSION(S), MALFEASANCE OR INTENTIONAL MISCONDUCT OF CONSULTANT, ITS
OFFICERS, AGENTS,SERVANTS OR EMPLOYEES.
IN NO EVENT SHALL EITHER PARTY BE LIABLE TO THE OTHER FOR ANY
INDIRECT, SPECIAL, INCIDENTAL, CONSEQUENTIAL OR PUNITIVE DAMAGES OR FOR
ANY LOST PROFITS ARISING OUT OF OR RELATING TO ANY SERVICES PROVIDED BY
MMA OR ITS AFFILIATES. THE AGGREGATE LIABILITY OF MMA, ITS AFFILIATES AND
ITS AND THEIR EMPLOYEES TO THE CITY FOR DAMAGES ARISING OUT OF OR
RELATING TO THE PROVISION OF SERVICES BY MMA OR ITS AFFILIATES SHALL NOT
EXCEED ONE TIMES (IX) THE ANNUAL REVENUE RECEIVED BY MMA FROM OR ON
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ACCOUNT OF THE CITY. THIS PROVISION APPLIES TO THE FULLEST EXTENT
PERMITTED BYAPPLICABLE LA WAND TOALL CAUSES OFACTION.
CONSULTANT COVENANTS AND AGREES TO, AND DOES HEREBY, INDEMNIFY,
HOLD HARMLESS AND DEFEND THE CITY, ITS OFFICERS, AGENTS, SERVANTS AND
EMPLOYEES, FROM AND AGAINST ANY AND ALL CLAIMS OR LAWSUITS FOR EITHER
PROPERTY DAMAGE OR LOSS (INCLUDING ALLEGED DAMAGE OR LOSS TO
CONSULTANT'S BUSINESS AND ANY RESULTING LOST PROFITS) AND/OR PERSONAL
INJURY(INCLUDING DEATH) TO ANYAND ALL PERSONS, OFANY KIND OR CHARACTER,
WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH THIS
AGREEMENT, TO THE EXTENT CAUSED BY THE NEGLIGENT ACTS OR OMISSIONS OR
MALFEASANCE OF CONSULTANT,ITS OFFICERS,AGENTS,SERVANTS OR EMPLOYEES.
9. RESPONSIBILITIES OF THE CLIENT.
The City shall be solely responsible for the accuracy and completeness of information and other
documents the City furnishes to Consultant. The City recognizes and agrees that all services and
deliverables provided by Consultant are based on data and information furnished by the City.
Consultant will be under no obligation to investigate or verify the completeness or accuracy of any such
data or information, nor will Consultant have any liability for any errors, deficiencies or omissions in
any services, deliverables, evaluations, reports or recommendations provided to, or any insurance
coverages placed on behalf of, the City that are based on such inaccurate or incomplete data or
information.
10. ASSIGNMENT AND SUBCONTRACTING.
Consultant shall not assign or subcontract any of its duties, obligations or rights under this
Agreement without the prior written consent of the City. If the City grants consent to an
assignment, the assignee shall execute a written agreement with the City and the Consultant under which
the assignee agrees to be bound by the duties and obligations of Consultant under this Agreement.
The Consultant and Assignee shall be jointly liable for all obligations under this Agreement prior to
the assignment. If the City grants consent to a subcontract, the subcontractor shall execute a written
agreement with the Consultant referencing this Agreement under which the subcontractor shall agree
to be bound by the duties and obligations of the Consultant under this Agreement as such duties and
obligations may apply. The Consultant shall provide the City with a fully executed copy of any such
subcontract.
11. INSURANCE.
Consultant shall provide the City with certificate(s) of insurance documenting policies of the
following coverage limits that are to be in effect prior to commencement of any work pursuant to this
Agreement:
11.1 Coverage and Limits
(a) Commercial General Liability
$1,000,000 Each Occurrence
$2,000,000 Aggregate
(b) Automobile Liability
$1,000,000 Each accident on a combined single limit basis or
$250,000 Bodily injury per person
$500,000 Bodily injury per occurrence
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$100,000 Property damage
Coverage shall include any auto used by the Consultant, its employees,
representatives in the course of the providing services under this Agreement.
"Any auto"shall be any auto owned,hired and non-owned.
(c) Workers' Compensation
Statutory limits Employer's liability
$100,000 Each accident/occurrence
$100,000 Disease-per each employee
$500,000 Disease - policy limit
This coverage may be written as follows:
Workers' Compensation and Employers' Liability coverage with (i) limits consistent with
statutory benefits outlined in the law of the state in which the services are being
provided with respect to the Workers' Compensation Law and (ii) minimum policy
limits for Employers' Liability of $100,000 each accident/occurrence, $500,000 bodily
injury disease policy limit and $100,000 per disease per employee.
(d) Professional Liability(Errors&Omissions)
$1,000,000 Each Claim Limit
$1,000,000 Aggregate Limit
Professional Liability coverage may be provided through an endorsement to the
Commercial General Liability (CGL) policy, or a separate policy specific to
Professional E&O. Either is acceptable if coverage meets all other requirements.
Coverage shall be claims-made, and maintained for the duration of the contractual
agreement and for two(2)years following completion of services provided.
11.2 Certificates.
Certificates of Insurance evidencing that the Consultant has obtained all required
insurance shall be delivered to the City prior to Consultant proceeding with any work
pursuant to this Agreement. One or more certificates of insurance evidencing on-going
coverage in accordance with this Agreement shall be submitted to the City annually upon
request.
The Commercial General Liability and Automobile Liability insurance policies shall
be endorsed to include the City as an additional insured thereon, with respect to their
vicarious liability arising from Consultant's provision of services pursuant to this Agreement.
The Commercial General Liability and Automobile Liability insurance policies shall contain
a Waiver of Subrogation for the benefit of the City of Fort Worth. Waiver of subrogation
shall also be provided under the Workers' Compensation insurance policy for injuries
resulting from Consultant's performance of the work or operations under the contract,
excluding the recklessness, negligence, and willful misconduct of the City. The term City
shall include its employees, officers, and officials, in respect to the contracted services. Any
failure on the part of the City to request required insurance documentation shall not constitute
a waiver of the insurance requirement. A minimum of thirty(30)days' notice of cancellation
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or material reduction in limits of coverage shall be provided to the City by Consultant upon
receipt of such notice. Ten(10) days' notice shall be acceptable in the event of non-payment
of premium. Notice and copies of all insurance related documents shall be sent to the Risk
Manager, City of Fort Worth, 200 Texas Street, Fort Worth, Texas 76102, with copies to the
City Attorney at the same address.
12. COMTLIANCE WITH LAWS.ORDINANCES,R S AND REGULATIONS.
Consultant agrees to comply with all applicable federal, state and local laws, ordinances, rules
and regulations. If the City notifies Consultant of any violation of such laws, ordinances, rules or
regulations,Consultant shall immediately desist from and correct the violation.
13. NON-DISCRIMINATION COVENANT.
Consultant, for itself, its personal representatives, assigns, subcontractors and successors in
interest, as part of the consideration herein, agrees that in the performance of Consultant's duties and
obligations hereunder, it shall not discriminate in the treatment or employment of any individual or group
of individuals on any basis prohibited by law. If any claim arises from an alleged violation of this non-
discrimination covenant by Consultant, its personal representatives, assigns, subcontractors or successors
in interest, Consultant agrees to assume such liability and to indemnify and defend the City and hold the
City harmless from such claim.
14. NOTICES.
Notices required pursuant to the provisions of this Agreement shall be conclusively determined
to have been delivered when (1) hand-delivered to the other party, its agent, employee, servant or
representative, (2) delivered by facsimile with electronic confirmation of the transmission, or (3)
received by the other party by United States Mail, registered, return receipt requested, addressed as
follows:
To The CITY: To CONSULTANT:
City of Fort Worth Trion Group, a division of Marsh & McLennan
Agency LLC
Attn: Brian Dickerson Attn: Ma beth Gray, Consultant
200 Texas Street 2300 Renaissance Boulevard
Fort Worth TX 76102-6311 King of Prussia,PA 19406
Facsimile: (817)392-8654 Facsimile: (484)288-6678
15. SOLICITATION OF EMPLOYEES.
Neither the City nor Consultant shall, during the term of this Agreement and additionally for a
period of one year after its termination, knowingly solicit for employment or employ, whether as
employee or independent contractor, any person who is or has been employed by the other party during
the term of this Agreement, without the prior written consent of the person's employer, which consent
shall not be unreasonably withheld. This provision shall apply only to the Consultant solicitation
activities for employment located at 2300 Renaissance Boulevard,King of Prussia, PA 19406, and not all
of Marsh&McLennan Agency LLC.
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16. GOVERNMENTAL POWERS.
It is understood and agreed that by execution of this Agreement, the City does not waive or
surrender any of its governmental powers.
17. NO WAIVER.
The failure of the City or Consultant to insist upon the performance of any term or provision of
this Agreement or to exercise any right granted herein shall not constitute a waiver of the City's or
Consultant's respective right to insist upon appropriate performance or to assert any such right on any
future occasion.
18. GOVERNING LAW/VENU
This Agreement shall be construed in accordance with the internal laws of the State of Texas. If
any action, whether real or asserted, at law or in equity, is brought on the basis of this Agreement, venue
for such action shall lie in state courts located in Tarrant County, Texas or the United States District Court
for the Northern District of Texas, Fort Worth Division.
19. SEVERABILITY.
If any provision of this Agreement is held to be invalid, illegal or unenforceable, the validity,
legality and enforceability of the remaining provisions shall not in any way be affected or impaired.
20. FORCE MAJEURE.
The City and Consultant shall exercise their best efforts to meet their respective duties and
obligations as set forth in this Agreement, but shall not be held liable for any delay or omission in
performance due to force majeure or other causes beyond their reasonable control (force majeure),
including, but not limited to, compliance with any government law, ordinance or regulation, acts of God,
acts of the public enemy, fires, strikes, lockouts, natural disasters, wars, riots, material or labor
restrictions by any governmental authority,transportation problems and/or any other similar causes.
21. HEADINGS NOT CONTROLLING.
Headings and titles used in this Agreement are for reference purposes only and shall not be
deemed a part of this Agreement.
22. REVIEW OF COUNSEL.
The parties acknowledge that each party and its counsel have reviewed and revised this
Agreement and that the normal rules of construction to the effect that any ambiguities are to be resolved
against the drafting party shall not be employed in the interpretation of this Agreement or exhibits hereto.
23. AMENDMENTS/MODIFICATIONS/EXTENSIONS.
No extension, modification or amendment of this Agreement shall be binding upon a party hereto
unless such extension, modification, or amendment is set forth in a written instrument, which is executed
by an authorized representative and delivered on behalf of such party.
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24. SIGNATURE AUTHORITY.
The person signing this Agreement hereby warrants that he/she has the legal authority to execute
this Agreement on behalf of the respective party, and that such binding authority has been granted
by proper order, resolution, ordinance or other authorization of the entity. The other party is fully
entitled to rely on this warranty and representation in entering into this Agreement.
25. INFORMAL DISPUTE RESOLUTION.
Except in the event of termination on the basis of breach, if either City or Contractor has a claim,
dispute, or other matter in question for breach of duty, obligations, services rendered or any warranty that
arises under this Agreement, the parties shall first attempt to resolve the matter through this dispute
resolution process. The disputing party shall notify the other party in writing as soon as practicable after
discovering the claim, dispute, or breach. The notice shall state the nature of the dispute and list the party's
specific reasons for such dispute. Within ten (10) business days of receipt of the notice, both parties shall
commence the resolution process and make a good faith effort, either through email, mail, phone
conference, in person meetings, or other reasonable means to resolve any claim, dispute, breach or other
matter in question that may arise out of, or in connection with this Agreement. If the parties fail to resolve
the dispute within sixty (60) days of the date of receipt of the notice of the dispute, then the parties may
submit the matter to non-binding mediation in Tarrant County, Texas, upon written consent of authorized
representatives of both parties in accordance with the Rules of the American Arbitration Association or
other applicable rules governing mediation then in effect. The mediator shall be agreed to by the parties.
Each party shall be liable for its own expenses, including attorneys' fees; however, the parties shall share
equally in the costs of the mediation. If the parties cannot resolve the dispute through mediation,then either
party shall have the right to exercise any and all remedies available under law regarding the dispute.
26. WAIVER OF JURY TRIAL; LIMITATION OF RIGHT TO SUE.
Each party, on behalf of itself and its affiliates, to the fullest extent permitted by law, knowingly,
voluntarily, and intentionally waives its right to a trial by jury in any action or other legal proceeding arising
out of or relating to this Agreement or any services provided by Consultant or its affiliates. The waiver
applies to any action or legal proceeding, whether sounding in contract, tort or otherwise. Each party, on
behalf of itself and its affiliates, also agrees not to include any employee, officer or director of the other
party or its affiliates as a party in any such action or proceeding.
27. DISCLAIMERS.
The form of Consultant's compensation, whether by commission, fee, or both, shall not affect
Consultant's role as advisor or the scope of the Services to be provided by Consultant. The City agrees that
all decisions regarding the amount, type or terms of coverage shall be the City's ultimate responsibility.
While Consultant may provide advice and recommendations, the City must decide the specific coverage
that is appropriate for its particular circumstances and financial position. Consultant's service obligations
to the City are solely contractual in nature. The City acknowledges that, in performing services, Consultant
and its affiliates(i) are not acting as a fiduciary for the City except to the extent required by applicable law
and(ii)do not have a fiduciary or other enhanced duty to the City.
28. COMPENSATION DISCLOSURE.
Attached as Exhibit D is a "Compensation Disclosure" addressing other payments that may be
received by Consultant. By execution of this Agreement, Consultant affirms that such information is
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complete and accurate as of the date listed below. In the event of any change to the information
contained in Exhibit D, Consultant shall provide City with an updated Exhibit D as soon as reasonably
possible and in any event no later than sixty (60) days after the effective date of such change. In the
context of the compensation disclosure,the terms"we"and"our"refer to Consultant and the terms"you"
and"your"reference the City.
29. ENTIRETY OF AGREEMENT.
This Agreement, including the schedule of exhibits attached hereto and any documents
incorporated herein by reference, contains the entire understanding and agreement between the City and
Consultant, their assigns and successors in interest, as to the matters contained herein. Any prior or
contemporaneous oral or written agreement is hereby declared null and void to the extent in conflict
with any provision of this Agreement.
INNESS HEREOF,the parties hereto have executed this Agreement in multiples this day
of
CITY OF FORT WORTH: TRION GROUP, A DIVISION OF MARSH &
MCLENNAN AGENCY LL
By: By:
Sus n nis IF
Jef ly
Assistant City Manager ViKe Presidents�&Marketing
Date: (�o 3.0 17 Date:
ATTE T: ATTEST:
B L By:
N,5SA kbCity Secretary
APPROVED AS TO FORM
AND LEGALITY:
By: 14X�� -
Assi ant City Attrney
CONTRACT, AUTHORIZATION:
M&C: i ) I 7N1
Date Approved:
1295 Form Certification No.
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
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EXHIBIT A: STATEMENT OF WORK
Prescription Drug Consulting
Consultant shall provide a two-phase engagement. The first objective is to evaluate the terms and pricing of
the City's current agreement with its Pharmacy Benefits Manager, Envision. The object is to use
Consultant's leverage to establish better terms while ensuring minimal change to program design, funding,
and program delivery. The evaluation will focus on a short Request for Proposal (RFP) process and
negotiations in regards to the pharmacy programs outlined below.
Phase One: EvisionRx Negotiations
• Trion will utilize its financial evaluation and market leverage (namely its coalition pricing) to
negotiate more competitive financial terms with the City's current PBM, Envision, with respect to
the administration of the prescription drug benefits offered under the self-insured group health plans
maintained by The City of Fort Worth; and all applicable groups contained within the City's current
program.
Consultant will provide the following services:
Ongoing;PBM Management Services and Program Performance Reviews under Current Contract(2017)
• Quarterly review of utilization report results for the City
• Coordinating, as necessary, with PBM clinicians and financial analysts in reviewing utilization
results and developing consultative advice for the City
• Quarterly monitoring of discounts and dispensing fees achieved versus PBM's pricing guarantees
• Semi-annual review of rebates shared with the City versus PBM's pricing guarantees
• Assistance with escalation of issues with PBM
Annual Year-End Program Reviews
• Review of year-end utilization results with the City
• Preparation of annual performance summaries for the City
• Identify cost management opportunities (e.g., cost-share structures, cost management programs,
etc.)and provide benchmarking data
• Coordinate, as necessary, with PBM clinicians and financial analysts in reviewing utilization results
and developing consultative advice for the City
• Review of PBM's performance guarantee results
• Meetings with the City's team to present year-end utilization results and potential future savings
opportunities
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Phase Two: PBM Procurement
This second phase of consulting work begins with a full evaluation or financial and other provisions to
compare the price and terms of the City's current pharmacy agreements with the Trion Coalition to
reestablish the financial enhanced pricing and terms for the City. Consultant's coalition (the "Collective")
is a collective arrangement for participants to use their combined purchasing power to secure a highly
competitive prescription drug pricing model while retaining autonomy and control over their benefit plan
structure,financing arrangement and contract terms.
The value includes, on average, a reduction of 10% to 15% or more in total Rx costs through lower
administrative costs, higher discounts and guaranteed greater rebates. Additional, ongoing savings are
achievable through longer-term cost and trend management, bundled pricing for clinical programs, and
"built-in" savings escalators as the consortium grows in size/volume. Trion has coalitions with the two of
the largest PBM's,Express Scripts(ESI)and OptumRx.
The following scope of services will be provided by Consultant in order to evaluate alternative PBM
solutions:
Discovery
The Discovery Phase will begin with the receipt of all healthcare benefit cost and utilization, as well as plan
design and demographic data.
In the Discovery Phase,Consultant undertakes a multi-step process that includes the following objectives:
• Develop a "current state" of the City's specific plan design and costs, coupled with demographic
and eligibility data.
• Create a specific baseline that illustrates not only historical information, but also a projection of
future costs and utilization under a"do nothing"approach.
The Discovery Phase, and resulting proposed healthcare design/program, is used in constructing the
healthcare vendor RFP to ensure that the City's business objectives are aligned with its future healthcare
vendor.
Comparison of the current program to the Trion Coalition Pricing
Consultant will begin to draft the prescription drug RFP concurrently with the facilitation of the Discovery
phase.
The RFP will take into account and reflect the City's
• Ability to meet plan design and funding requirements.
• Comparison of network discounts:
— Potential network savings, based on combination of differences in negotiated pricing
arrangements and utilization management controls, will be evaluated. The evaluation will
compare the bidding vendors' discounts by type of prescription (e.g., retail, mail, brand,
generic, etc.) with the City's actual utilization to determine which discount model best
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aligns with the City's usage history and anticipated need. Trion will ensure a discount
guarantee is included by the PBM for the recommended product; if the guaranteed discount
is not achieved by the vendor, the City may receive a dollar-for-dollar reimbursement from
the PBM
• Comparison of rebates:
— The evaluation focuses on overall level of guaranteed rebates per prescription. Trion will
compare City's current rebate arrangements to those offered by the bidding vendors and
recommend the one that achieves the highest level of guaranteed rebates.
• Administration Fee comparison:
— Administration fees are evaluated at the both the plan and per-script level (i.e., dispensing
fee) with a goal of achieving a competitive dispensing fee and no administration fee at the
plan level. Trion will compare the City's current administration fee arrangements with
those offered by bidding vendors and provide an analysis of the projected savings/costs for
each.
• Analysis of provider networks and formularies:
— A primary consideration during the vendor selection process is the breadth of a vendor's
provider networks. Formulary disruption will also be analyzed to the extent that the City
experiences changes to its preferred list of drugs.
• Clinical management program analysis:
— The City may or may not offer clinical management programs (e.g., step therapy, prior
authorization, etc.). Consultant's analysis will focus on a comparison of the imbedded
programs compared to the bidding vendors, as well as the cost associated with the
programs.
• Proposed costs and services in relation to projected baseline costs and current services provided.
— Trion will analyze the costs and services offered by each proposer and show how they
compare to the City's current arrangements.
• Performance guarantees:
— Trion shall identify and highlight differences in performance metrics of each bidder. In
addition, Trion will construct and negotiate a comprehensive set of performance metrics
and resulting guarantees that are specific to the City's needs and objectives.
Summary of Findings
Once the detailed plan components are evaluated as part of the formal RFP process,Consultant will develop
and illustrate the overall financial impact by producing an estimated annual cost that utilizes projected
claims,coupled with the discount,rebates and retention factors proposed by the bidding vendors.
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This analysis will constitute the basis for highlighting the "hard dollar" potential cost savings associated
with changing or aggregating vendors. In addition, Consultant will illustrate the "soft dollar" opportunity
based on the more comprehensive capabilities (e.g., services and tools) available through the alternative
vendors.
Upon completion of the formal RFP analysis, Consultant will prepare a comprehensive report of marketing
results and findings, including projected program costs and savings, finalist recommendations and potential
areas of negotiation. Consultant will meet with assigned City staff to review the marketing evaluation
report and select finalists (if applicable). If finalist meetings are warranted, Consultant will schedule the
finalist interviews/on-site visits and develop agendas for finalist meetings. In addition, Trion
representatives will attend all finalist meetings and assist in final negotiations of prescription drug pricing,
vendor service, and performance standards/guarantees. The Summary of Findings phase will conclude with
the City's approval of the prescription drug vendor. Trion will notify all bidders of the City's decision.
Implementation Support
Depending on the outcome of the prescription drug vendor marketing, the following out of scope services
may be needed as part of the Implementation phase.
If a prescription drug vendor change is warranted, Consultant is prepared to facilitate the implementation
tasks on behalf the City to ensure the successful implementation of the agreed-upon services.
As part of implementation management Trion will work with the City to make sure the vendor(s) live up to
its proposal(s) and the City's expectations in the administration and management of the benefit programs.
Consultant will work closely with the City and its vendor(s) to ensure that benefit components that
Consultant developed and negotiated are accurately reflected in the contract. In addition, Consultant will
attend vendor meetings("kick-off meeting,weekly progress updates, etc.) and be available for daily support
throughout the implementation process.
Service costs for the above services will be covered by either service fees paid by the Client, commissions
received in respect to the Client's benefit plans for which Trion Group, a Marsh&McLennan Agency LLC
company is the broker of record, or a combination of both and to the extent available and subject to
applicable law.This arrangement is not offered as an inducement to purchase insurance of any type, but
rather to help demonstrate that the services Trion Group, a Marsh&McLennan Agency LLC company
provides are commensurate with the overall compensation Trion Group,a Marsh&McLennan Agency
LLC company receives. Service costs are outlined in greater detail on Exhibit B hereto.
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EXHIBIT B: PRICING SCHEDULE
For the period from November 1, 2016 through September 30, 2017, the City shall pay Consultant a fee for
the Services of$86,862.50. Thereafter, should the City join the Collective, Consultant will receive revenue
from the Collective fees only. However, if the City does not join the Collective,the City shall pay an annual
fee of$86,862.50 billed to the City monthly over twelve (12) months. Payment shall be due within thirty
(30)days from the invoice date.
Prescription Drug Guaranteed Savings
Definition: Trion will guarantee that the Net Annual Cost (i.e., final paid claims resulting from the
contractual pricing guarantees+base administrative fees—guaranteed rebates shared with the City)derived
from the Trion Rx Coalition will yield at least $3,000,000 in savings as long as there are not substantial
changes to the population of eligible City participants.
Measurement: The savings will be calculated based on the 2017 pricing guarantees as outlined in the
City's 2016 renewal addendum with EnvisionRx (i.e., the baseline period pricing guarantees) compared to
the pricing guarantee terms of the Trion Rx Coalition for the most recent twelve (12) months (i.e., the
guarantee period). The actual utilization experience results(e.g., script counts and pre-discounted AWP per
script, by drug type and channel) achieved during the guarantee period will be used to develop the Net
Annual Cost results that would have been generated under the EnvisionRx contract addendum's pricing
terms, as well as the Net Annual Cost results under the Trion Rx Coalition. Provided that the enrollment,
claims and utilization mix are consistent with those applied in the final cost and savings analysis prepared
for the City prior to their decision to move from EnvisionRx to the Trion Rx Coalition,the guarantee period
will yield at least$3,000,000 in savings to the City.
Penalty: The demonstration of$3,000,000 in savings based on the results of the Trion's analysis (i.e., the
measurement methodology) will constitute successful achievement of the performance standard. If the
savings between the baseline period and guarantee period do not yield a minimum of$3,000,000, Trion will
pay a penalty (i.e., reduction in commissions) based on the following achieved savings range for the
guarantee period:
• Savings: $0-$1,499,999; Penalty: 100%reduction of commissions
• Savings: $1,500,000- $1,999,999;Penalty: 75%reduction of commissions
• Savings: $2,000,000- $2,499,999;Penalty: 50%reduction of commissions
• Savings: $2,500,000- $3,000,000;Penalty: 25%reduction of commissions
Any penalty shall be enforced in the subsequent fiscal year. For instance, if the City achieves only
$1,000,000 in savings in fiscal year 2018 based on the criteria list above, Consultant shall not receive any
commissions from OptumRx for fiscal year 2019. Consultant shall sign a written agreement with OptumRx
detailing this penalty provision and provide a signed copy to City.
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EXHIBIT C: SIGNATURE VERIFICATION FORM
Full Legal Name of Company: Trion Group, a Marsh& McLennan Agency LLC company
Legal Address: 2300 Renaissance Boulevard, King of Prussia, PA 19406
Services to be provided: PBM Consultant
Execution of this Signature Verification Form ("Form") hereby certifies that the following
individuals and/or positions have the authority to legally bind the Company and to execute any
agreement, amendment or change order on behalf of Company. Such binding authority has been
granted by proper order, resolution, ordinance or other authorization of Company. The City is fully
entitled to rely on the warranty and representation set forth in this Form in entering into any
agreement or amendment with Company. Company will submit an updated Form within ten (10)
business days if there are any changes to the signatory authority. The City is entitled to rely on any
current executed Form until it receives a revised Form that has been properly executed by the
Company.
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Pharmacy Benefits Consulting Page 15 of 20
EXHIBIT D: COMPENSATION DISCLOSURE
Marsh & McLennan Agency ("MMA") prides itself on being an industry leader in the area of transparency
and compensation disclosure. We believe you should understand how we are paid for the services we are
providing to you. We are committed to compensation transparency and to disclosing to you information that
will assist you in evaluating potential conflicts of interest.
As a professional insurance services provider, MMA and its subsidiaries facilitate the placement of
insurance coverage on behalf of our clients. In accordance with industry custom, we are compensated
either through commissions that are calculated as a percentage of the insurance premiums charged by
insurers, or fees agreed to with our clients.
MMA receives compensation through one or a combination of the following methods:
• Retail Commissions—A retail commission is paid to MMA by the insurer(or wholesale broker) as a
percentage of the premium charged to the insured for the policy. The amount of commission may vary
depending on several factors, including the type of insurance product sold and the insurer selected by
the client. Retail commission rates can vary from transaction to transaction.
• Client Fees—Some clients may negotiate a fee for MMA's services in lieu of, or in addition to, retail
commissions paid by insurance companies. Fee agreements are in writing, typically pursuant to a
Client Service Agreement, which sets forth the services to be provided by MMA, the compensation to
be paid to MMA, and the terms of MMA's engagement. The fee may be collected in whole, or in part,
through the crediting of retail commissions collected by MMA for the client's placements.
• Contingent Commissions—Many insurers agree to pay contingent commissions to brokers who meet
set goals for all or some of the policies the brokers place with the insurer during the current year. The
set goals may include volume, profitability, retention and/or growth thresholds. Because the amount of
contingent commission earned may vary depending on factors relating to an entire book of business
over the course of a year, the amount of contingent commission attributable to any given policy
typically will not be known at the time of placement.
• Supplemental Commissions—Certain insurers and wholesalers agree to pay supplemental
commissions, which are based on a broker's performance during the prior year. Supplemental
commissions are paid as a percentage of premium that is set at the beginning of the calendar year.
This percentage remains fixed for all eligible policies written by the insurer during the ensuing year.
Unlike contingent commissions, the amount of supplemental commission is known at the time of
insurance placement. Like contingent commissions, they may be based on volume, profitability,
retention and/or growth.
• Wholesale Broking Commissions—Sometimes MMA acts as a wholesale insurance broker for
certain transactions. In these placements, MMA is engaged by a retail agent that has the direct
relationship with the insured. As the wholesaler, MMA may have specialized expertise, access to
surplus lines markets, or access to specialized insurance facilities that the retail agent does not have.
In these transactions, the insurer typically pays a commission that is divided between the retail and
wholesale broker pursuant to arrangements made between them.
• Other Compensation—From time to time MMA may be compensated by insurers for providing
administrative services to clients on behalf of those insurers. Such amounts are typically calculated as
a percentage of premium or are based on the number of insureds. Additionally, from time to time,
insurers may sponsor certain MMA training programs and/or events.
We will be pleased to provide you additional information about our compensation and information about
alternative quotes upon your request. For more detailed information about the forms of compensation we
receive please refer to our Marsh & McLennan Agency Compensation Guide at
http://res.cloudinM.com/mma/image/upload/vl473800190/MMA Compensation Guide for Clients rev 9.6.16 wghfvy_pdf
Pharmacy Benefits Consulting Page 16 of 20
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APPENDIX 1:HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)
BUSINESS ASSOCIATE AGREEMENT
This Business Associate Agreement (the "Agreement") is made and entered into as of the I` day of
November, 2016(hereinafter the "Date")by and between City of Fort Worth, on behalf of the prescription
drug plans (hereinafter "Covered Entity"), and Trion Group, a Marsh & McLennan Agency LLC
Company(hereinafter"Business Associate").
Recitals
WHEREAS, the Department of Health and Human Services ("HHS") has promulgated regulations at
45 C.F.R. Parts 160-164, implementing the privacy and electronic security requirements set forth in the
Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of
1996, Public Law 104-191, as amended by American Recovery and Reinvestment Act of 2009 (P.L. 111-5,
ARRA) ("HIPAA");
WHEREAS, Business Associate acknowledges that certain provisions of HIPAA have been amended
in ways that directly regulate Business Associate's obligations and activities with respect to PHI;
WHEREAS, HIPAA provides, among other things, that Covered Entity is permitted to disclose
Protected Health Information (as defined below) to Business Associate and allow Business Associate to
obtain and receive Protected Health Information, if Covered Entity obtains satisfactory assurances in the
form of a written contract that Business Associate will appropriately safeguard the Protected Health
Information; and
WHEREAS, Business Associate will create, receive, maintain or transmit certain Protected Health
Information in conjunction with the services being provided by Business Associate to Covered Entity
pursuant to the Professional Services Agreement entered into by the parties as of November 1, 2016 (the
"Services Agreement"), thus necessitating a written agreement that meets the applicable requirements of
HIPAA. Both parties have mutually agreed to satisfy the foregoing regulatory requirements through this
Agreement.
NOW THEREFORE, Covered Entity and Business Associate agree as follows:
1 Definitions; Applicability.
(a)All terms not defined herein shall have the meaning ascribed to them in HIPAA.
(b) This Agreement shall apply only with respect to and to the extent that Business Associate
creates,receives,maintains or transmits PHI for or on behalf of Covered Entity.
2 Obligations and Activities of Business Associate
(a)Business Associate agrees to not use or further disclose Protected Health Information other than
as permitted or required by this Agreement or as Required by Law.
(b)Business Associate agrees to use commercially reasonable and appropriate safeguards to prevent
use or disclosure of the Protected Health Information other than as provided for by this Agreement.
(c) Business Associate agrees to report to Covered Entity any use or disclosure of the Protected
Health Information not provided for by this Agreement of which it becomes aware. In event of a Breach of
Unsecured PHI by Business Associate or any of its officers, directors, employees, or subcontractors,
Business Associate shall promptly notify Covered Entity in accordance with 45 C.F.R. 164.410.
Pharmacy Benefits Consulting Page 17 of 20
(d) Business Associate and Covered Entity agree to mitigate, to the extent practicable, any harmful
effect that is known to it arising out of a use or disclosure of Protected Health Information in violation of the
requirements of this Agreement.
(e) Business Associate agrees to ensure that any subcontractors that create, receive, maintain, or
transmit Protected Health Information on behalf of Business Associate agrees to substantially similar
restrictions and conditions that apply through this Agreement to Business Associate with respect to such
information.
(f) Business Associate agrees to provide access to Protected Health Information in a Designated
Record Set, in the time and manner Required by Law, to Covered Entity or, as directed by Covered Entity,
to an Individual, in order to meet the requirements under 45 C.F.R. 164.524. Business Associate may
impose a reasonable cost-based fee for the provision of copies of PHI in a Designated Record Set in
accordance with 45 C.F.R. 164.524(c)(4).
(g) Business Associate agrees to make any amendment(s) to Protected Health Information in a
Designated Record Set pursuant to 45 C.F.R. 164.526 at the request of Covered Entity or an Individual, and
in the time and manner Required by Law.
(h) Business Associate agrees to make internal practices, books, and records relating to the use and
disclosure of Protected Health Information received from, or created or received by Business Associate, on
behalf of Covered Entity, available to the Secretary, for purposes of the Secretary determining Covered
Entity's or Business Associate's compliance with HIPAA.
(i) Business Associate agrees to document such disclosures of Protected Health Information and
information related to such disclosures as would be required for Covered Entity to respond to a request by
an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 C.F.R.
164.528.
0) Business Associate agrees to provide to Covered Entity, upon request and in the time and
manner Required by Law, an accounting of disclosures of an Individual's Protected Health Information,
collected in accordance with Section 2(i) of this Agreement, to permit Covered Entity to respond to a
request by an Individual for an accounting of disclosures of Protected Health Information in accordance
with 45 C.F.R. 164.528. If Covered Entity requests an accounting of an Individual's Protected Health
Information more than once in any twelve (12) month period, Business Associate will impose a reasonable
fee for such accounting in accordance with 45 C.F.R. 164.528(c).
(k) Business Associate agrees to comply, where applicable, with Subpart C of 45 CFR Part 164 to
maintain the security of the Electronic Protected Health Information and to prevent unauthorized uses or
disclosures of such Electronic Protected Health Information. Business Associate shall report to the Covered
Entity any Security Incident that results in the unauthorized use or disclosure of Protected Health
Information of which it becomes aware.
3 Permitted Uses and Disclosures by Business Associate
(a) Business Associate may use or disclose Protected Health Information to perform its
obligations and services to Covered Entity,provided that such use or disclosure would not violate HIPAA if
done by Covered Entity.
(b) Business Associate may use Protected Health Information for the proper management and
administration of the Business Associate or to carry out the legal responsibilities of the Business Associate
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h
or as otherwise permitted by HIPAA.
(c) Business Associate may disclose Protected Health Information for the proper management and
administration of the Business Associate, provided that disclosures are Required by Law, or Business
Associate obtains reasonable assurances from the person to whom the information is disclosed that it will be
held confidential and used or further disclosed only as Required by Law or for the purpose for which it was
disclosed to the person, and the person notifies the Business Associate of any instances of which it is aware
in which the confidentiality of the information has been breached.
(d) Business Associate may use Protected Health Information to provide data aggregation services
to Covered Entity.
4 Obligations of Covered Entity.
4.1 Provisions for Covered Entity to Inform Business Associate of Privacy Practices and
Restrictions
(a) Covered Entity shall provide Business Associate with the notice of privacy practices that
Covered Entity produces in accordance with 45 C.F.R. § 164.520,as well as any changes to that notice.
(b) Covered Entity shall provide Business Associate with any changes in, or revocation of,
permission by Individual to use or disclose Protected Health Information, if such changes affect Business
Associate's permitted or required uses and disclosures.
(c) Covered Entity shall notify Business Associate, in writing, of any restriction to the use or
disclosure of Protected Health Information that Covered Entity has agreed to in accordance with 45 C.F.R. §
164.522.
(d) Covered Entity warrants and represents that it shall provide to, or request from, the Business
Associate only the minimum Protected Health Information necessary for Business Associate to perform or
fulfill a specific function required or permitted hereunder.
(e) If Protected Health Information is transmitted by electronic transfer or sent in physical media by
or on behalf of Covered Entity, Covered Entity shall transmit all such Protected Health Information to
Business Associate in an encrypted format,to be mutually agreed by the parties.
4.2 Permissible Requests by Covered Entity.
Covered Entity represents and warrants that it has the right and authority to disclose Protected Health
Information to Business Associate for Business Associate to perform its obligations and provide services to
Covered Entity, and Covered Entity shall not request Business Associate to use or disclose Protected Health
Information in any manner that would violate HIPAA, other applicable laws or Covered Entity's privacy
notice, if done by Covered Entity.
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5 Term and Termination
(a) Term. The provisions of this Agreement shall take effect as of the Date (such date, the
"Effective Date"),and shall continue for the term of the Services Agreement.
(b) Termination for Cause.Upon the parties mutual agreement that there has been a material breach
by Business Associate which does not arise from any breach by Covered Entity, Covered Entity shall
provide an opportunity for Business Associate to cure the breach or end the violation and terminate this
Agreement if Business Associate does not cure the breach or end the violation within a mutually agreeable
time, or immediately terminate this Agreement if cure of such breach is not possible.
(c)Effect of Termination.
(1)Except as provided in paragraph(2)of this section,upon termination of this Agreement,
for any reason, Business Associate shall return or destroy all Protected Health Information received from
Covered Entity, or created or received by Business Associate on behalf of Covered Entity. Business
Associate shall request, in writing, Protected Health Information that is in the possession of subcontractors
of Business Associate.
(2)In the event the Business Associate determines that returning or destroying the Protected
Health Information is infeasible, Business Associate shall extend the protection of this Agreement to such
Protected Health Information and limit further uses or disclosures to those purposes that make the return or
destruction infeasible,for so long as Business Associate maintains such Protected Health Information.
6 Miscellaneous
(a) Re ug latory References. A reference in this Agreement to a section in HIPAA means the section
as in effector as amended,and for which compliance is required.
(b) Amendment. Upon the enactment of any law or regulation affecting the use or disclosure of
Protected Health Information, or the publication of any decision of a court of the United States or any state
relating to any such law or the publication of any interpretive policy or opinion of any governmental agency
charged with the enforcement of any such law or regulation, the parties agree to negotiate in good faith to
amend the Agreement as necessary to comply with such law or regulation.
(c) Survival. The obligations of Business Associate under section 5(c)(2) of this Agreement shall
survive the termination of this Agreement.
(d) Interpretation. Any ambiguity in this Appendix shall be resolved in favor of a meaning that
permits both parties to comply with HIPAA.
(e) No third party beneficiary. Nothing express or implied in this Agreement is intended to confer,
nor shall anything herein confer, upon any person other than the parties and the respective successors or
assigns of the parties, any rights,remedies, obligations,or liabilities whatsoever.
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