HomeMy WebLinkAboutContract 54095-A1 DocuSign Envelope ID:A7D4B89A-2EAB-4487-BD5C-6F180FC1C7AA
CSC No. 54095-A1
AMENDMENT No. 1
TO THE BUSINESS SERVICES AGREEMENT
BETWEEN ACCOLADE, INC.AND CITY OF FORT FORTH
This "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 replace the Population Served grid in the Services Commitment Form ("SCF")
of the BSA.
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. The Population Served grid in the SCF is deleted in its entirety and replaced with the attached
Population Served grid.
2. This 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 Amendment and the BSA,the terms of this Amendment will govern.
IN WITNESS WHEREOF, the Parties hereto, by their duly authorized representatives, have executed this
Amendment.
CUSTOMER:
City of Fort Worth Contract Compliance Manager:
DocuSigned by: By signing I acknowledge that I am the person
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t SUS a responsible for the monitoring and
y FEF51489D2B842 F _ administration of this contract, including ensuring
Name: Jesus Chapa all performance and reporting requirements.
Title: Assistant City Manager
Date: Docu Signed by:
Approval c�ampwnded: By. L�MaAAt, Rikn ft,
h/q�(� � �� Name: Joanne Hinton
By:
Title: Benefits Manager
Name: Nathan Gregory
Title: Assistant Director of Human Resou ces
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
DocuSign Envelope ID:A7D4B89A-2EAB-4487-BD5C-6F180FC1C7AA
Approved as to Form and Legality:
Attest: 44�nanq
Poo FORT�dd
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Pa*o°° o #P Docu Signed by:
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By: Name: John B.Strong
Name: Mary Kayser Title: Assistant City Attorney
Title: City Secretary
Contract Authorization:
M&C:
ACCOLADE:
Accolade, Inc.
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ocu Signed by:
By:
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Name: Rajeev Singh
Title: CEO
Date: 8/7/2020
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
DocuSign Envelope ID:A7D4B89A-2EAB-4487-BD5C-6F180FC1C7AA
POPULATION SERVED 2
Approximate Employee and Member Counts(Members=Employee+Dependents) 1, 2
Population Self-Funded Fully-Insured Waived Total
Type
Employees Members Service Employees Members Service Employees Members Service Employees Members
Active Full-Time 4,504 9,245 F,OE 1,200 2,400 L,OE 5,704 11,645
Active Part-
Tim e
Seasonal
Temporary - -
COBRA 10 20 F,OE 10 20
Pre-65 Retirees 1,300 2,000 F,OE 1,300 2,000
Over-55
Retirees
Union/Collectiv
e Bargaining
International/
FxPa is
Short-term
Disability
Long-term
Disability
FMLA/Leave
Other
Total
Employees& 5,814 11,265 1,200 2,400 7,014 13,665
Members
Total for Full
Service Only
5,814 11,265 5,814 11,265
Customer
Employee 4,900
Minimum3 85%
'For all categories except"Waived,"Member count includes employee and all enrolled dependents. For"Waived,"count refers only to employees
or former employees.
Z References to F,L,OE,and N are service types referenced in the"Services Ordered"Table above. Full Service(F)means the full service set forth in
the Services Description Guide. Limited Service(L)includes limited assistance for individuals who call in but are not covered on a Customer's self-
funded health plan supported as defined in the Services Description Guide.Pre-Launch Open Enrollment(OE)service are to assist individuals in
understanding and enrolling in Customer's health benefit plans during the Open Enrollment period. "N"means no service elected.
3 Applies to Full Service(F)only.