HomeMy WebLinkAboutContract 57224-A1CSC No. 57224-A1
AMENDMENT TO
ADMINISTRATIVE SERVICES AGREEMENT
This Amendment to the Administrative Services Agreement (this "Amendment") dated as of July 01, 2021 (the
"Amendment Effective Date") amends the Administrative Services Agreement (the "Agreement") entered into
as of January 01, 2021, as amended, by and between Meritain Health, Inc. ("Meritain") and City of Fort Worth
("Client') as follows:
1. FEE SCHEDULE
A. The Administrative Rates set forth under Section 1 of the Fee Schedule, on page 17 of the Agreement, is
hereby amended to add the following new Administrative Fees commencing as of July 01, 2021 through
December 31, 2025:
Administrative Services
• Aetna Choice® POS II Network Access
• Claims Fiduciary Services Level 2
• Data File Feed
• Hello Heart
• Medical Plan Administration
• PBM Administration Fee
• Reinsurance Administration
• State Reporting and Remittance
• Summary of Benefits and Coverage ("SBC") Production
• Telemedicine0O
• Run -Out
Administrative Services
ATLAS Reporting Package
2. MISCELLANEOUS
Fee
$20.61
Fee Frequency of
Occurrence
$0.00 Waived
Any capitalized term not defined in this Amendment shall have the meaning ascribed to it in the Agreement.
Except as specifically amended by the terms of this Amendment, all surviving terms, provisions, and fees of the
Agreement are hereby ratified and confirmed and the Agreement, as modified by this Amendment, remains in
full force and effect.
In Witness Whereof, the parties have executed this Amendment on the dates set forth below.
MERITAIN HEALTH, INC.
CITY OF FORT WORTH
Name: Margie Mann
Name: Jesica McEachern
Title: Regional President
Title: Assistant City Manager
Date: January 19, 2023
Date: May 31, 2023
0121 —City of Fort Worth —Amend ment-Fees Remittances 1 v010423
Amendment 1 to City of Fort Worth CSC No. 57224
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
City of Fort Worth
By:`�_�
Name: Jesica McEachern
Title: Assistant City Manager
Date: May 31, 2023
Approval Recommended:
n,►�z By:
Name: Dianna Giordano
Title: Director of Human Resources
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Attest: �QoF FaRrOQd
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Name: Jannette Goodall
Title: City Secretary
Contract Compliance Manager:
By signing I acknowledge that I am the person
responsible for the monitoring and
administration of this contract, including
ensuring all performance and reporting
requirements.
By: 9'.,�
Name: Joanne Hinton
Title: Benefits Manager
Approved as to Form and Legality:
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By:
Name: Jessika J. Williams
Title: Assistant City Attorney
Contract Authorization:
M&C: N/A
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
0121 — City of Fort Worth — Amendment -Fees Remittances
Amendment 1 to City of Fort Worth CSC No. 57224
2 v010423