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CM-2022-024 - 1/28/2022TERMS AMENDMENT This Amendment ("Amendment") is made to the Administrative Services Agreement ("Agreement") by and between United HealthCare Services, Inc. ("United") on behalf of itself and its affiliates and City of Round Rock ("Customer"), Contract No. 925175, and is effective on January 1, 2022 unless otherwise specified. Any capitalized terms used in this Amendment have the meanings shown in the Agreement. These terms may or may not have been capitalized in prior contractual documents between the parties but will have the same meaning as if capitalized. The agreements that are being amended include any and all amendments, if any, that are effective prior to the effective date of this Amendment. Nothing shown in this Amendment alters, varies oraffects any of the terms, provisions or conditions of the agreements other than as stated herein. The parties, by signing below, agree to amend the agreements as contained herein. City of Round Rock By Laurie Hadley, City Manager Date e Z Q -2b Z Z 62� United HealthCare Services, Inc. By -f, - Authorized Signature Print Name Lisa Sekely Print Title Regional Contract Manager Date January 14, 2022 Proprietary Information of UmtedHealth Group Renewal4Q2021 v2 The Administrative Services Agreement is amended on January 1, 2022 as noted below. This Amendment will not affect any of the terms, provisions or conditions of the Agreement except as stated herein. Following the Effective Date and after Customer has provided one (1) months' worth of claims funding, this Amendment is deemed executed by the parties. 1. All references to out of network programs in the Asreement, each as applicable, are replaced in their entirety. As such, Section All Network in Exhibit A is amended to include the followine sub- section: Out of Network Programs. United offers out of network programs that strive to increase savings to Customer by accessing discounts or negotiating reductions on out of network claims. United offers a mix of out of network programs that offer varying degrees of discounts, consumer advocacy, and cost controls. Customers elected out of network programs are identified in Exhibit B -- Fees. Programs are subject to change or termination at United's discretion. 11. The followine re lace the Navi card row in the Other Fees table in Exhibit B — Fees: Other Fees Consolidated Appropriations Act, 2021 ("CAA") Support Services. United will support Customer's compliance with the requirements of the CAA, including the No Surprises Act ("NSA"), by the respective enforcement date as follows: • NSA medical billing and the independent dispute resolution ("IDR"): o United will determine if a claim is subject to the NSA billing protections. o If United and a provider are unable to come to an agreement within the prescribed negotiation period for a claim subject to the NSA billing protections, United will manage, direct, and make decisions and submissions to support the IDR for Customer. o All qualifying payment amounts under the NSA will be calculated based on an insurance market across all self -insured group health plans administered by United. o United will not use third party provider networks for services covered by the NSA. a The fees for programs in which the parties share in the savings achieved off a provider's billed charge will continue to apply to all services covered under the NSA. a Customer shall fund all settlement amounts and payments required as a result of any IDR process decision through the Bank Account, a Customer shall fund the $50 IDR administration fee and all [DR arbitrator fees through the Bank Account. • Revised medical Plan ID cards (if United provides Plan Participants with ID cards currently). • Provider directory enhancements. • Continuity of care and external appeals support for surprise medical bills- • Support related to Mental Health Parity Non -Quantified Treatment Limitations audits initiated by the U.S. Department of Labor, U.S- Department of Health and Human Services or the U.S. Department of Treasury- • Provide language to support Customer's anti -gag clause attestation For the 2022 plan year, United will not charge separate services fees outside of base rates for the CAA Support Services. Customer remains responsible for the $50 government agency administration assessment and fees charged by the IDR arbitrator. Fees for CAA Support Services for plan years after 2022 will be provided at a future date once regulatory guidance is received and final compliance requirements are determined. 2 Proprietary Infommm;ion ofGnued}{ealth Group Naviguard Program $2.50 per Employee per month • Offers a reimbursement methodology applicable to out of network claims which calculates allowed amounts based on what a healthcare provider generally accepts for the same or similar service. • Includes an advocacy component where Participants can access dedicated resources, and on-line tools and materials to help Participants stay in network and where assistance is provided in explaining reimbursement methodologies. • If the provider objects to what it was paid from the application of the allowed amount, or member contacts United for support with resolving a balance bill, United will increase compensation for a particular claim if. (a) United reasonably concludes that the particular facts and circumstances related to a claim provide justification for reimbursement greater than that which would result from the application of the allowed amount, and (b) United believes that it would serve the best interests of the Plan and its Participants (including interests in avoiding costs and expenses of disputes over payment of claims). 111. The followins replaces the Net Cost Guarantee in Exhibit C R Performance Guarantees: The rest ofthis page is intentionally blank.1 3 Proprietary Information of UnitedHealth Group UnitedHealthcare Net Cost Guarantee Effective for Policy January 1, Year Beginning: 2022 UHC ASO Billable Admin Fee $51.83 Percent of Fees rrr Risk 40% Fees @,, Risk Target Claim Factor Claim PEPM Lessthan $806.43 $20.73 $919.97 Annual ASO $562,000 Base Fees Annual Fees $225,000 Risk Number of 903 Employees $806.43 up to $827.09 $827.10 up to $848.30 $848.31 up to $870.05 $870.06 up to $892.36 Risk Free Corridor» $892.37 up to $947.57 $947.58 up to $981.68 $981.69 up to $1,017.02 $1,017.03 $1,053.65 $1,091.58 Assumptions and Caveats: up to $1,053.64 up to $1,091.57 up to $1,128.06 Amount at Rick $90 aoo $7z 000 $54,000 $36,000 $18 000 $0 $45,000 $90,000 $135 000 $180 000 $225 000 Guarantee is effective for the quoted 1 plan year only. Illustration assumes the following services/programs will be included in 2 the employee benefit plan: PHS 3.0 High - Texas Custom The number of covered employees assumed in this pruposal is listed below 3 by plan offering: Assumed Ouoted Choice Monthly Claim Target I Proprietary Information of UnuedHealth Grii..�, Customer Pay UHC UHC pays the customer and Choice Plus Covered Factors _ Plans Enrollees PSPM Choice - Premium Designation 433 $927,30 Nexus EPO OA 470 $913.22 COMPOSITE 903 $919.97 Reconciliation will be based actual covered lives by plan during the plan year and the claim target 4 factors by plan listed above. Reconciliation will be based actual claims INCURRED from January I, 5 2022 to December 31, 2022 and PAID from January 1, 2022 to March 31, 2023 Reconciliation will be performed within 180 days but no earlier than 120 days after the close of the 6 plan year. Actual claims include all Medical claims and Pharmacy claims if 7 applicable, except for the following: Benefits for services incurred prior to the effective date of the policy. Losses in excess of $200,000 per covered individual. Losses in excess of usual and customary for out of network claims. Losses associated with benefits not covered by the underlying employee benefit plan, but paid by the employee benefit plan. Maximum guarantee payout is 8 $225,000. Assumes UnitedHealthcare is the only 9 carrier offered. 10 United Healthcare reserves the right to adjust the projected target claim factor or rescind this guarantee under any of the following circumstances: Fnrollment in total or by plan varies - 151�0 or more from the assumptions listed in this proposal. An award is not made within 90 days of the issuance of this proposal. Changes in federal, state or other applicable legislation or regulation require changes to this proposal Changes to any of the included servicesiprograms listed in item 2 above. Any changes made to the plan of benefits offered covered by this guarantee. In the event of a pandemic, UHC reserves the right to revisit or revoke this guarantee. UHC will work with the customer to adjust for any claims utilization impact of COVID-19 in the 202012021 baseline period and the guarantee period. The intent is to stay true to our Net Cost Guarantee (NCG) commitment but normalize (1 f-) for unforeseen impacts of the pandemic, including not just direct COVID-19-related costs but also the potential material reduction in care 2 Proprietary Information of UnitedHeiilt;i Group during the pandemic -and subsequent pent-up demand after the pandemic for non- emergent/elective services, in an actuarial based fair manner for both parties. We will itemize and reconcile these claim costs accordingly in the Net Cost Guarantee. Guarantee is provided in lieu of any Network Discount Guarantees previously quoted. Proprietary Information of UnitedHealth Group IEOU ND ROCK XAS City of Round Rock Agenda Item Summary Agenda Number: Title: Consider executing a Terms Amendment to the Administrative Services Agreement with United Healthcare (UHC) Services, Inc. Type: City Manager Item Governing Body: City Manager Approval Agenda Date: 1/28/2022 Dept Director: Valerie Francois Cost: Indexes: Attachments: LAF - Amendment to UHC ASA (0120 22), City of Round Rock ASA Amend Terms Other 1.1.2022_UHC signed 1.14.22 Department: Human Resources Text of Legislative File CM-2022-024 This amendment is a cost reduction for the Naviguard Program in the current agreement. The rate reduced from $4.50 to $2.50 per employee per month. City of Round Rock Page 1 of 1