CM-2016-1267 - 12/19/2016 i
{
SUPPLEMENTAL AGREEMENT NO.2
TO"CITY OF ROUND ROCK AGREEMENT
FOR ON SITE MEDICAL CLINIC SERVICES
WITH
HEALTHSTAT.
CITY OF ROUND ROCK §
§
STATE OF TEXAS § KNOW ALL BY THESE.PRESENTS:
COUNTY OF TRAVIS §
COUNTY OF WILLIAMSON §
THIS SUPPLEMENTAL AGREEMENT NO. 2 to "City of Round Rock Agreement for
On Site Medical Clinic Services with Healthstat, Inc.," hereinafter called "Supplemental
Agreement No. 2;" is made, by and between the City of Round Rock, Texas, a home-rule
municipality, hereinafter called "City" and Healthstat; Inc., hereinafter called the "Services_
Provider."
WHEREAS; City and Services Provider executed the referenced"City of Round Rock
Agreement for On Site Medical Clinic Services with Healthstat, Inc.," hereinafter called the
"Agreement,"on January 23,.2014 by Resolution No.R-14-0143=G2;and
WHEREAS,.the Agreement,provided in the appended.:Exhibit"C" ("Service Cost")that
the City shall pay Seivices Provider Program Administration Fees in the amount of$61.8.1 per
Clinic Participant per month to cover the cost of operating the On Site Medical Clinic (the
"Clinic")for a monthly fee of$48,211:80; and
WHEREAS, 'in October of 2015, the Service Costs were amended pursuant to
Supplemental Agreement No. 1;and
WHEREAS; pursuant to Supplemental Agreement No. 1., the City pays the Services
Provider Program Administration Fees'in the amount of$67:22 per Clinic Participant per month
for a monthly fee of $52,433.69; and
WHEREAS, 'the parties desire to further amend -the Services Provider Program
Administration Fees--
NOW
ees;NOW THEREFORE, in consideration of the mutual promises and obligations in the
Agreement and this Supplemental Agreement No. 2, City and Services Provider agree that said
Agreement is amended and supplemented as follows:
00369021/ss2
i
i
201 .. E
t
Exhibit"C"of the Agree a is hereby amended as follows:
Program Administr-cation Fees. ring the initial term of this Agreement, Employer shall pay
Healthstat a fee of k $67.22 per Clinic Participant per.month to cover the cost to support
effective on-going operation of the program unless Employer does not pay by ACH. For every
Participant over 780 participants,.the Program Administration Fee shall be $24.99 per
month:
Clinic Location Minimum Program Administration Fee
Billed Per:Month
Round Rock,Texas $593493.69 .L$52411,00
II.
This Supplemental Agreement No. 2 shall amend the original Agreement only as set forth
herein with no other changes in terms or conditions of the original Agreement.
IN WITNESS WHEREOF, City and Services Provider have executed this Supplemental
Agreement tobe effective as of the last date of due execution by both parties.
CITY OF ROUND ROCK,TEXAS HEALTHSTAT,INC.
By: fil I A I V 5, By:
PrinteName: LAuRIE-I- ecY Printed Name:
Title: r'vI" Title:, )at(` rV Ic�e c r
Date Si d:
. pgneDate Signed:
ATTEST:
By:
Sara L.White;City,Clerk
FOR CITY, P ROVED AST FORM:
By 1
Steph : I;. .Sheets.City Attorney
2
City of Round Rock
ROUND ROCK
TEXAS Agenda Item Summary
Agenda Number:
Title: Consider executing Supplemental No. 2 to the City of Round Rock
Agreement with Healthstat, Inc. for On Site Medical Services
Type: City Manager Item
Governing Body: City Manager Approval
Agenda Date: 12/16/2016
Dept Director: Valerie Francois
Cost:
Indexes:
Attachments: LAF-Supplemental No. 2 to Healthstat Agreement (12-12-16)
(00369167xA08F8), Amendment 2, City of Round Rock, Billing Structure,
client version, wah, sk
Department: Human Resources Department
Text of Legislative File CM-2016-1267
Consider executing Supplemental No. 2 to the City of Round Rock Agreement with Healthstat,
Inc.for On Site Medical Services
This agreement is to modify the cost for participants over 780 as identified in the intial agreement.The
number of participants increased from the initial agreement because dependents were allowed to use the
clinic. In addtion,the mandatory HRA's for all members on the plan resulting in us exceeding the 780
participants allotted at the guaranteed rate.
$24.99 per participant per month(only if exceed 780 participants)
Self Insurance Fund
Staff recommends approval
City of Round Rock Page 1 Printed on 12113/2016