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HomeMy WebLinkAboutResolution - 4524 - Master Services Agreement-FHS Inc, WNIC Renewal - Employee Health Insurance - 06_23_1994Resolution No. 4524 June 23, 1994 Item #15 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock BE and is hereby authorized and directed to execute for an on behalf of the City of Lubbock a Master Services Agreement by and between the City of Lubbock and First Health Strategies, Inc., and an associated Acceptance of Annual Renewal of a Minimum Premium Agreement executed in 1988 by and between the City of Lubbock and Washington National Insurance Company, both attached herewith, which shall be spread upon the minutes of Council and as spread on the minutes of the Council shall constitute and be a part of this Resolution as if fully copied herein in detail. Passed by the City Council this 23rdday of ATTEST: &fr' A � C�a-L etty Nf Johnson, Ch Secretary APPROVED AS TO CONTENT: 1-74� dXZ54� Mary Andre s, Director of Human Resources APPROVED AS TO FORM: Donald G. Vandiver, First Assistant City Attorney 4: Wrw May 10, 1994 Washington national® INSURANCE COMPANY April 20, 1994 Ms . Lou Moore City of Lubbock P.O. Box 2000 Lubbock, TX 79457 RE: Renewal Acceptance Dear Lou: HEALTH W SJON MICHAEL D. COLLINS, Senior Account Manager F. MARIE FARMER, Customer Service Coordinator Toll Free 1-800/287-8915 214/644-9484 FAX 214/644-9483 RECEIVED PERSONNEL DEPT APR 2 2 1994 ,_.,._.A M ...-P.M CITY OF LUBBOCK Enclosed please find a copy of my renewal letter to Steve McBride as formal notification of the rate adjustments needed effective April 1, 1994. Please have Mary Andrews sign where indicated and return a copy to me for the completion of my files. Should you have any questions, please feel free to contact me. Sincerely, Michael D. Collins Senior Account Manager MDC/klh cc: Steve McBride, First Health 2435 N. Central Expressway, Suite 890 ■ Richardson, Texas 75080 Wasliington national$ INSURANCE COMPANY F,EALTH D(VISK)N MICHAEL D. COLLINS, Senior Account Manager F. MARE FARMER, Customer Service Coordinator TOM Free 1-800/267-8915 214/644-9484 FAX 214/644-9483 January 28, 1994 Mr. Steve McBride First Heahh 222 West Las Colinas Blvd. Suite 1360 Irving, Texas 75039 RE. City of Lubbock - April 1, 1994 Renewal Dear Steve: The renewal for The City of Lubbock is April 1, 1994. The following is a summary of our evaluation. We have evaluated a current census and based on age, sex and amount of life insurance on each participant, we have concluded that there will be no rate adjustment needed for the Term Life, AD&D, Dependent Life and Optional Life portions of the plan. We are requesting a 6.4% increase in the Minimum Premium Premium and a 4.22% increase in the Monthly Liability Limit Factor. There will be no increase in the Post Termination Liability Limit Factors. This is the first rate increase that we have requested in two years and, in terms of actual dollars and cents, this represents only a $0.41 difference for the employee and $0.60 difference for the dependent. The rate structure for the Minimum Premium Program is broken into three major components: Minimum Premium Premium, Monthly Liability Limit Factors and Post Termination Liability Limit Factors. We are requesting a 14.8% increase in the Minimum Premium Premium which includes all fixed costs. One of the major components of the Minimum Premium Premium is the $125,000 Pooling Charge. This year, there was a total of $230,730 in claims which exceeded the pooling level. Leveraged trend is no doubt an important factor in increased 2435 N. Central Expressway, Suite 890 r Richardson, Texas 75080 Washington National Insumnce Company Mr. Steve McBride First Health Page 2 pooled charges. In order to keep the Minimum Premium at a lower level the City may wish to consider a $135,000 or a $150,000 Pooling Level. We are also recommending a 14.52% increase in the Monthly Claim Liability Funding Factors. We are not requesting any adjustment in the Post Termination Liability Limit Factors. Both Allen Saba and I have reviewed the Underwriters work -up of this Renewal and feel that the Renewal is fair and competitive. One obvious method of reducing fixed cost is to increase the current Pooling Level from $125,000 to $135,000 or $150,000. However, perhaps a more viable option is the implementation of the Affordable PPO combined with an appropriate plan design to encourage usage of the network. This implementation, along with a change in the Pooling Level will keep this Renewal at a minimum. Once again, it has been a pleasure working with you and The City of Lubbock in providing a comprehensive and proactive benefit program. We look forward to working with you in the future. Should you wish to discuss any aspect of this Renewal, please feel free to contact me. Sincerely, h\Qc(,L, Michael D. Collins Senior Account Executive MDC/klh Enclosures cc: Allen Saba Mike Sweeney APPROVED AS --Mayor Title APPROVED AS TO FORM: June, 23, 1994 Date Assistant City Attorney CITY OF LUBBOCK RENEWAL RATE SUMMARY MEDICAL PLAN Current Monthly Minimum Premium Premium Renewal Employee Medical $ 12.18 $ 13.98 Dependent Medical 21.37 25.54 Dual Spouse Medical 9.20 10.56 Employee Medicare 12.18 13.98 Spouse Medicare 21.37 24.54 Monthly Claims Liability Limit Factors Employee Medical $169.36 $193.95 Dependent Medical 183.69 210.36 Dual Spouse Medical 14.32 16.40 Employee Medicare 89.19 102.14 Spouse Medicare 89.19 102.14 Post -Termination Reserve Liability Limit Factors Employee Medical $ 521.12 $ 521.12 Dependent Medical 565.20 565.20 Dual Spouse Medical 44.04 44.04 Employee Medicare 274.49 274.49 Spouse Medicare 274.49 274.49 WasninQton nationals IN"ANCE COMPANv CITY OF LUBBOCK RENEWAL RATE SUMMARY DENTAL PLAN Current Monthly Minimum Premium Premium Renewal Employee Dental $ .48 $ .51 Dependent Dental .44 .47 Dual Spouse Dental .48 .51 Monthly Claims Liability Limit Factors Employee Dental Dependent Dental Dual Spouse Dental Post -Termination Reserve Liability Limit Factors $ 8.95 13.48 4.54 $ 9.33 14.05 4.73 Employee Dental $27.44 $27.44 Dependent Dental 41.40 41.40 Dual Spouse Dental 13.95 13.95 Washington national INSURANCE COMPANY FIRST MASTER SERVICES AGREEMENT This Master Services Agreement ("this Agreement") is made between the FIRST HEALTH affiliate(s) identified in the attached Services and Fees Exhibit(s) (hereinafter referred to as "FIRST HEALTH", either individually or collectively, as required by the context), and CITY OF LUBB= ("Client"), as Plan Sponsor and/or Administrator of the City of Lubbock EM10yee Benefit Plan (the "Plan"). 1. SERVICES TO BE PERFORMED. FIRST HEALTH shall perform the services described in the attached Services and Fees Exhibit(s) (the "Exhibit(s)") in accordance with the terms of the Plan and within the framework of directives, policies, interpretations, rules, practices and procedures made by Client, to the extent that such are consistent with the Exhibit(s) and all applicable laws and regulations. Notwithstanding any other provision of this Agreement or the Exhibit(s), FIRST HEALTH's services shall not include the services of legal counsel, investment advisors, or certified public accountants. FIRST HEALTH may suggest the use of such professional advisors but shall not be responsible for the quality or cost of any services so provided. 2. STANDARD OF PERFORMANCE. FIRST HEALTH shall exercise reasonable care, diligence and skill in performing the services provided under this Agreement. 3. AUTHORITY OF FIRST HEALTH. FIRST HEALTH is engaged to perform the services under this Agreement as an independent contractor and not as a fiduciary of the Plan or as an employee or agent of Client. FIRST HEALTH shall have no final discretionary authority or control over the management or disposition of Plan assets, and no authority over or responsibility for Plan administration. Because FIRST HEALTH is neither the Plan Sponsor or Administrator, nor a provider of health care services to Plan participants or beneficiaries (collectively "claimants"), FIRST HEALTH shall have no responsibility for: (a) any funding of Plan benefits; (b) any insurance coverage relating to the Plan, claimants, or Client; or (c) the nature or quality of professional health services rendered to claimants. 4. FEES. For the services provided under this Agreement, Client shall pay FIRST HEALTH the fees described in the Exhibit(s). Unless otherwise noted in the Exhibit(s), FIRST HEALTH is authorized to deduct any fees and other charges due under this Agreement, as soon as they are properly determined, from any account Copyright 1993 FIRST HEALTH Strategies, Inc. CONMS7R1 0903 established by Client over which FIRST HEALTH has withdrawal authority. Otherwise, Client shall pay any amounts due under this Agreement within ten calendar days after receiving a statement therefor, unless a different time period is expressly stated in the Exhibit(s). Interest shall accrue on any past -due amounts at, the lesser of twelve percent per annum or the maximum rate allowed by law. 5. LIABILITIES OF THE PARTIES. The parties each acknowledge that the Plan Administrator, and not FIRST HEALTH, has the final discretionary authority to determine what benefits will be paid by the Plan. Accordingly, Client shall defend FIRST HEALTH against any third -party claims relating to the Plan and indemnify FIRST HEALTH against any expense or liability (including reasonable attorneys' fees) arising from such claims; provided, however, that Client shall not be required to defend or indemnify FIRST HEALTH hereunder if and to the extent that such claim, expense or liability is due to FIRST HEALTH's breach of its obligations under this Agreement, including without limitation those set forth in paragraphs 1 and 2 above. Except as provided in the preceding sentence, FIRST HEALTH and Client shall each be responsible for its own acts and omissions and those of its respective agents, and shall each indemnify the other against any claims, expense or liability (including reasonable attorneys' fees) arising out of its own acts or omissions. Rights of indemnification under this paragraph 5 shall survive termination of this Agreement. 6. COMPLIANCE WITH APPLICABLE LAWS. FIRST HEALTH and Client shall each be solely responsible for compliance with all laws, rules and regulations that are now or hereafter applicable to each of them and their own performance under this Agreement. FIRST HEALTH shall not be responsible for establishing or maintaining the Plan or the Plan Sponsor in compliance with applicable- state or federal legal requirements. Nor shall FIRST HEALTH be an entity that is responsible for payment under the Plan, as referenced in federal Medicare secondary payer laws and regulations. 7. COSTS AND EXPENSES. FIRST HEALTH shall, at its own expense, make arrangements for sufficient personnel and facilities to provide its services under this Agreement. Client shall be responsible for all other expenses relating to Plan establishment, administration and benefits, including any applicable tax -related liabilities and all legal, accounting, and other professional fees. 8. BOOKS AND RECORDS. Client shall provide to FIRST HEALTH, or cause it to be provided, all information reasonably required by FIRST HEALTH to properly render its services under this Agreement ('Plan Records"), which shall remain the property of Client. FIRST HEALTH shall maintain all Plan Records received by it and at Client's expense, shall make such records available for inspection or copying at FIRST HEALTH's office(s) where such records are kept, during normal business hours with reasonable advance notice. Upon Client's termination of this Agreement, FIRST Copyright 1993 FIRST HEALTH strategies. Inc. CONMSIRI 09193 HEALTH shall deliver to Client or its designee as soon as reasonably possible those Plan Records in FIRST HEALTH's possession. The Plan Records may be delivered in the format in which they are maintained by FIRST HEALTH, but shall include sufficient format explanations and documentation to enable the recipient to have immediate use of the record information. Client shall reimburse FIRST HEALTH for all costs reasonably incurred in providing such records, including the costs of any programming or other changes that may be required as the result of any requests by Client for information in a format other than the format in which FIRST HEALTH has maintained such records. FIRST HEALTH shall maintain all Plan Records in its possession for seven years, or until they have been transferred to Client or its designee, whichever occurs first. FIRST HEALTH shall be entitled to retain, at its own expense, copies of any Plan Records that FIRST HEALTH reasonably determines are relevant to any existing or potential claims against FIRST HEALTH, but shall not use those records for any purpose other than resolving such claims. 9. CONFIDENTIALITY. FIRST HEALTH shall keep all Plan Records confidential, and shall. disclose the information in such records only to Client or its designee; provided, however, that FIRST HEALTH may condition the release of medical information identifiable with individual claimants ("personal information") upon the Client's written confirmation that such information is being requested by an authorized representative of the Plan Administrator for a lawful purpose. Personal information may also be disclosed by FIRST HEALTH to the claimant to whom such information pertains, or to his/her legal guardian or other representative, upon receipt of written authorization from such person. FIRST HEALTH may also disclose Plan Records whenever required by order of a court or administrative agency with jurisdiction in the matter. FIRST HEALTH may use data relating to the Plan for statistical or reporting purposes in a manner that will not disclose personal information or the identity of the Plan. 10. PROPRIETARY INFORMATION. A. As the result of this Agreement, each party to this Agreement and its respective agents and contractors may have access to information of a proprietary nature owned or licensed by the other, e.g., information concerning the other's systems, programs, processes and methods (collectively the "Information"). FIRST HEALTH and Client both acknowledge that the Information of each has great value to the other and, if disclosed or used in violation of this paragraph 10, would cause the other immediate and irreparable injury. FIRST HEALTH and Client, and their respective employees and agents, shall not disclose or disseminate to anyone, or use for their own benefit, any Information of the other except as contemplated by this Agreement. B. If either party to this Agreement is validly served with a subpoena, discovery request, or other process lawfully compelling production of Copyright 1993 FIRST HEALTH Strategies. Inc. COWMS7R.3 09I93 the other's Information ("Legal Process"), the party served shall immediately notify the other party. The other party may, at its own expense, take any actions it deems necessary to preserve the confidentiality of its Information; provided, however, that no party shall have any obligation to contest any Legal Process. C. Neither party to this Agreement will use without permission or otherwise infringe upon the other's names, marks, copyrights or other intellectual property. 11. TERM AND TERMINATION. A. The effective date(s) and term(s) of this Agreement with respect to each service provided by FIRST HEALTH are indicated in the Exhibit(s). If an Exhibit provides that a term of service will be automatically renewed, either party may terminate this Agreement with respect to that service by giving the other not less than sixty days written notice prior to the beginning of any such renewal term. Additionally, either party shall have the right to terminate this Agreement, with respect to any service(s), effective: (1) Upon the failure of the other party to cure any monetary default (including failure to pay FIRST HEALTH's fees and charges or to properly fund a benefits account or otherwise provide for allowed claims) within ten calendar days after written notice thereof; (2) Upon the failure of the other party to cure any material, non - monetary default within twenty calendar days after written notice thereof, or to commence within that same period to cure any such default that cannot reasonably be resolved within twenty days and to continue diligently working towards such cure thereafter for a period not to exceed ninety calendar days; (3) Immediately upon the date the other party becomes insolvent, has a receiver or bankruptcy trustee appointed for it, or makes a general assignment for the benefit of creditors; or (4) Upon the effective date of any fee adjustment proposed by FIRST HEALTH in accordance with the terms of an Exhibit, if Client does not agree to such adjustment. B. Upon the effective date of the termination of this Agreement for any reason, each party shall: (1) Pay to the other party all amounts due under this Agreement Copyright 1993 FIRST HFALTH strategies. Inc. CONMSIR.a 09/93 within the lesser of twenty calendar days or the time period specified herein; (2) Immediately cease to represent that FIRST HEALTH is a service provider with respect to the Plan, and Client shall immediately notify the Plan participants and beneficiaries of this fact; and (3) Immediately return to the other party any of its Information and any materials, excluding Plan Records, bearing the other parry's names or marks. Alternatively, such Information or materials may be destroyed with the other parry's written consent. 12. NO THIRD PARTY BENEFICIARIES. Nothing in this Agreement, express or implied, is intended to confer upon any other entity or person (including without limitation any claimant or other person receiving or eligible to receive Plan benefits) any rights or remedies under or by reason of this Agreement. 13. ENTIRE AGREEMENT; AMENDMENTS. This Agreement, together with the Exhibit(s), constitutes the entire agreement between FIRST HEALTH and Client with respect to the subject matter hereof, and supersedes all prior. proposals, discussions, negotiations, and writings between the parties relating to such subject matter. This Agreement may only be modified by a writing executed by authorized representatives of both FIRST HEALTH and Client. 14. SEPARABILITY. If any provision of this Agreement is held to be illegal or unenforceable by a court of competent jurisdiction, the remaining provisions shall remain in effect and the illegal or unenforceable provision shall be modified so as to conform to the original intent of this Agreement to the greatest extent legally permissible. 15. FORCE MAJEURE. The obligations of either FIRST HEALTH or Client under this Agreement, except for the obligation to make monetary payments, shall be suspended during the continuance of any force majeure applicable to that party. The term "force majeure" shall mean any cause not reasonably within the control of the party claiming suspension, including without limitation an act of God, industrial disturbance, war, riot, weather -related disasters, earthquake, governmental action, and unavailability or break down of equipment. The party claiming suspension under this paragraph 15 shall take reasonable steps to resume performance as soon as possible without incurring unreasonably excessive costs. Copyright 1993 RRST HEALTH strategies. Inc. COMNSTRS 09193 16. ASSIGNMENT. Neither party may assign its rights or duties under this Agreement without the prior written consent of the other, except that FIRST HEALTH may assign this Agreement to a different subsidiary or affiliate of FIRST HEALTH, and may subcontract certain duties to non-affiliated third parties, provided that such assignments and subcontracts shall not relieve FIRST HEALTH of any liability under this Agreement. This Agreement shall be binding upon and inure to the benefit of the parties' respective successors and permitted assigns. 17. ATTORNEYS' FEES. The prevailing party in any proceedings that concern the interpretation or enforcement of this Agreement shall be entitled to recover reasonable costs and attorneys' fees incurred in connection with such proceedings, including any appeal. 18. NOTICES. All notices given under this Agreement shall be in writing and shall be hand -delivered, transmitted by telecopy, sent by registered or certified mail (return receipt requested), or delivered by a nationally -recognized overnight courier service, to the address(es) set forth on the signature page of the Exhibit(s), or to such other address as a party may hereafter designate in writing. A hand -delivered, telecopied or overnight-couriered notice shall be deemed given only when actually received. A notice sent by registered or certified mail shall be deemed given on its actual receipt or the fifth day after the date mailed as evidenced by the sender's receipt, whichever occurs first. WHEREFORE, FIRST HEALTH and Client have executed this Master Services Agreement with respect to each service described in the Exhibit(s) as of the date(s) indicated therein. Copyright 1993 MST HEALTH Strategies, Ire. CONMSM6 09/93 FIRST xFauK SERVICES AND FEES EXHIBIT TO MASTER SERVICES AGREEMENT FOR ADMINISTRATIVE SERVICES I. EFFECTIVE DATE AND TERM. With respect to this Exhibit, the accompanying Master Services Agreement shall be effective from _ AVri 1 1 , 199__4__, to March 31 , 199__S_. Thereafter, with respect to this Exhibit, the Master Services Agreement shall automatically renew for successive _ I year terms unless initialed below by Client and FIRST HEALTH: No automatic renewal: _-)7v- J CI ient FIRST HEALTH The amount of fees and costs payable to FIRST HEALTH during any renewal term shall be subject to adjustment as provided under paragraph N.A. below. 11. SERVICES. After its receipt and processing of all necessary Plan data and other information, the FIRST HEALTH affiliate signing below shall provide the following administrative services in connection with the Plan A. Provide information, based on records provided by the Plan, concerning Plan eligibility and benefits provisions to all claimants and their health care providers by telephone during normal business hours, including toll -free access if separately agreed upon, and by mail in response to written inquiries. Such information shall not constitute a determination of benefits that will be paid under the Plan, or a guarantee or certification to anyone that any amount will be paid. Benefit determinations can only be made after a complete claim is submitted and fully processed by FIRST HEALTH, and are subject to all eligibility requirements, limitations, exclusions and other provisions of the Plan in effect when a claim is processed- B. Perform the following claims administration services in accordance with the terms of the accompanying Master Services Agreement and of the Plan, including any summaries or "write- ups" of the Plan as may be approved by the Plan Sponsor or Plan Administrator as the correct interpretation of Plan provisions: Receive and review claims and claims -related documents. 2. Verify eligibility and calculate amounts payable under the Plan in light of Plan provisions concerning medical necessity, reasonableness of charges and preferred provider or other service arrangements. Correspond with claimants and/or their providers to obtain any required additional information and to determine whether other coverage for the claim exists under other benefit plans, insurance contracts, health maintenance organizations, or government - sponsored benefit programs. Copyright 1"3 FIRST HEALTH Strategies. Inc. CONADM-EX1 N"J 4. Prepare and mail explanations of benefits (or denials of benefits) and benefit payment checks drawn on one or more demand deposit accounts. Such accounts shall be designated by Client, who shall ensure that the accounts contain sufficient funds at all times for the continuous and timely payment of benefits claims processed by FIRST HEALTH hereunder. If FIRST HEALTH determines that the accounts do not contain such funds, FIRST HEALTH may so notify Client and suspend further performance of services under this Exhibit pending termination of the accompanying Master Services Agreement as provided in paragraph II.A.(1) thereof, with respect to the services described in this Exhibit. 5. Provide any insurance carrier from which Client or the Plan obtains stop -loss or other coverage with information reasonably required by the carrier for payment of claims under such coverage. FIRST HEALTH assumes no responsibility or liability for the non- payment of such claims by any insurance carrier. 6. Seek reimbursement of overpayments of Plan benefits and offset such erroneous payments against subsequent claims in accordance with Plan provisions and applicable law. FIRST HEALTH shall have no obligation to take legal action against anyone to recover overpayments or to otherwise enforce any provisions of the Plan. Conduct the claims review and appeals procedure in accordance with Plan provisions. Consistent with FIRST HEALTH's lack of discretionary authority or control over Plan administration, FIRST HEALTH shall advise the Plan Administrator of all appeals of denied claims and the Plan Administrator shall make all final benefit determinations in such cases. C. Provide one copy of FIRST HEALTH's current form of plan document and/or summary plan description and all related standard administrative forms and assist with the design and printing of claims forms, ID cards, and other supplies designed specifically for the Plan. D. Provide all reports included, from time to time, in FIRST HEALTH's standard reporting package. E. Provide the Plan Sponsor with any data maintained by FIRST HEALTH that is required by the Plan in the preparation of required reports and filings. F. Attend meetings with the Plan Sponsor as reasonably requested and necessary for the provision of services under this Exhibit. G. Obtain quotations, as requested by Client, for policies of insurance, if available, including stop -loss or excess risk coverage and/or ancillary coverages such as life and AD&D. The decision to purchase any such insurance shall be made solely by Client. FIRST HEALTH may assist Client in evaluating quotations but makes no representations or warranties regarding the adequacy of any particular coverage or carrier. FIRST HEALTH may receive commissions or other compensation in connection with Client's purchase of such insurance as described in the accompanying Disclosure of Insurance Commissions form, which shall be completed by FIRST HEALTH and acknowledged by Client or other named Plan fiduciary before such insurance is purchased. H. Correspond with claimants and their representatives regarding possible third -party liability for expenses paid by the Plan on claimants' behalf, request repayment of those expenses in accordance with any subrogation provisions of the Plan. FIRST HEALTH shall have no responsibility or liability for the refusal of claimants or their representatives to reimburse the Plan for such expenses. FIRST HEALTH shall have no obligation to take any legal action to enforce the Plan's subrogation rights. Provide the optional services for which a fee is indicated in Section III.C. below. Copyright 1"3 FIRST HEALTH Strategic, Inc. CONADWElL3 W93 M. FEES. The fees and costs payable to FIRST HEALTH for the products and services provided under this Exhibit shall be as follows: A. An initial one-time fee of $ NIA , payable prior to commencement of services under this Exhibit. B. The base monthly fees(s) indicated and initialed below by Client and FIRST HEALTH, for claims incurred and received after the effective date of this Exhibit: 2. 4. INITIAL APPLICABLE FEES HERE: $ 3.191(Eed. per number of Covered Employees / as of the first day of the month. $1. 21dent . Client FIRST HEALTH $4.80sed.per dependent & $1.82 dent.as of lot day of the aonth. a. "Covered Employees" means each covered active employee and any other person covered by the Plan in his or her own right (such as former employees or others electing COBRA continuation coverage) and not by reason of his or her status as a dependent or spouse of a current or former employee. b. If Claims Transactions exceed per month per 100 Covered Employees during any [check one] ,three/ six/ twelve month period during any [check one] __plan/ calendar year, an additional fee of $ per excess Claims Transaction during such period, payable within sixty days after the end of the period. "Claims Transaction" means each separate disposition or step in the processing and resolution of a claim, including an initial approval, denial, or request for additional information, and each such subsequent activity with respect to the claim until it is resolved. $ N/A per Claims Transaction per month A monthly fee equal to percent of the aggregate dollar amount of claims paid during the month. _NIA / NIA Client FIRST HEALTH _IA / N/A Client FIRST HEALTH ther including any combination of the above: / 8.$8 for ed.or dent. per cla:hu over >nClient 68Z Utilization (annual) FIRST HEALTH C. The fee(s) for optional services indicated and initialed below by Client and FIRST HEALTH: FIRST HEALTH Interact. - Standard Report Package: $ - Analytical Services: $ (or $ per hour) - Sub -license: $ (and/or $ per Covered Employee per month) INITIAL BELOW IF THESE SERVICES ARE SELECTED: Client FIRST HEALTH NIJA / MIA Client FIRST HEALTH MIA / N/A Client FIRST HEALTH Copyright M FIRST HEALTH Strategies, Inc. CONADM-EXJ 0"3 E. 2. Run -In Claims. The following fees for processing claims incurred prior to the effective date of this Exhibit: 3. Run -Out Claims. The following fees for processing claims incurred after the expiration of the Master Services Agreement with respect to this Exhibit (provided, however, that all other provisions of the Agreement and this Exhibit shall remain in effect during such processing): N/A / N/A Client FIRST HEALTH N/A / N/A Client FIRST HEALTH 4. Other Optional Services. Client - The following fees for the additional services hereafter described: MEDICARE SECONDARY PAYOB — $20. per hour SPECIAL REPORTS & SUPPLIES — Cost Advance Payment of First Month's Fees. FIRST HEALTH Unless both Client and FIRST HEALTH initial below, prior to the commencement of services under this Exhibit, Client shall pay to FIRST HEALTH the amount of $ representing approximately one month's fees hereunder. Client shall receive credit for such payment on the invoice for the first month of services. No advance payment: Client FIRST HEALTH Increase in Non -controllable Costs. Increases in the rate of any non -controllable cost beyond that in effect as of the date of this Exhibit or its most recent renewal shall be borne by Client. "Non -controllable cost" means any expense FIRST HEALTH incurs which is directly attributable to FIRST HEALTH's performance under this Exhibit and which is beyond the reasonable control of FIRST HEALTH, e.g., postage rates. Copyright 1993 FIRST HEALTH Strategies, Inc. CONADM-0" 0"3 IV. MISCELLANEOUS. A. FIRST HEALTH may adjust its fees for any reason effective as of any renewal date of this Exhibit upon at least thirty days advance written notice of the amount of the proposed adjustment. FIRST HEALTH may also adjust its fees for any reason during any renewal term effective as of the first day of any month upon at least ninety days advance written notice of the amount and effective date of the proposed adjustment. FIRST HEALTH may also propose such adjustments during the initial term of this Exhibit if the number of eligible Plan Claimants decreases by ten percent from the number as of the effective date of this Exhibit indicated above. Client may terminate the Master Services Agreement with respect to this Exhibit, as provided under paragraph I LA.(4) of the Master Services Agreement, if it does not accept any fee adjustment proposed by FIRST HEALTH. B. Mutually acceptable fee adjustments may be reflected in a letter which shall be signed by authrized representatives of FIRST HEALTH and Client and attached to this Exhibit. Except for adjustments in fees and charges expressly set forth in such a letter, all terms and conditions of this Exhibit and the Master Services Agreement shall remain in effect until the Master Services Agreement is terminated with respect to this Exhibit as provided therein. C. Other miscellaneous terms, if any: Copyright 1"3 FIRST HEALTH Strategies Inc. CONADM-EX.S rW VI. EXECUTION OF AGREEMENT. CTTy OF 1FXMB t'R [Print Name of Client] David R. Langston [Print Name of Person Signing Above] Mayor [Print Title of Person Signing Above] Address: P.O. Boa 2000 Lubbock. Texas 79457 Attn: Lou Moore FIRST HEALTH STRATEGIES (TPA), INC. By: [Signature of FIRST HEALTH Corporate Officer] Steve KcBride [Print Name of Person Signing Above] Senior Vice President [Print Title of Person Signing Above] Address: 222 W. Las Colinas Blvd. Suite 1360 Irvin¢: Texas 75039 Attn: Glenda Jackson APPROVED AS CONTENT: AS TO FORM: Human Resources Assistant City Attorney Copyright 1"3 FIRS! HEALTH Strategim toe. CONADM-ER.i 0"3 FIRST xEauK ERISA PTE 77-9 DISCLOSURE OF INSURANCE COMMISSIONS THIS FORM MUST ACCOMPANY EACH ADMINISTRATIVE SERVICES EXHIBIT TO A FIRST HEALTH MASTER SERVICES AGREEMENT ' o.) .18141,40 21y1' Z13M IV a U F71, Insurer. Washington National Minimum Premium The products being purchased by the above Plan or its Sponsor include the following: Life AD&D Dependent Life x Stop Loss Other. INITIAL AND RENEWAL COMMISSIONS FIRST HEALTH will receive the following initial and renewal sales commissions expressed as a percentage of the gross annual premium payments (i.e. ): Life: Stop Loss: Initial: 0 % Initial: 0 % Each Renewal: 0 % Each Renewal: 0 % FIRST HEALTH has agreed to pay N/A (% or $) of the commissions received to (name and address): ADDITIONAL COMPENSATION FIRST HEALTH may receive additional compensation from the Insurer in the form of a production bonus, service fees, override commissions or a profit sharing arrangement. Such compensation may be based upon FIRST HEALTH's potential volume of business with the Insurer, the overall profitability of the Insurer's business, or other similar factors. The amount of such additional compensation, if any, will not be known until the end of the agreement period with the Insurer. Information regarding such additional compensation, insofar as it relates to the Plan, will be available for the Plan fiduciaries' review after such amounts have been determined. Copyright IM FIRST HEALTH Strategies, Inc. CoNrMEXI 0"3 OTHER COSTS OR FEES Other costs or fees (in addition to commissions disclosed above) that may be charged to the Plan or its Sponsor by the Insurer include policy change fees and costs, early contract termination charges, or certain other fees, discounts, penalties, or adjustments which may be imposed under the terms of the recommended contract. These additional costs or fees may be summarized as follows: RELATIONSHIP TO INSURER FIRST HEALTH [check one] is x is not an affiliate of the Insurer. FIRST HEALTH [check one] is x is not limited by any agreement with the Insurer in its ability to recommend the purchase of insurance products from other insurers or funding organizations. Explanation if applicable: RELATIONSHIP TO PLAN To avoid a possible prohibited transaction under the Employee Retirement Income Security Act of 1974 ("ERISA"), if applicable to the above Plan, FIRST HEALTH may not be: 1. Affiliated with the Plan Sponsor or any other employer who has employees covered by the Plan; 2. A Plan Trustee (other than a nondiscretionary trustee who does not render investment advice concerning Plan assets); 3. A named Plan Administrator, or 4. A named Plan Fiduciary or other fiduciary who is expressly authorized in writing to manage, acquire or dispose of Plan assets on a discretionary basis. ACKNOWLEDGEMENT The undersigned acknowledges receipt of the information contained in this statement prior to any purchase of the insurance products described above and approves the proposed transaction on behalf of the Plan or Plan Sponsor without receiving, either directly or indirectly, any compensation or other consideration for his or her own personal account from any party dealing with the Plan in connection with the transaction. The undersigned certifies that, to the best of his or her knowledge and belief, FIRST HEALTH is not related to the Plan in any capacity described above. (Signature of Plan Administrator or other named Fiduciary) May 26, 1994 Date Copyright 1"3 FUtST HEALTH strategies, Inc CONPPE-EX2 "/93 FIRST xEauK SERVICES AND FEES EXHIBIT TO MASTER SERVICES AGREEMENT FOR HEALTH CARE MANAGEMENT SERVICES I. EFFECTIVE DATE AND TERM. With respect to this Exhibit, the accompanying Master Services Agreement shall be effective from April 1 , 199_ , to March 31 , 199_5 _. Thereafter, with respect to this Exhibit, the Master Services Agreement shall automatically renew for successive 1 year terms unless initialed below by Client and FIRST HEALTH: No automatic renewal: / r , / Client FIRST HEALTH The amount of fees and costs payable to FIRST HEALTH during any renewal term shall be subject to adjustment as provided under paragraph III.A. below. H. SERVICES AND FEES. After its receipt and processing of all necessary Plan data and other information, the FIRST HEALTH affiliate signing below shall perform those services for which a fee is indicated and initialed by Client and FIRST HEALTH. INITIAL BELOW IF THESE SERVICES ARE SELECTED: A. HEALTH CARE MANAGEMENT -INPATIENT. / Client FIRST HEALTH Determination of whether unscheduled surgical procedures are cosmetic or medically necessary ("preauthorization") and, if requested, determination of the amount that will be paid by the Plan for such procedure(s) subject to certain specified conditions ("predetermination"). Requests for predeterminations must be submitted in writing. 2. Determination of medical necessity of scheduled procedures ("precertification") for all hospital admissions, including psychiatric and chemical dependency admissions. 3. Admission review (all inpatient admissions). 4. Cyclic concurrent continued stay management. 5. Discharge planning. 6. Catastrophic case management. Copyright M FUM HEALTH Shalgio, toe. COIVHCM-EXl 0"3 7. Inpatient behavioral case management. 8. Claims review (described in H.D. below). 9. Quality assurance studies. 10. Referrals to preferred provider physicians and hospitals. 11. Health information services via toll free number (if necessary). 12. Standard Activity reports. $ 1.24 per Covered Employee per month $1.98 per covered dependent per month MaterniHealth may be added for the following additional fees (check selected services): • High Risk Maternity No • Short Stay Maternity No $ N A per Covered Employee per month B. HEALTH CARE MANAGEMENT -COMPREHENSIVE. N/A / N/A Client FIRST HEALTH 1. All services included in Health Care Management -Inpatient, above. 2. Ambulatory precertification of medical necessity of the following services: Arthroscopy (knee) Carpal Tunnel Hammertoe Hemolrhoidectomy Hysteroscopy Infusion Chemotherapy Myringotomy Pacemaker Implantation PET/PERT/PETT Scan Septoplasty Tonsillectomy and/or Adenoidectomy Thallium Stress Test Tympanostomy UGI Endoscopy 3. Specialized management for alternative levels of care (check selected services): Home Health Care Management Hospice Management Extended Care Facility Management Podiatry Management Chiropractic Management MaterniHealth • High Risk Maternity • Short Stay Maternity $ per Covered Employee per month Copyright f9M3 FIRST HEALTH strategies, lee. CONHCM-Ex.2 "193 C. HEALTH CARE MANAGEMENT -FOCUS. N/A / N/A Client FIRST HEALTH 1. Determination of whether unscheduled surgical procedures are cosmetic or medically necessary ("preauthorization") and, if requested, determination of the amount that will be paid by the Plan for such procedure(s) subject to certain specified conditions ("predetermination"). Requests for predetermination must be submitted in writing. 2. Notification by participants of any of the following services being scheduled for purposes of Catastrophic Case Management screening ("prior notification"): • Inpatient Hospital Admissions • Inpatient Behavioral Admission • Home Health Care • Hospice • Extended Care Facilities 3. Catastrophic Case Management. 4. MatemiHealth (check selected services): • High Risk Maternity • Short Stay Maternity S. Claims Review. $ per Covered Employee per month D. CLAIMS REVIEW. N/A / N/A Client FIRST HEALTH 1. Retrospective review of medical claims to determine appropriateness of charges by examining, e.g., level of care, type of service, coding practices, etc. $ per Covered Employee per month E. AMBULATORY BEHAVIORAL CASE MANAGEMENT. N/A / N/A Client FIRST HEALTH 1. Specialized case management provided by professional staff with advanced degrees and/or experience in the behavioral sciences. 2. Precertification and concurrent certification of medical necessity of services provided in a provider's office or facility -based services (day/partial hospitalization). 3. Standard Activity Reports. $ per Covered Employee per month Copyright M RRST HEALTH strategies, Im CON''HCM-E .3 09193 F. DENTAL MANAGEMENT. g f e / N J, Client FIRST HEALTH 1. Determination of whether unscheduled procedures are cosmetic or medically necessary ("preauthorization") and, if requested, determination of the amount that will be paid by the Plan for such procedure(s) subject to certain specified conditions ("predetermination"). Requests for predeterminations must be submitted in writing. 2. Claims Review. 3. Standard Activity Reports. $ per Covered Employee per month G. DISABILITY MANAGEMENT. N/A / N/A Client FIRST HEALTH 1. Precertification and Concurrent/Follow-up Services. Precertification, concurrent or follow-up reviews, and physician review services on a per -case basis. Individual services (i.e., inpatient hospital admission, physical therapy, or chiropractic services) precertified for any given claimant will be billed as separate cases. $ / hour 2. Medical and/or Vocational Case Management. N/A / N/A Client FIRST HEALTH 3. 4. Telephonic or on -site services performed by a qualified RN or Vocational Rehabilitation counselor for the purposes of medical assessment and/or coordination under workers' compensation, short term disability, or long term disability coverage, and issues impacting return to work. All activity will be pre -approved bythe adjuster, payor, or other designee of Client. _ / hour plus expenses, e.g., long distance tolls, mileage and other travel expenses Hospital Bill Review. N/A / N/A Client FIRST HEALTH Hospital bills will be pre-screened for audit potential at no charge. All audits review length of stay and fee adjustments required by state schedules, and recalculate for per diem rates. Prescreen No Charge Hospital Bill < $5,000 $ + access fee Hospital Bill < $10,000 $ + access fee Hospital Bill $10,000+ % of Billed Amount Travel No Charge Independent Medical Evaluation (IME) Scheduling. N/A Client / N/A FIRST HEALTH FIRST HEALTH Case Manager will identify an appropriate IME physician, schedule the 13.4E appointment, and notify the patient of the appointment. per IME Copyright 1"3 FIRST HEALTH S&Ate&s, Inc. CONHCM-EX.4 "193 H. HOSPITAL BILL NEGOTIATION/AUDIT. -"a / Client FIRST HEALTH 1. Negotiation of hospital bills greater than $20,000, with onsite audit if necessary. 2. Standard Activity Reports. Negotiation Fees: 20% of the savings negotiated (the difference between the hospital's billed charges and the negotiated charge). Onsite Audit Fees: 3% of the audited charges. I. MANAGED SECOND OPINION. N/A_ / N/A Client FIRST HEALTH 1. Application of clinical criteria to identify cases which could benefit from a second opinion for the following procedures: C-Section Cholecystectomy Hysterectomy Laminectomy 2. Standard Activity Reports. $ per Covered Employee per month J. SET-UP SERVICES. Exploratory Laparotomy Mastectomy Prostatectomy N/A / N/A Client FIRST HEALTH 1. One standard employee communication package (English only; Spanish version provided for extra fee) per Covered Employee. Any material describing FIRST HEALTH's services distributed by the Plan must fast be reviewed and approved by FIRST HEALTH, at the hourly rate then currently charged by FIRST HEALTH for such review. 2. Loading of Plan benefit information. $ , plus actual printing costs for employee communication packets. K. ADVANCE PAYMENT OF FIRST MONTH'S FEES. Unless both Client and FIRST HEALTH initial below, prior to the commencement of services under this Exhibit, Client shall pay to FIRST HEALTH the amount of $ representing approximately one month's fees hereunder. Client shall receive credit for such payment on the invoice for the first month of services. No advance payment: / Client FIRST HEALTH Copyright 1"3 FIRST HEALTH Strategies. Imo CONWM-EX3 W93 III. MISCELLANEOUS. A. FIRST HEALTH may adjust its fees for any reason effective as of any renewal date of this Exhibit upon at least thirty days advance written notice of the amount of the proposed adjustment. FIRST HEALTH may also adjust its fees for any reason during any renewal term effective as of the first day of any month upon at least ninety days advance written notice of the amount and effective date of the proposed adjustment. FIRST HEALTH may also propose such adjustments during the initial term of this Exhibit if the number 'of eligible Plan Claimants decreases by ten percent from the number as of the effective date indicated above. Client may terminate the Master Services Agreement with respect to this Exhibit, as provided under paragraph I IA.(4) of the Master Services Agreement, if it does not accept any fee adjustment proposed by FIRST HEALTH. B. Mutually acceptable fee adjustments may be reflected in a letter which shall be signed by authorized representatives of FIRST HEALTH and Client and attached to this Exhibit. Except for adjustments in fees and charges expressly set forth in such a letter, all terms and conditions of this Exhibit and the Master Services Agreement shall remain in effect until the Master Services Agreement is terminated with respect to this Exhibit as provided therein. C. As used in this Exhibit, "Covered Employee" means each covered active employee and any other person covered by the Plan in his or her own right (such as former employees or others electing COBRA continuation coverage) and not by reason of his or her status as a dependent or spouse of a current or former employee. D. FIRST HEALTH shall have no responsibility or liability to anyone for the results of professional services rendered by health care providers. FIRST HEALTH shall have no right or obligation under this Exhibit or the Master Services Agreement to intervene in the determination of what such services shall be or how they shall be rendered. Decisions to obtain or deliver any health care service shall always be made only by the patient and/or the patient's treating professional. E. FIRST HEALTH may rely on the recommendations of licensed health care professionals retained by FIRST HEALTH to assist it in rendering the health care management services provided for under this Exhibit. F. FIRST HEALTH's health care management services do not include a guarantee or certification to anyone that particular professional services are covered under the Plan or that benefits will be paid for those services. Final eligibility and coverage decisions can be made by the Plan's claims payor only after a complete claim is submitted and fully processed for payment. G. Other miscellaneous terms, if any: Copyright 1"3 FIRST HEALTH Strategies. tne. CONHCM-EXA "M3 TV. EXECUTION OF AGREEMENT. rTTY nV T.IT1RBnCX [Print Name of Client] David R. Langston [Print Name of Person Signing Above] Mayor [Print Title of Person Signing Above] Address: 1625 13th Street Lubbock. Texas 79401 FIRST HEALTH REVIEW, INC. By: [Signature of FIRST HEALTH Corporate Officer] Steve McRridA [Print Name of Person Signing Above] RArtier Vice Pregident [Print Title of Person Signing Above] Address: 222 W. Las Colinas Blvd. Suite 1360 Irving, Texas 75039 Attn: Glenda Jackson APPROVED AS APPROVED AS TO FIORH: TD 0 —) /a, els Mary Andr, , Director of d . Vandiver, First Human Resources Assistant City Attorney Copyright M FIRST HEALTH Strategies, Inc. CONHCM.FX-7 0"3 SERVICES AND FEES EXHIBIT TO MASTER SERVICES AGREEMENT FOR PRESCRIPTION DRUG PROGRAM L EFFECTIVE DATE AND TERM. With respect to this Exhibit, the accompanying Master Services Agreement shall be effective from April 1 , I99 4 , to March 31 , 199 5 . Thereafter, with respect to this Exhibit, the Master Services Agreement shall automatically renew for successive 1 year terms unless initialed below by Client and FIRST HEALTH: No automatic renewal: ► VI- / Client FIRST HEALTH The amount of fees and costs payable to FIRST HEALTH during any renewal term shall be subject to adjustment as provided under paragraph V.A. below. H. SERVICES. After its receipt and processing of all necessary Plan data and other information, the FIRST HEALTH affiliate signing below shall provide the following services in connection with the Plan's prescription drug benefits: A. Maintain eligibility records and provide information, based on records furnished by the Plan, concerning Plan eligibility and benefits, to all claimants and health care providers, by a toll -free telephone number available all days, twenty-four hours per day. FIRST HEALTH shall be entitled to rely on all such eligibility information furnished by Client, and shall have no liability to anyone for any inaccuracy in such information. B. Receive and review claims; verify eligibility, based on the information described in the preceding subparagraph A; and determine amounts payable under the Plan for claims received by FIRST HEALTH after the effective date specified in Section I above. C. Prepare benefit payment checks drawn on designated demand deposit accounts, which shall be fully funded no less than two business days after FIRST HEALTH notifies Client of its drug claim payments. If such funding is not timely made, FIRST HEALTH may withdraw the amount of such deficit from the security deposit account described in Section III. A. below. D. Provide FIRST HEALTH's standard prescription drug program reporting package which shall include the following: I. Prescription Drug Summary (PDS) 2. Population Utilization Profile (PUP) 3. Group Detail Report 4. Weekly Statement of Account Copyright M FIRST HEALTH Strategies, Inc_ CONRX-EXI "/93 Any change in this standard reporting package, and any agreement as to optional reports and the fees therefor, shall be set forth in a separate writing signed by both FIRST HEALTH and Client. E. Maintain a record of claims transactions. F. Electronically transmit eligibility information to, and capture prescription drug claims on magnetic tape from, contracting pharmacies. G. Administer the claims review and appeals procedure in accordance with Plan provisions, subject to the Plan Administrator making all final benefit determinations in cases of benefits initially denied by FIRST HEALTH. H. Adjust payments to providers to account for underpayments. Seek reimbursement of overpayments and offset such erroneous payments against future claims in accordance with Plan provisions and applicable law. FIRST HEALTH shall have no obligation to take any legal action against anyone to recover overpayments or otherwise enforce any provisions of the Plan. I. Provide the Plan Administrator with any data maintained by FIRST HEALTH that is required by the Plan in the preparation of required reports and filings. Client shall bear the cost of providing any such data in a format other than FIRST HEALTH's then standard format. J. Perform drug utilization review services for which a fee or fees are designated in Section IV.B. below, according to FIRST HEALTH's standard policies and procedures for such review services. III. SECURITY DEPOSIT ACCOUNT. This section shall be applicable unless initialed here by an authorized representative of FIRST HEALTH: A. Client shall maintain a minimum balance of $ NSA in a demand deposit account designated by FIRST HEALTH. Such deposit shall serve as security for performance of Client's obligations under this Exhibit and accompanying Master Services Agreement. Any interest earned on this account shall be retained by Client. B. At any time the balance of the security deposit account falls below one-half of the amount specified in the preceding subparagraph A., FIRST HEALTH shall not be obligated to make benefit payments. In such an event, FIRST HEALTH may: (1) advise claimants and their providers as to the insufficiency of funds, but shall not be required to do so; and/or (2) terminate the accompanying Master Services Agreement as provided in paragraph 11.A.(1) thereof, with respect to the services described in this Exhibit. C. At any time that Client is delinquent in the payment of any of the amounts provided in Section IV of this Exhibit, FIRST HEALTH may directly withdraw the amount of such delinquency from the security deposit account after giving Client five days advance written notice of its intent to do so. IV. FEES. The fees and costs payable to FIRST HEALTH for the services provided under this Exhibit shall be as follows: A. A start-up fee of $ NIA for positive enrollment, eligibility tape transfer, plan loading and other set-up services. CMr*bt M FIRST HEALTH Strategies. Inc. CONRX-EX.2 0"3 B. $ 95 per point -of -service electronic claim transaction processed (paid or denied). $ 1 - RA _ per processed claim transaction submitted via a claim form. per processed claim transaction submitted through a mail order program. per processed claim transaction submitted via magnetic tape. $ .20 per claim for concurrent drug utilization review. per claim for retrospective drug utilization review. C. All costs incurred by FIRST HEALTH for the preparation and printing of necessary documents, at FIRST HEALTH's actual cost plus twenty percent for handling. D. Any increase in the rate of any non -controllable cost beyond that in existence as of the effective date of this Exhibit, or the most recent date of renewal. "Non -controllable cost" [Hearts any expense FIRST HEALTH incurs which is directly attributable to FIRST HEALTH's performance hereunder and which is beyond the reasonable control of FIRST HEALTH, e.g., postage rates. E. Costs incurred for employee presentations, client specific network expansion or for the preparation of employee promotional materials, as mutually agreed upon under paragraph V.D. below, or in a separate writing. F. Advance Payment of First Month's Fees. Unless both Client and FIRST HEALTH initial below, prior to the commencement of services under this Exhibit, Client shall pay to FIRST HEALTH the amount of $ N f A representing approximately one month's fees hereunder. Client shall receive credit for such payment on the invoice for the fast month of services. No advance payment: /,0A - / Client FIRST HEALTH V. MISCELLANEOUS. A. FIRST HEALTH may adjust its fees for any reason effective as of any renewal date of this Exhibit upon at least thirty days advance written notice of the amount of the proposed adjustment. FIRST HEALTH may also adjust its fees for any reason during any renewal term effective as of the first day of any month upon at least ninety days advance written notice of the amount and effective date of the proposed adjustment. FIRST HEALTH may also propose such adjustments during the initial term of this Exhibit if the number of eligible Plan Claimants decreases by ten percent from the number as of the effective date indicated above. Client may terminate the Master Services Agreement with respect to this Exhibit, as provided under paragraph I I.A.(4) of the Master Services Agreement, if it does not accept any fee adjustment proposed by FIRST HEALTH. B. Mutually acceptable fee adjustments may be reflected in a letter which shall be signed by authorized representatives of FIRST HEALTH and Client and attached to this Exhibit. Except for adjustments in fees and charges expressly set forth in such a letter, all terms and conditions of this Exhibit and the Master Services Agreement shall remain in effect until the Master Services Agreement is terminated with respect to this Exhibit as provided therein. C. FIRST HEALTH shall have no responsibility or liability to anyone for the results of professional services rendered by health care providers. FIRST HEALTH shall have no right or obligation Copyright 1"3 FIRST HEALTH Strategies. Inc. CONRX-EX3 09/93 under this Exhibit or the Master Services Agreement to intervene in the determination of what such services shall be or how they shall be rendered. Decisions to obtain or deliver any health care service shall always be made only by the patient and/or the patient's treating professional. D. Other miscellaneous terms, if any: VL EXECUTION OF AGREEMENT. CITY OF LUBBOCK [Print Name of Client] Representative] David R. Langston [Print Name of Person Signing Above] Mayor [Print Title of Person Signing Above] Address: 1629 Pith Street APPROVED AS TO NTII�Tr Mary Andqfws, Director of lftunan Re ounces FIRST HEALTH STRATEGIES (TPA), INC. By: [Signature of FIRST HEALTH Corporate Officer] Steve MyRride [Print Name of Person Signing Above] Senjnr VirP PrPsid rnt [Print Title of Person Signing Above] Address: 222 W. Las Cal inan Rlud _ .••-•fir • •-, Donald G. Vandiver, First Assistant City Attorney Copyright 1"3 FIRST HEALTH Strategim Inc- CONRX-EXA 09/93