HomeMy WebLinkAboutResolution - 2010-R0464 - Service Agreement For Vision Insurance - Davis Vision, Inc. - 09/27/2010Resolution No. 2010-RO464
September 27, 2010
Item No. 5.9
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the Mayor of the City of Lubbock is hereby authorized and directed to
execute for and on behalf of the City of Lubbock, a Service Agreement for Vision
Insurance as per RFP 10 -113 -DT, by and between the City of Lubbock and Davis Vision,
Inc., and related documents. Said Service Agreement is attached hereto and incorporated
in this resolution as if fully set forth herein and shall be included in the minutes of the
City Council.
THAT the City Manager, or her designee, may execute any routine documents and
forms associated with said insurance coverage.
Passed by the City Council on - September 27, 2010
ATTEST:
TOM MARTIN, MAYOR
Rebec Garza, City Secretary
APPROVED AS TO CONTENT:
Leisa Hutcheson, Director of Human Resources and
Risk Management
APPROVED AS TO FORM:
Chad Weaver, Assistant City Attorney
J vw:ccdocs/RES.Risk Mgmt-Davis Vision
j September 10, 2010
Resolution No. 2010-RO464
City of Lubbock, TX
SERVICE AGREEMENT
Vision Insurance
RFP 10 -113 -DT
Contract 9749
This Service Agreement (this "Agreement') is entered into as of the 27`" day of, September
2010, ("Effective Date") by and between Davis Vision, Inc. (the "Company"), and the City of Lubbock
(the "City").
RECITALS
WHEREAS, the City has issued a Request for Proposals 10 -113 -DT for vision insurance for its
employees; and
WHEREAS, the proposal submitted by the Company has been selected as the proposal which
best meets the needs of the City and its employees for this service; and
WHEREAS, the Company desires to perform as an independent contractor to provide vision
insurance upon terms and conditions maintained in this Agreement; and
NOW THEREFORE, for and in consideration of the mutual promises contained herein, the City
and Company agree as follows:
City and Company acknowledge the Agreement consists of the following exhibits which are
attached hereto and incorporated herein by reference:
1 - This Agreement
2 - Exhibit A - Intent and General Conditions
3 - Exhibit B - Proposal Submittal
In the event of a conflict between this Agreement and its Exhibit(s), and the terms and conditions
of the Vision Policy, the Vision Policy shall control.
ARTICLE I
SERVICE
1.1 Company agrees to perform those services for the City that are specified on Exhibit A
(the "Services") and attached hereto.
1.2 Company shall use its commercially reasonable efforts to render Services under
this Agreement in a professional and business -like manner and in accordance with
the standards and practices recognized in the industry.
Non -appropriation clause: All funds for payment by the City under this Agreement for
vision insurance are subject to the availability of an annual appropriation for this purpose
by the City. In the event of non -appropriation of funds by the City Council of the City of
Lubbock for vision insurance provided under the Agreement, the City will terminate that
portion of the Agreement, without termination charge or other liability, on the last day of
the then -current fiscal year or when the appropriation made for the then -current year for
the goods or services covered by this Agreement is spent, whichever event occurs first. If
Contract Davis Vision (3) FINAL -REDLINE 091410 Page 1 of 7
at any time funds are not appropriated for the continuance of this Agreement, cancellation
shall be accepted by the Company on thirty (30) days prior written notice, but failure to
give such notice shall be of no effect and the City shall not be obligated under this
Agreement beyond the date of termination.
ARTICLE II
NUSCELLANEOUS
2.1 This Agreement is made in the State of Texas and shall for all purposes be construed in
accordance with the laws of said State, without reference to choice of law provisions.
2.2 This Agreement is performable in, and venue of any action related or pertaining to
this Agreement shall lie in, Lubbock, Texas.
2.3 This Agreement and its Exhibits contains the entire agreement between the City and
Company and supersedes any and all previous agreements, written or oral, between the
parties relating to the subject matter hereof. No amendment or modification of the terms
of this Agreement shall be binding upon the parties unless reduced to writing and signed
by both parties. In the event of a conflict between this Agreement and its Exhibit(s), and
the terms and conditions of the Vision Policy, the Vision Policy shall control.
2.4 This Agreement may be executed in counterparts, each of which shall be deemed an
original.
2.5 In the event any provision of this Agreement is held illegal or invalid, the remaining
provisions of this Agreement shall not be affected thereby.
2.6 The waiver of a breach of any provision of this Agreement by any parties or the failure
of any parties otherwise to insist upon strict performance of any provision hereof shall
not constitute a waiver of any subsequent breach or of any subsequent failure to perform.
2,7 This Agreement shall be binding upon and inure to the benefit of the parties and their
respective heirs, representatives and successors and may be assigned by Company or
the City to any successor only on the written approval of the other party.
2.8 All claims, disputes, and other matters in question between the Parties arising out of or
relating to this Agreement or the breach thereof, shall be formally discussed and
negotiated between the Parties for resolution. In the event that the Parties are unable to
resolve the claims, disputes, or other matters in question within thirty (30) days of
written notification from the aggrieved Party to the other Party, the aggrieved Party shall
be free to pursue all remedies available at law or in equity.
IN WITNESS WHEREOF, this Agreement is executed as of the Effective Date.
Contract Davis Vision (3) FINAL-RF.DLM 091410 Page 2 of 7
City of Lubbock, TX
Tom Marfm, Mayor
ATTEST:
Reber Garza, City Secretary
AP
ST
CONTENT
Leisa Hutcheson, Director of Human Resources
and Risk Management
APPR AS FORM:
Chad Weaver, Assistant City Attorney
Contract Davis Vision (3) FINAL -REDLINE 091410 Page 3 of 7
Davis Vision, Inc.
ame: a �,� ('pn�� , ) Cf r r
Title:
Resolution No. 2010-RO464
EXHIBIT A
CITY OF LUBBOM TEXAS
Vision Insurance
RFP 10 -113 -DT
I. INTENT AND GENERAL CONDITIONS
The following services will be required by the successful proposer:
1.1 Non -Exclusive Agreement: This Agreement is non-exclusive, and the plan may make similar
agreements with other providers.
1.2 To provide vision insurance, as underwritten by HM Life Insurance Company, for City
employees at rates pursuant to Exhibit B.
1.3 Provide an account representative that is the central contact for all City questions and concerns.
1.4 Provide all materials necessary for enrollment in insurance policies stated in 1.2 above.
1.5 Provide on-site enrollment assistance for the initial enrollment and at subsequent annual
enrollment periods.
1.6 Guarantee rates for Vision Insurance for City employees for a period of three (3) years with a
fourth (e) year continuance at the City's option.
II. ADDITIONAL SPECIFICATIONS
2.1 Independent contractor: Company is and shall at all times be deemed to be an independent
contractor and shall be wholly responsible for the manner in which it performs the services
required of it by the terms of this Agreement. Nothing herein contained shall be construed as
creating a relationship of employer and employee, or principal and agent, between the Plan and
Company's or any of Company's agents or employees or between Company and any member of
its staff. Company assumes exclusively the responsibility for its acts and the acts of its
employees as they relate to the services to be provided during the course and scope of their
employ. Company, its agents and employees shall not be entitled to any rights or privileges of
the Plan's employees and/or Members and shall not be considered in any manner to be the Plan
employee(s).
2.2 Ownership of records and databases: Except for microfilm, all records relating to the Plan and
the Employer that come into the possession of the Company shall remain the property of the
Employer and shall remain confidential; provided that the Company shall have the right to make
copies of such records and data and to include data collected during the performance of this
Agreement with data collected from other sources to create one or more master databases. All
such master databases and any data included therein shall be the property of the Company and
shall not be used or disclosed by Employer; provided however, that the Company shall not
disclose to any third party any Employer -specific or Plan -specific data contained in any such
master database, unless required by law.
Contract Davis Vision (3) FINAL -REDLINE 091410 Page 4 of 7
2.3 Covered employee information: Name, address, salary, etc. will not be utilized for any purpose
other than the administration of Plan benefits, but may be disclosed if required by law.
III. CONTRACT TERM
3.1 The contract term of this Agreement shall commence on January 1, 2011 and shall be for a period
of one (1) year, with the City's option to renew the contract annually for up to two (2) additional
one (1) year terms, contingent upon satisfactory performance evaluations by the City.
3.2 Either party may terminate this Agreement with a sixty (60) day written notice.
IV. CITY RIGHT TO AUDIT
4.1 At any time during the term of this Agreement, or thereafter, the City, or a duly authorized audit
representative of the City or the State of Texas, at its expense and at reasonable times, reserves
the right to audit Company's records and books relevant to all services provided to the City and its
employees under this Agreement. In the event such an audit by the City reveals any errors or
overpayments by the City, Company shall refund the City the full amount of such overpayments
within thirty (30) days of such audit findings, or the City, at its option, reserves the right to deduct
such amounts owing the City from any payments due Company.
V. INDEMNIFICATION
5.1 Company shall defend, indemnify, and hold harmless the City for any and all third party claims,
demands, liabilities, and expenses (including attorney's fees and costs of defense) incurred by the
Plan as a direct and sole result of the performance of the Company's obligations under this
Agreement.
V. INSURANCE
6.1 Prior to the approval of this Agreement by the City, the Company shall furnish a completed
Insurance Certificate to the City, which shall be completed by an agent authorized to bind the
named underwriter(s) to the coverages, limits, and termination provisions shown thereon, and
which shall fitrnish and contain all required information referenced or indicated thereon. THE
CITY SHALL HAVE NO DUTY TO PAY OR PERFORM UNDER THIS CONTRACT UNTIL.
SUCH CERTIFICATE SHALL HAVE BEEN DELIVERED TO THE CITY.
6.2 Subject to the Company's right to maintain reasonable deductibles in such amounts as are
approved by the City, the Company shall obtain and maintain in full force and effect for the
duration of this contract, and any extension hereof, at Company's sole expense, insurance
coverage written by companies approved by the State of Texas and acceptable to the City, in the
following type(s) and amount(s):
TYPE AMOUNT
1. Worker's Compensation Statutory
and
Employers Liability $500,000
Contract Davis Vision (3) FINAL -REDLINE 091410 Page 5 of 7
2.
3.
4.
Commercial General (public) Liability insurance including coverage for the
following:
a. Premises operations
b. Products/completed operations
C. Personal injury
d. Advertising injury
e. Contractual liability
Errors and Omissions
Comprehensive Automobile Liability
a. Any auto
6.3 ADDITIONAL POLICY ENDORSEMENTS
Combined single limit for
bodily injury and property
damage of $500,000 per
occurrence or its equivalent.
$1,000,000
Combined single limit for
bodily injury and property
damage of $300,000 per
occurrence or its equivalent.
The City shall be entitled, upon request, and without expense, to receive copies of the policies
and all endorsements thereto and may make any reasonable request for deletion, revision, or
modification of particular policy terms, conditions, limitations, or exclusions (except where
policy provisions are established by law or regulation binding upon either of the parties hereto or
the underwriter of any of such policies). Upon such request by the City, the Company shall
exercise reasonable efforts to accomplish such changes in policy coverages, and shall pay the
cost thereof.
6.4 REQUIRED PROVISIONS
The Company agrees that with respect to the above required insurance, insurance contracts
and certificate(s) of insurance will contain and state, in writing, on the certificate or its
attachment, the following required provisions:
a. Name the City of Lubbock and its officers, employees, and elected representatives as
additional insureds, (as the interest of each insured may appear) as to commercial general
liability insurance;
b. Provide for sixty (60) days notice to the City for cancellation, nonrenewal, or material
change (except in the instance of non-payment);
c. Provide for notice to the City at the address shown below by registered mail;
d. The Company agrees to waive subrogation against the City of Lubbock, its officers,
employees, and elected representatives for injuries, including death, property damage, or
any other loss to the extent same may be covered by the proceeds of insurance;
e. Provide that all provisions of this contract concerning liability, duty, and standard of care
together with the indemnification provision, shall be underwritten by contractual liability
coverage sufficient to include such obligations within applicable policies.
£ All copies of the Certificates of Insurance shall reference the project name or bid number
for which the insurance is being supplied.
6.5 NOTICES
Contract Davis Vision (3) FINAL -REDLINE 091410 Page 6 of 7
The Company shall notify the City in the event of any change in coverage and shall give such
notices not less than sixty (60) days prior the change, which notice must be accompanied by a
replacement CERTIFICATE OF INSURANCE.
All notices shall be given to the City at the following address:
Marta Alvarez - Purchasing Manager
City of Lubbock
1625 13th Street
Lubbock, Texas 79401
6.6 Approval, disapproval, or failure to act by the City regarding any insurance supplied by the
Company shall not relieve the Company of full responsibility or liability for damages and
accidents as set forth in the contract documents. Neither shall the bankruptcy, insolvency, or
denial of liability by the insurance company exonerate the Company from liability.
Contract Davis Vision (3) FINAL -REDLINE 091410 Page 7 of 7
Resolution No. 2010-RO464
Exhibit B
Eye Health Examination inclusive of Dilation (when professionally indicated) 12 Months
Spectacle Lenses 12 Months
Frame 12 Months
Contact Lens Evaluation, Fitting & Fallow -Up Care 12 Months
Contact Lenses (in lieu or eyeglasses) 12 Months
C.O $ �5 a r G: F' C�a ty 3 •f rr x+. dxv� Zf Hca-` 041 S s.
7"`��1 T.="�. �T`:.k�>,v` -r ,2:. lt��" /.... ,-6--r-�zi,` r,'•,F >.r.:.,�rk"'''N._`y'£.�'°r, ~.
11
Eye Health Examination $15
Spectacle Lenses $15
Contact Lens Evaluation, Fitting & Follow -Up Care $15
Eyeglass l3enefft Frame'' Average f2e}a11 Valve= X_0% *Wd �
Non -Collection Frame Allowance (Retail): Up to $130
Davis Vision Frame Collection ` tin lieu of Allowance);
..
Fashion level
Up to $125
Designer level
Up to $175
Premier level
Up to $225
E`yegiass Behe#it:-spectecla Lenses
Average Reiail Value
All ranges of prescriptions and sizes
$60-$120
Choice of glass or plastic lenses
$30-$35
Oversize Lenses
$20
Tinting of plastic lenses
$20
Scratch -Resistant Coating
$25-$40
Polycarbonate Lenses''
$60-$75
Ultraviolet Coating
$25-$30
Standard Anti -Reflective (AR) Coating
$50-$70
Premium AR Coating
S65-$90
Ultra AR Coating
$100-5125
Standard Progressive Lenses
$150-$195
Premium Progressives (Vanlux', etc.)
$195-$300
Intermediate -Vision Lenses
$150-$175
Blended -Segment Lenses
$40-$50
High -Index Lenses
$90-$150
Polarized Lenses
$95-$110
Photochromic Glass Lenses
$30-$60
Plastic Photosensitive Lenses
$95-$150
Scratch Protection Plan: Single Vision Lenses Multifocal
Contact Lane Seneiif
Up to $130
Plus a 20% discount on any overage'
Included
Included
$25 copayment
Member Charges
..
Included
Included
Included
Included
Included
$0 or $30
$12
$35
$48
$60
$50
$90
$30
$20
$55
$75
$20
$65
S201$40
Non -Collection Contact Lenses: Materials Allowance Up to $105
Plus a 15% discount on any overage''
- Evaluation, Fitting & Follow -Up Care — Standard Lens Types 15% Discount
- Evaluation, Fitting & Follow -Up Care — Specialty Lens Types 15% Discount
Collection Contact Lensesn (in lieu of Allowance): Included
- Materials (up to 4 boxes), Evaluation, Fitting & Follow-up Care
Medically Necessary Contact Lenses (with prior approval) Included
- Materials, Evaluation, Fitting & Follow -Up Care
Eye Examination- �p to S40 Single Vision Lenses, up to $40 Trifocal Lenses: up to $80 Elective Contact Lenses up to $105
Frame. up to $45 Bifocal Lenses: up to S60 Lenticular Lenses. up to $80 Medically Necessary GL- up to $225
Orae -year eyeglass breakage; warranty included
July 27, 2010 Not I,i,. , "Ind utnur) F„r,r cri, .,,suu:,e, rehlio„si,ip Page 2
Member
Member + One
Member + Family
Monthly Ratiry
$ 5.82
$ 10.48
$ 1630
The proposed rates herein are guaranteed for four years and are based on the following assumptions:
Size of group: 2,040 members
Funding method: Voluntary (100% Member -Paid)
Effective date: January 1, 2011
of rw,; w;,ornn! or exrq(T',jI 4%
or C.Ity ,f 2,*S ",,410er.
July 27, 2010 Page 3
In-Network: The Choice is yours
Using the Davis Vision program couldn't be easier. Just select the network provider of your choice, identify
yourself as a Davis Vision member, make an appointment, and leave the rest up to us.
Eye Health Examination
Members receive a comprehensive eye health examination, including dilation, when professionally indicated.
After the copayment, the eye health examination is covered in full.
Frames
Davis Vision offers limitless choice:
• Retail Allowance: All frames are covered in full up to the plan-specified allowance, plus members receive a
20% discount off any overage that may apply."
• Davis Vision Frame Collection: In lieu of the frame allowance, members can select any frame from Davis
Vision's exclusive Collection! The Collection features three levels of frames: Fashion, Designer and Premier,
with retail values of $125 - $225. All of the Fashion and Designer frames are fully covered! Any Premier
level frame is only $25. By selecting a Collection frame, member eyewear is often completely covered. In
fact, approximately 7 out of 10 members take advantage of the tremendous savings by selecting a Davis
Vision Collection frame."
Spectacle Lenses
Standard lenses are covered in full and many extras are included at no cost to our members. Plus, Davis Vision
members can select many of the most popular lens options at greatly discounted prices, reflecting savings of up
to 40% - 60% off as compared to average retail pricing.
Contact Lenses
Members who select contact lenses in lieu of eyeglasses are offered the same great choice:
• Elective Contact Lens Allowance: applicable towards any contact lenses, plus members receive a 15%
discount off any overage that may apply." Members also receive a 15% discount off evaluation, fitting and
follow-up care.
• Davis Vision Contact Lens Collection: In lieu of the allowance, members may be fit with contact lenses
from our Collection, all of which are covered in full up to the plan-specified amount below and include
evaluation, fitting and follow-up care.
StandardlDaily Wear. One pair of lenses
Disposable: Four boxes/multi-packs
Planned Replacement: Two boxes/multi-packs
Out-of-Network
Members may visit any provider of their choice. If an out-of-network provider is selected, the member pays the
provider fees for services and materials at the point of service and then is reimbursed according to the plan
schedule outlined in the 'Proposed Benefits" table.
IwId mrnliSi ch,;(. _ai[r,' At %NAI!r;� .il In, incns. , vf� 15Fr5 :,:II ,2tr:i•:2 !!;,? f,, I allcr:,a: n: ES tr,r,ard Vidl:!-Of "'i 8c,9r^iay 1;,,,i 'j, rea. e disc,amfs ri:;l aPp1ca4±c.
Partir`Pni!^C, r:�t+all ; rr..;i:f�r•: Np r,.alty .lr, nc't d spial -ne c r7i!:•ai;r., qu± i,E ,c, Itradimlly en. Ivirid tem-:Gt2m a utr,•paf.;l,41 ,,;i ,.lt•nl iii, fuah goar.!ity ar(i quality)
• , W,m.:arn ad �,.. nm�r-�,i n f: rf! tntit +n ;; 'Idr.,nai mart her n,:-.:.rn r:.p; ,-rrvrr.cn
The Davis elision program goes over and above to
offer many value-added features at no extra oast!
One -Year Breakage Warranty
All eyeglasses come with a breakage warranty for repair or replacement of the frame and/or lenses for a period of
one year from the date of delivery. The one-year breakage warranty applies to all plan covered eyeglasses (i.e. all
spectacle lenses, Davis Vision Collection frames and national retailer frames, where our exclusive Frame
Collection is not displayed).
Scratch -Protection Plan
Standard scratch -resistant coating is available for plastic lenses free of charge. Members may also purchase an
optional scratch -protection plan which will replace scratched lenses with new lenses of the same material, style
and prescription, at no charge (for a period of one-year from the original date of dispensing).
Medically Necessary Contact Lenses Covered in Full Upon Prior Approval
When "medically necessary" contact lenses are prescribed and approved to correct a member's eyesight, Davis
Vision will cover the cost in full. Contact lenses may be determined as medically necessary in the treatment of the
following conditions: Keratoconus, Anisometropia, Corneal Disorders, Pathological Myopia, Aniseikonia, Post-
traumatic Disorders, Aphakia, Aniridia and Irregular Astigmatism. In general, medically necessary contact lenses
may be prescribed in lieu of eyeglasses, when it will result in significantly better visual acuity and/or improved
binocular function, including avoidance of diplopia or suppression.
Replacement Contact Lens Program
Davis Vision's proprietary Lens 1-2-3!4' mail order program offers the guaranteed lowest prices on contact lens
replacements. Members simply call 1 -800 -LENS 123 or visit www.lensl23.com with their current prescription.
Ancillary Product Discount
At most participating network offices, members will receive a 20% courtesy discount on items not covered by the
benefit, e.g., second pairs, sunglasses, etc. Disposable contact lenses are available at a 10% discount."
Laser Vision Correction Discounts
Davis Vision members are entitled to savings of up to 25% off the provider's usual and customary fees, or a 5%
discount on any advertised special through our network of physicians and refractive surgery centers (some
centers provide a flat fee equating to these discount levels).
Low Vision
With prior approval by Davis Vision, members who require low -vision services and optical devices are entitled to
the following coverages. Both in- and out -of -network services are eligible for:
• One comprehensive Low -Vision evaluation every five years, with a maximum charge of $300. This
examination, sometimes called a functional vision assessment, can determine distance and clarity of
vision, the size of readable print, the existence of blind spots or tunnel vision, depth perception, eye -hand
coordination, problems perceiving contrast and lighting requirements for optimum vision.
• Maximum Low -Vision Aid allowance of $600 with a lifetime maximum of $1,200 for items such as high
power spectacles, magnifiers and telescopes. These devices are utilized to maximize use of available
vision, reduce problems of glare or increase contrast perception, based on the individual's visual goals
and lifestyle needs
• Follow-up care: four visits in any five year period, with a maximum charge of $100 for each visit.