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HomeMy WebLinkAboutResolution - 2006-R0567 - Contract - Covenant Medical Group - On-Site Medical Services - 11/21/2006Resolution No. 2006-RO567 November 21, 2006 Item No. 5.21 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 and on behalf of the City of Lubbock, a Contract with Covenant Medical Group for on-site medical services for employees and dependants, which Contract is attached hereto and incorporated herein as part of this Resolution. Passed by the City Council this 21st day of November , 2006. DAVID MILLER., MAYOR ATTEST: Reb cca Garza, City Secretary APPROVED AS TO CONTENT: Manager APPROVED AS TO FORM: D. Mitchell Satterwhite, Assistant City Attorney gs/ccdocs/Cont Covenant Med Grp -Onsite Med Serv.res Nov 20, 2006. Resolution No. 2006-RO567 November 21, 2006 Item No. 5.21 Covenant Medical Group and Covenant Health System On -Site Medical Services Agreement for Employees and Dependants This Employer Agreement is made and entered into this lit day of January 2007, by and between the City of Lubbock ("Employer"), and Covenant Medical Group and Covenant Health System, a Texas corporation ("CMG/CHS"). Recitals: A. CMG/CHS contracts with employers to provide physicians or physician extenders (nurse practitioners or physician assistants) and/or medical assistants at the employer's place of business to perform certain medical services to the employees of such employers and/or their dependents. B. The Employer desires to contract with CMG/CHS and CMG/CHS desires to contract with the Employer for CMG/CHS to furnish a physician and nurse to provide certain onsite medical services to the employees of the Employer's health plan and/or their dependents on the terms and subject to the conditions contained herein. NOW, THEREFORE, for good and valuable consideration, the receipt and the sufficiency of which are hereby acknowledged, the Employer and CMG/CHS hereby agree as follows: ARTICLE I SCOPE OF SERVICES 1.01 Provision of Medical Professional. CMG/CHS shall furnish a physician(s) (hereafter referred as "Medical Professional"), and medical assistants to include a licensed vocational nurse and a patient representative (hereafter collectively referred to as "Medical Assistant") to provide the Medical Services (as defined herein) at a location selected and agreed to by CMG/CHS and provided by the Employer to the covered employees of the Employer's health plan and/or the dependents thereof. CMG/CHS is not committing to furnish a particular person as the Medical Professional/Medical Assistant and, at any time and from time to time, CMG/CHS may change the Medical Professional/Medical Assistant. Employer shall have the opportunity to interview all final physician candidates identified by CMG/CHS. Employer shall also have the right to have CMG/CHS remove a physician upon written notice, which notice shall specify the time by which the physician shall be removed. The Medical Services to be furnished by CMG/CHS are listed on Exhibit A. The Employer and CMG/CHS may, at any time and from time to time, amend or supplement Exhibit A by written agreement. 1.02 Standards of Medical Professional Performance. CMG/CHS shall ensure that the Medical Professional is obligated to perform or deliver the following, supported by a Medical Assistant under the Medical Professional's direction and control: (a) The Medical Professional shall determine his or her own means and methods of providing Medical Services in connection with this Agreement. (b) The Medical Professional shall comply with all applicable laws and regulations with respect to the licensing and the regulation of physicians, and shall ensure that the Medical Assistant does the same with respect to the licensing and regulation of nurses. (c) The Medical Professional and Medical Assistant shall provide the Medical Services in a manner consistent with all applicable laws and regulations and in a professional manner consistent with Medical Services provided in the community. (d) The Medical Professional shall maintain, during the term of this Agreement, Appropriate Credentials including: (1) A duly issued and active license to practice medicine and prescribe medication in the State of Texas, (2) A good standing with his or her profession and State of Texas professional association, (3) The absence of any license restriction, revocation, or suspension, (4) The absence of any involuntary restriction placed on his or her federal DEA registration, and (5) The absence of any conviction of a felony. (e) In the event that any Medical Professional (1) has his or her license to practice medicine or prescribe medication restricted, revoked or suspended, (2) has an involuntary restriction placed on his or her federal DEA registration, (3) is convicted of a felony, or (4) is no longer in good standing with his or her professional or State of Texas licensing authority, CMG/CHS shall promptly remove that Medical Professional and replace such Medical Professional with another Medical Professional that meets the requirements of Section 1.02 (d). CMG/CHS shall remove and promptly replace any Medical Assistant or other Health Professional (as defined in Section 1.08) who has his or her professional license restricted, revoked or suspended, is convicted of a felony, or is no longer in good standing with his or her professional or State of Texas licensing authority. -2- (f) CMG/CHS shall ensure that any Medical Assistant or other Health Professional complies with the requirements of this Section 1.02 with respect to performance, licensing, certification, and good standing, as applicable, except as otherwise provided in Section 1.06 with respect to medical doctor interns and residents. CMG/CHS shall require the Medical Professional, Medical Assistant or any other Health Professional to notify CMG/CHS immediately in the event she or he learns of the possibility that any of the events specified in Section 1.03(e) may occur and CMG/CHS shall immediately notify the Employer of such notification, so that the Employer can determine whether or not to exercise its right to remove the individual pursuant to Section 1.01. 1.03 Scheduling and Location of Services. CMG/CHS shall mutually agree on the location(s) and schedule for the provision of the Medical Services. 1.04 Facilities. The Employer shall provide the Medical Professional an examination room(s) which shall be reasonably satisfactory, in the judgment of the Medical Professional, for the provision of the Medical Services. In addition, the Employer shall provide to the Medical Professional a private office, which private office may be used by the Medical Professional to maintain a desk and a small refrigerator for the storage of laboratory specimens and prescription drugs; the private office shall be reasonably satisfactory to the Medical Professional, in the judgment of the Medical Professional, and the private office shall have a lock which permits the Medical Professional to limit access to the private office. 1.05 Equipment and Supplies. The Employer shall also provide the equipment and the supplies listed on Exhibit B. The Medical Professional shall notify the Employer of additional equipment and supplies reasonably required in connection with the provision of the Medical Services and the date by which such equipment and supplies are required and the Employer shall provide such equipment and supplies by that date. CMG/CHS shall provide the equipment and the supplies listed on Exhibit B. CMG/CHS shall also work with the Employer's Prescription Benefit Manager to supply generic and limited brand name prescriptions. The list of such prescriptions may be changed or updated by Employer. Employer shall notify CMG/CHS of such changes or updates. 1.06 Insurance. CMG/CHS shall ensure that the Medical Professional maintains, throughout the term of this Agreement, professional liability insurance covering the acts and omissions of the Medical Professional, in the minimum annual coverage amounts and of the type and kind required by the Employer in a type and form acceptable to the City. In the alternative, if CMG/CHS self -insures as defined under the Texas Insurance Code, CMG/CHS shall provide to the Employer all state filings indicating solvency of any self-insured plan and any other proof of solvency as may be -3- required by the Employer. CMG/CHS will require the Medical Professional to notify CMG/CHS immediately in the event he or she does not have the required coverage and will promptly remove and replace such Medical Professional with another qualified Medical Professional. CMG/CHS shall provide Employer proof of such professional liability insurance maintained by the Medical Professional. CMG/CHS will provide a Certificate of Insurance naming the City of Lubbock as certificate holder. The Certificate will provide that the insurance company will provide a minimum of ten days prior notice of cancellation, termination or modification of coverage. CMG/CHS's shall maintain general liability insurance that shall contain broad form contractual liability with a combined single limit of a minimum of $1,000,000 each occurrence and in the aggregate and shall include the following: • Bodily Injury and Property Damage • Broad Form Contractual Liability + Personal Injury and Advertising Injury + Fire legal liability • Products and completed operations Medical Professional and CMG/CHS shall elect to obtain workers' compensation coverage pursuant to Section 406.002 of the Texas Labor Code. Further, Medical Professional and CMG/CHS shall maintain said coverage throughout the term of this Agreement and shall comply with all provision of Title 5 of the Texas Labor Code to ensure that the Medical Professional and CMG/CHS maintains said coverage. Any termination of workers' compensation insurance coverage by Medical Professional and CMG/CHS or any cancellation or non -renewal of workers' compensation insurance coverage for the Medical. Professional and CMG/CHS shall be a material breach of this contract. Medical Professional and CMG/CHS may maintain Occupational Accident and Disability Insurance in lieu of Workers' Compensation. In either event, the policy must be endorsed to include a waiver of subrogation in favor of the City of Lubbock. Employer's Liability with limits of at least $500,000 each accident, $500,000 by disease policy limit, and $500,000 by disease each employee shall also be obtained and maintained throughout the term of this Lease. CMG/CHS's general liability insurance policy through policy endorsement must include wording, which states that the policy shall be primary and non-contributory with respect to any insurance carried by City of Lubbock. The certificate of insurance must reflect that the above wording is included in evidenced policies. All policies must be endorsed to include a waiver of subrogation in favor of the City of Lubbock. The Certificate will provide that the insurance company will provide a minimum of ten days prior notice of cancellation, termination or modification of coverage. 4- 1.07 Indemnity and Release. CMG/CHS SHALL INDEMNIFY AND HOLD HARMLESS, TO THE FULLEST EXTENT PERMITTED BY LAW, THE CITY, AND CITY'S RESPECTIVE OFFICERS, EMPLOYEES, ELECTED OFFICIALS AND/OR AGENTS FROM AND AGAINST ANY AND ALL LOSSES, DAMAGES, CLAIMS OR LIABILITIES, OF ANY FIND OR NATURE, WHICH ARISE DIRECTLY OR INDIRECTLY, OR ARE RELATED TO, IN ANY WAY, MANNER OR FORM, THE ACTIVITIES CONTEMPLATED HEREUNDER, CMG/CHS'S OCCUPATION OF THE LANDS OR OTHER CITY OWNED LANDS, OR THE OMISSION OF THE ACTIVITIES CONTEMPLATED HEREUNDER CMG/CHS FURTHER COVENANTS AND AGREES TO DEFEND ANY SUITS OR ADMINISTRATIVE PROCEEDINGS BROUGHT AGAINST THE CITY AND/OR THE CITY'S RESPECTIVE OFFICERS, EMPLOYEES, ELECTED OFFICIALS AND/OR AGENTS ON ACCOUNT OF ANY SUCH CLAIM, AND, WITHOUT LIMITING THE INDEMNITY PROVIDED HEREIN, TO PAY OR DISCHARGE THE FULL AMOUNT OR OBLIGATION OF ANY SUCH CLAIM INCURRED BY, ACCRUING TO, OR IMPOSED ON THE CITY, OR THE CITY'S RESPECTIVE OFFICERS, EMPLOYEES, ELECTED OFFICIALS AND/OR AGENTS, AS APPLICABLE, RESULTING FROM ANY SUCH SUITS, CLAIMS, AND/OR ADMIMSTRATIVE PROCEEDINGS OR ANY MATTERS RESULTING FROM THE SETTLEMENT OR RESOLUTION OF SAID SUITS, CLAIMS, AND/OR ADMINISTRATIVE PROCEEDINGS. -5- THE INDEMNITY AND RELEASE PROVIDED HEREIN SHALL SURVIVE THE TERMINATION OR VOIDANCE OF THIS AGREEMENT. 1.08 Responsibilities of Parties. The Employer and CMG/CHS are independent contractors. The CMG/CHS shall be solely responsible for the actions and /or omissions of Medical Professional, Medical Assistant, and other Health Professionals and the actions and/or the omissions of any agent or any employee used by CMG/CHS in connection with providing the Medical Services contemplated by this Agreement. Neither the Employer nor CMG/CHS shall have any control nor involvement in the independent exercise of medical judgment by the Medical Professional, and the Employer shall not incur any liability for the actions or the omissions of the Medical Professional and/or any agent or any employee used by CMG/CHS in connection with this Agreement. CMG/CHS agrees to indemnify and hold harmless Employer from and against any cost, damage, expense, loss, liability or obligation of any kind, including, without limitation, reasonable attorney's fees, which Employer may incur in connection with CMG/CHS's furnishing of Medical Professionals, Medical Assistants or other Health Professionals, or with the medical services provided by them, under this Agreement. 1.09 Other Licensed Health Professionals. The Employer agrees and acknowledges that CMG/CHS may from time to time have other Health Professionals assist the Medical Professional and/or replace the Medical Professional during his or her regularly scheduled time at the Employer's place of business in the event of an emergency at the hospital or at the Medical Professional's office (provided, however, that CMG/CHS will require the Medical Professional to ensure that the services provided by replacement individuals do not exceed the scope of their professional training and licensure). "Health Professional" shall mean a duly licensed nurse practitioner, medical doctor and licensed physician's assistant. Sections 1.02 and 1.07 shall apply in the same manner to the Health Professional as such section applies to the Medical Professional. CMG/CHS shall also ensure or require that all Health Professionals who provide services hereunder have insurance coverage consistent with the requirements of Section 1.06. From time to time CMG/CHS, upon consent of a covered employee of the Employer's health plan and/or spouse or dependent of the employee, may have medical doctors that are interns or residents associated with one of the medical schools in the State of Texas observe and assist the Medical Professional for educational and teaching purposes under the Medical Professional's direct supervision. 1.10 Billing. CMG/CHS shall ensure that the Medical Professional shall not solicit payment from covered employees of the Employer's health plan and/or their dependents, or Employer, or from the Employer Benefit Plan for the Medical Services provided by the Medical Professional. CMG/CHS may bill, on a zero balance due basis, the Employer Benefit Plan for the sole purpose of providing information regarding disease and case management information. -6- 1.11 Medical Records. CMG/CHS shall maintain medical records with respect to all of the patients. All medical records shall be maintained in a professional manner consistent with the accepted practice of the community. CMG/CHS shall also require the Medical Professional comply with the HIPAA privacy standards. All patient records maintained by CMG/CHS in connection with this Agreement shall be the sole property of CMG/CHS subject to the patients' right to access their medical records. The Employer understands and agrees that all of the medical records and other protected health information maintained by CMG/CHS will be held in strictest confidence, and that the Employer will not be entitled to have access to the medical records maintained by CMG/CHS, in the absence of an appropriate written authorization from the patient/employee.. CMG/CHS shall be required to have each patient/employee execute a duly authorized release allowing CMG/CHS to provide medical information to the Employer's Claim administrator. This is for the sole purpose of providing the Employer's Claim administrator information necessary for disease and case management. In the event of termination of this Agreement as outlined in Article 11I, CMG/CHS will provide to participating covered employees of the Employer's health plan and/or spouse or dependent of the employee, an appropriate written release form authorizing the participating covered employee of the Employer's health plan and/or spouse or dependent of the employee to transfer their medical records to the new on-site services provider. 1.12 Monthly Reports. CMG/CHS shall provide to the Employer, no later than the 5ch day of the month immediately following the end of each month of the calendar year, a written report with respect to the provision of the Medical Services during the immediately preceding month. The written report shall be in form reasonably satisfactory to each of the Employer and CMG/CHS and it is contemplated that the written report will report (a) the number of covered employees and dependents treated by the Medical Professional during such immediately preceding month, (b) the number of Health Risk Assessments conducted during such immediately preceding month, and (e) the number of covered employees for whom primary care services were provided. 1.13 Noncompliance by CMG/CHS. In the event that the Employer becomes aware of any failure by CMG/CHS to comply with the obligations which are contemplated by this Agreement, the Employer shall immediately provide written notice to CMG/CHS of such failure, which written notice shall describe the failure in reasonable detail, and CMG/CHS shall use its best efforts to address such failure. As provided in Section 1.41, Employer shall have the right to require the immediate removal of the Medical Professional by CMG/CHS. E►m ARTICLE II COMPENSATION 2.01 Monthly Fee. No later than the 151h day of each calendar month immediately following the receipt of the CMG/CHS invoice, the Employer shall pay to CMG/CHS the amount of $8,333.33 per month, for the months of January through November, and the amount of $8,333.34 for the Month of December for furnishing the Medical Services and supplies provided under this Agreement during the immediately preceding calendar month. 2.02 Additional Fees. No later than the 15th day of each calendar month immediately following the receipt of the CMG/CHS invoice, the Employer shall pay to CMG/CHS for additional services as outlined in Exhibit C. ARTICLE III TERM AND TERMINATION 3.01 Term. This Agreement shall be for a term of one year commencing on January 1, 2007, subject to earlier termination in accordance with this Agreement. Unless either the Employer or CMG/CHS gives written notice of non -renewal to the other party at least sixty (60) calendar days prior to the end of the initial term or of any renewal term, this Agreement shall be automatically renewed for an additional two - one year periods. 3.02 Termination With or Without Cause. This Agreement may be terminated by either the Employer or CMG/CHS, with or without cause, by providing the other party at least sixty (60) calendar days' prior written notice. 3,03 Effect of Expiration or Termination. The expiration or the termination of this Agreement shall not affect the obligation of the Employer to pay compensation to CMG/CHS or pay for any outstanding invoice for the period prior to such expiration or termination and shall not affect the obligation of CMG/CHS to provide monthly reports for the period prior to the effective date of such expiration or such termination. ARTICLE IV MISCELLANEOUS -8- 4.01 Notice. All notices and other communications permitted or required pursuant to this Agreement shall be in writing, addressed to the party at the address set forth at the end of this Agreement or to such other address as the party may designate from time to time in accordance with this Section 4.01. All notices and other communications shall be (a) mailed by certified or registered mail, return receipt requested, postage pre -paid, (b) personally delivered or (c) sent by facsimile with a receipt confirmation. Notices mailed pursuant to this Section 4.01 shall be deemed given as of three days after the date of mailing and notices personally delivered or sent by facsimile shall be deemed given at time of receipt. 4.02 Assignment. Except as provided in Section 4.07, neither the Employer nor CMG/CHS may assign or otherwise transfer this Agreement to a third party without the prior written consent of the other party, which may be given or withheld by the other party in its sole discretion. 4.03 Entire Agreement; Amendment. This Agreement constitutes the entire agreement between the Employer and CMG/CHS with respect to the subject matter hereof and supersedes all prior agreements. This Agreement shall not be amended or waived, in whole or in part, except in writing signed by both of the Employer and CMG/CHS. 4.04 GOVERNING LAW. THIS AGREEMENT IS TO BE CONSTRUED UNDER TEXAS LAW WITHOUT REGARD TO CONFLICT OF LAW RULES THAT WOULD DIRECT APPLICATION OF THE LAWS OF ANY OTHER JURISDICTION. THE OBLIGATIONS OF THE PARTIES CREATED BY THIS AGREEMENT ARE PERFORMABLE, AT LEAST IN PART, IN LUBBOCK COUNTY, TEXAS. VENUE FOR ANY ACTION BROUGHT PURSUANT TO THIS AGREEMENT, OR ACTIVITY CONTEMPLATED HEREBY, SHALL EXCLUSIVELY BE IN LUBBOCK COUNTY, TEXAS. 4.05 In the conduct of this Agreement, CMG/CHS may use only such advertising materials as are in compliance with the laws, rules and regulations of the jurisdictions in which used and which have been approved, in writing by the Employer, in advance of their use. No written or oral advertising, or marketing material, or letterhead, business card or other similar matter or material, which includes Employer's name or otherwise refers to Employer may be printed, published, distributed or used in any way without the prior written approval thereof by Employer. -9- 4.05 Access to Books and Records. Subject to applicable privacy laws related to patient health information, both of CMG/CHS and the Employer agree to provide access to their books and records, regarding this agreement, to the other party. 4.06 Successors. This Agreement is binding upon the parties, their successors and assigns. Thirty (30) days notice of any change in ownership, management, etc. shall be given the other party by the party experiencing the change. In such event, this Agreement shall be assumed upon a change of ownership, change of control, change in management, reorganization, etc. of, or at, Employer. 4.07 Compliance. CMG/CHS maintains a Corporate Responsibility Program. This program is intended to prevent compliance concerns such as fraud, abuse, false claims, excess private benefit and inappropriate referrals. Employer hereby agrees that any regulatory compliance concerns that Employer becomes aware of shall be promptly reported either to an appropriate CMG/CHS manager or through the hotline (877-808- 8133). CMG/CHS agrees that referrals of employees of the Employer's health plan and/or their dependents shall be made in accordance with any federal or state laws, and that CMG/CHS will maintain a copy of the Employer's approved network list at the on- site clinic for review by patients. This network list shall be used, in consulting with the patient, to determine the best possible referral. uOZ IN WITNESS WHEREOF, the Employer and CMG/CHS have executed and delivered this Agreement as of the date first above written. CITY OF LUBBOCK, TEXAS DAVID A. YILLER, MAYOR ATTEST: Q-t-Q�� 9--\, , Rebecca Garza, City Secretary APPROVED AS TO CONTENT: �-...I Leisa Hutcheson, Risk Manager APPROVED AS TO FORM: Don Vandiver, Assistant City Attorney COVENANT MEDICAL CROUP By: Name:u-�•o Title: 't -1e'-5 t&e' r { 4 ` COVEN I= 0'(�' c c& -r - HEALTH SYSTEM Name: �ut�er Title: Geb Resolution No. 2006-RO567 EXHIBIT A "SCOPE OF SERVICES" Medical Services include but are not limited to the following: • Chronic illness evaluation, treatment and management o Diabetes o High Cholesterol o Etc. • Acute Conditions o Sore throats/strep/ears/headache a Cough, Sinus o Strains/sprains/musculoskeletal problems o Acute urinary complaints • Physicals • Injections and immunizations • Minor surgical procedures, such as sutures for laceration treatment • Vaginal and Breast Exams * Digital Rectal Exams • ECG • Urine Pregnancy • Ordinary and routine care of the nature of a visit to family practice doctor's office Long Term Prevention Programs Included • Personal Wellness Profile Risk Assessment with comprehensive blood draw analysis (not included in base quote, see attached pricing sheet) • Aggregate data analysis from your employee population that allows us to develop just the right programs for the Pharmacy Benefit Manager + Out reach Program to touch the people with the highest health risks + Health Management programs targeted for the greatest impact (obesity, diabetes, high blood pressure, etc.) via web based education • Self Care Education Tools and Manual online and in print form Comprehensive Health Education Training • Coordination of medical information with Plan Administrator for case and disease management Program Enablers and Infrastructure Included • 24 hour on-call coverage • Telephonic appointment scheduling • Medical management and documentation _!2_ • Clinic Inventory Management (standard supplies) • Medical Professional recruiting • Medical Assistant recruiting • Medical Professional management • Medical Assistant management • Monthly Analysis, Trends, Reporting & Survey Results -13- Resolution No. 2006-RO567 EXHIBIT B MEDICAL SUPPLIES AND EQUIPMENT Items provided by CMG/CHS in accordance with the Agreement. Disinfectant Suture supplies Waste cans Glucose test supplies Waste can liners Strep testing supplies Gloves Mono testing supplies Diag Set 3.5V Halogen/disposable covers Disposable gowns Sundry jars Disposable drapes Urinalysis supplies Thermometer (freezer) Table paper 3" Elastic bandage Thermometer/disposable covers Cold pack 4 X 4's Emesis basins Tongue depressors Medications/Injectables (by physician order) Cotton balls Lab supplies (Tubes, requisitions, tourniquets) Alcohol Wall Posters, Charts Alcohol dispenser Needles Blood pressure cuffs Syringes Biohazard stickers Stethoscope "Allergic To" stickers Surgical tape Sharps containers Biohazard bags and Removal Service Trash removal, Clean-up, and General Maintenance Items provided by the Employer in accordance with the Agreement. Small refrigerator Exam stools Lockable cabinet Weight/height scales Gooseneck light Desk Waiting room furniture Chairs Facility Utilities Computer, Fast Internet Connection, "4 in 1" Printer/Fax/Copier/Scanner -14- Resolution No. 2006—RO567 EXHIBIT C ADDITI®NAL SERVICES Items provided by CMG/CHS in accordance with the Agreement to be paid by Employer. Basic Lab Tests — the drawing of the blood would be included in the basic additional services. The following is a list that may from time to time be changed with written agreement and associated costs: • Basic Metabolic Panel $11.00 ea • Comprehensive Metabolic Panel $ 9.11 ea • Lipid Panel $17.41 ea • Hepatic Function Panel $10.62 ea • Hemoglobin $12.61 ea • Iron $ 8.42 ea • Prostate Specific Antigent, Total $23.90 ca + Pap Smear (does not include Path prof fees) $13.73 ea • Surepath/thinprep $25.00 ea • Thyroid Stimulating Hormone $21.83 ea • Complete Blood Count $ 8.41 ea • Prothrombin Time $ 5.11 ea • Sedimentation Rate, Erythrocyte, Non -Automatic $ 4.61 ea • Rheumatoid Factor $ 7.37 ea • InfAgt, Immunoassay $15.59 ea • Bld Ct, HgPlatelet Automated Differential, WBC $10.00 ea + Thyroxine, Free $11.72 ea All other lab tests shall be billed to the Employer at the customary rate of the claims administrator. Diagnostic tests shall be billed to the Employer's health plan provider. Health Risk Assessments and associated wellness tests: • Performed through on-site clinic • Performed at specific locations/departments -15- $35.00 ca $45.00 ea