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City of Miami Vendor Responsibility Checklist Name of Firm: Corporate Synergies Group LLC d/b/a Foundation Risk Partners Public Entity Services Use the "Upload" button to attach PDF documentation for each section. To delete attachment(s), use the appropriate "Delete" button to the right and then use the "Clear" button for the corresponding attachment box to clear that field. CATEGORY City Vendor Registration Affirmation Select State of Florida Corporation (Sunbiz) YES D&B YES Pacer Select Bid/Proposal Bond N/A Upload Clear Upload Clear Upload Clear Upload Clear RESPONSE iSupplier Number: CSG Sunbiz.pdf foundation risk partners public entity services - Google Search.pdf Your DUNS Lookup - CSG.pdf Use the "Upload" button to attach PDF documentation for each section. To delete attachment(s), use the appropriate "Delete" button to the right and then use the "Clear" button for the corresponding attachment section to clear that field. PERFORMANCE/REFERENCE CHECKS ATTACHMENTS System of Award Managment (SAM) NO Convicted Vendor List NO NO N/A Debarred Contractors Suspended Contractors Suspended Vendors -State: NO Scrutinized Companies List: NO Google Search: YES Upload Clear Upload Clear Upload Clear Upload Clear mg Upload Clear Upload Clear Upload Clear nvicted Vendor List _ Vendor Registra...pdf barred Contractor List, May 2025.pdf Suspended Vendor List _ Vendor Registra...pdf 1025_09_30_web_u pdate_pfia_proh i bited_Iist. pdf CSG FRPPE Principals Google ai Search.pdf foundation risk partners public entity services - Google Search.pdf corporate synergies group Ilc - Google Search.pdf Updated: 9/30/2025 STATE BOARD OF ADMINISTRATION OF FLORIDA 1801 HERMITAGE BOULEVARD, SUITE 100 TALLAHASSEE, FLORIDA 32308 (850) 488-4406 POST OFFICE BOX 13300 32317-3300 Protecting Florida's Investments Act "Scrutinized Companies" Chapter 287.135, Florida Statutes RON DESANTIS GOVERNOR CHAIR BLAISE INGOGLIA CHIEF FINANCIAL OFFICER JAMES UTHMEIER ATTORNEY GENERAL CHRIS SPENCER EXECUTIVE DIRECTOR Chapter 287.135, Florida Statutes was created effective July 1, 2011, and prohibits a company on the Scrutinized Companies with Activities in Sudan List or on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List from bidding on, submitting a proposal for, or entering into or renewing a contract with an agency or local governmental entity for goods or services of $1 million or more. Pursuant to Chapter 215.473, Florida Statutes, the Florida State Board of Administration is charged with maintaining a complete list of scrutinized companies. Scrutinized companies are judged according to whether they meet the following criteria: Sudan: 1. Have a material business relationship with the government of Sudan or a government -created project involving oil related, mineral extraction, or power generation activities, or 2. Have a material business relationship involving the supply of military equipment, or 3. Impart minimal benefit to disadvantaged citizens that are typically located in the geographic periphery of Sudan, or 4. Have been complicit in the genocidal campaign in Darfur. Iran: 1. Have a material business relationship with the government of Iran or a government -created project involving oil related or mineral extraction activities, or 2. Have made material investments with the effect of significantly enhancing Iran`s petroleum sector. The SBA is not responsible for compliance with Chapter 287.135, Florida Statutes. The SBA's responsibilities are solely focused on the Protecting Florida's Investments Act and Chapter 215.473 as it relates to the identification of "Scrutinized Companies" that have prohibited business operations in Sudan or Iran. The table on the following pages provides the List of Prohibited Investments (Scrutinized Companies). This list is updated as part of the Protecting Florida's Investments Act (PFIA) and the Global Governance Mandates Quarterly Report, upon review and approval by the Trustees of the State Board of Administration. September 30, 2025 Page 2 Table 7: List of Prohibited Investments (Scrutinized Companies) (New companies are highlighted and in bold.) Prohibited Investments (Scrutinized Companies) Scrutinized Country Country of Incorporation Initial Appearance on Scrutinized List Full Divestment Aviation Industry Corporation of China (AVIC) Sudan China September 24, 2019 Yes AviChina Industry & Technology Sudan China June 4, 2019 Yes AVIC International Finance Ltd Sudan China September 24, 2019 Yes AVIC International Holdings Ltd (formerly listed as AVIC International) Sudan China June 4, 2019 Yes Bank of Kunlun Co Ltd Sudan & Iran China March 7, 2018 Yes Chennai Petroleum Corp Ltd Sudan India September 19, 2007 Yes China BlueChemical Ltd Iran China March 19, 2013 Yes China Energy Engineering Corporation Sudan China September 30, 2025 No China Gezhouba Group Company Ltd Sudan China September 30, 2025 No China National Petroleum Corporation (CNPC) Sudan & Iran China December 11, 2012 Yes China Oilfield Services Ltd Iran China June 16, 2011 Yes China Petrochemical Corporation (Sinopec Group) Sudan & Iran China December 3, 2019 Yes China Petroleum & Chemical Corp (CPCC) Sinopec Sudan & Iran China September 19, 2007 Yes China Petroleum Engineering Corp Sudan & Iran China March 7, 2018 Yes China Railway Group Limited Iran China September 24, 2024 Yes Cirrus Aircraft Ltd Sudan Cayman Islands September 24, 2024 Yes CNOOC Ltd Iran China June 16, 2011 Yes CNOOC Energy Technology & Services Ltd Iran China June 15, 2021 Yes CNOOC Finance Limited Iran China September 24, 2013 Yes CNOOC Finance (2003) Limited Iran China December 17, 2024 Yes CNOOC Finance (2011) Limited Iran China December 17, 2024 Yes CNOOC Finance (2012) Limited Iran China December 17, 2024 Yes CNOOC Finance (2013) Limited Iran China December 17, 2024 Yes CNOOC Finance (2014) ULC Iran China October 17, 2017 Yes CNOOC Finance (2015) Australia PTY Ltd Iran China December 17, 2024 Yes September 30, 2025 Page 3 Prohibited Investments (Scrutinized Companies) Scrutinized Country Country of Incorporation Initial Appearance on Scrutinized List Full Divestment CNOOC Finance (2015) USA LLC Iran China December 17, 2024 Yes CNPC Capital Company Limited Sudan & Iran China June 14, 2017 Yes CNPC Finance HK Ltd Sudan & Iran China March 26, 2024 Yes CNPC General Capital Ltd Sudan & Iran China June 26, 2012 Yes CNPC Global Capital Limited Sudan & Iran China December 15, 2020 Yes CNPC HK Overseas Capital Ltd Sudan & Iran China June 16, 2011 Yes COSL Finance (BVI) Limited Iran China September 24, 2013 Yes COSL Singapore Capital Ltd Iran Singapore December 4, 2018 Yes Daqing Huake Group Co Ltd Sudan China March 25, 2008 Yes Egypt Kuwait Holding Co. SAE Sudan Kuwait January 13, 2009 Yes Engineers India Limited Iran India September 24, 2024 Yes FACC AG Sudan Austria June 4, 2019 Yes Gazprom Iran Russia September 19, 2007 Yes Gazprom Neft Iran Russia September 16, 2008 Yes Gazprom Promgaz Iran Russia June 4, 2019 Yes GPN Capital SA Iran Luxembourg June 4, 2019 Yes Harbin Electric Co. Ltd. Sudan China September 19, 2007 Yes Hindustan Petroleum Corporation Ltd Sudan & Iran India June 13, 2018 Yes Indian Oil Corp Ltd (IOCL) Sudan & Iran India September 19, 2007 Yes IndOil Global BV Sudan & Iran India September 24, 2024 Yes Jiangxi Hongdu Aviation Sudan China September 19, 2007 Yes Kimanis Power Sdn Bhd Sudan Malaysia September 24, 2024 Yes KLCC Property Holdings Bhd Sudan Malaysia April 14, 2009 Yes Kunlun Energy Company Ltd. Sudan & Iran Hong Kong September 19, 2007 Yes Lanka IOC Ltd Sudan India September 19, 2007 Yes Managem SA Sudan Morocco November 9, 2010 Yes September 30, 2025 Page 4 Prohibited Investments (Scrutinized Companies) Scrutinized Country Country of Incorporation Initial Appearance on Scrutinized List Full Divestment Mangalore Refinery & Petrochemicals Ltd Sudan & Iran India September 19, 2007 Yes Malaysia Marine & Heavy Engineering Holdings Bhd Sudan Malaysia March 18, 2014 Yes MISC Bhd Sudan Malaysia September 19, 2007 Yes Moscow Integrated Power Co PJSC Iran Russia September 24, 2024 Yes Mosenergo Iran Russia September 16, 2008 Yes Norinco International Cooperation Ltd Iran China September 24, 2024 Yes Offshore Oil Engineering Co Iran China December 17, 2024 Yes OGK-2 PJSC Iran Russia September 24, 2024 Yes Oil India Ltd Sudan India September 18, 2012 Yes Oil & Natural Gas Corp (ONGC) Sudan & Iran India September 19, 2007 Yes ONGC Videsh Limited (OVL) Sudan & Iran India March 18, 2014 Yes Pengerang LNG Two Sdn Bhd Sudan Malaysia September 24, 2024 Yes Perseus Mining Ltd Sudan Australia August 23, 2022 Yes PetroChina Sudan & Iran China September 19, 2007 Yes Petroliam Nasional (Petronas) Sudan Malaysia September 19, 2007 Yes Petronas Capital Limited Sudan Malaysia September 19, 2007 Yes Petronas Chemicals Group Bhd Sudan Malaysia June 16, 2011 Yes Petronas Chemicals Derivatives Sdn Bhd Sudan Malaysia September 24, 2024 Yes Petronas Chemicals Glycols Sdn Bhd Sudan Malaysia September 24, 2024 Yes Petronas Chemicals Olefins Sdn Bhd Sudan Malaysia September 24, 2024 Yes Petronas Dagangan Bhd Sudan Malaysia September 19, 2007 Yes Petronas Gas Berhad Sudan Malaysia September 19, 2007 Yes Petronas Global Sukuk Sudan Malaysia August 2, 2016 Yes PowerChina Construction Group Ltd Iran China March 5, 2025 Yes PowerChina Hebei Engineering Corp Ltd Iran China March 5, 2025 Yes PowerChina Sepcol Electric Power Construction Iran China June 10, 2025 Yes September 30, 2025 Page 5 Prohibited Investments (Scrutinized Companies) Scrutinized Country Country of Incorporation Initial Appearance on Scrutinized List Full Divestment Power Construction Corporation of China Ltd Iran China September 24, 2024 Yes Putrajaya Management Sdn Bhd Sudan Malaysia March 18, 2014 Yes Sberbank Russia PJSC Iran Russia September 24, 2024 Prior to 9/23/2025, subject to U.S. freeze Sinopec Capital 2013 Ltd Sudan & Iran China September 24, 2013 Yes Sinopec Century Bright Capital Investment Ltd Sudan & Iran China December 3, 2019 Yes Sinopec Engineering Group Co Ltd Sudan & Iran China March 18, 2014 Yes Sinopec Group Overseas Development 2018 Ltd Sudan & Iran China December 15, 2020 Yes Sinopec Group Overseas Development 2017 Ltd Sudan & Iran China September 11, 2019 Yes Sinopec Group Overseas Development 2016 Ltd Sudan & Iran China August 2, 2016 Yes Sinopec Group Overseas Development 2015 Ltd Sudan & Iran China December 15, 2020 Yes Sinopec Group Overseas Development 2013 Ltd Sudan & Iran China March 18, 2014 Yes Sinopec Kantons Holdings Ltd Sudan & Iran Bermuda September 19, 2007 Yes Sinopec Oilfield Equipment Corporation Sudan & Iran China April 14, 2009 Yes Sinopec Oilfield Service Corp Sudan & Iran China March 25, 2008 Yes Sinopec Shanghai Petrochemical Sudan & Iran China September 19, 2007 Yes Societe Metallurgique D'imiter Sudan Morocco November 9, 2010 Yes Soar Wind Ltd Sudan China March 5, 2025 Yes Territorial Generating Company No 1 Iran Russia June 4, 2019 Yes # of Prohibited Investments 95 - - The following companies were removed from the PFIA Prohibited Investments List this quarter. Removed Company Country of Incorporation No companies removed this quarter. 10/3/25, 8:25 AM corporate synergies group Ilc - Google Search Al Mode All Images News Maps Short videos Videos More Tools Results for Delaware • Choose area • Corporate Synergies • https://www.corpsyn.com Employee Benefits Made Personal by Corporate Synergies Corporate Synergies is a national insurance and employee benefits brokerage & consultancy. About Us Meet Corporate Synergies ... A nationally trusted employee ... Contact Corporate Synergies is a national insurance and employee ... A Career in Benefits © 2025 Corporate Synergies Group, LLC. All Rights ... Benefits Administration Corporate Synergies is a national insurance and employee ... Key Benefits Experts Gary Cassidy and Corporate Synergies' internal creative ... 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Corporate Synergies Group is a national, independent Employee Benefits and Property and Casualty insurance broker and consulting firm People also search for Corporate synergies group Ilc phone number Corporate Synergies Foundation Risk Partners Corporate Synergies Glassdoor Corporate Synergies careers Corporate Synergies nyc Corporate Synergies revenue Corporate synergies linkedin Corporate synergy meaning 1 2 3 4 5 6 7 8 9 10 Next https://www.google.com/search?q=corporate+synergies+group+Ilc&sca_esv=1001961491 ba09a8&ei=ZsDfaJLeKoTIkPIP5J3juAg&gs_ssp=eJzj4tVP1... 3/4 10/3/25, 8:25 AM corporate synergies group Ilc - Google Search Delaware - Based on your past activity - Update location Help Send feedback Privacy Terms https://www.google.com/search?q=corporate+synergies+group+Ilc&sca_esv=1001961491 ba09a8&ei=ZsDfaJLeKoTIkPIP5J3juAg&gs_ssp=eJzj4tVP1... 4/4 10/3/25, 9:14 AM Detail by Entity Name DIVISION OF CORPORATIONS (f vj tyr : Jj. rtrr official Store of F/uritia websfty Department of State / Division of Corporations / Search Records / Search by Entity Name / Detail by Entity Name Foreign Limited Liability Company CORPORATE SYNERGIES GROUP, LLC Filing Information Document Number FEI/EIN Number Date Filed State Status Last Event Event Date Filed Event Effective Date Principal Address 780 W. Granada Boulevard Ormond Beach, FL 32174 Changed: 04/06/2024 Mailing Address 780 W. Granada Boulevard Ormond Beach, FL 32174 M10000005304 20-1622581 12/02/2010 DE ACTIVE LC STMNT OF RA/RO CHG 05/15/2024 NONE Changed: 03/17/2025 Registered Agent Name & Address REGISTERED AGENT SOLUTIONS, INC. 1200 SOUTH PINE ISLAND ROAD PLANTATION, FL 33324 Name Changed: 05/15/2024 Address Changed: 07/21/2025 Authorized Person(a) Detail Name & Address Title Manager, Co -CEO https://search.sunbiz.org/Inquiry/CorporationSearch/Search ResultDetail?inquirytype=EntityName&directionType=1 nitial&searchNameOrder=CORPOR... 1/3 10/3/25, 9:14 AM Bloom, Andrew 780 W. Granada Boulevard Ormond Beach, FL 32174 Title Manager, Co -CEO Lisa, Mike 780 W. Granada Boulevard Ormond Beach, FL 32174 Title Manager Ambrosia , Daniel 780 W. Granada Boulevard Ormond Beach, FL 32174 Title Manager Lydecker , Charles 780 W. Granada Boulevard Ormond Beach, FL 32174 Title Manager Schwartz , Joel 780 W. Granada Boulevard Ormond Beach, FL 32174 Annual Reports Report Year Filed Date 2023 03/02/2023 2024 04/06/2024 2025 03/17/2025 Document Images 03/17/2025 --ANNUAL REPORT 05/15/2024 -- CORLCRACHG 04/06/2024 -- ANNUAL REPORT 03/02/2023 --ANNUAL REPORT 04/04/2022 --ANNUAL REPORT 04/30/2021 --ANNUAL REPORT 04/28/2020 --ANNUAL REPORT 04/30/2019 --ANNUAL REPORT 04/30/2018 --ANNUAL REPORT 04/26/2017 --ANNUAL REPORT 04/11/2016 --ANNUAL REPORT 04/14/2015 --ANNUAL REPORT 03/11/2014 --ANNUAL REPORT 04/09/2013 --ANNUAL REPORT View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format Detail by Entity Name https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=1 nitial&searchNameOrder=CORPOR... 2/3 10/3/25, 9:14 AM 04/02/2012 --ANNUAL REPORT View image in PDF format 04/25/2011 --ANNUAL REPORT View image in PDF format 12/02/2010 -- Foreign Limited View image in PDF format Detail by Entity Name Florida Department of State, Division of Corporations https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=1 nitial&searchNameOrder=CORPOR... 3/3 Debarred Contractors List (Updated: May 2025) M IAM 1-DADE COUNTY # Debarred Entity and/or Individuals (abc order) Address Initiating Dept and Contact Person Cause of Debarment Effect of Debarment Length of Debarment Contractor's Certificate of Competency or License Number; or Qualifier, when applicable 1 Aaron Construction Group, Inc. 10820 NW 138 St. Bay C-1 Hialeah Gardens, FL 33018 Public Housing and Community Development Department (PHCD Director, (786) 469-4106) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period. 9/12/19 - 9/12/29 n/a 2 Diego Alejandro Estepa Vazquez (Individual, former officer of Aaron Construction Group, Inc.) 10820 NW 138 St. Bay C-1 Hialeah Gardens, FL 33018 Public Housing and Community Development Department (PHCD Director, (786) 469- 4106) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County Indefinitely. 9/12/19 - Indefinite n/a 3 Javier Estepa (Individual, former officer of Aaron Construction Group, Inc.) 10820 NW 138 St. Bay C-1 Hialeah Gardens, FL 33018 Public Housing and Community Development Department (PHCD Director, (786) 469- 4106) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County Indefinitely. 9/12/19 - Indefinite n/a 4 ABC Construction Inc 7280 NW 8th St, Miami, FL 33126 State Attorney's Office (State Attorney, 305-547-0100) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a five (5) year period 11/2/2022 - 11/2/2027 n/a 5 Jorge Gonzalez (individual, former owner/president of ABC Construction Inc) 7280 NW 8th St, Miami, FL 33126 State Attorney's Office (State Attorney, 305-547-0100) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a five (5) year period 11/2/2022 - 11/2/2027 n/a 6 Another Garage Gate, Inc. 3771 NW 51 ST UNIT A, Miami, FL 33142 State Attorney's Office (State Attorney, 305-547-0100) The debarment is a condition of an Order of Probation. As such, he should be ineligible for any new work from any County Department. Excluded from Contracting w/Miami-Dade County for a five (5) year period 08/30/2023 - 08/30/2028 n/a 7 Raudel Diaz (Individual, princiapl of Another Garage Gate, Inc.) 3771 NW 51 ST UNIT A, Miami, FL 33142 State Attorney's Office (State Attorney, 305-547-0100) The debarment is a condition of an Order of Probation. As such, he should be ineligible for any new work from any County Department. Excluded from Contracting w/Miami-Dade County for a five (5) year period 08/30/2023 - 08/30/2028 n/a 8 Association of Community Organizations for Reform Now (ACORN) 2609 Canal St, 4th floor New Orleans, LA 70119 U.S. Congress (Office of Management & Budget, 202- 395-3080) Section 163 of the Continuing Appropriations Resolution, 2010, Division B of Public Law #111-68 Excluded from Contracting w/ Miami -Dade County Indefinitely. 10/07/2009 - Indefinite n/a 9 Biscayne Housing Group, LLC 25 Se 2nd Ave, Miami, FL, 33131-1508 Public Housing and Community Development Department (PHCD Director, (786) 469-4106) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period 1/5/2021 - 1/5/2031 n/a 10 Michael Cox (individual, former partner of Biscayne Housing Group, LLC) 828 NW 9th Ave Miami, Fl 33136 Public Housing and Community Development Department (PHCD Director, (786) 469- 4106) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period 1/5/2021- 1/5/2031 n/a 11 BJK Construction Services, Inc 970 W McNab Rd # 210, Fort Lauderdale, FL 33309 Internal Services Department (ISD Director, 305-375-1135) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period. 7/8/2021- 7/8/2031 n/a This report is maintained by Strategic Procurement Department (SPD). Please note: this list is only updated when an entity or indMdual is added or removed. For any questions, please contact Michou Jean, at (305) 375-3161. 1 Debarred Contractors List (Updated: May 2025) M IAM 1-DADE COUNTY H 12 Debarred Entity and/or Individuals (abc order) Address Initiating Dept and Contact Person Cause of Debarment Effect of Debarment Length of Debarment Contractor's Certificate of Competency or License Number; or Qualifier, when applicable Michael Runyan (individual, owner of BJK Construction Services, Inc) 4411 Ne 30 Ave, Lighthouse Point, FL 33064 Internal Services Department (ISD Director, 305-375-1135) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period. 7/8/2021- 7/8/2031 n/a 13 Carlisle Development Group 2950 SW 27th AveSte 200 Miami, Fl 33133 Public Housing and Community Development Department (PHCD Director, (786) 469-4106) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period 1/5/2021- 1/5/2031 n/a 14 Lloyd Boggio (individual, former partner of Carlisle Development Group) 3316 Devon CT, Miami, FI 33133 Public Housing and Community Development Department (PHCD Director, (786) 469- 4106) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period 1/5/2021- 1/5/2031 n/a 15 Matthew Greer (individual, former partner of Carlisle Development Group) 240 Ari Way Miami Beach, FI 33141 Public Housing and Community Development Department (PHCD Director, (786) 469- 4106) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period 1/5/2021- 1/5/2031 n/a 16 Design Management and Builders Corporation 5514 NW 72ND AVE, Miami, Florida, 33166 Public Housing and Community Development Department (PHCD Director, (786) 469-4106) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period 9/22/2021-9/22/2031 n/a 17 Arturo P. Hevia (individual, owner of Design Management and Builders Corporation) 2411 SW 83 COURT Miami, FL 33155 Public Housing and Community Development Department (PHCD Director, (786) 469- 4106) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period 9/22/2021-9/22/2031 n/a 18 Ecological Paper Recycling, Inc. 2350 NW 149th Street Opa Locker, FL 33054 Internal Services Department (ISD Director, 305-375-1135) Violation of Section 10-38 Excluded from Contracting w/ Miami -Dade County Indefinitely. 11/18/2015 - Indefinite n/a 19 Jose Flores (indvidual, former officer of Ecological Paper Recycling, Inc.) 2350 NW 149th Street Opa Locka, FL 33054 Internal Services Department (ISD Director, 305-375-1135) Violation of Section 10-38 Excluded from Contracting w/ Miami -Dade County Indefinitely. 11/18/2015 - Indefinite n/a 20 Manuela Flores (individual, former officer of Ecological Paper Recycling, Inc.) 2350 NW 149th Street Opa Locka, FL 33054 Internal Services Department (ISD Director, 305-375-1135) Violation of Section 10-38 Excluded from Contracting w/ Miami -Dade County Indefinitely. 11/18/2015 - Indefinite n/a 21 William Hernandez (individual, former officer of Ecological Paper Recycling,Inc.) 2350 NW 149th Street Opa Locka, FL 33054 Internal Services Department (ISD Director, 305-375-1135) Violation of Section 10-38 Excluded from Contracting w/ Miami -Dade County Indefinitely. 11/18/2015 - Indefinite n/a 22 Global Electrical & Lighting Supplies, Inc. 13751 SW 143rd Ct SUITE 101, MIAMI, FL 33186 Internal Services Department (ISD Director, 30S-37S-113S) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period 1/18/2018 - 1/18/2028 n/a 23 Rolando Perez (individual, former officer of Global Electrical & Lighting Supplies, Inc.) 13752 SW 143rd CT, SUITE 101, MIAMI, FL 33186 Internal Services Department (ISD Director, 305-375-1135) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period 1/18/2018 - 1/18/2028 n/a This report is maintained by Strategic Procurement Department (SPD). Please note: this list is only updated when an entity or indMdual is added or removed. For any questions, please contact Michou Jean, at (305) 375-3161. 2 Debarred Contractors List (Updated: May 2025) M IAM 1-DADE COUNTY # Debarred Entity and/or Individuals (abc order) Address Initiating Dept and Contact Person Cause of Debarment Effect of Debarment Length of Debarment Contractor's Certificate of Competency or License Number; or Qualifier, when applicable 24 Vivian Perez (individual, former officer of Global Electrical & Lighing Supplies, Inc.) 13753 SW 143rd CT, SUITE 101, MIAMI, FL 33186 Internal Services Department (ISD Director, 305-375-1135) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period 1/18/2018 - 1/18/2028 n/a 25 Hialeah Transport, LLC 2965 E. llth Avenue Hialeah, FL 33013 Internal Services Department (ISD Director, 305-375-1135) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County Indefinitely. 12/21/2015 - Indefinite n/a 26 Amancio Alonso (individual, former officer of Hialeah Transport LLC) 2965 E. llth Avenue Hialeah, FL 33013 Internal Services Department (ISD Director, 305-375-1135) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County Indefinitely. 12/21/2015 - Indefinite n/a 27 Jose Barroso (indvidual, former officer of E&C Electrical Service, Inc.) 1625 NE 104th St Miami Shores, FL 33138 Internal Services Department (ISD Director, 305-375-1135) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period. 1/18/2018 - 1/18/2028 n/a 28 Roy J. Bustillo (individual, former officer of Municipal Lighting Systems Group, Inc.) 7035 SW 47th St A Miami, FL 33155 Internal Services Department (ISD Director, 305-375-1135) Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a ten (10) year period. 1/18/2018 - 1/18/2028 n/a 29 Jorge De La Noval (individual, owner and operator of The Ultimate Electrician) 13701 SW 88TH ST STE 222 MIAMI, FL 33186 Miami Dade County Office of Inspector General, 305-375- 1946 Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a five (5) year period 8/26/2021- 8/26/2026 n/a 30 Siltek Affordable Housing, LLC. 5800 SW 178th Ave, Southwest Ranches, FL 33331 Public Housing and Community Development Department (PHCD Director, (786) 469-4106) Violation of Section 10-39 Excluded from Contracting w/Miami-Dade County for a ten (10) year period 6/20/2024 - 6/19/2034 n/a 31 Rene Antonio Sierra (individual, former officer of Siltek Affordable Housing LLC.) 481 Ranch Road Weston, Florida 33325 Public Housing and Community Development Department (PHCD Director, (786) 469- 41061 Violation of Section 10-38 Excluded from Contracting w/Miami-Dade County for a nine (9) year period 11/30/2019 - 11/29/2028 n/a This report is maintained by Strategic Procurement Department (SPD). Please note: this list is only updated when an entity or indMdual is added or removed. For any questions, please contact Michou Jean, at (305) 375-3161. 3 10/3/25, 8:27 AM foundation risk partners public entity services - Google Search -F d - - k paw riarz Pt. bli x o, � Al Mode All News Images Short videos Forums Videos More Tools Foundation Risk Partners i40 https://foundationrp.com Foundation Risk Partners Foundation Risk Partners is one of the fastest growing insurance brokerage and consulting firms in the United States comprised of a network of highly respected ... Missing: ptiblie I Show results with: public Specialized Industry Expertise From large engineering firms to local accountants, each ... Regional Locations We are a full -service, regional agency providing our insurance ... Board of Directors Our mission at Foundation Risk Partners (FRP) is to continue ... Consult With a Broker Our mission at Foundation Risk Partners (FRP) is to continue ... 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Director of Public Entity Services at Foundation Risk Partners • Experience: Foundation Risk Partners • Education: The Ohio State University • Location:... Spectrum Enterprise https://enterprise.spectrum.com > insights > case -studies Foundation Risk Partners tackles massive expansion ... Foundation Risk Partners acquired 174 agencies in six years, using fiber circuits, Managed Network Edge, and Unified Communications with RingCentral for ... ErbFairview Insurance https://fairviewinsurance.com Fairview Insurance I Since 1970 Working on behalf of individuals, companies and public entities, we provide customized insurance plans, employee benefits, and financial planning services. Our ... ®Sica Fletcher https://www.sicafletcher.com > fairview Fairview Insurance Agency Associates Merger Fairview's decision to partner with Foundation Risk Partners (FRP) enables the firm to reposition the business with a growth partner and accelerate expansion. 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[ 320.17 KB ] Visual Image Design Firm, LLC ARA; Narrnnccpp DOH 06/25/15 Notice of Default - Visual Imanp f)pcinn Updated 12/10/19 Document reader download links: Adobe PDF Reader Agency Organization Copyright ©2025 Department of Management Services - State of Florida 5/27/25, 5:00 PM Your DUNS Lookup Request for Corporate Synergies Group, LLC - Johnson, Charles - Outlook Outlook Your DUNS Lookup Request for Corporate Synergies Group, LLC From Dun & Bradstreet <t.email@dnb.com> Date Tue 5/27/2025 4:20 PM To Johnson, Charles <CJohnson@miamigov.com> CAUTION: This is an email from an external source. Do not click links or open attachments unless you recognize the sender and know the content is safe. 05/27/25 Charles Johnson, The following is the Dun & Bradstreet D-U-N-S® Number for Corporate Synergies Group, LLC D-U-N-S number: 078877502 If this is YOUR COMPANY, learn how to monitor and potentially impact your Dun & Bradstreet business credit file with D&B Credit Insights. Call 1-800-700-2733, Monday through Friday, 8:00 AM to 6:00 PM local time or contact us at Dun & Bradstreet support. Having trouble seeing this email? View in browser Please add e.email@dnb.com to ensure delivery of our emails to your inbox. This is a notification regarding your service with Dun & Bradstreet. Privacy and Terms of Service Notice: Your privacy is important to us; please see our Privacy Policy and Terms of Use. To unsubscribe from future emails click here or to update your email preferences, please click here. © 2025 Dun & Bradstreet, Inc. All rights reserved. 15335 Gate Pkwy, Jacksonville, FL 32256, USA about:blank?windowld=SecondaryReadingPanel 1/1 City of Miami, Florida RFP 1896386 ?ROFESSIONAL SERVICES AGREEMENT By and Between The City of Miami. Florida ADA CONSULTANT This Professional Services Agreement ("Agreement") is entered into this day of , 2025 by and between the City of Miami, a municipal corporation of the State of Florida, whose address is 444 S.W. 2ndAvenue, 10th Floor, Miami, Florida 33130 ("City"), and, Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services, a foreign limited liability company, qualified to do business in the State of Florida whose principal address is 780 W. Granada Boulevard, Ormond Beach, FL 32174, hereinafter referred to as the ("Consultant"). RECITALS: WHEREAS, the City of Miami issued Request for Proposals No. 1896386, on August 16, 2024 (the "RFP" attached hereto, incorporated hereby, and made a part of as Exhibit A) for the provision of leasing, property management, and construction management services ("Services" as more fully set forth in the scope of work "Scope" attached hereto as Exhibit B) for the City of Miami's Department of Risk Management ("Risk"), and Consultant's Response and Price Proposal ("Price Proposal", attached hereto, incorporated hereby, and made part of hereof as Exhibit C), in response thereto, has been selected as the most qualified proposal for the provision of the Services. WHEREAS, the Evaluation Committee appointed by the City Manager determined that the Proposal submitted by the Consultant was responsive to the RFP requirements, and recommended that the City Manager negotiate with the Consultant; and WHEREAS, the City wishes to engage the Services of Consultant, and Consultant wishes 1 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 to perform the Services for the City; and WHEREAS, the City and the Consultant desire to enter into this Agreement under the terms and conditions set forth herein; NOW THEREFORE, in consideration of the mutual covenants and promises herein contained, Consultant and the City agree as follows: TERMS 1. RECITALS AND INCORPORATIONS: DEFINITIONS: The recitals are true and correct and are hereby incorporated into and made a part of this Agreement. The City's RFP is hereby incorporated into and made a part of this Agreement and attached hereto as Exhibit "A". The Services and Scope of Work are hereby incorporated into and made a part of this Agreement and attached as Exhibit "B". The Consultant's Response and Price Schedule, dated September 16, 2024 in response to RFP 1896386, is hereby incorporated into and made a part of this Agreement as attached Exhibit "C". The Consultant's Insurance Certificate is hereby incorporated into and made a part of this Agreement as attached Exhibit "D". The Consultant's Company Resolution is hereby incorporated into and made a part of this Agreement as Exhibit "E". The Consultants Anti Human -Trafficking Affidavit is hereby incorporated and made a part of this Agreement as attached Exhibit "F". The order of precedence whenever there is conflicting or inconsistent language between documents is as follows in descending order of priority: (1) Professional Services Agreement ("PSA") (2) Addenda/Addendum to the RFP, if any; (3) RFP; and (4) Consultant's Response and Price Schedule, dated September 16, 2024 acknowledging Services and Scope of Work and pricing component of services and, response to the Request for Proposals. 2. TERM: The Agreement shall become effective on the date on the first page and shall be for an 2 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 initial term of three (3) years with an option to renew for two (2) additional one (1) year periods. The City, acting by and through its City Manager, shall have the option to extend or terminate the Agreement for convenience, that is, for any or no cause. 3. SCOPE OF SERVICES: A. Consultant agrees to provide the Services as specifically described, and under the special terms and conditions set forth in Exhibits "A" and "B" hereto, which by this reference is incorporated into and made a part of this Agreement. B. Consultant represents to the City that: (i) it possesses all qualifications, licenses, certificates, authorizations, and expertise required for the performance of the Services, including but not limited to full qualification to do business in Florida, and meet all requirements of section 468.385, et seq., Florida Statutes; (ii) it is not delinquent in the payment of any sums due the City, including payment of permits, fees, occupational licenses, etc., nor in the performance of any obligations or payment of any monies to the City; (iii) all personnel assigned to perform the Services are and shall be, at all times during the term hereof, fully qualified and trained to perform the tasks assigned to each and possess the licenses , registrations, and certifications required by law to perform such tasks ; (iv) the Services will be performed in the manner described in Exhibit "B"; and (v) each person executing this Agreement on behalf of Consultant has been duly authorized to so execute the same and fully bind Consultant as a party to this Agreement. C. Consultant shall always provide fully qualified, competent, and physically capable employees to perform the Services under this Agreement. Consultant shall possess and maintain any required licenses, permits and certifications to perform the Services under this Agreement. City may require Consultant to remove any employee the City deems careless, incompetent, insubordinate, intoxicated on the job, or otherwise objectionable and whose continued services under this Agreement is not in the best interest of the City 3 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 4. COMPENSATION: A. Consultant, as its sole compensation for the Services provided, shall receive compensation as indicated in Exhibit "C", which by this reference is incorporated into and made a part of this Agreement. B. Prices shall remain firm and fixed for the term of the Contract, including any renewal or extension periods. Consultant represents, warrants and guarantees to the City that Consultant shall completely, timely and properly perform the Work and all of its obligations under the Agreement, in accordance therewith, for the Contract Price agreed upon by the parties. This Contract Price shall constitute Guaranteed Maximum Cost to the Owner for performing the Work inclusive of labor, materials, equipment, supplies, and any allowable overhead and profit. The City shall (absent a prior Amendment with a justifiable compelling cause approved as an Amendment to this Agreement) have no liability or obligation to pay any amount in excess of the stated Contract Price and Consultant shall have no recourse in that respect except to seek an Amendment to the Agreement. All costs in excess of the Contract Price shall be paid solely by Consultant without reimbursement or additional compensation from the City. 5. OWNERSHIP OF DOCUMENTS: Consultant understands and agrees that any information, document, report, data or other digital record, or any other material whatsoever which is given by the City to Consultant, its employees, or any subconsultant, or which is otherwise obtained or prepared by Consultant solely and exclusively for the City pursuant to or under the terms of this Agreement, is and shall always remain the property of the City. Consultant agrees not to use any such information, document, report, data, or material for any other purpose whatsoever without the written consent of the City Manager, which may be withheld or conditioned by the City Manager in his/her sole discretion. Consultant is permitted to make and to maintain duplicate copies of the files, records, documents, 4 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 etc. if Consultant determines copies of such records are necessary after the termination of this Agreement; however, in no way shall the confidentiality as permitted by applicable laws be breached. The City shall maintain and retain ownership of any and all documents which result upon the completion of the work and Services under this Agreement as per the terms of this Section 5. 6. AUDIT AND INSPECTION RIGHTS AND RECORDS RETENTION: A. Consultant agrees to provide access to the City or to any of its duly authorized representatives, to any books, documents, papers, and records of Consultant which are directly pertinent to this Agreement, for the purpose of audit, examination, excerpts, and transcripts. The City may, at reasonable times, and for a period of up to three (3) years following the date of final payment by the City to Consultant under this Agreement, audit and inspect, or cause to be audited and inspected, those books, documents, papers, and records of Consultant which are related to Consultant's performance under this Agreement. Consultant agrees to maintain all such books, documents, papers, and records at its principal place of business in Miami -Dade County, or its local office in Miami -Dade County or to otherwise make them available in Miami -Dade County for a period of three (3) years after final payment is made under this Agreement and all other pending matters are closed. Consultant's failure to adhere to, or refusal to comply with, this condition shall result in the immediate cancellation of this Agreement by the City. B. The City may, at reasonable times during the term hereof, inspect the Consultant's facilities and perform such tests, as the City deems reasonably necessary, to determine whether the goods or services required to be provided by Consultant under this Agreement conform to the terms hereof. Consultant shall make available to the City all reasonable facilities and assistance to facilitate the performance of tests or inspections by City representatives. All audits, tests and inspections shall be subject to, and made in accordance with, the provisions of Sections 18-100, 18-101, and 18-102 of the Code of the City of Miami, Florida ("City Code"), which Sections apply to this Agreement, as same may be amended or supplemented, from time to time. 5 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 7. AWARD OF AGREEMENT: Consultant represents and warrants to the City that it has not employed or retained any person or company employed by the City to solicit or secure this Agreement and that it has not offered to pay, paid, or agreed to pay any person any fee, commission, percentage, brokerage fee, or gift of any kind contingent upon or in connection with, the award of this Agreement. 8. PUBLIC RECORDS; A. Consultant understands that the public shall have access, at all reasonable times, to all documents and information pertaining to City Agreements, subject to the provisions of Chapter 119, Florida Statutes, and agrees to allow access by the City and the public to all documents subject to disclosure under applicable laws. Consultant's failure or refusal to comply with the provisions of this section shall result in the immediate cancellation of this Agreement by the City. B. Consultant shall additionally comply with Section 119.0701, Florida Statutes, including without limitation: (1) keep and maintain public records that ordinarily and necessarily would be required by the City to perform this service; (2) upon request from the City's custodian of public records, provide the City with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in Chapter 119, Florida Statutes, or as otherwise provided by law; (3) ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the Agreement if the Consultant does not transfer the records to the City; (4) upon completion of the Agreement, transfer, at no cost, to the City all public records in possession of the Consultant or keep and maintain public records required by the City to perform the service, if the Consultant transfers all public records to the City upon completion of the Agreement, the 6 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 Consultant shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements, if the Consultant keeps and maintains public records upon completion of the Agreement, the Consultant shall meet all applicable requirements for retaining public records, all records stored electronically must be provided to the City, upon request from the City's custodian of public records, in a format that is compatible with the information technology systems of the City. Notwithstanding the foregoing, Consultant shall be permitted to retain any public records that make up part of its work product solely as required for archival purposes, as required by law, or to evidence compliance with the terms of the Agreement. C. Should Consultant determine to dispute any public access provision required by Florida Statutes, then Consultant shall do so at its own expense and at no cost to the City. IF THE CONSULTANT HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONSULTANT'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THE CONTRACT, CONTACT THE DIVISION OF PUBLIC RECORDS AT (305) 416-1830, VIA EMAIL AT pUBLICRECORDS( MIAMIGOV.COM, OR REGULAR MAIL AT CITY OF MIAMI OFFICE OF THE CITY ATTORNEY, 444 SW 2ND AVENUE, 9T" FLOOR, MIAMI, FL 33130. THE CONSULTANT MAY ALSO CONTACT THE RECORDS CUSTODIAN AT THE CITY OF MIAMI DEPARTMENT WHO IS ADMINISTERING THIS CONTRACT. 9. COMPLIANCE WITH FEDERAL. STATE AND LOCAL LAWS; Consultant understands that agreements with local governments are subject to certain laws and regulations, including laws pertaining to public records, conflict of interest, record keeping, etc. City and Consultant agree to comply with and observe all such applicable federal, state and local laws, rules, regulations, codes, and ordinances, as they may be amended from time to time. 7 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 Consultant further agrees to include in all of Consultant's agreements with subconsultants for any Services related to this Agreement this provision requiring subconsultants to comply with and observe all applicable federal, state, and local laws rules, regulations, codes, and ordinances, as they may be amended from time to time. Local laws in accordance with this Section shall mean the applicable laws of the City of Miami, and Miami -Dade County. 10. INDEMNIFICATION: Consultant shall indemnify, hold and save harmless, and defend (at its own cost and expense), the City, its officers, agents, directors, and/or employees, from all liabilities, damages, losses, judgements, and costs, including, but not limited to, reasonable attorney's fees, to the extent caused by the negligence, recklessness, negligent act or omission, or intentional wrongful misconduct of Consultant and persons employed or utilized by Consultant in the performance of this Contract. Consultant shall further, hold the City, its officials and employees, indemnify, save and hold harmless for, and defend (at its own cost), the City its officials and/or employees against any civil actions, statutory or similar claims, injuries or damages arising or resulting from the permitted Work, even if it is alleged that the City, its officials, and/or employees were negligent. In the event that any action or proceeding is brought against the City by reason of any such claim or demand, the Consultant shall, upon written notice from the City, resist and defend such action or proceeding by counsel satisfactory to the City. The Consultant expressly understands and agrees that any insurance protection required by this Contract or otherwise provided by the Consultant shall in no way limit the responsibility to indemnify, keep and save harmless and defend the City or its officers, employees, agents and instrumentalities as herein provided. The indemnification provided above shall obligate the Consultant to defend, at its own expense, to and through trial, administrative, appellate, supplemental or bankruptcy proceeding, or to provide for such defense, at the City's option, any and all claims of liability and all suits and actions of every name and description which may be brought against the City, whether performed 8 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 by the Consultant, or persons employed or utilized by Consultant. These duties will survive the cancellation or expiration of the Contract. This Section will be interpreted under the laws of the State of Florida, including without limitation and interpretation, which conforms to the limitations of Sections 725.06 and/or 725.08, Florida Statutes, as applicable and as amended. Consultant shall require all sub -consultant agreements to include a provision that each sub -consultant will indemnify the City in substantially the same language as this Section. The Consultant agrees and recognizes that the City shall not be held liable or responsible for any claims which may result from any actions or omissions of the Consultant in which the City participated either through review or concurrence of the Consultant's actions. In reviewing, approving or rejecting any submissions by the Consultant or other acts of the Consultant, the City, in no way, assumes or shares any responsibility or liability of the Consultant or sub -consultant under this Contract. Ten dollars ($10) of the payments made by the City constitute separate, distinct, and independent consideration for the granting of this Indemnification, the receipt and sufficiency of which is voluntarily and knowingly acknowledged by the Consultant. 11. DEFAULT: If Consultant fails to comply with any term or condition of this Agreement, or fails to perform in any material way any of its obligations hereunder, and fails to cure such failure after reasonable notice from the City, then Consultant shall be in default. Consultant understands and agrees that termination of this Agreement under this section shall not release Consultant from any obligation(s) accruing prior to the effective date of termination. Should Consultant be unable or unwilling to commence to perform the Services within the time provided or contemplated herein, then, in addition to the foregoing, Consultant shall be liable to the City for all expenses incurred by the City in preparation and negotiation of this Agreement, as well as all costs and expenses 9 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 incurred by the City in the re -procurement of the Services, including consequential and incidental damages. Upon the occurrence of a default hereunder the City, in addition to all remedies available to it by law, may immediately, upon written notice to Consultant, terminate this Agreement whereupon all payments, advances, or other compensation paid by the City to Consultant while Consultant was in default shall be immediately returned to the City. If the City fails to comply with any term or condition of this Agreement, or fails to perform in any material way any of its obligations hereunder, and fails to cure such failure after reasonable notice from Consultant, the City shall be in default, which shall be treated as a termination pursuant to Section 13. 12. RESOLUTION OF AGREEMENT DISPUTES: Consultant understands and agrees that all disputes between Consultant and the City based upon an alleged violation of the terms of this Agreement by the City shall be submitted to the City Manager for his/her resolution, prior to Consultant being entitled to seek judicial relief in connection therewith. In the event that the amount of compensation hereunder exceeds Twenty - Five Thousand Dollars and No/Cents ($25,000), the City Manager's decision shall be approved or disapproved, as applicable, by the City Commission, whose decision shall be final. Consultant shall not be entitled to seek judicial relief, recourse, remedy or to file a civil action unless: (i) it has first received City Manager's written decision, approved or disapproved, as applicable, by the City Commission if the amount of compensation hereunder exceeds Twenty -Five Thousand Dollars and No/Cents ($25,000), or (ii) a period of sixty (60) days has expired, after submitting to the City Manager a detailed statement of the dispute, accompanied by all supporting documentation one hundred twenty (120) days if City Manager's decision is subject to City Commission approval); or (iii) City has waived compliance with the procedure set forth in this section by a written instrument clearly waiving compliance , signed by the City Manager. In no event may the amount of compensation under this Section exceed the total compensation set forth in Section 4 (A) of this 10 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 Agreement. The adherence to this Section is the condition precedent to the institution of any civil action by the Consultant against the City. 13. TERMINATION: OBLIGATIONS UPON TERMINATION: A. The City, acting by and through its City Manager, shall have the right to terminate this Agreement, in its sole discretion, and without penalty, at any time, by giving written notice to Consultant at least thirty (30) calendar days prior to the effective date of such termination. In such event, the City shall pay to Consultant compensation for Services rendered and approved expenses incurred prior to the effective date of termination. In no event shall the City be liable to Consultant for any additional compensation and expenses incurred, other than that provided herein, and in no event shall the City be liable for any consequential or incidental damages. The Consultant shall have no recourse or remedy against the City for a termination under this subsection except for payment of fees due prior to the effective date of termination. B. The City, by and acting through its City Manager, shall have the right to terminate this Agreement, in its sole discretion, and without penalty, upon the occurrence of an event of a material breach hereunder, and failure to cure the same within thirty (30) days after written notice of default. In such event, the City shall not be obligated to pay any amounts to Consultant for Services rendered by Consultant after the date of termination, but the parties shall remain responsible for any payments that have become due and owing as of the effective date of termination. In no event shall the City be liable to Consultant for any additional compensation and expenses incurred, other than that provided herein, and in no event shall the City be liable for any direct, indirect, special, consequential, or incidental damages. 14. INSURANCE: A. Consultant shall, always during the term hereof, maintain such insurance coverage(s) as may be required by the City. The insurance coverage(s) required as of the 11 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 Effective Date of this Agreement are attached hereto as Exhibit "D" and incorporated herein by this reference. The City RFP number and title of the RFP must appear on each certificate of insurance. The Consultant shall add the City of Miami as an additional insured to its commercial general liability, and auto liability policies, and as a named certificate holder on all policies. Consultant shall correct any insurance certificates as requested by the City's Risk Management Administrator. All such insurance, including renewals, shall be subject to the approval of the City for adequacy of protection and evidence of such coverage(s) and shall be furnished to the City Risk Management Administrator on Certificates of Insurance indicating such insurance to be in force and effect and any cancelled or non -renewed policy will be replaced with no coverage gap and a current Certificate of Insurance will be provided. Completed Certificates of Insurance shall be filed with the City prior to the performance of Services hereunder, provided, however, that Consultant shall at any time upon request file duplicate copies of the Certificate of Insurance with the City. B. If, in the judgment of the City, prevailing conditions warrant the provision by Consultant of additional liability insurance coverage or coverage which is different in kind, the City reserves the right to require the provision by Consultant of an amount of coverage different from the amounts or kind previously required and shall afford written notice of such change in requirements thirty (30) days prior to the date on which the requirements shall take effect. Should the Consultant fail or refuse to satisfy the requirement of changed coverage within thirty (30) days following the City's written notice, this Agreement shall be considered terminated on the date that the required change in policy coverage would otherwise take effect. C. Consultant understands and agrees that all liabilities regarding the use of any of Consultant's employees or any of Consultant's subconsultants for Services related to this Agreement shall be borne solely by Consultant throughout the term of this Agreement and that this provision shall survive the termination of this Agreement. Consultant further understands and agrees that insurance for each employee of Consultant and each subconsultant providing Services 12 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 related to this Agreement shall be maintained in good standing and approved by the City Risk Management Director throughout the duration of this Agreement. D. Consultant shall be responsible for assuring that the insurance certificates required under this Agreement remain in full force and effect for the duration of this Agreement, including any extensions hereof. If insurance certificates are scheduled to expire during the term of this Agreement and any extension hereof, Consultant shall be responsible for submitting new or renewed insurance certificates to the City's Risk Management Administrator as soon as coverages are bound with the insurers. In the event that expired certificates are not replaced, with new or renewed certificates which cover the term of this Agreement and any extension thereof: (i) the City shall suspend this Agreement until the new or renewed certificate(s) are received in acceptable form by the City's Risk Management Administrator; or (ii) the City may, at its sole discretion, terminate the Agreement for cause and seek re -procurement damages from Consultant in conjunction with the violation of the terms and conditions of this Agreement. E. Compliance with the foregoing requirements shall not relieve Consultant of its liabilities and obligations under this Agreement. 15. NONDISCRIMINATION: Consultant represents to the City that Consultant does not and will not engage in discriminatory practices and that there shall be no discrimination in connection with Consultant's performance under this Agreement on account of race, color, sex, religion, age, handicap, marital status, or national origin. Consultant further covenants that no otherwise qualified individual shall, solely due to his/her race, color, sex, religion, age, handicap, marital status, or national origin, be excluded from participation in, be denied services, or be subject to discrimination under any provision of this Agreement. 13 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 16. ASSIGNMENT; The Consultant's services are considered specialized and unique. This Agreement shall not be assigned, sold, transferred, pledged, or otherwise conveyed by Consultant, in whole or in part, and Consultant shall not assign or otherwise subcontract any part of its operations performing these services under this Agreement, without the prior written consent of the City Manager, which may be withheld or conditioned, in the City Manager's sole discretion. 17. NOTICES: All notices or other communications required under this Agreement shall be in writing and shall be given by hand -delivery or by registered or certified U.S. Mail, return receipt requested, addressed to the other party at the address indicated herein or to such other address as a party may designate by notice given as herein provided. Notice shall be deemed given on the day on which personally delivered; or, if by mail, on the fifth day after being posted or the date of actual receipt, whichever is earlier. TO CONSULTANT: TO THE CITY OF MIAMI: Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services 780 W. Grenada Boulevard Ormond Beach FL 32174 14 Employee Benefit Consulting Services Arthur Noriega V City Manager 444 SW 2nd Avenue, 10th Floor Miami, FL 33130 George K. Wysong, III City Attorney 444 SW 2nd Avenue, 9th Floor Miami, FL 33130-1910 David Ruiz Interim Director, Risk Management Department 444 SW 2nd Avenue, 9th Floor Miami, FL 33130-1910 Annie Perez, CPPO Procurement Director/Chief Procurement Officer 444 SW 2nd Avenue, 6th Floor Miami, FL 33130-1910 City of Miami, Florida RFP 1896386 18. MISCELLANEOUS PROVISIONS', A. This Agreement shall be construed and enforced according to the laws of the State of Florida. Venue in any proceedings between the parties shall be in Miami -Dade County, Florida. Each party shall bear its own attorney's fees. Each party waives any defense, whether asserted by motion or pleading, that the aforementioned courts are an improper or inconvenient venue. Moreover, the parties consent to the personal jurisdiction of the aforementioned courts and irrevocably waive any objections to said jurisdiction. The parties irrevocably, knowingly and voluntarily waive any rights to a jury trial in any action or proceeding between them arising out of this Agreement. B. No waiver or breach of any provision of this Agreement shall constitute a waiver of any subsequent breach of the same or any other provision hereof, and no waiver shall be effective unless made in writing. C. Should any provision, paragraph, sentence, word or phrase contained in this Agreement be determined by a court of competent jurisdiction to be invalid, illegal or otherwise unenforceable under the laws of the State of Florida or the City of Miami, such provision, paragraph, sentence, word or phrase shall be deemed modified to the extent necessary in order to conform with such laws, or if not modifiable, then the same shall be deemed severable, and in either event, the remaining terms and provisions of this Agreement shall remain unmodified and in full force and effect or limitation of its use. D. Consultant shall comply with all applicable laws, rules, and regulations in the performance of this Agreement, including but not limited to licensure, and certifications required by law for professional service Consultants. E. No modification or amendment hereto shall be valid unless in writing and executed by properly authorized representatives of the parties hereto. Except as otherwise set forth in Section 2 above, the City Manager shall have the sole authority to extend, amend, or modify this Agreement on behalf of the City. 15 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 19. SUCCESSORS AND ASSIGNS; This Agreement shall be binding upon the parties hereto, their heirs, executors, legal representatives, successors, or assigns, if any. 20. INDEPENDENT CONTRACTORS; Consultant has been procured and is being engaged to provide Services to the City as an independent contractor, and not as an agent or employee of the City. Accordingly, neither Consultant, nor its employees, nor any subconsultant hired by Consultant to provide any Services under this Agreement shall attain, nor be entitled to, any rights, emoluments, or benefits under the Civil Service or Pension Ordinances of the City, nor any rights afforded classified or unclassified employees of the City. Consultant further understands that Florida Workers' Compensation benefits available to employees of the City are not available to Consultant, its employees, or any subconsultant hired by Consultant to provide any Services hereunder, and Consultant agrees to provide or to require subconsultant(s) to provide, as applicable, workers' compensation insurance for any employee or agent of Consultant rendering Services to the City under this Agreement. Consultant further understands and agrees that Consultant's or subconsultants' use or entry upon City properties shall not in any way change its or their status as an independent contractor. 21. CONTINGENCY CLAUSE: Funding for this Agreement is contingent on the availability of funds and continued authorization for program activities and the Agreement is subject to amendment or termination due to lack of funds, reduction of funds, failure to allocate or appropriate funds, and/or change in program directions, applicable laws or regulations, upon thirty (30) days written notice. 16 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 22. FORCE MAJEURE: A "Force Majeure Event" shall mean an act of God, act of governmental body or military authority, fire, explosion, power failure, flood, storm, hurricane, sink hole, other natural disasters, epidemic, riot or civil disturbance, war or terrorism, sabotage, insurrection, blockade, or embargo not within the control of the Consultant. In the event that either party is delayed in the performance of any act or obligation pursuant to or required by the Agreement because of a Force Majeure Event as herein defined, the time for required completion of such act or obligation shall be extended by the number of days equal to the total number of days, if any, that such Force Majeure Event actually delay such party. The party seeking delay in performance shall give notice to the other party in writing, within two (2) days of the Force Majeure Event, specifying the anticipated duration of the delay, and if such delay shall extend beyond the duration specified in such notice, additional notice shall be repeated no less than monthly so long as such delay due to a Force Majeure Event continues. Any party seeking delay in performance due to a Force Majeure Event shall use its best efforts to rectify any condition causing such delay and shall cooperate with the other party to overcome any delay that has resulted. 23. CITY NOT LIABLE FOR DELAYS: Consultant hereby understands and agrees that in no event shall the City be liable for, or responsible to Consultant or any subconsultant, or to any other person, firm, or entity for or on account of, any stoppages or delay(s) in work herein provided for, or any damages whatsoever related thereto, because of any injunction or other legal or equitable proceedings or on account of any delay(s) for any cause over which the City has no control. The sole remedy which may be granted to the Consultant, in the reasonable discretion of the City Manager, following a prompt and detailed request to be officially transmitted by the Consultant is an extension of time. No other recourse or remedy will be available to the Consultant against the 17 Employee Benefit Consulting Services City of Miami, Florida City. RFP 1896386 24. USE OF NAME: Consultant understands and agrees that the City is not engaged in research for advertising, sales promotion, or other publicity purposes. Consultant is allowed, within the limited scope of normal and customary marketing and promotion of its work, to use the general results of this project and the name of the City. The Consultant agrees to protect any confidential information provided by the City and will not release information of a specific nature without prior written consent of the City Manager or the City Commission. 25. NO CONFLICT OF INTEREST: Pursuant to City of Miami Code Section 2-611, as amended ("City Code"), regarding conflicts of interest, Consultant hereby certifies to the City that no individual member of Consultant, no employee, and no subconsultant under this Agreement nor any immediate family member of any of the same is also a member of any board, commission, or agency of the City. Consultant hereby represents and warrants to the City that throughout the term of this Agreement, Consultant, its employees, and its subconsultants will abide by this prohibition of the City Code. 26. NO THIRD -PARTY BENEFICIARY: No persons other than the Consultant and the City (and their successors and assigns) shall have any rights as an express or implied third -party beneficiary whatsoever under this Agreement. 27. SURVIVAL; All obligations (including but not limited to indemnity and obligations to defend, save and hold harmless) and rights of any party arising during or attributable to the period prior to expiration 18 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 or earlier termination of this Agreement shall survive such expiration or earlier termination. 28. TRUTH -IN -NEGOTIATION CERTIFICATION. REPRESENTATION AND WARRANTY: Consultant hereby certifies, represents and warrants to the City that on the date of Consultant's execution of this Agreement, and so long as this Agreement shall remain in full force and effect, the wage rates and other factual unit costs supporting the compensation to Consultant under this Agreement are and will continue to be accurate, complete, and current. Consultant understands, agrees, and acknowledges that the City shall adjust the amount of the compensation and any additions thereto to exclude any significant sums by which the City determines the contract price of compensation hereunder was increased due to inaccurate, incomplete, or non- current wage rates and other factual unit costs. All such contract adjustments shall be made within one (1) year of the end of this Agreement, whether naturally expiring or earlier terminated pursuant to the provisions hereof. 29. COUNTERPARTS/ELECTRONIC SIGNATURES: This Agreement and any amendments hereto may be executed in counterparts and all such counterparts taken together shall be deemed to constitute one and the same instrument, each of which shall be an original as against either party whose signature appears thereon, but all of which taken together shall constitute but one and the same instrument. An executed facsimile or electronic scanned copy of this Agreement shall have the same force and effect as an original. The parties shall be entitled to sign and transmit an electronic signature on this Agreement (whether by facsimile, PDF or other email transmission), which signature shall be binding on the party whose name is contained therein. Any party providing an electronic signature agrees to promptly execute and deliver to the other parties an original signed Agreement upon request. 30. ENTIRE AGREEMENT: This instrument and its attachments constitute the sole and final agreement of the parties 19 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 relating to the subject matter hereof and correctly set forth the rights, duties, and obligations of each to the other as of its date. Any prior agreements, promises, negotiations, or representations not expressly set forth in this Agreement are of no force or effect. 31. ANITRUST VIOLATOR VENDORS: A person or an affiliate who has been placed on the Antitrust Violator Vendors List following a conviction or being held civilly liable for an antitrust violation may not submit a bid, proposal, or reply on any agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on any agreement with a public entity for the construction or repair of a public building or public work; may not submit a bid, proposal, or reply on leases of real property to a public entity; may not be awarded or perform work as a grantee, supplier, subcontractor, or consultant under an agreement with a public entity; and may not transact new business with a public entity 32. ANTI -HUMAN TRAFFICKING: Consultant confirms and certifies that it is not in violation of Section 787.06, Florida Statutes, and that it does not and shall not use "coercion" for labor or services as defined in Section 787.06, Florida Statutes. The Advisor shall execute and submit to the City an Affidavit, of even date herewith, in compliance with Section 787.06(13), Florida Statutes, attached an incorporated herein as Exhibit "F." If the Advisor fails to comply with the terms of this Section, the City may suspend or terminate this Agreement immediately, without prior notice, and in no event shall the City be liable to Advisor for any additional compensation or for any consequential or incidental damages. 33. E-VERIFY By entering into this Agreement, Consultant and its subcontractors are jointly and severally obligated to comply with the provisions of Section 448.095, Florida Statutes, as amended, titled "Employment Eligibility." Consultant affirms that (a) it has registered and uses the U.S. Department 20 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 of Homeland Security's E-Verify system to verify the work authorization status of all new employees of Consultant; (b) it has required all subcontractors to this Agreement to register and use the E-Verify system to verify the work authorization status of all new employees of the subcontractor; (c) it has an affidavit from all subcontractors to this Agreement attesting that the subcontractor does not employ, contract with, or subcontract with, unauthorized aliens; and (d) it shall maintain copies of any such affidavits for the duration of the Agreement. Registration information is available at: http://www.uscis.gov/e-verify. If City has a good faith belief that Consultant has knowingly violated Section 448.09(1), Florida Statutes, then City shall terminate this Agreement in accordance with Section 448.095(5)(c), Florida Statutes. In the event of such termination, Consultant agrees and acknowledges that it may not be awarded a public contract for at least one (1) year from the date of such termination and that Consultant shall be liable for any additional costs incurred by the City because of such termination. In addition, if City has a good faith belief that a subcontractor has knowingly violated any provisions of Sections 448.09(1) or 448.095, Florida Statutes, but Consultant has otherwise complied with its requirements under those statutes, then Consultant agrees that it shall terminate its contract with the subcontractor upon receipt of notice from the City of such violation by subcontractor in accordance with Section 448.095(5)(c), Florida Statutes. Any challenge to termination under this provision must be filed in the Circuit or County Court by the City, Consultant, or subcontractor no later than twenty (20) calendar days after the date of Agreement termination. 21 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 IN WITNESS WHEREOF, the Parties have executed this Agreement, or have caused the same to be executed, as of the date and year first above written. "Consultant" Co , ,. rate Synergies Group, LLC d/b/a ation k P,di iers Public Entity Services a foreign limi -d liability company authorized to do business in Florida ATTEST: By: ■i . i :nt. ► By: Print = me: Name: � 1 � Title: Title: f l U PAb1 4 L MICHELE C. GOMEZ MY COMMISSION # HH 330742 EXPIRES: November 19, 2028 •uisr „; ci;R AWN \ • ATTEST: "CITY" CITY OF MIAMI, a Florida municipal corporation By: By: Todd B. Hannon Arthur Noriega V City Clerk City Manager APPROVED AS TO LEGAL FORM AND APPROVED AS TO INSURANCE CORRECTNESS: REQUIREMENTS: By: By. Geroge K. Wysong, III David Ruiz, Interim Director City Attorney Risk Management 22 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 WHEREAS, COMPANY RESOLUTION (Company Name), a (State and type of incorporation, e.g., New York Corporation/LLC), desires to enter into an agreement with the City of Miami ("City" for the purpose of performing the Services described in the Supplement to which this resolution is attached; and WHEREAS, the Board of Managers at a duly held company meeting has considered the matter in accordance with the bylaws of the company; NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF MANAGERS that this company is authorized to enter into the Supplement with the City, and (1st Name), the ; ' (1st Title), and L (2nd Name), the (2nd Title), are hereby authorized and directed to execute the Supplement in the name of this Company and to execute any other document and perform any acts in connection therewith as may be required to accomplish its purpose. 1 r IN WITNESS WHEREOF, this V day of , 20 Q&VL O 1w' aeL) By: Name & Title: �' f/ L Q'z.i/ aro (print) ("Full Name of Company") (State and type of incorporation) (Signature of 1st Name above) By: (Signature of 2nd Name above) Name & Title: (print) 23 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 EXHIBIT A RFP No. 1896386 24 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 EXHIBIT B SCOPE OF WORK Provide employee benefit consulting services per specifications 25 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 EXHIBIT C CONSULTANT'S RESPONSE AND PRICE PROPOSAL 26 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 EXHIBIT D INSURANCE REQUIREMENTS EMPLOYEE BENEFIT CONSULTING SERVICES Commercial General Liability A. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence $1,000,000 General Aggregate Limit $2,000,000 Personal and Adv. Injury $1,000,000 Products/Completed Operations $1,000,000 B. Endorsements Required City of Miami listed as an additional insured Contingent and Contractual Liability Premises and Operations Liability Primary Insurance Clause Endorsement II. Business Automobile Liability A. Limits of Liability Bodily Injury and Property Damage Liability Combined Single Limit Any Auto Including Hired, Borrowed or Non -Owned Autos Any One Accident $ 1,000,000 B. Endorsements Required City of Miami listed as an additional insured III. Worker's Compensation Limits of Liability Statutory -State of Florida Waiver of Subrogation Employer's Liability A. Limits of Liability $100,000 for bodily injury caused by an accident, each accident $100,000 for bodily injury caused by disease, each employee $100,000 for bodily injury caused by disease, policy limit 27 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 IV. Professional Liability/Errors and Omissions Coverage Combined Single Limit Each Claim $5,000,000 General Aggregate Limit $5,000,000 Retro Date Included V. Umbrella Liability A. Each Claim $2,000,000 Policy Aggregate $2,000,000 B. Endorsements Required City of Miami listed as additional insured Coverage is excess follow form over all applicable liability policies contained herein Successful Proposer agrees to maintain professional liability / Errors & Omissions coverage, for a minimum of two (2) years after termination of the contract period subject to continued availability of commercially reasonable terms and conditions of such coverage. BINDERS ARE UNACCEPTABLE. The insurance coverage required shall include those classifications, as listed in standard liability insurance manuals, which most nearly reflect the operations of the bidder. All insurance policies required above shall be issued by companies authorized to do business under the laws of the State of Florida, with the following qualifications: The Company must be rated no less than "A-" as to management, and no less than "Class V" as to financial strength, by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent. All policies and/or certificates of insurance are subject to review and verification by Risk Management prior to insurance approval. Certificates will indicate no modification or change in insurance shall be made without thirty (30) days written advance notice to the certificate holder. NOTE: CITY RFP NUMBER AND/OR TITLE OF RFP MUST APPEAR ON EACH CERTIFICATE. Compliance with the foregoing requirements shall not relieve the bidder of his liability and obligation under this section or under any other section of this Agreement. --If insurance certificates are scheduled to expire during the contractual period, the Successful Proposer shall be responsible for submitting new or renewed insurance certificates to the City at a minimum of ten (10) calendar days in advance of such expiration. --In the event that expired certificates are not replaced with new or renewed certificates which 28 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 cover the contractual period, the City shall: (1) Suspend the contract until such time as the new or renewed certificates are received by the City in the manner prescribed in the Request for Proposal. (2) The City may, at its sole discretion, terminate this contract for cause and seek re -procurement damages from the Successful Proposer in conjunction with the General and Special Terms and Conditions of the Request for Proposal. The Successful Proposer shall be responsible for assuring that the insurance certificates required in conjunction with this Section remain in force for the duration of the contractual period; including any and all option terms that may be granted to the Successful Proposer. The above policies shall provide the City of Miami with written notice of cancellation or material change from the insurer in accordance to policy provisions. 29 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 EXHIBIT E COMPANY RESOLUTION AND EVIDENCE OF QUALIFICATION TO DO BUSINESS IN FLORIDA 30 Employee Benefit Consulting Services City of Miami, Florida RFP 1896386 EXHIBIT F ANTI HUMAN -TRAFFICKING AFFIDAVIT 31 Employee Benefit Consulting Services CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM Arthur Noriega V City Manager ocuSignetlbyy� �ILILc.a. ) L1.✓, ‘--89540EB73CAC463_ DATE: July 14, 2025 SUBJECT: Recommendation of Award for Request for Proposals ("RFP") No. 1896386 Employee Benefit Consulting Services FROM: Annie Perez, CPPO, Director/Chief Procurement Officer REFERENCES: RFP No. 1896386 ENCLOSURES: Report of the Evaluation Committee (Substituted) Recommendation: Based on the findings below, the Department of Procurement ("Procurement") hereby requests approval for the award of a contract to the highest ranked responsive and responsible Proposer, Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services ("FRPPE"), pursuant to Request for Proposals ("RFP") No. 1896386, for the provision of Employee Benefit Consulting Services. Background: On August 16, 2024, Procurement, on behalf of the City of Miami's ("City") Department of Risk Management ("Risk"), issued RFP No. 1896386 under full and open competition, to obtain proposals from experienced and qualified firms for the provision of Employee Benefit Consulting Services. On September 16, 2024, four (4) Proposals were received in response to the RFP. Proposers were required to meet all of the minimum qualification requirements established in the RFP, in order to be deemed qualified to provide said services. Subsequently, the Proposals were reviewed by Procurement for responsiveness, and all four (4) Proposals were deemed responsive. The Evaluation Committee ("Committee") met on February 4, 2025, to review and evaluate the proposals. One (1) external Committee Member was unable to attend due to extenuating circumstances. The remaining four (4) Committee Members voted unanimously to move forward with the evaluation of the Proposals. A discussion and evaluation of the Proposals occurred, and a consensus was reached by the Committee pursuant to the guidelines published in the RFP. On May 5, 2025, Oral Presentations were held wherein all four (4) responsive Proposers gave brief presentations before the Committee. Each proposing firm was allotted fifteen (15) minutes to present the highlights of their submitted Proposals, but no modifications to said Proposals were accepted. Immediately thereafter, the Committee re-evaluated the Proposals. There were no changes to Proposers' scores as a result of the Oral Presentations. Following evaluations, the Committee recommended that the City enter into negotiations with FRPPE, the highest -ranked responsive and responsible Proposer. Accordingly, the Negotiating Team met with FRPPE June 10, 2025, to negotiate a contract. Due diligence was conducted to determine FRPPE's responsibility, including verifying corporate status, and that there were no performance or compliance issues, nor any adverse findings related to the responsibility of FRPPE. Fiscal Impact: FRPPE initially proposed to perform the services pursuant to this RFP for an aggregate fee of eight hundred and thirty-five thousand dollars ($835,000) over the term of the contract, inclusive of optional renewal periods, which is in line with industry standards for services of similar scope and nature. Negotiations with FRPPE resulted in a savings of seven percent (7%) from the originally proposed price, reducing FRPPE's aggregate compensation to seven hundred and seventy-five thousand five hundred and fifty-five dollars ($775,550) over the term of the contract. The term for the contract is three (3) years, with the option to renew for two (2) additional one (1) year periods. Procurement hereby recommends award of a contract to FRPPE. Your signature below will indicate approval of this recommendation. APPROVED: I a nmla July 23, 2025 1 11:12:26 EDT Arthur Noriega V Date City Manager AP:cj cc: Larry M. Spring, CPA, Assistant City Manager / Chief Financial Officer David Ruiz, Interim Director, Risk Thomas M. Fossler, Assistant City Attorney Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director, Procurement CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM Arthur Noriega V City Manager y.—Docus,9nedov ‘--895a1DEa73CAC060_ FROM: Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department DATE: July 1, 2025 SUBJECT: Report of Evaluation Committee for Employee Benefit Consulting Services REFERENCES: Request for Proposals (RFP) No. 1896386 ENCLOSURES: Report of the Evaluation Committee for Employee Benefit Consulting Services (Substitution) The Report of the Evaluation Committee for Employee Benefit Consulting Services pursuant to RFP No. 1896386 is hereby being substituted with the attached. The purpose of the substitution is to correct a scrivener's error in paragraph 1 that erroneously listed the name of the highest - ranked Proposer as "Corporate Strategies Group, LLC d/b/a Foundation Risk Partners Public Entity Services", rather than "Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services", its correct legal business name. AP:cj cc: David Ruiz, Interim Director, Risk Management Department Thomas M. Fossler Assistant City Attorney Yadissa A. Calderon, CPPB, Assistant Director, Department of Procurement CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM TO: Arthur Noriega V City Manager DocuSignea by: FROM: Annie Perez, CPPO, Director/Chief Procurement Officer Recommendation: Based on the findings belo , approval to negotiate a contr Corporate Strategies Group, ("FRPPE"), pursuant to Request Employee Benefit Consulting Service Background: DATE: May 29, 2025 SUBJECT: Report of Evaluation Committee for Employee Benefit Consulting Services REFERENCES: Request for Proposals ("RFP") No. 1896386 ENCLOSURES: Review/Score Sheets rtment of Procurement ("Procurement") hereby requests ighest ranked responsive and responsible Proposer, Foundation Risk Partners Public Entity Services Is ("RFP") No. 1896386, for the provision of On August 16, 2024, Procurement, on behalf of Management ("Risk"), issued RFP No. 1896386 u proposals from experienced and qualified firms for th Services. On September 16, 2024, four (4) Proposals wer Proposers were required to meet all of the minimum qualifi RFP, in order to be deemed qualified to provide said services. reviewed by Procurement for responsiveness, and all fou responsive. of Miami's ("City") Department of Risk nd open competition, to obtain f Employee Benefit Consulting ed in response to the RFP. ion • -ments established in the tly, the Proposals were sals were deemed The Evaluation Committee ("Committee") met on February 4, 2025, to review and evaluate the proposals. One (1) external Committee Member was unable to attend due to extenuating circumstances. The remaining four (4) Committee Members voted unanimously to move forward with the evaluation of the Proposals. A discussion and evaluation of the Proposals occurred, and a consensus was reached by the Committee pursuant to the guidelines published in the RFP. The evaluation criteria were given respective weights for a maximum of one hundred (100) points per Committee member. Preliminary Scores: The preliminary scores are listed below in order of ranking: Proposer Technical Score (max. 320) Compensation Score (max. 80) Total Combined Score (max. 400) 1 Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services 312 78 390 2 AON Consulting, Inc. 308 69 377 3 Gallagher Benefit Services, Inc. 308 58 366 4 Gherig Group, a Risk Strategies Company 284 51 335 On May 5, 2025, Oral Presentations were held wherein all four (4) responsive Proposers gave brief presentations before the Committee. Each proposing firm was allotted fifteen (15) minutes to present the highligh accepted. Immedial I changes to Propose Post -Oral Presentation heir submitted Proposals, but no modifications to said Proposals were eafter, the Committee re-evaluated the Proposals. There were no as a result of the Oral Presentations. The post -oral presentation tec ce scores submitted are as follows. Proposer lam I wSc (m .320 Compensation Score (max. 80) Total Combined Score (max. 400) 1 Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services 312 308 & 78 )ZIK\377 516 390 366 335 2 AON Consulting, Inc. 3 Gallagher Benefit Services,308 Inc. 4 Gherig Group, a Risk Strategies Company 284 Due diligence was conducted to determine FRPPE's responsibility, including verifying corporate status, and that there were no performance or compliance issues, nor any adverse findings related to the responsibility of FRPPE. Prior to negotiations, Procurement will further review the Proposal submitted by the recommended Proposer. Procurement will continue further due diligence of the Proposal submitted by the recommended Proposer. Negotiations: The Committee recommends that the City enter into negotiations with FRPPE, the highest ranked Proposer. In the event the City and FRPPE are unable to reach an agreement, negotiations with FRPPE will be terminated and the City will enter into negotiations with the second highest -ranked Proposer. If negotiations fail with both the highest and second -ranked proposers, the City will enter into negotiations with the third -ranked Proposer. If negotiations fail with the three (3) highest- ranked Proposers, the City will enter into negotiations with the fourth -ranked Proposer. If negotiations fail with all four (4) Proposers, the City will re -solicit for these services. The following individuals will participate in the negotiations: Charles Johnson, III, Sr. Procurement Contracting Manager, Procurement David Ruiz, Interim Director, Risk Jair Espinoza, Benefits Manager, Risk Consensus Statement: The Committee recommends FRPPE for the following primary reasons: 1) FRPPE and its key personnel have the necessary relevant experience, qualifications, and past performance history to provide the services required in the RFP, at the level required by the City; and 2) FRPPE submitted a comprehensive Proposal, which detailed how the services would be performed in a manner that will meet the City's needs. FRPPEs proposed standards and the I interest of the City. Copies of the score sheet score sheet. APPROVED: AP:cj CDocuSignea by: V{(uur Noviuy, 850cF.372EIa. sation is $835,000.00 in the aggregate, which is within industry ng all four (4) Proposers. It will be further negotiated in the best mmittee member are attached, as well as the composite Arthur Noriega V City Manager June 3, 2025 1 18:02:46 EDT cc: Larry M. Spring, CPA, Assistant City Manager / Chiee Fin ►Officer David Ruiz, Interim Director, Risk Thomas M. Fossler, Assistant City Attorney Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director` Date CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM Arthur Noriega V City Manager i—Docus,9nedov. DATE: July 1, 2025 SUBJECT: Report of Evaluation Committee for Employee Benefit Consulting Services (Substitution) FROM: Annie Perez, CPPO, Director/Chief Procurement Officer REFERENCES: Request for Proposals ("RFP") No. 1896386 ENCLOSURES: Review/Score Sheets Recommendation: Based on the findings below, the Department of Procurement ("Procurement") hereby requests approval to negotiate a contract with the highest ranked responsive and responsible Proposer, Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services ("FRPPE"), pursuant to Request for Proposals ("RFP") No. 1896386, for the provision of Employee Benefit Consulting Services. Background: On August 16, 2024, Procurement, on behalf of the City of Miami's ("City") Department of Risk Management ("Risk"), issued RFP No. 1896386 under full and open competition, to obtain proposals from experienced and qualified firms for the provision of Employee Benefit Consulting Services. On September 16, 2024, four (4) Proposals were received in response to the RFP. Proposers were required to meet all of the minimum qualification requirements established in the RFP, in order to be deemed qualified to provide said services. Subsequently, the Proposals were reviewed by Procurement for responsiveness, and all four (4) Proposals were deemed responsive. The Evaluation Committee ("Committee") met on February 4, 2025, to review and evaluate the proposals. One (1) external Committee Member was unable to attend due to extenuating circumstances. The remaining four (4) Committee Members voted unanimously to move forward with the evaluation of the Proposals. A discussion and evaluation of the Proposals occurred, and a consensus was reached by the Committee pursuant to the guidelines published in the RFP. The evaluation criteria were given respective weights for a maximum of one hundred (100) points per Committee member. Preliminary Scores: The preliminary scores are listed below in order of ranking: Proposer Technical Score (max. 320) Compensation Score (max. 80) Total Combined Score (max. 400) 1 Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services 312 78 390 2 AON Consulting, Inc. 308 69 377 3 Gallagher Benefit Services, Inc. 308 58 366 4 Gherig Group, a Risk Strategies Company 284 51 335 On May 5, 2025, Oral Presentations were held wherein all four (4) responsive Proposers gave brief presentations before the Committee. Each proposing firm was allotted fifteen (15) minutes to present the highlights of their submitted Proposals, but no modifications to said Proposals were accepted. Immediately thereafter, the Committee re-evaluated the Proposals. There were no changes to Proposers' scores as a result of the Oral Presentations. Post -Oral Presentation Scores: The post -oral presentation technical and price scores submitted are as follows. Proposer Technical Score (max. 320) Compensation Score (max. 80) Total Combined Score (max. 400) 1 Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services 312 78 390 2 AON Consulting, Inc. 308 69 377 3 Gallagher Benefit Services, Inc. 308 58 366 4 Gherig Group, a Risk Strategies Company 284 51 335 Due diligence was conducted to determine FRPPE's responsibility, including verifying corporate status, and that there were no performance or compliance issues, nor any adverse findings related to the responsibility of FRPPE. Prior to negotiations, Procurement will further review the Proposal submitted by the recommended Proposer. Procurement will continue further due diligence of the Proposal submitted by the recommended Proposer. Negotiations: The Committee recommends that the City enter into negotiations with FRPPE, the highest ranked Proposer. In the event the City and FRPPE are unable to reach an agreement, negotiations with FRPPE will be terminated and the City will enter into negotiations with the second highest -ranked Proposer. If negotiations fail with both the highest and second -ranked proposers, the City will enter into negotiations with the third -ranked Proposer. If negotiations fail with the three (3) highest- ranked Proposers, the City will enter into negotiations with the fourth -ranked Proposer. If negotiations fail with all four (4) Proposers, the City will re -solicit for these services. The following individuals will participate in the negotiations: Charles Johnson, III, Sr. Procurement Contracting Manager, Procurement David Ruiz, Interim Director, Risk Jair Espinoza, Benefits Manager, Risk Consensus Statement: The Committee recommends FRPPE for the following primary reasons: 1) FRPPE and its key personnel have the necessary relevant experience, qualifications, and past performance history to provide the services required in the RFP, at the level required by the City; and 2) FRPPE submitted a comprehensive Proposal, which detailed how the services could be performed in a manner that will meet the City's needs. FRPPEs proposed compensation is $835,000.00 in the aggregate, which is within industry standards and the lowest among all four (4) Proposers. It will be further negotiated in the best interest of the City. Copies of the score sheets for each committee member are attached, as well as the composite score sheet. APPROVED: aitar Po `"` July 2, 2025 1 13:08:29 EDT Arthur Noriega V Date AP:cj cc: Larry M. Spring, CPA, Assistant City Manager / Chief Financial Officer David Ruiz, Interim Director, Risk Thomas M. Fossler, Assistant City Attorney Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director, Procurement Employee Benefit Consulting Services RFP 1896386 EXHIBIT E PRICE PROPOSAL A. Employee Benefit Consulting Services The not -to -exceed price and estimated hours for providing all employee benefit consulting services as stated in the Scope of Services. The price includes all costs associated to provide these services. Term Estimated Hours Not -To -Exceed Price 1 Initial Term (Years 1-3) 3,300 $465,930 2 First 1-year OTR Period 1,100 $155,310 3 Second 1-year OTR Period 1,100 $155,310 Note: The City will pay the Consultant at the hourly rate indicated below for any work involved to complete the City's request if the work significantly exceeds the hours stated. Similarly, the fee shall be reduced if there is significantly less work than anticipated. B. Not -to -Exceed Hourly Rate for Additional Work Below is the not -to -exceed hourly rate for additional work not included within the Scope of Services. Breakdown of Not to Exceed Price Staff Position/ Classification Proposed Maximum Hourly Rates Initial Term Years 1 - 3 OTR 1 Year 4 OTR 1 Year 5 Lead Consultant $ 250 $ 250 $ 250 $ $ $ $ $ $ Notes: 1) The not -to exceed price in Section A, and the hourly rates in Section B, shall remain firm and fixed for the term of the Contract, including any renewals or extensions thereof. 2) The hourly rates above include all costs to include normal administrative fees, such as telephone, mailing, faxes, duplication charges, overnight mail, and including all out of pocket expenses, such as travel incurred in connection with the services (refer to CH.112.061 of the Florida Statutes regarding travel expenses), per diem, and miscellaneous costs and fees, and is incorporated in this price schedule, as they will not be reimbursed separately by the City. 3) The City will pay the Consultant at the hourly rate indicated within Section B, for any work involved to complete the City's request for work that is not included within the Scope of Services. The City reserves the right to negotiate the final pricing for this work on a project by project basis, at the City's sole discretion. Andrew Bloom President & CEO Signature Printed Name Title 1Tit .m ANNIE PEREZ, CPPO ARTHUR NORIEGA V Chief Procurement Officer City Manager July 28, 2025 All Responding Proposers (See Distribution List) SUBJECT: RFP 1896386, Employee Benefit Consulting Services Dear Proposers: The Evaluation of the proposals tendered in response to the above cited solicitation has been completed. The City Manager has recommended award as shown within the enclosed document. This notice is provided in accordance with Section 1.20 of the solicitation, and Sections 18-74 of the City of Miami Code. Our provision of this notice also serves to confirm the lifting of the Cone of Silence from this procurement action as dictated by Section 18-74 (d) (2) of the City of Miami Code. We appreciate the participation of all proposers which responded to the subject action. If you have any questions, please contact me at 305-416-1924 or cjohnson@miamigov.com. Sincerely, Charles Johnson, III, NIGP-CPP Senior Procurement Contracting Manager Distribution List: AON Consulting, Inc. Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services Gallagher Benefit Services, Inc. Gherig Group, a Risk Strategies Company Enclosure: City Manager's Award Recommendation Memo c: City Clerk David Ruiz, Interim Director, Risk Management Thomas M. Fossler, Assistant City Attorney Annie Perez, CPPO, Director/Chief Procurement Officer Yadissa A. Calderon, CPPB, Assistant Director, Department of Procurement CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM Arthur Noriega V City Manager y.—Docus,9nedov ‘--895a1DEa73CAC060_ FROM: Annie Perez, CPPO Director/Chief Procurement Officer Procurement Department DATE: July 1, 2025 SUBJECT: Report of Evaluation Committee for Employee Benefit Consulting Services REFERENCES: Request for Proposals (RFP) No. 1896386 ENCLOSURES: Report of the Evaluation Committee for Employee Benefit Consulting Services (Substitution) The Report of the Evaluation Committee for Employee Benefit Consulting Services pursuant to RFP No. 1896386 is hereby being substituted with the attached. The purpose of the substitution is to correct a scrivener's error in paragraph 1 that erroneously listed the name of the highest - ranked Proposer as "Corporate Strategies Group, LLC d/b/a Foundation Risk Partners Public Entity Services", rather than "Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services", its correct legal business name. AP:cj cc: David Ruiz, Interim Director, Risk Management Department Thomas M. Fossler Assistant City Attorney Yadissa A. Calderon, CPPB, Assistant Director, Department of Procurement CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM TO: Arthur Noriega V City Manager DocuSignea by: FROM: Annie Perez, CPPO, Director/Chief Procurement Officer Recommendation: Based on the findings belo , approval to negotiate a contr Corporate Strategies Group, ("FRPPE"), pursuant to Request Employee Benefit Consulting Service Background: DATE: May 29, 2025 SUBJECT: Report of Evaluation Committee for Employee Benefit Consulting Services REFERENCES: Request for Proposals ("RFP") No. 1896386 ENCLOSURES: Review/Score Sheets rtment of Procurement ("Procurement") hereby requests ighest ranked responsive and responsible Proposer, Foundation Risk Partners Public Entity Services Is ("RFP") No. 1896386, for the provision of On August 16, 2024, Procurement, on behalf of Management ("Risk"), issued RFP No. 1896386 u proposals from experienced and qualified firms for th Services. On September 16, 2024, four (4) Proposals wer Proposers were required to meet all of the minimum qualifi RFP, in order to be deemed qualified to provide said services. reviewed by Procurement for responsiveness, and all fou responsive. of Miami's ("City") Department of Risk nd open competition, to obtain f Employee Benefit Consulting ed in response to the RFP. ion • -ments established in the tly, the Proposals were sals were deemed The Evaluation Committee ("Committee") met on February 4, 2025, to review and evaluate the proposals. One (1) external Committee Member was unable to attend due to extenuating circumstances. The remaining four (4) Committee Members voted unanimously to move forward with the evaluation of the Proposals. A discussion and evaluation of the Proposals occurred, and a consensus was reached by the Committee pursuant to the guidelines published in the RFP. The evaluation criteria were given respective weights for a maximum of one hundred (100) points per Committee member. Preliminary Scores: The preliminary scores are listed below in order of ranking: Proposer Technical Score (max. 320) Compensation Score (max. 80) Total Combined Score (max. 400) 1 Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services 312 78 390 2 AON Consulting, Inc. 308 69 377 3 Gallagher Benefit Services, Inc. 308 58 366 4 Gherig Group, a Risk Strategies Company 284 51 335 On May 5, 2025, Oral Presentations were held wherein all four (4) responsive Proposers gave brief presentations before the Committee. Each proposing firm was allotted fifteen (15) minutes to present the highligh accepted. Immedial I changes to Propose Post -Oral Presentation heir submitted Proposals, but no modifications to said Proposals were eafter, the Committee re-evaluated the Proposals. There were no as a result of the Oral Presentations. The post -oral presentation tec ce scores submitted are as follows. Proposer lam I wSc (m .320 Compensation Score (max. 80) Total Combined Score (max. 400) 1 Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services 312 308 & 78 )ZIK\377 516 390 366 335 2 AON Consulting, Inc. 3 Gallagher Benefit Services,308 Inc. 4 Gherig Group, a Risk Strategies Company 284 Due diligence was conducted to determine FRPPE's responsibility, including verifying corporate status, and that there were no performance or compliance issues, nor any adverse findings related to the responsibility of FRPPE. Prior to negotiations, Procurement will further review the Proposal submitted by the recommended Proposer. Procurement will continue further due diligence of the Proposal submitted by the recommended Proposer. Negotiations: The Committee recommends that the City enter into negotiations with FRPPE, the highest ranked Proposer. In the event the City and FRPPE are unable to reach an agreement, negotiations with FRPPE will be terminated and the City will enter into negotiations with the second highest -ranked Proposer. If negotiations fail with both the highest and second -ranked proposers, the City will enter into negotiations with the third -ranked Proposer. If negotiations fail with the three (3) highest- ranked Proposers, the City will enter into negotiations with the fourth -ranked Proposer. If negotiations fail with all four (4) Proposers, the City will re -solicit for these services. The following individuals will participate in the negotiations: Charles Johnson, III, Sr. Procurement Contracting Manager, Procurement David Ruiz, Interim Director, Risk Jair Espinoza, Benefits Manager, Risk Consensus Statement: The Committee recommends FRPPE for the following primary reasons: 1) FRPPE and its key personnel have the necessary relevant experience, qualifications, and past performance history to provide the services required in the RFP, at the level required by the City; and 2) FRPPE submitted a comprehensive Proposal, which detailed how the services would be performed in a manner that will meet the City's needs. FRPPEs proposed standards and the I interest of the City. Copies of the score sheet score sheet. APPROVED: AP:cj CDocuSignea by: V{(uur Noviuy, 850cF.372EIa. sation is $835,000.00 in the aggregate, which is within industry ng all four (4) Proposers. It will be further negotiated in the best mmittee member are attached, as well as the composite Arthur Noriega V City Manager June 3, 2025 1 18:02:46 EDT cc: Larry M. Spring, CPA, Assistant City Manager / Chiee Fin ►Officer David Ruiz, Interim Director, Risk Thomas M. Fossler, Assistant City Attorney Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director` Date CITY OF MIAMI, FLORIDA INTER -OFFICE MEMORANDUM Arthur Noriega V City Manager i—Docus,9nedov. DATE: July 1, 2025 SUBJECT: Report of Evaluation Committee for Employee Benefit Consulting Services (Substitution) FROM: Annie Perez, CPPO, Director/Chief Procurement Officer REFERENCES: Request for Proposals ("RFP") No. 1896386 ENCLOSURES: Review/Score Sheets Recommendation: Based on the findings below, the Department of Procurement ("Procurement") hereby requests approval to negotiate a contract with the highest ranked responsive and responsible Proposer, Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services ("FRPPE"), pursuant to Request for Proposals ("RFP") No. 1896386, for the provision of Employee Benefit Consulting Services. Background: On August 16, 2024, Procurement, on behalf of the City of Miami's ("City") Department of Risk Management ("Risk"), issued RFP No. 1896386 under full and open competition, to obtain proposals from experienced and qualified firms for the provision of Employee Benefit Consulting Services. On September 16, 2024, four (4) Proposals were received in response to the RFP. Proposers were required to meet all of the minimum qualification requirements established in the RFP, in order to be deemed qualified to provide said services. Subsequently, the Proposals were reviewed by Procurement for responsiveness, and all four (4) Proposals were deemed responsive. The Evaluation Committee ("Committee") met on February 4, 2025, to review and evaluate the proposals. One (1) external Committee Member was unable to attend due to extenuating circumstances. The remaining four (4) Committee Members voted unanimously to move forward with the evaluation of the Proposals. A discussion and evaluation of the Proposals occurred, and a consensus was reached by the Committee pursuant to the guidelines published in the RFP. The evaluation criteria were given respective weights for a maximum of one hundred (100) points per Committee member. Preliminary Scores: The preliminary scores are listed below in order of ranking: Proposer Technical Score (max. 320) Compensation Score (max. 80) Total Combined Score (max. 400) 1 Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services 312 78 390 2 AON Consulting, Inc. 308 69 377 3 Gallagher Benefit Services, Inc. 308 58 366 4 Gherig Group, a Risk Strategies Company 284 51 335 On May 5, 2025, Oral Presentations were held wherein all four (4) responsive Proposers gave brief presentations before the Committee. Each proposing firm was allotted fifteen (15) minutes to present the highlights of their submitted Proposals, but no modifications to said Proposals were accepted. Immediately thereafter, the Committee re-evaluated the Proposals. There were no changes to Proposers' scores as a result of the Oral Presentations. Post -Oral Presentation Scores: The post -oral presentation technical and price scores submitted are as follows. Proposer Technical Score (max. 320) Compensation Score (max. 80) Total Combined Score (max. 400) 1 Corporate Synergies Group, LLC d/b/a Foundation Risk Partners Public Entity Services 312 78 390 2 AON Consulting, Inc. 308 69 377 3 Gallagher Benefit Services, Inc. 308 58 366 4 Gherig Group, a Risk Strategies Company 284 51 335 Due diligence was conducted to determine FRPPE's responsibility, including verifying corporate status, and that there were no performance or compliance issues, nor any adverse findings related to the responsibility of FRPPE. Prior to negotiations, Procurement will further review the Proposal submitted by the recommended Proposer. Procurement will continue further due diligence of the Proposal submitted by the recommended Proposer. Negotiations: The Committee recommends that the City enter into negotiations with FRPPE, the highest ranked Proposer. In the event the City and FRPPE are unable to reach an agreement, negotiations with FRPPE will be terminated and the City will enter into negotiations with the second highest -ranked Proposer. If negotiations fail with both the highest and second -ranked proposers, the City will enter into negotiations with the third -ranked Proposer. If negotiations fail with the three (3) highest- ranked Proposers, the City will enter into negotiations with the fourth -ranked Proposer. If negotiations fail with all four (4) Proposers, the City will re -solicit for these services. The following individuals will participate in the negotiations: Charles Johnson, III, Sr. Procurement Contracting Manager, Procurement David Ruiz, Interim Director, Risk Jair Espinoza, Benefits Manager, Risk Consensus Statement: The Committee recommends FRPPE for the following primary reasons: 1) FRPPE and its key personnel have the necessary relevant experience, qualifications, and past performance history to provide the services required in the RFP, at the level required by the City; and 2) FRPPE submitted a comprehensive Proposal, which detailed how the services could be performed in a manner that will meet the City's needs. FRPPEs proposed compensation is $835,000.00 in the aggregate, which is within industry standards and the lowest among all four (4) Proposers. It will be further negotiated in the best interest of the City. Copies of the score sheets for each committee member are attached, as well as the composite score sheet. APPROVED: aitar Po `"` July 2, 2025 1 13:08:29 EDT Arthur Noriega V Date AP:cj cc: Larry M. Spring, CPA, Assistant City Manager / Chief Financial Officer David Ruiz, Interim Director, Risk Thomas M. Fossler, Assistant City Attorney Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director, Procurement 10/2/25, 3:55 PM Detail by Entity Name DIVISION OF CORPORATIONS 1 an official 3lu k of Florida web iuv Department of State / Division of Corporations / Search Records / Search by Entity Name / Detail by Entity Name Foreign Limited Liability Company CORPORATE SYNERGIES GROUP, LLC Filing Information Document Number M10000005304 FEI/EIN Number 20-1622581 Date Filed 12/02/2010 State DE Status ACTIVE Last Event LC STMNT OF RA/RO CHG Event Date Filed 05/15/2024 Event Effective Date NONE Principal Address 780 W. Granada Boulevard Ormond Beach, FL 32174 Changed: 04/06/2024 Mailing Address 780 W. Granada Boulevard Ormond Beach, FL 32174 Changed: 03/17/2025 Registered Agent Name & Address REGISTERED AGENT SOLUTIONS, INC. 1200 SOUTH PINE ISLAND ROAD PLANTATION, FL 33324 Name Changed: 05/15/2024 Address Changed: 07/21/2025 Authorized Person(a) Detail Name & Address Title Manager, Co -CEO https://search.sunbiz.org/Inquiry/CorporationSearch/Search ResultDetail?inquirytype=EntityName&directionType=1 nitial&searchNameOrder=CORPOR... 1/3 10/2/25, 3:55 PM Bloom, Andrew 780 W. Granada Boulevard Ormond Beach, FL 32174 Title Manager, Co -CEO Lisa, Mike 780 W. Granada Boulevard Ormond Beach, FL 32174 Title Manager Ambrosia , Daniel 780 W. Granada Boulevard Ormond Beach, FL 32174 Title Manager Lydecker , Charles 780 W. Granada Boulevard Ormond Beach, FL 32174 Title Manager Schwartz , Joel 780 W. Granada Boulevard Ormond Beach, FL 32174 Annual Reports Report Year Filed Date 2023 03/02/2023 2024 04/06/2024 2025 03/17/2025 Document Images 03/17/2025 --ANNUAL REPORT 05/15/2024 -- CORLCRACHG 04/06/2024 --ANNUAL REPORT 03/02/2023 --ANNUAL REPORT 04/04/2022 --ANNUAL REPORT 04/30/2021 --ANNUAL REPORT 04/28/2020 --ANNUAL REPORT 04/30/2019 --ANNUAL REPORT 04/30/2018 --ANNUAL REPORT 04/26/2017 --ANNUAL REPORT 04/11/2016 --ANNUAL REPORT 04/14/2015 --ANNUAL REPORT 03/11/2014 --ANNUAL REPORT 04/09/2013 --ANNUAL REPORT View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format Detail by Entity Name https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=1 nitial&searchNameOrder=CORPOR... 2/3 10/2/25, 3:55 PM 04/02/2012 --ANNUAL REPORT View image in PDF format 04/25/2011 --ANNUAL REPORT View image in PDF format 12/02/2010 -- Foreign Limited View image in PDF format Detail by Entity Name Florida Department of State, Division of Corporations https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=1 nitial&searchNameOrder=CORPOR... 3/3 10/2/25, 3:56 PM sunbiz.org - Florida Department of State DIVISION OF CORPORATIONS ��'rr_; r-/ Qrg Previous on List Next on List Return to List No Filing History an official 3iat' of Florida ► ethic Fictitious Name Search Submit Fictitious Name Detail Fictitious Name FOUNDATION RISK PARTNERS PUBLIC ENTITY SERVICES Filing Information Registration Number G25000119663 Status Filed Date Expiration Date Current Owners County Total Pages Events Filed FEI/EIN Number Mailing Address ACTIVE 09/12/2025 12/31 /2030 1 MULTIPLE 1 NONE NONE 780 W. GRANADA BLVD. ORMOND BEACH, FL 32174 Owner Information CORPORATE SYNERGIES GROUP, LLC 780 W. GRANADA BLVD. ORMOND BEACH, FL 32174 FEI/EIN Number: 20-1622581 Document Number: M10000005304 Document Images 09/12/2025 -- Fictitious Name Filing View image in PDF format Previous on List Next on List Return to List No Filing History Florida Department of State, Division of Corporations Fictitious Name Search Submit https://dos.sunbiz.org/scripts/ficidet.exe?action=DETREG&docnum=G25000119663&rdocnum=G20000164841 1/1 City of Miami RFP #1896386 — Employee Benefit Consulting Services RFP Certification Statement: i Request for Proposals No. 1896386 Certification Statement Please quote on this form, if applicable, net prices for the items) listed. Return signed original and retain a copy for your files. Prices should include all costs, including transportation to destination. The City reserves the right to accept or reject all or any part of this submission. Prices should be firm for a minimum of 180 days following the time set for closing of the submissions. In the event of errors in extension of totals, the unit prices shall govern in determining the quoted prices. We (I) certify that we have read your solicitation, completed the necessary documents, and propose to furnish and deliver, F.Q.B. DESTINATION, the items or services specified herein. The undersigned hereby certifies that neither the contractual party nor any of its principal owners or personnel have been convicted of any of the violations, or debarred or suspended as set in section 18-107 or Ordinance No. 12271. All exceptions to this submission have been documented in the section below (refer to paragraph and section). EXCEPTIONS: We (I) certify that any and all information contained in this submission is true; and we (1) further certify that this submission is made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a submission for the same materials, supplies, equipment, or service, and is in all respects fair and without collusion or fraud. We (1) agree to abide by all terms and conditions of this solicitation and certify that I am authorized to sign this submission for the submitter. Please print the following and sign your name: PROPOSER NAME: Corporate Synergies Group, LLC dba Foundation Risk Partners Public Entity Services ADDRESS: 780 W. Granada Blvd., Ormond Beach, FL 32174 PHONE: 386-999-0001 FAX: 386-777-2819 EMAIL: Eric.Brewer@corpsyn.com CELL(Optional): 4.--. SIGNED BY: Eric Brewer TITLE: Vice President, Senior Consultant DATE: FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM SHALL DISQUALIFY THIS RESPONSE. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 1 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Request for Proposals No. 1896386 Certifications Legal Name of Finn: Corporate Synergies Group, [IC dba Foundation Risk Partners Public Entity Services Firm's Federal Employer Identification Number ("FEIN"): 20-1622581 Entity Type: Partnership, Sole Proprietorship, Corporation, etc. L1C Year Established: 2003 Office Location: City of Miami, Miami -Dade County, or Other Other - Ormond Beach Business Tax Receipt/Occupational License Number: 1077207 Business Tax Receipt/Occupational License Issuing Agency: Florida Department of Financial Services Business Tax Receipt/Occupational License Expiration Date: N/A Will Subcontractor(s) be used? (Yes or No) Yes If subcontractor(s) will be utilized, provide their name, address and the portion of the work they will be responsible for under this contract (a copy of their license(s) must be submitted with your bid response). If no subcontractor(s) will be utilized, please insert N/A.: Jay C. Miniati, FSA, MAAA, MBA, 3750 Gunn Highway, Suite 301, Tampa, FL 33618; Actuary Services Please list and acknowledge all addendum/addenda received. List the addendum/addenda number and date of receipt (i.e. Addendum No. 1, 1/1/24). If no addendum/addenda was/were issued, please insert N/A, Addendum No. 1, 9/3/24 Addendum No. 2, 9/10/24 Addendum No. 3, 9/12/2024 Has Proposer reviewed the attached Sample Professional Services Agreement? Yes / No Yes 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 2 *FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Request for Proposals No. 1896386 Acknowledge that if awarded, Proposer will be required to execute the Professional Services Agreement in substantially the attached form. In addition, Proposer must acknowledge that certain clauses (including 42 Term, #6 Audit and Inspection Rights and Records Retention, #8 Public Records. #9 Compliance with Federal, State and Local Laws, # l0 Indemnification/Hold Harmless/Duty to Defend, #I3 Termination; Obligation Upon Termination, #15 Nondiscrimination, and # 23 City Not Liable for Delays) are non-negotiable. We affirm that if awarded we will execute the Professional Services Agreement. We acknowledge that certain clauses are non-neeotiable. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 3 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Addendum #1 AN 'fl E PEREZ, (.PPO Procure:vent- DIft turf (Net Pf-,set. err., '..It Officer ARTHUR NURiEGt V Cl2y Mnagc.r ADDENDUM NO. 1 RFP 1896386 September 3, 2024 REQUEST FOR PROPOSALS ("RFP") FOR EMPLOYEE BENEFIT CONSULTING SERVICES The following changes, additions, clarifications, and deletions amend the RFP documents of the above captioned RFP and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. A. The deadline for the submission of Proposals has been changed to Tuesday, September 10, 2024, at 5:00 PM. B. Section 2.28, Antitrust Violator Vendors, is hereby deleted in its entirety and is hereby replaced as follows_ Pursuant to Section 287.137, Florida Statutes, a person or an affiliate who has been placed on the Antitrust Violator Vendors List following a conviction or being held civilly liable for an antitrust violation may not submit a bid, proposal, or reply on any agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on any agreement with a public entity for the construction or repair of a public building or public work; may not submit a bid, proposal, or reply on leases of real property to a public entity; may not be awarded or perform work as a grantee, supplier, subcontractor, or consultant under an agreement with a public entity; and may not transact new business with a public entity. C. The following are inquiries received from Prospective Proposers and the City's corresponding responses: Q1. Exhibit A, Current City Benefits Consulting Agreement, will not open and is damaged. Please update the file. Al. The file has been repaired and replaced in the Documents Section of BidSync. Q2. Exhibit B is the Insurance Brokerage Contract for the City of Fort Lauderdale. Was this meant to be included? A2. Yes. The City is currently accessing this contract for the provision of Insurance Brokerage Services. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 4 FOUNDATION 4,40 PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Q3. Will the City agree that, unless required by applicable law, the City will audit during the term of the agreement and not three (3) years after its expiration? A3. No. Refer to Section 6 of the Sample Professional Services Agreement ("PSA ). This clause is non-negotiable and will remain in effect as written. Q4. Will the City confirm that the liquidated damages provision contained within Section 1.12, is not applicable to the services required through this RFP? A4. Section 1.12, Response Form, does not mention liquidated damages. However, Section 1.13, Bid Security Forfeited Liquidated Damages does, and it is not applicable to this solicitation because no bid bond is required. Q5. With regard to Sections 1.42, Indemnification and 2.11, insurance Requirements, does the City agree that indemnification should be limited to grossly negligent acts and omissions, breaches of contract, intentional misconduct or violations of law? A5. No. Q6. Does the City agree that unless required by applicable law, the City may audit relevant records only; not facilities? A6. No. Refer to the response to Question 3 above. Q7. Will the City confirm that prompt payment discounts are not required? A7. Yes. This is confirmed. Q8. Pursuant to Section 2.23, Non -Appropriation of Funds, can the City confirm that the Successful Proposer will be paid for satisfactorily completed work up until the date it receives notice of non -appropriation or until the termination date listed in such notice, whichever is later? A8. Yes. This is confirmed. Q9. Will the City agree to an extension of the RFP submission deadline? A9. Yes. Refer to Item A above. THIS ADDENDUM 1S AN ESSENTIAL PORTION OF THE RFP AND SHALL BE MADE A PART THEREOF. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 5 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ALL OTHER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME. Annie Perez, CPPO Chief Procurement Officer/Director AP:cj cc. Ann -Mane Sharpe, Director, Risk Management Department Thomas M. Fossler, Assistant City Attorney Yadissa A. Calderon, CPPB, Assistant Director of Procurement This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. Corporate Syner res Group LLC dba k' /�j e to NAME OF FIRM: Foundation Riskartners Public Entity Services DATE: 1 ( i SIGNATURE: 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 6 #FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Addendum #2 ANNIE PEREZ, CPPO ProcurererA Director/ Chie€ Procurement Officer ARTHUR NCRIEGA V City YfanaKar ADDENDUM NO. 2 RFP 1896386 September 10, 2024 REQUEST FOR PROPOSALS ("RFP") FOR EMPLOYEE BENEFIT CONSULTING SERVICES The following changes, additions, clarifications, and deletions amend the RFP documents of the above captioned RFP and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. The deadline for the submission of Proposals has been changed to Monday, September 16, 2024, at 5:00 PM. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFP AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME. aGLl ..s 4. U A4 for Annie Perez, CPPO Director/Chief Procurement Officer AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Thomas M. Fossler, Assistant City Attorney Yadissa A. Calderon, CPPB, Assistant Director of Procurement This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. Corporate Synergies Group LLC dba r> NAME OF FIRM: Foundation RiskPartners Public Entity ServicesDATE: SIGNATURE: 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 7 414i$FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Addendum #3 ANNIE PEREZ, CPPO Procurement ©erecter/ Chief Procurement Officer ARTHUR NORIEGA V City Manager ADDENDUM NO. 3 RFP 1896386 September 12, 2024 REQUEST FOR PROPOSALS ("RFP") FOR EMPLOYEE BENEFIT CONSULTING SERVICES The following changes, additions, clarifications, and deletions amend the RFP documents of the above captioned RFP and shall become an integral part of the Contract Documents- Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. A. Section 2.19, Evaluation/Selection Process and Contract Award, subsection (7), has been deleted in its entirety and replaced as follows: All Proposers whose Proposals have been deemed responsive, shall participate in oral presentations before the Committee as part of the evaluation process. Oral presentations shall be scheduled at the convenience of the Committee and will be recorded. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFP AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME. Annie Perez, CPPO Director/Chief Procurement Officer AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Thomas M. Fossler, Assistant City Attorney Yadissa A. Calderon, CPPB, Assistant Director of Procurement This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. Corporate Syn r ies Groo LLC dba NAME OF FIRM' Foundation Risk?artners Public Entity Services DATE: SIGNATURE: 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 8 $FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services 2.7 Proposers' Minimum Qualifications: A. Have at least ten (10) years continuous experience, with the same Federal Employer Identification Number, providing employee health benefit consulting services, similar in scope as described in the RFP, Section 3.1, Specifications/Scope of Services, for public sector groups of 3,000 employees or greater. We affirm we meet these requirements. The Foundation Risk Partners benefits division, Corporate Synergies (FEIN 20-1622581), was founded in 2003. Since then, our benefits professionals have supported the health and welfare programs for local, regional, and national employers, such as H&M and IKEA. Our agency also handles a variety of public sector clients, many of which are large, complex, self -funded accounts, in excess of 3,000 lives. Our cases studies, references, and comparable contracts outline our demonstrated ability to provide employee health benefit consulting services, similar in scope to the RFP as outlined for the City of Miami. B. Be an active registered corporation with the State of Florida Department of State, Division of Corporations. We affirm that we are duly licensed and in good standing with the State of Florida. Please note we are pending an address change on our corporate insurance license below. Lo7A DEPARTMENT of FINANCrAI FOUNDATION RISK PARTNERS, CORP. 1540 CORNERSTONE. R1,VD DAYTONA BEACH FL 321 I7 Agency License Number L 100460 Location Number. 301116 Issued On 09/2212017 ER VICES Pursuant "lo Section 626,0428. Florida Stmutes,'This Agency I. election Shall Be In The Active Full -Time Charge OfA Licensed And Appointed Agent Holding The Rerluired Agent Licenseslb Transact the I,.ines Uf Insurance Being Handled At This Location. Pursuant To Subsecl ion 626.172y41, Florida Statutes. Each Agency Location Must Display The Liccnae Prominently 1 n A Manner That Makes It Clearly \isihle To Any Customer Dr Potential Customer Who Enters The Agency 1.0ealion. Jimmy PaLmnis Chief limincinl Ofiigrr Stele of Florida 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 9 #,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services DEPARTMENT of FIN,ANCIgL SERVICES CORPORATE SYNERGIES GROUP. LLC 390 N ORANGE AVENUE SL 11 L 2300 ORLANDO FL 32801 Agency License Number L.077207 Location Number: 230451 Issued On 02/1312012 Pursuant To Section 626.0428, Florida Statutes, This Agency Location Shall Be In The Active Full -Time Charge Of Licensed And Appointed Agent Holding The Required Agent Licenses To Transact The Lines Of Insurance Being Handled At This Location. Pursuant To Subsection 626.172(4), Florida Statutes, Each Agency Location Must Display The License Prominently In A Manner That Makes It Clearly Visible To Any Customer Or Potential Customer Who Enters The Agency Location. Jeff Atwater Chief Financial Officer State of Florida 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 10 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services DIVISION Of 51inb,z.. ! CORPORATIONS a official State of Florida website aartment of Stake 1 Division of Corporations f Search Records / Search by FEIIEIN Number i Previous On List Next On List Return to List No Events No Name History Detail by FEI/EIN Number =oreign Limited Liability Company CORPORATE SYNERGIES GROUP, LLC Filing information Document Number FEI?EIN Number Date Filed State Status m10000005304 20-1622581 12/02/2010 DE ACTIVE „SNII�I�Z CORPORATIONS DIVISION of an official State of Florida website .Jartment of State 1 Division of Corporations f Search Records 1 Search by Entity Name / Previous On List Next On List Return to List No Events No Name History 'foundation risk partners corpl 'Search' Detail by Entity Name Foreign Profit Corporation FOUNDATION RISK PARTNERS, CORP_ Filing Information Document Number F170000-00884 FEIIEIN Number 81-5191759 Date Filed 02124/2017 State DE Status ACTIVE 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 11 041, FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services C. Must be an independent consulting firm and not affiliated with any insurance company, third party administration agency, or insurance provider network. We affirm that we are an independent consulting firm, not affiliated with any insurance company, third party administration company, or insurance provider network. As public entity specialist we are fully transparent. We do not have preference to one carrier, and we work solely to the City's benefit, not the insurance companies. Our commitment is to, year in and year out, negotiate the optimal carrier contracts available in the marketplace, and leverage the breadth and depth of our book of business to do so. D. Have a Lead Managing Consultant, who will be assigned to the City of Miami account, who possesses a minimum of seven (7) years' experience in progressively responsible administrative oversight of public sector benefits, and the application of State of Florida regulations, as of the proposal submission date. Eric Brewer will serve as the City's primary point of contact. Eric, who currently handles public and private sector benefit plans throughout Dade County and the State of Florida, understands the unique needs associated with this type of organization. He will bring a strong understanding of the factors required to help the City contain cost, remain compliant and drive administrative efficiencies for your staff. With budget being paramount in all public sector organizations, Eric specializes in long-term strategies to mitigate cost while minimizing the amount of change experienced by employees. He has also deployed robust wellness programs to help mitigate common cost drivers associated with large public entities. E. Have never filed for bankruptcy, be in sound financial condition, have no record of civil litigation or pending lawsuits involving criminal activities of a moral turpitude, and shall not have conflicts of interest with the City. We affirm Foundation Risk Partners has never filed bankruptcy and we are in sound financial condition. We also have no record of civil litigation or pending lawsuits involving criminal activities of moral turpitude, and we have no conflicts with the City of Miami. The financial strength of Foundation Risk Partners if backed by Partners Group, a leading global private markets firm. Since 1996, they have invested more than $195 billion USD in private equity, private real estate, and private infrastructure. Nationally, Foundation Risk Partners is a top 20 firm with annualized revenues in excess of $600 million. F. Not have a member, principal, officer, or stockholder who is in arrears or in default of any debt or contract involving the City, is a defaulter or surety upon any obligation to the City, and/or has failed to perform faithfully any contract with the City. We affirm neither Foundation Risk Partners, nor any of its principals, officers, or stakeholders are in arrears or in default of any debt or contract involving the City (as party to a contract or otherwise); nor have failed to perform faithfully on any previous contract with the City. We place performance guarantees in our consulting agreements with fees at risk to illustrate to our clients our commitment to deliver on the scope of service. To date, our firm has never paid out a performance guarantee for a failure to meet the terms of our agreements. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 12 #,FOUNDATION PUBLIC ENTITY SERVICES The foregoin i tru nt sworn was swoto a subscribed before 9 day of t C t by EtfiL O. as the Flelshe is personally known to p (NO iid'" ". L RAER]VERA t/ice'.. Notary Pub€Ic - State of Ronda Commission l NN /14285 ' arv. My Comm. Expires Jan 6, 2026 M I Bonded through National Notary Assn. 11 antarmeamowtemstemorra My Commission Expires: City of Miami RFP #1896386 — Employee Benefit Consulting Services Attachment F, Human Trafficking Affidavit: ATTACHMENT F ANTI -HUMAN TRAFFICKING AFFIDAVIT 1. The undersigned affirms, certifies, attests, and stipulates as follows: a. The entity is a non-govemmental entity authorized to transact business in the State of Florida and in good standing with the Florida Department of State, Division of Corporations. b. The nongovernmental entity is either executing, renewing, or extending a contract (including, but not limited to, any amendments, as applicable) with the City of Miami ("City") or one of its agencies, authorities, boards, trusts, or other City entity which constitutes a governmental entity as defined in Section 287.138(1), Florida Statutes (2024), c. The nongovernmental entity is not in violation of Section 787.06, Florida Statutes (2024), titled "Human Trafficking." d. The nongovernmental entity does not use "coercion" for labor or services as defined in Section 787.06, Florida Statutes (2024), attached and incorporated herein as Exhibit Affidavit- 1. 2. Under penalties of perjury, I declare the following: a. I have read and understand the foregoing Anti -Human Trafficking Affidavit and that the facts, statements and representations provided in Section I are true and correct, b. I am an officer or a representative of the nongovernmental entity authorized to execute this Anti - Human Trafficking Affidavit. Nongovernmental Entity: Corporate Synergies Group, LLC dba Foundation Risk Partners Public Entity Services Name: Eric Brewer Officer Title: Vice President, Senior Consultant Signature of Officer: Office Address: 780 W. Granada Blvd., Ormond Beach, FL 32174 Email Address: Eric.Brewer@corpsyn.com Main Phone Number: 386-949-0001 FEINNo. 210-1/6/2/2/5/8/1 STATE OF FLORIDA COUNTY OF MIAMI-DADE me by means off physical presence or O online notarization, this uthori d officer or representative for the nongovernmental entity.. me or has roducedIc� identification. mkra FA):1-ViA Sig fttturedf lren Talrtyrg Oa tki ,rya (Printed, Typed,do�r��Sta Stamped Name of NotarryCPuubblic) 780 W. Granada Blvd. Ormond Beach, FL 32174 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Tab 1 Cover Page 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 14 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Employee Benefit Consulting Services RFP #1896386 DUE DATE: September 16, 2024 @ 5:00 P.M. Eric Brewer, VP Lead Managing Consultant 780 W. Granada Blvd. Ormond Beach, FL 32174 (407) 612-6355 Eric.Brewer@corpsyn.com ORIGINAL Alan Florez, EVP Public Entity Practice Leader 780 W. Granada Blvd. Ormond Beach, FL 32174 (386) 455-0128 AFlorez@foundationrp.com Kim McBee, SVP Specialty Lines Sales Leader 780 W. Granada Blvd. Ormond Beach, FL 32174 (386) 281-3765 KMcbee@foundationrp.com Ah,FOUNDATION �.i"K PUBLIC ENTITY SERVICES Primary Office: 780 W. Granada Blvd. Ormond Beach, FL 32174 Local Business Address: 8700 West Flagler St., Suite #402 Miami, FL 33174 Phone: (386) 999-0001 Fax: (386) 777-2819 FEIN: 20-1622581 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 15 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Tab 2 Table of Contents 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 16 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services RFP Certification Statement Addendum #1 Addendum #2 Addendum #3 2.7 Proposers Minimum Qualifications Attachment F, Human Trafficking Affidavit Tab Page 1 4 7 8 9 13 Cover Page 1 14 Table of Contents 2 16 Executive Summary 3 18 Proposer's Relevant Experience, 4 21 Qualifications, and Past Performance Relevant Experience and Qualifications of Key 5 55 Personnel and Subcontractors Performing Services Proposed Approach to Providing the Services 6 65 Price Proposal 7 126 Appendix 8 128 Sample Compliance eAlert 130 Samples Compliance Checklist 133 Compliance Calendar 136 Sample Communication Campaigns 147 Sample Renewal Timeline 149 Implementation and Service Timeline Samples 150 Sample Self -Funded Monthly Dashboards 152 BenefitsVlP Flyer 160 Sample BenefitsVlP Report 162 Sample Strategic Roadmap 175 Innovu Sample Analytic Dashboard 183 Sample Benefit Guide 193 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 17 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Tab 3 Executive Summary 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 18 #,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services A signed and dated summary of not more than two (2) pages containing Proposer's overall Qualifications and Experience and Technical Qualifications, as contained in the submittal. Proposer shall include the name of the organization, business phone and contact person and a summary of the work to be performed. 9/16/2024 Procurement Department Miami Riverside Center 444 SW 2nd Avenue, 6th Floor Miami, Florida 33130 RE: City of Miami RFP#1896386 Mr. Johnson, Thank you for the opportunity to present our employee benefits consulting capabilities, service platform, and proven results to The City of Miami. Our services and expertise are positioned to mitigate the City's healthcare cost and risk challenges. We are fully prepared to fulfill each Scope of Services requirements outlined in the City's RFP and to meet all other requirements listed in the document. Throughout our response we address all the core pillars of our service and benefits model. Our benefits platform focuses on strategy, design, and execution in all areas of the client's benefits program from an industry, employer, and participant perspective. Our goal is to improve the member experience in the healthcare delivery system. We proudly represent large national brands such as, ABC Fine Wine & Spirits, IKEA, and H&M, along with numerous cities and municipalities in the U.S., such as The City of Miami Beach, The City of N. Miami, The City of North Miami Beach, and the City of Hoboken. We understand the unique needs associated with a public entity, helping these employers manage people, compensation, and benefits programs in the face of mounting costs, regulatory pressures and ongoing changes in the healthcare and insurance industries, particularly important considering the impact of COVID-19 and the current recruiting environment. As a hopeful partner with the City, we wish to make it clear that we will work for you, not insurance companies. Our commitment is to, year in and year out, negotiate the optimal carrier contracts available in the marketplace, and leverage the breadth and depth of our book of business to do so. „FOUNDATION RISK PARTNERS PUBLIC ENTITY SERVICES We use resources to deliver data -driven decisions that lead to enhanced long-term strategies that align with your culture and benefit philosophies. Key elements in our platform include the following: • Audit of pharmacy programs • A detailed utilization and financial review • Evaluation of stop loss risk • Identification of cost drivers • Personal support of your employees • Employee education and communication strategies • A skilled in-house compliance staff • Voluntary benefits consultation • COVID-19 Information Resources • Wellness initiatives, Population Health Management, and Direct Primary Care CITY OF ROBO<EN $1 Million Saved 2015: $1 M Annual Savings Negotiated direct contract between City and Carepoint Health Systems (CHS) following CHS"s departure from Horizon Blue Cross/Blue Shield network. Resulted in more than $1 million annual savings. PASSAIC COUNTY $9 Million Saved 2018: Eligibility Audit Performed an eligibility audit on self -insured medical and prescription programs. Found 50+ deceased members and over 100 dependents over the age of 26 years old still actively enrolled in programs. 2020: $9M Annual Savings Negotiated self -insured medical and prescription contracts. Resulted in $9 minion annual savings. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 19 $$FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services • Proactive partner committed to containing $38M+ healthcare spend with innovative, creative, and Tong -term cost - containment strategies. For example, The City's Medical cost trend is 10% year -over -year, with catastrophic claims representing a significant portion of trend (34% increase vs. prior year). We recommend a continued emphasis on well visits, onsite clinic utilization, biometrics, cancer screenings and chronic condition adherence to mitigate the severity and frequency of catastrophic claims moving forward. • Proven results mitigating healthcare inflation and driving transparency in healthcare systems, as illustrated in our case studies). • We place our fees at risk via performance guarantees to ensure top-level service and results for the City. • With the City's 20% Rx trend year -over -year cost -mitigation strategies are critical. Our Internal Pharmacy Benefit Manager (PBM) expertise stands ready to evaluate contract terms, cost control opportunities, and program performance. Based on the information provided, we have identified a savings of approximately $2 million without changing the drug formulary. • Customized communication and year-round population health management are critical for the City. 52% of current population is suffering from a chronic condition, with top claim categories being neoplasms and musculoskeletal. A continued focus on population health management and the effect management of chronic conditions will be important for future cost -mitigation. • 3rd largest benefits specialist in the US. Top 3 National partner with Cigna with Platinum status and National Advisory Board representation. Top -Tier status with all other major national carriers. • Dedicated Public Entity practice providing 100+ years of industry experience, led by Alan Florez. Nationally Recognized thought leaders with heavy involvement in PRIMA, Florida League of Cities, SHRM, and other industry resources. • In-house employee resolution center (BenefitsVlP) • Strategic partnership with the Florida League of Cities • Dedicated service lead (Eric Brewer), with a team of 8-10 individuals involved in ongoing support. • South Florida presence through our two local offices in North Miami and Fort Lauderdale. • In-house benefits attorney, with a full supporting compliance department. • With a diverse workforce, CSG's benchmarking software will inform the City's program design. For example, ensuring employee pricing and cost -share are competitive, while ensuring the offering of one medical plan meets the needs of a diverse workforce. Our firm places over $5.5 billion in annual premium volume with virtually all major and regional carriers. We have achieved Tier 1 status with carriers, serve on their advisory boards and maintain direct access to top-level executives within their organizations. We will leverage our position to develop and negotiate cost -controlled, high -value benefit programs on behalf of the City and your employees. As will be communicated throughout our RFP response, we are a performance -based organization that is culturally committed to driving and enhancing business and benefits results. We design and manage the benefit programs of other organizations of similar size, demographics, and complexity to the City. They are achieving high-level value for their benefits investment via our comprehensive platform, technologies, and concierge -level service. Our strategic recommendations are data driven, emphasize transparency, and cost saving program performance. Thank you again for the opportunity to present our capabilities. Alan Florez, Public Entity Practice Leader Direct: 386.455.0128 AFlorez@foundationrp.com Eric Brewer, VP, Senior Benefits Consultant Direct: 407.613.6355 eric.brewer@corpsyn.com 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 20 40# FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Tab 4 Proposer's Relevant Experience, Qualifications, and Past Performance 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 21 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services a) Describe the Proposer's organizational history and structure, past performance and state the number of years the Proposer has been in business, using the same FEIN, providing a similar service(s). Provide the number of employees and the primary markets served. Firm Overview: Foundation Risk Partners (FRP) supports local, regional, and national employers, with combined premiums of over $5.5 billion. Foundation Risk Partners has a division dedicated exclusively to our public entity clients. To this effect we understand the needs of public entities, BUT we also understand that each City is completely unique in their challenges, demographics, support needs, and expectations. We support over 125 public entity clients throughout the country. Some of them include City of Miami Beach, City of North Miami, and City of North Miami Beach. Before partnering to form FRP, the benefits arm of our firm in Florida was known as Corporate Synergies Group. Corporate Synergies was founded in 2003 has continuously used the same FEIN. As a regional benefits broker Corporate Synergies quickly grew to the third largest benefits specialist in the nation, as ranked by Business Insurance magazine in their most recent insurance broker survey. Corporate Synergies Group currently operates offices throughout the Eastern U.S. The lead consultant and account management team identified to manage the City's benefits program are located between our Ormond Beach and Orlando offices with ancillary support provided by some of our satellite offices including local resources in our South Florida offices. Foundation Risk Partners is a privately held brokerage and consulting firm that is headquartered in Ormond Beach, Florida. FRP began with the convergence of two large, established consulting and brokerage firms (Acentria Insurance and Corporate Synergies Group). FRP currently operates in 22 states with more than 2,300 employees in 180+ offices. We are among the 20 largest insurance consulting and brokerage firms in the United States and among the fastest growing in its segment. Our firm is committed to excellence in all facets of insurance and benefits. We embrace our team members, clients, and partners with a culture of exceptional service, personal and corporate growth, and innovation. Foundation Risk Partners is one of the fastest growing insurance brokerage and consulting firms in the United States. Through acquisition and organic growth, we continue to expand throughout all regions with a specific growth strategy that ensures a complimentary mix of industry expertise, coverage, specialized services, location, values, and cultural fit. The team at Foundation Risk Partners is driven to seek new levels of success for our partners while providing superior results for our clients. We are a rare combination of industry experience, leadership, and innovation. We embrace the success of each of our member agencies and further support them through the collective capabilities of our internal network. We invite you to experience the difference. Office Location: Foundation Risk Partners' Corporate office and headquarters is in Ormond Beach, Florida. We have approximately 150 employees in our Ormond Beach office, with the remainder of our personnel throughout other regional offices. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 22 #40FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Corporate Commitment to Employee Benefits: 50% of FRP's business is dedicated to employee benefits. We are fully committed to providing benefits consulting and administration to the City. FRP —National 1 180 LOCATIONS • 22 STATES • 2300+ PROFESSIONALS • $5.5+ BILLION PREMIUM UNDER MANAGEMENT Foundation Risk Partners, is strategically built on a solid foundation distinguished by collaboration, excellence and client -focused partnerships. We are a unique company comprised of industry leaders who redefine what clients should expect from their insurance brokers. 4 Headquartered in Ormond Beach, Florida, with over 150 locations across the U.S., Foundation Risk Partners provides services within the employee benefits, property & casualty and personal lines space, while also offering solutions in life, surety and other special programs. t�1 .1i■ Our strategic growth is rooted in the expertise of our selected partners and our innovative approach to surround clients with exceptional data -driven resources and a growing -team of professionals who are exceptional at analyzing risk exposure and providing solutions to minimize potential risk. The Executive Team at Foundation Risk Partners represents more than 250 years of combined industry experience. Together with the talent, strength and culture of its diverse, community -caring team, Foundation Risk Partners continues to elevate its ranking as a Top 20 insurance brokerage in the nation. The Financial Strength of Foundation Risk Partners is backed by Partners Group, a leading global private markets firm. Since 1996, they have invested more than $195 billion USD in private equity, private debt, private real estate, and private infrastructure. 180 121 22 170 50 2, 300+ OFFICE LOCATIONS U.5. CITIES STATES PARTNER AGENCIES STATES LICENSED TEAM MEMBERS MT Mos per Region Mat R.ybn 27 3E R.ylon 63 Mill R.yow . 23 Total cltl.. 121 NE Ra/Mw NU D 4* FOUNDATION • FRP Daytona Beach MQ 780 W. Granada, Blvd. Ormond Beach, FL 32174 June 2024 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 2 ,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services b) Provide a list of all principals, partners, officers, owners and/or directors of Proposer, including joint ventures and/or sub-consultant(s), if applicable. FRP'S EX CUTIVE TEAM LEADERSHIP Charlie Lydecker Chairrr1an/CEO, Foundation Risk Partners Led by Charlie Lydecker, the experience of the Executive Leadership Team at Foundation Risk Partners includes publicly traded insurance intermediaries, best - in -class regional brokers and specialty distributors. The collaborative result is a leadership team that is relentlessly focused on continuing to develop a sales organization where everyone can be the most successful while being exceptional at analyzing risk exposure and providing the best solutions for our clients. Charlie Lydecker C.lrairrTIdr:/CEO, Foundation Risk Partners Thomas Tinsley Chief Administrative Officer, Foundation Risk Partners Ben Barbieri Chief Acquisition Officer, Foundation Risk Partners Rich Dinan Chief Information Officer, Foundation Risk Partners Alan Florez National Sales Director / EVP, Foundation Risk Partners Mike Lill Co-President/CEO, Corporate Synergies John Turner Chief Operating Officer, Foundation Risk Partners Tom Leek Chief Legal Officer / EVP, Foundation Risk Partners Jeff Leonard Chief Financial Officer, Foundation Risk Partners Mary Lawless Prebir en[, Acentric, / COO of Southeast, FRP Kevin Mason CEO, Acentria / President of Southeast, FRP Andrew Bloom Co-President/CEO, Corporate Synergies 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 2 #,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services FRP Board of Directors: Charlie Lydecker CEO, Foundation Risk Partners FRP Board Chairman EXPANDED BIO Kathleen Shanahan Co -CEO. Turtle & Hughes, Inc. FRP Board Member EXPANDED BIO Dan Ambrosia Senior Investment Leader, Partners Group FRP Board Member EXPANDED BIO Bill Bloom EVP, The Hartford (Ret.) FRP Board Member EXPANDED BIC Michael E. Martin Managing Director, Warburg Pincus, NY FRP Board Member Joel Schwartz Partner, Partners Group FRP Board Member Bruce Crawford Lieutenant General US Army (Retired) FRP Board Member EXPANDED BIO Jorge Dominicis Co -Chairman, Board of Managers, Wellpath FRP Board Member EXPANDED BIO Foundation Risk Partners is a privately held organization. If selected, we can provide a more comprehensive list of shareholders upon request. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 25 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services c) Indicate whether the City has previously awarded any contracts to the Proposer. If so, discuss the nature of contract, types of services performed, and the term of the contract. We affirm that we have not been awarded any contracts with the City. d) Provide a detailed list of five (5) comparable contract (similar in scope of services to those requested herein), which Proposer has either ongoing, or has completed within the past ten (10) years. The description should identify for each project: i. Client ii. Description of work iii. Total dollar value of the contract. iv. Dates covering the term of the contract. v. Client's contact person and phone number. vi. Statement of whether proposer is/was the prime contractor or subcontractor. If Proposer was the subcontractor, name the prime contractor. vii. Detail Proposer's responsibilities and the results of the project. Specify whether or not the scheduled completion time for each project was met; if not met, please provide an explanation. Where possible, list and describe those projects performed for government clients or similar size private entities (excluding and work performed for the City of Miami). Please see our 5 comparable contracts starting on the following page. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 26 #,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Comparable Contract #1 Client: City of Miami Beach Description of Work: Employee Benefits Consulting Services Total Dollar Value of the Contract: $177,000 Dates Covering the Term of the Contract: 2021— Present Client Contact Person and Phone Number: Marvin Adams, (305) 673-7000 Ext 26209 Statement of whether Proposer is/was the prime or subcontractor: FRP is the prime contractor. Detail Proposer's responsibilities and the results of the project: • Assistance with the development of long-range benefit program strategies. • Support services surrounding RFPs, compliance, and employee communication. • Assistance in the development of alternative strategies to mitigate claim cost and reduce fixed cost. • Ongoing meeting schedule to discuss benefits -related topics. • Monthly plan performance tracking. • Plan and contribution benchmarking. • Assistance with deployment of future wellness and Population Health Management initiatives, and vendor evaluation. • Actuarial and financial reporting services — IBNR, renewal projections, OPEB/GASB, 112.08, quarterly reviews, and budget tracking. Results since project inception: • Negotiated initial stop loss renewal within first weeks of engagement to a 0% with dividend, $415k savings. • Conducted Rx program contract and detailed analysis to improve terms, without changing PBM or formulary, $927k net savings over previous contract during initial period. • Reduced Specialty Pharmacy spend by $316k in 2023 plan year. • Evaluated Medicare Advantage option for retirees — 54 — 71% cost savings projected, $1M - $2.2M. 56% savings on enrollees in 1st year. • Introduced concierge primary care platform with significant ROI opportunity. • Evaluated diabetes prevention program with $67k estimated net annual savings. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 27 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Comparable Contract #2 Client: City of North Miami Description of Work: Employee Benefits Consulting Services Total Dollar Value of the Contract: $143,254 Dates Covering the Term of the Contract: 2021— Present Client Contact Person and Phone Number: Lura Woodley, 305-560-0486 Statement of whether Proposer is/was the prime or subcontractor: FRP is the prime contractor. Detail Proposer's responsibilities and the results of the project: • Assistance with the development of long-range benefit program strategies. • Establish a wellness program focused on preventive care. • Identify underlying cost -drivers and modify plans to proactively mitigate future costs. • Support services surrounding RFPs, compliance, and employee communication. • Assistance in the development of alternative strategies to mitigate claim cost and reduce fixed cost. • Ongoing meeting schedule to discuss benefits -related topics. • Monthly plan performance tracking. • Assistance with development of future wellness and Population Health Management initiatives. Results since project inception: • Average annual medical cost trend of 4.9%, with the most recent renewal representing the successful transition to a new carrier with minimal disruption to employees. • Transition the ancillary products with a strengthening of contract and benefit, while reducing the annual spend by 13%. • Optimize and support benefits administration technology platform. • Provide onsite primary care for employees through our partnership with Dr. Moise and Comprehensive Health Center. • Provide a service platform that has allowed for consistency and continuity of process amid staff transitions. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 28 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Comparable Contract #3 Client: Township of Irvington Description of Work: Employee Benefits Consulting Services Total Dollar Value of the Contract: Standard Commission, 3% of max cost Dates Covering the Term of the Contract: 2015 — Present Client Contact Person and Phone Number: Musa Malik, 973-399-8111 Statement of whether Proposer is/was the prime or subcontractor: FRP is the prime contractor. Detail Proposer's responsibilities and the results of the project: Full Broker services for Medical and Prescription programs with strategic long-term goals, program structure review through data analysis, renewal solutions with cost control initiatives, and day to day benefit management support to create efficiencies. Results: • 2015: $300k savings by moving +65 Retirees from self -insured program to a direct Aetna Medicare Advantage Program. • 2015: negotiated self -insured medical and prescription contracts with Meritain/Aetna for active employee population, which resulted in $3M annual savings. • 2017: performed an eligibility audit on self -insured medical and prescription programs. Found 30+ deceased members and 25+ dependents over age 26 still actively enrolled in programs. • 2019: negotiated membership into Aetna via Metropolitan Health Insurance Fund at a reduction of medical and prescription premiums by moving +65 retires from Aetna direct program. Resulted in $500k in savings. Over $3.5M in savings since the start of the contract. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 29 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Comparable Contract #4 Client: County of Passaic Description of Work: Employee Benefits Consulting Services Total Dollar Value of the Contract: $200,000 fee Dates Covering the Term of the Contract: 2018 — Present Client Contact Person and Phone Number: Anthony De Nova, 973-881-4405 Statement of whether Proposer is/was the prime or subcontractor: FRP is the prime contractor. Detail Proposer's responsibilities and the results of the project: FRP provides full broker services for all lines of employee benefits (group medical, dental vision and additional ancillary coverages) including but not limited to employer support services, planning and negotiation, and employee support services. • Assistance with the development of long-range insurance strategies. • Assistance in the development of alternative strategies to reduce claims and premium. • Consultation as to the probable impact of strategies elected by the entity. • Notification of entity staff as to local, state, and federal regulations and recommendations for compliance as required. Upon being named Broker of Record as of July 1, 2018, our firm conducted a prescription program analysis with a projected 3-year savings of over $10 million. • 2018: performed an eligibility audit on self -insured medical and prescription claims. Found 50+ deceased members and over 100 over age dependents still actively enrolled in programs. • 2020: negotiated self -insured medical and prescription contracts. Resulted in $9M annual savings. We replaced Horizon Blue Cross with Aetna/Meritain for third party administrative services. We were able to achieve an $8 million savings in the first year with this move because of our ability to properly manage Out of Network repricing from the TPA's, which almost tripled the network discount/savings. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 30 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Comparable Contract #5 Client: County of Warren Description of Work: Employee Benefits Consulting Services Total Dollar Value of the Contract: Standard Commission, 3% of max cost Dates Covering the Term of the Contract: 2018 — Present Client Contact Person and Phone Number: Danielle M Davis, 908-475-7950 Statement of whether Proposer is/was the prime or subcontractor: FRP is the prime contractor. Detail Proposer's responsibilities and the results of the project: FRP provides full broker services for all lines of employee benefits (group medical, dental vision and additional ancillary coverages) including but not limited to employer support services, planning and negotiation, and employee support services. • Assistance with the development of long-range insurance strategies. • Assistance in the development of alternative strategies to reduce claims and premium. • Consultation as to the probable impact of strategies elected by the entity. • Notification of entity staff as to local, state, and federal regulations and recommendations for compliance as required. Results — over $2M saved: • 2018: Moved the County out of NJ SHBP into a private fully insured medical and prescription program. Zero employee disruption to medical network. Resulted in $600k savings. • 2019: Secured self -insured medical program from current carrier that delivered anticipated maximum liability less than fully insured renewal premium. Zero employee disruption to medical network. $1M annual savings. • 2019: Negotiated Medicare Advantage contract for +65 retirees. Resulted in $500k annual savings. • 2021: Secured self -insured prescription program from current carrier. Zero employee disruption to prescription network. $1M projected annual savings. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 31 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services e) Provide information concerning any prior or pending litigation or proceedings, either civil or criminal, involving Proposer, its partners, managers, other key staff members, and its professional activities or performance, that Proposer has been involved in which may affect the performance of the services to be rendered herein, if applicable. State the nature of the litigation, a brief description of each case, the outcome or projected outcome, and the monetary amounts involved. Discuss any bankruptcies involving Proposer, its partners, manager(s), or other key staff members, if applicable. We affirm that there is no prior or pending litigation, either civil or criminal, involving Foundation Risk Partners, its partners, managers, other key staff members, and its professional activities or performance, that Foundation Risk Partners has been involved in which may affect the performance of the services to be rendered herein. There are also no bankruptcies to report. f) Provide a minimum of three (3) references on Attachment B, Reference Submittal form, of clients to whom services of a similar nature were provided, as described within Section 2.8, References. The City reserves the right to contact any reference as part of the qualification process. Please see our references starting on the following page. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 32 #40 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services City of Winter Garden — Testimonial Letter City of Winter Garden P: 407.658.4111 300 West Plant Street Winter Garden, FL 34787 wintergarden-fl.gov iflj R 61IRD[11 May 28, 2024 Re: Corporate Synergies Employee Benefits To Whom It May Concern: I have been requested to write a letter of recommendation for Corporate Synergies. It is my honor to do so. I have had the pleasure of working with professionals from this company for the last twenty (20) years. Corporate Synergies has exceeded our expectations in many ways. Whether it is taking care of employee claims, explaining EOBs, or answering daily questions that may arise. If you want a company that becomes an extension of your HR team, to help employees with enrollments, on -site visits and providing great advice on plan design, funding, self -insured or fully funded programs and wellness programs. If you are seeking innovative ways to achieve your employee benefit goals then I suggest you let Corporate Synergies be your partner as they have been our strategic partner for many years. If you have any questions, please call me at 407.656.4111 ext. 2247 or frank.gilbertla cwgdn.com. Sincerely, Frank M. Gilbert Asst. City Manager — Administrative Services W I N I E R G A Fj D, <. .. wir 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 33 #40,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services City of North Miami — Testimonial Letter I NflTH'M IAM 1 FLORIDA June 3, 2024 Re: Recommendation Letter To Whom It May Concern: This letter serves as an official recommendation for Corporate Synergies. I have had the privilege of working with Eric Brewer and his team for the past two (2) years in his capacity as Vice President, Senior Benefits Consultant. Eric and his team are dedicated, hardworking, knowledgeable, and do an exceptional job as the City of North Miami's "Record of Agent". It is truly a pleasure to work with consultants that are not only professional but produce positive results. Therefore, I highly recommend Corporate Synergies along with Eric Brewer and Team without any reservations. Please do not hesitate to contact me if you need any further assistance or have any questions. I can be reached via email at Iwoodley@northmiamifl.gov or by phone at (305) 895-9862. Sincerely, c!� Lura F. Woodley Personnel Director 776 NE 125 Street I North Miami I Florida 133161 305.893.E511 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 34 %FOIJNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services City of Miami Beach — Testimonial Letter i� r`tif 0 BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov Human Resources Department, Benefits Division Tel: (305)673-7524 June 3, 2024 To Whom It May Concern, Re: Foundation Risk Partners - Employee Benefit Consulting Services am writing to recommend the Foundation Risk Partners team for your Employee Benefit Consulting Services. Throughout our collaboration, they demonstrated deep industry knowledge and tailored a benefits package that aligned perfectly with our company's needs and budget. Their comprehensive review of our existing program and identification of improvement areas significantly enhanced the overall value provided to our employees Additionally, they facilitated smooth negotiations with insurance carriers, which resulted in more favorable terms and rates for our company. They have delivered on several cost mitigation strategies for our healthcare program. I recommend the Foundation Risk Partners team to any organization looking to enhance their benefits program due to their expertise, commitment to client service, and results -driven approach. If you need any additional information, please contact me at (305) 673-7000 ext. 6209 or send an e-mail to MarvinAdams@miamibeachfl.gov. Sincerely, Marvin Adams Employee Benefits Manager We are comnlrfled f0 provrdlg excellent padre service and safety to all who ave. work, and play in our vibrant. nopigal. nlston5 cpmmun4y- 780 W. Granada Blvd. Ormond Beach, FL 32174 #,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services RFP NO.: 1896386 Attachment B Reference Submittal Form CATEGORY: Employee Benefiit Consulting Services FIRM NAME: Corporate Synergies Group, LLC dba Foundation Risk Partners Public Entity Services Reference Section Summarized Requirements: Refer to the details in Section 2.8, References, to verify that the information provided will suffice as proof of meeting the requirements of this solicitation. Past Performance Reference Check #1 Company/Organization Name: City of Winter Garden Address: 300 West Plant Street, Winter Garden, FL 34787 Contact Person: Frank Gilbert Contact Phone Number: 407-656-4111 ext. 2247 Contact E-mail (if applicable): frank.gilbert@cwgdn.com Date of Contract or Sale: 8/23/2019 - Current Past Performance Reference Check #2 Company/Organization Name: City of North Miami Address: 776 NE 125 Street, North Miami, FL 33161 Contact Person: Laura F Wood ley Contact Phone Number: 305-893-6511 Contact E-mail (if applicable): Iwoodley@northmiamifl.gov Date of Contract or Sale: 4/1/2021-Current Past Performance Reference Check #3 Company/Organization Name: city of Miami Beach Address: 1700 Convention Center Drive., Miami Beach, FL 33139 Contact Person: Marvin Adams Contact Phone Number: 305-673-7000 ext. 6209 Contact E-mail (if applicable): MarvinAdams@miamibeachfl.gov Date of Contract or Sale: 8/9/2021- Current 1 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 36 4FOUNDATION1 PUBLIC ENTITY SERVICE City of Miami RFP #1896386 — Employee Benefit Consulting Services g) Provide information or documentation to Proposer's qualifications and experience from which the City can benefit under this contract. Our services and expertise are positioned to mitigate the City's healthcare cost and risk challenges. We are fully prepared to fulfill each Scope of Services requirements outlined in the City's RFP and to meet all other requirements listed in the document. Throughout our response we address all the core pillars of our service and benefits model. Our benefits platform focuses on strategy, design, and execution in all areas of the client's benefits program from an industry, employer, and participant perspective. Our goal is to improve the member experience in the healthcare delivery system. Technical Qualifications & Experience — Why Us? • Proactive partner committed to containing $38M+ healthcare spend with innovative, creative, and long- term cost -containment strategies. For example, The City's Medical cost trend is 10% year -over -year, with catastrophic claims representing a significant portion of trend (34% increase vs. prior year). We recommend a continued emphasis on well visits, onsite clinic utilization, biometrics, cancer screenings and chronic condition adherence to mitigate the severity and frequency of catastrophic claims moving forward. • Proven results mitigating healthcare inflation and driving transparency in healthcare systems, as illustrated in our case studies. • We place our fees at risk via performance guarantees to ensure top-level service and results for the City. • With the City's 20% Rx trend year -over -year cost -mitigation strategies are critical. Our Internal Pharmacy Benefit Manager (PBM) expertise stands ready to evaluate contract terms, cost control opportunities, and program performance. Based on the information provided, we have identified a savings of approximately $2 million without changing the drug formulary. • Customized communication and year-round population health management are critical for the City. 52% of current population is suffering from a chronic condition, with top claim categories being neoplasms and musculoskeletal. A continued focus on population health management and the effect management of chronic conditions will be important for future cost -mitigation. • 3rd largest benefits specialist in the US. Top 3 National partner with Cigna with Platinum status and National Advisory Board representation. Top -Tier status with all other major national carriers. • Dedicated Public Entity practice providing 100+ years of industry experience, led by Alan Florez. Nationally Recognized thought leaders with heavy involvement in PRIMA, Florida League of Cities, SHRM, and other industry resources. • In-house employee resolution center (BenefitsVlP) • Strategic partnership with the Florida League of Cities • Dedicated service lead (Eric Brewer), with a team of 8-10 individuals involved in ongoing support. • South Florida presence through our two local offices in North Miami and Fort Lauderdale. • In-house benefits attorney, with a full supporting compliance department. • With a diverse workforce, CSG's benchmarking software will inform the City's program design. For example, ensuring employee pricing and cost -share are competitive, while ensuring the offering of one medical plan meets the needs of a diverse workforce. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 37 FOUNDATION 41114010. PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services We proudly represent large national brands such as, ABC Fine Wine & Spirits, IKEA, and H&M, along with numerous cities and municipalities in the U.S., such as The City of Miami Beach, The City of N. Miami, The City of North Miami Beach, and the City of Hoboken. We understand the unique needs associated with a public entity, helping these employers manage people, compensation, and benefits programs in the face of mounting costs, regulatory pressures and ongoing changes in the healthcare and insurance industries, particularly important considering the impact of COVID-19 and the current recruiting environment. As a hopeful partner with the City, we wish to make it clear that we will work for you, not insurance companies. Our commitment is to, year in and year out, negotiate the optimal carrier contracts available in the marketplace, and leverage the breadth and depth of our book of business to do so. We use resources to deliver data -driven decisions that lead to enhanced long-term strategies that align with your culture and benefit philosophies. Key elements in our platform include the following: • Audit of pharmacy programs • A detailed utilization and financial review • Evaluation of stop loss risk • Identification of cost drivers • Personal support of your employees • Employee education and communication strategies • A skilled in-house compliance staff • Wellness initiatives, Population Health Management, and Direct Primary Care • Voluntary benefits consultation • COVID-19 Information Resources Our firm places over $5.5 billion in annual premium volume with virtually all major and regional carriers. We have achieved Tier 1 status with carriers, serve on their advisory boards and maintain direct access to top-level executives within their organizations. We will leverage our position to develop and negotiate cost -controlled, high -value benefit programs on behalf of the City and your employees. We are a performance -based organization that is culturally committed to driving and enhancing business and benefits results. We design and manage the benefit programs of other organizations of similar size, demographics, and complexity to the City. They are achieving high-level value for their benefits investment via our comprehensive platform, technologies, and concierge -level service. Our strategic recommendations are data driven, emphasize transparency, and cost saving program performance. PASSAIC COUNTY $9 Million Saved 2018: Eligibility Audit Performed an eligibility audit on self -insured medical and prescription programs. Found 50+ deceased members and over 100 dependents over the age of 26 years old still actively enrolled in programs. 2020: S9M Annual Savings Negotiated self -insured medical and prescription contracts. Resulted in $9 million annual savings. CITY OF HOBO{EN $1 Million Saved 2015: $1 M Annual Savings Negotiated direct contract between City and Carepoint Health Systems (CIS) following CHS's departure from Horizon Blue Cross/Blue Shield network. Resulted in more than $1 million annual savings. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 38 $$FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Here are specific examples of how we've secured favorable outcomes for our clients: lase Study 1 Situation: County with 4000 enrolled hired FRP in 2018 to help manage rising healthcare costs. Solution: Upon engagement, our firm conducted several audits and program reviews which produced several strategic opportunities. We conducted a prescription program analysis and an eligibility audit. We also replaced BCBS with Aetna/Meritain for TPA services. this change allowed us to properly manage out of network repricing from the TPAs. TPAs use multiple network wraps to re -price out of network claims which results in only approximately 25% discounts on billed charges. Our approach achieves over 60% discount for services, which nearly triples the savings out of network. Result: The prescription analysis projected $10 million in savings over a 3-year period. The eligibility audit determined more than twenty deceased members remained enrolled on the County's benefits program, which saved the County in continuing unnecessary contributions. We also generated $8 million in savings in the 1st year with proper management of Out of Network claim repricing. Case Study 2 Situation: Client since 2013. 1,000 enrolled City looking to lower claims to control rising healthcare premiums. Solution: In June of 2016 a key hospital/health system exited the carrier network. This action would have increased the City's budget by over $5 million. Result: Our firm effectively negotiated a direct contract between the City and the health system, which resulted in saving the City's budget. The direct contract is fully transparent to the City, without excess and hidden profit to the carrier. We work to achieve the greatest cost savings to the client. Case Study 3 Situation: An employee suffered a major heart attack and was rushed to the closest hospital, which was out -of -network. When the employee received an unexpected bill for $21,000, he called BenefitsVlP for help. Solution: The BenefitsVlP advocate filed appeals with carrier on behalf of employee and arranged for bills and collection notices to be held until appeal was resolved. The advocate also provided the carrier with information about other insurers' policies of covering emergency care as in -network. Result: $19,000 decrease in employee's out-of-pocket expenses when the carrier agreed to cover the admission as in -network. The carrier also revised its policy to cover emergency care at in -network levels, regardless of whether the hospital participates in the network. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 39 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Case Study 4 Situation: A client's adult dependent had hemophilia. This member's factor 7 drug no longer worked and was moved to a rare alternative immunotherapy. Claims went from $250,000 to $5 million a year due to the immunotherapy. The client couldn't move the full pharmacy benefit because it was under a three-year contract. Solution: We marketed and negotiated this one class of specialty medication because the client did not wish to disrupt all plan members with a total PBM change. We successfully implemented a specialty pharmacy arrangement for this drug class. Result: Client saved $1.2 million annually. Case Study 5 Situation: 500 life self -funded employer received a 55% increase on their stop loss renewal due to an influx of large claims, with specialty pharmacy as a major driver. The plan was running $703k over budget with 3 months remaining in the plan year. Solution: We were hired a couple of weeks before open enrollment to help drive a solution to the stop loss renewal, which had a $315,000 premium increase. The client was told alternate carriers would quote based on their participation. We acted immediately and engaged the marketplace and were able to secure proposals. We brought in a transparent PBM with 100% pass through contract. This allowed us to also bring in a partner to mitigate specialty drug spend. Result: We took an aggressive approach based on the Rx savings anticipated and sold a 2.5% stop loss increase with the same coverage limits, which resulted in $300,000 in savings. We had a decrease on the table on an alternate option. We were immediately able to shift $300,000 in specialty Rx costs away from the plan using our strategy. We also reduced fixed cost fees by $79,000 to avoid paying the TPA for a service our team provides in-house. Combined, our efforts saved over $870k within a couple of weeks of being hired. /Case Study 6 Situation: A Florida city has approximately 350 full-time employees and spends $3 million per year on healthcare. The city tried participation -based wellness with incentives offered to employees for participation, but healthcare costs continued to escalate year -over -year. Solution: We deployed an outcome -based wellness program (backed with a technology platform) that financially rewarded preventive care activities and improvements to measurements such as high blood pressure, smoking, cholesterol, and obesity. We also deployed nutritional seminars with metabolic profiling and kinetic testing, yielding 98% participation. Result: This employer group yielded a 10% immediate ROI, offsetting the cost associated with the wellness platform entirely with a 2:1 return. This group has also had flat renewals for the previous three years on the aforementioned $3 million spend. The city as successfully created a culture of wellbeing as well that employees now embrace. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 40 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Case Study 7 (--- Situation: A public sector client hired our firm to accomplish two primary goals (1) Mitigate premium spend on healthcare (2) Drive administrative efficiency to support their budget -driven reduction in HR staff. This client spends —3M in premium per year in health insurance premium with —200 active and retiree participants on their plan. Solution: We helped the client identify the underlying cost drivers of their program with the deployment of a full participation -based wellness program for the previous two years, steps -driven wellness program within which HRA funding occurs based on steps taken each day, along with an annual onsite health fair. We rolled out our SmartBEN Essentials online enrollment technology tool, benefits administration outsourcing support and BenefitsVlP employee advocacy services. Result: The client has reduced its benefits spend by an average of -5% over the last three renewal cycles with no changes in the benefits offered to employees. We've also taken on all functions associated with benefits administration, becoming an extension of the client's internal benefits staff with direct interaction with employees for anything relating to the benefits program. --) Case Study 8 Situation: One of our public sector clients has a self -funded health plan with approximately 1500 covered employees. They conducted a broker RFP during the spring of 2021 and hired FRP to be their benefits consultant. Our contract began on September 1st and the City had not yet received their Stop Loss renewal for the plan year beginning on October 1st Based on what we learned during the bid process, we identified pharmacy as an area of opportunity to control rising healthcare costs. A review of the current Rx spend and contract language was an immediate priority project for our team. Solution: FRP immediately secured the initial Stop Loss renewal which had a +19.8% increase. A historical loss ratio and claims review was performed by the FRP team, and we engaged with the marketplace to assess carrier appetite and drive a solution to the increase. With regard to the pharmacy, we conducted an initial discount analytics assessment using a vendor partner to determine how the current terms align with market norms. Result: With negotiations, FRP negotiated the Stop Loss renewal to a rate pass with the current carrier, mitigating a $415,505 premium increase for the City. The new contract also has improved terms, with the addition of a dividend option to return surplus premiums to the City in a favorable claim year. We proceeded with the pharmacy analytics engagement process and project a savings of 18.78% in the first year, which will result in $1M in gross savings on pharmacy spend with no impact to plan members. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 41 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services h) Describe any relevant industry/subject matter expertise, including any experience in the requested services listed herein, and any unique or proprietary project methodologies relevant to the requested services. How we Differ from our Competitors: We take pride in being a firm that understands the importance of creativity and continued thought leadership, backed with world -class service and execution. We understand that each client is unique and it's our job as a partner to identify and address the unique challenges and needs for each of our clients. As a privately held company, we have the flexibility of a boutique firm with the reach of a national firm. We speak Government: Foundation Risk partners has a dedicated Public Entity practice that recognizes the unique exposures and evolving risk profiles of our municipal clients and strives to reduce the total cost of risk. The practice believes in public service and is dedicated to reducing program cost, mitigating risk, and functioning as an extension of your staff. We understand the bid process and public record laws while maintaining familiarity with the constantly changing and complex statutes that apply to governmental organizations. This specialized knowledge is especially vital when negotiating renewal and program changes with insurance carriers and health insurance consortiums. Our expertise guarantees an exemplary benefit program. Our seasoned team members are subject matter experts in their core competencies: The team identified to serve the City's benefits program includes seasoned professionals that bring collectively more than 100 years of benefits experience to the table along with different perspectives. These varied backgrounds and expertise, coupled with FRP's collegial approach, will enable valuable feedback to the City of Miami from all points of view, including finance, associate experience, and ease of administration. We use resources to deliver data -driven decisions that lead to enhanced long-term strategies that align with your culture and benefit philosophies: We will draw data from your workforce; this process will help you gain insights that are specific to the City of Miami and will provide insightful, targeted, actionable solutions that drive meaningful savings and improved productivity. We will use our data engine to measure the impact of the solutions we implement to drive continuous improvement. We focus attention on day-to-day client needs: Unlike consulting firms, we do not work on a per -hour basis. Rather, we are measured on client satisfaction. Our concierge -level of service has and remains a keystone of our company philosophy throughout our history. As our firm grows and evolves, we continue to make investments in our infrastructure, services, and personnel, but our approach to support always remains constant for the client and their member base. Our service is hands-on, continuous, and personal. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 42 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services We seek client feedback to improve our services: We conduct the Net Promoter Score (NPS) survey every year for each client based on their renewal date. We survey the client's key financial decision -makers and day-to-day service contacts to gauge overall satisfaction and loyalty to our services and to identify and quickly resolve issues. The survey process is triggered by an email 45 days after the renewal to invite participation. Our executive operating committee reviews survey results. The NPS is a survey based on a 0-10 scale of the likelihood that a client will recommend a firm's services. NPS can be as low as —100 (where every customer is a detractor) or as high as +100 (where every customer is a promoter). An NPS that is positive (i.e., higher than zero) is determined to be good, and an NPS of +50 is considered excellent. Our corporate NPS score is 76. We are privately owned with unfettered access to enterprise -wide account teams and all levels of senior management. Our privately held status allows our clients the comfort of knowing they, not shareholders, are our No. 1 priority. Moreover, FRP is a flat organization with limited hierarchical structure. This means our clients have access to not just their account teams, but all levels of senior management and expertise that resides in all parts of our organization, which reinforces the statement that clients are our No. 1 priority. We provide a dedicated advocacy team that delivers best in class service to the City's employees and dependents. One -on -One Employee Advocacy: Foundation Risk Partners' exemplary service approach to the way we conduct business is called BenefitsVlP working as an extension to your Human Resources office. Employees are provided with a first -party administrative and advocacy support team providing response and resolution for employees and their dependents. BenefitsVlP Key Operational Points: ■ An average of 22 years industry experience ■ Direct access to carriers, providers & tools ■ Flexible access to advocates ■ Multi -Lingual ■ Adapt to your culture. ■ Consultative approach Help starts here 1.1,101610114...10 nee. pox potarlell Y..1.-mg*MISS rr 1.866.284.2053 BenefitsVlP. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 43 #40 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services VIP BenefitsVlP is NOT a Call Center...but rather a one stop first -party administrative and advocacy support team providing response and resolution for employees and their dependents. Your BenefitsVlP team is an extension of your organization and available to employees/dependents in a variety of ways, making it a simple and seamless engagement. Our team handles ALL your benefits with 1 number to call, no matter the carrier. Phone (Vanity Line) Offered so that your advocacy team is identified in a branded way consistent with other services IL J Email Inquiries activated from multiple points available to co-workers such as websites and portals ram=, Fax Inquiries can be sent via a dedicated line to your BenefitsVlP learn 8enefitspfp • • • • • • Respond to Inquiries/Resolve Claims Plan Utilization & Trend Reporting Research Care Providers/Facilities Precertification for proceduresfRx Healthcare Coaching Verify Dependent Status Enrollment Support Percent of issues resolved within 24 hours. Operational Points • Average 22 Years Industry Experience • Direct Access to Carriers, Providers & Tools • Flexible Access to Advocates • Multi -Lingual • National Time Zone Coverage • Counseling Approach Percent of issues resolved in first call. Average number of seconds to answer call 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 44 $FOl1NDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services BenefitsVlP Help starts here. Reporting Examples BenefitsVlP utilizes people and advanced technology to identify, track, and report issues and member actions/behaviors/satisfaction on an ongoing basis. This allows the customer service and experience of your employees to be measured and in cases, shows us where to improve. Lastly, the reports serve as stewardship reports for audits/compliance with our scope of services. Reports identify: ■ Detailed Utilization Information ■ Emerging Service Trends ■ Average Resolution Time ■ FIR/Employee Usage ■ Productivity Savings Calculations ■ Opportunities (e Employee Education) Upon closing all cases, we can survey co- workers regarding their satisfaction with: ■ The outcome of the case ■ How BenefitsVlP managed the case BenefitsVlP *BenefitsVlP team members are employees of Foundation Risk Partners, located in the US, with avg experience of 20 years. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 4 City of Miami RFP #1896386 — Employee Benefit Consulting Services Test Client January 2023 through December 2023 Executive Summary Below is a quick snapshot of the total case review and top three service types for this reporting period. Total Case Review Total number of employees 2,650 Total cases 282 Average resolution time (in days) 0 87 Employer hours saved 36.32 Employee hours saved 33343 Total Hours saved 369.75 Test Client 45 40 35 30 25 20 15 10 Conllrmation Benef itsV! F' Open Enrollment - ID Cards General BenefitsVl January 2023 through December 2023 Who's asking? Listed below are who contacts your BenefitsVIPtp team compared to all Corporate Synergies clients, clients of like industry and clients of like size. Inc 9n 89 7n an 50 4E1 ao 2n 1n 0 Number Your All clients Of clients Of Inquirer ar Cases Organization clients Like Industry Like Size Employee 271 961% 89.396 88.296 0.096 Spws;e/l?ependent 2 0.796 2.096 2.496 0.0% Employer 6 2.196 6.1% 6.496 0.096 Other 3 12% 2.796 3.196 0.096 Total_ 282 Employee Spou€!Dependent Empbyer Omer Your Organization Clients of Like Industry AU Clients Clients of Like Size 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 46 #$FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Our Approach to carrier and product selection: Our consultants have exclusive access to advisory boards of the most dominant carriers in the market. We represent virtually every carrier nationwide and sit on several national advisory boards: Aetna, Cigna, United HealthCare, Hartford, Lincoln Financial, MetLife and Reliance Standard. We have achieved Preferred status with most of the major insurers. Preferred status typically results in a higher level of advocacy from the carrier, including but not limited to: • Enhanced claims reporting at no additional cost. • Dedicated service teams. • Inclusion on the carriers' Advisory Council. • Accelerated case implementation. • Direct access to underwriters and medical directors. • New product roll out. We maintain direct access to decision -makers within carrier organizations and can leverage when negotiating with carriers on rates, policy terms, plan design, and escalated issues. Our carrier relationships provide us with leading edge concepts such as alternative funding, consumer driven health plans, onsite clinics, offsite clinics, disease management, innovative plan designs and wellness programs. Foundation Risk Partners has extensive experience in dealing with all types of funding arrangements, including fully insured, minimum premium, self -funded programs, as well as numerous insurance carriers, third party administrators and stop loss providers. Our proprietary Risk Decision Support Tool uses real-time and historical data to help employers make crucial funding decisions. This high -quality analysis allows our evaluation and recommendation proposals to be presented and communicate the information in a clear and concise manner. Measuring client satisfaction: Built into our communication plans (beyond telephonic and scheduled face-to-face meetings) are several levels of electronic correspondence that measure client satisfaction. We utilize these key methods to gauge and ensure continued client satisfaction: • Listening to Our Clients: Beyond adding measurables and metrics around client satisfaction, it's most important for us to be receptive and aware of our clients' needs. We are good listeners. We also understand the importance of being a proactive partner, anticipating our clients' needs and bringing ideas and options to the table worth consideration. • Performance Guarantees: Built into our Broker Consulting Service Agreement. If we're not doing our job as contractually agreed upon, we're returning a portion of our annual service fees. • Net Promoter Score: An index that measures the willingness of clients to recommend a company's products or services to others. NPS is a proxy for gauging the customer's overall satisfaction with a company's product or service and the customer's loyalty to the brand. NPS is a key initiative for our firm. • Client Advisory Council: Convened on a regular basis. Clients advise us on their benefit issues, management of industry trends, business priorities and recommendations for strategic direction. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 47 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Our influence as a Market Leader: Our goal in being a market leader is to be in front of the innovation curve, delivering data to our client to make better decision all in an effort to maximize benefits for our client while driving down their overall cost. We define a market leader as a firm who: • Negotiating Power: A National firm with Tier 1 status with all carriers. • Thought Leadership: Innovative and creative ideas to create strategic plans to maximize employee benefits while managing cost drivers. • People: Qualified staff with technical skills to keep our client promises. We back it up with a performance guarantee. Below are examples of what this looks like in practice: Industry Thought Leadership: Thought leadership at our firm starts with being innovative, creative, and never accepting the status quo. There is no "one right way" of being a good thought leader, but the Foundation Risk Partners culture revolves around staying in front of the innovation curve and bringing forward -thinking and innovation to our clients consistently. To that end, approximately 40 of our internal subject matter experts, including Senior Benefits Consultant Kim McBee, write best -practice articles, which are routinely published as guest commentary by some of the nation's most recognizable media sources. Our media "pick-up rate" is among the benefit and insurance industry's highest: an average of 99% of weekly articles authored by our staff members are published in trade, business, and national media. CURREPORT 202RENT INSURANCE 4 CORPORATE SYNERGIES' BUILDING BENEFITSTECHNOLOGY INTO LONG-TERM BENEFITS STRATEGY Benefits are complicated_ The right ben,. administration sokudon can help employers achieve longtemplerm employee benefits goals. You want a solntlon Nat ran snip e2aeem sour tenem sbateg wnu For more than five years, our articles have been a staple in Employee Benefit News. Our articles and interviews of our staff members have also appeared in HR Dive, Huffington Post, Fortune Magazine, Newsday, Crain's New York, Employee Benefits Views, Plan Sponsor, Chief Executive.net, CFO.com, BenefitsPro, SHRM, HIX, Success Magazine, Corporate Wellness Magazine, Workplace HR & Safety, Life Health Pro, Property & Casualty 360, and Philadelphia Business Journal. Additionally, our experts are often interviewed by media sources for their insights into business insurance and benefits best practices. Our articles have earned an APEX award for publication excellence. We also publish select staff articles in its annual Current Insurance Journal magazine, which is also an APEX award -winner for publication and content excellence. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 48 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Educational Events: We are committed sharing our best practices with clients and prospective clients via: • Sponsoring employee benefit forums that attract leading experts and organizations as panelists • Presenting regular webinars to help clients delve deeper into topics such as ACA compliance, benefits administration, and wellness strategies. Carrier Tier 1 Status and Broker Advisory Boards: Foundation Risk Partners maintains Tier 1 status with all major carriers. The criteria and benefits differ depending on the carrier; however, this normally means that Foundation Risk Partners and our clients receive a higher level of advocacy from the carrier, including but not limited to enhanced claims reporting at no additional cost, dedicated service teams, inclusion on the carriers' Advisory Council, accelerated case implementation and direct access to underwriters and medical directors. We maintain direct access to decision -makers within carrier organizations. We leverage this industry clout when negotiating with carriers on rates, policy terms and plan design. We maintain relationships with and have access to the C-suite and executive management of all major national and regional carriers. Several members of our staff serve on the Broker Advisory Boards of national insurers, including: Preferred Carrier Partners Florida's Largest Carriers Broker Status Tier Broker Advisory Board Member Aetna Platinum (Top) Yes Cigna Platinum (Top) Yes Florida Blue Diamond (Top) Not Available Hartford Preferred Yes Humana Top Yes Lincoln Financial Preferred Yes MetLife Preferred Yes Reliance Standard Preferred Yes United Concorida Preferred Yes United HealthCare Platinum (Top) Yes Ancillary / Supplemental Carrier Partners Aetna Ancillary Advantica Aflac Allstate Ameritas Cincinnati Life Colonial Delta Dental EyeMed Florida Guardian Hartford Combined Life Humana Ancillary Lincoln Minnesota Life Mutual of Omaha OneAmerica Principal Renaissance Simple Dental Solstice Sun Life The Standard TransAmerica United Healthcare United Security Unum VSP Ancillary 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 49 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services City/Town/Village: • Alford, Town of • Altha, Town of • Apopka, City of • Arcadia, City of • Aventura, City of • Bal Harbour Village • Deltona, City of • Destin, City of • Dora!, City of • Fort Myers, City of • Havana, Town of • Hillsboro Beach, Town of • Lantana, Town of • Lauderhill, City of • Lauderdale by the Sea, Town of • Mary Esther, City of • Miami Beach, City of • Miami Shores, Village of • Niceville, City of • North Bay Village • North Miami, City of • North Miami Beach, City of • Panama City Beach, City of • Parker, City of • Port St, Joe, City of • Quincy, City of • Sebastian, City of • Sunrise, City of • Titusville, City of • Valparaiso, City of • Wauchula, City of • Windermere, Town of • Winter Garden, City of • Winter Park, City of School District: • DeSoto County School District • Gadsden County School District • Hamilton County School District • Hardee County School District Public Entity Clients Florida • Hendry County School District • Jackson County School District • Okaloosa School District • Suwannee County School District Other County Clients: • Calhoun County BOCC • Franklin County BOCC • Gadsden County BOCC • Gulf County BOCC • Hardee County BOCC • Jackson County BOCC • Lafayette County BOCC • Taylor County BOCC • Washington County BOCC Additional Entities: • Baker Fire District • Crestview Housing Authority • Destin Fire Control District • Florida Health Care Plans • Florida Keys Mosquito Control District • Halifax Health • Lakeland Area Mass Transit District • New Smyrna Beach Utilities • North Bay Fire Control District • Northwest Florida Water Management District • Ocean City Wright Fire Control District • Okaloosa Island Fire Control District • Osceola Clerk of Court • Panama City Downtown CRA • Panama City Downtown North CRA • Panama City Millville CRA • Panama City St Andrews CRA • Quincy Gadsden Airport Authority • South Walton Mosquito Control District • Suwannee Valley Transit Authority • Tice Fire Control District 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 50 SFOUNDATION PUP.LK ENT TYS RV.CrS City of Miami RFP #1896386 — Employee Benefit Consulting Services Public Entity Clients Outside of Florida New Jersey: • Bayonne Board of Education • Bayonne, City of • Brick, Township of • Hoboken, City of • Irvington Board of Education • Irvington, Township of • Jersey City Board of Education • Keyport, Borough of • Livingston, Township of • Lopatcong, Township of • Mendham Borough Board of Education • Morristown, Town of • Newark Board of Education • Newark, City of • North Jersey District Water Commission • Orange, City of • Passaic Board of Education • Passaic Valley High School Board of Education • Passaic Valley Water Commission • Passaic, City of • Passaic, County of • Red Bank, Borough of • RWJ Barnabas • Totowa Board of Education • Vernon, Township of • Warren, County of • West Orange, Township of • Wood Ridge, Borough of Indiana: • City of Crown Point • City of Muncie • City of Scottsburg • Crawford County Schools • East Washington School Corp • Floyd County Community Action Agency dba Floyd County Head Start • Lake County Convention and Visitors dba South Shore Convention & Visitors Authority North Carolina: • Davie County Government • Durham County Government • Durham, City of • Fuquay Varina, Town of • Garner, Town of • Hope Mills, Town of • Lillington, Town of • Selma, Town of • Spring Lake, Town of • State Employee Association of North Carolina • Zebulon, Town of Kentucky: • Bluegrass Regional Water • Breathitt County Library • City of Spring Mill • Greenup County Health Department • Harrison County Planning Commission • Housing Authority of Maysville • Housing Authority of Vanceburg • Local Health Department dba Kentucky Health Depts. • Louisville & Jefferson County Visitors & Convention Commission • Marion County Fiscal Court • Oldham County Fiscal Court 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 51 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Foundation Risk Partner's was recognized as "2024 Business Partner of the Year" through our Acentria Public Risk division. FRP's multiple divisions and service platforms are designed to meet the needs specific to each client based on complexity and region. As you will see with the enclosed service team, some of the members on our service team contributing to this recognition would be on the team assigned to the City of Miami, serviced through our Corporate Synergies benefits division. Acentric Jnsura 1::= tL F!IY.N 3,10C f llos,er 2va • f + Folk. Public Risk has be, Y..._red with receivi ~::'.` .24 Business Partner . ,.= Year by Suwannee County Board of Public Education and nominated for the Commissioner's Business Recognition Awards, courtesy of Ted Roush, Superintendent of the Suwannee County School District This esteemed award p.- ',or^iiation highlights exceptional business education partnerships that are ::ecu C..sttic to student success and academic excellence. D..oush remarked, "Acentria Public Risk staff has exceeded expectations, going and beyond to work with the District. Their ability to think "outside the box' :: =ing creative, innovative, and always having a problem -solving mindset as L- = _ =- --ed the entire District. This has resulted in substantial cost savings to _:.. -end our heartfelt gratitude to Ted Roush and the Suwanee County School _rict for this prestigious nomination and award. Additionally, we want to our deep appreciation to all our dedicated staff members for their hard 'work '-d commitment. #Acentrialnsurance #AcentriaPublicRisk #CommisionersBusinessRecognitionAward #SuwaneeCountySchoolDistrict 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 52 OUNDATION ,F PUBLIC ENTITY SERVICES AMM City of Miami RFP #1896386 — Employee Benefit Consulting Services i 1 i SUWfANNEE COUNTY SCI-11001, DISTRICT JERRY TAYLOR LISTRI[ I'I NORMAN CRAWFORD DISTRICT 2 TIM ALCORN DISTRICT 3 I MO Ohio Avenue, South Live (Jule, Florida 3206.4 Telephone: (3861647-4604 • Far. (386) 364=2635 TED l.. ROUSH Superintendent of Schools April l{i, 2024 Dear Prospective Acentria Client ED DA SILVA 1}LSTRICT t RONALD WHITS 13LS RIC'1' 9 LEONARD DIETZEN, ]tt BOARD ATTORNEY In an effort to explore options acid lower health insurance premium costs, the District put out en RHr for employee benefits brokerage services it 2022, At the conclusion of the KR' process, the Fringe Benefits Committee recommended to the Suwannee County School Board that Acentria Public Risk Farmers Corporation/Jordan Insurance Agency be awarded the bid. In February 2023, the School Board chose Antria as the new broker. The change has been an overwhelming success. Acentria staff has exceeded expectations, going above and beyond to work with the District. Their ability to think "outside the box" by being creative, innovative, and always having a problem -solving mindset has benefited the entire District. This has resulted in a substantial cost savings to the District, in addition, we are fortunate to have acocss to Acentria staff locally, F,ven staff who are not local are easily accessible; they do not hesitate to travel to the District when needed_ We could not be mare happy with the decision to go with Acentric. Chia company continues to impress, as its staff provides updates and beneficial advice at School Board meetings can a quarterly psis, and always looks for orals to bring the best possible programs and services to the table_ Mott notable is than the level of integrity, honesty. and transparency Acentric displays is a rare attribute in this area of expertise. The Suwannee County School District looks foruward to a continued partnership with Acentria to ensure the future success of our District and its employees_ Please do not hesitate to contact me if you should have any questions. Sincerely, ,Nc TexTL, Roush Superintendent of Schools ro "Swamarx COTITfy S4440l A trrkol sit! be a $3.warra n/raretdemr ehaoih'hg a!f students me -art persona! asrresr. " .A Fully ... tredired Srharl),saem,S.4CSCAW, Act d ru g TY,+rarum rf 1dixi', ED * Equal' OppardPPRdk' EXTM_P' r 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 53 #40 FOUN DATION PUBLIC ENTITY SERVICES m City of Miami RFP #1896386 — Employee Benefit Consulting Services Suwannee County School District — Service Team Tearn Leaders Co -Team Lead Alan Florez EVP-Public Entity Practice Leader Property Specialist Co -Team Lead David Lodwick Public Entity Services Director Casualty & Work Comp Specialist Servicing Team Program Administration Claims, Loss Control, & Risk Management Vice President -Public Sector Vice President of Claims Service Jonathan Jallad Dedicated Agent, Primary Contact, Service Lead Debbie Tappin, JD Head of Claims Account Executive -Public Sector Loss Control -Public Sector Stephanie Pignataro Client Services Director Nino Gallini Dir_ Of Loss Control Account Manager -Public Sector Risk Management Ashleigh Wood Client Services Manager Ross Beach Dir Of Risk Management Specialist Resources Ancillary Lines Flood Alternative Market Leader Sam Medvick Jeff Baiza Freya Perdomo Marketing Operations Associate Dir. Of Flood Division Dir. Of Marketing Team Leaders Co -Team Lead Co -Team Lead Bruce Tillman Vice President, Local Office Leader Dedicated Agent, Single Point of Contact Mike Carraway VP, Employee Benefits Large Group Self Funding Leader Servicing Team Program Administration Client Services, Benefits Technology Administration Vice President, Local Office Account Manager -Benefits Daniel Tillman Back up Agent, Co -Lead Contact Rebecca Peavey Local office Benefits Manager Account Manager II -Benefits Client Services Coordinator -Public Sector Glenn Little Public Sector Self Funding Tiffany Lowe Local Office Benefits Manager Account Executive -Public Sector Technology Integration Robin Riley Client Services Director Taylor Wimberley Ben Admin Integration Leader Specialist Resources Stop Loss Compliance Pharmacy Benefits Wellness Daniel Pitts Alex Doberstein, Stop Loss Brokerage Benefits Resource Leader Kali Panagos, Pharm.D., RPH Juliana Orth, RN Consulting & Clinical Wellness Coordinator 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 54 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Tab 5 Relevant Experience and Qualifications of Key Personnel and Subcontractors Performing Services 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 55 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services a) Provide an organizational chart showing the Proposer's Lead Managing Consultant and all key personnel, including their titles, to be assigned to this project. All key personnel include all partners, managers, seniors, and other professional staff that will perform work and/or services in the project resulting from this solicitation. The chart must clearly identify the Proposer's employees and any subcontractors or sub -consultants. This information shall include the general functions to be performed by key individuals and the subcontractors or sub -consultants. Account Management Organizational Chart John Kern Regional Vice President, 5°I.* Eric Brewer Vice President, Lead Managing Consultant 35%' Kim McBee Senior Vice President, Specialty Lines 5 'Ye Dan Kuperstein, Sr. VP of ComplianceiERISA Attorney 5% Dorothy Summers, Compliance Consultant Eileen Scoggins, Director of BenefitsVlP 5% BenefitsVlP Support Team Karen Walker, Senior Account Manager 25% Stephanie Grady, Account Specialist % orstrategy and execution of pian harmonization each key team member Mil devote to theproject. This does not include subject matter experts who wiii support on an as needed basis. Luciano Franco, VP of Underwriting 5%* Data Warehouse Analytics Jay C. Miniati, Actuary Gary Cassidy, Director, 'Employee Education & Communication 5%* Luray Tober Client Solution Director 5% 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 56 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services b) Describe the experience, qualifications, and other vital information, including number of years of relevant experience on previous similar projects, of the Lead Managing Consultant and all key personnel, who will be assigned to this project. Eric Brewer, Senior Benefits Consultant Account Role: Lead Managing Consultant Eric Brewer is an accomplished healthcare professional with over a decade of experience helping employers navigate the cost pressure, regulatory compliance and administrative challenges that go along with a group benefits program. Eric's knowledge of self -funding, pharmacy benefit carve -outs, reference -based pricing and population health management help him guide his clients based on each employers' unique needs and circumstances. Eric takes pride in being innovative and disruptive, with a long-term strategic focus to help his clients' combat constant market pressures. Throughout Eric's career, he has managed benefit programs for employer groups ranging from 250 to 25,000 employees. Out of the office, Eric is a proud husband, and a father of two boys. Eric can often be found fishing or golfing when he's not in the office. Eric earned a bachelor's degree in economics from Brown University, Providence, Rhode Island. Eric served as defensive captain of the Brown Football team and was proudly part of Brown's 2005 Ivy League Championship team. Years of industry experience: 15+. Business Continuity Plan: Foundation Risk Partners applies a team approach to servicing our clients. Our Agency Management System is a common operating platform and is located on a secure cloud. Our multiple office structure allows for redundancy and continued, uninterrupted service in the event of a catastrophic event that could impact South Florida and beyond. During the COVID-19 pandemic, our entire organization was transitioned to a virtual work setting to ensure continued support for our clients during these challenging times. While this is not permanent, we have proven our ability to transition to 100% remote in order to better serve our clients when needed. Each of our clients is supported by 8-10 highly specialized individuals with overlapping skillsets and redundant familiarity with each of our clients. This allows for consistent, high-level service for our clients as team members inevitably change or individuals are unavailable periodically. Foundation Risk Partners wholly owns a pharmacy consulting practice, ArmsRx. Led by Jennifer Wilson, ArmsRx plays a critical role in helping our clients navigate the complex and costly pharmacy landscape. ArmsRx will be involved periodically to support the City as we evaluate and structure the optimal pharmacy arrangement over the long-term. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 57 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services c) Provide resumes, if available, with job descriptions and other detailed qualification information on the Lead Managing Consultant and all key personnel who will be assigned to this project. Eric Brewer, Senior Benefits Consultant Account Role: Lead Managing Consultant Eric Brewer is an accomplished healthcare professional with over a decade of experience helping employers navigate the cost pressure, regulatory compliance and administrative 1 challenges that go along with a group benefits program. Eric's knowledge of self -funding, pharmacy benefit carve -outs, reference -based pricing and population health management help him guide his clients based on each employers' unique needs and circumstances. Eric takes pride in being innovative and disruptive, with a long-term strategic focus to help his clients' combat constant market pressures. Throughout Eric's career, he has managed benefit programs for employer groups ranging from 250 to 25,000 employees. Years of industry experience: 15+. Kim McBee, Senior Vice President Account Role: Specialty Lines Sales Leader Kim, who currently handles public and private sector benefit plans, understands the unique needs associated with public sector clients. As Senior Vice President of our Specialty Lines, Kim plays a critical role in deploying all the resources within FRP to support our clientele. She will bring a strong understanding of the factors required to help the City contain cost, remain compliant and drive administrative efficiencies for your staff. With budget being paramount in all public sector organizations, Kim specializes in long term strategies to mitigate cost while minimizing the amount of change experienced by employees. She has also deployed robust wellness programs to help mitigate common cost drivers associated with large public entities. Kim has been with Foundation Risk Partners for over 5 years and has 17+ years of experience. John Kern, Regional Vice President Account Role: Executive Sponsor John Kern is an accomplished healthcare executive with experience in all phases of employee benefits consultation. He has earned an industry -wide reputation as a creative developer of benefits solutions. He has deep expertise with short and long-term benefits strategy, healthcare reform/regulatory compliance, funding alternatives, wellness plans, benchmarking, benefits and payroll administration, actuarial services, executive benefits, and private exchanges. He serves as Corporate Synergies' leader for the Florida Region, where he has overall management responsibility for teams of benefits consultants and account management professionals. John is an expert on reference -based pricing and benefits cost control. His article, "Here's Why Reference - based Pricing is Gaining Momentum" was named a top 10 article by popularity by Employee Benefit News. John has more than 25 years of experience in benefits and insurance. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 58 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Additional Foundation Risk Partners Staff Support Daniel Kuperstein, ERISA Attorney Account Role: Benefit Program Compliance Executive Leadership and Client Support Our skilled internal compliance staff is under the direction of Dan Kuperstein, an ERISA attorney and expert in Healthcare Reform. He has deep expertise in employee benefits, labor, and employment law. He advises clients and ensures compliance related to, the Affordable Care Act, COBRA, HIPAA, ERISA, GINA, and all other government regulations related to employee benefits. Dan is a frequently published author of articles on regulatory compliance; these articles have been published by Employee Benefit News, Philadelphia Business Journal, Fortune, and several other respected media sources. Dan and our senior compliance consultant, Dorothy Summers, host in-depth webinars, which are typically held quarterly or more often. Years of industry experience: 16. Patty McGee, Director of Account Management Account Role: Secondary Day -to -Day Account Management Patty provides general day-to-day account management support, supervises account deliverables, and updates the strategic planning process. She develops health and welfare benefits programs based on needs analysis, budget forecasting, and detailed contract comparisons. She is focused on delivering exceptional client service. Patty is a seasoned employee benefits professional with an extensive background in the carrier channel. She draws on her technical expertise and marketplace awareness to serve as a consultative resource for her clients. Years of industry experience: 25. Karen Walker, Account Manager Account Role: Day -to -Day Account Management — Ensuring Business Continuity Karen Walker is a graduate of James Madison University and has immersed herself in the insurance industry for over 25 years, specializing in employee benefits. For almost a decade, she has worked primarily with Public Sector clients, many of whom have onsite employee health centers and she has participated in the entire process from initial planning to full implementation. She also has experience developing wellness programs to promote employee health and well-being. Her goal is to provide top-notch insurance solutions tailored to meet the unique needs of each client. Years of industry experience: 25+. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 59 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Stephanie Grady, Senior Account Specialist Account Role: Day -to -Day Account Management, Marketing, Communication Support Stephanie brings extensive experience to our benefits team. She spent the first half of her career as an HR professional. She assists our clients with the renewal management, contract review, plan and requirements auditing, benefit guide and custom communication creation, and eligibility management. Years of industry experience: 13 Eileen Scoggins, BenefitsVlP Account Role: On -site Director of Employee Advocacy Center As Director of BenefitsVlP, our high -touch, first -to -call employee advocacy and service department, Eileen Scoggins instills a consistent focus on urgent and accurate benefits issue resolution. She manages the New Jersey and Florida BenefitsVlP staff, analyzes call/contact types to identify emerging trends or issues, and employs methods to resolve them. Years of industry experience: 21. Luray Tobar, Client Solutions Director Account Role: New Client Service Solution Launch Supervision Luray Tobar is the driving force behind new client benefits administration and technology solution service launches. She creates and drives standard processes and coordination of all client solutions -related activities. She oversees the implementation and maintenance of business administration technology and workflow automation. Her team members serve as project managers and facilitators for and between the various internal FRP departments, the client, and third -party vendors. Client solutions manages the complete and timely implementation of the benefit solution, such as BenefitsVlP employee advocacy, COBRA, surveys, total compensation statements, our internal benefits administration technology, as well as fully outsourced benefits administration services. Years of industry experience: 20. Erica Stricker, Registered Nurse Account Role: Registered Nurse Erica works closely with our client's solely to the furtherance of wellbeing and engagement activities. She works with carriers and other vendors to maximize use of resources that are available including attending wellness fairs and engage with employees in clinical discussions with both wellness committees and members to cater wellness initiatives based on individual needs. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 60 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services der t Gary Cassidy, Director, Employee Education, Communications and Wellness Account Role: Employee Education, Communications and Wellness Strategist Gary Cassidy and our internal creative team of writers and designers generate professional, branded communication materials that support the client and engage/educate employees. He manages our internal, award -winning (APEX, iCOMM, and carrier), communications and graphics staff who possess insurance industry and benefits experience. The creative team works with Account Management to develop and implement education and wellness strategies designed to drive positive changes in plan participant benefits understanding and behavior. Gary is a frequently published author of articles on wellness and disease management. He hosts our internal Wellness MINUTE videos series, has co -hosted our wellness and employee education webinars, and is a sought-after conference speaker. Years of industry experience: 25. til Dedicated BenefitsVlP Employee Advocacy and Support Team Account Role: Personal Inquiry and Issue Support for HR and Employees Upon contract agreement, we will assign a dedicated BenefitsVlP team (six to seven advocates) to support City's employees and HR staff. The BenefitsVlP team consists of highly trained and experienced insurance experts whom we refer to as advocates. Our advocates will be deeply and personally involved in your program through direct contact with plan participants and your HR staff. Once an advocate is contacted with an inquiry or issue, she or he stays involved to the successful resolution. Average years of industry/customer service experience: 20. Client Engagement Manager Account Role: Implementation Specialist We will assign a manager responsible for client program transition, system set-up, configuration, maintenance, and reporting. The Client Engagement Manager will coordinate and implement the program with the support of a team staffed with a Project Specialist and numerous other FRP support and operations personnel. Client engagement staff members report to Luray Tobar, Director of Client Solutions. Average years of industry/technical experience: 20. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 61 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Pharmacy Team • Jennifer Wilson Chief Executive Officer, ARMSRx Jennifer offers her clients over twenty years of knowledge and expertise in the Employee Benefits and Pharmacy Benefits Industry. Her broad consulting experience includes building payors an in-house PBM model, exploring the marketplace for clients with existing PBM's for an appropriate match for those who need to outsource part of, or the entire pharmacy piece. Jennifer's client base is not limited to payors alone, PBM's have utilized her expertise in contributing to their success in growth by assisting with advice and guidance on how the marketplace perceives certain aspects of services offered and promoting successful marketing strategies. Jennifer has been interviewed, authored multiple articles, and presented at many industry conferences, forums, and continuing education events for the past two decades, including AHIP, SIIA, Employee Benefit Expo, Employers Healthcare congress, HCAA, multiple insurance and self -funded conferences, CEBS, Pharmacy Contracting forum and HR shows. Jennifer is a 2019 AMCP Hall of Fame recipient and 2018 AMCP Leading Industry Innovator recipient. Dr. Kali Panagos Pharm.D., R.Ph, Executive Vice President, Consulting & Clinical, ARMSRx Dr. Panagos has over twenty years of experience, half of which have been exclusively dedicated to the managed care space overseeing Clinical Development, Operations & Client Services/Management. Innovative, forward thinking and results driven, Dr. Panagos delivers real value by ensuring client results are aligned with proper objectives and best interests now and in the future. Dr. Panagos provides leadership, strategic direction and oversight to clinical and operation teams including managing vendor partnerships with brokers, TPAs, mail/specialty and PBM platforms. She has expertise in the design of market competitive clinical program offerings rooted with clinical integrity. Dr. Panagos is an MTM, and immunization certified licensed clinical pharmacist, has practiced in various settings including community, hospital, and academia. She has served on the faculty and administration of Long Island University's Arnold & Marie Schwartz College of Pharmacy and is a pharmacy mentor at St. John's University College of Pharmacy. She has also served with the New York State Board of Pharmacy as an examiner for the pharmacy compounding licensure examination. Dr. Panagos holds a Bachelor of Science degree in Biology with a minor in Computer Science and a Bachelor of Science degree in Pharmacy from St. John's University, New York. Additionally, Dr. Panagos holds a Doctorate degree in Pharmacy from Shenandoah University Bernard J. Dunn College of Pharmacy, Winchester Virginia. She is an active member of the Association of Managed Care Pharmacy (AMCP) and Healthcare Businesswomen's Association (HBA). 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 62 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Wende Ward SVP Strategy/Corporate Development, ARMSRx Wende has more than twenty years of pharmacy benefit management experience, working with all lines of business and across all market segments, including health plans, employers, third party administrators and government programs. Wende has worked in both the pharmacy benefit manager role as well as the pharmacy benefits consultant role in various positions including sales, consulting, operational and client management. Her experience includes working for a large national PBM managing large national accounts, as well as working for a mid -sized national PBM working with health plan clients. She has worked with brokers/consultants, employers, and health plans nationwide to manage prescription drug spend and overall healthcare costs through comprehensive analysis, strategies, and guidance. She is a current member of the Healthcare Businesswomen's Association (HBA). Wende earned her Bachelor of Arts degree from University of Cincinnati. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 63 #4P,FOUNDATION PUBLIC ENTITY SERVICES mMIE City of Miami RFP #1896386 — Employee Benefit Consulting Services Sub-Contractor/Actuary JAY C. MINIATI, FSA, MAAA, MBA 3750 Gunn Highway, Suite 301, Tampa, Florida 33618 Phone (813) 963-2420 javc iavminiati.com www.layminiati.com SUMMARY • Senior level consulting actuary who excels in client -facing advisory role; demonstrates leadership in: • Financial management and modeling • Expert witness testimony • Health insurance subject matter expertise: • Self -funded health plans • Cost projections, trend analysis, benefit design, enrollment migration scenarios, contribution strategy • Underwriting, carrier negotiations, rate setting, funding alternatives, reserves/IBNR, plan performance EXPERIENCE JAY MINIATI ACTUARIAL SERVICES, President and Chief Actuary - Tampa, Florida - 2010 to Present • Founded independent actuarial consulting firm focused on meeting the needs of employer -sponsored benefit plans and legal case work. AON CONSULTING, Vice President and Actuary - Tampa, Florida - 2006 to 2010 • Regularly advised and presented financial and strategic recommendations to the Board of Directors, C-suite and Insurance Committee leadership of corporate, public, PEO and MEWA organizations. • Counseled over 70 clients annually in 2007, 2008 and 2009 (20% in public sector). UBS FINANCIAL SERVICES INC., Financial Advisor, CFP® - Tampa, Florida - 2003 to 2006 • Managed client relationships with assets totaling $73 million across 200 households in 23 states. • Developed one-on-one and household selling expertise. MILLIMAN, Consulting Actuary - Tampa, Florida - 1998 to 2002 • Provided expertise to health care providers, insurance companies, government agencies and employers. • Directed the team that advised the government of Puerto Rico regarding its $1.5 billion Medicaid program. • Advised Anthem Blue Cross in the largest demutualization and subsequent IPO of a health benefits company. AETNA, INC., Hartford, Connecticut - 1989 to 1998 • Chief Actuary, Aetna Health New Zealand Ltd. (1997 to 1998) o Played a key role in the financial turnaround of Aetna's distressed healthcare subsidiary in New Zealand. o Drove improvement of the company's earnings from a $9 million loss before my arrival to a $4 million profit. • Actuary (1989 to 1997) o Supported Latin America and Asia Pacific operations through life and health pricing and reserve projects. o Assessed profitability of pension business by conducting mortality experience studies. o Evaluated and negotiated provider contracts for managed care networks. o Developed and maintained pricing models for single premium and structured settlement annuity business. o Priced individual life and second -to -die universal life insurance business. EDUCATION UNIVERSITY OF CHICAGO, GRADUATE SCHOOL OF BUSINESS, Chicago, Illinois - 2002 Master of Business Administration, with Honors DUKE UNIVERSITY, Durham, North Carolina - 1989 Bachelor of Arts, Mathematics, with Honors (also majored in Economics) PROFESSIONAL CREDENTIALS FSA: Fellow, Society of Actuaries - 1997 MAAA: Member, American Academy of Actuaries - 1994 PERSONAL Eagle Scout, Boy Scouts of America - 1982 780 W. Granada Blvd. IIII Ormond Beach, FL 32174 Page 64 City of Miami RFP #1896386 — Employee Benefit Consulting Services Tab 6 Proposed Approach to Providing the Services 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 65 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Foundation Risk Partners Public Entity Services is dedicated to providing world class service to our municipal clients. In this section, we cover all questions regarding Brokerage/Consulting Services, Communication, Enrollment and Benefits Administrative Services. Key differentiators within this section that Foundation Risk Partners Public Entity Services will bring to the City of Miami: • Expertise in evaluating program customization and plan options, including actionable data to enable informed recommendations and decisions. o Retiree Carveouts, Virtual medicine, Tailored Plan Design, International Mail Order, On/Near-site Clinics, PBM analysis, and Direct Contracts. • Prescription audit and analysis, yielding significant savings opportunities through contract terms, audits, and targeted Specialty programs, as exemplified in our case studies (see pages 39- 41) • Identification of strategic opportunities to manage healthcare spend with transparent partners, as described in Case Studies 1&2 (page 39) with our proven out of network claim re -pricing results. • Employee support with 91% of all Benefits related questions answered within 24 Hours. 80% answered during first call. o Multi-lingual employee advocacy, including Spanish and Creole. • Communication Campaigns crafted around strategic goals and BenefitsVlP tracking reports. o Ex. Tobacco Cessation o Ex. Primary Care Physician vs. Urgent Care vs. Emergency Room o Ex. COVID-19 guidelines, test site availability and virtual visit access • Dedicated service lead (Eric Brewer), with a team of 8-10 individuals involved in ongoing support. • Onsite and local representation for meetings as needed. • In-house benefits attorney aligned to the City of Miami to support all aspects of benefits compliance. • Adaptive Timelines, and performance guarantees to increase transparency with City staff and ensure the City receives a promise that can be measured. • Nationally Recognized thought leaders with heavy involvement in PRIMA, Florida League of Cities, SHRM, and numerous industry publications. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 66 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services a) Describe Proposer's approach to project organization and management, including the responsibilities of Proposer's Lead Managing Consultant and Proposer's key personnel, and key personnel of any subcontractor or sub -consultant, that will perform work in this project. r Service Team — City of Miami Eric Brewer Lead Managing Consultant • Contact Person • Expertise with healthcare reform/compliance, funding alternatives, wellness plans, benchmarking, benefits administration, underwriting, actuarial services and utilization analysis. • Identifies client benefit coals and financial obiectives. Karen Walker Senior Account Manager Niro • Employee benefits and retirement Professional • Subject matter expert on Life & Disability/Voluntary product offerings • Financial, funding mechanism, and employee contribution modeling services • Monitor Compliance aspects of each account and ensure clients remain compliant Dan Kuperstein Senior VP of Compliance/ERISA Attorney • General Counsel & Senior Vice President of Compliance • Attorney with experience in employee benefits, labor, and employment matters, • Experience in ERISA. The Affordable Care Act, COBRA, HIPPA and GINA compliance as well. Kim McBee, REBC, GBDS Senior Vice President ri • Specialty Lines Leader • As a specialty lines leader, Kim brings over a decade's worth of experience and understands every aspect of the business. • She unifies the platforms within Foundation Risk Partners portfolio of companies to best support our clients. Stephanie Grady Account Specialist foto • Marketing clients' employee benefits to insurers, preparing proposal documents and benefits guides, and developing carrier relationships. • Provides administrative back-up for every function and discipline, responds to client questions, coordinates resources, and manages back -end work for annual benefit plan renewals. Gary Cassidy Director, Employee Education & Communication. 11 `1 • • Employee Education, Communications and Wellness Strategist • Manages internal communications and graphics staff • Develop and implement education and wellness strategies deigned to drive positive changes in plan participant benefits understanding and behavior. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 67 $$FOIJNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Service Team — (. ity of Miami Continued • Director of Employee Advocacy Center — benefitsVIP • Manages the New Jersey and Florida BenefitsVIP staff_ • Analyzes call/contact types to identify emerging trends or issues Luray Mbar Client Solutions Director • Client Service Solution Launch Supervision • Responsible for the day-to-day management of the Client Solutions team. • Her team members serve as project managers and facilitators for and between the various internal Corporate Synergies departments, the client, and third -party vendors. Luciana Franco Vice President of Underwriting • Responsible for management of underwriting staff, operations, and uniformity of all related processes for each Corporate Synergies region • Assists with renewals, market analysis, rrid-year projections, and utilization reviews • Develops long -and short-term cost containment strategies for health and welfare benefit plans John Kern Regional Vice President • Accomplished healthcare executive with experience in all phases of employee benefits consultation. • Expertise with short- and long- term benefits strategy, healthcare reform/ regulatory compliance, funding alternatives, wellness plans, be nc hma rki ng, and payroll administration. Subcontractor • Expertise in financial management and modeling, actuarial certifications, statutory filings, cost projections, trend analysis, reserve valuations • Self -funded health insurance cost projections/budget development • Reserves/IBNR • Large claim, trend, stop loss cost/benefit analysis • 112_€8filing • Enrollrrent migration scenarios upon plan change 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 68 4FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services b) Provide Proposer's operational plan that clearly indicates how the Proposer plans to provide the services requested in this Solicitation. The Proposer's operational plan must detail how the Proposer intends to fully satisfy all service requirements outlined within Item A, General Requirements and Services to be Provided, of Section 3.1, Specifications/Scope of Work, of this RFP. We affirm that we will fully satisfy all service requirements outlined within section 3.1, specifications/scope of work. Please see the following pages for detailed information on each scope of service item. Scope of Service Starts Here 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 69 #40 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services A. General Requirements and Services to be Provided: 1. Self -Funded Plan Performance and Monitoring and Auditing: a) Monitor the performance of, and compliance with, all established contractual requirements of the self -funded medical plan, including reviewing, and approving any annually updated Summary(ies) of Benefit Coverage ("SBC") and similar documents, and/or amendments. Foundation Risk Partners is prepared to meet and exceed the Scope of Service requirements outlined in the City's RFP. Below are several tools and services available to meet this requirement. Claims Analysis: Our claims analyzer software receives raw data feeds from the carriers (when self -funded and acknowledging this will be a tool that benefits HCM only upon that transition) and formulates scenarios, premium equivalent rates, IBNR, lag reporting, high claim dollar detail by category, risk assessments and a full comprehensive reporting package. The software drills down and identifies hidden cost drivers in health and welfare benefits plans. We model the impact of plan design changes, demographics, and clinical and lifestyle management programs to determine the most sensible and data -driven approach to achieving cost savings and optimal plan design. We will continue to benchmark your benefits program against peer groups to ensure the competitiveness of your programs while simultaneously reviewing employee -specific aspects, including contributions, communication material, and overall plan satisfaction. Health Plan Cost Gauge how your total health plan expense per employee compares to that of other slmllarly slzal esnpbyers in your rag tot l and Industry. Keep In nth id; • PIescr Ipllen drug alyd flxe[f rxasLs slru.wl are based ors values provided. • Claim arnounLs represent claims pail during the pep lcx8; they may rl1L !elle(' all claims I1177l rred o. this period. I ri•acgirn0 Points to consider. • Do you employ the roost appropriate funding method for your health plan? • Ts there a need to review contribution levels nr implement a spousal carve out? • what Impact do Catastrophic claims have 611 your oasts? is there a noticeable return an investment for [barraged care or u{her cost containment programs? • Would potential cost savings he achieved if services, such as utilization review and disease management, were lmhundled? norm scarce: 'Hmpoyei r•e.Rn Banal Cs Ann uel 1 Trutt Vryrront 21117 Colmar. 704771341 Grou0, LLC. d 14.000 is11,000 - .310 00n- 58,000- S@,000 - $4,000 83,0vo- en 1 ■ nce.. r Region ■ Stu ■ industry' Total nrlr dw /.:T F8000 r~' dual- 4r amino''-- S12,704_48 Total heath pan f 511,1311,947.61 Ne�rn Lust pm employBe {rB I4ri; 18,030141 Norrn tole) Lust t. region) 58,418,230.00 Norm mst par employee (sm ploy.' size) 59,082.90 Norm total cost (ernpdtyo' cizo) S8,203,60106 Norm cost per employee (industry type) $9,039.73 N6rm total mat t nattstry type) 88,244,235.00 e Henry.] K.ieet Parra4y Poundallan end h..Rn Research and 300370 - t.ru.ry r, 2CIe - Ga0•mb•r 31, 241e13 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 7 »FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Risk Decision Support: An example of our technical resources is our Risk Decision Support Tool that uses real-time and historical data to help employers make crucial funding decisions. The tool, which also aids in budgeting, allows the employer to make informed decisions. It provides clarity on the appropriate specific deducible level and how it can be used to maximize the return on capital at risk at the City's risk tolerance level. It delivers a crisp visual representation on the relative risk/reward characteristics of various self -funded structures. CLIENT SUMMARY RISK DECISION SUPPORT TOOL RESULTS (based on database of 10 mean Pees arm 51Wbdfron In rearm, and =trmrlbNydeveloped rang manualt Fully Insured off. 7/1/2018 Based on Employee Count: 200 Self -Funded Base Case: ASO w $SDK I5L Carrier Proposed Fully Insured Premium $2,626,500 Self -Funded Scenario Case: ASO w $75K I5L Actuarially Determined Fully Insured Premium $2.846,884 elf -Funded Options: Base Case Expected Cast 52,527,331 550.000 12/18 SO odd2 known risk Scenario Case Expected Cost $2,466,407 $75.000 12/18 SOodd?known risk Expected Return of Self -Funding C0000 0.6 r5o00 .4 0.2 Base Case Scenario 98% Capelask • Erp Rot ♦ not on CapgiRkk These results ore based an 10.000 simulations. 41tFOUNDATION RISK PA PUBLIC ENTITY SERVICE Likelihood of Self -Funded Option Beating Fully Insured (This Year) Over 3 Yrs. Over 5 Yrs. 69.60% 87.95% 139.3956 76.50% 90.52% 95.50% Ca pita I at Risk (amount over the Expected level that represents the potential maximum actual cost at aspecified Confidence krel) Confidence Level l%of time that the accu ranee is likely. --905 Confidence level equates to 9 out of 10 years. 5248,960 90% $291,778 9096 Likelihood o1 Beating FI 0.696 i 0.765 Base Casa Scenario iu4a1 Annual Plan Cost 30011000 'swam 2000000 1000000 SF Pion Cost versus FI Premium ✓ s$ ,P� re, .r rf cs a rya a s m9 ;✓ -j d+ 's w `oet Percentile of Total Annual Plan Cost Outcomes -BC SF Plan Cost -SC SF Plan Cost -RC FI Premium SC FI Premium 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 71 ,$FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Provider network analysis: Our process includes repricing of claims when appropriate, discount analysis using resident zip codes, geo access studies and radial analyses to evaluate access, and CPT -code analysis based on the top 20 utilized services. When access to carrier claims data is not possible, we rely on the results of the marketing of the client's plan to prospective carriers. We provide those carriers with summary claim reports and demographics on the client's population. The prospective carrier will know whether their network discounts are strong in the geographic regions utilized by that client (in comparison to the incumbent carrier) and set their pricing accordingly. Claim re -pricing strategies: Most PPO networks do not protect self -funded employers from out of network claims. With our approach, we generate an additional 25% savings on these claims. This is accomplished without benefit design changes, it's equal to or better than collective bargaining agreements, and employees are held harmless. Stop -loss analysis: We collect year -over -year data to review expected and aggregate loss ratios; renewal developments and policy year claim projections; a claim lag study and calculation and appropriateness of IBNR reserves; development of equivalent rates; individual stop -loss analysis to determine historical loss ratio and appropriateness of pooling levels and costs; analysis of stop -loss contract including contract basis, reimbursement methodology, terminal liability provisions, terms, and pricing; and more to gain a detailed understanding of your loss history. From a pharmacy benefit perspective, our ongoing client management, includes a full team of senior level pharmacy benefit professionals with a diverse range of expertise, including Account Management, Implementation, Financial Analysts, and Clinical Pharmacists (Pharm.D.) We work with you on an ongoing basis to perform the following functions throughout the year. Annual Pharmacy Benefit Management: We work with you to discuss pharmacy benefit management strategy/goal as well as attend and participate in the annual review with the PBM. Quarterly Pharmacy Benefit Management: On a quarterly basis, we monitor PBM vendor performance, review utilization/costs, and review PBM generated reports. Our team will provide guidance and recommendations based on the utilization. In reviewing the claims data, we may make recommendations for clinical interventions which provide significant savings to the plan. These interventions may include moving a patient to a lower cost medication. Bi-Weekly/Monthly Pharmacy Benefit Management: On a bi-weekly/monthly basis, we provide a high level of communication with regular meetings. We review the ongoing PBM issues log and comment on open items/action items. We review any plan design changes and discuss member impact and recommended communication plans. Our team continually provides pharmacy benefit industry updates, including legislative, new products, and more. Ongoing PBM/Contract Management: On an ongoing basis, we support pharmacy benefit related questions and resolution of complex pharmacy issues. Our team will support ongoing PBM contract review, enhancements and negotiations and evaluate vendor programs to control costs. Industry leading clinical interventions: Our clinical team provides solutions that reduce cost and improve outcomes which enable plans to remain successful and sustainable. Our clinical interventions utilize an extraordinary depth of clinical pharmacy expertise and professionalism to work effectively 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 72 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services with all key components of patient care in order to achieve remarkable outcomes — clinically effective, member centered with significant plan savings. Our strategies favor clinically useful drugs over financially driven brands resulting in truly lowest net cost for plans. Improved value overall, bring transparency forward and reduce costs. b) Secure statistical reports, etc., directly from the third -party administrator's depository to evaluate and ensure compliance with contracted performance standard levels. Successful Proposer shall ascertain whether or not financial penalties for performance non-compliance have been properly recorded, and liquidated damages assessed against third -party administrator. Reporting: We provide reporting to ensure deliverables are achieved and plan performance is monitored and measured. Reporting is also an essential aspect of evaluating vendor service guarantees and monitoring the fiscal health of a client's overall benefits program. We take a custom approach with a combination of vendor reporting, industry sources and supplementary reports to answer requirements. Standard reporting includes the following: • Evaluate compliance with any third -party administrators' contractual requirements and any performance guarantees. • Review all claim/account data provided by carriers, including full analysis and validation of renewal exhibits. • Compare performance from period to period and relative to Book of Business benchmarks. • Identify trends and monitor plan utilization patterns for opportunities to adjust plan design or consumer behavior. • Ensure Service Plan key initiatives are monitored and tracked to planned deliverables. • Provide relevant statistics of member calls to the client's dedicated BenefitsVlP team, including usage, incident prevalence and productivity savings. • Evaluate service level guarantees, including but not limited to claims payment turnaround, network discount guarantees, fixed cost guarantees and claims management guarantees. • Provide cost projections during the mid -year pre -renewal process for the upcoming renewal, track cost and identify areas of concern. Quarterly Strategy: We conduct quarterly meetings to review claims and financials, address any service and administration issues, and discuss industry updates on compliance or trends. Benchmarking: We assess your plan designs, identify trends, and monitor plan utilization patterns for opportunities to adjust plan design or consumer behavior. Each of these factors is measured against a national database so we can compare the City's factors against comparable municipalities. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 73 ##FOUNDATION PUBLIC ENTITY SERVICES L� City of Miami RFP #1896386 — Employee Benefit Consulting Services Benefit Overview— HDHP Coverage Benefit Overview — HDHP Premiums Cn,a00eal am re maim re ft tiva. . Waxy Benefit Overview— PPO Coverage Benefit Overview— PPO Premiums 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 74 #FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services c) Conduct bi-annual onsite claims audit of self -funded plans at administrator's facility, as deemed necessary by the City, to include review and compliance with contractually established: (i) Performance Standards, (ii) Payment Accuracy of Claims, (iii) Coding Accuracy of Claims, (iv) Plan Provisions Accuracy. Medical and Ancillary Plan Oversight and Contract Monitoring: We continuously evaluate the performance of our vendor partners to ensure that they are operating in the mutual interests of our clients and best meeting the unique needs of our clients. Our insurance carrier/TPA/vendor performance management process features: • Designing metrics and establishing performance standards for service levels • Claims review and full utilization analysis including IBNR and Lag Triangles • Plan provision accuracy will be monitored to ensure claims are being paid and administered in accordance with the plan design. • Monitoring vendor performance and client satisfaction • Exploring and benchmarking the marketplace as a means of recommending the best possible vendors • Measuring on -going financial stability • Verifying proper licensure • Support before, during, and after a government audit of a benefit plan • Negotiating preferred pricing and performance guarantees • Innovating new processes to improve service delivery to clients • Developing new service solutions in support of the ever -changing HR/employee health and welfare benefits landscape We measure and evaluate the above criteria for vendors that provide third party administration, consolidated billing, COBRA administration, benefits administration technologies, FSA, transit, and various other reimbursement accounts, etc. Additionally, our client engagement managers monitor vendor project plans. These implementation consultants assist clients with the deliverables to meet budgetary and major milestones required for each project. If a provider has fallen below an acceptable financial rating, the City will be notified immediately to assess the impact and identify the appropriate remediation with alternate vendors or products that continue to meet the needs of the City. In lieu of this question, we carefully evaluate the providers we recommend to our clients, so this is not a conversation we ever have to have with the City. PBM Oversight and Contract Monitoring: Ongoing Plan Monitoring: Our consulting team tracks the guarantees to monitor financial performance throughout the contract year. This is accomplished by intaking the claims (weekly, bi-monthly or monthly transmissions; based on client preference), eliminating excluded claims, and input coding to recognize the guarantee definitions that impact pricing. We monitor the PBM's performance and provide notification when discounts and dispensing fees are outside of contractual parameters. If issues or anomalies are identified, we document back to the PBM and Client as our consulting team works through the issues in question. We perform claim reviews for 100% of claims data provided we are in receipt of appropriate and necessary data and information. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 75 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services We estimate and track rebates throughout the course of the year in the same manner. As we intake and track claims by channel and days' supply, under a per Brand drug rebate contract, we can readily estimate the claims and reconcile to the PBM rebate reporting when it becomes available. Additionally, high -cost claims monitoring is another area in which we provide oversight to manage the plan's costs through clinical management and interventions for those high -cost, complex therapies. PBM Audit Services: We offer a full suite of pharmacy benefit consulting services, including Pharmacy Benefit Audits. The following audits are the most common performed. • Financial Guarantees • Pricing — Lesser of Logic • Rebates (Per Rx Guarantees) Performance Guarantees: Our Analysts will review the contract to ascertain the applicable performance guarantees during the audit period. Documentation from the PBM will be requested to ensure the guarantee was measured properly and met. Any deficiencies or shortfalls will be identified as audit findings. Financial Guarantees: We will perform a pricing accuracy audit to provide assurance that the contractual discounts from AWP pricing are correct. We review the related contract and any applicable amendment language regarding the financial guarantees. A recalculation of the guarantees according to the drug and guarantee definitions will be performed to ensure the PBM has accurately reported the results. Any significant differences will be investigated and reported. Lower/Lesser of Logic (LoL) Pricing Accuracy: We will review the related contract, any applicable amendment language regarding Lesser/Lower of Logic methodology. We recalculate each claim to ensure the client paid the lowest cost in accordance with the contract. Discrepancies will be investigated and reported. d) Conduct a bi-annual audit of the Pharmacy Benefits Management Program ("PBM") Agreement, for the review and compliance of all formulary rebates, to determine if the City receives guaranteed rebate amounts, in accordance with contractual obligations. Semi -Annual Audit of the Pharmacy Benefits Management Program ("PBM") Agreement: Our pharmacy benefit experts are highly seasoned professionals with in-depth experience in all aspects of the Pharmacy Benefit Management (PBM) industry, providing pharmacy benefit consulting services for clients nationwide. Our seasoned consulting staff has on average 20+ years of pharmacy benefit management experience coming from all areas of the pharmacy benefit industry (including PBMs, Specialty Pharmacies, Audit departments and more). We are uniquely positioned to provide pharmacy benefits expertise, ongoing monitoring, and management of the pharmacy benefit for our clients. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 76 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Our in-house pharmacy benefit consulting team will provide ongoing monitoring to confirm financial contractual guarantees. We will conduct a semi-annual audit of the Pharmacy Benefits Management Program ("PBM") Agreement to review for compliance of all formulary rebates, to determine if the City receives guaranteed rebate amounts, in accordance with contractual obligations. Rebate Guarantees: Our consultants will review the related contract, any applicable amendment language and plan set up documentation regarding rebate payment and guarantees. We will audit and calculate the number of brand claims that should be eligible for rebates. The qualified claim counts, and applicable rebate guarantee rates will be used to calculate the total rebate payment owed. This will be compared to what was paid by the PBM for the time period of the audit. Any shortfalls will be investigated and reported. Benefit Design: A review of all contracts and plan documentation including benefit set-up sheets, prior authorization criteria, step -therapy rules, and any other applicable benefit design elements will be performed. The appropriate plan designs will be applied, and applicable copays and deductibles, as applicable will be tested. Thought Leadership: Helping clients proactively manage cost -impacting industry trends such as Weight Loss Medications (GLP-1's) and biosimilars. With the pharmacy industry constantly changing, as a partner, it is critical that we remain nimble and position our clients to navigate those changes quickly and effectively from a plan management and contractual perspective. Evaluating Pharmacy Spend: Pharmacy, especially specialty medications, is the fastest rising component of healthcare costs. In an environment of political and public finger -pointing and increased scrutiny of the intricate shell game of the drug supply chain, the industry's middlemen (i.e., PBMs, wholesalers) will be forced to increase value and efficiencies or risk being squeezed out of the equation. Pharmacy benefits are typically the most utilized benefit by plan members and one of the fastest - growing cost -drivers. Specialty drugs are medications with high costs for a course of treatment or a year of therapy. Some health plans also categorize drugs as specialty if they are novel therapies that require special handling, monitoring, or administration, or are used to treat rare conditions. In general, elevated costs are a distinguishing characteristic of specialty drugs. A survey by EDM Serono Specialty Digest found that 85% of health plans consider high cost a determining factor in identifying specialty drugs. Medicare's definition of specialty drugs is also based on price: pharmaceuticals costing $600 or more per month are considered specialty. Specialty drugs are a constantly growing segment of today's medical treatment plans for complex diseases, including cancer, multiple sclerosis, rheumatoid arthritis, and hepatitis C. Specialty drugs cost an exorbitant amount; they now make up roughly one-third of the total U.S. prescription drug spend and are expected to rise to 50% in the next 2 years. It's not uncommon for two or three individuals' prescription expenses for one or two specialty drugs to represent more than half of an employer plan's entire drug spend. And as a result, it's also not uncommon for an employer plan's prescription claim costs to increase 30-40% in one year. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 77 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Our clinical team provides solutions that reduce cost and improve outcomes which enable plans to remain successful and sustainable. Our clinical interventions utilize an extraordinary depth of clinical pharmacy expertise and professionalism to work effectively with all key components of patient care to achieve remarkable outcomes — clinically effective, member centered with significant plan savings. Our strategies favor clinically useful drugs over financially driven brands resulting in truly lowest net cost for plans. Improved value overall, bring transparency forward and reduce costs. Sample Audit Findings Commercial Health & Welfare Plan Audit Scope: Plan Design and In- House Pharmacy Claims Errors Identified: $405,000 Issues included: SAW code errors and days supply logic for specialty claims Commercial Government Entity Audit Scope: Pricing, Financial Guarantees, Plan Design, and Rebate Guarantees Errors Identified: $95,000 Issues included: The lesser of logic in the claims adjudicaton system was not set up properly and excluded the usual and customary NBC) price. Commercial Government Entity Audit Scope: Pricing, Financial Guarantees, Plan Design, and Rebates Errors Identified: $14,400 ARMSRx identified a pricing error with a specialty drug. The appropriate discount was not charged. ARMSRx PBM Audit specialists test claims for accuracy and contract adherence. Additional Savings Opportunities Clinical Interventions Clinical Management/Oversight Dose Optimization Intervention Cushing's Syndrome KORLYM Savings $48,000/claim Specialty Medication Intervention Hepatitis C HARVONI Savings $18,000/claim Gene Therapy Intervention Cystic Fibrosis TRIKAFTA Savings $290,000/year Alternative Pricing High Dollar Program Claim (340B) Intervention HereditaryAngiodema Graf Combination TAKHZYRO DUEXIS Savings $77,000/year Savings $29,500/year 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 78 #, FO U N D AT I O N PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services e) Request directly from the City's Third -Party Administrator, the Quarterly Rebate and Annual Reconciliation Report, for the purpose of its review and subsequent briefing of the Project Manager on findings and conclusions. We will work with the City's Third -Party Administrator to receive the quarterly rebate and annual reconciliation report for the purpose of its review and subsequent briefing of the project manager on findings and conclusions. Our Pharmacy Benefit experts will review the quarterly rebate reports and annual reconciliation reports. As we will track the financials throughout the year, we are prepared for the reconciliation from our point of view. When the PBM delivers their version of the reconciliation, we work through the disparate claims to understand where they are accounted for within the reconciliation and come to our conclusion or findings. We will review the related contract, any applicable amendment language and plan set up documentation regarding rebate payment and guarantees. During this review, we will audit and calculate the number of brand claims that should be eligible for rebates. The qualified claim counts, and applicable rebate guarantee rates will be used to calculate the total rebate payment owed. This will be compared to what was paid by the PBM for the time period. f) Assist in coordinating the compilation, verification, and reporting of necessary census or reports for actuarial analyses and operational audits, as needed. Our team will work with our actuary to provide financial and strategic recommendations for the City of Miami. We will help compile necessary reports and other data elements to perform this work. We will perform large claim and trend analysis, rate development, contribution strategies, stop loss cost/benefit, cost projections and budget development, reserves/IBNR, statutory filings, among other evaluations to monitor plan performance. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 79 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services 2. Strategic Review of Benefit Plan Designs: a) Monitor the performance of, and compliance with, all established contractual requirements of the City's multiple Employee Benefits Program. We will develop a Service Plan to describe and track the systematic implementation of components such as plan marketing; plan and vendor management; claims analysis; BenefitsVlP employee support; an initial onboarding compliance assessment, COBRA administration, etc.; benefits administration technology; surveys; total compensation statements; tailored employee communications; wellness programs; and all aspects of the City's benefits program. We constantly monitor plan performance by reviewing available monthly claims data for all employee benefits. Based on performance, we consider alterations. This close attention to detail ensures that the City of Miami's employee benefits program will always be compliant with its contractual obligations. Your account management team considers plan inspection part of their due diligence as a City partner and is meticulous in their approach because they understand how the constantly changing landscape of healthcare legislation has created an undue burden on employers. Your account management team also regularly researches the industry for methods to improve plan design, employee engagement, wellness strategies, etc., and communicates this information to clients. The City will have a dedicated compliance consultant and have direct access to our full compliance staff via phone or email as part of our concierge approach to client service and peace of mind. Performance management process features include the following: • Designing metrics and establishing performance standards for service levels. • Claims review and full utilization analysis including IBNR and Lag Triangles. • Plan provision accuracy will be monitored to ensure claims are being paid and administered in accordance with the plan design. • Monitoring vendor performance and client satisfaction. • Exploring and benchmarking the marketplace as a means of recommending the best possible vendors. • Measuring on -going financial stability • Verifying proper licensure • Support before, during, and after a government audit of a benefit plan. • Negotiating preferred pricing and performance guarantees. • Innovating new processes to improve service delivery to clients. • Developing new service solutions in support of the ever -changing HR/employee health and welfare benefits landscape. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 80 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services b) Analyze all current City employee benefit options and plans, and recommend changes as necessary, based upon market analysis, legislation, and availability, to better meet the City's multiple Employee Benefits Program's service objectives, identify opportunities for cost containment if applicable, and/or better terms of service. Our team will analyze current plan structure and design, historical, current, and projected costs, claims experience and utilization, contracts, etc. At the same time, we review employee -specific aspects, including contributions, communication material, and overall plan satisfaction. Our analysis leads to the annual Service Plan and a long-term Strategic Benefits Plan, which are comprised of tactical and strategic initiatives and the resources required to accomplish objectives. The annual Service Plan is a single, time -activated working document with clearly defined priorities and timelines for each step of new client implementation; this process is ongoing and adjusted as necessary throughout the year. It describes and tracks all components of the delivery phase, the implementation of plan management, claims analysis, BenefitsVlP employee support, COBRA administration (if needed), benefits administration technology, surveys, Total Compensation Statements, tailored employee communications, etc. Our analysis leading to the design of the annual Service Plan also forms the basis of a three- to five-year Strategic Annual Business Plan. Our recommendations are designed to mitigate cost increases that typically encompass cost containment strategies, population wellness, contribution strategies, etc. Whether our analyses target annual plan activities or long-range goals, the process identifies performance consistency and potential deficiencies and aberrant situations. The process also facilitates the consideration of new and emerging products and trends. We will work collaboratively with the City to align your benefits strategy to deliver the lowest possible cost and highest possible value. At the same time, we will prepare the City to anticipate and respond to an ever -evolving healthcare landscape. If we are a successful proposer, our first objective for your organization will be the establishment of a strategy, predicated on identifying the factors currently driving cost for the City and how those costs can be remediated. First Objective Develop Strategy • Client Data Gathering & Analysis • Cost Drivers (Plan/Profile/Risk) • Benchmark Analysis • Considerations ❑ Claims ❑ Culture o Goals & Objectives o Budget Requirements o Employee Perception o Challenges o Improvement Opportunities a Timing Execute Plan ▪ ;nnuaAction Plan • INarketAnalysis • Claims Experience ▪ Plan Underwriting • Plan Offerings ▪ Plan Funding • Carrier Negotiations • Contract Review • Open Enrollment Measure Results • Plan Utilization • Claims a Netwarks/Disoounts • Trends • Issues a Design Anomalies ■ Employee Satisfaction • Benchmark Report • Participant Behaviors • Wellness Compliance ■ Predictive Modeling G Pre -Renewal O Post -Renewal 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 81, ,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Our analytics platform helps employers gain transparency within their data to identify quantifiable savings to hold their carriers and vendors accountable. Potential Savings Opportuniiiu In Dis $82,000 Increase GDR $24,000 $5,000 Inappropriate Med. Svcs. $4,000 Site of Care $2,000 Reduce RX Waste $17,000 Unenrolled Claims $4,000 FR Avoidance $2,000 Overage Dep. /w Claim:_ $o 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 82 #40 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services The platform offers layers of data -driven insights, including standard dashboards that quickly identify what is driving costs within your population and identifies emerging trends. • Identify healthcare waste. • Quantify and target savings. • Set ROI performance guarantees with each vendor to obtain maximum value. • Measure the impact each solution implemented delivers. • Identify potential savings opportunities. Enrollment Y -2 599 Members Subscribers 381 Cost Per Month Total Spend Vs. Budget S3.91.1 S38M Previous $4.8M 14.2M 90 SIM S2M SJM $.1M $SM Medical Spend Net Spend Budget Pharmacy Spend-) Financial -3 Risk Score 6.3 High Cost Claimants - 5 Members $945.5K $445.5KSl Reimb. v •52 S100K Threshold Potential Savings Opportunities This platform also provides the City with a means to meet your obligations as a fiduciary under the new CAA requirements. VAULT ANALYSIS & REPORTING BENCHMARKING Secures your procurement process and documentation: Organize, tirnestamp and store the documentation needed to run a fiduciary process Dissects and analyzes your medical and Rx data to: Substantiate your procurement decisions Perform regulatory reporting • Provide substantial savings opportunities Improve your population health Provides the benchmarking necessary to meet Fiduciary procurement obligations: • Plan design benchmarking • Pharrna benchmarking • Site of care benchmarking 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 83 $FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services c) Attend the City's monthly Healthcare Insurance Committee meetings, comprised of Union leaders and/or representatives, City HR Labor, City Benefits, and others, and provide technical and expert support to the City as part of its bargaining unit driven commitments. Support and responsibilities shall include, but are not limited to: i. Assist in the agenda preparation of, and participate in, the meetings. ii. Assist in documenting meeting minutes, provide feedback on prior meeting elevated or take- away items. iii. Conduct in -person or virtual presentations as needed on topics such as, but not limited to: (a) Rates, (b) Coverage Issues, (c) Eligibility, (d) Emerging Trends, (e) Critical Success Factors, (f) Financial Reports. iv. If needed assist in coordinating and co -hosting educational workshops/presentations on key legislation affecting any employee benefits for City Risk Management employees, union officials, fiduciary administrators, and other service providers. We affirm we will meet these requirements, in addition, because our approach to supporting our clients' benefits program is a year-round engagement, we aim to over -communicate to ensure the congruence of support with the right path toward achieving your long-term strategic goals. Our meeting structure includes, but is not limited to: • Ongoing Activity: We currently hold bi-weekly project plan calls to touch base on all program management activities. During these calls we discuss the status of each open activity detailed in the Project Plan. • Quarterly Strategy: We conduct quarterly meetings to review claims and financials/budget, address any service and administration issues, review BenefitsVlP reporting, and discuss industry updates on compliance or trends. • Mid -Year Pre -Renewal: 7 months in advance of the renewal our team will review claim reporting and utilization provided by the carrier. Our actuarial team will utilize develop claim projections for the upcoming fiscal/plan year. This information will prepare you well in advance and will allow us to strategize on how to address cost -drivers mid -year while allowing you to budget appropriately. • Renewal Review: Due to the size of your group and your funding status, we can request that the carriers deliver the renewals several months prior to your actual effective date. We will review incumbent carrier renewal numbers along with the marketing approach preferred by procurement. • Post -Renewal Strategic Planning Meeting: This occurs approximately one month after the renewal. We review the financial results of the open enrollment, changes in plan enrollment etc., and the processes of enrollment while looking for areas of improvement. This meeting is also used to set the agenda for other priorities after open enrollment has been completed. The client relationship is extremely critical to our value. The multiple touch points we offer throughout the relationship will develop a deeper understanding of your needs. We also enhance that perspective with informal get-togethers and discussions. In addition to face-to-face meetings, your team members will be available by phone and email. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 84 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services d) Provide strategic and operational, technical support to the City by identifying opportunities for enhancing current and future benefit plans, including funding designs, to broaden the reach and efficacy of City employee benefit offerings. We benchmark programs to compare how the City's current plan compares to other employer - sponsored government plans in the state and geographical area. We utilize our multi -sourced normative benchmarking data base that consists of 50,000 unique employer groups via Truven Health Analytics. Critical Services: • Audit of Pharmacy Programs to monitor dosage, FDA guidelines, claim processing, and to ensure claims are progressed in the correct tier. This process will generate a savings for the City. • Evaluating a Pharmacy Carve -out plan will provide the City with transparency into the pharmacy benefits, allowing greater understanding and control of the City's spend, improved contract terms, and the ability to track/monitor performance. Based on the information provided, we have identified a savings of approximately $2 million without changing the drug formulary. • Retiree program expertise with our innovative solutions to enhance retiree benefits and manage costs. Evaluation of Group Medicare Plans for the City's retirees. Fully insured Group Medicare plan provide a single platform design with a broad, national provider access. It's tailored to provide you with the value and flexibility to meet the healthcare benefit needs of your retirees. Since a Medicare group plan is responsible for the entire claim liability, the plan offers clinical programs and services to help retires lead healthier lives. Savings opportunity, 30% to 60%. Group Medicare Retiree Plans Structure of plan Claim administration Quality incentives for health care providers Coordinated care and support Proactive closure of gaps in care Incentives for health and wellness Traditional Approach , Medicare + Employer Group Plan Group Medicare PPO Approach 1 i- Single Plan • Out of network claim repricing approach to improve the City's spend by approximately 25%. • Concierge Primary Care Benefits as an alternate approach to an on -site clinic. This will bridge the convenience of telemedicine with in -person care, improves accessibility, and reduces cost. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 85 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Below are details of these services: • Review current employee benefits program performance. • Analyze the factors driving plan costs, based on available experience data, and review utilization reports to determine cost drivers. • Deliver an analysis that compares program costs, plan designs, administration costs, network discounts and network accessibility. • Establish objectives and annual and long-term strategies to manage your benefits program. • Develop a renewal plan and timeline that meets the City's annual and long-term objectives and mitigates risk and cost increases. • During the plan marketing phase, prepare RFPs to obtain competitive quotes from carriers and other vendors, and serve as the contact during the bidding process. • Evaluate vendors and carriers to determine conformity to contracts, performance guarantees, costs, and provisions. • Negotiate with carriers and other benefit program providers on your behalf; evaluate new contracts. • Provide cost projections and funding analysis, including a review of current and recommended funding methodology. • Establish claims reports for medical and prescription drug, with details of paid claims and applicable reimbursements, as well as premium/funding and enrollment summaries. Review these reports with your team to identify and address trends. • Evaluate your demographics and develop voluntary benefits product recommendations to fill gaps in core coverages and assist in the management of these benefit products. • Benchmark medical plan costs and employee contributions against employers of similar size in your industry and region. • Meet with your key representatives on an ongoing basis to discuss the overall strategy and keep you informed of significant marketplace changes and trends. • Support open enrollment with insurance experts and presentations; provide benefit guides for new plans and updates to existing plans. • Deliver a new -client onboarding compliance assessment that identifies immediate areas of non- compliance and rectify these issues. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 86 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services • Deliver comprehensive compliance support from our in-house experts, including a detailed compliance service calendar with activities and key dates to keep your plans in compliance year after year. • Provide oversight and guidance on legislative issues and pending or new legislation. • Provide access to a benefits attorney and other in-house compliance experts to answer your questions as they occur. • Communicate ongoing regulatory guidance in a timely manner with actionable guidance. • Provide a dedicated team of employee advocates who will answer your members' questions and resolve benefit issues on their behalf. • Design and deliver targeted communications campaigns that promote employee engagement, program cost control and benefits consumerism. • Deliver an internally written and designed monthly health/benefits blog, HealthDiscovery.org, to your employees. • Advise on benefits administration and enrollment technology platforms as well as human support to aid employees in decision -making as well as day-to-day and annual benefits administration. e) Provide professional consulting, and legal advice on the review of recommended plan amendments, and for other benefits -related matters, as necessary, to ensure compliance with federal, state, and local legislation. We affirm we will meet this requirement. Additional details on our compliance support services can be found on page 133. We can also coordinate educational initiatives for City of Miami. Corporate Synergies hosts a series of thought leadership events, which include webinars and forums throughout the year. Our compliance team continuously monitors legislative changes, both at the State and Federal level. The CAA's transparency requirements could pose a hardship on employers that are often not equipped to monitor and act upon the law. Our skilled compliance staff will analyze how the CAA, as it presently exists or is amended, impacts your plans. They will deliver timely advice, guidance, and assistance, including any required or recommended plan changes. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 87 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services f) Strategize with the City on short-term and long-term health and wellness objectives in terms of benefits plan design and funding and alert the City of any significant variations that would warrant redesign. Our approach to long-term planning revolves around two core principles: 1. Continue offering employees quality benefits that help protect their financial and health and wellbeing, while helping protect our clients' costs associated with offering healthcare. 2. Establish a long-term strategy with a near -term progression that minimizes the impact year -over - year of changes that help progress toward long-term financial and strategic goals. Our approach to establishing a plan follows the below depicted progression. Any consideration we recommend to the City from a strategic perspective will have a savings projection clearly defined, along with the cost -benefit -analysis of any change from the current program. Develop Strategy ▪ Client Data Gathering & Analysis ■ Cost Drivers (Plan/Profile/Risk} • Benchmark Analysis • Considerations o Claims • Culture • Goals & Objectives o Budget Requirements o Employee Perception • Ohallenges 2. Improvement Opportunities o Timing Execute Plan ■ Annual Action Plan ■ hlarketAnalysis ■ Claims Experience ■ Plan Underwriting ■ Plan offerings ■ Plan Funding ■ Carrier Negotiations ■ Contract Review ■ Open Enrollment Measure Results Plan Utilization o Claims o Networks/Discounts • Trends a ISSlIQS a Design Anomalies Employee Satisfaction Benchmark Report Participant Behaviors Wellness Compliance Predictive Modeling • Pre -Renewal 4 Post -Renewal 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 88 #40 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Ultimately, we will collaborate with the City to establish a 5 Year Strategic plan which we have provided an illustrative example of below. Preliminary 5 Year Plan I Synergies360 (illustrative) PHASE 1 • h:lanE. errent E7.iorsemerrt • Camnnuri€crn & Education • Medical .>: 5aseline• • Compliance Assessment • Benefrte Newsletter • PEssiv a Wellness In tiativas • Benchmarking • Case Management • Review & Maximize: Core Buy -up Funding Analysis Opt -out Program Contribution Modeling FSA.s PHASE 2 • Communication & Eillucation ■ Consumer Driven Healthcare (HR.s} ■ Ft4 Carve -out ■ smoking surcharge ▪ .Act've wellness ni: a: ves ..tiliiation analysis ■ Network Analysis • Health Risk Assessmerrts • disease Management ■ ROI Analysis • Benefits website ■ Employee Surveil= • wellness Fairs ■ Voluntary Benefits Gap Analysis F#IAISE3 • Communication &Education • Employee. Dependent Accountability • Health 3awrngs Accounts IHDHP;I • Risk Identircadon & Stratification • Personal Health Rsmrds • Value -based Benefit Design • Dependent. edit • Bio-rnetric Testi rig • Automation of Benefits Administration ■ Communication & Education ■ Claim Audit • Non-compliance Monitoring & Penalties • R41 Reporting • Predictive Modeling ■ Wellness Wadies yOutreach I • Deferred Compensation .Arrangement ■ Performance -based St tiered Netvorlo PHASE li • Communication & Education • Medical Tourism • Lifestyle Ac€auntabi. t • On -site Wellness Center • Private Marketplaces • T_le-Medici re 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 89 #FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services g) Advise the City in establishing strategic goals with respect to the City's multiple employee benefit plans and the continuing branding of Risk's Employee Wellness Program, Stay Active Miami ("SAM"), for the purpose of improving the overall health of the employee population, while managing cost- effectiveness and increasing wellness engagement. Your benefits consultant and account management team will schedule a strategic planning session with your team. During this session they will analyze your existing plan components, identify short- and long- term goals, and develop agreed -upon checkpoints and measurement metrics. The result will be a three- year strategic plan with a focus on short-term execution. This plan will be consistent with your current and future goals, demographics, and City culture. Our wellness strategies are designed using a comprehensive set of data sources on health plan costs and utilization, as well as complying with Federal and State mandates. • Negotiate with your health insurance carrier wellness dollars to financially support your health fair, biometric screening event and activities. • Wellness Committee — At the City's discretion, our team can set up, manage, and attend all wellness committee meetings to share and implement ideas and structure. • Set up and manage a timeline for all activities, with the City Wellness committee input. • We are prepared to assist/manage a biometric screening/health fair event that includes Health Risk Assessments, employee's wellness education and local wellness vendor participation. • Include wellness incentives for participation. • Strive for 50% or better participation. • Review reporting from Health Risk Assessments and claim reporting to analyze top conditions. • Review EAP utilization and educate employees on using the program. • Develop and manage custom wellness activities with a focus on the City's Health Risk Assessment reporting throughout the year, such as: walking challenges, weight loss, lunch n learns, financial fitness campaigns, health workplace initiatives, and promote the City's EAP program. • FRP will design and conduct customized assessments and/or employee surveys. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 90 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Multi Year Strategy Baseline Reporting Targeted Campaigns Measurement i= ■ = ■: Lifestyle Management No Ifs, Ands or Butts.., EPIC Lifestyles Solutions Technology Platform: We can provide employee wellness -related communications through our optional EPIC Lifestyles Solutions wellness and disease management portal. This award -winning wellness portal (Corporate Vision Magazine, Business Worldwide Magazine, and EmTech Excellence Awards) provides an enhanced interactive experience for plan participants. EPIC Lifestyles Solutions wellness and disease management portal supports: • Immediate and Long-term Strategy: Plan, implement and integrate EPIC into an annual and long-term wellness program. • Scalability: Sized to meet needs regardless of the employer's current stage in wellness. • Open Access: Enrolled employees/spouse and anyone not enrolled in the medical plan can participate. • Cost -Effectiveness: Only pay for participants registered on the EPIC portal. • Reporting: Aggregate on -demand employer reporting. 1i00% MOBILE: WE'VE GOT AN APP FOR THAT! • theBRID E o accclprfte YOUR Benefits ra r eracl yw de�+7i.i ay call we of Co*PlaY App Store 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 91 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services • Unlimited Challenges: Provided via FRP's library of 40+ challenges. • Communications: Not a DIY solution, but a defined suite of communications. • Diversity: Multiple languages supported. EPIC provides three separate tools: The Bridge, The Challenge and The Portal, that can be mixed and matched depending on a client's needs. 1111 ri ACTIVITY ACT vary 'IVITT !fJ' '..I- .LI 6fT'vl+t Y Mmirr r hlw vE:LNESS WANES'S WE1LNEzS ,E,LN ".: WELLWESS 780 W. Granada Blvd. Ormond Beach, FL 32174 PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services h) Attend City health and wellness meetings scheduled monthly, weekly, or as needed by the City; assist in procuring and monitoring relationship with health and wellness vendors for City of Miami Group Benefits sponsored whole -health and wellness events, such as employee Health Fairs, educational seminars and/or similar events. We affirm that we will meet this requirement. Our analysis reports and industry recognized thought leadership qualifies us to meet this requirement. As stated previously, our wellness strategies are designed using a comprehensive set of data sources on health plan costs and utilization, as well as complying with Federal and State mandates. • Negotiate with your health insurance carrier wellness dollars to financially support your health fair, biometric screening event and activities. • Wellness Committee — At the City's discretion, our team can set up, manage, and attend all wellness committee meetings to share and implement ideas and structure. • Set up and manage a timeline for all activities, with the City Wellness committee input. • We are prepared to assist/manage a biometric screening/health fair event that includes Health Risk Assessments, employee's wellness education and local wellness vendor participation. • Include wellness incentives for participation. • Strive for 50% or better participation. • Review reporting from Health Risk Assessments and claim reporting to analyze top conditions. • Review EAP utilization and educate employees on using the program. • Develop and manage custom wellness activities with a focus on the City's Health Risk Assessment reporting throughout the year, such as: walking challenges, weight loss, lunch n learns, financial fitness campaigns, health workplace initiatives, and promote the City's EAP program. • FRP will design and conduct customized assessments and/or employee surveys. Multi Year Strateg, Baseline Reporting GET CONNECTED! A Targeted Campagrts Lifestyle Management +Open Eerakheenl wN be team °cicbef 13er Octobee 32, 2014. Measurement No Ifs, Ands or w 11• ■! ■ 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 93 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Additionally, our staff regularly attends national and regional conferences, forums and symposiums sponsored by industry and trade associations, including the National Business Group on Health. We also leverage memberships in the following groups to gain insights into benefits and health and wellness innovations: 1 rnation l 1'ourkcdatior]I OF EPFOY'L[G P1.AN! ad+te rr'!rn RAeseurrtl I i,ertcterskw,p SI-RM 50CIETY FOR HUMAN -`-r :; E MANAGEMENT WELLNESS c£]k.FNCiL CIF �n+IERIC,� N A IluN4I. I( 11111. fIt.+.pAN r Si'tl.°F ii•k;:ti S CII4TRl Cf#nn 'J • Ewa • Lead Cj Fei. financial executives Inteinaglonal 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 94 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services 3. Federal, State and Local Legal Compliance, Research Services and Related Requirements: a) Provide research, advice, and interpretation of federal, state, and local benefit regulations and legislation, upon the City's request. Federal and State regulatory compliance is a core competency. Our full -service, comprehensive benefits compliance services are provided through our internal Compliance Department under the direction of our head Benefits Attorney, Daniel Kuperstein. Our engagement for the City will begin with a thorough compliance assessment audit and continue 52 weeks a year. We will leverage our systematic monitoring and information -sharing platform to educate and inform the City on all Federal and State laws, regulations, and guidance that impact your health and welfare plans. We communicate relevant changes through our detailed eAlerts, which we deliver to clients following a government announcement. We also discuss developments in our client -facing webinars, which occur at least quarterly, postings to our HAWC Forum, and in our Compliance MINUTE video series on corpsyn.com. Our compliance team also publishes an annual Compliance Calendar and Compliance Checklist, both of which are included in the Appendix. (Pages 136/133) We host a Linkedln group, Health & Welfare Compliance Forum (HAWC), with postings on employee benefits compliance, Healthcare Reform alerts, updates, and industry news. If the City isn't already a member, your staff members can join HAWC at linkedin.com/groups/7459898. Your account management team regularly researches the industry for methods to improve plan design, employee engagement, wellness strategies, etc., and communicates this information to clients. The City will have a dedicated compliance consultant and have direct access to our full compliance staff via phone or email as part of our concierge approach to client service and peace of mind. b) Provide professional consulting support and advice on specific research, compliance -related issues, and other general matters, as deemed necessary by the City. Our compliance consultants routinely communicate breaking news that we learn from participation in the Legislative Working Group for the Council of Insurance Agents and Brokers (CIAB) in Washington, D.C. We also monitor legislative sources, including subscription news services through Thomson Reuters Checkpoint and BNA, as well as through the government agencies. We discuss legislative and regulatory developments in our detailed eAlerts, which we deliver to clients following a government announcement. Further, the compliance team and the CIAB occasionally join forces to give both client -facing and internal trainings on significant regulatory developments. Our clients may receive outside vendor communications after an event has transpired, but the communication's content is sometimes inaccurate or uses scare tactics to get the client's attention. By contrast, our compliance team carefully crafts eAlert communications, which are peer reviewed by all compliance consultants on the team to provide accurate and practical takeaways that our clients can understand. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 95 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services April 2, 2019 Court Blocks Final Regulation on Association Health Plans On March 28, 2019, a federal district cart judge in Washington, D.G bleckedlthe final regulation ("Final Ruler) on association health plans l'AHPs"}- The Final Rule, issued by the U.S_ Department of Labor('DGL") in June, 2018, pursuant to an Executive Order by Prmadent Trump, had eased the requirements under ERISAfoe-smallemployers and i nd iaiduals to join together in an employer gra u p or association in order to create an 'association health plan' TARP"). As • explained in our earlier eAlert on the final Rule (available e-e), the final Rule had made it easier for small employers and sole proprietors to join together in en employer group to avoid costly small group and individual heealth insurance market rules under the Affordable Care Act (ACA). Among other changes, the Final Rule made two major changes to the pre-existing DOL rules on AFlPs (referred to as 'the Sub -regulatory Guidance' or 'Previous Rules`) -the final Rule: ▪ Relaxed the 'cam monality of interest' requirement to form a 'bona fide association," which is necessary to establish an AI-P, where, prior to the Final Rule, organizations interested in setting up an AHP had to show that they had several common interests, such as being in the same industry, cr Having a common I, .rpose; and ▪ In the same trade, industry, line of business., or profession; or ■ Have a principal place of business within a region that does not exceed the boundaries the same state or the same metropolitan area (even if the metropolitan area includes more Man one state}. With regard to this second change, the Final Rule broadened eligibility for participation in AHPsto include 'working owners,' for example, sole proprietors and -other slelf- emplo}ed individuals, where there are no common law employees, provided ce tni•i requirements are met and the individual is not ig. o = 'or any other subsidized group health plan SYNOPSIS This case commenced after 11 states and the District of L olumbia sued the DOL on grounds that the Final Rule had unlawfully stretched the definition of `employer" beyond what was originally intended under ERISA. The Final Rule that was vacated by the oaurt did nat repleoe or invalidate the Previous Rules on AHPs. Our comprehensive suite of compliance services features: • Onsite Compliance Assessment/Audit: A thorough review of the client's current compliance initiatives and a complete report, recommendations, and Service Plan for remediation of all deficiencies and ongoing best practices • Regulatory eAlert Bulletin Services: The latest information on regulatory changes • Webinars: Information -sharing and expert analysis on a variety of topics • In -House Compliance Expertise: Information -sharing and guidance on all health and welfare compliance topics: Compliance assessments: Review plans, policies, procedures, and filings for compliance with federal, state, and local laws and regulations. Plan document/SPD amendment: Draft and amend plan documents and summary plan descriptions. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 96 #,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Filing and reporting assistance: ACA Information Reporting. Healthcare Reform guidance: Proactive consultation by experts in the ACA and other related laws and regulations. o HIPAA training: Educating privacy officers and PHI handlers on how to protect sensitive employee information and to abide by notification requirements. o COBRA compliance review: Procedure evaluation, premium billing, qualifying events tracking, eligibility, reporting, training and more. o Nondiscrimination consulting: Plan review to determine equal treatment of employees regarding eligibility, contributions, and benefit offerings. Wellness plan review: Ensure compliance with ACA, HIPAA, GINA, ADA and other laws and regulations. Miscellaneous consultation: Analysis of regulations specific to COVID-19 (FFCRA), Analysis of USERRA, GINA, cafeteria plans, Section 125, Consumer -Driven Health Plans and more. c) Provide timely updates, providing ample opportunity for the City to meet its fiduciary responsibilities and take appropriate action on any proposed and effectuated changes in the legal environment that affect employee benefits (i.e., Employee Retirement Income Security Act ("ERISA"), Patient Protection Affordable Care Act ("PPACA"), COBRA, Health Insurance Portability and Accountability Act ("HIPAA") and IRS Sections 123, etc.), including and tax law newsletters or special advisories released. We affirm that we will meet this requirement. Our compliance team, led by our in-house benefits attorney, will complete a full compliance audit to ensure your program is meeting all regulatory requirements associated with Affordable Care Act, COBRA, HIPAA, ERISA, USERRA, cafeteria plans, flexible spending accounts, Section 105 medical expense reimbursement programs, reporting and disclosure requirements such as Medicare Part D. Compliance Update with Dan Kuperstein & Dot Summers: We are recognized by SHRM to offer Professional Development Credits (PDCs) for SHRM-CP or SHRM- SCP. Our forums and webinars have also met the HR Certification Institute's criteria to be pre -approved for recertification credit. Our webinars and forums are valid for at least one PDC for SHRM-CP or SHRM- SCP and HRCI credit. ERISA attorney Dan Kuperstein and other internal subject matter experts host quarterly hour-long, deep -dive webinars on a variety of topics. You don't have to be a client to participate in our webinars or regional HR/benefits conferences, and there is no cost to attend. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 97 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services c)RPOI rid SYNERGIES COMPLIANCE UPDATE DAN&DOT NEW COMPLIANCE WEBINAR SERIES REGISTRATION OPEN d) Review plan design documents of self -funded medical and IRS Section 125 flexible benefits plans, for compliance with applicable governing laws. During our initial onboarding of every new client, a compliance assessment is completed to ensure the employer is not at risk from any violations and is compliant with all applicable laws. The assessment is built to mock a DOL audit and includes an Affordable Care Act liability analysis, all required annual notices and a review of all plan documents (medical, dental, FSA/Section 125). We help the client draft a wrap document and summary plan description (SPD) that contains all their benefit options and programs, including retiree health plans, EAPs, wellness plans, etc. When significant legislative and regulatory changes occur, our compliance team notifies all clients through our eAlert program. The eAlert describes the developments and the impact on their plan. As needed, the compliance team can draft amendments to plan documents and Summaries of Material Modification (SMM) to the SPD to reflect legislative and regulatory changes. Our compliance team is well -versed in the management of self -funded medical plans and is keenly aware of the additional risk exposure complex employers like City of Miami face in administering them. We make it our mission to hold all clients harmless and will do no less for you and your employees. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 98 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services e) Obtain IRS private letter rulings for the City, as necessary and applicable, at the discretion of the City, in consultation with the Successful Proposer. Foundation Risk Partners has a skilled in-house compliance team, who are experts in the Affordable Care Act and all other laws and regulations that impact benefit programs. They identify and resolve immediate risks and develop an ongoing strategy to keep plans compliant year after year. They communicate relevant government regulations and carrier information that affect benefits. Our team is under the direction of Dan Kuperstein, Benefits Attorney, and expert in Healthcare Reform. He has a deep expertise in employee benefits and labor and employment law. He advises clients on and ensures compliance related to, the Affordable Care Act, COBRA, HIPAA, ERISA, GINA, ARPA, and all other government regulations related to employee benefits. We provide compliance support associated with ACA reporting requirements. We work with preferred ACA reporting vendors to help our clients satisfy the annual 1095-C and 1094-C requirements. Our commitment to the City is to identify your unique needs associated with information reporting and variable hour tracking to determine the appropriate vendor required to meet each of these requirements. In the event the City receives a notification from the IRS with an applicable ESRP (shared responsibility payment), our team will review the penalty letter, help write a response, and gather necessary documentation to respond to the IRS. We've helped numerous clients mitigate significant potential financial liabilities associated with ACA reporting. f) Ensure compliance with all PPACA provisions/requirements. g) The ACA's compliance requirements have posed a hardship on businesses that are often not equipped to monitor and act upon the law. Our skilled compliance staff will analyze how the ACA, as it presently exists or is amended, impacts your plans. They will deliver timely advice, guidance, and assistance, including any required or recommended plan changes. They will also provide ongoing support related to applicable State and Federal regulations, COBRA and HIPAA assessments, compliance updates, annual communication requirements, etc. They will systematically communicate relevant regulatory updates that may affect your health and welfare benefits, and provide in-depth training via personal contact, complimentary webinars, etc. Your engagement with Corporate Synergies will begin with an onboarding compliance assessment to determine and resolve any immediate risk and exposure. Provide necessary and supporting calculations for any benefits related to IRS payments/fees. Foundation Risk Partners' dedicated account management teams are knowledgeable and experienced in all aspects of health & welfare programs. The City is also supported by an actuarial team, in-house underwriters, and other compliance subject matter experts. The healthcare arena is in an ever -evolving landscape, and we support our clients as new requirements emerge. For requirements such as the PCORI fee, FRP will send out an annual notification to remind the City of the annual deadline. We will also provide calculations using the approved methodologies to determine which approach is the best financial option for the City. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 99 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services 4. Development of Request for Proposals (RFP) / Request for Qualifications (RFQ) Proposal / Qualifications Review and Negotiations: a) Provide assistance and technical expertise in the development of RFP's/RFQ's to be issued by the City on behalf of Risk. We affirm that we will meet this requirement and provide reports and comparisons to aid in the City's decision -making process. Foundation Risk Partners will take a fresh and unbiased look at the current policies and vendors in place. We will obtain proposals from appropriate carriers, working in collaboration alongside the City's Human Resources, Finance, and Budget staff to ensure a successful process on behalf of the City. Our in-house pharmacy benefit consulting experts will formally evaluate Pharmacy Benefit Management (PBM) vendors through a Request for Proposal (RFP) process. Our team will develop the pharmacy benefit request for bid/request for proposal (RFP) specific to your needs and distribute to "best fit" PBMs that best align with your goals. We will review and analyze the vendor proposals based on required criteria and results of these vendor evaluations will be presented in a summary format as a Report of Findings. Both quantitative and qualitative analytics are provided. We will coordinate and conduct finalist meetings, demonstrations and presentations as well as negotiate the BAFO (best and final offer) pricing. General PBM RFP steps are outlined below: • Step I — Develop, release, and coordinate the RFP in the marketplace. This will include meeting with you to understand specific, targeted client requirements. • Step II — Evaluate and grade qualitative responses in detail, weighted scores indicate a favorable position as finalist. • Step III — Prepare quantitative analytics on an equal basis of comparison for the financial offering including retail network discounts, mail order, specialty, dispensing and administration fees and rebates. Network and formulary comparisons and impact reporting may be included as well as ancillary fees, allowances, and other financial aspects of the offer. We will also provide a comprehensive view of the Performance Guarantees and dollars at risk being offered. • Step IV— Create the Report of Findings which summarizes in a concise, thorough manner each vendor, the advantages, and disadvantages of the key points of the offers and succinct pricing comparisons. We will create the RFP Summary providing all qualitative and quantitative analytics culminating the entire process for your reference. We will then deliver and review the Report of Findings Summary and determine vendors to invite to finalist phase. • Step V — Finalist Meetings. We will then coordinate and conduct finalist meetings, including applicable system/tool demonstrations. We will prepare vendors for the meeting, facilitate the meetings, and evaluate presentations and finalist performance. During this time, we will negotiate and secure best and final offers (BAFO). • Step VI — PBM Contract Negotiation. Once PBM award notification has occurred, we will support final contract negotiations. Our continuous marketplace activity puts us in an excellent position to advise on PBM contracts, including negotiation in the areas of pricing, rebates, administrative fees, 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 100 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services pricing terms, applicable provisions and definitions, credits/allowances, performance guarantees and more. Additionally, we will ensure that the PBM RFP agreed upon terms, requirements, pricing, etc. will be carried through to final contract. Sample Renewal Process Schedule Tenative Dates Work Plan Time Frame Establish Objectives Pre -renewal meeting: 210days prior to renewal Develop the renewal strategy Initial budget/claim projection Discuss current benefits and carriers Discuss voluntary benefits Gather Data Collect information for insurance carrier submissions 180days prior to renewal Analyze employee survey results, Prepare RFPs with coordination and approval from HR and Procurement Receive Proposals Submit RFPs to Carriers and post electronically 150-120 days prior to renewal Receive renewal Updage budget/claim projection Receive proposals from insurance carriers Prepare Marketing Presentation Prepare network analysis 90days prior to renewal Prepare preferred drug list analysis Prepare marketing presentation and present to HR, Finance, Budget Negotiate with insurance carriers best and final Present best and final to HR Attend City Council meeting to present recommendations for approval Enrollment Meetings Coordinate with HR to set up dates, locations and time for open enrollment meetings 60- 45 days prior to renewal Coordinate meetings with insurance carriers Provide HR with Open Enrollment flyers Complete Employee Benefits Booklet Submit and confirm eligibility received from carriers Group numbers issued and ID cards ordered Finalize & Confirm ID cards delivered 30days up to effecive date Reconcile initial insurance carrier invoices Confirm propoer issuance of all policies and contracts Review and confirm objectives were met 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 101 FOUNDATION F'UP.LK ENT TYS RV.CFS City of Miami RFP #1896386 — Employee Benefit Consulting Services b) Provide assistance and technical expertise in reviewing competitive RFP's/RFQ's, including the establishment of appropriate performance standards, in development by the City. Market Solicitation and Renewal Negotiation: All vendor proposals will be reviewed and evaluated by our team prior to presentation to the City staff. This evaluation and presentation process will be inclusive of the following: • Provide a detailed carrier analysis of their proposed contract, plans, and cost compared to the in - force program. • Illustrate the differences to include the advantages and disadvantages. • Total program cost details. • Employer and employee contribution modeling. • All proposal details to include caveats and exclusions. • Network analysis with reports on provider disruption, discounts, to determine viable options for the City. During the PBM RFP process, once vendors have submitted their proposal responses, we will prepare quantitative analytics on an equal basis of comparison for the financial offering including retail network discounts, mail order, specialty, dispensing and administration fees and rebates. Network and formulary comparisons and impact reporting may be included as well as ancillary fees, allowances, and other financial aspects of the offer. We will also provide a comprehensive view of the Performance Guarantees and dollars at risk being offered. Once our analysis is complete, we will meet with HR, Budget, and Finance staff as needed to review all options and recommendations. After our presentation, we will begin the best and final negotiation process, securing any missing information and clarifying details prior to making a final recommendation. We will collaborate with City staff on the best and final process, then we will provide a formal evaluation and recommendation for presentation to the Board for approval. c) Assist in the formulation of technical responses to clarifications inquiries received from prospective proposers to be issued via addenda to an RFP/RFQ. Formal Bid Process: Our team will collaborate with your risk management, human resources, and procurement team in creating a Request for Proposal (RFP). During our RFP process, we will work with the City's HR staff and Procurement office to prepare and manage the process to obtain competitive proposals from carriers and other vendors and serve as the contact during the bidding process. Our RFP is customized and approved by the city to include: • Detailed benefit plan design • Appetite for risk • Historical cost information • Demographics • Identify the appropriate markets to • Industry approach. • Locations • Customized request for proposal (RFP) • Technological knowledge 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 102 ##FOUNDATIQiN PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services • Provider networks and discounts • Wellness and disease management capabilities Foundation Risk Partners has vast experience in the solicitation of all insurances through working with public entity procurement departments and abiding by Sunshine Law and State Legislation. For PBM RFPs, our pharmacy benefit consulting team will support the process from beginning to, which will include development of technical responses to clarification inquiries received from prospective vendors during the RFP process. d) Provide assistance in assessing qualifications and analyzing data provided in proposals received from prospective proposers. Successful Proposer may be required to participate as a technical expert/non- voting member in the Evaluation/Selection Committee meetings as deemed necessary by the City, at its sole discretion. Our renewal process begins with a pre -renewal meeting that is 7 months in advance of the renewal. Our in-house underwriters and actuary partners will develop budget and claim projections for the upcoming year. Our team will focus on the following: • Claim reporting • Emerging trends • Utilization review • Administrative issues or concerns • Employee survey • Future budgetary concerns • Benchmarking • The development of the renewal timeline and approach • The state of the carriers This information will prepare the City in advance of a bid process or warranted vendor change. We will lay out the pros and cons of the process before a final decision is made: plan designs, provider and facility -specific network comparison reports, pharmacy implications, reporting capabilities, service platforms (online and in -person), wellness capabilities, service guarantees and their specific renewal methodologies. Committee members will have the ability to meet with the potential new vendor(s) prior to making a final decision. As an authorized agent for virtually every A- or better rated insurance company/vendor in the marketplace, we pride ourselves on our ability to work with total objectivity in all our initiatives. For PBM RFPs, our pharmacy benefit consulting team will support the process of assessing qualifications and analyzing data provided in proposals received. Our subject matter experts prepare a comprehensive Report of Findings that include both quantitative analyses and qualitative results, comparing advantages and disadvantages of each vendor. We focus on aligning our clients with the best suited vendor partners by utilizing data analytics to assist the City staff in decisions on plan design to obtain optimal benefit value. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 103 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services e) Test the adequacy of proposed provider and pharmacy networks, analyze hospital, physical and pharmacy discounts, perform geographic -access match studies and conduct medical provider/prescription disruption analyses. Our pharmacy experts test the adequacy of proposed pharmacy networks as well as proposed formularies. We perform a pharmacy network disruption analysis, which includes geo-access analysis, utilizing client census data. Additionally, we look at the proposed formulary compared to current to identify formulary changes and member impact for all tiers. Once the disruption is identified, we work with you to develop a targeted member outreach to ensure members are informed of the change and aware of their options and alternatives. f) Provide assistance to the City, as deemed necessary by the City, in assessing the rates and fees proposed by the Proposers — and in negotiation strategy for competitive rates, discounts and services for current and future projects. As a hopeful partner with the City, we wish to make it clear that we will work for you, not insurance companies. Our commitment is to, year in and year out, negotiate the optimal carrier contracts available in the marketplace and leverage the breadth and depth of our book of business to do so. We utilize an analytics platform that would help the City make informed decisions with transparency into your data to identify quantifiable savings to hold your carriers and vendors accountable. The traditional way of looking at benefits in silos falls short of providing adequate and relevant insights. Healthcare, Worker's Compensation, and your employees' Financial Wellness are all interconnected with this platform. Our in-house underwriters are experienced in all aspects of health and welfare benefits and have the ability to develop and calculate pre -renewal projections; in-depth renewal analysis and competitive marketing; negotiations with carriers and stop -loss writers; claim lag analysis and IBNR calculations/annual reserve adjustments: equivalent rates; and claim factors. All vendor proposals will be reviewed and evaluated by our team prior to presentation to City's Risk Management and/or HR team. This evaluation and presentation processes will be inclusive of the following: • Provide a detailed carrier analysis of their proposed contract, plans, and cost compared to the in - force program. • Illustrate all proposed plans to include the advantages and disadvantages. • Detailing a cost comparison of the total program cost. • Employer and employee contribution modeling. • All proposal details to include caveats and exclusions. • Network analysis with reports on provider disruption, discounts, to determine viable options for the City with minimal disruption to employees and their dependents. • Pharmacy Benefit Manager and Pharmacy Preferred Drug List evaluation. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 104 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services 5. Other Related Duties: a) Provide ongoing support, review and interpretation of plan provisions and IRS regulations for Section 125 flexible benefits plan. Our team conducts a health & welfare compliance assessment. Internal Revenue Code requirements are covered at length including, but not limited to: • Plan Documents/SPD's • Salary Reduction Agreements • Domestic Partner/Civil Union Contributions • Nondiscrimination Practices • Code Section 79 Life Insurance Taxation Section 125 plan documents and management are included with our services. b) Develop employee communications, including formulation of employee surveys, and focus groups, as deemed necessary by the City. All findings and statistical analyses conducted shall be presented, in writing, to the Project Manager upon completion. Customized Communications: Employee communications are a core competency. We provide in-house employee education and communication strategies that engage and educate plan participants to increase benefit literacy and assist in controlling employer costs. Our campaigns feature targeted messaging to heighten participant awareness and perceived benefit value while promoting consumerism through education and engagement. Our typical communication deliverables include open enrollment and new hire employee packets/benefit guides, posters, flyers, newsletters, postcards, and PowerPoint presentations. All of these can be electronic and linked to any web -based platform. • A printed benefits guide that is updated at renewal, provides all the annual notification requirements associated with the Exchange Notice, Michelle's Law, COBRA, Newborns' and Mother's Health Protection Act, HIPAA, CHIP, WHCRA, MHPAEA, Medicare Part D notices, etc. The guide can exist on your HRIS or intranet allowing easy content updates. • A traditional benefit summary can be converted into an electronic flip book. • Custom videos and multi -media presentations covering a wide range of communications topics. • Social media can be an important part of a communication strategy. Our award -winning social media solutions have help clients reach and connect with employees that were previously disengaged. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 105 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services We are constantly seeking feedback from our clients and their employees to make sure we are meeting the individual needs of each client. We understand that every client has specific needs, and we affirm that we will continue to provide surveys and alter our service accordingly. Below is additional information on our employee advocacy platform. ''aretto Analysis: =o referred to as the $0J2O ratio or the Pareto P I nciple which states that 8O':. of the tinlume cases) comes from 2c"sr6 the causes a Pareto alysis helps us to quickly identify the 'Vital few' that we should focus ati. as apposed to the 'interesting many.' ix. Ass 107 101 • Sd1 , J 44 1 Resource 3uc 7rt ^•.erase Benerns Adminin uon L yF4 rton-Hesitn & V.'e liar.'_ '_lair's m. Incoming calls: Through personal and ongoing contact with the City and your employees, BenefitsVlP will identify, track and report benefit inquiries, activities, and issues. We compile this information in a BenefitsVlP Analysis Report, which provides valuable data on emerging service trends, benchmarking, HR/employee usage, productivity savings calculations, and average resolution time. BenefitsVlP advocates stay involved in a claims issue from the first call from an employee through the resolution of the case. As they interact with your employees, they will collect data on these interactions, which are then utilized by Account Management and our benefits consultants to fine-tune benefit programs. An example: if multiple employees report that they don't understand how to use a specific aspect of their plans, this may indicate a need for a targeted education campaign. Call monitoring system, call tracking and resolution procedures: The team lead is responsible for daily review of open cases. An automated system notifies team leads and the BenefitsVlP director if a case is open longer than expected using type of case as the determining factor. BenefitsVlP representatives handle their case communication whether requesting additional information or providing resolution. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 106 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Key performance indicators the Call Center tracks by client: Our employee support center, BenefitsVlP, tracks every interaction we have with your employees and all calls are recorded. This allows us to track key metrics such as: • First call resolution • Resolution turnaround • Who is calling (employees, spouses, dependents) • How they are reaching us (phone, email, other) • For what are we being contacted (benefits administration, claims, coverage, resource support, non - health & welfare). Page from sample reports depicted below. These reports can be pulled upon request at any time. How are we being contacted? _red below is how your BenefitsieWe team Is being contacted compared to all r:arpnrate 2yner es clients. clients of like industry and clients of like size. Rummer Your All Clkrncot L4•s 0ce2t 0r at0uaeta Or tpnLmbrx CA OM In4:strp' Like Slur Phone 403 86.9% 71.7% 72.29E 72.5% Erroll 52 111% 264% 25.3% 25.5% abler 12 2 6%. 1.4% i9% 159E Tatat: 467 100 E0 80 40 20 P ocr e Email 0-.her For what are we being contacted? he data below reflects the types of cases being handled for your organization compared to all Corporate Synergies clients, clients of like industry and lase Type Number Of Your All r 9ients Of clients Of cases Organisation Bents Like Industry Like Size Benefits Administration, 74 26296 35496 28296 00% claims 15 5.3% 12.696 181% 00% Overage 40 14296 10.996 243% 0091 Resource Support 98 34.8% 27.296 26.9% 0.0% Non-HeOIS&Welfare 55 19.5% 5996 2596 00% Benefits Adel iniseatioa 780 W. Granada Blvd. Ormond Beach, FL 32174 Total: 282 Claims Coverage Resource Comm Non-ReaMB Welfare Your Organization • Clients of Like Industry All Clients Clients of Like Size 1.6 ,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Unlike typical call centers that are measured by average handle times (which translates into moving the employee off the phone call as quickly as possible) the measurement of the BenefitsVlP support center's success is the employee's peace of mind. One of the many attributes of BenefitsVlP is its ability to increase employee satisfaction with their benefits plans. Rather than our advocates being measured by average handle time, they are measured on the timeliness of resolutions, the percentage of resolutions we were able to provide on the first call, along with the percentage of resolutions provided within 24 hours. Our company -wide average is 91% of calls are resolved within 24 hours with 80% being resolved on the first contact we have with an employee. As an extension of our clients HR team, this ensures a positive and best in class level of support when we interact with our clients' employees. How is employee satisfaction is assessed? We monitor BenefitsVlP via our quality assurance program to ensure that our advocates are providing good service and accurate information. We can also design a custom survey for your BenefitsVlP team to use to determine satisfaction among your plan participants. What is the process for resolving customer complaints/issues? The team lead or senior representative distributes cases. Once assigned, the BenefitsVlP representative is the owner from start to finish. This allows our advocates to provide thorough and timely assistance for each case we handle, also preventing employees from having to explain the same issue to multiple people each time they call. BenefitsVlP team members possess deep expertise with claims adjudication and rarely need to escalate a case. However, when a carrier is not processing a claim according to the contract and we need to escalate, our process includes involving management -level individuals within our firm and the carrier organization. BenefitsVlP doesn't hesitate to escalate a claim up to C-level carrier personnel when needed. All service representatives can handle all inquiries/issues that flow into the department. A case is escalated to the team lead when the representative is unable to resolve the issue timely (in accordance with standards set up by the department, i.e., benefits within 48 hours; claims within 72 hours). This escalation is automated via our CRM system. lithe team lead needs to escalate further, the BenefitsVlP director or account management team is brought in to reach out to carrier/vendor management to ensure resolution. One -on -One Employee Advocacy: Foundation Risk Partners' exemplary service approach to the way we conduct business is called BenefitsVlP working as an extension to your Human Resources office. Employees are provided with a first -party administrative and advocacy support team providing response and resolution for employees and their dependents. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 108 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services BenefitsVlP Key Operational Points: • An average of 22 years industry experience • Direct access to carriers, providers & tools • Flexible access to advocates • Multi -Lingual • Adapt to your culture. • Consultative approach BenefitsVlP Advocates' Coachable Moments: Enrollment Support Educating members on the process associated with making their annual enrollment elections through your online election tool(s) Urgent Care Centers Educating members on the use of urgent care centers vs. utilizing the emergency room. Carrier Nurse Help Line Educating members on the offerings of their particular carrier's nurse help line. Use of Generics Educating members on the use of generics instead of brand name or non -preferred medications. Mail-order Prescriptions Educating members on the use of mail order for their maintenance medications instead of using retail pharmacies on a regular basis. In -network Utilization Guiding members to use in -network providers and facilities as opposed to going out of network. HDHP Explanation Providing detailed explanation on high deductible health plans. HDHP/HRA Explanation Providing guidance to members on how their health reimbursement account applies to their high deductible health plan. HDHP/HSA Explanation Providing guidance to members on how their health savings account applies to their high deductible health plan. HRA Explanation Providing detailed explanation on health reimbursement accounts. Preventive Services Providing guidance on coverage as it pertains to preventive and routine services. FSA Explanation Providing education on the cost savings associated with a flexible spending account (health, dependent care, transit, commuter) Benefit Plan Comparison Providing education on the differences in plan offerings so the employee can make an educated decision on their elections. FOIJNDATIQN 780 W. Granada Blvd. Page 109$$ Ormond Beach, FL 32174 PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services (--- BenefitsVIP Case Study 1: Situation: An employee received a carrier notification of denial of payment for her final day of hospitalization. The carrier determined that day of confinement was not medically necessary. When the employee questioned the carrier decision, she was told she needed to file an appeal. She contacted BenefitsVlP. Solution: The BenefitsVlP advocate filed obtained a copy of the hospital bill and reviewed it along with plan benefits. The advocate spoke to the carrier several times and noted it was the physician who determined she should remain hospitalized for another day. BenefitsVlP presented the case facts and requested a review of the payment denial. Result: The carrier overturned the denial without an appeal and paid the final day in full. The employee was only responsible for her in -patient copay. BenefitsVlP Case Study 2: Situation: An employee contacted BenefitsVlP regarding invoices she received from a facility for services rendered back in 2015. The carrier originally paid the claims but retracted $19,419.60 two years later due to a COB discrepancy. Solution: BenefitsVlP escalated the issue to decision -makers at the carrier as these claims were two years old. BenefitsVlP also contacted the facility's billing office to notify them the claims were being reprocessed and requested they place the account on hold to avoid any further collection proceedings. The carrier updated the employees COB file and reprocessed all impacted claims. Result: The patient's balance was reduced to $0. c) Conduct Benefit Plan modeling, as requested by the City. We will work with our actuary to model benefit plan design options, including evaluation of cost savings and enrollment migration scenarios. FRP provides benchmarking programs to compare how the City's current plan compares to other employer -sponsored government plans in the state and geographical area. We assess your plan designs, identify trends, and monitor plan utilization patterns. In addition, we use our benchmarking data for opportunities to educate employees. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 110 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services d) Work collaboratively with other City consultants, and the Office of the City Attorney, and any other City representatives as deemed necessary by the City. We work as an extension of your staff office to support all aspects of your benefits program. We will work in tandem as a trusted and valuable resource for the City. We will establish a regular meeting schedule, an annual calendar with milestones and key deliverable dates. e) Attend meetings with various providers under contract with the City, or with City staff not directly involved with the Employee Benefits Program, at the Project Manager's request. We affirm that we will meet this requirement. f) At the City's request, but not less than semi-annually, present to the City for consideration, a list of three (3) to five (5) critical topics that are relevant to employee benefit programs and health/welfare. The City will identify the topics that best align with its objectives, at the City's sole discretion. The Successful Proposer shall prepare an analysis that identifies observations and recommendations for the City to consider. We take pride in being a firm that understands the importance of creativity and continued thought leadership, backed with world -class service and execution. We understand that each client is unique and it's our job as a partner to identify and address the unique challenges and needs for each of our clients. As a privately held company, we have the flexibility of a boutique firm with the reach of a national firm. FRP recognizes the unique exposures and evolving risk profiles of our municipal clients and strives to reduce the total cost of risk. We believe in public service and is dedicated to reducing program cost, mitigating risk, and functioning as an extension of your staff. The team identified to serve the City's benefits program includes seasoned professionals that bring collectively more than 100+ years of benefits experience to the table along with different perspectives. These varied backgrounds and expertise, will enable valuable feedback to the City's staff from all points of view, including finance, associate experience, and ease of administration. We use resources to deliver data -driven decisions that lead to enhanced long-term strategies that align with your culture and benefit philosophies. We will draw data from your workforce; this process will help you gain insights that are specific to the City and will provide insightful, targeted, actionable solutions that drive meaningful savings and improved productivity. We will use our data engine to measure the impact of the solutions we implement to drive continuous improvement. We welcome the opportunity to share recommendations, industry updates, and other important topics to the City on an ongoing basis. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 111 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services g) Provide ad -hoc analysis and benefits related reporting to the City, as deemed necessary by the City We utilize a combination of carrier reports, our own proprietary models and templates developed over many years with client feedback, and industry best practices to provide the following reporting capabilities: • Financial Exposure: We review all claim/account data provided by carriers, including full analysis and validation of renewal developments (as applicable based on funding), claim projections, claim factors, loss ratios, and other contractual and budget -related exposures. • Plan Utilization and Trend Analysis: We use carrier reporting packages as a starting point to develop a customized analysis that clearly illustrates key cost drivers, metrics and year -over -year trends. Our executive summaries, key observations and charts provide an efficient way for clients to understand the most relevant aspects of factors driving their costs, how the plan is performing and the emerging health risks within their plan participant population. • Alternative Funding Analysis: Our consultants and underwriters are industry veterans with expertise in every funding arrangement available in the market, including Administrative Services Only (ASO), ASO with stop -loss, participating contracts/shared returns, minimum premium, level funded, graded preferred, fully insured, trust arrangements, benefit captives, Reference Based Pricing, and direct contracts. We evaluate a client's demographics, financial risk tolerance and claims experience against all available and viable alternatives in the market to determine the most suitable and favorable program structure. • Underwriting: In collaboration with our actuaries, our in-house underwriters are experienced in all aspects of health and welfare benefits and can develop and calculate pre -renewal projections; in- depth renewal analysis and competitive marketing; negotiations with carriers and stop -loss underwriters; claim lag analysis and IBNR calculations/annual reserve adjustments: equivalent rates; and claim factors. • Benchmarking: We assess your plan designs, identify trends, and monitor plan utilization patterns for opportunities to adjust plan design or consumer behavior. Each of these factors is measured against a national database so we can compare the City's factors against comparable municipalities. • Project Plan Status: We ensure that Service Plan key initiatives are monitored and remain on track to planned deliverables. • Plan Member Support/BenefitsVlP: We provide relevant statistics of member calls to the client's dedicated BenefitsVlP team, including usage, incident prevalence and productivity savings. BenefitsVlP is a proprietary in-house employee healthcare advocacy unit. • Vendor Performance: We evaluate service level guarantees, including but not limited to claims payment turnaround, network discount guarantees, fixed -cost guarantees prescription rebate guarantees, and claims management guarantees. • Stop Loss Analysis: We ensure that your reinsurance arrangements are properly managed (appropriateness of ISL/aggregate thresholds and corridors, competitive marketing, captives). 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 112 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services • Contribution Strategies: We provide detailed contribution modeling annually as part of our planning and renewal process. Below are examples of contribution models we have implemented for clients: o Contributions as % of wages with not -to -exceed limits. o Contributions based on core/buy-up strategy. o Contribution based on salary bands for associates and executives (all with fixed dollar amount) o Spousal and/or dependent surcharges. o Contribution modeling compliant with affordability provisions of Healthcare Reform and safe harbor test modeling. o Smoker surcharge contribution scenarios. o Contribution based on percentage of total rate. o Applying percentage of fixed cost increase to employee contributions. o Lowering costs on EPO/HMO plan, smaller increases to lower salary tier (a strategy to encourage higher enrollment, migration.) h) Provide other related consulting services, as identified by the City. We affirm we will support the City as needed as a strategic partner based on current and future needs. We understand that each of our clients, along with an ever -evolving benefits landscape, require us to be a nimble and adaptable partner with each client we serve. We take pride in being a well -capitalized national brokerage with robust capability, without losing site of our most important attribute, people that take care of people. FRP is pushing the boundaries of insurance excellence. We utilize our office locations to provide local services and our firms national presence for resources to our public entity clients. We are comprised of industry leaders who redefine what clients should expect from their insurance consultants. We've identified leading platforms and services within the Employee Benefits, Commercial, Personal, and Risk Management space. Our strength is rooted in the expertise of our selected partners, their innovative approach, and the ability to serve our clients with these pooled resources. Our centralized agency management system, and ability to perform our services 100% remotely prove our ability to create redundancy within our team and to have the resources to take care of our clients. We will continue to add services and additional capabilities to drive value and results for our clients. Our national resources allow us to bring whatever necessary to service the City. FRP offers increasing levels of communications support services. These levels include both standard and optional services to help design the appropriate plan for your organization. Our firm offers the highest level of choice and flexibility through tailored education and enrollment materials that leverage company -specific brand standards. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 113 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Benefit Education and Benefit/Wellness Campaigns: • Includes up to 120 hours of design time to create a suite of tailored employee benefits communications. • One-on-one consultation with our Director of Employee Education & Communication. • Create a unique brand for client's employee benefit communications utilizing branding requirements (color, fonts, photography, paper stock, writing style). • Create a 12-month campaign strategy that targets the specific needs and goals of the City. Benefits Administration Outsourcing: We can assume responsibility for benefits administration activities on your behalf to help drive efficiencies. This level includes management of your benefits administration technology, and/or management of best -of -breed marketplace options that meet your organization's needs. Our internal experts deliver day-to-day and annual benefits administration tactical support. Compliance risk mitigation and personal employee advocacy include standard and optional services by our firm. We consult on and provide direct support for: • Enrollment and eligibility maintenance • Data connectivity • Reporting and data analysis • Premium support services • Management of system site content • New hire, life event and dependent verification communications & processing. • Employee password resets • Employee enrollment processing BenefitsVlP Mobile App: Our optional BenefitsVlP mobile app gives plan participants immediate and direct access to their dedicated BenefitsVlP advocacy team as well as tools and resources to help them better utilize their benefits program. The app's features include: • Call BenefitsVlP: One click to call their dedicated BenefitsVlP team. • Your Benefits: Copay, deductibles, coinsurance, and additional plan information. • Company Plans: List of all carriers and vendors with group numbers and websites. • Employee Benefits Guide: Seamless year-round access to employee benefits guide. • Your ID Card: Take a photo of insurance ID cards and send them to a doctor. • Rx Pricing: Search locally for best prescription prices through GoodRx. • Find a Doctor/Dentist/Optician: Link to provider searches. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 114 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services • Geofencing: Instant alerts to use telemedicine, if applicable, when an ER or Urgent Care is visited. • Emergency Services: Store emergency contact information and medical history in one place. • Find Price: Find out the average cost of various medical procedures. • Healthcare 101: Definitions of commonly used medical and insurance terms. • Medical Research: A symptom checker from the world-renowned Mayo Clinic. BenefitsVlR Mobile Powered by Rightway ■ Access your ID Card & Benefits Guide ■ Call a Concierge ■ Telemedicine Alerts ■ Call your Carriers ■ Talk to a Doctor ■ Prescription Discounts ■ Find a Provider ■ Emergency Contacts • Visit Costs • Symptom Checker ■ Answers to Common Benefit Questions Optimizing HR & Member Experience Current Member Experience Phone Website Aetna. Resources 800 272 7252 reso rmeaforlmnp.cnm for Living Login. PCS Password' PC5 Amin Thin Benefitplace Blue Cross Blue Shield Delta Dental Florida Retirement System (FRS) Health & Wellness Center Health & Wellness Center -Wellness Staff 800.828.9341 877-336-8082 [akin ruepm.anfyl p Bess Corn aPrnmi-1.nr1114,mfgof 855-630-6824 FLBrcnloreMelan.con, 800.521.2651 deltadentalins cops 866-446-9377 my FRS. corn TASC-F5A& COBRA 800-422-4661 The Standard Life Insurance 5 hort-Term Dim b'i lity Long -Term Disability Risk Management & Benefits Department 800.628.8600 800-368.2859 800-368-1135 maw -land corn Acentria's Member Experience 866.123.4567 Monday- Friday 1S:30a m - 8 00pm EST Email: benefits@tenearseip<nm ne A.naraemnne trseemes 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 115 ##POUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services NurseVI P Clinical Support Services *Additional fee applies for our NurseVlP service. We provide concierge -level clinical advocacy services for employees and their dependents. Patients who face the emotional and financial impact of an unplanned surgery or unexpected diagnosis may not know they have care options or may hesitate to question the provider's opinion. To answer this need, Corporate Synergies has integrated an optional registered nurse advocacy within our internal BenefitsVlP service and support center. NurseVlP advocates provide compassionate support and guide participants to understand their options when facing an unplanned surgery, unexpected diagnosis or decisions regarding rehabilitation or long-term care. Our NurseVlP advocates interact with doctors, hospitals, insurance companies, nursing homes, equipment suppliers, community services —anyone and everyone involved in care for an illness or injury. They answer questions and provide the personal support participants need to receive optimal care and derive the best possible value from your employee benefits plan. NurseVlP is comprised of registered nurses who help sick or injured employees navigate the confusing maze of tests, medical opinions, unfamiliar terms, treatment options and other healthcare concerns. Handle medical appeals • Review recommended procedures • Assist in scheduling appointments • Coordinate 2nd or 3rd opinions • Ensure medical information is sent prior to an appointment • Find the lowest cost for prescriptions/ devices not covered under benefits • Negotiate out-of-pocket costs with providers • Help promote company well-being programs BenefYIR H.Y.ah WR. 866.286.535 J nag NurseVlP 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 116 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services B. Meetings: Successful Proposer shall be available for periodic meetings where deliverables are discussed. We affirm that we will meet this requirement. Our public entity team members are available to attend meetings with the City as needed. End of Scope of Services 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 117 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services c) Describe in detail the manner in which Proposer will monitor the performance of the City's self - funded medical plan. Please see pages 70 — 74 for additional information on how we will meet this requirement. d) Provide the recent, current, and projected workload of the Proposer, and the general workload of those key employees to be assigned to this engagement. Discuss in general the anticipated percentage of time to be dedicated to this engagement by each assigned staff member. Our account management teams have a manageable workload to provide premium service to our entire client base. Our teams are not required to service a certain minimum number of clients. Clients are assigned to teams based on employee population size and program complexity. Additionally, we segment our teams by client size due to variations in state and federal mandates. This strategy allows us to devote resources where they are needed the most. Five to eight associates work on each account in some capacity at the same time. Please see page 56 for an exhibit detailing the team structure and anticipated percentage of time each associate will devote to this engagement. e) Describe the methodology that will be used in order to audit the plan's compliance with all contractual/regulatory requirements. Please see page 95 for additional information on how we will meet this requirement. f) Describe how Proposer has applied the proposed project approach in comparable contracts to make recommendations to improve programs and describe the net effects of those recommendations. Our comparable contracts (pages 27-31) and case studies (pages 39-41) outline the results we've achieved on behalf of our clients. We've included case studies that highlight our results in supporting complex claims issues, wellness programs and other solutions to help our clients use innovation and creativity in their benefits programs. g) Provide a list of any additional services, not included in this Solicitation, that the Proposer can offer to the City. If Proposer is offering any additional, describe the services in detail. Note that services will be paid at the hourly rates provided on Form A, Price Proposal Schedule. The City has a right to negotiate said price. The below optional services are billed on a per -employee -per -month (PEPM) basis, not on an hourly basis as provided on Form A. Because of that, pricing will be established if the services described below are applicable. BenefitsVlP Mobile App: Our optional BenefitsVlP mobile app gives plan participants immediate and direct access to their dedicated BenefitsVlP advocacy team as well as tools and resources to help them better utilize their benefits program. The app's features include: • Call BenefitsVlP: One click to call their dedicated BenefitsVlP team. • Your Benefits: Copay, deductibles, coinsurance, and additional plan information. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 118 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services • Company Plans: List of all carriers and vendors with group numbers and websites. • Employee Benefits Guide: Seamless year-round access to employee benefits guide. • Your ID Card: Take a photo of insurance ID cards and send them to a doctor. • Rx Pricing: Search locally for best prescription prices through GoodRx. • Find a Doctor/Dentist/Optician: Link to provider searches. • Geofencing: Instant alerts to use telemedicine, if applicable, when an ER or Urgent Care is visited. • Emergency Services: Store emergency contact information and medical history in one place. • Find Price: Find out the average cost of various medical procedures. • Healthcare 101: Definitions of commonly used medical and insurance terms. • Medical Research: A symptom checker from the world-renowned Mayo Clinic. BenefitsVlP Mobile Powered by Rihtwav Access your ID Card & Benefits Guide Call a Concierge Telemedicine Alerts Call your Carriers Talk to a Doctor Prescription Discounts Find a Provider Emergency Contacts Visit Costs Symptom Checker Answers to Common Benefit Questions 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 119 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services EPIC Lifestyles Solutions Technology Platform: We can provide employee wellness -related communications through our optional EPIC Lifestyles Solutions wellness and disease management portal. This award -winning wellness portal (Corporate Vision Magazine, Business Worldwide Magazine, and EmTech Excellence Awards) provides an enhanced interactive experience for plan participants. EPIC Lifestyles Solutions wellness and disease management portal supports: • Immediate and Long-term Strategy: Plan, implement and integrate EPIC into an annual and long-term wellness program. • Scalability: Sized to meet needs regardless of the employer's current stage in wellness. • Open Access: Enrolled employees/spouse and anyone not enrolled in the medical plan can participate. • Cost -Effectiveness: Only pay for participants registered on the EPIC portal. • Reporting: Aggregate on -demand employer reporting. • Unlimited Challenges: Provided via FRP's library of 40+ challenges. • Communications: Not a DIY solution, but a defined suite of communications. 100% MOBILE: WE'VE GOT AN APP FOR THAT vr, 1000. App Store • Diversity: Multiple languages supported. EPIC provides three separate tools: The Bridge, The Challenge and The Portal, that can be mixed and matched depending on a client's needs. CORPORATE SYNERGIES' ACTIVY ACTM11 :In AMITY ACTMtt challenge catalog 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 120 • FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services NurseVIP Clinical Support Services: *Additional fee applies for our NurseVlP service. We provide concierge -level clinical advocacy services for employees and their dependents. Patients who face the emotional and financial impact of an unplanned surgery or unexpected diagnosis may not know they have care options or may hesitate to question the provider's opinion. To answer this need, Corporate Synergies has integrated an optional registered nurse advocacy within our internal BenefitsVlP service and support center. NurseVlP advocates provide compassionate support and guide participants to understand their options when facing an unplanned surgery, unexpected diagnosis or decisions regarding rehabilitation or long-term care. Our NurseVlP advocates interact with doctors, hospitals, insurance companies, nursing homes, equipment suppliers, community services —anyone and everyone involved in care for an illness or injury. They answer questions and provide the personal support participants need to receive optimal care and derive the best possible value from your employee benefits plan. NurseVlP is comprised of registered nurses who help sick or injured employees navigate the confusing maze of tests, medical opinions, unfamiliar terms, treatment options and other healthcare concerns. • Handle medical appeals ■ Review recommended procedures ■ Assist in scheduling appointments ■ Coordinate 2nd or 3rd opinions ■ Ensure medical information is sent prior to an appointment ■ Find the lowest cost for prescriptions/ devices not covered under benefits ■ Negotiate out-of-pocket costs with providers ■ Help promote company well-being programs 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 121 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Client Solutions: As employee benefits become more complex, it's all the more important for client partners to provide more functionality and services in one platform. Our enrollment options are integrated into our benefits administration outsourcing option. Upon vetting and selecting a partner, our in-house Client Solutions project managers, technicians and administrative support personnel assume responsibility for the successful implementation, maintenance, and ongoing support of the solutions. Supporting our benefits administration clients is a team of dedicated experts housed in our Client Solutions department. The 14-member department averages more than 18 years of experience with benefits administration technology and processes. Our Client Solutions Managers have previously held multiple positions within the benefits administration community (i.e., data analyst, project manager, configuration specialist). This ensures they have a full understanding of implementation and ongoing processes. Client Solutions Managers have experience with numerous different benefit technology platforms. Our Client Solutions Department has the required technical expertise to implement the solution and deliver a unique benefits experience to employees by administratively supporting the various benefit -related transactions (including outsourcing services). They consult on and provide the appropriate tools/services necessary to effectively manage the benefits program. They gather requirements, research solutions, and recommend best practices to help your staff effectively manage your benefits program. Custom Communications: Employee Communications is one of our core competencies. We do this with our internally generated APEX and iComm award -winning communication programs that make complicated benefits concepts easy to understand and align with your overall business and plan objectives. We deliver award -winning solutions because of our commitment to a best -in -class employee education and communications process. Our first step is to understand the client's history, culture, demographics, and geographic makeup. We also discuss past successes and challenges when communicating with participants. Corporate Synergies offers increasing levels of communications support services to our clients. These levels include both standard and optional services to help design the appropriate plan for your organization. Our firm offers the highest level of choice and flexibility through tailored education and enrollment materials that leverage company -specific brand standards. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 122 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY WHO IS ELIGIBLE? INCOME PROTECTION ELIGIBILITY RETIREMENT FULL-TIME EXEMPT EMPLOYEES (40 HOURS PER WEEK( Medical / Vision Medical Opt Out Vision for Medical Opt Out Dental Flexible Spending Accounts Employee Assistance Program Commuter Benefit Plans Basic Life / AD&D (2 x salary) Optional and Dependent Life Long Term Disability 1" of the month following date of hire 1" of the month following 60 days of employment FULL-TIME NON-EXEMPT EMPLOYEES & COMMISSIONED LOAN OFFICERS (40 HOURS PER WEEK} Flexible Spending Accounts Employee Assistance Program Commuter Benefit Plans Medical / Vision Medical Opt Out Vision for Medical Opt Out Dental Basic Life / AD&D (2 x salary) Optional and Dependent Life Long Term Disability 1" of the month following date of hire 1" of the month following 60 days of employment PART-TIME EMPLOYEES (20 BUT LESS THAN 40 HOURS PER WEEK) Employee Assistance Program Medical / Vision for FT ACA" HealthSherpa 1.of the month following date of hire 1' of the month following 80 days of employment Part-time, Medicare eligible, or employees losing coverage may enroll throughout the year ADDITIONAL BENEFITS ELIGIBLE DEPENDENTS • Spouses/Civil Union Partners • Children/Step-children to age 26 (regardless of marital or full-time student status) LIFE EVENT CHANGES If you experience a qualifying life event during the plan year, you have 30 days to make a change to your current benefit elections. Examples include: • Marriage • Divorce • Birth/adoption of a child • Spouse or dependent child gains or loses alternate coverage or dependent status • Death of a dependent 'Part-dme employees hired at 304 hourshveek are classrfredas full -tine ACA and are eligible for MedrealNtsta at full-dme rates Viewing the applicable wailing period flours for part -fine employees wiN be tracked for a t2-mandi measurement period per Affordable Care Act (ACA) guidelines Part -fine employees aweragirg 3L4 fioursAveek during the measurement period will be eligible air AMed'caWfsion at full-time rates on the 1st of the month A elrgtheapplicableardministratleperiod. BENEFITSVIP' 866288.5354 3 I NEW JERSEY 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 123 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Innovu: The explosion of technology -based solutions has become a game changer for the healthcare marketplace. However, this change has also increased an organization's risk to spend money on solutions that seem "glitzy" but do not provide value to the business or savings to the healthcare plan. Therefore, understanding plan drivers and "root causes" is important. For self -funded clients, our approach, through the use of Innovu, allows us to utilize a powerful business intelligence platform to identify the root cause of plan costs, qualify the opportunity, and provide a business case for ALL solutions. Through Innovu, we measure the impact of all solutions to ensure they are delivering the expected outcome. This approach has proven to deliver quantifiable results while taking a prudent approach to use of corporate dollars. Innovu allows for the integration of data across multiple streams that include medical/Rx, wellness, biometrics, eligibility, HRIS/enrollment, workers' compensation, disability, etc. For the first time, you can see how ALL costs correlate with each other. Demo Medical Overview Cost Share Employee-\ 14% � A+396 Allowed $2.9M Employer 86% Medical Paid Paid $2.5M • -26' Claimants Claims 538 5,997 Claim Type Category Visits per 1,000 Outpatient Inpatient Emergency Inpatient 42% 35% Other 0% Professional 23% 235 57 • +20 .. Outpatient 1,129 • -p7,, Current Period: Jan 20 - Dec 20 Previous Period: Jan 19 - Dec 19 (Paid) ER Utilization Visits Paid 141 $385K Network Status In -Network 100% Y+6% Out -of - Network 0% Top Places of Service by Pald Amount Mace of Service Inpatient Hospital On Campus - Outpatient Hospital Emergency Room - Hospital Office Ambulatory Surgical Center Telehealth Independent Laboratory Urgent Care Facklity Home Claimants Total Paid Total % 35 $983K 39% 244 $813.6K 32% 113 3324.9K 13% 464 $276.2K 11% 17 $49.4K 2% 111 $27.8K 1% 229 $24K 1% 71 $11.3K s1% 39 $9.723 s 1% This report and its contents are the confidential and proprietary information of Innovu, LLC. Ne disclosure or use of these materials may be made without the express written consent of Innovu, LLC. innovu. 7 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 124 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services NurseVlP Clinical Support Services: As an option, we provide concierge -level clinical advocacy services for employees and their dependents. Patients who face the emotional and financial impact of an unplanned surgery or unexpected diagnosis may not know they have care options or may hesitate to question the provider's opinion. To answer this need, Corporate Synergies has integrated an optional registered nurse advocacy within our internal BenefitsVlP service and support center. NurseVlP advocates provide compassionate support and guide participants to understand their options when facing an unplanned surgery, unexpected diagnosis or decisions regarding rehabilitation or long-term care. Our NurseVlP advocates interact with doctors, hospitals, insurance companies, nursing homes, equipment suppliers, community services —anyone and everyone involved in care for an illness or injury. They answer questions and provide the personal support participants need to receive optimal care and derive the best possible value from your employee benefits. Total Compensation Statements: Corporate Synergy's Total Compensation Statement describes, in clear language, the value of your employees' compensation and benefits package. The statement includes your contributions to their health insurance, retirement, disability, life insurance, Social Security, and government -required benefits, such as Workers' Compensation. ACA Information Reporting: We work with preferred ACA reporting vendors to help our clients satisfy the annual 1095-C and 1094-C requirements for our clients. We will identify your unique needs associated with information reporting and variable hour tracking to determine the appropriate vendor required to meet each of these requirements. The typical scope of services associated with this includes: • 1095-C distribution to employees • 1094-C and 1095-C filing with the IRS • Variable Hour tracking required for benefits eligibility determination. • Data normalization • Compliance support associated with ACA Reporting requirements. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 125 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Tab 7 Proposed Price 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 126 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Proposer shall state its price for providing all services as stated within this Solicitation. Proposer shall submit pricing stated as a flat, fixed fee per year, which shall include all expenses necessary for the requested services. Proposer must use Attachment E - Price Proposal Form. Employee Benefit Consulting Services EXHIBIT E PRICE PROPOSAL RFP 1896386 A. Employee Benefit Consulting Services The not -to -exceed price and estimated hours for providing all employee benefit consulting services as stated in the Scope of Services. The price includes all costs associated to provide these services. Term Estimated Hours Not -To -Exceed Price 1 Initial Term (Years 1-3) 3,300 $501,000 2 First 1-year OTR Period 1,100 $167,000 3 Second 1-year OTR Period 1,100 $167,000 Note: The City will pay the Consultant at the hourly rate indicated below for any work involved to complete the City's request if the work significantly exceeds the hours stated. Similarly, the fee shall be reduced if there is significantly less work than anticipated. B. Not -to -Exceed Hourly Rate for Additional Work Below is the not -to -exceed hourly rate for additional work not included within the Scope of Services. Breakdown of Not to Exceed Price Staff Position/ Classification Proposed Maximum Hourly Rates Initial Term Years 1 -3 OTR 1 Year 4 OTR 1 Year 5 Lead Consultant $ 250 $ 250 $ 250 $ $ $ $ $ $ Notes: 1) The not -to exceed price in Section A, and the hourly rates in Section B, shall remain firm and fixed for the term of the Contract, including any renewals or extensions thereof. 2) The hourly rates above include all costs to include normal administrative fees, such as telephone, mailing, faxes, duplication charges, overnight mail, and including all out of pocket expenses, such as travel incurred in connection with the services (refer to CH.112.061 of the Florida Statutes regarding travel expenses), per diem, and miscellaneous costs and fees, and is incorporated in this price schedule, as they will not be reimbursed separately by the City. 3) The City will pay the Consultant at the hourly rate indicated within Section B, for any work involved to complete the City's request for work that is not included within the Scope of Services. The City reserves the right to negotiate the final pricing for this work on a project by project basis, at the City's sole discretion. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 127 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Tab 8 Appendix 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 128 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services TAB 8 - TABLE OF CONTENTS Appendix Sample Compliance eAlert Samples Compliance Checklist Compliance Calendar Sample Communication Campaigns Sample Renewal Timeline Implementation and Service Timeline Samples Sample Self -Funded Monthly Dashboards BenefitsVlP Flyer Sample BenefitsVlP Report Sample Strategic Roadmap Innovu Sample Analytic Dashboard Sample Benefit Guide TAB 8 Page 130 133 136 147 149 150 152 160 162 175 183 193 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 129 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services COMPLIANCE ALERT CORPORATE SYNERGIES CIV� la,a,uvo Iravvi�cu 1 AL)C lAdpol umg Instructions for Reporting Due June 1 Action Required: • Employers and plan sponsors should make sure that their plan service providers are using the revised RxDC Instructions when completing their 2023 RxDC reporting requirements. CORPORATE SYNERGIES' February 23, 2024 The Centers for Medicare & Medicaid Services (CMS) has issued revised reporting instructions ("Instructions") for prescription drug data collection ("RxDC") reporting required under the Consolidated Appropriations Act, 2021 (CAA). The RxDC reporting deadline for the 2023 reference year is just around the corner —June 1, 2024. CMS has also published updated templates and guidance materials on its RxDC Resource Page. As background, and as explained in prior E-Alerts (here here and here), the CM requires that group health plans and health insurance issuers (called "reporting entities") report, on an annual basis, certain prescription drug and healthcare spending information from the prior year (called the "reference year") in a series of data file reports (labeled from Di to D8) to the Departments of Labor, Health and Human Services, CMS and Treasury (the "Agencies"). The RxDC reporting is completed in coordination with the plan's insurers, third party administrators (TPAs), pharmacy benefit managers (PBMs) and other service providers and is uploaded to a dedicated CMS website called the Enterprise Portal in the CMS Health Insurance Oversight System ("HIOS"). For most employers and plan sponsors, the plans' insurers and service providers will completely handle all of the required RxDC reporting on the plan sponsor's behalf. What Should Employers and Plan Sponsors Do Next? Employers and plan sponsors should make sure that they and their plans° service providers are using the revised RxDC Instructions when completing their RxDC reporting for the 2023 reference year. Additionally, its important to remember that, like last year, there is no good faith relief for this year's filing (for the 2023 reference year). It's also important to remember that insurance carriers, TPAs, PBMs and other plan service providers have varying rules and requirements, including different deadlines for when information must be provided to them from the plan sponsor, and so, in light of that, its important to communicate with your plans' different service providers well in advance of the June 1, 2024 deadline. and to speak with your plans' trusted advisors about this year's reporting. ■ Full Explanation Follows This communication is in no way intended to substitute for legal advice. Please contactyour attorney for advice about any legal issues. O 2024 Corporate Syner6es Group, LLC. All rights reserved. Page 1 of 3 780 W. Granada Blvd. FOUNDATION Ormond Beach, FL 32174 PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services CMS Issues Revised RxDC Reporting Instructions for Reporting.. June 1 The Centers for Medicare & Medicaid Services (CMS) has issued revised reporting instructions ("Instructions") for prescription drug data collection ("RxDC") reporting required under the Consolidated Appropriations Act, 2021 (CAA). The RxDC reporting deadline for the 2023 reference year is just around the corner —June 1, 2024. CMS has also published updated templates and guidance materials on its RxDC Resource Page. As background, and as explained in prior E-Alerts (here here and here) the CAA requires that group health plans and health insurance issuers (called "reporting entities") report, on an annual basis. certain prescription drug and healthcare spending information from the prior year (called the `reference year") in a series of data file reports (labeled from D1 to D8) to the Departments of Labor, Health and Human Services, CMS and Treasury (the "Agencies"). The RxDC reporting is completed in coordination with the plan's insurers, third party administrators (TPAs). pharmacy benefit managers (PBMs) and other service providers and is uploaded to a dedicated CMS website called the Enterprise Portal in the CMS Health Insurance Oversight System ("HIOS"). For most employers and plan sponsors, the plans' insurers and service providers will completely handle all of the required RxDC reporting on the plan sponsor's behalf. How do the Revised Reporting Instructions Change the Requirements for RxDC Reporting? What follows is a summary of some of the key revisions to the Instructions that employers and plan sponsors should be aware of: • Sections 5.6 and 5.7: Most notably, this Section of the Instructions provides that, starting with this year's upcoming reporting, the "aggregation restriction" will be enforced. The "aggregation restriction" rule requires that data submitted in the data files D1 and 03 through D8 must riot be aggregated at a "less granular level" than the aggregation level used by the reporting entity that submitted the data in the D2 data file. This change was designed to help the Agencies to better facilitate data analysis for purposes of publishing their biannual public report required under the CAA. Section 5.7 provides helpful examples of how to complete the reporting in compliance with the aggregation restriction rule. ■ Section 8.1: This Section clarifies that medical devices, nutritional supplements and aver -the -counter drugs are excluded from prescription drug lists (that is, excluded from data files D3 through D8) unless the National Drug Code for the product is on the CMS Drug and Therapeutic Class Crosswalk (the Crosswalk spreadsheet is available on the CMS RxDC Resource Page here in the 3rd bullet down under "Primary Filing Resources"). • Section 6.1: • Simplifies the calculation of "average monthly premium" so that it is no longer calculated on a per -member basis, as previously required. Starting with the upcoming reporting, plan sponsors should divide the annual premium amounts by 12 instead of dividing by member months when calculating the average monthly premium, • Simplifies the calculation of "premium equivalents" by (i) clarifying that premium equivalents may be reported on a cash basis or on a retrospective basis, and (ii) providing additional details on amounts that should be included or excluded from premium equivalents. • Section 4.2: This Section was revised to clarify how to populate the benefit carve -outfield in the P2 plan list file. ■ Section 3.6: This Section provides instructions on how to submit data when the plan list or data files exceed the maximum allowable size limit in HIOS. • Section 8.3: This Section adds a column to the D6 data file to collect prescription drug enrollment information, which will report the total number of member months covered during the reference year under the pharmacy benefit for which pharmacy spending is reported. • Section 9.1: This Section provides instructions to reporting entities on how to report information on retained rebates when exact amounts are unknown. CORPORATE SYNERGIES 780 W. Granada Blvd. Ormond Beach, FL 32174 This communication is in no way intended to substitute for legal advice. Please contact your attorney for advice Page 2 of 3 about any legal issues. O 2024 Corporate synergies Group. LLC. All rights reserved. City of Miami RFP #1896386 — Employee Benefit Consulting Services In addition to the above, below are helpful reminders from prior rule clarifications made by the Agencies: • Reminder (Section 3.3): Multiple Vendors Can Submit Same Data File Type for the Same Plan: Beginning with last year's RxDC reporting, the Agencies confirmed that while plans are "encouraged" to submit only one data file of each data file type for the same plan, if plan service providers are unable to work together to complete a single data file for a plan, it will be permissible for more than one reporting entity to submit the same data file type on behalf of the same plan. For example, where a plan has separate insurance carriers —one for mental health benefits and one for medical benefits —both insurers can submit a D2 file ("Spending by Category") on behalf of the same plan (the first insurer would report the plan's data relating to mental health benefits and the second would report the plan's data relating to medical benefits). However, it should be noted that multiple reporting entities cannot upload files into the same HIOS submission. Each reporting entity must create its own submission in HIOS. • Reminder: No More Good Faith Efforts Relief: For the 2020 and 2021 reference year's reporting, the Agencies issued guidance indicating that they would not take enforcement action against health plans or issuers that utilized good faith efforts and a reasonable interpretation of the regulations to complete their requi red reporting. To date, the Agencies have not announced any similar "good faith" relief for reporting for either the 2022 or 2023 reference years. What Should Employers and Plan Sponsors Do Next? Employers and plan sponsors should make sure that they and their plans' service providers are using the revised RxDC Instructions when completing their RxDC reporting for the 2023 reference year. Additionally, it's important to remember that, like last year, there is no good faith relief for this year's filing (for the 2023 reference year). Finally, its also important to remember that insurance carriers, TPAs, PBMs and other plan service providers have varying rules and requirements, including different deadlines for when information must be provided to them from the plan sponsor, and so, in light of that, it's important to communicate with your plans' different service providers well in advance of the June 1, 2024 deadline, and to speak with your plans' trusted advisors about this year's reporting. ■ CORPORATE SYNERGIES' 780 W. Granada Blvd. Ormond Beach, FL 32174 If you have any additional questions, please call your Corporate Synergies Account Manager or 866.CSG.1719. This communication is in no way intended to substitute for legal advice. Please contact your attorney for advice Page 3 of 3 about any legal issues. O 2024 Corporate Synergjes Group, LLC. All rights reserved. City of Miami RFP #1896386 — Employee Benefit Consulting Services 2021 COMPLIANCE CHECKLIST To prepare for new health and welfare plan mandates under recently enacted COVID-19 relief laws, including the Coronavirus Aid, Relief, and Economic Security (CARES) Act, and the Consolidated Appropriations Act, 2021 (CAA), as well as the next phase of the Affordable Care Act's (ACA) mandates and other ongoing requirements, make sure you have a compliance strategy in place. This checklist is designed to assist you with compliance planning in 2021. COV1D-19 Relief Laws, including the CARES Act and the CAA: Confirm your group health insurance plans are in compliance with the following: ❑ Cover COVID-19 Testing without C. RES Act) Confirm that all group health plans offer COVID-19 diagnostic testing without cost -sharing, preauthorization or other medical management requirements. This coverage must include related services furnished during urgent care, emergency room, or in -person or telehealth provider visits that result in an order for, or administration of, a covered diagnostic COVID-19 test. This requirement will remain in effect through the duration of the HHS-declared public health emergency, which commenced on January 27, 2020, and is still in effect. D Temporary Safe Harbor for Telehealth and Remote Care Services for High Deductible Health Plans (CARES Act) If your plan includes a high deductible health plan (HDHP) option (so that participants may be eligible to contribute to an HSA), it may (without losing HDHP status) cover telehealth and other remote care services without a deductible for plan years beginning on or before December 31, 2021. This temporary safe harbor applies broadly —it is not limited to coverage for COVID-19-related services. DOS Ensure that your plan is continuing to comply with the temporary COVID-19 relief rules (generally referred to as the "Outbreak Period Rules") issued by the DOL and IRS in 2020 that apply during the presidentially -declared National Emergency Period, which commenced on March 1, 2020, and is still in effect. To comply, ensure that your plan is permitting extended deadlines for applicable COBRA elections, HIPAA special enrollment period elections and claims appeals, as more fully explained in our eAlert. ❑ Plans to ". '1A) The CAA provides five new temporary rules that give sponsors of Health and Dependent Care FSAs (HCFSA and DCFSA, respectively) the option to be more flexible when dealing with their participants' unused funds in these account -based plans. These FSA relief measures are optional for employers, and if adopted, the CM allows an amendment to be made by the last day of the first calendar year beginning after the end of the plan year in which the amendment is effective. For example, for an amendment applicable to a 2020 calendar -year plan, plan sponsors will have until December 31, 2021 to make the amendment. For additional information and examples showing how these temporary rules work, see our Guide to the 2021 FSA Relief Chart, ❑ Ensure Compliance with New Mental Health Parity Rules Applicable to Self -insured Plans (CAA) If your medical plan is self -insured, ensure that your third party administrator (TPA) or applicable insurance carrier has completed the required comparative analysis of your plan's non -qualitative treatment limitations (NQTL) showing compliance with the current mental health parity requirements of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). While some states already require insurers to disclose these analyses, the CAA amended the MHPAEA to require that all group health plans and insurers be prepared to disclose these comparative analyses to the DOL upon request as early es February 10, 2021. Ensure that your plan is complying with the CAA's new "surprise billing" rules prior to the beginning of the 2022 plan year. Under these new ruses, for plan years beginning on or after January 1, 2022, group health plans must Implement procedures to prevent surprise medical bills (i.e., bills from an out -of -network medical provider that are typically received when a patient is forced to use that provider during an emergency). Additional information about how these rules will work can be found in our eAlert on the CAA. #FOUNDATION RISK NERS PUBLIC ENTITY SERVICES 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 133 #,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Affordable Care Act: Confirm your group health insurance plans are in compliance with the following: D ACA Employer Shared Responsibility Provisions ("Employer Mandate" or -Pay or Play") First, count the number of employees your organization employed last year to determine if your organization is an applicable large employer (ALE) this year. If your organization employed 50 or more full-time employees, including full-time equivalent workers, in 2020 it would be subject to Pay or Play in 2021. Then take the following steps: • Determine whether health Insurance coverage is offered to at least 95% of your full-time employees (working, on average, at least 30 or more hours per week) and their dependent children. • Review whether the plan provides minimum value by using one of the three available methods —minimum value calculator; safe harbor checklists; or actuarial certification— and/or confirm the information provided from the fully insured carrier on the Summary of Benefits and Coverage. • If your organization's MV Plan or MVP Arrangement does not provide coverage for in -patient hospitalization services and physician services, it will not meetthe ACA's minimum value requirement, even if it satisfied the minimum value calculator's requirements. •Assess the affordability of your lowest -cost single tier health coverage under one of the IRS's affordability safe harbors (form W-2, rate of pay, or federal poverty line) to ensure that the cost of such coverage does not exceed the applicable percentage of your employees' income. In 2021, the affordability threshold is 9.83% of income. • If your organization is offering an ICHRA in 2021, the amount you contribute to each ICHRA (when compared to the cost of the monthly premium for the self -only tier of the lowest -cost silver plan on the applicable Exchange), makes the ICHRA affordable to the employee under these same affordability rules. See our eAlerts on the ICHRAS HERE and HERE. Other ACA Compliance Requirements: ❑ Out -of -Pocket Maximums Make sure the plan's out-of-pocket maximums are limited to $8,550 for single coverage and $17,100 for other than self -only coverage, and that accumulators under separate benefit plans (such as medical and prescription drug plans) are combined toward these maximums. ❑ Waiting periods Ensure waiting periods for coverage have been reduced to 90 days or less, unless an exception applies. Continue to report the aggregate cost of coverage on employees' Form W-2 (employers that file 250 or more W-2s). Q Summary of Benefits and Coverage (SBC) Continue to provide plan participants with an SBC during open enrollment and to new hires thereafter. For plan years beginning in 2021, the SBC must be provided in the new, updated format, available on the U S Department of Labor's webslte. ❑ Hhange Notice Ensure that the Exchange Notice continues to be provided to all new hires regardless of eligibility for the medical plan within 14 days of the date of hire. This notice explains the conditions for which an employee is eligible for a subsidy under the Exchanges. ❑ dical Loss Ratio Rebates Distribute within 90 days of receipt of any medical loss ratio rebates from the insurance carriers (applies only to fully insured plans). Confirm that your wellness programs with medical examinations or disability -related inquiries comply with final regulations issued under the ADA and GINA in 2016 and that health -contingent wellness programs comply under HIPAA, as amended by the ACA. Note that a special privacy notice is required under the final ADA regulations for plan years beginning on or after January 1, 2017 (see our eAlert on the privacy notice). While the "incentive" -related provisions of the ADA and GINA regulations were invalidated, the remaining rules in those regulations that are not related to incentives remain in effect. (Note that the EEOC issued proposed incentive -related wellness rules under the ADA and GINA in January, 2021, but pursuant to a White House memorandum the Biden administration has instructed the EEOC to withdraw these regulations to allow for review and approval by the current administration.). Q Patient Centered Outcomes Research Fee (PCOR) Review health coverage provided to determine if it is subject to PCOR; payment is due July 31, 2021. Note that a Budget law signed in December 2019 extends the PCOR fee through 2029. See our eAlert on this development. $$FOUNDATIQN RISK PARTNERS PUBLIC ENTITY SERVICES 780 W. Granada Blvd. FOUNDATION Ormond Beach, FL 32174 PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ❑ Information Reporting First, count the number of employees your organization employed last year to determine if it is an ALE. If it employed 50 or more full-time employees, including full-time equivalent workers last year, then it is an ALE and must take the following steps: • Determine which IRS information reporting requirements apply to your health plans. • Analyze the information you will need for reporting and coordinate internal and external resources to help track required data in 2021. For 2020 information reporting submitted in 2021, note that: • The deadline for furnishing the 2020 Forms 1095-C and 1095-B to employees/enrollees, was extended to March 2, 2021. • The deadline for filing the forms with the IRS is March 31, 2021 if filing electronically, and February 28, 2021 if not filing electronically. If your organization's health plans have participants residing in or working in California, Massachusetts, New Jersey, Rhode Island, Vermont or Washington D.C., then make sure that you are prepared to comply with the different state information reporting obligations in those states. See our Guide to Employer Obligations under State Individual Mandate Laws. ERISA and Ongoing Compliance Responsibilities in 2021: Ensure compliance with, and that amendments have been finalized for, the following: In late 2016, the DOL released final regulations under ERISA on disability claims procedures that are applicable to all claims for disability benefits filed on or after January 1, 2018_ In 2021, plan sponsors should continue to confirm with insurance carriers that documents and processes have been updated. Additional information can be found in our eAlert on this topic. ❑ Form 5500s Ensure that Form 5500s have been filed by the end of the 7th month following the end of the plan year, and that the Summary Annual Report is provided to participants within 2 months after the Form 5500 filing. Also, ensure that all other reporting and disclosure requirements have been complied with, includingthe time limits for disclosure of SPDs and SMMs. ❑ ' Ensure that all required annual notices have been provided to participants including the Children's Health Insurance Program Notice, Women's Health and Cancer Rights Act Notice, HIPAA Special Enrollment, Newborn's & Mother's Health Protection Act, Women's Health and Cancer Rights Act, USSERA, QMCSO, Mental Health Parity, and Medicare Part D. ❑ Creditable Coverage Status Report annually to the Centers for Medicare and Medicaid Services (CMS) the creditable coverage status of prescription drug plans via online form by no later than 60 days from the beginning of a plan year. NOTE: The Corporate Synergies 2021 Compliance Checklist is designed to help plan sponsors of health and welfare plans identify significant compliance requirements in 2021. It is not designed to identify all compliance obligations. Information contained in this Compliance Checklist is current as of February 5, 2021, but subject to change due to the ongoing release of additional or clarifying legislation or regulatory guidance by the U.S. Department of Labor, Internal Revenue Service, or other applicable regulatory agencies throughout the year Corporate Synergies is not a law firm, and accordingly, the contents of this Compliance Checklist do not constitute legal advice. The information provides only general guidance and not all rules and requirements are reflected. Synergies3605M Corporate Synergies takes a full view of the insurance landscape, studies it from every angle, pursues innovation where none exists, and transforms this deeper understanding into actionable strategies to protect our clients and their participants. We call our approach Synergies360. For more information visit corpsyn.com or call 877.426.7779 Corporate Synergies is a national insurance and employee benefits brokerage and consultancy that delivers strategies to control costs, relieve administrative burdens and mitigate risk. With offices in: New Jersey 1 New York 1 Pennsylvania 1 Maryland 1 Florida All nets reserved. Coyorete Synergies Group. LLC CaIforra lcense i# OET919 NOTE LIas not Intended to be tarot legal a e.Pleaseco'xsultyour tax, or legal ad Aber Carta n s. a are subject to an adational brokerage and tonsultogfee and are not evadable In auursdletlons. 780 W. Granada Blvd. Ormond Beach, FL 32174 RFP #1896386 — Employee Benefit City of Miami Consulting Services COMPLIANCE CALENDAR - 2 021 CALENDAR YEAR PLANS Significant Due Dates Deadline Item/Form Filling/Disclosure/Plan Action Requirements Plans Affected January 2021 First day of the plan year beginning on or after January 1, 2021. Health FSA Contribution The Health FSA contribution maximum remained $2.750 in 2021. This maximum onlyapplies to the employee contribution and does not applyto any employer contribution or carryover amount. The maximum carryover amount remained at $550 for 2021. Fully Insured and Self -Insured Flans. First day of the plan year beginning on or after January 1, 2021. Dependent Care FSA Contribution The Dependent Care FSA contribution maximum remained $5,000 in 2021 Fully Insured and Self -Insured Plans. January 1, 2021 through the end of 2021. Optional Amendment for Health and Dependent Care FSAs under CM Amend Health and Dependent Care FSA Plans to Take Advantage of Temporary Optional Relief Rules (CAA): The CAA provides five new temporary rules that give sponsors of Health and Dependent Care FSAs (HCFSA and DCFSA, respectively) the option to be more flexible when dealing with their participants' unused funds in these account -based plans. These FSA relief measures are optional tar employers, and if adapted. the CAA allows an amendmentte be made by the last day of the first calendar year beginning after the end of the plan year in which the amendment is effective. For example for an amendment applicable to a 2020 calendar -year plan, plan sponsors will have until December 31, 2021 to make the amendment. For additional information and examples showing how these temporary rules work, see our Guide to the Fully Insured and Self -Insured Plans. 2021 FSA Relief Chart First day of the plan year beginning on or after January 1, 2021. Updated 2021 Summary of Benefits and Coverage (SEC) Continue to provide plan participants with an SEC during open enrollmentand to new hires thereafter. For plan years beginning in 2021, the SEC must be provided in the new, updated format, available on the U.S. Department of Fully Insured and Self -Insured Plans. Labor's werslte. See additional information about SEC disclosure requirements helots under "Enrollment -related Disclosures." First day of the plan year beginning on or after January 1, 2021. ACA Out -of -Pocket Maximums The ACAs out-of-pocket maximums required for non-grandfathered plans increased to $8,550 for self -only and $17100 for other coverage. Fully Insured and Self -Insured Plans. Non-Crandfathered Plans, File 2020 Forms W-2 no later than January 31, 2021. Distribute to employees by the same date. Forms W-2—Health Plan Coverage Reporting The W2 must reportthe total value of "applicable employer sponsored coverage- provided to the employee during 2020. Sponsors of fully insured and sal&insured plans who send 250 or more Forms W-2. Januaryl, 2021 until the end of the president -declared National Emergency Period. Outbreak Period Rules Ensure that your plan is continuing to comply with the temporary COVID-19 relief rules (generally referred to as the -outbreak Period Rules') issued by the DOL and IRS in 2020that apply during the presidential -declared National Emergency Period. which commenced on March 1, 2020, and is still in effect_ To comply, ensure that your plan is permitting extended deadlines for applicable COBRA elections. HIPAAspecial enrollment period elections and claims appeals, as more fully explained ID our eAlert. Fully Insured and Self -Insured Mans. 411 780 W. Granada Blvd. Page 136 #FOUNDATION Ormond Beach, FL 32174 PUBLIC ENTITY SERVICES RFP #1896386 — Employee Benefit City of Miami Consulting Services COMPLIANCE CALENDAR - 1 n I1. CALENDAR YEAR PLANS Significant Due Dates iiiiiiiip Deadline Item/Form Filling/Disclosure/Plan Action Requirements Plans Affected end of Janthe HI-d 2021 publnnl ic the HHS-declared public health emergency CARES Ad -Temporary Group Health Plan Rules Cover COVID-19 Testing without Cost Sharing (CARES Act): Confirm that all group health plans offer COVI D-19 diagnostic testing without cost -sharing. preauthorization. or other medical management requirements This coverage must include related services furnished during urgent care, emergency room, in -person or telehea Ith provider visits that result in an order for or administration of a covered diagnostic COVID-19 test. This requirement will remain in effeotthrough the duration of the HHS-declared public health emergency, which commenced on January 27. 2020, and is still in effect. py Temporary Safe Harbor for Telehealth and Remote Care Services for High Deductible Health Plans (CARES Act): if your plan includes a high deductible health plan (HDHP) option (so that participants may be eligible to contribute to an HSA). It may (without losing HDHP status) cover telehealth and other remote care services without a deductible for plan years beginning on or before December 31. 2021. This temporary safe harbor applies broadly —it is not limited to coveragefor COVI D19-related services_ Fully Insured and Self -Insured Group Health Plans. February 2021 February 10,2021 rY MHPAEA Comparative requireysisd of under is required under the Consolidated Appropriations Act, 2021 (CAA) Ensure Compliance with New Mental Health Parity Rules Applicable to Self -Insured Plans (CAA): if your medical plan is self -insured. ensure that your third party administrator (TPA) or applicable insurance carrier has completed the required comparative analysis of your plan's non -qualitative treatment limitations(NQTL) showing compliance with the current mental health t is of the Mental Health Parity d Addiction Act of 2008 MHPAEA. While some parity ryan Equity { ) states already require insurers to disclose these analyses, the CAA amended the MHPAEAto requirethat all group health plans and insurers be prepared to disclose these comparative analyses to the DOL upon request as early as February10, 2021. Self -Insured plan sponsors, although TPAs and insurers gwi sponsors working with such have likely already completed such analyses. File Forms 1094-C and 1095-C (or 1095-B) by February 28, 2021 (if by paper). Fonts 1095-0 (or 1095-B) and Forms 1094-C Refer to the requirements below (in March) pertaining to "ACA Information Reporting Requirements for the 2020 Calendar Year' Fully Insured Plans sponsored by ALES report only on Part l and Part II of the. Form 1095-C. Self -Insured Plans sponsored by ALES report on Parts I, 11 and III of the Form 1095-C. Self -Insured Plans sponsored by employers with fewer than 50 full-time employees and full-time equivalents in the prior calendar year (non -ALES) report on the Form 1095-B. 780 W. Granada Blvd. Page 137 dvFOUNDATION Ormond Beach, FL 32174 PUBLIC ENTITY SERVICES RFP #1896386 — Employee Benefit City of Miami Consulting Services COMPLIANCE CALENDAR - 2021 CALENDAR YEAR PLANS Significant Due Dates Deadline Item/Form Filling/Disclosure/Plan Action Requirements Plans Affected March 2021 No later than 60 daysfrom the beginning of the plan year. March 1, 2021 Part D Creditable Coverage Online Form Notice to CMS Complete creditable coverage online form. Fully Insured and Self -Insured calendar year plans. Notifies CMS whether prescription drug coverage offered is creditable or not (as determined under applicable CMS guidelines). Distribute Forms 1095-C (or 1095.5) to employees by March 2, 2021 (extended for 2021 from the original January 31 deadline). Farms 1095-C (or 1095-B)and Fomis 1094-C ACA Information Reporting Requirements for the 2020 Calendar Year: ACA information reporting rules require applicable large employer (ALE) members. that is, employers with 50 or more full-time and full-time equivalent employees in the prior ca lends r year. to report on their compliance with the ACAS requirement to offer minimum essential coverage (MEC): minimum value(MV)and affordable coverage to applicable full-time employees Specifically, filing of the forms with the IRS, and furnishing them to employees. is typically done early in the year followingthe calendar year for which reporting is required. Fully Insured Plans sponsored by ALEs report only on Partl and Part II of the Form 1095-C. Self -Insured Plans sponsored by ALEs report on Parts I. II and III of the Form 1095-C. Self -Insured Plans sponsored by employers with fewer than 50 full-time employees and full-time equivalents in the prior calendar year (non -ALES) report en. the Form 1095-B. File Forms 1094-C and 1095-C (or 1095-B) by March 31, 2021 (if electronic). Forms 1095-C (or 1095-B) and Forms 1094-C Refer to the requirements in the row above pertaining to 'ACA Information Reporting Requirements for the 2020 Calendar Year ' . Fully Insured Plans sponsored hyALEs report only on Part and Part II of the Form 1095-C_ Self -Insured Plans sponsored by ALES report on Parts I, II and III of the Form 1095-C. Self -Insured Plans sponsored by employers with fewer than 50 full-time employees and full-time equivalents in the prior calendar year (non -ALES) report on the Form 1095-B. 780 W. Granada Blvd. Page 138 FOUNDATION Ormond Beach, FL 32174 PUBLIC ENTITY SERVICES RFP #1896386 — Employee Benefit City of Miami Consulting Services COMPLIANCE 2021 CALENDAR Significant CALENDAR - YEAR PLANS Due Dates iiiimink Deadline Item/Form Filling/Disclosure/Plan Action Requirements Plans Affected July 2021 Due atthe end of the 7th month following the end of the plan year. DUe, 2019 Form 5500 due July 31, 2021 unless extended. Form 5500 for Each Retire and Retiree Health and Welfare Plan File Form 5500 electronically with the IJ.S. Department of Labor See instructions an eleeteonie filing. Employee benefit plans covered by Part 1 of Title of ERISA. including fully insured and self- insured medical pia ns. Pla ns with 100 or more enrolled at the beginning of the plan year. A one-time extension of up to two and one-half months is available byfiling. An extension may be obtained byfiling Form 5558 {Application for Extension of Time to File Certain Employee Plan Returns) on or before the due date. Due July31, 2021 for 2020 plan year. Note The PCORI fee was re reinstated in December, 2019. Form 720 to report PCORI fee PCORI Fee Requirements for the 2020 Plan Year File Form 720 with IRS. See IRS Instructions. Self -Insured Medical Plans and Fury Insured Plans with an HRA. Note' The POORI fee for plan year ending December 31, 2019 is$254 and for plan year ending December 31, 2020 is $2.66 per covered person_ September 2021 Within nine months after the end of the plan year, or, if the Form 5500 annual report is extended, within two months after the close of the extension period for filing the Form 5500. Otto by September 30, 2021 unless the Form 5500 is extended. Summary Annual Repart(No Extension of Fonn 5500) Deliver bythe same method applicable to the plan's SPD. Fully Insured and Self -Insured Plans. Plans with 100 or more enrolled at beginning of plan year. October 2021 Furnish to Medicare beneficiaries seeking enrollment in the health plans prior to October 15, 2021_ Medicare Part Creditable Coverage Notice Notice provided to all Medicare eligible individuals regarding status of RX coverage as either creditable or non -creditable (determined in accordance with CMS guidelines). Deliver by same method applicable to the plan's SPD. It is recommended to send to all covered individuals on the Plan as the Plan Sponsor may not be aware of Medicare - eligible dependents on the plan and should notask/request this information. Fully Insured and self -Insured Plans. If the 2020 Form 5500 wasy extended, the Form 5500 is due by October 15, 2021. Fonn 5500 (Extended) Ole Form 5500 electronically with Department of Labor. See instructions On eleotfonl6 fining. P �� Fully Insured and Self -Insured Plans. Plans with 100 or more enrolled at beginning of plan year. Only 6 en extension was filed. A one-time extension of up to two and one-half months is available byfiling Form5555 (Application for Extension of Time to Ole Certain Employee Pien Returns) on or before the due date 780 W. Granada Blvd. Page 139 frFOUNDATION Ormond Beach, FL 32174 PUBLIC ENTITY SERVICES RFP #1896386 — Employee Benefit City of Miami Consulting Services COMPLIANCE CALENDAR - 2021. CALENDAR YEAR PLANS Significant Due Dates Deadline Item/Form Filling/Disclosure/Plan Action Requirements Plans Affected Disclosures to ALL employees provided at time of hire Within 14 days of the date of hire_ Malltetplace Notice (or Exchange Notice) Goes to all employees without regard to whether they are eligible for health coverage, Deliver bythe same method applicable to the plan's SPD. Fully Insured and Self -Insured Plans, Enrollment -Related Disclosures At the time a Medicare beneficiary eIigiblefor the medical plan seeks coverage under the plan. PartD Creditable Coverage Notice (Applies Dnlytoa Plan Sponsors Major Medical Plans) Notice provided to all Medicare eligible individuals regarding status of RX coverage as either creditable or non -creditable (determined in accordance with CMS guidelines), Deliver bythe same method applicable to the plan's SPD. Recommendation is to send to all covered individuals as Plan Sponsor may not be aware of Medicare•eligible dependents. Fully Insured and Self -Insured Plans. At or before the time an eligible employee is first offered an enrollment opportunity in the health plan. HIPAA Special Enrollment Notice Use the HIPAA Special Enrollment Notice provided by CSG within your other annual benefits notices. Deliver bythe same method applicable to the plans SPD. Fully Insured and Self -Insured Plans. Upon enrollment in the plan. Womeds Health and Cancer Rights Act Notice use notice provided by CSG within annual Benefits Notice. Deliver bythe same method applicable to the plan's SPD. Fully Insured and Self -Insured Plans. At the time an eligible person is offered an enrollment opportunity in the health Ian. p Summaryot Benefits and Coverage (SBC) Deliveryrules: • First class mail , Electronically in accordance with specific guidance issued by DOL. Can include copy within Enrollment System. Single SSC sent to address of employee is considered notice to everyone residingetthe same address: however, separate SBCs are required to "beneficiaries' residing at a separate address (e.g., an alternate recipient subjectto a QMCSO). Fully Insured and Self -Insured Plans. Following enrollment in anygroup health plan. HIPAA Privacy Notice Provide to individuals who enroll in (or automatically enrolled in)the Medical, Dental, Vision, Health FSA, and Employee Assistance Plans. Asingle notice to the enrolled employee or retiree is deemed notice to all other .covered individuals. NOTE: If provided electronically, advance consent must be obtained. Fully Insured and Self -Insured Plans. 780 W. Granada Blvd. Page 140 FOUNDATION Ormond Beach, FL 32174 PUBLIC ENTITY SERVICES � Il City of Miami RFP #1896386 — Employee Benefit Consulting Services COMPLIANCE CALENDAR _ 2021. CALENDAR YEAR PLANS Significant Due Dates Deadline Item/Form Filling/Disclosure/Plan Action Requirements Plans Affected Disclosures that must be furnished automatically WHEN AN EMPLOYEE OR RETIREE FIRST BECOMES ELIGIBLE FOR THE HEALTH PLAN To covered Individuals within 90 days after coverage under a group health plan begins. COBRA General Notice (Applies to All Health Plans) Applies to employers with 20 or more employees. Asingle notice addressed to both the covered employee and covered spouse/adult child may be delivered If(i) spouse/ adult child and covered employee reside at same address and (ii) become covered at same time. Aseparate notice must be delivered to spouse if spouse enrolls separately or Iives at separate address. Notice must also be sent to covered children who do not live with employee or spouse who receives notice (e_g., QMCSO child). Fully Insured and Self -Insured Plans. Employer with 20 or more employees Tithe preceding calendar year. ERISA requires SPD to be provided to the participant within 9D days of becoming covered in the plan. Summary Plan Descriptions (includes any certificate of coverage provided by insurance carrier) Must deliver SPD to participants by means "reasonably calculated to ensure actual receipt." Permissible delivery methods: ▪ Hand delivery ▪ First class mail Electronic (compliance with the -electronic disclosure" safe harbor in U.S. Department of Labor regulations will satisfythe general disclosure standard) Fully Insured and Self - Insured plans with 2 or more participants. Disclosures provided annually to ALL employees without regard to health and welfare plan eligibility Provide to all employees annually. Rules do net establish a due date or time period. CHIPRA Subsidy Notice Employers that maintain group health plans in states that provide Medicaid or CHIP assistance in the form of premium assistance subsidies are required to give written notice to their employees, informing them of the potential opportunities for premium assistance currently available in the state in which they reside to help them pay for group health coverage. Deliver bythe same methods applicable to the plan's SPD. Do not have to send to dependents. Fully Insured and Self -Insured Plans. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 141 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services COMPLIANCE 2021 CALENDARYEAR CALENDAR - PLANS Due Dates Significant Deadline Item/Form Filling/Disclosure/Plan Action Requirements Plans Affected Disclosures that must be furnished ANNUALLY to the Individuals eligible for or enrolled In a plan Upon enrollment in the plan. Women's Health and Cancer Right's Act Notice Use notice provided by CSG within the annual benefits notices. Delivery bysame methods applicable to SPD. Fully Insured and Self -Insured Plans, Provide to all employees annually. Rules do not establish a due date or time period CHIPRA Special Enrollment Notice Employers that maintain group health plans in states that provide Medicaid or CHIP assistance in the form of premium assistance subsidies are required to give written notice to their employees. informingthem of the potential opportunities for premium assistance currently available in the state in which they reside to help them pay for group health coverage. Use notice provided by CSG within the annual benefits notices. Deliver bythe same methods applicable to the plan's SPD. Fully Insured and Self -Insured Plans. At the time the eligible employee Is offered an annual enrollment opportunity in thehealth plan. Summary of Benefits and Coverage (SBC) Rules for SBC disclosure: deliver by: • First class mail Electronically in accordance with specific guidance issued by the U.S.Dept. of Labor to the extentthat enrollment is conducted electronically. • Single SSC sentto address of employee is considered notice to everyone residing atthe same address; however, separate SBCs are required to "beneficiaries" residing at a separate address (e.g., an alternate recipient subject to a QMCSO) Fully Insured and Self -Insured Plans- 780 W. Granada Blvd. Page 142 ##,FOUNDATION Ormond Beach, FL 32174 PUBLIC ENTITY SERVICES RFP #1896386 — Employee Benefit City of Miami Consulting Services COMPLIANCE CALENDAR - 1021. CALENDAR YEAR PLANS Significant Due Dates Notices and Disclosures Triggered by Events Deadline Item/Form Filling/Disclosure/Plan Action Requirements Plans Affected Notice of Child Support Order —Applies to Any Health Plan AS soon as possible upon receipt of Support Order. Notice of Medical Child SupportOrder(MCSO) Phan Administrator. upon receipt of MCSO. must promptly issue a notice to participant and each alternate recipient of the receipt of the MCSO (including plan's procedures for determining its qualified status). Plan Administrator must also issue a separate notice to the participant and each alternate recipient as to whether the MCSO is qualifiedwfthin a reasonable time after its receipt 'Reasonable' depends on the facts and circumstances but should not be longer than 40 days. Fully Insured and Self.Insured Plans. As soon as possible upon receipt of Support Order National Medical Child Support Order Notice (NMSN) The employer/Plan Sponsor must either send Part Ain the applicable State agency (if coverage cannot be provided due to one of the permitted reasons), or Part B to the Plan Administrator, within 20 business days of the date of the NMSN (or sooner 6 possible). Plan Administrator must promptly notify affected persons of receipt of the NMSN and reviewthe procedures for determining its qualified status. Plan Administrator must within 40 business days after the date of NMSN (or sooner if reasonable) complete and return Part B to the issuingagenoy and provide required information to affected persons. Fully Insured and Self -Insured Plans. PHI Privacy Breach —Applies to Any Health Plan Concurrently wdh the notice to individuals. Notice of Breach hyoidng More than 500 Covered Individuals File notice electronically. Fully Insured and Self.Insured Plans if Breach Occurred. Without unreasonable delay, but not later than 60 days after discovery of the breach. Notice ofBreach To Affected Individuals See HIPAA Privacy Policies and Procedures for more information regarding the method of delivery(including procedures for handling returned mail). Fully Insured and Self -Insured Plans if Breach occurred. Without unreasonable delay, but not later than 60 days after discovery of the breach_ Nance al -Breach [olio Media See HIPAA Privacy Policies and Procedures for more information. Fully Insured and Self.Insured Plans if Breach Occurred. 780 W. Granada Blvd. Page 143 #0,FOUNDATION Ormond Beach, FL 32174 PUBLIC ENTITY SERVICES 1 RFP #1896386 — Employee Benefit City of Miami Consulting Services COMPLIANCE 2 0 CALENDAR Significant CALENDAR - YEAR PLANS Due Dates 111 Deadline Item/Form Filling/Disclosure/Plan Action Requirements Plans Affected Request for Documents and Notices Within 30 days of the request. Requests for documents or instruments governing the terms of the plan fe.g., SPD. plan This Includes the SPD. Form 5500, trusts, contracts or other instruments under>vhlch the plan is established or operated_ Deliver bythe same methods applicable to the plan's SPD. Fully Insured and Sel&Insured Plans. document,Form 5500) A health plan must provide a HIPPO, Notice of Privacy Practices and Privacy Notice to individuals— • no later than the date by which the plan is required to comply with the HIPAAPrivacy Rule (the initial "compliance date," for most health plans, was April 14 2003); • on an ongoing basis after the compliance date. at the time of an individual's enrollment in the plan, and upon request by any individual. HIPAA Notice of Privacy Practices and HIPAA Privacy Notice Employers can deliver by the same methods applicable to the plan's SPD. May be provided electronically if requested electronically. but it is not acceptable to simply"post' these materials on a website or make them available to employees en the plan sponsors Intranet Fully Insured and Self.lnsured Plans. Within 7 business days of the request. Summary of Benefits Coverage required by ACA May be provided electronically if requested electronically Fully Insured and Self -Insured Plans. 780 W. Granada Blvd. Page 144 ##FOUNDATION Ormond Beach, FL 32174 PUBLIC ENTITY SERVICES � Il City of Miami RFP #1896386 — Employee Benefit Consulting Services COMPLIANCE CALENDAR - 2021. CALENDAR YEAR PLANS Significant Due Dates Deadline Item/Form Filling/Disclosure/Plan Action Requirements Plans Affected Changes to the Plan Within 210 days of the last day of the plan year in which the change is adopted. Summary of Matedal Modification (SMM)to a Health and Welfare Plan (Other than a material reduction in health plan benefits) This is a notice of changes to the plan that are not material reductions in the health plan's benefits. such es lower deductibles, changes in eligibility (ether than to eliminate classes of individuals previously eligible or other material reductions)_ We generally recommend that plan sponsors provide notice as soon as possible prior to the effective date of the change. Deliver bythe same methods applicable to plan's SPD. Fully insured and self -insured plans with 2 or more enrolled and material change has occurred. ERISA requires a notice of material reduction in covered health benefits to be delivered within 60 days of the date the change is adopted bythe plan. Notice of Material Reduction in Benefits of a Health and Welfare Plan This Is a notice of any material reduction In covered services, such as: • an elimination of benefits payable under the plan, • a reduction of benefits payable under the plan (including a reduction that occurs as a result of a change in formulas, methodologies, or schedules that serve as the basis for making benefit determinations), • an increase in premiums. deductibles, co-insurance, copayments, or other amounts to be paid by a participant or beneficiary • a reduction in the service area covered Cyan HMO, and • an imposition of new conditions or requirements (i_e.. preauthorization requirements) to obtai nine services or benefits under the plan. Fully insured and self -insured plans with 2 or more enrolled and material change has occurred. Notice must be provided 60 days prior to the effective date of the change Material change in SBC infommation that is effective other than first day of plan year (applies only to medical plans) Deliver by same methods applicable to SBC. Fully Insured and self -insured plans with 2 or more enrolled and material change has occurred. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 145 ##FOUNDATION PUBLIC ENTITY SERVICES � Il City of Miami RFP #1896386 — Employee Benefit Consulting Services COMPLIANCE CALENDAR - 4" 2 1 CALENDAR YEAR PLANS Significant Due Dates Filling/Disclosure/Plan Action Requirements Plans Affected Termination of Health Coverage or Reduction in Hours of Service that Causes a Loss of Coverage Notice of a Qualifying Event (divorce, dependent child aging out) The COBRA administrator must provide notice of the qualifying event within 44 days of a termination cif employment or reduction in hoursof employment that causes a loss of coverage under the terms of the applicable group health plan. COBRA Election Notice (applies to all group health plans, including Medical, Dental, Vision, EAP, Wellness, Health FSA and HRA) Deliver by Certificate of Mailing or Certified Mail. Asingle notice addressed to both the covered employee and covered spouse/ adult child may he delivered if spouse/adult child and covered employee reside at same address. Notice must be provided to the COBRA administrator as soon as possiblefollowing the termination of employment/ reduction of hours of employmentte ensure that the COBRA administrator timely delivers the notice. Fully Insured and Self-lnsured Plans. Employer with 20 or more employees in preceding calendar year Rescission Agroup health plan that rescinds coverage due to fraud or intentional misrepresentation must give affected individuals at least 30 days' advancewritten notice Rescission of Coverage Notice (applies only to medical plans) Deliver bythe same methods applicable to the plan's SPD. Fully Insured and Self -Insured Plans. NOTE; The Corporate Synergies 2021 Compliance Calendar is designed to help plan sponsors of health and welfare plans identify significant compliance requirements in 2021 it is based on a 2021 calendar -year plan and Is not designed to Identify all compliance obligations. information contained in this Compliance Calendar is current as of February 5, 2021, but subject to change due to the ongoing release of additional or clarifying legislation or regulatory guidance by the U.S. (Department of Labor, Internal Revenue Service. or other applicable regulatory agencies throughout the year. Synergies360°M Corporate Synergies takes a full view of the insurance landscape, studies It from every angle, pursues innovation where none exists, and transforms this deeper understanding into actionable strategies to protect our clients and their participants. We call our approach Synerges360_ Corporate Synergies is not a law firm, and accordingly, the contents of this Compliance Calendar do not constitute legal advice. The information provides only general guidance and not all rules and requirements are reflected. Please contact your Corporate Synergies consultant or account manager if you have any questions about the information contained in this Compliance Calendar. For more information visit corpsyn.com or call 877.426.7779 Corporate synerp es is a nab oral insurance and employee benefits brokerage and consultancy that derivers etrategi es to csntrol costsrelieve administrative burdens and mitigate risk. With offices in. NewJersey 1 New York 1 Pennsylvania 1 Maryland I Florida 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 146 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ,FOUNDATION SK PARTNERS PUBLIC ENTITY SERVICES MIGRATION COMMUNICATION CAMPAIGN TIMELINE DELIVERABLES AUDIENCE BEGIN PROJECT CLIENT SIGN -OFF TO CLIENT Initial Conference Call 02 13 Campaign Presentation 03 08 Campaign Approval by Client 03 15 Strategy and Measurement Development Meetings Weekly meetings to review, discuss and develop strategy Content Development Kick -Off Campaign Jump start awareness and provide high-level information and resources. Pre - communications delivered to senior leadership, district managers and managers with level -specific timelines talk tracks and Q&A responses Logo Creation Binder: Cover (2 versions) Binder: Spine (2 versions) Binder: Inside Cover (2 versions) Teaser: Poster (4 versions) Binder: Letter (2 versions) MANAGERS Kick-off: Letter (2 versions) EMPLOYEES Paycheck: Poster (3 versions) EMPLOYEES Paycheck: Flyer (4 versions) EMPLOYEES Contacts: Poster EMPLOYEES Contacts: Flyer EMPLOYEES Benefits/Payroll Highlight: Letter (4 versions) MANAGERS Benefits/Payroll Highlight: Letter (4 versions) EMPLOYEES Benefits/Payroll Highlight: Letter (4 versions) COBRA Ongoing 04 15 04 15 04 15 04 15 04 15 04 15 04 15 05 09 05 09 05 09 05 09 05 23 05 23 05 31 04 24 04 24 05 10 04 15 05 10 04 15 05 10 04 15 05 31 05 31 05 16 05 16 05 16 05 16 05 23 05 23 05 23 05 23 TBD TBD TBD TBD 05 31 05 31 05 31 05 31 TBD TBD Health & Welfare (ADP) "What's New/How To" Campaign Information specific to how employees will engage with their new ADP online sdution Talking Points: Email VP OPERATIONS 05 24 06 14 06 17 Talking Points: WIIFM MANAGERS 05 28 06 18 06 21 Talking Points: WIIFM MANAGERS 05 28 06 18 06 21 Talking Points for Employees: Email MANAGERS 05 31 06 21 06 24 Flyer EMPLOYEES 06 03 06 24 06 27 Poster (11" X 17") EMPLOYEES 06 03 06 24 06 27 Payroll (ADP) "What's New/How To" Campaign Information specific to how employees' payrdl will be affected and what they can expect Talking Points: Email VP OPERATIONS 06 21 07 12 07 15 Talking Points: WIIFM MANAGERS 06 25 07 16 07 19 Talking Points for Employees: Email MANAGERS 06 28 07 19 07 22 Flyer EMPLOYEES 06 30 07 21 07 24 Poster (11" X 17") EMPLOYEES 06 30 07 21 07 24 780 W. Granada Blvd. Page 147 Ormond Beach, FL 32174 #,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ® FOUNDATIION RISK PARTNERS PUBLIC ENTITY SERVICES 2019 COMMUNICATION CAMPAIGN TIMELINE DELIVERABLES FINAL CONTENT Initial Meeting Campaign Presentation Revised Campaign Review Campaign Approval by Client OPEN ENROLLMENT Benefits Fair 1ST TO DRAFT PRINTER Flu Shot Flyer 09 12 2019 09 14 2019 10 11 2019 Pre -Enrollment Communications OE Poster 09 13 2019 Benefits Guide 09 17 2019 OE Flyer 09 23 2019 Wellness Incentive Flyer/Form 09 25 2019 Benefit Fair Poster 10 02 2019 10 14 2019 10 29 2019 10 18 2019 10 29 2019 10 07 2019 10 18 2019 10 14 2019 10 26 2019 10 16 2019 10 28 2019 TO CLIENT 1112 19 10 19 2019 11 01 2019 11 04 2019 10 21 2019 11 01 2019 11 01 2019 OPEN ENROLLMENT ENDS 1126 19 Post -Enrollment: New Hire Benefits Guide 12 07 2019 NA 12 21 2019 TOTAL HOURS DESIGN AND CONTENT COSTS INCLUDE: One (1) initial draft; Two (2) - Three (3) rounds of edits, Preparation and/or delivery of one (1) final file; Printing, shipping, handling, and postage will be administered as covered under the client's Service Agreement. Dates are subject to change. If the CONTENTTO FOUNDATION RISK PARTNERS' date is moved up or a 15t 2"d 3`d EDITS, CLIENT APPROVAL or TO PRINTER date is missed, the TO CLIENT date will also be adjusted accordingly. Print materials will require standard lead time of three (3) weeks (15 business days) from the TO PRINTER date to allow for production and distribution. FINAL CONTENT AND LAYOUT APPROVAL, ALL FINAL QUANTITIES and DELIVERY DETAILS for the complete project must be provided by the client on the CLIENT APPROVAL date for the entire print job to be considered complete and ready to be prepa red and sent to the printer (TO PRINTER). If all required components are not delivered on the CLIENT APPROVAL date, the TO CLI ENT date will also be adjusted accordingly. 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 148 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Renewal Process Schedule Tenative Dates Work Plan Time Frame Establish Objectives Pre -renewal meeting: 210days prior to renewal Develop the renewal strategy Initial budget/claim projection Discuss current benefits and carriers Discuss voluntary benefits Gather Data Collect information for insurance carrier submissions 180days prior to renewal Analyze employee survey results, Prepare RFPs with coordination and approval from HR and Procurement Receive Proposals Submit RFPs to Carriers and post electronically 150-120days prior to renewal Receive renewal Updage budget/claim projection Receive proposals from insurance carriers Prepare Marketing Presentation Prepare network analysis 90days prior to renewal Prepare preferred drug list analysis Prepare marketing presentation and present to HR, Finance, Budget Negotiate with insurance carriers best and final Present best and final to HR Attend City Council meeting to present recommendations for approval Enrollment Meetings Coordinate with HR to set up dates, locations and time for open enrollment meetings 60 - 45 days prior to renewal Coordinate meetings with insurance carriers Provide HR with Open Enrollment flyers Complete Employee Benefits Booklet Submit and confirm eligibility received from carriers Group numbers issued and ID cards ordered Finalize &Confirm ID cards delivered 30daysupto effecive date Reconcile initial insurance carrier invoices Confirm propoer issuance of all policies and contracts Review and confirm objectives were met 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 149 FOUNDATION PUBLIC ENTITY SERVICES Sample Implementation & Service Timeline FOUNDATION Start Projected Completion Responsibility Status Comments 1. Initial Onboarding $ Information Gathering a) Identify/introduce team members (Account Management, Compliance, BeneftsVlP, Client Solutions, Wellness and Education) 2/12019 2/1/19 CSG Completed b) Notify carriers and establish meeting date to review open issues 2/12019 2/2/2019 CSG Completed c) Establish team contact lists for CSG and Client 2/12019 2/12019 CSG/Client Completed d) Furnish list of all coverage lines and vendors 2/12019 2/12019 Client Completed e) Collect policies and loss data [5 years] 2/12019 2/152019 Client Completed f) Visit major locations to understand culture and engage with employees 2/1/2019 3/1/2019 CSG Completed 2. Benefits Administration a) Document all administrative processes and procedures 2/12019 2/12019 CSG/Client Completed b) Obtain administrative access with online enrollment vendor and begin collaboration with CSG Client Solutions team 2/1/2019 2/1/2019 CSG/Client Completed c) BeneftsVlP Cultural Discovery and Kick-off Call 2/15/2019 2/152019 CSG/Client Completed e Establish week) o•en items review meetin• 2/15/2019 2/152019 CSG Completed 'a. Cost Mitigation. and .Straiggic Planning a) Determine overall program objectives 2/1/2019 2282019 CSG/Client Completed b) Run historical claims detail through CSG's claims analyzer tool to identify and benchmark primary cost drivers and conditions 2/1/2019 2/28/2019 CSG Completed c) Provide full plan design and contribution benchmarking of all lines of coverage to determine how current offerings compare to market norms 2/1/2019 2282019 CSG Completed d) Perform cost driver analysis and forensic underwriting 2/1/2019 2282019 CSG Completed e) Present 5 year strategic planning iniatives to achieve program objectives (PBM analysis, Network Discount Review, Stop -loss Review, Network Disruption Analysis, Disease Management, Population Health Management) 2/1/2019 2282019 CSG Completed f) Refine and solidify 5 year strategic plan based off collaboration and input from Client 2282019 3/102019 CSG Completed g) Establish monthly financial review meetings (claims 3/1/2019 3/12019 CSG Completed dashboard, fixed costs, IBNR and financial projections) 4.1RFEERMSnd Open Enrollmenparation a) Set renewal timeframe expectations from incumbent carriers/vendors 2/1/2019 2282019 CSG/Client Completed b) Obtain and assess renewal options with the client 3/1/2019 3/82019 CSG Completed c) Determine carrier/vendor RFP strategy with the client 3/1/2019 3/8/2019 CSG Completed 70 T F, CO l0 C1 00 rr m 3 13 O rD rD W O rD i-r fi 0 011 rn O rr N rD rD N r) rt 0 of 3 S37U12i3S ASLLN3 7i Mil 17LZZ£ 1: `Peas puouu0 •pn18 epeuea9 •M 08L NOI1VCINf1Ord Sample Implementation & Service Timeline FOUNDATION -ISK FAQ, .. ,BLIC EMIT' SERVICES Start Projected Completion Responsibility Status Comments d) Review all renewal recommendations and options with the client for the upcoming plan year 3l82019 3/152019 CSG Completed e) Obtain all renewal decisions from client 4/15/2019 4/182019 CSG Completed f) Prepare all aspects of the Open Enrollment event, including employee meetings, communication and enrollment setup 4/15/2019 5/152019 CSG In Progress g) Communicate all enrollment changes to the carriers to ensure ID card distribution occurs before plan anniversary date 6/1/2019 6/162019 CSG Not Started a) Introduce CSG compliance team 2/1/2019 2/1/2019 CSG/Client Completed b) Complete onsite full audit of ERISA, DOL, IRS and HIPPA policies and procedures currently in place 2/16/2019 2/162019 CSG Completed c) Compliance audit scorecard review with gaps reviewed and remediation plan established 2/16/2019 3/3/2019 CSG Completed d) Remediate any compliance gaps identified 3/3/2019 4/2/2019 CSG Completed e) Wrap Plan Doc and SPD created or modified based off of current state 2/16/2019 4/2/2019 CSG Completed _ Ensure annual 1095-c/1094-c distribution com.lete 1/1/2020 4/1/2020 CSG Not Started Employee Communications & Education - a) Develop benefit guides for new hires 2/15/2019 3/152019 CSG Completed b) Establish 2019 employee communication and education project plan (content and delivery dates) and review with Client Team to ensure were driving the messaging to impact behavior and culture 2/21/2019 4/72019 CSG / Client Completed c) Smart -phone application setup. Allows telemedicine, BVIP access, Rx pricing, provider search, geo-fencing around Rx and ER, push notifications to all employees, electronic ID cards) 3/1/2019 4/152019 CSG Completed d) Send-pdf ready communication pieces branded for Client designed to drive appreciation and understanding of benefits 3/15/2019 ONGOING CSG In Progress T F, 00 l0 00 01 m 3 O fD fD W fD fD .=r 0 y c rr S. (J) fD A fD N rt 0 3 City of Miami RFP #1896386 — Employee Benefit Consulting Services CORPORATE SYNERGIES ABC Corp Plan Performance Budget Summary 1/1/2020 - 12/31/2020 Data Through April 2020 • Gross Plan Costs for the Current Period YTD are running at 99.6 % of the YTD Current Period's Gross Budget. • Gross Plan Costs for the Prior Period ran at 93.9% of the Prior Period's Gross Budget. • Medical net of Stop Loss for the current period was 74.0% of the Current Period's Gross Budget. Rx was 9.5% and Administration and Stop Loss was 16.5% of the Current Period's Gross Budget. • There are 8 Large Claimants in the Current Period and there were 16 in the Prior Period. • The Average Employee Enrollment in the Current Period is 1,165 and in the prior period it was 1,036. Budget Summary Current - YTD Gross Plan Costs $6,336451 PEPM $1,359.49 Gross Budget $6,363,227 PEPM $1,365.24 Actual / Budget - YTD 150% MO% 50% 0% PflOr Plan Year Current 776 $1,8110.00 $1,600.00 $1,441.00 $1,200.00 $1,041.00 $900.00 $641.00 54m.00 $241.00 $0.00 Jan-20 Gross Plan Costs vs. Gross Budget Apr-20 Jul-20 •Gross • Net • Paid • Paid • Fixed Cost Budget Medical Claims Rx Claims 1,200 1,000 900 600 400 200 Total Monthly Enrollment !,F ....... Ma y ■Current Plan Yr ■Prior Plan Yr Budget Summary % of Plan Spend - YTD 5.0% • Net Medical • Net Rx • Stop LeSs Premium •Admin Fees $700,000 $600,000 $ 00,000 $400,000 53oy0no 5200,000 $100,000 50 Medical Paid Stop Loss 5612,449 $150,000 Top 5 Large Claimants 5271,.194 5194,537 5191,756 5150,000 1150,000 5150,000 Medical Paid -Stop Loss 51,6,516 $1e0,000 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 152 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services CORPORATE SYNERGIES' ABC Corp Plan Performance Claim Summary 1/1/2020 - 12/31/2020 Data Through April 2020 • The YTD Current Period Claim PEPM is: $1,005.90, compared to Prior Period's $1,094. 18. • In the Current Period, Rx Claims represent 0.0 % of Total Medical and Rx Claims; this is compared to 18.3% in the Prior Period. (Generally, Rx Claims represent 18-25% of Total Medical and Rx Claims). • In the Prior Period, the Stop Loss Reimbursement was 132.8 % of the Paid Stop Loss Premium. In the Current Period, the Stop Loss Reimbursement is 95.7% YTD. • The expected number of claims over $100,000 is 16.4, and over the pooling level of $150,000 is 8.5.* Net Medical Net Rx Total Claims Prior Plan Year Current YTD PEPM PEPM $893.63 $1,005.90 $200.56 0.00 $1,094.18 $1,005.90 %Chance 12.6% •100.0°% Prior Plan Year •Net Medical -PEPM •NM Rx PEPM .Net Medical -PEPM •Net Rx - PE, % of Claims by Payment Range ■Prior Plan Year • Current Plan Year a$100K $100K to $150K Pooling ›$150K Pooling Prior Plan Year $11,514,796 $330,190 $3,922,200 Current Plan Year $4,247,786 $359,973 $1,428,433 Claim Summary 51,200 $1,000 9800 5600 $400 5200 50 Current vs. Prior Plan Year Claims - PEPM $1,005.90 Prior Current •Medical •Rx $2,500,000 52,000,000 51,500,000 $1,000,000 $500,000 50 132Atip Loss Premium vs. Claims Above Pooling i 95.7% ..nor Plan Year Current-1TD • Individual Stop Loss Premium • Claims > Pooling • Individual Stop Loss - Premium Loss Ratio 140.0. 120.0% 100.0. 80.0, 60.0, 40.0, 20.0, o.ov Current Plan Year Prior Plan Year Individual Stop Loss Premium $708,595 $1,484,652 Claims Above Pooling $678,433 $1,972,200 Loss Plato 95.7% 132.8% 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 153 FOUNDATION PUBLIC ENTITY SERVICES ■ City of Miami RFP #1896386 - Employee Benefit Consulting Services CORPORATE SYNERGIES' ABC Corp 1/1/2020 - 12/31/2020 Total Account - All Divisions Medical & Prescription Drug Expense vs. Budget *Administrator: Aetna *Reinsurance Carrier: Aetna 2019 (No Rx) 2020 (w/Rx) 'Individual Stop Loss Terms: Paid in 12 Aggregate Max Claims PEPM $1,130.16 $1,425.75 'Aggregate Stop Loss Terms: Paid in 12 Specific Stop Loss Pooling Level: $150,000 Expected Claims PEPM $904.13 $1,140.60 Aggregate Pooling Level: $150,000 Covered Benefits: Medical & RX 2019 Expected w/Rx $1,179.74 Corridor: 125% Lasered High Claimants: No Covered Benefits: Medical & RX Aggregating Specific: No Minimum Attachment Point: $20,033,784 1 ■ Jan-20 imp Feb-20 Mar-20 Apr-20 May-20 Jun-20 Jul-20 Aug-20 Sep-20 Oct-20 Nov-20 Dec-20 Total PEPM Enrollment EEs Medical Claims Pharmacy Claims Stop Loss Refunds Net Paid Claims Fixed Costs 1,171 1,172 1,159 1,159 0 0 0 0 0 0 0 0 $1,564,918 $1,175,525 $1,148,641 $1,547,196 $0 $0 $0 $0 $0 $0 $0 $0 $98,538 $117,522 $175,458 $208,394 $0 $0 $0 $0 $0 $0 $0 $0 $294,982 $143,072 $148,961 $160,873 $0 $0 $0 $0 $0 $0 $0 $0 $1,368,474 $1,149,975 $1,175,138 $1,594,717 $0 $0 $0 $0 $0 $0 $0 $0 $263,210 $263,372 $260,457 $261,109 $0 $0 $0 $0 $0 $0 $0 $0 4,661 $5,436,279 $599,912 $747,889 $1166.36 $128.71 $160.46 $5,288,303 $1,048,148 $1134.61 $224.88 Gross Plan Costs Gross Budget Plan Costs Aggregate Claims Pd Net Pd. Claims' vs. Budget Max Claims Outside Agg % of Agg Max. $1,631,684 $1,413,348 $1,435,594 $1,855,825 $0 $0 $0 $0 $0 $0 $0 $0 $1,598,626 $1,599,377 $1,582,612 $1,582,612 $0 $0 $0 $0 $0 $0 $0 $0 102.1% 88.4% 90.7% 117.3% PEN/A tON/A tON/A tON/A tON/A tON/A #N/A #N/A $6,336,451 $1 359.49 $6,363,227 $1 365.24 99.6% $1,669,482 $1,670,266 $1,652,758 $1,652,758 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 82.0% 68.8% 71.1% 96.5% #N/A #N/A #N/A #N/A #N/A pN/A pN/A #N/A 0 ,645,264 ?I $1 425.75 $0.00 79.6% Jan-191 Feb-19' Mar-18 Apr-19I May-19 Jun-19' Jul-19i Aug -19 Sep -19, Oct-19, Enrollment Medical EEs Claims Pharmacy Claims Stop Loss Refunds Net Paid Claims Fixed Costs 1,012 1,014 1,015 1,025 1,032 1,031 1,036 1,046 1,060 1,070 1,066 1,031 $803,832 $871,012 $1,327,008 $876,266 $1,694,213 $988,073 $1,159,083 $1,709,480 $897,721 $1,170,277 $994,948 $830,887 $242,306 $197,396 $190,920 $200,061 $184,591 $207,911 $207,830 $204,382 $198,072 $245,725 $189,702 $225,492 $0 $0 $302,777 $4,320 $162,546 $211,075 $311,784 $585,724 $129,477 $109,041 $198,251 $193,413 $1,046,138 $1,068,408 $1,215,151 $1,072,007 $1,716,258 $984,909 $1,055,129 $1,328,138 $966,316 $1,306,962 $986,398 $862,965 $208,944 $209,465 $209,705 $211,693 $213,162 $212,907 $214,030 $216,079 $218,984 $221,017 $220,097 $212,988 12,437 $13,322,799 $2,494,387 $1,071.19 $200.56 $2,208,408 $13,608,778 $2,569,069 $177.56 $1,094.18 $206.56 Gross Plan Costs Gross Budget Loss Ratio $1,255,082 $1,277,872 $1,424,856 $1,283,700 $1,929,420 $1,197,816 $1,269,159 $1,544,217 $1,185,300 $1,527,978 $1,206,495 $1,075,953 $1,401,807 $1,405,409 $1,406,795 $1,419,818 $1,429,516 $1,427,854 $1,435,889 $1,448,636 $1,468,309 $1,482,164 $1,476,622 $1,428,685 89.5% 90.9% 101.3% 90.4% 135.0% 83.9% 88.4% 106.6% 80.7% 103.1% 81.7% 75.3% $16,177,847 $17,231,503 $1,300.74 $1,385.46 93.9% Aggregate Claims Pd Net Pd. Claims Max Claims Outside Agg % of Agg Max. $1,143,496 $1,146,434 $1,147,564 $1,158,188 $1,166,099 $1,164,743 $1,171,298 $1,181,695 $1,197,744 $1,209,045 $1,204,525 $1,165,421 $242,306 $197,396 $190,920 $200,061 $184,591 $207,911 $207,830 $204,382 $198,072 $245,725 $189,702 $225,492 70.3% 76.0% 89.3% 75.3% 131.3% 66.7% 72.3% 95.1% 64.1% 87.8% 66.1% 54.7% $14,056,252 $2,494,387 $1,130.16 $200.56 79.1% * Please see Terms and Conditions for a list of administration and stop loss fees by plan * The minimum attachment point for the current contract year is the greater of (1) the sum of each month's number of employees multiplied by the Monthly Deductible Factor(s) or (2) the Minimum Attachment Point. * Pharmacy costs were excluded from Aggregate Stop Loss coverage in 2019 * Budget is determined by multiplying enrollment by expected PEPM claims and fixed costs Plan ',By. Budget All 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 154 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 - Employee Benefit Consulting Services CORPORATE SYNERGIES ABC Corp 1/1/2020 - 12/31/2020 Division A Medical & Prescription Drug Expense vs. Budget Administrator: Aetna Reinsurance Carrier: Aetna 2019 (No Rx) 2020 (w/Rx) Individual Stop Loss Terms: Paid in 12 Aggregate Max Claims PEPM $1,130.16 $1,425.75 Aggregate Stop Loss Terms: Paid in 12 Specific Stop Loss P oling Level: $150,000 Expected Claims PEPM $904.13 $1,140.60 Aggregate Pooling Level: $150,000 Covered Benefits: Medical & RX 2019 Expected w/Rx $1,179.74 Corridor: 125% Lasered High Claim nts: No Covered Benefits: Medical & RX Aggregating Specific: No Medical Only in 2019 I Enrollment EEs Medical Claims Pharmacy Claims Stop Loss Refunds Net Paid Claims Fixed Costs Gross Plan Costs Gross Budget Plan Costs Aggregate Claims Pd Net Pd. Claims vs. Budget Max Claims Outside Agg % of Agg Max.. 1 Jan-20 Feb-20 Mar-20 Apr-20 May-20 Jun-20 Jul-20 Aug-20 Sep-20 Oct-20 Nov-20 Dec-20 J9.141 661 655 649 649 0 0 0 0 0 0 0 0 $608,078 $547,857 $792,779 $947,982 $0 $0 $0 $0 $0 $0 $0 $62,945 $77,680 $107,146 $107,357 $0 $0 $0 $0 $0 $0 $0 $0 $o $124,272 $65,756 $0 $0 $0 $0 $0 $0 $0 •.0 $671,023 $625,537 $775,653 $989,584 $0 $0 $0 $0 $0 $0 $0 $148,207 $146,973 $145,605 $146,000 $0 $0 $0 $0 $0 $0 $0 2,614 $2,896,695 $355,129 $190,028 $3,061,796 $586,786 1 108.28 135.87 72.70 1 171.45 224.50 $819,230 $772,511 $921,258 $1,135,583 $0 $0 $0 $0 $0 $0 $0 $902,491 $894,777 $885,521 $885,521 $0 $0 $0 $0 $0 $0 $0 90.8% 86.3% 104.0% 128.2% #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A $3,648,582 $3,563,310 1 395.95 1 365.24 102.2% $942,492 $934,437 $924,770 $924,770 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $o $0 $0 $0 $0 $0 $0 $0 $0 71.2% 66.9% 83.9% 107.0% #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A $3,726,469 1 425.75 $0 •0.00 82.2% NNW Enrollment EEs Medical Claims Pharmacy Claims Stop Loss Refunds Net Paid Claims Fixed Costs Gross Plan Costs Gross Budget Plan Costs Aggregate Claims Pd Net Pd. Claims vs. Budget Max Claims Outside Agg % of Ogg Max. F'o Mar-1 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Total PEPM 578 580 580 583 581 580 577 578 584 589 586 584 $749,485 $524,456 $865,433 $555,115 $1,129,664 $012,905 $811,997 $1,206,454 $407,352 $042,719 $406,232 $459,406 $133,804 $103,849 $88,950 $107,800 $87,751 $99,634 $95,793 $112,565 $100,753 $92,951 $84,505 $130,701 $0 $0 $263,395 $664 $144,287 $178,800 $213,702 $428,848 $20,911 $51,239 $42,231 $118,173 $883,289 $628,305 $090,987 $662,251 $1,073,129 $533,078 $094,029 $890,171 $481,195 $084,430 $448,506 $471,935 $119,073 $119,473 $119,490 $120,097 $119,717 $119,511 $118,872 $119,141 $120,309 $121,349 $120,800 $120,311 6,980 $8,371,218 $1,239,055 $1,468,370 $1,199.31 $177.52 $210.37 $8,141,903 $1,438,204 $1,166.46 $206.05 $1,002,361 $747,778 $810,477 $782,348 $1,192,846 $653,188 $812,901 $1,009,312 $601,564 $805,779 $569,306 $592,246 $800,795 $803,566 $803,560 $807,722 $804,951 $803,560 $799,410 $800,795 $809,108 $810,035 $811,879 $809,108 125.2% 93.1% 100.9% 96.9% 148.2% 81.3% 101.7% 126.0% 74.3% 98.7% 70.1% 73.2% $9,580,107 $9,670,501 $1,372.51 $1,385.46 99.1% $653,232 $655,493 $655,493 $658,883 $656,623 $655,493 $652,102 $653,232 $600,013 $605,064 $662,274 $600,013 $133,804 $103,849 $88,950 $107,800 $87,751 $99,034 $95,793 $112,565 $100,753 $92,951 $84,505 $130,701 114.7% 80.0% 91.8% 84.2% 150.1% 66.2% 91.7% 119.0% 57.6% 88.9% 55.0% 51.7% $7,888,517 $1,239,055 $1,130.16 $177.52 87.5% Div' ion A 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 155 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 - Employee Benefit Consulting Services CORPORATE SYNERGIES ABC Corp 1/1/2020 - 12/31/2020 Division B Medical & Prescription Drug Expense vs. Budget Administrator: Aetna Reinsurance Carrier: Aetna 2019 (No Rx) 2020 (w/Rx) Individual Stop Loss Terms: Paid in 12 Aggregate Max Claims PEPM $1,130.16 $1,425.75 Aggregate Stop Loss Terms: Paid in 12 Specific Stop Loss Pooling Level: $150,000 Expected Claims PEPM $904.13 $1,140.60 Aggregate Pooling Level: $150,000 Covered Benefits: Medical & RX 2019 Expected w/Rx $1,179.74 Corridor: 125% Lasered High Claimants: No Covered Benefits: Medical & RX Aggregating Specific: No Medical Only in 2019 Enrollment EEs Medical Pharmacy Stop Loss Net Paid Claims Claims Refunds Claims Fixed Costs Gross Plan Costs Gross Budget 1 Jan-20 Feb-20 Mar-20 Apr-20 May-20 Jun-20 Jul-20 Aug-20 Sep-20 Oct-20 Nov-20 Dec-20 Total PEPM 424 421 416 416 0 0 0 0 0 0 0 0 $893,597 $501,484 $307,358 $508,461 $0 $0 $0 $0 $0 $0 $0 $24,829 $35,234 $54,220 $62,275 $0 $0 $0 $0 $0 $0 $0 $294,982 $143,072 $24,689 $95,118 $0 $0 $0 $0 $0 $0 $0 $623,444 $95,560 $393,645 $95,095 $336,889 $93,638 $475,618 $93,856 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 .0 .0 1,676 $2,210,899 $176,558 .1318.84 '.105-32 $557,861 .33277 $1,829,596 $378,149 .1 091.38 '.225.57 Plan Costs Aggregate Claims Pd Net Pd. Claims vs. Budget Max Claims Outside Agg % of Agg Max- $719,004 $488,741 $430,527 $569,474 $0 $0 $0 $0 $0 $0 $0 $578,179 $575,175 $567,666 $567,666 $0 $0 $0 $0 $0 $0 $0 .0 124.4% 85.0% 75.8% 100.3% #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A $2,207,745 $2,288,686 .1316.96 '.1365.24 96.5% $603,805 $600,668 $592,827 $592,827 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 103.3% 65.5% 56.8% 80.2% #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A .2,390,127 .1 425.75 •0 0-00 76.5% Enrollment EEs Medical Pharmacy Stop Loss Net Paid Claims Claims Refunds Claims Fixed Costs Gross Plan Costs Gross Budget Plan Costs Aggregate Claims Pd Net Pd. Claims vs. Budget Max Claims Outside Agg 7 of Agg Max- -19 eb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Total PEPM 357 360 361 365 368 369 379 386 393 398 397 368 $50,228 $335,506 $431,294 $296,831 $534,460 $326,684 $301,299 $483,608 $475,314 $476,029 $513,109 $345,124 $93,745 $72,854 $75,933 $66,639 $73,861 $81,190 $85,681 $72,475 $78,906 $93,193 $78,334 $76,357 $0 $0 $39,382 $3,656 $18,259 $32,214 $98,022 $156,876 $102,567 $57,801 $156,020 $75,241 $143,973 $408,360 $467,844 $359,814 $590,062 $375,660 $288,958 $399,207 $451,654 $511,421 $435,423 $346,240 $74,042 $74,643 $74,860 $75,740 $76,393 $76,580 $78,581 $80,105 $81,537 $82,590 $82,240 $76,336 4,501 $4,569,485 $1,015.22 $949,168 $740,037 $210-88 $164A2 $4,778,616 $933,649 $1,061.68 $207.43 $218,015 $483,003 $542,705 $435,554 $666,455 $452,240 $367,539 $479,313 $533,191 $594,011 $517,663 $422,576 $494,609 $498,765 $500,151 $505,692 $509,849 $511,234 $525,089 $534,787 $544,485 $551,413 $550,027 $509,849 44.1 % 96.8% 108.5% 86.1 % 130.7% 88.5% 70.0% 89.6% 97.9% 107.7% 94.1 % 82.9% $5,712,265 $6,235,949 $1,269.11 $1,385.46 91.6% $403,467 $406,858 $407,988 $412,508 $415,899 $417,029 $428,331 $436,242 $444,153 $449,804 $448,674 $415,899 $93,745 $72,854 $75,933 $66,639 $73,861 $81,190 $85,681 $72,475 $78,906 $93,193 $78,334 $76,357 12.4% 82.5% 96.1% 71.1 % 124.1 % 70.6% 47.5% 74.9% 83.9% 93.0% 79.6% 64.9% $5,086,850 $1,130.16 $949,168 $210.88 75.3% Division B 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 156 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 - Employee Benefit Consulting Services CORPORATE SYNERGIES ABC Corp 1/1/2020 - 12/31/2020 Division C Medical & Prescription Drug Expense vs. Budget Administrator: Aetna Reinsurance Carrier: Aetna 2019 (No Rx) 2020 (w/Rx) Individual Stop Loss Terms: Paid in 12 Aggregate Max Claims PEPM $1,130.16 $1,425.75 Aggregate Stop Loss Terms: Paid in 12 Specific Stop Loss P oling Level: $150,000 Expected Claims PEPM $904.13 $1,140.60 Aggregate Pooling Level: $150,000 Covered Benefits: Medical & RX 2019 Expected w/Rx $1,179.74 Corridor: 125% Lasered High Claim nts: No Covered Benefits: Medical & RX Aggregating Specific: No Medical Only in 2019 Enrollment EEs Jan-20 Feb-20 Mar-20 Apr-20 May-20 Jun-20 Jul-20 Aug-20 Sep-20 Oct-20 Nov-20 Dec-20 Medical Claims Pharmacy Claims Stop Loss Refunds Net Paid Claims Fixed Costs 86 95 95 95 0 0 0 0 0 0 0 0 $63,244 $126,185 $48,504 $90,753 $0 $0 $0 $0 $0 $0 $0 .0 $10,764 $4,608 $14,092 $38,762 $0 $0 $0 $0 $0 $0 $0 •.0 $0 $o $0 $0 $0 $0 $0 $0 $0 $0 $0 •.0 $74,007 $130,793 $62,596 $129,515 $0 $0 $0 $0 $0 $0 $0 .0 $19,443 $21,304 $21,213 $21,253 $0 $0 $0 $0 $0 $0 $0 .0 371 $328,685 886.42 $68,226 184.00 $0 0.00 $396,911 $83,213 '•1070.42 '•224.42 Gross Plan Costs Gross Budget Plan Costs Aggregate Claims Pd Net Pd. Claims vs. Budget Max Claims Outside Agg % of Agg Max.. $93,450 $152,096 $83, 809 $150,768 $0 $0 $0 $0 $0 $0 $0 .0 $117,957 $129,425 $129,425 $129,425 $0 $0 $0 $0 $0 $0 $0 .0 79.2% 117.5% 64.8% 116.5% #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A $480,124 1 294.83 $506,230 1 365.24 94.8 % $123,185 $135,161 $135,161 $135,161 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 60.1% 96.8% 46.3% 95.8 % #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A $528,668 1 425.75 $0 0 75.1% Enrollment EEs Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Total PEPM • Medical Claims Pharmacy Claims Stop Loss Refunds Net Paid Claims Fixed Costs 77 74 74 77 83 82 80 82 83 83 83 79 $4,119 $11,050 $30,282 $24,320 $30,088 $48,484 $45,787 $19,418 $15,055 $51,530 $75,607 $26,357 $14,757 $20,693 $26,038 $25,622 $22,979 $27,087 $26,356 $19,342 $18,413 $59,581 $26,863 $18,434 $0 $0 $0 $0 $0 $0 $o $0 $0 $0 $0 $0 $18,877 $31,743 $56,320 $49,942 $53,067 $75,571 $72,142 $38,760 $33,468 $111,110 $102,470 $44,790 $15,829 $15,349 $15,354 $15,856 $17,051 $16,816 $16,576 $16,832 $17,077 $17,077 $17,056 $16,341 956 $382,096 $306,163 $0 $688,259 $197,216 $399.51 $320.12 $0.00 $719.64 $206.21 Gross Plan Costs Gross Budget Plan Costs Aggregate Claims Pd Net Pd. Claims vs. Budget Max Claims Outside Agg % of Agg Max. $34,706 $47, 092 $71,674 $65,797 $70,118 $92, 387 $88,718 $55, 592 $50, 545 $128,188 $119,526 $61,132 $106,403 $103,078 $103,078 $106,403 $114,716 $113,053 $111,391 $113,053 $114,716 $114,716 $114,716 $109,728 32.6% 45.7% 69.5% 61.8% 61.1% 81.7% 79.6% 49.2% 44.1% 111.7% 104.2% 55.7% $885,475 $925.84 $1,325,053 $1,385.46 66.8% $86,796 $84,084 $84,084 $86,796 $93,577 $92,221 $90,865 $92,221 $93,577 $93,577 $93,577 $89,509 $14,757 $20,693 $26,038 $25,622 $22,979 $27,087 $26,356 $19,342 $18,413 $59,581 $26,863 $18,434 4.7% 13.1% 36.0% 28.0% 32.2% 52.6% 50.4% 21.1% 16.1% 55.1% 80.8% 29.4% $1,080,885 $1,130.16 $306,163 $320.12 35.4% Division C 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 157 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 - Employee Benefit Consulting Services Large Claims ABC Corp Large Claims Reports 1/1/2020 - 12/31/2020 Data Through April 2020 Total Account - All Divisions Current Plan Year: 1/1/2020 - 12/31/2020 Large Claim, ICD Description Amount Over Large Claim $150,000 Amount" Stop Loss Level Claimant 1 A Claimant 2 A Glalmant 3 B Clalmant4 A Glalmant 5 A Glalmant 6 A Clalmant7 C Claimant 8 8 Toxic Gastroenterltls And COIIt1s $612,449 $462,449 Health Examination For Newborn 9 To 28 Days Old $273,394 $123,394 Chronic Ran Syndrome $194,697 $44,697 Twin Llveborn Infant, Delivered By Cesarean $191,056 $41,056 Cystic Fibrosis With Pulmonary Mann festations $156,836 $6,836 Hypertensive Heart And Chronic I0dney Disease With Heart Failure And Wlth Stage 5 Chror $124,535 $0 Gaucher Disease $118,100 $0 Other A.e-related Cataract $117338 $0 Total 8 Claimants Over $100 8 405 $678 433 *Amount above reflect medical costs only. Pharmacy costs not paid under the medical benefit are excluded. Prior Plan Year: 1/1/2019 - 12/31/2019 Large Claim Info MIMM-ICD Description Amount Over Large Claim $150,000 Amount" Stop Loss Level Glalmant 1 A Encounter For Breast Reconstruction Fo1IOWIng Mastectomy $519,364 $369,364 Glalmant 2 A Unspecified Mood Affectivey Disorder $476,083 $326,083 Clalmant3 B Spinal Stenosls, Cervical Beg on $395,961 $245,961 Clamant C Rheumatoid Arthritis, Unspecllled $388,879 $238,879 Clalmant5 C Pain In RIgh1 Shoulder $343,727 $193,727 Glalmant 6 A Poslprocedural Hemorrhage Of A Genitourinary System Organ Or Structure Following A Se $289,992 $139,992 Glalmant 7 A Post -term Pregnancy $252,178 $102,178 Glalmant 8 B Res -noted 016300sls $246,346 $96,346 Claimant 9 B Other Displaced Fracture Of Fifth Cervical Vertebra, Initial Encounter For Closed Fracture $219,336 $69,336 Clalmant10 B Headache $211,227 $61,227 Claimant 11 A Gram-negative Sepsis, Unspecned $209,786 $59,786 Glalmant12 A Bradycardl a, Unspeohled $186,362 $36,362 Glalmant 13 B Sing le Llveborn Infant, Delivered VAglnally $182,969 $32,959 Glalmant 14 A Crohn's Disease Of Both Small And Large Intestine Wlthoul Complications $129,680 $0 Glalmant 15 B Polyp Of Corpus Uteri $127,805 $0 Claimant 16 A Post -term Pre.nanc $122705 $0 Total 16 Claimants Over $100 2 390 $1 972 200 **Amount above reflect medical costs only. Pharmacy costs not paid under the medical benefit are excluded. CORPORATE SYNERGIES 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 158 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Terminology Actual as %of Expected Admin Expense ABC Corp Terms and Conditions Total Plan Costs En bed by Expected Total Costs The Charge to Administer Your Plan Definition Dental Claims Pad Dental Claims for that month Expected Claims Med/RX Expected Total Costs Your Projected Medical and RX Claims Set at Renewal Your Projected Total Costs Set at Renewal Large Claims Lasered Hlgh Claimant Medical Claims Paid Claimants with Pad Medical Claims Over $100,000 An Indidual with a stop loss level different from the plan stop loss level Medical Claims for that month Minimum Attachment Point * The minimum attachment point for the current contract year Is the greater of (1) the sum of each month's number of employees multiplied by the Monthly Deductible Factor(s) or (2) the Mlnlmum Attachment Pent. RX Claims Paid RX Claims for that month Stop Loss Charges Stop Loss Recoverables The Charge for Catastrophic Claim Proiecilon Antic) pated Stop Loss Reimbursement Total Fixed Total Plan Costs Admin Expense and Stop Loss Charges Medical, Rx Claims, Admin and Stop Loss Chaes Administration and Stopr.Loss Costs Administration Rx Admin Fee Indluidual Stop Loss Rate (EE) Aggregate SL Rate (EE) Consulting Fee $40 50 $3.65 $152.03 $5 10 $21 38 PEPM PMPM PEPM PEPM PEPM Terms & Conditions CORPORATE SYNERGIES 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 159 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Our in-house BenefitsVlP experts deliver the gold standard of employee advocacy and support. Our advocates are personally involved in the employer's benefits program through direct contact with plan participants. Once contacted with an inquiry or issue, the advocate remains involved through the resolution. BenefitsVlP is a Different Kind of Support Center We assign each client to a dedicated BenefitsVlP team of six to eight highly specialized customer service/insurance experts. Our advocates serve as a first -to -call resource for each line of insurance coverage, drawing upon an average of 21 years of industry experience to provide compassionate, accurate resolution. The measurement of BenefitsVlP's success is the employee's peace of mind. BenefitsVlP advocates: ■ Successfully resolve 88% of inquiries within 24 hours ■ Maintain direct access to carrier and provider decision -makers for swift resolution ■ Protect the employer's ROI by turning each participant interaction into an opportunity to guide appropriate utilization through "coachable moments" ■ Ease benefits administration burdens on HR staff BenefitsVlP also captures and analyzes ongoing utilization data to shape employer strategies that guide long-range corporate benefit planning. of inquiries to BenefitsVlP are resolved within 24 hours of inquirieF are resolved with the first contact to BenefitsVlP $$FOUNDATION RISK PARTNERS PUBLIC ENTITY SERVICES 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 160 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Your insurance subscriber help desk [BenefitsVlP] is the best I've experienced. HR Department Director Foundation Risk Partners BenefitsVlP Participant and HR Advocacy and Support Center Our BenefitsVlP advocates guide plan participants duringannual enrollment and throughout the year via phone, fax, email and chat. General Inquires/Plan Utilization BenefitsVlP advocates: • Resolve benefit and claims problems, explaining the reason behind the issue to prevent it from reoccurring • Respond to coverage, service and eligibility questions, including dependent verifications • Locate participating physicians • Assist with pre -certification issues for medical procedures and prescriptions • Provide general support (ID card replacement, benefits information, etc.) • Assist with coordination of benefits inquiries/issues • Deliver ongoingcoachable moments Public Entity Services We take a full view of the insurance landscape, study it from every angle, pursue innovation where none exists, and transform this deeper understanding into actionable strategies to protect our clients and their participants. Monitoring and Reporting The client receives a quarterly BenefitsVlP Analysis, which reports on the following metrics: • Case summaries: average resolution time; estimated productivity savings (hours and cost); number and type of cases handled • The top three service types ■ Contact initiation and type • Claim types • Resource support delivered (i.e. ID cards, portal assistance, provider search, etc.) • Service case tracking • Factors driving contacts to the support center Benefit Plan Troubleshooting BenefitsVlP advocates: ■ Identify and resolve carrier/provider errors that threaten widespread program disruption For more information, contact Alex Doberstein, 386.999-0001 Foundation Rlsk Partners isa national insurance and employee benefits broker age and consultancy that delivers strategies to control costsrelieve adinlnlstiative burdens and mitigate nal: With Offices in Daytona Beach and Orlando, Florida r. la alcc ..Y,,7919 NOTE Tr, s nol Ir o o 6,1 1 ,1, 11 ,oull 1 6,1 rC hr,,.ry r.,,ubjea to a^ aclonnal brokaage and,.a s 780 W. Granada Blvd. Ormond Beach, FL 32174 17LZZ£ 1: `Peas puouu0 •pn18 epeuea9 'M 08L BenefitsVlP Analysis Report Benefits I P Hetp starts here- Page 1 of 30 1 Confidential and Proprietary Sample Client -1000 Lives January 2018 - December 2018 T I-, 00 l0 01 00 m 3 0 rD co z rD 0 01) c N tD fD N 0 3 53JI/1d3S A111N3 DIN rid 17LZZ£ 1: `Peas puouu0 •pn18 epeuea9 'M 08L NOI1VONf1Od Sample Client -1000 Lives January 2018 through December 2018 Introduction BenefitsVlP Your BenefitsVlP®Tea m takes great pride and satisfaction in providing advocacy and assistance to your organization anderr ployees, Our goal is to deliver exceptional support while we improve user experience, promote proper plan utilization, and help control employer and employee benefit costs. Through personal and ongoing contact with you and your employees, BenefitsVI identifies, tracks and reports benefit inquiries, activities and issues. We compile this information in a BenefitsVl i Analysis Report, which provides valuable data on emerging service trends, benchmar4a ng, HR/employee usage, productivity savings calculations, and average resolution time. We are pleased to provide your BenefitsVI Analysis report and appreciate your business Page 2of 30 I Confidential and Proprietary Sincerely, Grace Cempagne r rreczor, 8eRefrrs/P T N 00 0 oo m 3 O rD rD W rD rD 0 y c rr S. DQ rD A rD N rt 0 3 17LZZ£ 1: `Peas puouu0 53JI/1d3S A111N3 DIN rid •pn18 epeuea9 'M 08L N O I1VG N I~1 Od Sample Client -1000 Lives BenefitsVIP Ip sort: Executive Summary Below is a quick snapshot of the total case review and top three service types for this reporting period. Total Case Review 75 Total numherofemployees 1,026 Total oases 497 Average resolution time {in days) 4.66 Employer hours smell 34.0 Employee hourssaved 414.2 Total Hours saved 499.1 Observations ID cards Page 3 of 30 I Confidential and Proprietary Confirmation Portal assistance T N 00 0 00 m 3 O rD rD W rD z rD rr 0 y c rr fD rD N rt 0 3 53JI/1d3S A111N3 DIN rid 17LZZ£ 1: `Peas puouu0 •pn18 epeuea9 'M 08L Sample Client -1000 Lives January 2018 through December 2010 Who's asking? Listed blow are who contacts your BenefitsVIP®team compared to all Corporate Synergiesclients, clients of li Ive industry and clients of like size. 0 Inquirer Numher Yaur iJI dlerrts if IJIm dents of of Oasis 0rganhaten dents Indesty LIka tlae Employee Spouse/Dependent Employer Other 448 95.996 91.646 91.0% 98.9% 3 0.6% 1.7% 2.0% 1.3% 13 2.83 4.8% 5.196 9.396 3 0.696 1.896 1.9% 1.3% Emp ogee Cases By Inquirer Total: 467 Spouse/Dependent Employer Other BenefitsVlP Help surfs ticre. ▪ Your Organization IM Clients of Like Industry ▪ All Clients Clients of Like Size Page 4 of 30 Confidential and Proprietary 53JI/1d3S A111N3 DIN rid 17LZZ£ 1: `Peas puouu0 •pn18 epeuea9 'M 08L NOI1VONfOd Sample Client -1000 Lives January 2018 through December 2018 How are we being contacted? BenefitsVIP Listed below is how your BenefitsVIF+: team is being contacted compared to all Corporate Synergies clients, clients of like industry and clients of like size. Number Your ,WI Wards of LlIas dots of Origin of Coon OriknI FFIen dints Industry Lim SIN Phone 408 86.3% 71.7% 72.2% 72.5% Email 52 11.145 26.445 25.8% 25.645 Other 12 2.6% 1.4% 1.9s06 1.5% Phone Cases By Origin Total: 467 Help garts h<rr Email 'ther Page 5of 30l Confidential and Proprietary Your Organization • Clients of Like Industry All Clients Clients of Like Sze 70 T I-, Co l0 C1 W CD m 3 13 0 rD rD W z m 0 S. 011 rD A rD N 53JI/1d3S A111N3 DIN rid 17LZZ£ 1: `Peas puouu0 •pn18 epeuea9 'M 08L NOI1VONfOd Sample Client -1000 Lives January 2018 through December 2018 How do the tasks compare? B nefitsVIP The data below reflects the cases handled for your organization by general inquiries, activities performed, and issues resolved compared to all "orporate Synergies clients, clientsof Ii lie industry and d ients of like size, Number Yaur All d arrts of lllas cleats of case Teak of Oases 0rgenlrratlen dlents Indrrstgr Lim Slim Inquiry 408 86.3% 68.1% 76.1% 68.4% Activity 51 10.9% 26.2% 19.6% 26.9% Issue 13 2.3% 5.7% 4.3% 4.7% Total: 467' 100 80 60 40 20 Inquiry Inquiry is a question or clarification. Activity is a transaction or deed that requires action. Issue is a problem or concern. "This total may,te Tess than other case totals as "task" is not desnated untrl a case is actua#y closed. Cases By Task Activity Page 6 of 301 Confidential and Proprietary Issue Your Organization Clients of Like Industry All Clients CLients of Like Size 7O T 00 rn w 00 rn m 3 0 rD rD co z rD r7 0 S. rn rr N rD rD N r) rt 0 3 53JI/1d3S A111N3 DIN rid 17LZZ£ 1: `Peas puouu0 •pn18 epeuea9 'M 08L NOI1VONf1Od Sample Client - i000 Lives January 2018 through December 2018 For what are we being contacted? BenefitsVll The data below reflects the types of cases being handled for your organization compared to all Corporate Synergestile rrts, dients of like industry and clients of like size. 100 00 60 40 20 0 Cap 1yp Number Yaur All dents if Ilia dents of of Oases 0rganlaetien dents Industry Liza Sloe Benefits Administration Claim s Coverage Resource Support Non -Health &Welfare 101 21.60 40.3% 26.4% 46.9% 18 3.9% 9.6% 8.3% 5.9% 107 22.996 16.196 21.496 12.4% 197 42.296 26.996 39.3% 25.7% 44 9.4% 7.2% 4.6% 9.1% Benefits Administration Cases By Type Total: 467 Claims Coverage Resource Support Non -Health & Heip starts ,here. ■ Your Organization El Clients of Like Industry ▪ AttCtients Clients of Like Size Page 7 of 30 l Confidential and Proprietary T I-, 00 l0 C1 00 m 3 0 fD fD 0 fD rD f7 0 y rr S. fD A fD N 53JI/1d3S A111N3 DIN rid 17LZZ£ 1: `Peas puouu0 •pn18 epeuea9 'M 08L NOI1VONf1Od Sample January Pareto Also referred Analysis Pareto Client -1000 Lives 2018 through December 2018 Analysis: to as the 80/20 ratio or the Pareto Principle which states that 80%of the volume (cases) comesfrom 20%of the causes, A Pareto helps us to quickly identify the 'Vital few" that we should focus on, as opposed to the "interesting many." BenefitsVIP Help starts sere. tan ;pP,6 ure ,n I.:1 07 1 0.7 44 1 a I Resource Support Analysis Coverage Benefits Administration Non -Health & Welfare Page 8of 30 I Confidential and Proprietary Claims T T) I-, 00 lO C1 00 m 3 O fD fD W fD fD rr 0 S. 0-11 c rr fD A fD N 17LZZ£ 1: `Peas puouu0 53J1/1d3S,1111N3DIN rid •pn18 epeuea9 'M 08L I1 0 c v 0 Z Sample Client -1000 Lives January 2018 through December 2018 Resource Support BenefitsVIR 1009E 9096 BO% 7096 ® 13096. 5a% au 96 s 3096 20% - - 51 1096 — �. 18 12 1. 5 1 r '--® 4 ash IC ;;s•rs Fetal assistance Open Enrollment- auelified life event Pra,ndEr search Genetal c mpliance Fulfillment Payroll Deductions General Pareto Analysis Page 9of 301 Confidential and Proprietary 70 T 00 0 ab m 3 0 co z n O z CA c rr arcs fD A fD N 53J!Ad3S A111N3 DIN rid 17LZZ£ 1: `Peas puouu0 •pn18 epeuea9 'M 08L NOI1VONf1Od Sample Client -1000 Lives January 2018 through December 2018 Coverage ■--■ o ■ • 'A ° ■ ■ ■ ■ ° la ■ ■ ■ 42 4 11 4 1 r Ari r 1 r r1 r r r' mlr i .---0—_ .---0--. .--4._ ,--_ 9 7 1 6 11 �y,$'1 g8'g`� < „psi .COY y -�q�' UST,rg�`!' 'vr LSD` `V'� c, °areto Analysis Page 10 of 30 I Confidential and Proprietary BenefitsVlP 100 % 90% $l% 70% BO% 50% 4046 30% 20 % 10% 0% rt 0 3 'MIZE 1: `Peas puouu0 53JI/1d3S A111N3 DIN rid •pn19 epeueag •M 08L b CM? CD J NOIlVONflO Sample Client -1000 Lives January 2018 through December2O18 O rto TpOdtet-- MAatmrm L11115-1 Cost EixcmEtutlt—I o lrsr ar x o NJ —Detlr{TGe r..ilatbe mix 3 3 Prmar/me u611J Office visit P lys tbit roc.. t Pareto Analysis Outpatient surgery • M ajor services Page 11 of 30 I Confidential and Proprietary Epecls lV MI gs Petrmtlb0rtl do gi 2 BenefitsVIP en: rktl rigs 0-0 Malortlertlng��' Pharmacy Payment IAe r�ltK lai b of lean Mental1eahh, behavioral health, substance abuse Healthcare FSA R !p tans'IL', T N 00 to 00 rn m 3 O 03 z rD f1 0 to c rr S. N fD fD N rt 0 3 53JI/1d3S A111N3 DIN rid 17LZZ£ 1: `Peas puouu0 •pn18 epeuea9 'M 08L NOI1VONf1Od Sample Client -1000 Lives January 2018 through December 2018 Benefits Administration BenefitsVIP fc'fl . 9D% 00' 70% . E0% - ED% —,41.1% — 60 — 3 30%. 20% 32 10% 5 ®— 1 1 1 1 0% Confirmation System Navigation Enrollment entry PassworcliLogii Notices Data ocaaction Process LifenNortt assistance events Pareto Analysis Page 12 of 30 I Confidential and Proprietary 7a T F, 00 CD W 00 m 3 O rD fD co O fD rr 0 rn c rr S. 011 rD fD N rt 0 3 Sample Client -1000 Lives January 2018 through December 2018 Data GpnN Mask Orin OEM Owings B nefitsVlP Heip dart$ Vrer- Dot. (kaolin. twin ?o 00114 2018-01-02 Inquiry Employee CIGNA Medical Resource Support IDcards 2018-01-02 2C18-01-02 Inquiry Employee CIGNA Medical Resource Support IDcards 2C18-01-02 2C18-01-02 Inquiry Employee System Administration Benefits Administration Confirmation 2C18-01-02 2C18-01-02 Inquiry Employee CIGNA Medical Coverage Pharmacy 2C18-01-02 2C18-01-03 Inquiry Employee UnitedHealthcare Benefit Services Union Resource Support IDcards 2C18-01-03 2Q18-01-03 Inquiry Employee CIGNA Medical Co4erage Mental Health, hehavioralhealth, substa 2C18-01-03 2Q18-01-03 Inquiry Employee UnitedHealthcare Benefit Services Union Co4erage Cost 2C18-01-03 2Q18-01-03 Inquiry Employee CIGNA Medical Coverage Health/Ftnessprograms 2C18-01-05 20t18-01-05 Inquiry Employee System Administration BenefitsAdministration Confirmation 2018-01-05 2018-01-05 Inquiry Employee System Administration Benefits Administration Confirmation 2018-01-05 2018-01-05 Inquiry Employee CIGNA Medical Resource Support IDcards 2018-01-05 2018-01-05 Inquiry Employee CIGNA Medical Resource Support IDcards 2018-01-05 2018-01-05 Activity Employee CIGNA Medical Resource Support IDcards 2018-01-05 2018-01-05 Inquiry Employer CIGNA Medical Co4erage Cost 2018-01-09 2018-01-05 Inquiry Employee No Associated Coverage Nan -Health& Welfare Career hquiry 2018-01-08 2018-01-05 Inquiry Employee CIGNA Medical Coverage Cost 2018-01-05 2018-01-05 Inquiry Employer No Associated Coverage Non -Health& Welfare Career hquiry 2018-01-05 2018-01-08 Inquiry Employee UnitedHealthcare Benefit Services U(sion Benefits Administration Password/Loginassistance 2018-01-08 2018-01-08 Inquiry Employee CIGNA Medical Benefits Administration Confirmation 2018-01-08 2018-01-08 Inquiry Employee CIGNA Medical Resource Support IDcards 2018-01-08 2018-01-08 Inquiry Employee MetLife ho Dental Benefits Administration Confirmation 2018-01-08 2018-01-08 Inquiry Employer CIGNA Medical Coverage Cost 2018-01-09 2Q1.8-01-08 Inquiry Employee HSA Bank Medical Benefits Administration Confirmation 2Q1.8-01-09 2Q18-01-09 Inquiry Employee CIGNA Medical Resource Support IDcards 2Q18-01-09 2Q18-01-09 Inquiry Employee HSA Bank Medical Coverage Cost 2Q18-01-09 2Q18-01-10 Inquiry Employee CIGNA Medical Claims Office visit 2Q18-01-22 2Q18-01-10 Inquiry Employee HSA Bank Medical ResourceSJpport IDcards 2Q18-01-17 2Q18-01-11 Inquiry Employee Na Associated Coverage System Administration Benefits Administration Confirmation 20118-01-11 Service Case Tracking Page 13of 30I Confidential and Proprietary T T) I-, 00 l0 W 00 m 3 0 fD fD W fD fD 0 S. 01) i rF N fD A fD N rt 0 3 17LZZ£ 1: `Peas puouu0 •pn18 epeuea9 'M 08L ABC COMPANY ,FOUNDATION ♦ RISK PARTNEF PUBLIC ENTITY SERVICES 53JI/1d3S A111N3 DIN rid NOI1VONf1Od A ROADMAP for SUCCESS 9 T I-, 00 l0 C1 W 00 m 3 O W rr O y c rr S. 0'0 (D A (D N 17LZZ£ 1: `Peas puouu0 53JI/1d3S A111N3 Dllg rid •pn18 epeuea9 'M 08L NOI1VONf1OI Align employee benefit program with corporate mission to ensure quality healthcare and wellness programs and extend this to the employee population Offer a competitive employee benefits program to positively impact recruitment and retention Review current program to determine where gaps in coverage may exist, and achieve the greatest value from dollars spent Understand Cost !Drivers of the healthcare plan ABC COMPANY VALUES Make a Difference Help ifimug8 the difficult times in their lives. Make the pro cesseasy. Belong Familyfriendlycu)ture. Grow Opportunity to make en impact. ABC COMPANY POPULATION 612 employees/1336 members Higher female to male ratio (84.9% employees female, 59.4%„ members female) Average employee age is 50.6/ Average member age is 37.0 Millemials (1981.1997) 19.8% Gen X (1965-1980) 39.9% Baby Boomers (1946-1964) 39.3% Silent Generation (Before 1945) 1.6% 70.3% Participate in Core Plan 55.9% Elect Family Coverage r 2 T I-, 00 0 tT 00 m 3 0 W z iD 0 to c fD fD N 17LZZ£ 1: `Peas puouu0 53JI/1d3S A111N3 DIN rid •pn18 epeuea9 'M 08L NOI1VONf1OI Q NOTES 9 SETTING the STRATEGY COST DRIVERS Total Claim Spend for 2018: $9,675,452 96.5% Loss Ratio after removal of claims over the $200,000 pooling level Employer Claim Cost Share 92.9% 2018 Catastrophic claims data - 24 large claims over $50,000 which total $3,302,691 (34.1% of total claims) - Three claims in excess of the $200,000 pooling level - $538,163 — Sepsis - $532,077 — Musculoskeletal - $380,479— Multiple Myeloma - Four "Morbid Obesity" claims totaling $248,064 74 Hospital Admissions account for 35.7% of total medical spend Pharmacy accounts for 16.7% of Medical Spend (Benchmark between 18% - 20%) - $1,616,294 Total Pharmacy Spend - Average Script per Member: 9.5 scripts - Generic Utilization: 87.1% Emergency Room Utilization - 255 Visits to ER (Benchmark 250 Visits) - Average Cost per Visit. $1,209 (Dr. Office $92) - Average Cost per Member: $315.00 - Percent of Medical Spend: 6.6% $0 Employee Contribution for Core plan (98th percentile) PO 17LZZ£ 1: `Peas puouu0 53JI/1d3S A1LL •pn18 epeuea9 'M 08L Ae CD J 00 Q THREE YEAR STRATEGIC ROADMAP 2019 (CURRENT) Implement cost share for Core Plan Add HMV with either HSA, HRA and deductible cost share Increase Specialist, Urgent Care and Rx co -pays to benchmark norrns on Care EPO plan Explore the feasibility of carving out prescription drug program • Allowing employees to obtain certain medications at ABC COMPANY in-house pharmacy at a lower cost Employee to still have option to use Retail Rx as well as Mail Order at higher co -pays. Specialty to remain with Rx vendor Quarterly review of healthcare experience to address cost drivers Quarterly review of BenefitsVlP utilization data to address cost drivers and gaps Review option of moving to alternate funding arrangements (Self Insured/Minimum Premium) for Medical and Derrlal in order to gain cash flow and lower carrier margins Market Medical and Dental programs Market Life and Disability inclusive of Leave Administration Educate employees on discretionary health services: • Urgent Care Facility vs. Emergency Room • Telemedicine vs. Primary Care or Emergency Room • Advanced Imaging Services - Free Standing Facility vs. Hospital Based Focus on integrated care model (Medical, Rx Dental, Vision, & LTD) Review Cadillac Tax implications, in the event it is enacted YEAR 1(2020) Implement employee cost sham on Core EPO plan and continue to review and redesign current contributions Explore the feasibility of carving out prescription d rug program (if applicable) . Altowing employeesto obtain certain medications at ABC COMPANY in-house pharmacy at a lower cast Employee lc still have option to use Retail Rx as well as Mail Order at higher co -pays. Specialty to remain with Rx vendor If Self -Funded Begin to review the claims in greater detail In order to begin to determine cost drivers that can be impacted by design change (Data Warehouse) Explore Captive Stop Loss Options Dave members to Mrcm Networks with Tower Dr. Co.pays as incentive Explore `Reference Rased Pricing" Conduct employee focus group to determine employee needs/wants Review current voluntary program to ensure h aligns with employee needs Conduct dependent eligibility audit to ensure that all dependents en plan are truly eligible Quarterly review of healthcare experience to address cost drivers Quarterly review of BenetitsVlP utilization data to address cost drivers and gaps Continue to educate employees on discretionary health serrvices: Urgent Cure Facility vs. Emergency Room Telemedidne vs. Primary Care or Emergency Room • Advanced Imaging Services - Free Standing Facility vs. Hospital Based Focus on integrated care model (Medical, Fly, Dental, Vision, & LTD) Review Cadillac Tax implications. in the event it is enacted 4 How do we drive down claim costs? Focus on what providers can do to help manage claim costs Health Coaching ACO Opuory Nest Network Disease MGMT EncluniteACC Engagement Level Me&ral Tourism Centers of EnrFJenre How do we drive down claim costs? Maximize the way the plan works to avoid & lower costs Souxis Surcharge Cep_ Audit Speelnityy Rx Ter ReferenceBssed Pricing limited Rx Network HY Renew RxExclusions Mnandatwy Generic Rn Rx Step Therapy ✓n 0 Ha 3 17LZZ£ 1: `Peas puouu0 •pn18 epeuea9 'M 08L 9 CREATING STRATEGIC HARMONY Disruption vs- Value (Prioritizing beyond the deductible) 10 Not Happening Pray No way s scaleble Dads Pope Wipe" Disnai®Takrxe How do we drive down claim costs? Focus on making employees better consumers of healthcare A 1 :�fJb.l�irlgi D-0HP PCP Incontoie Teiernedi it Engagement Level,- Advocacy Cand ge TTsgapgrency 5¢lahetpWP ra 12 YEAR 2 (2021) YEAR 3 (2022) Continue to review and redesign current contributions Perform Annual Reconciliation of Carve -Out Rx program Implement smoker surcharge (this would need to be in conjunction with a smoking cessation program) If Self -Funded conduct Medical Claim Audit in order to ensure claims are being paid properly. Quarterly review of healthcare experience to address cost drivers Quarterly review of BenefitsVIP utilization data to address cost drivers and gaps Continue to educate employees on discretionary health services. This becomes even more important if a HUHP is implemented: • Urgent Care Facility vs. Emergency Room • Telemedicine vs. Primary Care or Emergency Room • Advanced Imaging Services - Free Standing Facility vs. Hospital Based Facility Continue to review data to determine cost drivers to look for other cost management options Focus on integrated care model (Medical. Rx, Dental, Vision, & LTD) Review Cadillac Tax implications, in the event it is enacted Perform Annual Reconciliation of Carve -Out Rx program Continue to utilize biometrics as a gateway to lower contributions and H.S.A. ern ployer funding. Quarterly review of healthcare experience to address cost drivers Quarterly review of BenefitsVlP utilization data to address cost drivers and gaps Continue to educate employees on discretionary health services. This becomes even more important it a HUHP is implemented: • Urgent Care Facility vs. Emergency Room Telemedidide vs. Primary Care or Emergency Room - Advanced Imaging Services - Free Standing Facility vs. Hospital Based Focdtily Continue to review data to determine cost drivers to look for Wirer rust management options Focus on integrated care model (Medical. Re, Dental, Vision. & LTD) Review Cadillac Tax implications, in the event it is enacted TI 00 0 C1 /w 00 Ol m 3 0 W 0 r"F 0 y 0 r"F t'D (D N n 0 3 53JI/1d3S A111N3 DIN rid 17LZZ£ 1: `Peas puouu0 •pn18 epeuea9 'M 08L AT CtQ CD 00 Q THREE YEAR STRATEGIC ROADMAP tze 2019 (CURRENT) Provide more choices that align with ABC COMPANY'S population Add a Minimal Contribution to Current Core EPO plan. • Example 1: $5.00 PEPP = $56,000 • Example 2: $10.00 PEPP= $112,000 Add substitute H BHP as Core plan • Zero contribution with deductible cost share Minimal contribution with deductible cost share Explore changes to Medical and Dental contribution structure - Core/Buy up . Salary Based Tier Contribution Structure • 4 Tier Contni buticn Structure Compare contributions and structure to industry benchmarks Use Alex tJell;Nision for onboarding consistency Use carrier decision support tools and cost estimation calculators to drive lowest cost with best outcomes YEAR 1(2020) Continue to review data to determine what changes need to be made to employee cost to manage overall cost of plan while remaining competitive Continue to review medical plan options and employee contribution strategies Introduce concept of tobacco cessation program Compare contributions and structure to industry benchmarks Quarterly review of healthcare experience to address cost. drivers Quartery review of BenehtoviP utilization data to address cost drivers and gaps Migrate population to HDHP through plan design and contributions Continue te use AlexflelyVision for onboarding consistency Use carrier decision support tools and cost estimation calculators to drive lowest cost with best outcomes 6 YEAR 2 (2021) YEAR 3 (2022) Continue to streamline administration and increase productivity Continue to streamline administration and increase productivity 11 -11 N 00 t.0 01 W 00 c m 3 O CD CD 07 CD z CD rr 0 to c rl• 04 CD A CD fA 53JI/1d3S A111N3 DIN rid 17LZZ£ 1: `Peas puouu0 •pn18 epeuea9 'M 08L b Ae v4 CD 00 NOI1VONf1Od Q THREE YEAR STRATEGIC ROADMAP VIVLI qMIN G72 2019 (CURRENT) Revisit technology goals that: 1. Mitigate risk (eliminate manual interventions), 2.Educate and empower employees (improve self service and communications), 3.Improve access to data (reporting). and 4.Streamline administration (dependent verification and life event, single sigrr-on) Define solution that seamlessly integrates with any Human Capital Management System. Solution should also have ability to minnectwilh all vendor partners Coordinate f unding through canter partners To mitigate a majority or all benefit administration technology costs (voluntary benefits) Implement technology to continue to streamline administration and increase productivity YEAR 2 (2021) YEAR 3 (2022) Continue to review medical plan options and employee contribution strategies Implement tobacco cessation program Continue to review data to determine what changes need to be made to employee cast to manage overall cost of pion while remaining competitive Compare contributions and structure to industry benchmarks Quavery review of healthcare experience to address cost drivers Quarterly review of BenefnsVtP utilization data to address cast drivers and gaps Migrate population to HDHP through plan design and contributions Continue to use Alei/JellyVision for onboarding consistency Use carrier decision support tools and cost estimation calculators to drive lowest cost with best outcomes Make contributions contingent upon tobacco cessation program engagement Continue to review data to determine what changes need to be made to employee cost to manage overall cost of plan while remainingcompetltfve Compare contributions and structure to industry benchmarks Quarterly review of healthcare experience to address cost drivers Quarterly review of BenefitsVlP utilization data to address cost drivers and gaps Migrate population to HDHP Through plan design and contributions Continue to use Alex/JellyVision for onboard ing consistency Use carrier decision support tools and cost estimation calculators to drive lowest cost with best outcomes TI I-, 00 t.0 C1 00 m 3 0 W z rD 0 to c 3 OQ fD fD to 17LZZ£ 1: `Peas puouu0 53J!Ad3S A111N3 DIN rid •pn18 epeuea9 'M 08L NOI1VONf1Od Q THREE YEAR STRATEGIC ROADMAP 2019 (CURRENT) WELLNESS BUDGET ($25,000: Emblem) January Lund ing renewal Map out spending for the remainder of the year METRIC -BEARING ACTIVITY Biemetric screenings ,Health Risk Assessments, Challenges. If not completed, employee will be assessed a contribution surcharge WELLNESS Annual activity challenge Barnett Screening; (90% participation) Health fair Flu shots Weight Watchers. STRATEGY Introduce Corporate Synergies' Director of Wellness Review key metrics driving healthcare casts and impacting productivity (VOI and RO1) Review key metrics that can be provided by Emblem and tracked and compared year -over -year Perform an employee survey for additional insght into the poputtions needs and interests INCENTIVES Giveaways (e.g., health fair and biome -Mc screenings and activity challenge) CONSUMERISM Create an annual communivation calendar through Corporate Synergies` Director of Employee Education & Communication Leverage Emblem communications Education Use Alea/JellyVision for on boarding consistency Use carrier decision support tools and cost estimation calculators to drive lowest cost with best outcomes YEAR 1(2020) WELLNESS PLATFORM Consider an exploratory REP for Mini -party wellness partners WELLNESS BUDGET (At least $25,000: Emblem/New Cartier) January funding renewal Make decisions about spending that will entrance and drive participant's engagements with their health and wellbeing METRIC -BEARING ACTIVITY Biometric screenings ,Health Risk Assessments, Challenges. If not completed, employee will be assessed a contribution Surcharge WELLNESS Annual activity challenge Biometric Screenings (96% participation) Health fair Ftu shots Weight Watchers• Conitinuousfy explore financial and emotional wellness programs STRATEGY Consider establishinga wellness committee and identifying internal wellness advocates Identify key metrics driving healthcare costs end impacting Productivity (VO1 and ROI) Identify key metrics that can be provided by ABC COMPANY arid hacked and compared year -over -year Define the most effective channels of choice to communicate with participants INCENTIVES Giveaways (e.g, health fair and biornetric screenings and activity challenge) Ensure that incentives are tied directly into promoting health lifestyle choices CONSUMERISM Leverage Emblem/Vendorcommunications Revisit the communication strategy and make adjustments based on wellness program goals and objectives TOBACCO CESSATION Establish a tobacco strategy starting with awareness 8 YEAR 2 (2021) YEAR 3 (2022) WELLNESS PLATFORM Continue with existing wellness platform WELLNESS BUDGET (Al least $25,000: Current Vendor) September funding renewal Make decisions about spendingthat will enhance and drive participant's engagements with their hearth and well-being METRIC -BEARING ACTIVITY Diametric screenings, Health Risk Assessments, Challenges If not completed, employee will be assessed a contribution Surcharge WELLNESS Annual activity challenge Biometric Screenings (90% participation) Health fair Flu shots Weight Watchers• Explore financial and emotional wellness programs Explore community arrei charity engagement opportunities STRATEGY Review key metrics driving healthcare costs and impacting productivity 5/O1 and ROI) Review key metrics that can be provided by Vendor and tracked and compared year -over -year Employee survey INCENTIVES Giveaways (e.g., health fair and biometrie screenings and activity challenge) Ensure that incentives are tied directly into promoting health lifestyle choices Consider integrating incentives with premium casts CONSUMERISM Leverage Vendor communications Revisit the communication strategy and make adjustments based on wellness program goats and objectives TOBACCO CESSATION Transition into a tobacco cessation program Consider integrating an incentive for being tobacco -free WELLNESS PLATFORM Perform an exporatory REP for third -party wellness partners WELLNESS BUDGET (At least $25.000: Current Vendor) September funding renewal Make decisions about spending that will enhance and drive participant's engagements with their health and well-being METRIC -BEARING ACTIVITY Biometric screen ings,Health Risk Assessments. Challenges. If not completed. ern ptoyee will be assessed a contribution Surcharge WELLNESS Annual activity challenge Biometric Screenings (50% participation) Health fair Flu shots weight Watchers. Explore financial and emotional wellness programs Explore community and charity engagement opportunities STRATEGY Review key metrics driving healthcare costs and impacting productivity (VOI and RO1) Review key metrics that can he provided by Vendor and tracked and compared year -over -year Employee survey INCENTIVES Giveaways (e.g., health fair and biametric screenings and activity challenge) Ensure that incentives are tied directly into promoting health Iffestyfe chokes Consider integrating incentives with premium costs Consider a tobacco surcharge CONSUMERISM Leverage Wellness Vendor communications Revisit the communication strategy and make adjustments based on wellness program goals and objectives feigning with the i0B's BCSA) TOBACCO CESSATION Monitor tobacco cessation program 9 TI N 00 l0 C1 W 00 m 3 0 2< co 0 rF 0 to c rr fD (D to City of Miami RFP #1896386 — Employee Benefit Consulting Services Overviews 3/1/21 Prepared for: Demo This report and its contents are the confidential and proprietary information of Innovu, LLC. No disclosure or use of Lhese materials may be made wi LhouL Lhe express wriLLen consent of Innovu, LLC. Compare Measure Collect Implement Frame Target innovu 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 183 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Demo Executive Overview Current Period: Jan 20 - Dec 20 Previous Period: Jan 19 - Dec 19 (Paid) Enrollment •-2/0 599 Members Subscribers 381 ♦ -4% Total Spend Vs, Budget $1 M Medical Spend Cost Per Month Risk Score High Cost Claimants 5 Members ` $945.6K ifs $473 $743 it Net Spend • Budget sa,. ra 54.251 $2M $3M $4M $5M Pharmacy Spend Financial ♦.6% 6.3 MOM $445.6KSL Reimb. ♦ -52% S1 OOK Threshold Potential Savings Opportunities Pharmacy $123K Medical $71 K This report and its contents are the confidential and proprietary information of Innovu, LLC. No disclosure or use of these materials may be made without the express written consent of Innovu, LLC. ►,, innovu 2 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 184 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Demo Cost Per Month Overview Current Period: Previous Period: Jan 20 - Dec 20 Jan 19 - Dec 19 (Paid) Cost Per Month 2 2 2 • w a Total $473 ♦ -,9°-, $743 ♦ -18-, PMPM by Relationship Enrollment Medical Rx Self $352 $120 j $408 ♦ -25°�0 ♦ , �. ISM ..' 3' Spouse Child $554 $189 $721 $496 V -23 '0 t-SO', ♦+155' 599 Members Subscribers 381 PEPM / PMPM History Chronic Conditions PMPM Diaoetes i PMPM • PEPM �, aao— Hypertensic,; s',oss �''� S560— 1,QSJl ♦ -24 r 1 1 1 i 1 I s Jan Asthma $862 Heart FT $1,99t A +34% This report and its contents are the confidential and proprietary information of Innovu, LLC. No disclosure or use of these materials may be made without the express written consent of Innovu, LLC. ►,, innovu 3 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 185 4FNDATI(7N PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Demo Enrollment Overview Current Period: Previous Period: Jan 20 - Dec 20 Jan 19 - Dec 19 (Paid) Enrollment 599 Members Subscribers 381 ♦ -4?r, Member Distribution Member Ratio Member Demographics Average Age Self fir 1.6 ♦.2Y Member Count 59 ■59- 118 R118 - 177 ■ 177 - 236 ■>_ 236 Male 297 Female 302 Enrollment By Month • 46.9 o ♦ Spouse Child 50.2 15.6 Members • Subscribers This report and its contents are the confidential and proprietary information of Innovu, LLC. No disclosure or use of these materials may be made without the express written consent of Innovu, LLC. *4 innovu 4 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 186 # FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Demo Financial Overview Current Period: Previous Period: Jan 20 - Dec 20 Jan 19 - Dec 19 (Paid) Total Spend Vs. Budget Spend Projection • Actual Budget ■ Net Spend $450k — $400k — $350k — $300k — $250k — "Mk 20 1 I -I 20 Mar May Jut Sep No Total Budget $3.6M • -15% Gross Claims -2s $2.5M Medical Total Net Spend $3 O. 1 A 7-14% �QQ ��9Y�i $500k — $400k — $300k — $200k — $100k — ■ Actual Budget Net Spend Projection "k I l l l l l l l l l l l l l l l l l t l l 2020 Mar May Jul 5ep Nov 2021 Mar May Jul Sep Paid to Allowed Ratio High Cost Claimants Employee--\ " 0.87 5 Members 19% �/Allowed '°" $945.6K • -so ;,, PaidMil $3.9M $3.4M Employer 2'1.1 Pharmacy $865.8K 81 % A +10% $445.6K SI- Relmb. Cost Share ♦-52 6,36116/1 This report and its contents are the confidential and proprietary information of Innovu, LLC. No disclosure or use of these materials may be made without the express written consent of Innovu, LLC. *4 innovu 5 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 187 # FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Demo High Cost Claimants Overview Current Period: Jan 20 - Dec 20 Previous Period: Jan 19 - Dec 19 (Paid) Top High Cost Claimants Current Previous Age Gender Relation Primary Diagnosis Enrolled Risk Medical Pharmacy Total Total 20 Female Child Unspecified kyphosis, thoracic region • 9.6 A $322,782 $925 $323,706 $1,879 56 Female Spouse Encounter for antineoplastic immunothe... • 10 A $181,656 $15,196 $196,852 $538,966 59 Female Self Encounter for antineoplaslic chemother.. • 10 4 $178,840 $6,268 $185,108 $252,789 0 Male Child Preterm newborn, gestational age 30 co... • 9 1 $130,528 $41 $130,570 $0 31 Female Self Immune lhrombocytopenicpurpure • 5.4A $109,287 $50 $109,337 $0 58 Female Self Chronic myeloid leuk, BCR/ABL-positive... • 9.8 4 $1,623 $96,093 $97,716 $73,144 57 Female Self Multiple sclerosis • 9.9 7 $900 $88,821 $89,721 $88,501 57 Female Self Calculus of gallbladder w acute cholec... • 9.7 A $76,437 $3,392 $7'9,830 $23,276 13 Male Child Autistic disorder • 9.8 A $2,275 $69,932 $72,207 $54,695 High Cost Claimants 5 Members • -34% $945.6K IMP $445.6KSL Reimb. Potential High Cost Claimants $90-99K $80-89K 1 $70-79K 2 $60-69K 2 $50-59K Members 550K Threshoid • .11 % 1 0 Members $679.6K 4 HCC by Relationship Child „n $454K 2 Members Spouse Self $197K $294K ♦ -75% ♦ -54>; 1 Members 2 Members This report and its contents are the confidential and proprietary information of Innovu, LLC. No disclosure or use of these materials may be made without the express written consent of Innovu, LLC. inn©vu® 6 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 188 FOUNDATION PUBLIC ENTITY SERVICES Employer 86% NML City of Miami RFP #1896386 — Employee Benefit Consulting Services Demo Medical Overview Current Period: Jan 20 - Dec 20 Previous Period: Jan 19 - Dec 19 (Paid) Cost Share Medical Paid Employee Paid 14°ro $2.5M •+3% Allowed $2.9M • -26% • -23 Claimants Claims 538 5,997 •-3% •-12% Claim Type Category Visits per 1,000 Outpatient Inpatient Emergency Inpatient 42% 35% Other Professional 23% 235 57 ♦-7% •+20% Vim,,, ✓�,,Jt Outpatient 1,129 ♦ -27% ER Utilization Visits Paid 141 $385K ♦-9% ♦-12% Network Status In -Network 100% Out -of - Network ♦ -B% Top Places of Service by Paid Amount Place of Service Claimants Total Paid Total % Inpatient Hospital 35 $983K 39% On Campus - Outpatient Hospital 244 $813.6K 32% Emergency Room - Hospital 113 $3249K 13% Office 454 $278.2K 11 % Ambulatory Surgical Center 17 $49.4K 2% Telehealth 111 $27.8K 1 % Independent Laboratory 229 $24K 1 % Urgent Care Facility 71 $11.3K e 1 % Home 39 $9,723 < 1 % This report and its contents are the confidential and proprietary information of Innovu, LLC. No disclosure or use of these materials may be made without the express written consent of Innovu, LLC. ►,, innovu 7 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 189 4FNDAT ION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Demo Pharmacy Overview Current Period: Previous Period: Jan 20 - Dec 20 Jan 19 - Dec 19 (Paid) Cost Share Pharmacy Paid Employee Paid 9t $865.8K •+1 Allowed $950K . -1 % Employer 91% Specialty Rx Claims Paid $320.8K ♦ -8 % 63% Total Paidlk_ Claimants Claims 412 5,311 ♦-6% ♦-11° 0 Maneoplastic Agents and Adiunctrva Therapies $105,765 Psychotherapeutic and Neurological Agents - Misuelleneuun $88,583 Other $126,451 31 Members 5% of Population Benchmark Paid PMPM Y. $120. Benchmark Paid per Quantity Generic 5137 Brand You A $.71 A $8.46 $.35 I $14.10 Brand vs. Generic i Dispensing Rate 81.1% Generic Brand $199.9K $664.7K ♦+13% ♦-4% Top Dnigs by Paid Amount Drug Name Specialty Claimants Total Paid Total Imatinib Mesylate 1 $96,093 11 % Tecfidera 1 $88,583 10% Trulicity 8 $63,134 7% Epidiolex • 1 $42,578 5% Advate • 1 $41,414 5% Humira Pen 0 1 $27,928 3% HumaLOG KwikPen 5 $24,710 3% Aptiom 1 $17,860 2% Farxiga 5 $16,666 2% This report and its contents are the confidential and proprietary information of Innovu, LLC. No disclosure or use of these materials may be made without the express written consent of Innovu, LLC. *4 innovu 8 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 190 # FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Demo Potential Savings Opportunities Overview Current Period: Jan 20 - Dec 20 Previous Period: Jan 19 - Dec 19 (Incurred) Potential Savings Opportunities Improve Rx Discount-, Duplicate Claims $82,000 $54,000 Increase GDR Reduce RX Waste $24,000 $17,000 Out of Network $5,000 Inappropriate Med. Svcs SI-o of Care $4,000 $2,000 Ur -lent -Wed Claims $4,000 ER Avoidance $2,000 Overage Dep. /w Claims $0 This report and its contents are the confidential and proprietary information of Innovu, LLC. No disclosure or use of these materials may be made without the express written consent of Innovu, LLC. inn©vu® 9 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 191 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services Demo Risk Overview Current Period: Previous Period: Jan 20 - Dec 20 Jan 19 - Dec 19 (Incurred) Risk Score Risk Distribution 10.0 4. 0.0 Risk By Relationship Self ▪ 5.9 Tili •+2% Spouse Child 6.8 5.8 ♦ -2io A+2.. 4 t : 4r. m,%• .. 5.0 Current Risk 10.0 Risk By Factor • INPATIENT UTILIZATION DEMOGRAPHIC PREVENTATIVE SERVICES OUTPATIENT UTILIZATION • VASCULAR DISEASE • ANTI INFECTIVE AGENTS • NFECTIOUS OISEASE $cRN CARD° RESPIRATORY • FAILURE/SHOCK DIABETES W/ CHRONIC COMP • NERVOUS SYS AGENTS High Risk Members HCC Current Future Age Gender Relation Risk Prev/Curr Cost Cost 20 Female Child 9.9 A $336.6K $25K-100K 57 Male Spouse 9.9 r $10K $100K-250K 37 Female Spouse 10.0 A $9,073 $25K-100K 43 Female Self 10.0 A $23.7K $25K-100K 64 Male Self 9.g rr $32.5K $100K-250K 57 Female Self 10.0 a $92.6K $2SK-100K 59 Female Self 10.0 A•• $158.SK $100K-250K 53 Male Self 9.9 A $36.4K $5K-25K 56 Female Spouse 10.0 A $202.6K $100K-250K This report and its contents are the confidential and proprietary information of Innovu, LLC. No disclosure or use of these materials may be made without the express written consent of Innovu, LLC. *4 innovu 10 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 192 # FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services 2020 BENEFITS GUIDE 4ri LOGO 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 193 $FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEAL'" ie" -BEING INCOME RETIREMENT PROTECTION ADDITIONAL BENEFITS NOTICES NAVIGATION OVERVIEW By clicking on the top navigation bar, topics listed in the left sidebar and/or interactive icons found in the lower right hand corner of all pages, you can jump to specific sections within this guide just like you would on your favorite websites. PRINT ONE PAGE BACK HOME PAGE ONE PAGE FORWARD Employee benefits account for a large portion of your total compensation package and are more valuable than ever before. This benefits guide is designed to clarify your eligibility and introduce you to your coverage options. Please review it carefully to understand when coverage begins, what each benefit provides and how to access coverage when you need it. Need help? Contact BenefitsVIP, your full -service benefits center, at 866.286.5354 with any questions. YOUR BENEFITS. YOUR CHOICES. YOUR HEALTH. This benefit summary provides selected highlights of the employee benefits program available. It is not a legal document and shall not be construed as a guarantee of benefits nor of continued employment. All benefit plans are govemed by master policies, contracts and plan documents. Any discrepancies between any information provided through this summary and the actual terns of such policies, contracts and plan documents shall be governed by the terms of such policies, contracts and plan documents. Company reserves the right to amend, suspend or terminate any benefit plan, in whole or in part, at any time. The authority to make such changes rests with the Plan Administrator. BENEFITSVIP®: 866.286.5354 2 I NEW JERSEY 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 194 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME PROTECTION RETIREMENT ADDITIONAL BENEFITS NOTICES WHO IS ELIGIBLE? 4144 ELIGIBILITY FULL-TIME EXEMPT EMPLOYEES (40 HOURS PER WEEK) Medical / Vision Medical Opt Out Vision for Medical Opt Out Dental Flexible Spending Accounts Employee Assistance Program Commuter Benefit Plans 1 s< of the month following date of hire Basic Life / AD&D (2 x salary) Optional and Dependent Life 1. of the month following 60 days of employment Long Term Disability FULL-TIME NON-EXEMPT EMPLOYEES & COMMISSIONED LOAN OFFICERS (40 HOURS PER WEEK) Flexible Spending Accounts Employee Assistance Program 1 at of the month following date of hire Commuter Benefit Plans Medical / Vision Medical Opt Out Vision for Medical Opt Out Dental Basic Life / AD&D (2 x salary) Optional and Dependent Life Long Term Disability 1" of the month following 60 days of employment PART-TIME EMPLOYEES (20 BUT LESS THAN 40 HOURS PER WEEK) Employee Assistance Program Medical / Vision for FT ACA' HealthSherpa 1"of the month following date of hire 1 a` of the month following 60 days of employment Part-time, Medicare eligible, or employees losing coverage may enroll throughout the year ELIGIBLE DEPENDENTS • Spouses/Civil Union Partners • Children/Step-children to age 26 (regardless of marital or full-time student status) LIFE EVENT CHANGES If you experience a qualifying life event during the plan year, you have 30 days to make a change to your current benefit elections. Examples include: • Marriage • Divorce • Birth/adoption of a child • Spouse or dependent child gains or loses alternate coverage or dependent status • Death of a dependent Part -Sine employees hired at 30+ hours/week are classified as fall -time AGA and are eligible for Medical/Vision at full-time rates following the applicable waiting period Hours for part-time employees will be tracked for a 12-month measurement period per Affordable Care Act (ACA) guidelines. Part -Sine employees averaging 30-t hours/Week during the measurement period Mil be ellgfble fir MedralWslon at full-time rates an the 1st of the month following the applicable administrative period BENEFITSVIPm: 866.286.5354 3) NEW JERSEY 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 195 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME PROTECTION RETIREMENT ADDITIONAL NOTICES BENEFITS MEDICAL EPO & DIRECT ACCESS MEDICAL BENEFIT Annual Deductible Out -of -Pocket Maximum Coinsurance Preventive Care Adult Preventive Care Adult Annual Physical Well -Child Care Outpatient Care Primary Care Physician Office Visits Specialist Office Visits Telemedicine (Virtual Doctor Visit) Outpatient Facility Surgery Outpatient Lab & X-Ray Initial Visit and all subsequent visits Emergency Care Ambulance when medically necessary At Hospital Emergency Room Outpatient Department Services in ER Urgent Care Hospital Services Inpatient Hospitalization After deductible BEN EFITSV IPm: 866.286.5354 HerIz n Blue. Cmss Blue. Shfeld of New Jerse, DIRECT ACCESS IN -NETWORK OUT -OF -NETWORK Individual: $1,000 Family: $2,000 Individual: $3,000 Family: $6,000 90% Plan / 10% Member Covered 100% $20 $40 $15 90%* Office /sit/LabCorp/Quest Diagnostics: 100% Other Outpatient Facility: 90%* ADVANTAGE EPO IN -NETWORK ONLY Individual: $1,000 Family: $2,000 Individual: $3,500 Family: $7,000 80% Plan /20% Member Covered 100% $20 $40 $10 80%* Office Visit/LabCorp/Quest Diagnostics: 100% Other Outpatient Facility: 80%* 80%* $100, then 80% 80%* $40 4 I NEW JERSEY 90%* 90%* 90%* $40 Individual: $2,000 Family: $4,000 Individual: $5,000 Family: $12,500 70% Plan / 30% Member Covered 70% 70%* 70%* Not Covered 70%* 70%* 90%* 70%* 70%* 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 196 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME PROTECTION RETIREMENT ADDITIONAL BENEFITS NOTICES OMNIA MEDICAL Horizon. Horizon Blue Cross Blue Shield of New Jersey BENEFIT IN -NETWORK ONLY (TIER 1) IN -NETWORK ONLY (TIER 2) Annual Deductible Out -of -Pocket Maximum' Coinsurance Preventive Care Adult Preventive Care Adult Annual Physical Well -Child Care Outpatient Care Primary Care Physician Office Visits Specialist Office Visits Telemedicine (Virtual Doctor Visit) Outpatient Facility Surgery Outpatient Lab & X-Ray Initial Visit and all subsequent visits Emergency Care Ambulance when medically necessary At Hospital Emergency Room Outpatient Department Services in an ER Urgent Care Hospital Services Inpatient Hospitalization *After deductible Individual: $500 Family: $1,000 Individual: $2,500 Family: $5,000 90% Plan / 10% Member Covered 100% $15 $25 $5 90%* Office Visit/LabCorp/Quest Diagnostics: 100% Other Outpatient Facility: 100% 100%* $100, then 90%* 90%* $25 90%* Individual: $2,500 Family: $5,000 Individual: $4,500 Family: $9,000 60% Plan / 40% Member Covered 100% $30 $50 $5 60%* Office Vsit/LabCcrp/Quest Diagnostics: 100% Other Outpatient Facility: 60%* 100% after Tier 1 deductible $100, then 90%* 60%* $50 60%* 'OMNIA Plan Tier 1 Deductible/OOP Maximum accumulates to Tier 2 Deductible/OOP Maximum. OMNIA Plan Tier 2 Deductible/OOP Maximum does NOT accumulate to Tier 1 Deductible/OOP Maximum. Once OMNIA Plan Tier 2 Deductible/OOP Maximum has been met, Tier 1 will also have been met. BEN EFITSV IP*: 866.286.5354 5 NEW JERSEY 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 197 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME ADDITIONAL RETIREMENT NOTICES PROTECTION BENEFITS WHAT IS OMNIA TIER 1? Horizon. Horizon Blue Cross Blue Shield of N w Jersew OM NIA TIER) DESIGNATED PROVIDERS You will pay less out of your pocket when your care is delivered by OMNIA TIER 1 designated doctors, hospitals and other health care professionals. When you select a doctor, hospital or and other health care professional designated as OMNIA TIER 1, you can expect: • A doctor who takes overall responsibility for your care • A team of health professionals, led and directed by your doctor, that closely monitors your health and responds to your specific needs • Wellness services and preventive care based on national guidelines, including wellness support and resources To locate OMNIA Tier 1 doctors, specialists and hospitals, log on to horizonblue.com and follow the steps below. OMNIA TIER 1 DESIGNATED DOCTORS OR SPECIALISTS: OMNIA TIER 1 HOSPITALS: • Click Find A Doctor link on home page. • Select the type of health care professional from the What are you looking for? dropdown list. • Select OMNIA from the Choose a plan to start dropdown ist. • Refine your search by entering a ZIP code or other criteria. • Identify OMNIA Tier 1 doctors and specialists by looking for the OMNIA Tier 1 loon (All other doctors will be listed as Tier 2). • Click Find A Doctor Ilnk on home page. • Select Hospitals from the What are you looking for? dropdown list, and select OMNIA from the Choose a plan to start dropdown list, • Look for hospitals with the OMNIA Tier 1 icon in the search results. BENEFITSVIP": 866.286.5354 6 I NEW JERSEY IS 44 it 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 198 ##FOUNDATION PUBLIC ENTITY SERVICES i City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME ADDITIONAL RETIREMENT NOTICES PROTECTION BENEFITS PRESCRIPTION DRUG EPO, DIRECT ACCESS & OM NIA Ho�riz �. 121VV Horizon Blue cross Blue Shield or New Jersey PRESCRIPTIONS RETAIL PHARMACY (30 DAY SUPPLY) MAIL ORDER SPECIALTY (90 DAY SUPPLY) (30 DAY SUPPLY) Generic Preferred Brand Non -Preferred Brand $20 $40 $60 $40 $80 S120 Members can get a 90 day supply at retail for 3x the retail, Rx copay. $100 through AllianceRx MAIL ORDER PHARMACY HOME DELIVERY Skip the lines at the pharmacy! Home delivery from AllianceRx Walgreens Prime makes it simple to get your long-term medicines sent to your doorstep for two times the retail copay cost (up to a 90 day supply). • Online: at alliancerxwp.com/home-delivery. The confirmation page will tell you how to order your prescription • By mail: Complete the registration form and mail it along with your prescription, to the address on the form • By phone: Call the Customer Care Center at 800.345.1985 and have your insurance information handy SPECIALTY DRUGS Certain specialty pharmaceuticals must be obtained from AllianceRx. Specialty pharmaceuticals are typically used to treat conditions such as: • Adenosine Deaminase Deficiency • Allergic Asthma • Alpha-1 Proteinase Inhibitor Deficiency • Anemia • Crohn's Disease • Prostate Cancer • Cytomegalovirus • Psoriasis • Fabry's Disease • Pulmonary Hypertension • Gaucher Disease • Respiratory Synctial Virus • Hypercalcemia of Malignancy • Rheumatoid Arthritis • Neutropenia For Prescription Drug Information, visit: www.goodrx.com and www.bestbuydrugs.net. BENEFITSVIP"': 866.286.5354 7 I NEW JERSEY 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 199 #FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME PROTECTION RETIREMENT ADDITIONAL BENEFITS NOTICES CONSUMERISM ^ BER SERVICES VISION DENTAL FLEXIBLE SPENDING ACCOUNT HealthSherpa GET APP HAPPY KNOW BEFORE YOU GO HORIZON NURSE LINE Immediate answers to health questions like treatment options and medication questions (( )) 0 0 dal Oa TELEMEDICINE - HORIZON CAREONLINE When you're sick and need care quick (e.g., diagnosis, prescriptions, etc.) PRIMARY CARE PHYSICIAN General health issues (e.g., preventive services, routine checkups, immunizations, etc.) SPECIALIST Surgical consultation or treatment (e.g., diagnostic testing services, heart, vascular, urological, lung, kidney, etc.) URGENT CARE Serious conditions that require immediate medial attention but are not life -threatening (e.g., minor cuts, sprains, bums, rashes, fever, etc.) EMERGENCY ROOM Serious or life -threatening conditions that require immediate attention (e.g., major trauma, loss of consciousness, uncontrolled bleeding, etc.) EPO DIRECT ACCESS OM NIA TIER 1 OMNIA TIER 2 NURSE LINE TELEMEDICINE PRIMARY CARE PHYSICIAN URGENT CARE EMERGENCY ROOM so $10 $20 $40 $40 $100 copay then 80% EI EN EFITSVIP': 866.286.5354 $o $15 $20 $40 $40 90% after deductible 8 I NEW JERSEY so $5 $15 $25 $25 $100 copay then 90% after deductible $o $5 $30 $50 $50 $100 copay then 90% after deductible 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 200 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME RETIREMENT PROTECTION ADDITIONAL BENEFITS NOTICES ght HORIIONCARE & BLUE CARD MOBILE APP MEMBER SERVICES HC _ON'S 24/7 NURSE LINE provides Immediate answers to your health questions anytime, from anywhere. Receive access to caring, registered nurses who have an average of 15 years of clinical experience to help you: • Choose appropriate medical care • Understand treatment options • Achieve a healthy lifestyle • Address medication questions To access care, call 1.888.624.3096 to speak with a nurse or login to your profile at horizonblue.com, select "Doctors and Care" and click on "24/7 Nurse Line" TELEMEDICINE - HORIZON CARLON LINE Horizon BCBS of NJ makes it easier to for you to consult with a doctor. Use HorizonCareOnline to talk with a licensed, U.S. board -certified doctor via video, chat or phone 24/7/365. With HorizonCaregnline, you can be treated for symptoms and conditions such as: Colds, Flu, Fever, Rash, Ear Infections and more. E-Prescriptions can also be provided in most states, but you must have the HorizonCareOnline mobile app downloaded on your smart phone. Ho "ICV Horizon Blue Gross Blue Shield of New Jersey • Visit HorizonCareOnline.com or call 877.716.5657 • When you first enroll, enter Horizon Blue Cross Blue Shield of New Jersey as your health plan • All discussions are private, secure and HIPAA- compliant BLUECARD PPO links in -network doctors and hospitals to Blue Cross and Blue Shield Plans throughout the United States. Company's medical plans include: • Access to a nationwide Blue network with in and out -of -network options • 24-hour, seven days a week emergency care • Urgent care coverage when traveling • Comprehensive in -network preventive and well care benefits To find care, visit the National Doctor and Hospital Finder at provider.bcbs.com, use the Blue National Doctor and Hospital App or call BenefitsVlP at 866.286.5354. BENEFITSVIP": 866.286.5354 9 I NEW JERSEY 41 4 PY 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 201 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME PROTECTION RETIREMENT ADDITIONAL BENEFITS NOTICES VISION VSP SIGNATURE BENEFIT IN -NETWORK OUT -OF -NETWORK REIMBURSEMENT WeIlVision Exam • Focuses on your eyes and overall wellness • Every calendar year Frames •$130 allowance for a wide selection of frames •$150 allowance for featured frame brands • 20% savings on the amount over your allowance $70 Costco 'Walmarr allowance • Every calendar year Eyeglass Lenses • Single, lined bifocal, lined trifocal vision lenses • Polycarbonate lenses for dependent children • Every calendar year Lens Enhancements • Standard progressive lenses • Tints/Photochromic adaptive lenses • Premium progressive lenses • Custom progressive lenses • Average savings of 35-40% on other lens enhancements • Every calendar year Contact Lenses (instead of glasses) •$130 allowance for contacts; copay does not apply • Contact lens exam (fitting and evaluation) • Every calendar year BEN EFITSV IPm: 866.286.5354 $10 copay for exam and glasses Combined with exam Combined with exam $0 $o $no-$90 $120-$160 Up to $60 copay Up to $50 copay Up to $70 Up to $50 Up to $75 Up to $100 Up to $120 Up to $105 N/A 10 I NEW JERSEY VS vi nn on re for lie GLASSES AND SUNGLASSES • Extra $20 to spend on featured frame brands. Visit vsp.com/specialoffers for details • 30% savings on additional glasses and sunglasses, including lens enhancements, from the same VSP provider on the same day as your WeIlVision Exam (or 20%from VSP Provider w/in 12 months of your WeIlVision exam) RETINAL SCREENING • $39 copay on routine retinal screening as an enhancement to WeIlVision Exam LASER VISION CORRECTION • Average 15% off the regular price or 5% off the promotional price; from contracted facilities • After surgery, use your frame allowance (if eligible) for sunglasses from any VSP doctor PRIMARY EYECARE • $20 copay (as needed). You can visit your VSP doctor for medical and urgent eyecare, who can diagnose, treat, and monitor common eye conditions like pink eye, and more serious conditions like sudden vision loss, glaucoma, diabetic eye disease, and cataracts PARTICIPATING RETAIL CHAINS • Cohen's Fashion Optical • Costco • Pearle Vision • Visionworks • MyEyeDr • Walmart • Sam's Club 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 202 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY MEDICAL PRESCRIPT! HEALTH WELL-BEING INCOME RETIREMENT ADDITIONAL NOTICES PROTECTION BENEFITS DENTAL A DELTA DENTAL PPO PLUS PREMIER STANDARD PLAN UPGRADED PLAN BENEFIT IN/OUT-OF-NETWORK IN/OUT-OF-NETWORK Annual Deductible Individual: $50 Family: $150 Individual: $50 Family: $150 Benefit Maximum Annual Orthodontic (Lifetime) $1,000 $1,300 $1,500 $1,500 Diagnostic & Preventive Services Exams (twice in 12 month period) Cleanings (twice in 12 month period) Full Mouth/Panoramic X-Rays (once in a 60 months period) Bitewing X-Rays (twice per benefit period for ages 18 and younger; once per benefit period for ages 19 and over) Fluoride treatment (unlimited frequency to age 15) 100% no deductible 100% no deductible Basic Services Fillings (composite/white fillings on all teeth) Extractions Endodontics (root canal) Periodontics Oral Surgery Sealants 70% after deductible 80% after deductible Major Services Crowns Bridgework Full and Partial Dentures Inlays and Onlays 5096 after deductible 50% after deductible Orthodontic Services (Children to age 19 only) 50% 50% BENEFITSVIP". 866.286.5354 11 I NEW JERSEY 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 203 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME "'GTIREMEI�' ADDITIONAL NOTICES PROTECTION BENEFITS FLEXIBLE SPENDING ACCOUNT PPY F6 16Wi BENEFITS RESOURCE = MOBILE APP Benent FLEXIBLE SPENDING ACCOUNT MEDICAL FLEXIBLE SPENDING ACCOUNT AND DEPENDENT CARE ACCOUNT When participating in an FSA, you select a specific amount of "pre-tax" money to be deducted from your paycheck each pay period. These dollars are subtracted from your gross earnings before taxes and put into an FSA to cover eligible out-of-pocket costs. Once you use your Beniversal® MasterCard® Prepaid Card or submit a claim for a qualified expense, you will be reimbursed from this account. You can change or cancel the election if you experience a qualifying life event during the plan year (January 1 - December 31). FSA participation requires an active election each year during open enrollment. These plans incorporate a 2% month grace period for active employees after the plan year ends and allows you to use unused monies towards eligible expenses incurred in the new plan year. Once the grace period ends, you have an additional one month run -out period to submit for reimbursement. If you terminate your employment or experience a life event mid -plan year resulting in plan cancellation, you have until the end of the plan year (12/31) to submit for expenses that were incurred prior to your last day of coverage. ACCOUNT TYPE EXAMPLES OF ELIGIBLE EXPENSES MONTHLY CONTRIBUTION ACCESS TO FUNDS PRE TAX BENEFIT LIMITS MEDICAL FSA (for yourself or any eligible dependent) DEPENDENT CARE FSA (for eligible dependents underage 13; disabled spouse, parent or child over age 13) • Medical Plan Deductibles • Medical Plan Coinsurance • Most Insurance Co -payments • Prescription Drugs • Vision Exams/Eyeglasses/ Contacts • Laser Eye Surgery • Dependent/Child Care Centers • Adult Day Care • Nursery School/Pre-School • After SchooVSummer Camp Max contribution is $2,750 per year Max contribution is $5,000 per year Allows immediate access to the entire contribution amount from the 1st day of the benefit year, before all scheduled contributions have been made. Submit claims up to your year-to-date accumulated amount in your account. You will be reimbursed based on your accumulated contribution amount. • Save 20% - 40% on your health care expenses • Save on purchases not covered by insurance • Reduce your taxable income • Save 20% - 40% on your dependent care expenses • Reduce your taxable ncome DRI has a $15 total minimum reimbursement requirement for each claim submission. • Login to briweb.com to access your account or register for the first time (Code: oceanfirst: User ID: SS#) BEN EFITSVIP 866.286.5354 12 I NEW JERSEY I If 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 204 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME PROTECTION RETIREMENT ADDITIONAL BENEFITS NOTICES MEDICAL PRESCRIPTION CONSUMERISM Introducing a partnership with HealthSherpa to bring affordable health insurance to you. HealthSherpa is a website and team of people who can help you find, enroll in, and make the best use of your marketplace health insurance. HealthSherpa is a secure and trusted partner of Healthcare.gov. •# HealthSherpa HealthSherpa is available to help the following groups of employees and dependents: • Part-time employees who need coverage • Employees who are leaving OceanFirst and need an affordable alternative to COBRA • Dependents turning 26 who will age out of coverage • Employees 65+ who need Medicare support Eligible employees may enroll in plans during the annual Marketplace Open Enrollment Period between November 1st through December 15th, 2019 or throughout the year if you fall under one of the groups listed above. HealthSherpa offers plans from established insurers like Horizon Blue Cross Blue Shield of NJ and options are available nationwide. All plans are comprehensive and cover: • Free preventive care • Hospitalization • Prescription drugs • Pregnancy & maternity • Emergency services • Pediatric services B E N E F I TSV I P': 866.286.5354 • Laboratory services • Birth control coverage • Mental health services • Breastfeeding coverage • Wellness services • And morel HealthSherpa APP HAPPY INSTANT SAVINGS EASY PLAN SHOPPING YEAR ROUND SUPPORT There are no dollar limits on payments for covered services and you cannot be denied or charged more for pre-existing conditions. Those who qualify may receive significant financial assistance with monthly premiums. Last year, most people enrolling through HealthSherpa paid $35/month or less for complete coverage with no pre-existing condition exclusions and no lifetime limits! Consumer advocates are available year round to assist employees by phone, email and chat: OceanFirst.HealthSherpa.com 844.587.9911 13 I NEW JERSEY * 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 205 #,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME ADDITIONAL RETIREMENT NOTICES PROTECTION BENEFITS App Store GET APP HAPPY Manage all of your plan benefits from the palm of your hand. Download any of the mobile apps shown below from App Store or Google Play to your smartphone for access on the go. JJ. J Horizon Blue New Horizon Blue DELTA DENTAL Delta Dental Delta Dental Mobile TRSRetire 800.755.5801 my.trsretire.com Horizon Blue Blue National Doctor and Hospital vs • p Vision Service Plan VSP Vision Care on the Go J Automatic Data Processing ADP Mobile Solutions BENEFITSVIP': 866.286.5354 14 I NEW JERSEY Horizon Blue Horizon CareOnline BRI Benefit Resource, Inc. BRiMobile Assist America Mobile App Login: 01-AA-SUL-100101 1 11 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 206 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME ADDITIONAL RETIREMENT NOTICES PROTECTION BENEFITS EMPLOYEE ASSISTANCE PROGRAM COMPANY EAP, administered by Quantum Health Solutions, is designed to help employees cope with personal and workplace issues. The EAP is available to all regular full-time and part-time employees and their household family members and premiums are fully funded by the Bank. To access EAP services, please call Quantum at 877.747.1200 or email admin@accessqhs.com BENEFITSVIP: 866.286.5354 15 I NEW JERSEY 4, QUANTUM IS 1 If 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 207 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services HEALTH WELL-BEING INCOME ADDITIONAL RETIREMENT NOTICES PROTECTION BENEFITS LIFE AND AD&D BASIC GROUP TERM LIFE AND AD&D INSURANCE OPTIONAL EMPLOYEE LIFE INSURANCE OPTIONAL SPOUSE LIFE INSURANCE OPTIONAL CHILD LIFE INSURANCE Sun Life Financial • Provides important financial protection for employees and their family members • Coverage equal to 2x annual salary up to $750,000 • Premium is fully funded by the Bank • Coverage elections in $10,000 Increments to a maximum of $500,000 • For newly eligible employees, the Guarantee Issue (GI) is $300,000 • Late Entrant GI: Elections up to $100,000 • Coverage up to half the employee's Optional Life election to a maximum of $250,000 • GI of $20,000; elections in increments of $5,000 • Coverage elected in $2,000 increments to a maximum of $10,000 • Available for children age 14 days to 26 years old Amounts of coverage in excess of GI require completion of an online Evidence of Insurability (EC!) application located at mysunlifebenefits_com. EOI is required for: • Employees when initial requested coverage exceeds $300K (GI Limit); a late entrant election exceeds $100K, or any subsequent increase to an existing election during an open enrollment period • Spouses when an initial election exceeds $20K (GI Limit); a late entrant election regardless of coverage amount; or any subsequent increase to an existing election during an open enrollment period • Children if late entrants or due to any subsequent' increase to an existing election during an open enrollment period Reminders: Spouse and Child life elections are contingent upon employee's enrollment in Optional Employee Life. Employees are responsible for the full monthly premiums and may cancel their policies at any time. BENEFITSVIP®: 866.286.5354 16 I NEW JERSEY 1 11 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 208 ##FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY ' F LTH WELL-BEING INCOME PROTECTION RETIREMENT ADDITIONAL NOTICES BENEFITS LIFE AND AD&D TRAVEL ASSISTANCE EMERGENCY TRAVEL ASSISTANCE www.assistamerica.com 800-872-1414 (within the US) 609-986-1234 (outside the US) medservices@assistamerica.com Membership #: 01-AA-SUL-100101 Sun Life Financial IDENTITY THEFT PROTECTION BENEFITSVIP': 866.286.5354 17 I NEW JERSEY IDENTITY THEFT PROTECTION www.securassist_com/sunlife Access code: 18327 877.409.9597 Membership #: 01-AA-SUL-100101 * 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 209 #40 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME RETIREMENT ADDITIONAL NOTICES PROTECTION BENEFITS LIFE AND AD&D TRAVEL ASSISTANCE DISABILITY BENEFITS ELIGIBILITY BENEFITS ELIGIBILITY BENEFITS NJ TEMPORARY DISABILITY BENEFITS Sun Life Financial • NJ employees are eligible to apply for temporary disability benefits in the event of illness or injury that prevents them from working for more than 7 calendar days • Premiums are funded by both employer and employee contributions as per state mandates. Refer to the NJ TDB Coverage Notice posted on ADP Workforce Now Resources > Tools/References for full details regarding required contributions • Effective 1/1/2020: Benefits provide 67% of average weekly earnings to a maximum of $667 per week • Effective 7/1/2020: Benefits provide 85% of average weekly earnings to a maximum of $881 per week • Payable to a maximum 26 weeks LONG TERM DISABILITY 180 days of continuous disability Full-time Staff up to and including AVP Level: • Benefits provide 60% of average monthly earnings up to $5,000 per month • Premiums are fully funded by the Bank Full-time Staff at VP Level and Above: • Benefits provide 60% of average monthly earnings up to $11,000 per month • Tax -Choice Plan that allows employees to pay the premiums and receive long term disability benefts tax-free, or choose to have the Bank pay the premiums and any long term disability benefits received become taxable • Additional information will be provided by Human Resources BEN EFITSVI P`: 866.286.5354 18 I NEW JERSEY 16 1 ft 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 210 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME ADDITIONAL RETIREMENT NOTICES PROTECTION BENEFITS MY TRSHETIRE APP ad RETIREMENT BENEFITS ELIGIBILITY AUTO -ENROLLMENT AND AUTO - ESCALATION EMPLOYER MATCH VESTING BENEFITS ELIGIBILITY FOR PLAN ENTRY PLAN ENTRY DATA ELIGIBILITY FOR ANNUAL ALLOCATION VESTING 401(K) RETIREMENT PLAN Retirement Plan funded by employee and employer contributions that allows employees to set aside pre-tax and/or Roth after-tax dollars up to the 2020 IRS maximum contribution limit of $19,500; employees age 50 and above may contribute up to an additional $6,500 per year in 'Catch-up contributions' Age 21; auto -enrolled following 3 months of service at 3% deferral if expected to work 1,000 hours during the first 12 months of service, deferral is automatically increased 1 % each year until 6% is reached. Rehires are re -enrolled after 30 days at 3% if previously eligible to participate in the plan Employer safe harbor match commences the month following 12 months of service and is based on the first 6% of employee deferrals up to a maximum 3.5% as follows: 1 % deferral = 1 % match 2% deferral = 1.5% match 3% deferral = 2% match 4% deferral = 2.5% match 5% deferral = 3% match 6% deferral = 3 5% match 100% vested in employer safe harbor match after two years of service EMPLOYEE STOCK OWNERSHIP PLAN (ESOP) Retirement Plan fully funded by the Bank that rewards employees with shareholder ownership Age 21 and completion of 12 months consecutive seance with a minimum 1,000 hours worked January 1st or July 1st following one year of service Participants must be actively employed on December 31 st of plan year and work 1,000 hours in the plan year (Jan 1 - Dec 31) 100% vested in employer contributions after 5 years of service; 100% vested in dividends upon issuance Please refer to the Summary Plan Description and related documents on ADP Workforce Now Resources > Tools/References for full details of each plan. Contact HUMAN RESOURCES with any questions. BEN EFITSV IP°': 866.286.5354 19 I NEW JERSEY 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 211 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME RETIREMENT PROTECTION ADDITIONAL BENEFITS TIES BENEFITSVIP., ■ = MOBILE APP • Benefit Z COMMUTER BENEFIT PLAN BRRleeource, PAY FOR MASS TRANSIT AND PARKING EXPENSES WITH TAX-FREE DOLLARS! By enrolling in a Commuter Benefit Plan, you can pay for qualified workplace mass transit and parking expenses with tax-free contributions. When you enroll, indicate how much you want to contribute to your Mass Transit and/or Parking Account. YOUR CONTRIBUTIONS You may contribute up to $500 per month each to your Parking and/or Mass Transit account and the first $270 is withheld on a pre-tax basis. WHAT ARE ELIGIBLE COMMUTING EXPENSES? Qualified workplace commuting expenses must be for mass transit and/or parking expenses incurred between a residence and place of employment. Qualified expenses include: buses, trains, subways, ferries, vanpools and include expenses incurred near your workplace or a location from which you commute to work (e.g. park -and -ride). WHAT IS THE BENIVERSAL CARD? After enrollment, you will receive the Beniversal Prepaid Mastercard or eTRAC Prepaid Mastercard for use at qualified mass transit and/or parking vendors. It works like a credit card and allows you to access CBP funds at the point -of -sale to pay for qualified mass transit and/or parking expenses. The Beniversal Card operates nationwide with approved vendors that accept MasterCard. KEY INFORMATION • A commuter benefit plan is an employee benefit offered by your employer in accordance with Section 132(f) of the Internal Revenue Code. • Plan funds must be used for qualified commuting expenses. Improper use of funds could result in plan restrictions or termination of the plan. • Your election(s) remain in effect until an election change is submitted. Check with your employer on how and when changes must be submitted. • Unused cash balances will be carried forward to be used for future qualified expenses for that account, Excess cash balances cannot be refunded from an account and can only be used for qualified expenses. • If you build up a balance, you may temporarily reduce your election to $0 in order to spend down the balance and remain active in the plan. Learn more about commuter benefit accounts or view our video presentation at www.BenefitResource.com TAX SAVINGS EXAMPLE nmuter expenses Monthly tax savings Annual tax savings $125 $37.50 $450.00 BENEFITSVIP°': 866.286.5354 20 I NEW JERSEY 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 212 * FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME RETIREMENT PROTECTION ADDITIONAL BENEFITS tIOTICES BENEFITSVIP HELP STARTS HERE BenefitsVlP is a powerful, one -stop contact center staffed by seasoned professionals. Your dedicated team of employee benefits advocates is ready to help you and your family members resolve your benefits issues. Let BenefitsVlP help you and your family members with: • Benefits questions • ID card requests • Billing issues • Claims resolution • Prescription issues • Provider network questions • ..and much more! BEN EFITSV IP': 866.286.5354 BenefitsVlP Nell) starts here. For service that's confidential and responsive, contact: 866.286.5354 Monday - Friday, 8:30am-8:OOpm (ET) Fax: 856.996.2755 Answers@benefitsvip.com QUESTIONS ANSWERED HERE COMPLETELY CONFIDENTIAL! Your dedicated BenefitsVlP advocates understand your benefit plans and are able to answer benefit questions and quickly resolve claims and eligibility issues. A majority of inquiries are resolved the same day and all calls adhere to privacy best practices. BenefitsVlRcom 21 I NEW JERSEY 1 it 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 213 FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME RETIREMENT PROTECTION ADDITIONAL BENEFITS NOTICES NOTICES Ali NOTICES WOMEN'S HEALTH AND CANCER RIGHTS ACT Under the Women's Health and Cancer Rights Act, group health plans must make certain benefits available to participants of health plans who have undergone a mastectomy. In particular, a plan must offer mastectomy patients benefits for: + Reconstruction of the breast on which the mastectomy was performed; • Any necessary surgery and reconstruction of the other breast to produce a symmetrical appearance, • Prostheses; and Treatment of physical conditions related to the mastectomy, including ymphedema. Our medical plans comply with these requirements. Benefits for these items are similar to those provided under the plan for similar types of medical services and supplies. CONTINUED COVERAGE UNDER COBRA Under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), you and your covered dependents may be able to continue certain health care benefits if you lose your coverage as the result of certain qualifying events. Contact the Benefits Department for more information. HIPAA REGULATIONS HELP PROTECT YOUR PRIVACY The privacy provisions of the Health Insurance Portability and Accountability Act of 1998 (HIPAA) help to ensure that your health care - related information stays private. New employees will receive a Privacy Practice Notice which outlines the ways in which the medical plan may use and disclose protected health information (PHI). The notice also describes your Tights. For more information, contact the Benefits Department_ GENETIC INFORMATION NON-DISCRIMINATION ACT - GINA GINA broadly prohibits covered employers from discriminating against an employee, individual, or member because of the employee's "genetic information," which is broadly defined In GINA to mean (1) genetic tests of the individual, (2) genetic tests of family members of the individual, and (3) the manifestation of a disease or disorder in family members of such individual. GINA also prohibits employers from requesting, requiring, or purchasing an employee's genetic information, This prohibition does not extend to information that is requested or required to comply with the certification requirements of family and medical leave laws, or to information inadvertently obtained through lawful inquiries under, for example, the Americans with Disabilities Act, provided the employer does not use the Information in any discriminatory manner. In the event a covered employer lawfully (or inadvertently) acquires genetic information, the information must be kept in a separate file and treated as a confidential medical record. and maybe disclosed to third parties only in very limited circumstances. SUMMARY OF MATERIAL MODIFICATION This Communication constitutes a Summary of Material Modifications ("SMM") which describes changes to your health care program effective January 1,2020. This SMM is a summary of the changes made to the program and the partial terms of Company medical plans. The SMM is not an official plan document. The actual Terms of the plans are contained in the plan documents. In the event of any discrepancy, or any conflict between this SMM and the official plan documents, the official plan documents will govern_ This SMM should be retained with your other benefits information. Company reserves the right to change, amend, or cease these benefits at any lime. SPECIAL ENROLLMENT RIGHTS This notice Is being provided to insure that you understand your right to apply for group health insurance coverage. You should read this notice even if you plan to waive coverage et this time. Loss of Other Coverage If you are declining coverage for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents' other coverage). However, you must request enrollment within 30 days after your or your dependents' other coverage ends (or alter the employer stops contributing toward the other coverage)_ Example, You waived coverage because you were covered undera plan offered by your spouse's employer. Your spouse terminates their employment. If you notify your employer within 30 days of the date coverage ends, you and your eligible dependents may apply for coverage under our health plan. Marriage, Birth, or Adoption If you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourselt and your dependents. However, you must request enrollment within 30 days after the marriage, birth, or placement for adoption. BENEFITSVIR"': 866.286.5354 22 I NEW JERSEY 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 214 * FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME RETIREMENT PROTECTION ADDITIONAL BENEFITS NOTICES NEWBORNS' AND MOTHERS' HEALTH PROTECTION AGT Under federal law, health core plans may not restrict any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a normal delivery, or less than 96 hours following a Cesarean section. However, federal law generally does not prohibit the mother's or newborn's attending provider, atler consulting with the mother and with the mother's consent, from discharging the mother or her newborn earlier than 46 hours (or 96 hours as applieable), YDUR RIGHTS UNDER MICHELLE'S LAW Effective January 1, 2010, full-time students covered under the group health plan, that would otherwise lose eligibility under the plan because of a reduction in their full-time class status due to a medically necessary leave of absence from school, may be eligible to extend their coverage under the plan for up to one year, or to age 28, whichever occurs first. The child must be a dependent child of a plan participant and be enrolled in the company group health plan on the basis of being a student at a postsecondary educational institution immediately before the first day of the leave. MENTAL HEALTH PARITY Effective January 1, 2010, the company- sponsored medical plans were modified to cover mental health and substance abuse expenses subject to the same treatment limits, deductibles, copayments, co-insurance and out-of-pocket requirements that apply to other medical and surgical expenses. This change applies to both inpatient and outpatient services. CHILDREN'S HEALTH INSURANCE PROGRAM REAUTHORIZATION ACT OF 2009 (CHIP) Signed into expand state CHIP eligibility to more children and expectant mothers with an extended 60-daytime frame to coordinate any changes to employer health elections in the event of gain or loss of eligibility and/or a subsidy under Medicaid or CHIP UNIFORMED SERVICES EMPLOYMENT AND REEMPLOYMENT RIGHTS ACT (USERRA) USERRA protects the job rights of individuals who voluntarily or voluntarily leave employment positions to undertake military service or certain types of service in the National Disaster Medical System. USERRA also prohibits employers from discriminating against past and present members of the uniformed services, and applicants to the uniformed services. The Act also slates that if an employee leaves their job to perform military service, they have the right to elect to continue existing employer -based health plan coverage for the employee and their eligible dependents for up to 24 months while in the military. Even if the employee doesn't elect to continue coverage during their military service, they have the right to be reinstated in their employer's health plan when they are reemployed,, generally without any waiting periods or exclusions (e.g. pre-existing condition exclusions) except for service -connected illnesses or injuries. TERMINATION OF HEALTH COVERAGE FOR CAUSE, INCLUDING FRAUD OR INTENTIONAL MISREPRESENTATION Company reserves the right to terminate health care coverage for you and/ or your dependent prospectively without notice for cause (as determined by the Plan Administrator), or 11 you and/or your dependent are otherwise determined to be ineligible for coverage under the plan. In addition, if you or your covered dependent commits fraud or intentional misrepresentation in an application for health coverage under the plan, in connection with a benefit claim or appeal, or in response to any request for information by Company or it's delegees (including the Plan Administrator or a claims administrator), the Plan Administrator may terminate your coverage retroactively upon 30-days' notice_ Failure to Inform any of such persons that you or your dependents are covered under another group health plan or knowingly providing terse information in order to obtain or continue coverage for an eligible dependent are examples of actions that constitute fraud under the plan. PREMIUM ASSISTANCE UNDER MEDICAID AND THE CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP) If you or your children are eligible for Medicaid or CHIP and you're eligible tor health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren't eligible for Medicaid or CHIP, you won't be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare,gov. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance' is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs. contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you quality, ask your state if it has a program that might help you pay the premiums for an employer -sponsored plan. If you or your dependents are eligible for premium assistance under Medicaid or CHIP, es well as eligible under your employer plan, your employer must allow you're enroll In your employer plan if you aren't already enrolled. This is called a "special enrollment" opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department o1 Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272). BENEFITSVIRr': 866.286.5354 23 I NEW JERSEY 4 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 215 #0,FOUNDATION PUBLIC ENTITY SERVICES City of Miami RFP #1896386 — Employee Benefit Consulting Services ELIGIBILITY HEALTH WELL-BEING INCOME PROTECTION RETIREMENT ADDITIONAL NOTICES BENEFITS If you Irve in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is currant as of July 31, 2019. Contact your State for more information on eligibility ALABAMA: Medicaid Web: http://rnyalhipp.com/ Phone: 1.55 5.692.5447 ALASKA: Medicaid The AK Health Insurance Premium Payment Program Website: http9/myakhipp.com/ Phone: 1. 56 8.251. 4661 Email: CustomerService53MyAKHIPP.com Medicaid Eligibility: http://dhssalaska.gov/dpa/Pagesimedicaid/defaultaspx ARKANSAS: Medicaid Web: http:i/myarhipp.com/ 8.55.MyARHIPp (855.692.7447) COLORADO: Health First Colorado (Colorado's Medicaid Program) 5 Child Health Plan Plus (CHP+) Health First Colorado Website: www.heahhiirstcolorado.com/ Health First Colorado Member Contact Center: 1.830,221.3943/ State Relay 711 CHP+ Colomdo.gov/HCPF/Child-Health-Flan-Plus CHP+ Customer Service: 1.300.359.1991/ State Relay 711 FLORIDA: Medicaid Web: www.ilmedicaidtplrecovery.com Phone: 1.877.357.3268 GEORGIA: Medicaid lNeb: dohgenreia.gov/medicaid Health Insurance Premium Payment (HIPP) Phone: 404.656.4507 INDIANA: Medicaid Healthy Indiana Plan for low-income adults 19-64 Website: http9/www.in.govltssalhip/ Phone: 1.87 7.438.4479 All other Medicaid Website: http)/www.lndianamedicaid.com Phone 1.803.403.0064 IOWA: Medicaid Web. http.i/dhs.iowa.gov/ime/members/medicaid-a-to-a hipp Phone: 1.888.346. 9562 B E N E F I TSV I Pe: 866.286.5354 KANSAS: Medicaid Web' www.kdheks.gov/hcf Phone: 1.785.296.3512 KENTUCKY: Medicaid Web: chis.ky.gov/dmsldefault.htm Phone: 1.500.535.2570 LOUISIANA: Medicaid Weh: http://dhh louisianagov/index_cfm/subhome/1/n/331 Phone: 1.886.395.2447 MAINE: Medicaid Web: wwwmaine.gov/dhhslati/public-aesistane04355x html Phone: 1 BOG .442.8033 TTY, Maine relay 711MA5SACHUSETTS: Medicaid and CHIP Web. http://www.mass.gov/eohhs/gov/departments/masshealth/ Phone: 1.800.462.1120 MINNESOTA: Medicaid Web, http:/lmn.gov/dhs/people-we-serve/seniors/health-care/health-care- prog rams/programs-and-serviees/medical-assistance.jsp Click on Health Care, then Medical Assistance Phone: 1.530.557.3739 MI550URC Medicaid Web: www.dss.mo.gov/mhd/participants/pagen/hipp.htm Phone: 573.751.2305 MONTANA: Medicaid Web: http://dphhsmt.gov/MontanaHealthcarePrograms/HIPP Phone: 1.530.594.3084 NEBRASKA: Medicaid Web: http://dhhs.ne.gov/Ghiidren_Family_Services/AccessNebraska/ Pages/accessnebraska indexaspx Phone: 1.555.532.7633 NEVADA: Medicaid Medicaid Web: dwss.nv.gov Medicaid Phone: 1.300.992.0900 NEW HAMPSHIRE: Medicaid Web: www_dhhs_nh.govfoii/documents/hippapp_pdf Phone: 603.271.5218 NEW JERSEY Medicaid and CHIP Medicaid Web: www.state.nj.uwhumanservices/ dmahvclienta/medicaid/ Medicaid Phone: 609 831.2392 CHIP Web: www.njfamilycare.org/index.html CHIP Phone: 1.800.701 0710 24 I NEW JERSEY 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 216 #0,FOUNDATION PUBLIC ENTITY SERVICES ■ City of Miami RFP #1896386 — Employee Benefit Consulting Services NOTICES WELL-BEING INCOME PROTECTION NEW YORK: Medicaid Web: htlps://www.health.ny.gov/health_care/medicaid/ Phone: 1.800.541.2831 NORTH CAROLINA: Medicaid Web: htlps://dma.ncdhhs.gov/ Phone: 919.855.4100 NORTH DAKOTA: Medicaid Web: www.nd.gov/dhs/services/medicalserv/medicaid/ 844.854.4825 OKLAHOMA: Medicaid and CHIP Web: www.insureoklahoma.org Phone: 1.888.365.3742 OREGON: Medicaid Web: htlp://healthcare.oregon.gov/Pages/index.aspx Phone: 1.800.699.907 5 PENNSYLVANIA: Medicaid Web: http://www.dhs.pa.gov/provider/medicalassistance/ healthinsurancepremi umpaymenthippprogram/index.htm Phone: 1.800.692.7462 RHODE ISLAND: Medicaid Web: http://www.eohhs.ri.gov/ Phone: 401.462.5300 SOUTH CAROLINA: Medicaid Web: www.scdhhs.gov Phone: 1.888.549.0820 SOUTH DAKOTA: Medicaid Web: dss.sd.gov Phone: 1.888.828.0059 TEXAS: Medicaid Web: www.gethipptexas.com Phone: 1 .800.440.0493 UTAH: Medicaid and CHIP Medicaid Website: https://medicaid.utah.gov/ CHIP Webstle: http://health.utah.gov/chip Phone: 1.877.543.7669 BENEFITSVIP°: 866.286.5354 RETIREMENT ADDITIONAL NOTICES BENEFITS VERMONT: Medicaid Web: www.greenmountaincare.org Phone: 1. 8 00.2 50.8 4 27 VIRGINIA: Medicaid and CHIP Medicaid Web: www.coverva.org/programs_premium_ assistance,cfm Medicaid Phone: 1.800.432.5924 CHIP Web: www.coverva.org/programs_premium_assistance.cfm CHIP Phone: 1.855.242.8282 WASHINGTON: Medicaid Web: https://www.hca.wa.gov/free or low cost health care/program- admin istrat ion/premium-payment-programPhone: 1.800.562.3022 exl.15473 WEST VIRGINIA: Medicaid Web: www.dhhr.wv.gov/bms Phone: 1.877.598.5820, HMS Third Party Liability WISCONSIN: Medicaid and CHIP Web: https://www.dhs.wisconsin.gov/publications/p1/p10095.pdf Phone: 1.800.362.3002 WYOMING: Medicaid Web: htlps://wyequalitycare.acs-inc.com/ Phone: 307.777.7531 To see if any more States have added a premium assistance program since July 31, 2017, or for more information on special enrollment rights, you can contact either: U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/ebsa 1.866.444.EBSA (3272) U.S. Department of Health and Human Services Centers fa Medicare & Medicaid Services www.cros.hhs.gov 1.877.267.2323, Menu Option 4, Ext. 61565 OMB Control Number 1210-0137 (expires 12/31/2019) 25 I NEW JERSEY 780 W. Granada Blvd. Ormond Beach, FL 32174 Page 217 *0,FOUNDATION PUBLIC ENTITY SERVICES Employee Benefit Consulting Services RFP 1896386 EXHIBIT E PRICE PROPOSAL A. Employee Benefit Consulting Services The not -to -exceed price and estimated hours for providing all employee benefit consulting services as stated in the Scope of Services. The price includes all costs associated to provide these services. Term Estimated Hours Not -To -Exceed Price 1 Initial Term (Years 1-3) 3,300 $465,930 2 First 1-year OTR Period 1,100 $155,310 3 Second 1-year OTR Period 1,100 $155,310 Note: The City will pay the Consultant at the hourly rate indicated below for any work involved to complete the City's request if the work significantly exceeds the hours stated. Similarly, the fee shall be reduced if there is significantly less work than anticipated. B. Not -to -Exceed Hourly Rate for Additional Work Below is the not -to -exceed hourly rate for additional work not included within the Scope of Services. Breakdown of Not to Exceed Price Staff Position/ Classification Proposed Maximum Hourly Rates Initial Term Years 1 - 3 OTR 1 Year 4 OTR 1 Year 5 Lead Consultant $ 250 $ 250 $ 250 $ $ $ $ $ $ Notes: 1) The not -to exceed price in Section A, and the hourly rates in Section B, shall remain firm and fixed for the term of the Contract, including any renewals or extensions thereof. 2) The hourly rates above include all costs to include normal administrative fees, such as telephone, mailing, faxes, duplication charges, overnight mail, and including all out of pocket expenses, such as travel incurred in connection with the services (refer to CH.112.061 of the Florida Statutes regarding travel expenses), per diem, and miscellaneous costs and fees, and is incorporated in this price schedule, as they will not be reimbursed separately by the City. 3) The City will pay the Consultant at the hourly rate indicated within Section B, for any work involved to complete the City's request for work that is not included within the Scope of Services. The City reserves the right to negotiate the final pricing for this work on a project by project basis, at the City's sole discretion. Andrew Bloom President & CEO Signature Printed Name Title City of Miami Solicitation RFP 1896386 Solicitation RFP 1896386 Employee Benefit Consulting Services Solicitation Designation: Public 8/20/2024 9:24 AM p. 1 City of Miami Solicitation RFP 1896386 City of Miami 8/20/2024 9:24 AM p. 2 City of Miami Solicitation RFP 1896386 Solicitation Number Solicitation Title Solicitation Start Date Solicitation End Date Question &Answer End Date Solicitation Contact Contract Duration Contract Renewal Prices Good for Item Solicitation RFP 1896386 Employee Benefit Consulting Services RFP 1896386 Employee Benefit Consulting Services Aug 16, 2024 5:25:55 PM EDT Sep 6, 2024 5:00:00 PM EDT Aug 28, 2024 5:00:00 PM EDT Charles Johnson 305-416-1924 cjohnson@miamigov.com See Specifications 1 annual renewal 180 days Item Response Form RFP 1896386--01-01 - Please disregard this line item. See RFP Document Quantity 1 each Prices are not requested for this item. Delivery Location City of Miami City of Miami Department of Procurement 444SW2ndAve 6th Floor Miami FL 33130 Qty 1 Expected Expenditure $1.00 Description Please disregard this line item. See RFP Document. 8/20/2024 9:24 AM p. 3 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 City of Miami Request for Proposals (RFP) Procurement Department Miami Riverside Center 444 SW 2ndAvenue, 6th Floor Miami, Florida 33130 Web Site Address: www.miamigov.com/procurement RFP Number: Title: Issue Date/Time: RFP Closing Date/Time: Pre-Bid/Pre-Proposal Conference: Pre-Bid/Pre-Proposal Date/Time: Pre-Bid/Pre-Proposal Location: Deadline for Request for Clarification: Contracting Officer: Contracting Officer E-Mail Address: 1896386 Employee Benefit Consulting Services Friday, August 16, 2024 Friday, September 6, 2024 at 5:00 PM Voluntary Wednesday, August 21, 2024 at 2:00 PM Virtual via Microsoft TEAMS Meeting ID 908 673 243# Passcode: xLvfct or via phone at (786) 598-2961 Phone Conference ID: 446 604 814# Wednesday, August 28, 2024 at 5:00 PM Johnson, Charles cjohnson@miamigov.com 8/20/2024 9:24 AM p. 4 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 Certification Statement Please quote on this form, if applicable, net prices for the item(s) listed. Return signed original and retain a copy for your files. Prices should include all costs, including transportation to destination. The City reserves the right to accept or reject all or any part of this submission. Prices should be firm for a minimum of 180 days following the time set for closing of the submissions. In the event of errors in extension of totals, the unit prices shall govern in determining the quoted prices. We (I) certify that we have read your solicitation, completed the necessary documents, and propose to furnish and deliver, F.O.B. DESTINATION, the items or services specified herein. The undersigned hereby certifies that neither the contractual party nor any of its principal owners or personnel have been convicted of any of the violations, or debarred or suspended as set in section 18-107 or Ordinance No. 12271. All exceptions to this submission have been documented in the section below (refer to paragraph and section). EXCEPTIONS: We (I) certify that any and all information contained in this submission is true; and we (I) further certify that this submission is made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a submission for the same materials, supplies, equipment, or service, and is in all respects fair and without collusion or fraud. We (I) agree to abide by all terms and conditions of this solicitation and certify that I am authorized to sign this submission for the submitter. Please print the following and sign your name: PROPOSER NAME: ADDRESS: PHONE: FAX: EMAIL: CELL(Optional): SIGNED BY: TITLE: DATE: FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM SHALL DISQUALIFY THIS RESPONSE. 8/20/2024 9:24 AM p. 5 City of Miami Solicitation RFP 1896386 Certifications Legal Name of Firm: Request for Proposals No. 1896386 Firm's Federal Employer Identification Number ("FEIN"): Entity Type: Partnership, Sole Proprietorship, Corporation, etc. Year Established: Office Location: City of Miami, Miami -Dade County, or Other Business Tax Receipt/Occupational License Number: Business Tax Receipt/Occupational License Issuing Agency: Business Tax Receipt/Occupational License Expiration Date: Will Subcontractor(s) be used? (Yes or No) If subcontractor(s) will be utilized, provide their name, address and the portion of the work they will be responsible for under this contract (a copy of their license(s) must be submitted with your bid response). If no subcontractor(s) will be utilized, please insert N/A.: Please list and acknowledge all addendum/addenda received. List the addendum/addenda number and date of receipt (i.e. Addendum No. 1, 1/1/24). If no addendum/addenda was/were issued, please insert N/A. Has Proposer reviewed the attached Sample Professional Services Agreement? Yes / No 8/20/2024 9:24 AM p. 6 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 Acknowledge that if awarded, Proposer will be required to execute the Professional Services Agreement in substantially the attached form. In addition, Proposer must acknowledge that certain clauses (including #2 Term, #6 Audit and Inspection Rights and Records Retention, #8 Public Records, #9 Compliance with Federal, State and Local Laws, #10 Indemnification/Hold Harmless/Duty to Defend, #13 Termination; Obligation Upon Termination, #15 Nondiscrimination, and # 23 City Not Liable for Delays) are non-negotiable. 8/20/2024 9:24 AM p. 7 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 IMPORTANT NOTICE TO PROPOSERS • FAILURE TO COMPLETE, SIGN, AND UPLOAD THE CERTIFICATION STATEMENT, CERTIFICATIONS SECTION AND ATTACHMENT, PRICE PROPOSAL, WILL RENDER YOUR PROPOSAL NON -RESPONSIVE. • ATTACHMENT FILES SHALL BE NO MORE THAN 250MB IN SIZE EACH, SHOULD THERE BE A NEED FOR A LARGER SIZE FILE TO BE UPLOADED SPLIT IN MULTIPLE FILES. • CONTACT BIDSYNC VENDOR SUPPORT TOLL -FREE NUMBER 800-990-9339, EMAIL SUPPORT(&BIDSYNC.COM, OR SUPPORT.BIDSYNC.COM FOR BIDSYNC TECHNICAL DIFFICULTIES AND/OR ISSUES. 8/20/2024 9:24 AM p. 8 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 Table of Contents Terms and Conditions 1. General Terms and Conditions 1.1. GENERAL TERMS AND CONDITIONS 2. Special Conditions 2.1. PURPOSE 2.2. VOLUNTARY PRE -PROPOSAL CONFERENCE 2.3. DEADLINE FOR RECEIPT OF REQUEST FOR ADDITIONAL INFORMATION/CLARIFICATION 2.4. TERM OF CONTRACT 2.5. CONDITIONS FOR RENEWAL 2.6. LIVING WAGE ORDINANCE 2.7. PROPOSERS MINIMUM QUALIFICATIONS 2.8. REFERENCES 2.9. LOCAL PREFERENCE 2.10EXECUTION OF AN AGREEMENT 2.11. INSURANCE REQUIREMENTS 2.12. PROJECT MANAGER 2.13. SUBCONTRACTOR(S) OR SUBCONSULTANT(S) 2.14. REMOVAL OF EMPLOYEES/SUBCONTRACTORS 2.15. UNAUTHORIZED WORK 2.16. CHANGES/ALTERATIONS 2.17. COMPENSATION 2.18. METHOD OF PAYMENT 2.19. EVALUATION/SELECTION PROCESS AND CONTRACT AWARD 2.20. RECORDS 2.21. ADDITIONAL SERVICES 2.22. TRUTH IN NEGOTIATION CERTIFICATE 2.23. NON -APPROPRIATION OF FUNDS 2.24. FAILURE TO PERFORM 2.25. TERMINATION 2.26. ADDITIONAL TERMS AND CONDITIONS 2.27. E-VERIFY EMPLOYMENT VERIFICATION REQUIREMENTS 2.28. ANTITRUST VIOLATOR VENDORS 2.29. ANTI -HUMAN TRAFFICKING 3. Specifications 3.1. SPECIFICATIONS/SCOPE OF WORK 4. Submission Requirements 4.1. SUMISSION REQUIREMENTS 5. Evaluation Criteria 5.1. EVALUATION CRITERIA 8/20/2024 9:24 AM P. 9 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 Terms and Conditions 1. General Terms and Conditions GENERAL TERMS AND CONDITIONS Intent: The General Terms and Conditions described herein apply to the acquisition of goods/equipment/services with an estimated aggregate cost of $25,000.00 or more. Definition: A formal solicitation is defined as issuance of an Invitation for Bids, Request for Proposals, Request for Qualifications, or Request for Letters of Interest pursuant to the City of Miami Procurement Code and/or Florida Law, as amended. Formal Solicitation and Solicitation shall be defined in the same manner herein. 1.1 ACCEPTANCE OF GOODS, EQUIPMENT OR SERVICES - Any good(s), equipment or services delivered under this formal solicitation, if applicable, shall remain the property of the seller until a physical inspection and actual usage of the good is made, and thereafter is accepted as satisfactory to the City. It must comply with the terms herein and be fully in accordance with specifications and of the highest quality. In the event the goods/equipment supplied to the City are found to be defective or does not conform to specifications, the City reserves the right to cancel the order upon written notice to the Contractor and return the product to the Contractor at the Contractor's expense. In terms of this Solicitation the use of the word "services" includes without limitation professional and personal services as that term professional and personal services is defined by the City of Miami Procurement Ordinance and as set forth in the Definitions Section 18-73 of the City Code. 1.2 ACCEPTANCE OF OFFER - Subject to prior occurrence of all condition's precedent set forth in Section 1.88, The signed or electronic submission of your solicitation response shall be considered an offer on the part of the Proposer; such offer shall be deemed accepted upon the occurrence of all conditions precedent and issuance by the City of a purchase order or notice to proceed, as applicable. In summation, execution of a Professional Services Agreement and/or Agreement, approval by a referendum as stated in this RFP, and issuance by the City of a purchase order, and/or notice to proceed, as applicable. 1.3 ACCEPTANCE/REJECTION - The City reserves the right to accept or reject any or all responses or parts of after opening/closing date and request re -issuance on the goods/services described in the formal solicitation. In the event of such rejection, the Director of Procurement shall notify all affected Proposers and make available a written explanation for the rejection. The City also reserves the right to reject the response of any Proposer: 1) Who has previously failed to properly perform under the terms and conditions of a Professional Services Agreement ("PSA") and/or Agreement, 2) Who failed to deliver on time, contracts of a similar nature, 3) Who is not in a position to perform the requirements defined in this formal solicitation 4) Who has been debarred, 5) Who is on the convicted vendors list, 8/20/2024 9:24 AM p. 10 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 6) Who is indebted to the City, or 7) Who is otherwise determined to be non- responsive or non -responsible. The City further reserves the right to waive any irregularities, minor informalities, or technicalities in any or all responses and may, at its discretion, re -issue this formal solicitation. 1.4 ADDENDA - It is the Proposer's responsibility to ensure receipt of all Addenda. Addenda are available on the BidSync Procurement Solutions Platform ("BidSync") only. 1.5 ALTERNATE RESPONSES WILL NOT BE CONSIDERED. 1.6 ASSIGNMENT - Contractor agrees not to subcontract, assign, transfer, convey, sublet, or otherwise dispose of the resulting Contract, or any or all its rights, title or interest herein, without the City Manager's prior written consent. 1.7 ATTORNEY'S FEES - In connection with any litigation, mediation and arbitration arising out of this Contract, each party shall bear their own attorney's fees through and including appellate litigation and any post judgment proceedings. 1.8 AUDIT RIGHTS AND RECORDS RETENTION - The Successful Proposer agrees to provide access at all reasonable times to the City, or to any of its duly authorized representatives, to any books, documents, papers, and records of Contractor which are directly pertinent to this formal solicitation, for the purpose of audit, examination, excerpts, and transcriptions. The Successful Proposer shall maintain and retain any and all of the books, documents, papers and records pertinent to the Contract for three (3) years after the City makes final payment and all other pending matters are closed. Contractor's failure to or refusal to comply with this condition shall result in the immediate cancellation of this contract by the City. The audit and inspection provisions set forth in Sections 18-100 to 18-102, City Code, are deemed as being incorporated by reference herein as set forth in full. 1.9 AVAILABILITY OF CONTRACT STATE-WIDE - Any governmental, not -for -profit, or quasi - governmental entity in the State of Florida, may avail itself of this Contract and purchase any, and all goods/services, specified herein from the Successful Proposer at the Contract price(s) established herein, when permissible by Federal, State, and local laws, rules, and regulations. Additionally, any governmental entity outside of the State of Florida but, within the Continental United States of America, may avail itself to this Contract and purchase any and all goods/services, specified herein from the Successful Proposer at the Contract price(s) established herein, when permissible by Federal, State, and local laws, rules, and regulations. Each governmental, not -for -profit or quasi -governmental entity which uses this Formal Solicitation and resulting Contract will establish its own Contract, place its own orders, issue its own purchase orders, be invoiced there from and make its own payments, determine shipping terms and issue its own exemption certificates as required by the Successful Proposer. 1.10 AWARD OF CONTRACT: 8/20/2024 9:24 AM p. 11 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 A. The PSA and/or Agreement, the Formal Solicitation, the Proposer's response, any addenda issued, and the blanket purchase order shall constitute the entire contract, unless modified in accordance with any ensuing amendment or addenda. B. The award of this contract may be preconditioned on the subsequent submission of other documents as specified in the Special Conditions or Technical Specifications. Proposer shall be in default of its contractual obligation if such documents are not submitted in a timely manner and in the form required by the City. Where Proposer is in default of these contractual requirements, the City, through action taken by the Department of Procurement, will void its acceptance of the Proposer's Response and may accept the Response from the next lowest responsive, responsible Proposal most advantageous to the City or re -solicit the City's requirements. The City, at its sole discretion, may seek monetary restitution from Proposer and its proposal bond or guaranty, if applicable, as a result of damages or increased costs sustained as a result of the Proposer's default. C. The term of the contract shall be specified in one of three documents which shall be issued to the Successful Proposer. These documents may either be a blanket purchase order, notice of award and/or contract award sheet. D. The City reserves the right to automatically extend this contract for up to one hundred twenty (120) calendar days beyond the stated contract term in order to provide City departments with continual service and supplies while a new contract is being solicited, evaluated, and awarded. If the right is exercised, the City shall notify the Proposer, in writing, of its intent to extend the contract at the same price, terms and conditions for a specific number of days. Additional extensions over the first one hundred twenty (120) day extension may occur, if, the City and the Successful Proposer are in mutual agreement of such extensions. E. Where the contract involves a single shipment of goods to the City, the contract term shall conclude upon completion of the expressed or implied warranty periods. F. An PSA and/or Agreement shall be awarded to the Proposer by the City Commission based upon the minimum qualification requirements reflected herein. As a result of a RFP, RFQ, or RFLI, the City reserves the right to execute or not execute, as applicable, an PSA and/or Agreement with the Proposer, whichever is determined to be in the City's best interests. Such PSA and/or Agreement which will be furnished by the City, will contain certain terms as are in the City's best interests, and will be subject to approval as to legal form by the City Attorney. All conditions precedent identified in Section 1.88 before any Agreement is binding. 1.11 BID BOND/ BID SECURITY - A cashier's or certified check, or a Bid Bond signed by a recognized surety company that is licensed to do business in the State of Florida, payable to the City of Miami, for the amount bid is required from all Proposers, if so indicated under the Special Conditions. This check or bond guarantees that the Proposer will accept the order or contract/agreement, as proposed, if it is awarded to the Proposer. Proposer shall forfeit proposal deposit to the City should the City award the contract/agreement to the Proposer and if Proposer fails to accept the award. The City reserves the right to reject any and all surety tendered to the City. Proposal deposits are returned to unsuccessful Proposers within ten (10) days after the award and Successful Proposer's acceptance of award. If sixty (60) days have passed after the date of the formal solicitation closing date, and no contract has been awarded, all deposits will be returned on demand. 8/20/2024 9:24 AM p. 12 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 1.12 RESPONSE FORM - All forms should be completed, signed and submitted accordingly. 1.13 BID SECURITY FORFEITED LIQUIDATED DAMAGES - Failure to execute a PSA and/or Agreement and/or file an acceptable Performance Bond, when required, as provided herein, shall be just cause for the annulment of the award and the forfeiture of the Bid Security to the City, which forfeiture shall be considered, not as a penalty, but in mitigation of damages sustained. Award may then be negotiated with the next highest ranked responsive and responsible Proposal most advantageous to the City or all responses may be rejected. 1.14 BRAND NAMES - If and wherever in the specifications brand names, makes, models, names of any manufacturers, trade names, or Proposer catalog numbers are specified, it is for the purpose of establishing the type, function, minimum standard of design, efficiency, grade or quality of goods only. When the City does not wish to rule out other competitors' brands or makes, the phrase "OR EQUAL" is added. When bidding/proposing an approved equal, Proposers will submit, with their response, complete sets of necessary data (factory information sheets, specifications, brochures, etc.) in order for the City to evaluate and determine the equality of the item(s) bid/proposed. The City shall be the sole judge of equality and its decision shall be final. Unless otherwise specified, evidence in the form of samples may be requested if the proposed brand is other than specified by the City. Such samples are to be furnished after formal solicitation opening/closing only upon request of the City. If samples should be requested, such samples must be received by the City no later than seven (7) calendar days after a formal request is made. 1.15 CANCELLATION - The City reserves the right to cancel all formal solicitations before its opening/closing. In the event of proposal cancellation, the Director of Procurement shall notify all prospective Proposers and make available a written explanation for the cancellation. 1.16 CAPITAL EXPENDITURES - Proposer understands that any capital expenditures that the firm makes, or prepares to make, in order to deliver/perform the goods/services required by the City, is a business risk which the Contractor must assume. The City will not be obligated to reimburse amortized or unamortized capital expenditures, or to maintain the approved status of any Contractor. If Contractor has been unable to recoup its capital expenditures during the time it is rendering such goods/services, it shall not have any claim upon the City. 1.17 CITY NOT LIABLE FOR DELAYS - It is further expressly agreed that in no event shall the City be liable for, or responsible to, the Proposer/Consultant, any sub-contractor/sub-consultant, or to any other person for, or on account of, any stoppages or delay in the work herein provided for by injunction or other legal or equitable proceedings or on account of any delay for any cause over which the City has no control. 1.18 COLLUSION - Proposer, by submitting a response, certifies that its response is made without previous understanding, agreement or connection either with any person, firm or corporation submitting a response for the same items/services or with the City of Miami's Procurement Department or initiating department. The Proposer certifies that its response is fair, without control, collusion, fraud or other illegal action. Proposer certifies that it is in compliance with the Conflict of Interest and Code of Ethics Laws. The City will investigate all potential situations where collusion may have occurred, and the City reserves the right to reject any and all responses where collusion may have occurred. 1.19 COMPLIANCE WITH FEDERAL, STATE AND LOCAL LAWS - Contractor understands that 8/20/2024 9:24 AM p. 13 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 contracts between private entities and local governments are subject to certain laws and regulations, including laws pertaining to public records, conflict of interest, records keeping, competitive solicitations etc., et. al., as applicable. City and Contractor agree to comply with and observe all applicable laws, codes and ordinances as that may in any way affect the goods or equipment offered, including but not limited to: A. Executive Order 11246, which prohibits discrimination against any employee, applicant, or client because of race, creed, color, national origin, sex, or age with regard to, but not limited to, the following: employment practices, rate of pay or other compensation methods, and training selection. B. Occupational, Safety and Health Act (OSHA), as applicable to this Formal Solicitation. C. The State of Florida Statutes, Section 287.133(3)(A) on Public Entity Crimes. D. Environment Protection Agency (EPA), as applicable to this Formal Solicitation. E. Uniform Commercial Code (Florida Statutes, Chapter 672). F. Americans with Disabilities Act of 1990, as amended. G. National Institute of Occupational Safety Hazards (NIOSH), as applicable to this Formal Solicitation. H. National Forest Products Association (NFPA), as applicable to this Formal Solicitation. I. City Procurement Ordinance City Code Section 18, Article III. J. Conflict of Interest, City Code Section 2-611;61. K. Cone of Silence, City Code Section 18-74. L. The Florida Statutes Sections 218.73 and 218.74 on Prompt Payment. M. City Financial Policies, City Code Chapter 18, Article IX. N. City of Miami Charter Sections 3(f) (iii) and 29-B. O. City of Miami Sale or Lease of Real Property, City Code Chapter 18, Article V. P. City of Miami Living Wage Ordinance, Chapter 18, Article X, City Code. Q. Alcoholic beverage, food and beverage laws, approvals and permits as required by state and local laws. R. Miami -Dade County Shoreline Review Ordinance Chapter 33D, Article III, Miami -Dade County Code. Lack of knowledge or notice by the Proposer will in no way be a cause for relief from responsibility. Non- compliance with all local, state, and federal directives, orders, regulations, and laws may be considered 8/20/2024 9:24 AM p. 14 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 grounds for termination of contract(s). Copies of the City Ordinances may be obtained from the City Clerk's Office. 1.20 CONE OF SILENCE - Pursuant to Section 18-74 of the City of Miami Code, a "Cone of Silence" is imposed upon each RFP, RFQ, or RFLI after advertisement and terminates at the time the City Manager issues a written recommendation to the Miami City Commission. The Cone of Silence shall be applicable only to Contracts for the provision of goods and services and public works or improvements for amounts greater than $200,000. The Cone of Silence prohibits any communication regarding RFPs, RFQs, or RFLIs between potential vendors, service providers, Proposers, lobbyists or consultants (among others) and the City's professional staff including, but not limited to, the City Manager and the City Manager's staff; the Mayor, City Commissioners, or their respective staffs and any member of the respective selection/evaluation committee. The provision does not apply to, among other communications, oral communications with the City's Procurement staff, provided the communication is limited strictly to matters of process or procedure already contained in the formal solicitation document. The provisions of the Cone of Silence do not apply to oral communications at duly noticed site visits/inspections, pre -proposal conferences, oral presentations before selection/evaluation committees, contract negotiations during any duly noticed public meeting, or public presentations made to the Miami City Commission during a duly noticed public meeting; or communications in writing or by email at any time with any City employee, official or member of the City Commission unless specifically prohibited by the applicable RFP, RFQ, or RFLI documents; or communications in connection with the collection of industry comments or the performance of market research regarding a particular RFP, RFQ, or RFLI, by City Procurement staff. Proposers must file a copy of any written communications with the Office of the City Clerk, which shall be made available to any person upon request. The City shall respond in writing and file a copy with the Office of the City Clerk (clerks@miamigov.com), which shall be made available to any person upon request. Written communications may be in the form of e-mail, with a copy to the Office of the City Clerk. In addition to any other penalties provided by law, violation of the Cone of Silence by any Proposer shall render any award voidable. A violation by a particular Proposer, Offeror, Respondent, lobbyist or consultant shall subject same to potential penalties pursuant to the City Code. Any person having personal knowledge of a violation of these provisions shall report such violation to the State Attorney and/or may file a complaint with the Miami -Dade County Ethics Commission. Proposers should reference Section 18-74 of the City of Miami Code for further clarification. This language is only a summary of the key provisions of the Cone of Silence. Please review City of Miami Code Section 18-74 for a complete and thorough description of the Cone of Silence. You may contact the City Clerk at 305-250-5360, to obtain a copy of same. 1.21 CONFIDENTIALITY - As a political subdivision and Florida municipality, the City of Miami is subject to the Florida Sunshine Act and Public Records Law. If this Contract/Agreement contains a confidentiality provision, it shall have no application when disclosure is required by Florida law or upon court order. 1.22 CONFLICT OF INTEREST - Proposers, by responding to this Formal Solicitation, certify that to the 8/20/2024 9:24 AM p. 15 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 best of their knowledge or belief, no elected/appointed official or employee of the City of Miami is financially interested, directly or indirectly, in the purchase of goods/services specified in this Formal Solicitation. Any such interests on the part of the Proposer or its employees must be disclosed in writing to the City. Further, you must disclose the name of any City employee (or former employee of the City who left City service within the past two (2) years) who owns, directly or indirectly, an interest of five percent (5%) or more of the total assets of capital stock in the Proposer's firm. A. Proposer further agrees not to use or attempt to use any knowledge, property or resource which may be within their trust, or perform their duties, to secure a special privilege, benefit, or exemption for itself, or others. Proposer may not disclose or use information not available to members of the general public and gained by reason of their position, except for information relating exclusively to governmental practices, for their personal gain or benefit or for the personal gain or benefit of any other person or business entity. B. Proposer who is a person (every officer, official and employee of the city, including every member of any board, commission or agency of the city) as defined in Section 2-611 of the City Code, hereby acknowledges that it has not contracted or transacted any business with the City or any person or agency acting for the City and has not appeared in representation of any third party before any board, commission or agency of the City within the past two years. Proposer further warrants that they are not related, specifically the spouse, son, daughter, parent, brother or sister, to: (i) any member of the commission; (ii) the mayor; (iii) any city employee; or (iv) any member of any board or agency of the City. C. A violation of this section may subject the Proposer to immediate termination of any Professional Services Agreement with the City, imposition of the maximum fine and/or any penalties allowed by law. Additionally, violations may be considered by and subject to action by the Miami -Dade County Commission on Ethics. 1.23 COPYRIGHT OR PATENT RIGHTS - Proposers warrant that there has been no violation of any intellectual property, copyright or patent rights in manufacturing, producing, or selling the goods or equipment shipped or ordered and/or services provided as a result of this formal solicitation, and Proposers agree to hold the City harmless from any and all liability, loss, or expense occasioned by any such violation. 1.24 COST INCURRED BY PROPOSER - All expenses involved with the preparation and submission of Responses to the City, or any work performed in connection therewith shall be borne by the Proposer(s). 1.25 DEBARMENT AND SUSPENSIONS (Sec 18-107) (a) Authority and requirement to debar and suspend. After reasonable notice to an actual or prospective Contractual Party, and after reasonable opportunity for such party to be heard, the City Manager, after consultation with the Chief Procurement Officer and the city attorney, shall have the authority to debar a 8/20/2024 9:24 AM p. 16 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 Contractual Party, for the causes listed below, from consideration for award of city Contracts. The debarment shall be for a period of not fewer than three years. The City Manager shall also have the authority to suspend a Contractual Party from consideration for award of city Contracts if there is probable cause for debarment, pending the debarment determination. The authority to debar and suspend contractors shall be exercised in accordance with regulations which shall be issued by the Chief Procurement Officer after approval by the City Manager, the city attorney, and the City Commission. (b) Causes for debarment or suspension. Causes for debarment or suspension include the following: (i) Conviction for commission of a criminal offense incident to obtaining or attempting to obtain a public or private Contract or subcontract, or incident to the performance of such Contract or subcontract. (ii) Conviction under state or federal statutes of embezzlement, theft, forgery, bribery, falsification or destruction of records, receiving stolen property, or any other offense indicating a lack of business integrity or business honesty. (iii) Conviction under state or federal antitrust statutes arising out of the submission of Bids or Proposals. (iv) Violation of Contract provisions, which is regarded by the Chief Procurement Officer to be indicative of non -responsibility. Such violation may include failure without good cause to perform in accordance with the terms and conditions of a Contract or to perform within the time limits provided in a Contract, provided that failure to perform caused by acts beyond the control of a party shall not be considered a basis for debarment or suspension. (v) Debarment or suspension of the Contractual Party by any federal, state, local, or other governmental (public) agency or entity. (vi) False certification pursuant to paragraph (c) below. (vii) Found in violation of a zoning ordinance for which the violation remains noncompliant. (viii) Found in violation any city ordinance or regulation and for which a civil penalty or fine is due and owing to the city. (ix) Any other cause judged by the City Manager to be so serious and compelling as to affect the responsibility of the Contractual Party performing city Contracts. (c) Certification. All Contracts for goods and services, sales, and leases by the city shall contain a certification that neither the Contractual Party nor any of its principal owners or personnel have been convicted of any of the violations set forth above or debarred or suspended as set forth in paragraph (b)(v). (d) Debarment and suspension decisions. Subject to the provisions of paragraph (a), the City Manager shall render a written decision stating the reasons for the debarment or suspension. A copy of the decision shall be provided promptly to the Contractual Party, along with a notice of said parry's right to seek judicial relief. 8/20/2024 9:24 AM p. 17 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 1.26 DEBARRED/SUSPENDED VENDORS - An entity or affiliate who has been placed on the State of Florida debarred or suspended vendor list may not: 1) submit a response fora contract to provide goods or services to a public entity; 2) Submit a response on a contract with a public entity for the construction or repair of a public building or public work; 3) Submit response on leases of real property to a public entity; 4) award or perform work as a contractor, supplier, subcontractor, or consultant under contract with any public entity; and 5) transact business with any public entity. 1.27 DEFAULT/FAILURE TO PERFORM - The City shall be the sole judge of nonperformance, which shall include any failure on the part of the successful Proposer to accept the award, to furnish required documents, and/or to fulfill any portion of this contract within the time stipulated. Upon default by the successful Proposer to meet any terms of this agreement, the City will notify the Proposer of the default and will provide the contractor three (3) days (weekends and holidays excluded) to remedy the default. Failure on the contractor's part to correct the default within the required three (3) days shall result in the Contract being terminated and upon the City notifying in writing the contractor of its intentions and the effective date of the termination. The following shall constitute default: A. Failure to perform the work or deliver the goods/services required under the Contract and/or within the time required or failing to use the subcontractors, entities and personnel as identified and set forth, and to the degree specified in the Contract. B. Failure to begin the work under this Contract within the time specified. C. Failure to perform the work with sufficient workers and equipment or with sufficient materials to ensure timely completion. D. Neglecting or refusing to remove materials or perform new work where prior work has been rejected as nonconforming with the terms of the Contract. E. Becoming insolvent, being declared bankrupt, or committing any act of bankruptcy or insolvency, or making an assignment for the benefit of creditors, if the insolvency, bankruptcy, or assignment renders the successful Proposer incapable of performing the work in accordance with and as required by the Contract. F. Failure to comply with any of the terms of the Contract in any material respect. All costs and charges incurred by the City as a result of a default or a default incurred beyond the time limits stated, together with the cost of completing the work, shall be deducted from any monies due or which may become due on this Contract. 1.28 DETERMINATION OF RESPONSIVENESS AND RESPONSIBILITY - Each proposal will be reviewed to determine if it is responsive to the submission requirements outlined in the Formal Solicitation. A. Responsive Proposal is one which follows the requirements of the Formal Solicitation, includes all documentation, is submitted in the format outlined in the Formal Solicitation, is of timely submission, and has appropriate signatures as required on each document. Failure to comply with these requirements may deem a Proposal non -responsive. 8/20/2024 9:24 AM p. 18 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 B. Determination of Responsibility. A Responsible Proposer shall mean a Proposer who has submitted a proposal and who has the capability, as determined under Section 18-95 of the City Code, in all respects to fully perform the Contract requirements, and the integrity and reliability of which give reasonable assurance of good faith and performance. 1. Proposals will only be considered from any person or firm who are regularly engaged in the business of providing the good(s)/service(s) required by the Formal Solicitation. Proposer must be able to demonstrate a satisfactory record of performance and integrity, and have sufficient financial, material, equipment, facility, personnel resources, and expertise to meet all contractual requirements. 2. The City may consider any information available regarding the financial, technical, and other qualifications and abilities of a Proposer, including past performance (experience) with the City or any other governmental entity, in making the award. 3. The City may require the Proposer(s) to provide documentation that they have been designated as an authorized representative of a manufacturer or supplier which is the actual source of supply, if required by the Formal Solicitation. 1.29 DISCOUNTS OFFERED DURING TERM OF CONTRACT - Discount Prices offered in the response shall be fixed after the award by the Commission, unless otherwise specified in the Special Terms and Conditions. Price discounts off the original prices quoted in the response will be accepted from successful Proposer(s) during the term of the contract. Such discounts shall remain in effect for a minimum of 180 days from approval by the City Commission. Any discounts offered by a manufacturer to Proposer will be passed on to the City. 1.30 DISCREPANCIES, ERRORS, AND OMISSIONS - Any discrepancies, errors, or ambiguities in the Formal Solicitation or addenda (if any) should be reported in writing to the City's Purchasing Department. Should it be found necessary, a written addendum will be incorporated in the Formal Solicitation and will become part of the purchase agreement (contract documents). The City will not be responsible for any oral instructions, clarifications, or other communications. A. Order of Precedence -Any inconsistency in this formal solicitation shall be resolved by giving precedence to the following documents, the first of such list being the governing documents. 1) PSA and/or Agreement and/or any Amendments to the PSA and/or Agreement 2) Specifications 3) Special Conditions 4) General Terms and Conditions 1.31 EMERGENCY / DISASTER PERFORMANCE - In the event of a hurricane or other emergency or disaster situation, the successful vendor shall provide the City with the commodities/services defined within the scope of this formal solicitation at the price contained within vendor's response. Further, successful vendor shall deliver/perform for the city on a priority basis during such times of emergency. 8/20/2024 9:24 AM p. 19 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 1.32 ENTIRE BID CONTRACT OR AGREEMENT - The Bid Contract or Agreement consists of this City of Miami Formal Solicitation and specifically this General Conditions Section, Contractor's Response and any written agreement entered into by the City of Miami and Contractor in cases involving RFPs, RFQs, and RFLIs, and represents the entire understanding and agreement between the parties with respect to the subject matter hereof and supersedes all other negotiations, understanding and representations, if any, made by and between the parties. To the extent that the agreement conflicts with, modifies, alters or changes any of the terms and conditions contained in the Formal Solicitation and/or Response, the Formal Solicitation and then the Response shall control. This Contract may be modified only by a written agreement signed by the City of Miami and Contractor. 1.33 ESTIMATED QUANTITIES - Estimated quantities or estimated dollars are provided for your guidance only. No guarantee is expressed or implied as to quantities that will be purchased during the contract period. The City is not obligated to place an order for any given amount subsequent to the award of this contract. Said estimates may be used by the City for purposes of determining the most advantageous Proposer meeting specifications. The City reserves the right to acquire additional quantities at the prices bid/proposed or at lower prices in this Formal Solicitation. 1.34 EVALUATION OF RESPONSES A. Rejection of Responses The City may reject a Response for any of the following reasons: 1) Proposer fails to acknowledge receipt of addenda; 2) Proposer misstates or conceals any material fact in the Response; 3) Response does not conform to the requirements of the Formal Solicitation; 4) Response requires a conditional award that conflicts with the method of award; 5) Response does not include required samples, certificates, licenses as required; and 6) Response was not executed by the Proposer's authorized agent. The foregoing is not an all-inclusive list of reasons for which a Response may be rejected. The City may reject and re -advertise for all or any part of the Formal Solicitation whenever it is deemed in the best interest of the City. B. Elimination from Consideration 1) A contract shall not be awarded to any person or firm which is in arrears to the City upon any debt or contract, or which is in default on a bid, payment/ performance, bond they have submitted or as the surety bond or certificate furnished has not performed despite demand they do so or otherwise upon any obligation to the City. 2) A contract may not be awarded to any person or firm which has failed to perform under the terms and 8/20/2024 9:24 AM p. 20 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 conditions of any previous contract with the City or deliver on time contracts of a similar nature. 3) A contract may not be awarded to any person or firm which has been debarred by the City in accordance with the City's Debarment and Suspension Ordinance. C. Determination of Responsibility 1) Responses will only be considered from entities who are regularly engaged in the business of providing the goods/equipment/services required by the Formal Solicitation. Proposer must be able to demonstrate a satisfactory record of performance and integrity; and, have sufficient financial, material, equipment, facility, personnel resources, and expertise to meet all contractual requirements. The terms "equipment and organization" as used herein shall be construed to mean a fully equipped and well -established entity in line with the best industry practices in the industry as determined by the City. 2) The City may consider any evidence available regarding the financial, technical and other qualifications and abilities of a Proposer, including past performance (experience) with the City or any other governmental entity in making the award. 3) The City may require the Proposer(s) to show proof that they have been designated as an authorized representative of a manufacturer or supplier which is the actual source of supply, if required by the Formal Solicitation. 1.35 EXCEPTIONS TO GENERAL AND/OR SPECIAL CONDITIONS OR SPECIFICATIONS - Exceptions to the specifications shall be listed on the Response and shall reference the section. Any exceptions to the General or Special Conditions shall be cause for the bid (IFB) to be considered non -responsive. It also may be cause for a RFP, RFQ, or RFLI to be considered non -responsive; and, if exceptions are taken to the terms and conditions of the resulting agreement it may lead to terminating negotiations. 1.36 F.O.B. DESTINATION - Unless otherwise specified in the Formal Solicitation, all prices quoted/proposed by the Proposer must be F.O.B. DESTINATION, inside delivery, with all delivery costs and charges included in the bid/proposal price, unless otherwise specified in this Formal Solicitation. Failure to do so may be cause for rejection of bid/proposal. 1.37 FIRM PRICES - The Proposer warrants that prices, terms, and conditions quoted in its response will be firm throughout the duration of the contract unless otherwise specified in the Formal Solicitation. Such prices will remain firm for the period of performance or resulting purchase orders or contracts, which are to be performed or supplied over a period of time. 1.38 FLORIDA MINIMUM WAGE AND CITY OF MIAMI LIVING WAGE ORDINANCE - A. Florida Minimum Wage. In accordance with the Constitution of the State of Florida, Article X, Section 24, employers shall pay employee wages no less than the minimum wage for all hours worked in Florida. 8/20/2024 9:24 AM p. 21 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 Accordingly, it is the Successful Proposer's/Contractor's and their subcontractor's responsibility to understand and comply with this Florida minimum wage requirement and pay its employees the current established hourly minimum wage rate. This minimum wage rate is subject to change or adjusted by the rate of inflation using the consumer price index ("CPI") for urban wage earners and clerical workers, CPI-W, or a successor index as calculated by the United States Department of Labor. Each adjusted minimum wage rate calculated, shall be determined and published by the Agency Workforce Innovation on September 30th of each year and take effect on the following January 1st. It is the Proposer's and their subcontractor's (if applicable), full responsibility to determine whether any of their employees may be impacted by this Florida Minimum Wage Law, at any given point in time during the term of the Bid Contract. If impacted, Proposer must provide, with its bid, employee name(s), job title(s), job description(s), and current pay rate(s). Failure to submit this information at the time of bid submittal constitute Successful Proposer's/Contractor's acknowledgement and understanding that the Florida Minimum Wage Law will not impact its prices throughout the term of the Bid Contract, and a waiver of any contractual price increase request(s). The City reserves the right to request and the Successful Proposer/Contractor must provide for any, and all information to make a wage and contractual price increase(s) determination. B. City of Miami Living Wage Ordinance. The City of Miami adopted a Living Wage Ordinance for City Service Contracts with a total contract value exceeding $100,000 annually, and that have been competitively solicited and awarded on, or after January 1, 2017 by the City. "Service Contract" means a contract to provide services to the City, excluding, however, professional services as defined by the "Consultants Competitive Negotiation Act" set forth in F.S. § 287.055, and Section 18-87 of the City Code, and/or the other exclusions provided by Section 18-557 of the City Code. If a solicitation requires services, effective on January 1, 2017, Contractors must pay to all its employees, who provide services, a living wage of no less than $15.00 per hour without health benefits; or a wage of no less than $13.19 an hour, with health benefits. This language is only a summary of the key provisions of the City of Miami Living Wage Ordinance. Please review Section 18-557 of the City Code for a complete and thorough description of the City of Miami Living Wage Ordinance. 1.39 GOVERNING LAW AND VENUE - The validity and effect of this Contract shall be governed by the laws of the State of Florida. The parties agree that any action, mediation or arbitration arising out of this Contract shall take place in Miami -Dade County, Florida. In any action or proceeding each party shall bear their own respective attorney's fees. 1.40 HEADINGS AND TERMS - The headings to the various paragraphs of this Contract have been inserted for convenient reference only and shall not in any manner be construed as modifying, amending or affecting in any way the expressed terms and provisions hereof. 1.41 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPPA) - Any person or entity that performs or assists the City of Miami with a function or activity involving the use or disclosure of "individually identifiable health information (IIHI) and/or Protected Health Information (PHI) shall comply with the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the City of Miami Privacy 8/20/2024 9:24 AM p. 22 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 Standards. HIPAA mandates for privacy, security and electronic transfer standards, which include but are not limited to: A. Use of information only for performing services required by the contract or as required by law; B. Use of appropriate safeguards to prevent non -permitted disclosures; C. Reporting to the City of Miami of any non -permitted use or disclosure; D. Assurances that any agents and subcontractors agree to the same restrictions and conditions that apply to the Proposer and reasonable assurances that IIHI/PHI will be held confidential; E Making Protected Health Information (PHI) available to the customer; F. Making PHI available to the customer for review and amendment; and incorporating any amendments requested by the customer; G Making PHI available to the City of Miami for an accounting of disclosures; and H Making internal practices, books and records related to PHI available to the City of Miami for compliance audits. PHI shall maintain its protected status regardless of the form and method of transmission (paper records, and/or electronic transfer of data). The Proposer must give its customers written notice of its privacy information practices including specifically, a description of the types of uses and disclosures that would be made with protected health information. 1.42 INDEMNIFICATION - Contractor shall indemnify, hold/save harmless and defend at its own costs and expense the City, its officials, officers, agents, directors, and employees, from liabilities, damages, losses, and costs, including, but not limited to reasonable attorney's fees, to the extent caused by the negligence, recklessness or intentional wrongful misconduct of Contractor and persons employed or utilized by Contractor in the performance of this Contract and will indemnify, hold harmless and defend the City, its officials, officers, agents, directors and employees against, any civil actions, statutory or similar claims, injuries or damages arising or resulting from the permitted work, even if it is alleged that the City, its officials and/or employees were negligent. These indemnifications shall survive the term of this Contract. In the event that any action or proceeding is brought against City by reason of any such claim or demand, Contractor shall, upon written notice from City, resist and defend such action or proceeding by counsel satisfactory to City. The Contractor expressly understands and agrees that any insurance protection required by this Contract or otherwise provided by Contractor shall in no way limit the responsibility to indemnify, keep and save harmless and defend the City or its officers, employees, agents and instrumentalities as herein provided. The indemnification provided above shall obligate Contractor to defend at its own expense to and through appellate, supplemental or bankruptcy proceeding, or to provide for such defense, at City's option, any and all claims of liability and all suits and actions of every name and description which may be brought against City whether performed by Contractor, or persons employed or utilized by Contractor. 8/20/2024 9:24 AM p. 23 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 This indemnity will survive the cancellation or expiration of the Contract. This indemnity will be interpreted under the laws of the State of Florida, including without limitation and which conforms to the limitations of §725.06 and/or §725.08, Fla. Statues, as amended from time to time as applicable. Contractor shall require all Sub -Contractor agreements to include a provision that they will indemnify the City. The Contractor agrees and recognizes that the City shall not be held liable or responsible for any claims which may result from any actions or omissions of the Contractor in which the City participated either through review or concurrence of the Contractor's actions. In reviewing, approving or rejecting any submissions by the Contractor or other acts of the Contractor, the City in no way assumes or shares any responsibility or liability of the Contractor or Sub -Contractor, under this Agreement. 1.43 FORMATION AND DESCRIPTIVE LITERATURE - Proposer must furnish all information requested in the spaces provided in the Formal Solicitation. Further, as may be specified elsewhere, each Proposer must submit for evaluation, cuts, sketches, descriptive literature, technical specifications, and Material Safety Data Sheets (MSDS)as required, covering the products offered. Reference to literature submitted with a previous response or on file with the Buyer will not satisfy this provision. 1.44 INSPECTIONS - The City may, at reasonable times during the term hereof, inspect Contractor's facilities and perform such tests, as the City deems reasonably necessary, to determine whether the goods and/or services required to be provided by the Contractor under this Contract conform to the terms and conditions of the Formal Solicitation. Contractor shall make available to the City all reasonable facilities and assistance to facilitate the performance of tests or inspections by City representatives. All tests and inspections shall be subject to, and made in accordance with, the provisions of the City of Miami Ordinance No. 12271 (Section 18-79), as same may be amended or supplemented from time to time. 1.45 INSPECTION OF RESPONSE - Responses received by the City pursuant to a Formal Solicitation will not be made available until such time as the City provides notice of a decision or intended decision or within 30 days after bid closing, whichever is earlier. Bid/Proposal results will be tabulated and may be furnished upon request via fax or e-mail to the Sr. Procurement Specialist issuing the Solicitation. Tabulations also are available on the City's Web Site following recommendation for award. 1.46 INSURANCE - Within ten (10) days after receipt of Notice of Award, the successful Contractor, shall furnish Evidence of Insurance to the Purchasing Department, if applicable. Submitted evidence of coverage shall demonstrate strict compliance to all requirements listed on the Special Conditions entitled "Insurance Requirements". The City shall be listed as an "Additional Insured." Issuance of a Purchase Order is contingent upon the receipt of proper insurance documents. If the insurance certificate is received within the specified time frame but not in the manner prescribed in this Solicitation the Contractor shall be verbally notified of such deficiency and shall have an additional five (5) calendar days to submit a corrected certificate to the City. If the Contractor fails to submit the required insurance documents in the manner prescribed in this Solicitation within fifteen (15) calendar days after receipt Notice of Award, the contractor shall be in default of the contractual terms and conditions and shall not be awarded the contract. Under such circumstances, the Proposer may be prohibited from submitting future responses to the City. Information regarding any insurance requirements shall be directed to the Risk Administrator, Department of 8/20/2024 9:24 AM p. 24 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 Risk Management, at 444 SW 2nd Avenue, 9th Floor, Miami, Florida 33130, 305-416-1604. The Proposer shall be responsible for assuring that the insurance certificates required in conjunction with this Section remain in effect for the duration of the contractual period; including any and all option terms that may be granted to the Proposer. 1.47 INVOICES - Invoices shall contain purchase order number and details of goods and/or services delivered (i.e. quantity, unit price, extended price, etc.); and in compliance with Chapter 218 of the Florida Statutes (Prompt Payment Act). 1.48 LOCAL PREFERENCE A. City Code Section 18-85, states, "when a responsive, responsible non -local bidder submits the lowest bid price, and the bid submitted by one or more responsive, responsible local bidders who maintain a local office, as defined in Section 18-73, is within fifteen percent (15%) of the price submitted by the non -local bidder, then that non -local bidder and each of the aforementioned responsive, responsible local bidders shall have the opportunity to submit a best and final bid equal to or lower than the amount of the low bid previously submitted by the non -local bidder. Contract award shall be made to the lowest responsive, responsible bidder submitting the lowest best and final bid. In the case of a tie in the best and final bid between a local bidder and a non - local bidder, contract award shall be made to the local bidder." B. City Code Section 18-86, states, "the RFP, RFLI or RFQ, as applicable, may, in the exercise of the reasonable professional discretion of the City Manager, director of the using agency, and the Chief Procurement Officer, include a five (5%) percent evaluation criterion in favor of proposers who maintain a local office, as defined in Section 18-73. In such cases, this five (5%) percent evaluation criterion in favor of proposers who maintain a local office will be specifically defined in the RFP, RFLI or RFQ, as applicable; otherwise, it will not apply. 1.49 MANUFACTURER'S CERTIFICATION - The City reserves the right to request from Proposers a separate Manufacturer's Certification of all statements made in the bid/proposal. Failure to provide such certification may result in the rejection of bid/proposal or termination of contract/agreement, for which the Proposer must bear full liability. 1.50 MODIFICATIONS OR CHANGES IN PURCHASE ORDERS AND CONTRACTS - No contract or understanding to modify this Formal Solicitation and resultant purchase orders or contracts, if applicable, shall be binding upon the City unless made in writing by the Director of Procurement of the City of Miami, Florida through the issuance of a change order, addendum, amendment, or supplement to the contract, purchase order or award sheet as appropriate. 1.51 MOST FAVORED NATIONS - Successful Proposer shall not treat the City of Miami ("City") worse than any other similarly -situated local government and, in this regard, grants the City a "most favored nations clause" meaning the City will be entitled to receive and be governed by the most favorable terms and conditions that Successful Proposer grants now or in the future to a similarly situated local government. 1.52 NO PARTNERSHIP OR JOINT VENTURE - Nothing contained in this Contract will be deemed or construed to create a partnership or joint venture between the City of Miami and Contractor, or to create any 8/20/2024 9:24 AM p. 25 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 other similar relationship between the parties. 1.53 NONCONFORMANCE TO CONTRACT CONDITIONS - Items may be tested for compliance with specifications under the direction of the Florida Depaitnient of Agriculture and Consumer Services or by other appropriate testing Laboratories as determined by the City. The data derived from any test for compliance with specifications is public record and open to examination thereto in accordance with Chapter 119, Florida Statutes. Items delivered not conforming to specifications may be rejected and returned at Proposer's expense. These non -conforming items not delivered as per delivery date in the response and/or Purchase Order may result in Proposer being found in default in which event any and all re -procurement costs may be charged against the defaulted contractor. Any violation of these stipulations may also result in the supplier's name being removed from the City of Miami's Supplier's list. 1.54 NONDISCRIMINATION EQUAL EMPLOYMENT OPPORTUNITY, AND AMERICANS WITH DISABILITIES ACT - Successful Proposer shall not unlawfully discriminate against any person in its operations and activities or in its use or expenditure of funds in fulfilling its obligations under this Agreement. Successful Proposer shall affirmatively comply with all applicable provisions of the Americans with Disabilities Act (ADA) in the course of providing any services funded by City, including Titles I and II of the ADA (regarding nondiscrimination on the basis of disability), and all applicable regulations, guidelines, and standards. In addition, Successful Proposer shall take affirmative steps to ensure nondiscrimination in employment against disabled persons. Successful Proposer affirms that it shall not discriminate as to race, age, religion, color, gender, gender identity, sexual orientation, national origin, marital status, physical or mental disability, political affiliation, or any other factor which cannot be lawfully used in connection with its performance under the Formal Solicitation. Furthermore, Successful Proposer affirms that no otherwise qualified individual shall solely by reason of their race, age, religion, color, gender, gender identity, sexual orientation, national origin, marital status, physical or mental disability, political affiliation, or any other factor which cannot be lawfully used, be excluded from the participation in, be denied benefits of, or be subjected to, discrimination under any program or activity. In connection with the conduct of its business, including performance of services and employment of personnel, Successful Proposer shall not discriminate against any person on the basis of race, age, religion, color, gender, gender identity, sexual orientation, national origin, marital status, physical or mental disability, political affiliation, or any other factor which cannot be lawfully used. All persons having appropriate qualifications shall be afforded equal opportunity for employment. 1.55 NON-EXCLUSIVE CONTRACT/ PIGGYBACK PROVISION - At such times as may serve its best interest, the City of Miami reserves the right to advertise for, receive, and award additional contracts for these herein goods and/or services, and to make use of other competitively bid (governmental) contracts, agreements, or other similar sources for the purchase of these goods and/or services as may be available. It is hereby agreed and understood that this formal solicitation does not constitute the exclusive rights of the successful Proposer(s) to receive all orders that may be generated by the City in conjunction with this Formal Solicitation. In addition, any and all commodities, equipment, and services required by the City in conjunction with 8/20/2024 9:24 AM p. 26 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 construction projects are solicited under a distinctly different solicitation process and shall not be purchased under the terms, conditions and awards rendered under this solicitation, unless such purchases are determined to be in the best interest of the City. 1.56 NOTICE REGARDING "CURES" - Proposals submitted with irregularities, deficiencies, and/or technicalities that deviate from the minimum qualifications and submission requirements of Request for Qualifications (RFQ), Request for Proposals (RFP), Invitation to Bid (ITB), Invitation for Bids (IFB), Invitation to Quote (ITQ), Requests for Letters of Interest (RFLI) and Request for Sponsorships (RFS) shall result in a non -responsive determination. any solicitation issued after May 6, 2019, shall comply with APM 2-19. APM 2-19 is attached hereto. only minor irregularities, deficiencies, and technicalities may be allowed to be timely cured by the proposer at the sole discretion of the city. material irregularities, deficiencies, and technicalities cannot be cured by the proposer, and are not waivable by the city. PROPOSALS SUBMITTED WITH IRREGULARITIES, DEFICIENCIES, AND/OR TECHNICALITIES THAT DEVIATE FROM THE MINIMUM QUALIFICATIONS AND SUBMISSION REQUIREMENTS OF THIS RFP/Q SHALL RESULT IN A NON -RESPONSIVE DETERMINATION. The City will not give consideration to the curing of any Proposals that fail to meet the minimum qualifications and submission requirements of this RFP/Q. Proposer understands that non -responsive Proposals will not be evaluated and, therefore, will be eliminated from the Evaluation/Selection Process. 1.57 OCCUPATIONAL LICENSE - Any person, firm, corporation or joint venture, with a business location in the City of Miami and is submitting a Response under this Formal Solicitation shall meet the City's Occupational License Tax requirements in accordance with Chapter 31.1, Article I of the City of Miami Charter. Others with a location outside the City of Miami shall meet their local Occupational License Tax requirements. A copy of the license must be submitted with the response; however, the City may at its sole option and in its best interest allow the Proposer to supply the license to the City during the evaluation period, but prior to award. 1.58 ONE PROPOSAL - Only one (1) Response from an individual, firm, partnership, corporation or joint venture will be considered in response to this Formal Solicitation. 1.59 OWNERSHIP OF DOCUMENTS - It is understood by and between the parties that any documents, records, files, or any other matter whatsoever which is given by the City to the successful Proposer pursuant to this formal solicitation shall at all times remain the property of the City and shall not be used by the Proposer for any other purposes whatsoever without the written consent of the City. 1.60 PARTIAL INVALIDITY - If any provision of this Contract or the application thereof to any person or circumstance shall to any extent be held invalid, then the remainder of this Contract or the application of such provision to persons or circumstances other than those as to which it is held invalid shall not be affected thereby, and each provision of this Contract shall be valid and enforced to the fullest extent permitted by law. 1.61 PERFORMANCE/PAYMENT BOND - A Contractor may be required to furnish a Performance/Payment Bond as part of the requirements of this Contract, in an amount equal to one hundred percent (100%) of the contract price. 1.62 PREPARATION OF RESPONSES - Proposers are expected to examine the specifications, required 8/20/2024 9:24 AM p. 27 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 delivery, drawings, and all special and general conditions. All bid/proposed amounts, if required, shall be either typewritten or entered into the space provided with ink. Failure to do so will be at the Proposer's risk. A. Each Proposer shall furnish the information required in the Formal Solicitation. The Proposer shall sign the Response and print in ink or type the name of the Proposer, address, and telephone number on the face page and on each continuation sheet thereof on which he/she makes an entry, where required. B. If so required, the unit price for each unit offered shall be shown, and such price shall include packaging, handling and shipping, and F.O.B. Miami delivery inside City premises unless otherwise specified. Proposer shall include in the response all taxes, insurance, social security, workmen's compensation, and any other benefits normally paid by the Proposer to its employees. If applicable, a unit price shall be entered in the "Unit Price" column for each item. Based upon estimated quantity, an extended price shall be entered in the "Extended Price" column for each item offered. In case of a discrepancy between the unit price and extended price, the unit price will be presumed correct. C. The Proposer must state a definite time, if required, in calendar days for delivery of goods and/or services. D. The Proposer should retain a copy of all response documents for future reference. E. All responses, as described, must be fully completed and typed or printed in ink and must be signed in ink with the firm's name and by an officer or employee having authority to bind the company or firm by his/her signature. Bids/Proposals having any erasures or corrections must be initialed in ink by person signing the response or the response may be rejected. F. Responses are to remain valid for at least 180 days. Upon award of a contract, the content of the Successful Proposer's response may be included as part of the contract, at the City's discretion. G. The City of Miami's Response Forms shall be used at all times. Use of any other forms will result in the rejection of the response. ANY REQUIRED ATTACHMENTS PROVIDED BY THE CITY MUST BE RETURNED TO THE CITY OR YOUR RESPONSE SHALL BE DEEMED NON -RESPONSIVE. 1.63 PRICE ADJUSTMENTS - Any price decrease effectuated during the contract period either by reason of market change or on the part of the contractor to other customers shall be passed on to the City of Miami. 1.64 PRODUCT SUBSTITUTES - In the event a particular good (that has been awarded and approved) becomes unavailable during the term of the Contract, the Contractor awarded that item may arrange with the City's authorized representative(s) to supply a substitute product at the awarded price or lower, provided that a sample is approved in advance of delivery and that the new product meets or exceeds all quality requirements. 1.65 CONFLICT OF INTEREST, AND UNETHICAL BUSINESS PRACTICE PROHIBITIONS - Contractor represents and warrants to the City that it has not employed or retained any person or company employed by the City to solicit or secure this Contract and that it has not offered to pay, paid, or agreed to pay any person any fee, commission, percentage, brokerage fee, or gift of any kind contingent upon or in connection with, the award of this Contract. 8/20/2024 9:24 AM p. 28 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 1.66 PROMPT PAYMENT - Proposers may offer a cash discount for prompt payment; however, discounts shall not be considered in determining the lowest net cost for response evaluation purposes. Proposers are required to provide their prompt payment terms in the space provided on the Formal Solicitation. If no prompt payment discount is being offered, the Proposer must enter zero (0) for the percentage discount to indicate no discount. If the Proposer fails to enter a percentage, it is understood and agreed that the terms shall be 2% 20 days, effective after receipt of invoice or final acceptance by the City, whichever is later. When the City is entitled to a cash discount, the period of computation will commence on the date of delivery, or receipt of a correctly completed invoice, whichever is later. If an adjustment in payment is necessary due to damage, the cash discount period shall commence on the date final approval for payment is authorized. If a discount is part of the contract, but the invoice does not reflect the existence of a cash discount, the City is entitled to a cash discount with the period commencing on the date it is determined by the City that a cash discount applies. Price discounts off the original prices quoted on the Price Sheet will be accepted from successful Proposers during the term of the contract. 1.67 PROPERTY - Property owned by the City of Miami is the responsibility of the City of Miami. Such property furnished to a Contractor for repair, modification, study, etc., shall remain the property of the City of Miami. Damages to such property occurring while in the possession of the Contractor shall be the responsibility of the Contractor. Damages occurring to such property while in route to the City of Miami shall be the responsibility of the Contractor. In the event that such property is destroyed or declared a total loss, the Contractor shall be responsible for replacement value of the property at the current market value, less depreciation of the property, if any. 1.68 PROVISIONS BINDING - Except as otherwise expressly provided in the resulting Contract, all covenants, conditions and provisions of the resulting Contract shall be binding upon and shall inure to the benefit of the parties hereto and their respective heirs, legal representatives, successors and assigns. 1.69 PUBLIC ENTITY CRIMES - A person or affiliate who has been placed on the convicted vendor list, following a conviction for a public entity crime may not: A. Submit a Bid to provide any goods or services to a public entity. B. Submit a Bid on a contract with a public entity for the construction or repair of a public building or public work. C. Submit responses on leases of real property to a public entity. D. Be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity. E. Transact business with any public entity in excess of the threshold amount provided in Section 287.017, CATEGORY TWO for a period of 36 months from the date of being placed on the convicted vendor list. 8/20/2024 9:24 AM p. 29 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 1.70 PUBLIC RECORDS - Proposer understands that the public shall have access, at all reasonable times, to all documents and information pertaining to City contracts, subject to the provisions of Chapter 119, Florida Statutes, and City Code, Section 18, Article III, and agrees to allow access by the City and the public, to all documents subject to disclosure under applicable law. Successful Proposer shall additionally comply with the provisions of Section 119.0701, Florida Statutes, titled "Contracts; public records". Proposer shall additionally comply with Section 119.0701, Florida Statutes, including without limitation: A. Keep and maintain public records that ordinarily and necessarily would be required by the City to perform this service. B. Provide the public with access to public records on the same terms and conditions as the City would at the cost provided by Chapter 119, Florida Statutes, or as otherwise provided by law. C. Ensure that public records that are exempt or confidential and exempt from disclosure are not disclosed except as authorized by law. D. Meet all requirements for retaining public records and transfer, at no cost, to the City all public records in its possession upon termination of this Agreement and destroy any duplicate public records that are exempt or confidential and exempt from disclosure requirements. E. All electronically stored public records must be provided to the City in a format compatible with the City's information technology systems. IF THE CONSULTANT HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONSULTANT'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS AGREEMENT, CONTACT THE DIVISION OF PUBLIC RECORDS AT (305) 416-1800, VIA EMAIL AT PUBLICRECORDS@MIAMIGOV.COM, OR REGULAR MAIL AT CITY OF MIAMI OFFICE OF THE CITY ATTORNEY, 444 SW 2ND AVENUE, 9TH FL, MIAMI, FL 33130. THE CONSULTANT MAY ALSO CONTACT THE RECORDS CUSTODIAN AT THE CITY OF MIAMI DEPARTMENT WHO IS ADMINISTERING THIS CONTRACT. 1.71 QUALITY OF GOODS, MATERIALS, SUPPLIES, PRODUCTS, AND EQUIPMENT - All materials used in the manufacturing or construction of supplies, materials, or equipment covered by this solicitation shall be new. The items bid/proposed must be of the latest make or model, of the best quality, and of the highest grade of workmanship, unless as otherwise specified in this Solicitation. 1.72 QUALITY OF WORK/SERVICES - The work/services performed must be of the highest quality and workmanship. Materials furnished to complete the service shall be new and of the highest quality except as otherwise specified in this Solicitation. 1.73 REMEDIES PRIOR TO AWARD (Sec. 18-106) - If prior to Contract award it is determined that a formal solicitation or proposed award is in violation of law, then the solicitation or proposed award shall be cancelled by the City Commission, the City Manager or the Chief Procurement Officer, as may be applicable, or revised to comply with the law. 1.74 RESOLUTION OF CONTRACT DISPUTES (Sec. 18-105) 8/20/2024 9:24 AM p. 30 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 A. Authority to resolve Contract disputes. The City Manager, after obtaining the approval of the City Attorney, shall have the authority to resolve disputes between the Proposer and the City which arise under, or by virtue of, a Contract between them; provided that, in cases involving an amount greater than $25,000, the City Commission must approve the City Manager's decision. Such authority extends, without limitation, to disputes based upon breach of Contract, mistake, misrepresentation, or lack of complete performance, and shall be invoked by a Contractual Party by submission of a protest to the City Manager. B. Contract dispute decisions. If a dispute is not resolved by mutual consent, the City Manager shall promptly render a written report stating the reasons for the action taken by the City Commission, or the City Manager, which shall be final and conclusive. A copy of the decision shall be immediately provided to the protesting party, along with a notice of such party's right to seek judicial relief, provided that the protesting party shall not be entitled to such judicial relief without first having followed the procedure set forth in this Section. 1.75 RESOLUTION OF PROTESTED SOLICITATIONS AND AWARDS (SECTION 18-104): Right to protest. The following procedures shall be used for resolution of protested solicitations and awards except for purchases of goods, supplies, equipment, and services, the estimated cost of which does not exceed $25,000.00. Protests thereon shall be governed by the administrative policies and procedures of purchasing. Protest of solicitation. a. Any prospective proposer who perceives itself aggrieved in connection with the solicitation of a contract may protest to the chief procurement officer. A written notice of intent to file a protest shall be filed with the chief procurement officer within three days after the request for proposals, request for qualifications or request for letters of interest is published in a newspaper of general circulation. A notice of intent to file a protest is considered filed when received by the chief procurement officer; or b. Any prospective bidder who intends to contest bid specifications or a bid solicitation may protest to the chief procurement officer. A written notice of intent to file a protest shall be filed with the chief procurement officer within three days after the bid solicitation is published in a newspaper of general circulation. A notice of intent to file a protest is considered filed when received by the chief procurement officer. Protest of award. a. Any actual proposer who perceives itself aggrieved in connection with the recommended award of contract may protest to the chief procurement officer. A written notice of intent to file a protest shall be filed with the chief procurement officer within two days after receipt by the proposer of the notice of the city manager's recommendation for award of contract. The receipt by proposer of such notice shall be confirmed by the city by facsimile or electronic mail or U.S. mail, return receipt requested. A notice of intent to file a protest is considered filed when received by the chief procurement officer; or b. Any actual responsive and responsible bidder whose bid is lower than that of the recommended bidder may protest to the chief procurement officer. A written notice of intent to file a protest shall be filed with the chief procurement officer within two days after receipt by the bidder of the notice of the city's determination of 8/20/2024 9:24 AM p. 31 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 non -responsiveness or non -responsibility. The receipt by bidder of such notice shall be confirmed by the city by facsimile or electronic mail or U.S. mail, return receipt requested. A notice of intent to file a protest is considered filed when received by the chief procurement officer. c. A written protest based on any of the foregoing must be submitted to the chief procurement officer within five days after the date the notice of protest was filed. A written protest is considered filed when received by the chief procurement officer. The written protest may not challenge the relative weight of the evaluation criteria or the formula for assigning points in making an award determination. The written protest shall state with particularity the specific facts and law upon which the protest of the solicitation or the award is based and shall include all pertinent documents and evidence and shall be accompanied by the required filing fee as provided in subsection (f). This shall form the basis for review of the written protest and no facts, grounds, documentation or evidence not contained in the protester's submission to the chief procurement officer at the time of filing the protest shall be permitted in the consideration of the written protest. No time will be added to the above limits for service by mail. In computing any period of time prescribed or allowed by this section, the day of the act, event or default from which the designated period of time begins to run shall not be included. The last day of the period so computed shall be included unless it is a Saturday, Sunday or legal holiday in which event the period shall run until the end of the next day which is neither a Saturday, Sunday or legal holiday. Intermediate Saturdays, Sundays and legal holidays shall be excluded in the computation of the time for filing. Authority to resolve protests; hearing officer(s). Hearing officers appointed by the city shall have authority to resolve protests filed under this chapter of the City Code. The city manager shall appoint a hearing officer, from a separate list of potential hearing officers pre -approved by the city commission, to resolve protests filed in accordance with this section, no later than five working days following the filing of a bid protest. The hearing officer shall have the authority to settle and resolve any written protest. The hearing officer shall submit said decision to the protesting party and to the other persons specified within ten days after he/she holds a hearing under the protest. (1) Hearing officer. The hearing officer may be a special master as defined in chapter 2, article X, section 2- 811 of the City Code, or a lawyer in good standing with the Florida Bar for a minimum of ten years with a preference given to a lawyer who has served as an appellate or trial court judge. The hearing officer may be appointed from alternative sources (e.g. expert consulting agreements, piggyback contracts, etc.) where the city commission adopts a recommendation of the city attorney that such action is necessary to achieve fairness in the proceedings. The engagement of hearing officers is excluded from the procurement ordinance as legal services. The hearing officers appointed in the pre -qualified group should be scheduled to hear protests on a rotational basis. (2) Right of protest. Any actual bidder or proposer who has standing under Florida law dissatisfied and aggrieved with the decision of the city regarding the protest of a solicitation or the protest of an award as set forth above in this section may request a protest hearing. Such a written request for a protest hearing must be 8/20/2024 9:24 AM p. 32 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 initiated with a notice of intent to protest followed by an actual protest as provided in subsection 18-104(a). The notice of intent to protest and the actual protest must each be timely received by the chief procurement officer and must comply with all requirements set forth in subsection 18-104(a). Failure to submit the required notice of intent to protest and the actual protest within the specified timeframes will result in an administrative dismissal of the protest. (3) Hearing date. Within 30 days of receipt of the notice of protest, the chief procurement officer shall schedule a hearing before a hearing officer, at which time the person protesting shall be given the opportunity to demonstrate why the decision of the city relative to the solicitation or the award, which may include a recommendation for award by the city manager to the city commission, as applicable, should be overturned. The party recommended for award, if it is a protest of award, shall have a right to intervene and be heard. (4) Hearing procedure. The procedure for any such hearing conducted under this article shall be as follows: a. The city shall cause to be served by certified mail a notice of hearing stating the time, date, and place of the hearing. The notice of hearing shall be sent by certified mail, return receipt requested, to the mailing address of the protester. b. The party, any intervenor, and the city shall each have the right to be represented by counsel, to call and examine witnesses, to introduce evidence, to examine opposing or rebuttal witnesses on any relevant matter related to the protest even though the matter was not covered in the direct examination, and to impeach any witness regardless of which party first called him/her to testify. The hearing officer may extend the deadline for completion of the protest hearing for good cause shown, but such an extension shall not exceed an additional five business days. The hearing officer shall consider the written protest and supporting documents and evidence appended thereto, supporting documents or evidence from any intervenor, and the decision or recommendation as to the solicitation or award being protested, as applicable. The protesting party, and any intervenor, must file all pertinent documents supporting his/her protest or motion to intervene at least five business days before the hearing, as applicable. The hearing officer shall allow a maximum of two hours for the protest presentation and a maximum of two hours for the city response. When there is an intervenor, a maximum of two hours will be added for the intervenor. In the event of multiple protests for the same project, the hearing officer shall allocate time as necessary to ensure that the hearing shall not exceed a total of one day. c. The hearing officer shall consider the evidence presented at the hearing. In any hearing before the hearing officer, irrelevant, immaterial, repetitious, scandalous, or frivolous evidence shall be excluded. All other evidence of a type commonly relied upon by reasonably prudent persons in the conduct of their affairs shall be admissible whether or not such evidence would be admissible in trial in the courts of Florida. The hearing officer may also require written summaries, proffers, affidavits, and other documents the hearing officer determines to be necessary to conclude the hearing and issue a final order within the time limits set forth by this section. d. The hearing officer shall determine whether procedural due process has been afforded, whether the essential requirements of law have been observed, and whether the decision was arbitrary, capricious, an abuse of discretion, or unsupported by substantial evidence as a whole. Substantial evidence means such relevant evidence as a reasonable mind might accept as adequate to support a conclusion. 8/20/2024 9:24 AM p. 33 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 e. Within ten days from the date of the hearing, the hearing officer shall complete and submit to the City Manager, the City Attorney, any intervenor, the Chief Procurement Officer, and the person requesting said hearing a final order consisting of his/her findings of fact and conclusions of law as to the denial or granting of the protest, as applicable. f. The decisions of the hearing officer are final in terms of city decisions relative to the protest. Any appeal from the decision of the hearing officer shall be in accordance with the Florida Rules of Appellate Procedure. Compliance with filing requirements. Failure of a party to timely file either the notice of intent to file a protest or the written protest, together with the required filing fee as provided in subsection (f), with the chief procurement officer within the time provided in subsection (a), above, shall constitute a forfeiture of such party's right to file a protest pursuant to this section. The protesting party shall not be entitled to seek judicial relief without first having followed the procedure set forth in this section. Stay of procurements during protests. Upon receipt of a written protest filed pursuant to the requirements of this section, the city shall not proceed further with the solicitation or with the award of the contract until the protest is resolved by the chief procurement officer or the city commission as provided in subsection (b) above, unless the city manager makes a written determination that the solicitation process or the contract award must be continued without delay in order to avoid an immediate and serious danger to the public health, safety or welfare. Costs. All costs accruing from a protest shall be assumed by the protestor. Filing fee. The written protest must be accompanied by a filing fee in the form of a money order or cashier's check payable to the city in an amount equal to one percent of the amount of the bid or proposed contract, or $5,000.00, whichever is less, which filing fee shall guarantee the payment of all costs which may be adjudged against the protestor in any administrative or court proceeding. If a protest is upheld by the chief procurement officer and/or the city commission, as applicable, the filing fee shall be refunded to the protestor less any costs assessed under subsection above. If the protest is denied, the filing fee shall be forfeited to the city in lieu of payment of costs for the administrative proceedings as prescribed by subsection (e) above. (Ord. No. 12271, § 2, 8-22-02; Ord. No. 13629, § 2, 9-8-16). 1.76 SAMPLES - Samples of items, when required, must be submitted within the time specified at no expense to the City. If not destroyed by testing, Proposer(s) will be notified to remove samples, at their expense, within 30 days after notification. Failure to remove the samples will result in the samples becoming the property of the City. 8/20/2024 9:24 AM p. 34 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 1.77 SELLING, TRANSFERRING OR ASSIGNING RESPONSIBILITIES - Proposer shall not sell, assign, transfer or subcontract at any time during the term of the Contract, or any part of its operations, or assign any portion of the performance required by this contract, except under and by virtue of written permission granted by the City through the proper officials, which may be withheld or conditioned, in the City's sole discretion. 1.78 SERVICE AND WARRANTY - When specified, the Proposer shall define all warranty, service and replacements that will be provided. Proposer must explain on the Response to what extent warranty and service facilities are available. A copy of the manufacturer's warranty, if applicable, should be submitted with your response. 1.79 SILENCE OF SPECIFICATIONS - The apparent silence of these specifications and any supplemental specification as to any detail or the omission from it of detailed description concerning any point shall be regarded as meaning that only the best commercial practices are to prevail and that only materials of first quality and correct type, size and design are to be used. All workmanship and services are to be first quality. All interpretations of these specifications shall be made upon the basis of this statement. If your firm has a current contract with the State of Florida, Department of General Services, to supply the items on this solicitation, the Proposer shall quote not more than the contract price; failure to comply with this request will result in disqualification of proposal. 1.80 SUBMISSION AND RECEIPT OF RESPONSES - Electronic Proposal submittals to this RFP are to be submitted through BidSync Electronic Bidding System ("BidSync") until the date and time as indicated in the Solicitation. The responsibility for submitting a Proposal on/or before the stated closing time and date is solely and strictly the responsibility of the Proposer. The City will in no way be responsible for delays caused by technical difficulties or caused by any other occurrence. Electronic Proposal submissions may require the uploading of electronic attachments. The submission of attachments containing embedded documents or proprietary file extensions is prohibited. All documents should be attached as individual files and labeled. Any Proposals received and time stamped through BidSync, prior to the Proposal submittal deadline shall be accepted as a timely submittal; anything thereafter will be rejected. Additionally, BidSync will not allow for the electronic Proposal submittal after the closing date and time has lapsed. Proposals will be opened promptly at the time and date specified. 1. Must register, free of charge, with BidSync Electronic Bidding System ("BidSync") to establish an account in order to have access to view and/or respond to any solicitations issued by the City of Miami's Procurement Department ("City"). 2. Shall submit all Proposals electronically. Hard copy Bid submittals will not be accepted. NO EXCEPTIONS. 3. Must submit the Certification Statement and associated solicitation documents which define requirements of items and/or services to be purchased and must be completed and submitted as outlined within the solicitation via BidSync. The use of any other forms and/or the modification of City forms will result in the rejection of the Proposer's Proposal submittal. 4. Shall ensure that the Certification Statement is fully completed and provided with your Proposal. Failure to comply with these requirements may cause the Proposal to be rejected. 8/20/2024 9:24 AM p. 35 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 5. Must ensure that an authorized agent of the Proposer's firm signs the Certification Statement and submits it electronically. FAILURE TO SIGN THE CERTIFICATION STATEMENT SHALL DEEM THE PROPOSAL NON -RESPONSIVE. 6. May be considered non -responsive if Proposals do not conform to the terms and conditions of this solicitation. 1.81 TAXES - The City of Miami is exempt from any taxes imposed by the State and/or Federal Government. Exemption certificates will be provided upon request. Notwithstanding, Proposers should be aware of the fact that all materials and supplies which are purchased by the Proposer for the completion of the contract is subject to the Florida State Sales Tax in accordance with Section 212.08, Florida Statutes, as amended and all amendments thereto and shall be paid solely by the Proposer. 1.82 TERMINATION -The City Manager on behalf of the City of Miami reserves the right to terminate this contract by written notice to the contractor effective the date specified in the notice should any of the following apply: A. The contractor is determined by the City to be in breach of any of the terms and conditions of the contract. B. The City has determined that such termination will be in the best interest of the City to terminate the contract for its own convenience; C. Funds are not available to cover the cost of the goods and/or services. The City's obligation is contingent upon the availability of appropriate funds. 1.83 TERMS OF PAYMENT - Payment will be made by the City after the goods and/or services awarded to a Proposer have been received, inspected, and found to comply with award specifications, free of damage or defect, and properly invoiced. No advance payments of any kind will be made by the City of Miami. Payment shall be made after delivery, within 45 days of receipt of an invoice and authorized inspection and acceptance of the goods/services and pursuant to Section 218.74, Florida Statutes and other applicable law. 1.84 TIMELY DELIVERY - Time will be of the essence for any orders placed as a result of this solicitation. The City reserves the right to cancel such orders, or any part thereof, without obligation, if delivery is not made within the time(s) specified on their Response. Deliveries are to be made during regular City business hours unless otherwise specified in the Special Conditions. 1.85 TITLE - Title to the goods or equipment shall not pass to the City until after the City has accepted the goods/equipment or used the goods, whichever comes first. 1.86 TRADE SECRETS EXECUTION TO PUBLIC RECORDS DISCLOSURE - All Responses submitted to the City are subject to public disclosure pursuant to Chapter 119, Florida Statutes. An exception may be made for "trade secrets." If the Response contains information that constitutes a "trade secret", all material that qualifies for exemption from Chapter 119 must be submitted in a separate envelope, clearly identified as "TRADE SECRETS EXCEPTION," with your firm's name and the Solicitation number and title marked on the outside. 8/20/2024 9:24 AM p. 36 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 Please be aware that the designation of an item as a trade secret by you may be challenged in court by any person. By your designation of material in your Response as a "trade secret" you agree to indemnify and hold harmless the City for any award to a plaintiff for damages, costs or attorney's fees and for costs and attorney's fees incurred by the City by reason of any legal action challenging your claim. 1.87 UNAUTHORIZED WORK OR DELIVERY OF GOODS - Neither the qualified Proposer(s) nor any of his/her employees shall perform any work or deliver any goods unless a change order or purchase order is issued and received by the Contractor. The qualified Proposer(s) shall not be paid for any work performed or goods delivered outside the scope of the contract or any work performed by an employee not otherwise previously authorized. 1.88 USE OF NAME - The City is not engaged in research for advertising, sales promotion, or other publicity purposes. No advertising, sales promotion or other publicity materials containing information obtained from this Solicitation are to be mentioned, or imply the name of the City, without prior express written permission of the City Manager or the City Commission. 1.89 VARIATIONS OF SPECIFICATIONS - For purposes of solicitation evaluation, Proposers must indicate any variances from the solicitation specifications and/or conditions, no matter how slight. If variations are not stated on their Response, it will be assumed that the product fully complies with the City's specifications. 8/20/2024 9:24 AM p. 37 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 2. Special Conditions 2.1. PURPOSE The purpose of this Solicitation is to establish a contract, for Employee Benefit Consulting Services, as specified herein, from a source(s), that will provide prompt and efficient service, fully compliant with the terms, conditions and stipulations of the Solicitation. 2.2. VOLUNTARY PRE -PROPOSAL CONFERENCE A Virtual Voluntary pre -proposal conference will be held Wednesday, August 21, 2024 at 2:00 PM, via Teams Meeting ID 908 673 243# ; Passcode: xLvfct, or via phone (786) 598-2961; Phone Conference ID — 446 604 814#. A discussion of the requirements of the Solicitation will occur at that time. Each potential Proposer is required, prior to submitting a Proposal, to acquaint itself thoroughly with any and all conditions and/or requirements that may in any manner affect the work to be performed. All questions and answers affecting the scope of work/specifications of the RFP will be included in an addendum, that will be distributed through BidSync, following the Pre -Proposal Conference to all the attendees. Because the City considers the Pre -Proposal Conference to be critical to understanding the Solicitation requirements, attendance is highly recommended. 2.3. DEADLINE FOR RECEIPT OF REQUEST FOR ADDITIONAL INFORMATION/ CLARIFICATION Any questions or clarifications concerning this solicitation shall be submitted electronically via the BidSync Portal. All questions must be received no later than Wednesday, August 28, 2024 @ 5:00 PM. All responses to questions will be sent to all prospective bidders/proposers in the form of an addendum. NO QUESTIONS WILL BE RECEIVED VERBALLY OR AFTER SAID DEADLINE. 2.4. TERM OF CONTRACT The Successful Proposer shall be required to execute a Professional Service Agreement ("Contract") with the City, which shall include, but not be limited to, the following terms: (1) The term of the Contract shall be for three (3) years with an option to renew for two (2) additional one (1) year periods. (2) The City shall have the option to extend or terminate the Contract. Continuation of the contract beyond the initial period is a City prerogative; not a right of the Proposer. This prerogative will be exercised only when such continuation is clearly in the best interest of the City. 2.5. CONDITIONS FOR RENEWAL Each renewal of this contract is subject to the following: (1) Continued satisfactory performance compliance with the specifications, terms and conditions established herein. (2) Availability of funds 8/20/2024 9:24 AM p. 38 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 2.6. LIVING WAGE ORDINANCE The City of Miami adopted a Living Wage Ordinance for City Service Contracts with a total contract value exceeding $100,000 annually, and that have been competitively solicited and awarded on, or after January 1, 2017 by the City. "Service Contract" means a contract to provide services to the City, excluding, however, professional services as defined by the "Consultants Competitive Negotiation Act" set forth in FL. Stat. § 287.055, and Section 18-87 of the City Code, and/or the other exclusions provided by Section 18-557 of the City Code. Section 18-557 is attached as Attachment A, and is located in the Documents Section of BidSync. Please refer to Attachment A, Section 18-557 in the Solicitation. If a solicitation requires services, effective on January 1, 2017, contractors must pay to all its employees, who provide services, a living wage of no less than $15.00 per hour without health benefits; or a wage of no less than $13.19 an hour, with health benefits. This language is only a summary of the key provisions of the City of Miami Living Wage Ordinance. Please review Attachment A, attached hereto, for a complete and thorough description of the City of Miami Living Wage Ordinance. 2.7. PROPOSERS' MINIMUM QUALIFICATIONS For a Proposer to be deemed responsive, the following minimum qualification requirements cited below shall be satisfied. In determining said responsiveness, each such minimum qualification requirement shall be addressed in detail in the Proposal submittal. Failure to meet each such following minimum qualification requirement and/or failure to provide sufficient detailed documentation concerning the same, shall result in the Proposal being deemed non -responsive. Proposers Shall: A. Have at least ten (10) years continuous experience, with the same Federal Employer Identification Number, providing employee health benefit consulting services, similar in scope as described in the RFP, Section 3.1, Specifications/Scope of Services, for public sector groups of 3,000 employees or greater; B. Be an active registered corporation with the State of Florida Department of State, Division of Corporations; C. Must be an independent consulting firm and not affiliated with any insurance company, third party administration agency, or insurance provider network. D. Have a Lead Managing Consultant, who will be assigned to the City of Miami account, who possesses a minimum of seven (7) years' experience in progressively responsible administrative oversight of public sector benefits, and the application of State of Florida regulations, as of the proposal submission date; and E. Have never filed for bankruptcy, be in sound financial condition, have no record of civil litigation or pending lawsuits involving criminal activities of a moral turpitude, and shall not have conflicts of interest with the City. 8/20/2024 9:24 AM p. 39 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 F. Not have a member, principal, officer, or stockholder who is in arrears or in default of any debt or contract involving the City, is a defaulter or surety upon any obligation to the City, and/or has failed to perform faithfully any contract with the City. Submittals that do not address each of the above stipulated requirements within its proposal submission, shall be considered non -responsive and eliminated from the process. 2.8. REFERENCES Each proposal MUST be accompanied by a list of three (3) references submitted on Attachment B — Reference Submittal form for projects performed for government clients, which shall include for each project, the name of the organization, dates covering the term of the contract; description of the scope of work; client contact person and phone number, and statement of whether Proposer was the prime contractor or subcontractor. 2.9 LOCAL PREFERENCE Proposers wishing to apply for the local office preference shall comply with the General Terms and Conditions, Section 1.48 Local Preference of this solicitation and with Section 18-73 of the City of Miami Procurement Code, titled "Definitions", and shall submit with the Proposal at the time of the Proposal due date the following: • Completion and submission of the attached City of Miami Local Office Certification Form provided as Attachment C, located in the Documents Section in BidSync; • Submission of a copy of the Proposer's lease documents at the location being deemed a City of Miami Local Office; • Submission of a City of Miami Business Tax Receipt; • Submission of a Miami Dade County Business Tax Receipt; and • Submission of a copy of the license, certificate of competency, and certificate of use that authorizes the performance of the Proposer. 2.10 EXECUTION OF AN AGREEMENT The Successful Proposer, evaluated and ranked in accordance with the requirements of this Solicitation, shall be awarded an opportunity to negotiate a Professional Services Agreement ("PSA") with the City. The City reserves the right to execute or not execute, as applicable a PSA with the Successful Proposer in substantially the same form as the sample PSA included as part of this solicitation. Such PSA will be furnished by the City, will contain certain terms as are in the City's best interest, and will be subject to approval as to legal by the City Attorney. 2.11. INSURANCE REQUIREMENTS INDEMNIFICATION Successful Proposer shall indemnify, hold and save harmless, and defend (at its own cost and expense), the City, its officers, agents, directors, and/or employees, from all liabilities, damages, losses, judgments, 8/20/2024 9:24 AM p. 40 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 and costs, including, but not limited to, reasonable attorney's fees, to the extent caused by the negligence, recklessness, negligent act or omission, or intentional wrongful misconduct of Successful Proposer and persons employed or utilized by Successful Proposer in the performance of this Contract. Successful Proposer shall further, hold the City, its officials and employees, indemnify, save and hold harmless for, and defend (at its own cost), the City its officials and/or employees against any civil actions, statutory or similar claims, injuries or damages arising or resulting from the permitted Work, even if it is alleged that the City, its officials, and/or employees were negligent. In the event that any action or proceeding is brought against the City by reason of any such claim or demand, the Successful Proposer shall, upon written notice from the City, resist and defend such action or proceeding by counsel satisfactory to the City. The Successful Proposer expressly understands and agrees that any insurance protection required by this Contract or otherwise provided by the Successful Proposer shall in no way limit the responsibility to indemnify, keep and save harmless and defend the City or its officers, employees, agents and instrumentalities as herein provided. The indemnification provided above shall obligate the Successful Proposer to defend, at its own expense, to and through trial, administrative, appellate, supplemental or bankruptcy proceeding, or to provide for such defense, at the City's option, any and all claims of liability and all suits and actions of every name and description which may be brought against the City, whether performed by the Successful Proposer, or persons employed or utilized by Successful Proposer. These duties will survive the cancellation or expiration of the Contract. This Section will be interpreted under the laws of the State of Florida, including without limitation and interpretation, which conforms to the limitations of Sections 725.06 and/or 725.08, Florida Statutes, as applicable and as amended. Successful Proposer shall require all subcontractors(s) agreements to include a provision that each subcontractor(s) will indemnify the City in substantially the same language as this Section. The Successful Proposer agrees and recognizes that the City shall not be held liable or responsible for any claims which may result from any actions or omissions of the Successful Proposer in which the City participated either through review or concurrence of the Successful Proposer's actions. In reviewing, approving or rejecting any submissions by the Successful Proposer or other acts of the Successful Proposer, the City, in no way, assumes or shares any responsibility or liability of the Successful Proposer or subcontractor(s) under this Contract. Ten dollars ($10) of the payments made by the City constitute separate, distinct, and independent consideration for the granting of this Indemnification, the receipt and sufficiency of which is voluntarily and knowingly acknowledged by the Successful Proposer. Note: Insurance Definitions, Conditions and Additional Requirements are provided as Attachment D to this solicitation which is located in the Documents Section of BidSync. The Successful Proposer shall furnish to City of Miami, c/o Procurement Depaitinent, 444 SW 2nd Avenue, 6th Floor, Miami, Florida 33130, Certificate(s) of Insurance which indicate that insurance coverage has been obtained which meets the requirements as outlined below: I. Commercial General Liability A. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence $ 1,000,000 8/20/2024 9:24 AM p. 41 City of Miami Solicitation RFP 1896386 B. General Aggregate Limit Personal and Adv. Injury Products/Completed Operations Endorsements Required City of Miami listed as additional insured Contingent & Contractual Liability Premises and Operations Liability Primary Insurance Clause Endorsement II. Business Automobile Liability Request for Proposals No. 1896386 $ 2,000,000 $ 1,000,000 $ 1,000,000 A. Limits of Liability Bodily Injury and Property Damage Liability Combined Single Limit Owned/Scheduled Autos Including Hired, Borrowed or Non -Owned Autos Any One Accident $ 1,000,000 B. Endorsements Required City of Miami listed as an additional insured III. Worker's Compensation Limits of Liability Statutory -State of Florida Waiver of Subrogation Employer's Liability A. Limits of Liability $1,000,000 for bodily injury caused by an accident, each accident $1,000,000 for bodily injury caused by disease, each employee $1,000,000 for bodily injury caused by disease, policy limit, IV. Professional Liability/Errors and Omissions Coverage Combined Single Limit Each Claim General Aggregate Limit Retro Date Included V. Umbrella Liability $ 5,000,000 $ 5,000,000 A Each Occurrence $ 2,000,000 Policy Aggregate $ 2,000,000 8/20/2024 9:24 AM p. 42 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 B. Endorsements Required City of Miami listed as additional insured Coverage is excess follow form over all applicable liability policies contained herein Consultant agrees to maintain professional liability/Errors & Omissions coverage for a minimum of 2 years after termination of the contract period subject to continued availability of commercially reasonable terms and conditions of such coverage. The above policies shall provide the City of Miami with written notice of cancellation or material change from the insurer in accordance with policy provisions. Companies authorized to do business in the State of Florida, with the following qualifications, shall issue all insurance policies required above: The company must be rated no less than "A-" as to management, and no less than "Class V" as to Financial Strength, by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent. All policies and /or certificates of insurance are subject to review and verification by Risk Management prior to insurance approval. 2.12. PROJECT MANAGER Upon award, Successful Proposer shall report and work directly with Ann -Marie Sharpe, Director, Risk Management, or designee, who shall be designated as the Project Manager for the City. 2.13. SUBCONTRACTOR(S) OR SUBCONSULTANT(S) A Sub -Consultant, herein known as Sub-Contractor(s) is an individual or firm contracted by the Proposer or Proposer's firm to assist in the performance of services required under this Solicitation. Sub -Contractors shall be paid through Proposer or Proposer's firm and not paid directly by the City. Sub -Contractors are allowed by the City in the performance of the services delineated within this Solicitation. Proposer must clearly reflect in its Proposal the major Sub-Contractor(s) to be utilized in the performance of required services. The City retains the right to accept or reject any Sub -Contractors proposed in the response of Successful Proposer(s) or prior to contract execution. Any and all liabilities regarding the use of a Sub-Contractor(s) shall be borne solely by the Successful Proposer(s) and insurance for each Sub-Contractor(s) must be maintained in good standing and approved by the City throughout the duration of the Contract. Neither Successful Proposer(s) nor any of its Sub -Contractors are considered to be employees or agents of the City. Failure to list all Sub -Contractors and provide the required information may disqualify any proposed Sub -Contractors from performing work under this Solicitation. Proposers shall include in their Responses the requested Sub -Contractor information and include all relevant information required of the Proposer. In addition, within five (5) working days after the identification of the award to the Successful Proposer(s), the Successful Proposer(s) shall provide a list confirming the Sub -Contractors that the Successful Proposer(s) intends to utilize in the Contract, if applicable. The list shall include, at a minimum, the name, location of the place of business for each Sub -Contractor, the services Sub -Contractor will provide relative to any contract that may result from this Solicitation, any applicable licenses, references, ownership, and other information required of 8/20/2024 9:24 AM p. 43 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 Proposer. 2.14. REMOVAL OF EMPLOYEES / SUBCONTRACTORS All employees of the Successful Proposer and Subcontractor(s)'s, if applicable, shall be considered to be, at all times, employees of the Successful Proposer and Subcontractor(s) under its sole direction and not employees or agents of the City. The Successful Proposer and Subcontractor(s) shall supply competent and capable employees. The City may require the Successful Proposer or Subcontractor(s) to remove an employee(s) the City deems careless, incompetent, insubordinate or otherwise objectionable and whose continued employment under this contract is not in the best interest of the City. 2.15. UNAUTHORIZED WORK The Successful Proposer shall not begin work until a Purchase Order and/or a Notice to Proceed are received. 2.16. CHANGES/ALTERATIONS Proposer may change or withdraw a Proposal at any time prior to Proposal submission deadline; however, no oral modifications will be allowed. Written modifications shall not be allowed following the proposal deadline. 2.17. COMPENSATION Each Proposer shall detail any and all fees and costs to provide the required services as detailed in Section 3, Scope of Services herein, on Attachment E, Price Proposal. The City reserves the right to add or delete any service, at any time. Should the City determine to add an additional service(s), for which pricing was not previously secured, the City will request that the Successful Proposer provide reasonable cost for same. Should the City determine the pricing to be unreasonable, the City reserves the right to negotiate the cost, or seek another vendor for the provision of said service(s). Failure to submit a Price Proposal (Attachment E) as required shall disqualify Proposer from consideration. Attachment E is located in the Documents Section of BidSpnc. 2.18. METHOD OF PAYMENT Payment will be made upon receipt and acceptance of invoices. No partial down payments will be made. 2.19. EVALUATION/SELECTION PROCESS AND CONTRACT AWARD The procedure for response evaluation, selection and award is as follows: (1) Solicitation issued; (2) Receipt of responses; (3) Opening and listing of all responses received; 8/20/2024 9:24 AM p. 44 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 (4) Procurement staff will review each submission for compliance with the submission requirements of the solicitation, including verifying that each submission includes all documents required; (5) An Evaluation Committee ("Committee"), appointed by the City Manager, comprised of appropriate City Staff and members of the community, as deemed necessary, with the appropriate technical expertise and/or knowledge, shall meet to evaluate each response in accordance with the requirements of this solicitation and based upon the evaluation criteria as specified herein; (6) The Committee reserves the right, in its sole discretion, to request Proposers to make oral presentations before the Committee as part of the evaluation process. The presentation may be scheduled at the convenience of the Committee and shall be recorded; (7) The Committee reserves the right to rank the proposals and shall make its recommendation to the City Manager requesting the authorization to negotiate. No Proposer(s) shall have any rights against the City arising from such negotiations thereof; (8) The City Manager reserves the right to reject the Committee's recommendation to negotiate, and instruct the Committee to re-evaluate and make another recommendation, or reject all proposals. No Proposer(s) shall have any rights against the City arising from such termination thereof; (9) If the City Manager accepts the Committee's recommendation to negotiate, Procurement will negotiate a final contract with the Successful Proposer, and submit a recommendation to award a contract (s) to the City Manager; (10) The City Manager shall then submit his or her award recommendation and negotiated contract(s) to the City Commission for approval. Written notice shall be provided to all Proposers. (11) If the City Manager accepts the award recommendation, the City Manager's recommendation for award of contract will be posted on the City of Miami Procurement Department website, in the Supplier Corner, Current Solicitations and Notice of Recommendation of Award Section. The notice of the City Manager's recommendation can be found by selecting the details of the solicitation and is listed as Recommendation of Award Posting Date and Recommendation of "Award To" fields. If "various" is indicated in the Recommendation of "Award To" field, the Proposer must contact the Contracting Officer for that solicitation to obtain the suppliers names. (12) After reviewing the City Manager's recommendation, the City Commission may: 1. Approve the City Manager's award recommendation and negotiated contract(s); 2. Reject all proposals; 3. Reject all proposals and instruct the City Manager to reissue a solicitation; or 4. Reject all proposals and instruct the City Manager to enter into competitive negotiations with at least three individuals or firms possessing the ability to perform such services and obtain information from said individuals or firms relating to experience, qualifications and the proposed cost or fee for said services, and make a recommendation to the City Commission. The decision of the City Commission shall be final. Written notice of the award shall be given to the Successful Proposer. 2.20. RECORDS During the contract period, and for a least five (5) subsequent years thereafter, Successful Proposer shall provide City access to all files and records maintained on the City's behalf. 2.21. ADDITIONAL SERVICES 8/20/2024 9:24 AM p. 45 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 Services not specifically identified in this Solicitation may be added to any resultant contract upon successful negotiation and mutual consent of the contracting parties. 2.22. TRUTH IN NEGOTIATION CERTIFICATE Execution of the resulting agreement by the Successful Proposer shall act as the execution of truth -in - negotiation certificate stating that wage rates and other factual unit costs supporting the compensation of the resulting Agreement are accurate, complete, and current at the time of contracting. The original contract price and any additions thereto shall be adjusted to exclude any significant sums by which City determines the contract price was increased due to inaccurate, incomplete, or non -current wage rates and other factual unit costs. All such contract adjustments shall be made within one (1) year following the end of the Agreement. 2.23. NON -APPROPRIATION OF FUNDS In the event no funds or insufficient funds are appropriated and budgeted or are otherwise unavailable in any fiscal period for payments due under this contract, then the City, upon written notice to the Successful Proposer or his/her assignee of such occurrence, shall have the unqualified right to terminate the contract without any penalty or expense to the City. No guarantee, warranty or representation is made that any project(s) will be awarded to any firm(s). 2.24. FAILURE TO PERFORM Should it not be possible to reach the Successful Proposer and/or should remedial action not be taken within forty-eight (48) hours of any failure to perform according to specifications, the City reserves the right to declare Successful Proposer in default of the contract or make appropriate reductions in the contract payment. 2.25. TERMINATION A. FOR DEFAULT If Successful Proposer defaults in its performance under this Contract and does not cure the default within thirty (30) days after written notice of default, the City Manager may terminate this Contract, in whole or in part, upon written notice without penalty to the City of Miami. In such event the Successful Proposer shall be liable for damages including the excess cost of procuring similar supplies or services: provided that if, (1) it is determined for any reason that the Successful Proposer was not in default or (2) the Successful Proposer's failure to perform is without his or his Subcontractor's control, fault or negligence, the termination will be deemed to be a termination for the convenience of the City of Miami. B. FOR CONVENIENCE The City Manager may terminate this Contract, in whole or in part, upon thirty (30) days prior written notice when it is in the best interest of the City of Miami. If this Contract is for supplies, products, equipment, or software, and so terminated for the convenience by the City of Miami the Successful Proposer will be compensated in accordance with an agreed upon adjustment of cost. To the extent that this Contract is for services and so terminated, the City of Miami shall be liable only for payment in accordance with the payment provisions of the Contract for those services rendered prior to termination. 2.26. ADDITIONAL TERMS AND CONDITIONS 8/20/2024 9:24 AM p. 46 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 No additional terms and conditions included as part of your solicitation response shall be evaluated or considered, and any and all such additional terms and conditions shall have no force or effect and are inapplicable to this solicitation. If submitted either purposely, through intent or design, or inadvertently, appearing separately in transmittal letters, specifications, literature, price lists or warranties, it is understood and agreed that the General Conditions and Special Conditions in this solicitation are the only conditions applicable to this solicitation and that the Proposer's authorized signature affixed to the Proposer's acknowledgment form attests to this. If a Professional Services Agreement ("PSA") or other Agreement is provided by the City and is expressly included as part of this solicitation, no additional terms or conditions which materially or substantially vary, modify or alter the terms or conditions of the PSA or Agreement, in the sole opinion and reasonable discretion of the City will be considered. Any and all such additional terms and conditions shall have no force or effect and are inapplicable to this PSA or Agreement. 2.27. E-VERIFY EMPLOYMENT VERIFICATION REQUIREMENTS Successful Proposer(s) shall E-Verify the employment status of all employees and subcontractors to the extent required by federal, state, and local laws, rules, and regulations. The City shall consider the employment by Successful Proposer(s) of unauthorized aliens a violation of Section 274A(e) of the Immigration and Nationality Act. If the Successful Proposer(s) knowingly employs unauthorized aliens, such violation shall be cause for termination of the Contract. Furthermore, the Successful Proposer(s) agrees to utilize the U.S. Agency of Homeland Security's E-Verify System, https://e- verify.uscis.gov/emp, to verify the employment eligibility of all employees during the term of this Contract. Successful Proposer(s) shall also include a requirement in subcontracts that the subcontractor shall also utilize the E-Verify System to verify the employment eligibility of all employees of the subcontractor during the term of this Contract. 2.28. ANTITRUST VIOLATOR VENDORS A person or an affiliate who has been placed on the Antitrust Violator Vendors List following a conviction or being held civilly liable for an antitrust violation may not submit a bid, proposal, or reply on any agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on any agreement with a public entity for the construction or repair of a public building or public work; may not submit a bid, proposal, or reply on leases of real property to a public entity; may not be awarded or perform work as a grantee, supplier, subcontractor, or consultant under an agreement with a public entity; and may not transact new business with a public entity. 2.29. ANTI -HUMAN TRAFFICKING The Proposer confirms and certifies that it is not in violation of Section 787.06, Florida Statutes, and that it does not and shall not use "coercion" for labor or services as defined in Section 787.06, Florida Statutes. The Proposer shall execute and submit to the City an Affidavit, of even date herewith, in compliance with Section 787.06(13), Florida Statutes, attached an incorporated herein as Attachment F If the Proposer fails to comply with the terms of this Section, the City may suspend or terminate this Agreement immediately, without prior notice, and in no event shall the City be liable to Proposer for any additional compensation or for any consequential or incidental damages. 8/20/2024 9:24 AM p. 47 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 All Proposers shall be required to complete and submit with their proposals, Attachment F, Anti - Human Trafficking Affidavit. Failure to complete and submit Attachment F as required may result in proposals being deemed non -responsive. 8/20/2024 9:24 AM p. 48 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 3 SPECIFICATIONS / SCOPE OF WORK Background The City of Miami, ("City"), is contracting for the provision of a broad range of benefits consulting services in support of the City's Employee Benefits Program. The City's Employee Benefits program, administered by the Group Benefits Division of the City's Risk Management Department, provides a wide array of benefits to eligible employees, retirees, Consolidated Omnibus Budget Reconciliation ("COBRA") participants, and eligible dependents. Benefit plans include group medical, dental, vision, term life, supplemental life, voluntary loan program, pre -paid legal services, identity theft protection, Retiree Medicare Eligible Part D, disability, pension benefits, Internal Revenue Service ("IRS") Section 125 flexible spending accounts. A. General Requirements and Services to be Provided: The Successful Proposer's responsibilities shall include, but not be limited to: 1. Self -Funded Plan Performance and Monitoring and Auditing The successful Proposer shall: a) Monitor the performance of, and compliance with, all established contractual requirements of the self -funded medical plan, including reviewing, and approving any annually updated Summary(ies) of Benefit Coverage ("SBC") and similar documents, and/or amendments. b) Secure statistical reports, etc., directly from the third -party administrator's depository to evaluate and ensure compliance with contracted performance standard levels. Successful Proposer shall ascertain whether or not financial penalties for performance non-compliance have been properly recorded, and liquidated damages assessed against third -party administrator. c) Conduct bi-annual onsite claims audit of self -funded plans at administrator's facility, as deemed necessary by the City, to include review and compliance with contractually - established: (i) Performance Standards (ii) Payment Accuracy of Claims (iii) Coding Accuracy of Claims (iv) Plan Provisions Accuracy Any errors identified by Successful Proposer must be properly classified as financial or non- financial, and presented in a written findings report upon completion of the audit, to the Project Manager. d) Conduct a bi-annual audit of the Pharmacy Benefits Management Program ("PBM") Agreement, for the review and compliance of all formulary rebates, to determine if the City receives guaranteed rebate amounts, in accordance with contractual obligations. 8/20/2024 9:24 AM p. 49 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 e) Request directly from the City's Third -Party Administrator, the Quarterly Rebate and Annual Reconciliation Report, for the purpose of its review and subsequent briefing of the Project Manager on findings and conclusions. f) Assist in coordinating the compilation, verification and reporting of necessary census or reports for actuarial analyses and operational audits, as needed. 2. Strategic Review of Benefit Plan Designs The Successful Proposer shall: a) Monitor the performance of, and compliance with, all established contractual requirements of the City's multiple Employee Benefits Program. b) Analyze all current City employee benefit options and plans, and recommend changes as necessary, based upon market analysis, legislation, and availability, to better meet the City's multiple Employee Benefits Program's service objectives, identify opportunities for cost containment if applicable, and/or better terms of service. c) Attend the City's monthly Healthcare Insurance Committee meetings, comprised of Union leaders and/or representatives, City HR Labor, City Benefits and others, and provide technical and expert support to the City as part of its bargaining unit driven commitments. Support and responsibilities shall include, but are not limited to: (i) Assist in the agenda preparation of, and participate in, the meetings. (ii) Assist in documenting meeting minutes, provide feedback on prior meeting elevated or take -away items. (iii) Conduct in -person or virtual presentations as needed on topics such as, but not limited to: (a) Rates (b) Coverage Issues (c) Eligibility (d) Emerging Trends (e) Critical Success Factors (f) Financial Reports (iv) If needed assist in coordinating and co -hosting educational workshops/presentations on key legislation affecting any employee benefits for City Risk Management employees, union officials, fiduciary administrators, and other service providers. d) Provide strategic and operational, technical support to the City by identifying opportunities for enhancing current and future benefit plans, including funding designs, to broaden the reach and efficacy of City employee benefit offerings. e) Provide professional consulting, and legal advice on the review of recommended plan amendments, and for other benefits -related matters, as necessary, to ensure compliance with federal, state and local legislation. f) Strategize with the City on short-term and long-term health and wellness objectives in terms of benefits plan design and funding and alert the City of any significant variations that would warrant redesign. 8/20/2024 9:24 AM p. 50 City of Miami Solicitation RFP 1896386 g) Request for Proposals No. 1896386 Advise the City in establishing strategic goals with respect to the City's multiple employee benefit plans and the continuing branding of Risk's Employee Wellness Program, Stay Active Miami ("SAM"), for the purpose of improving the overall health of the employee population, while managing cost-effectiveness and increasing wellness engagement. h) Attend City health and wellness meetings scheduled monthly, weekly, or as needed by the City; assist in procuring and monitoring relationship with health and wellness vendors for City of Miami Group Benefits sponsored whole -health and wellness events, such as employee Health Fairs, educational seminars and/or similar events. 3. Federal, State and Local Legal Compliance, Research Services and Related Requirements The Successful Proposer shall: a) Provide research, advice, and interpretation of federal, state and local benefit regulations and legislation, upon the City's request. b) Provide professional consulting support and advice on specific research, compliance -related issues, and other general matters, as deemed necessary by the City. c) Provide timely updates, providing ample opportunity for the City to meet its fiduciary responsibilities and take appropriate action on any proposed and effectuated changes in the legal environment that affect employee benefits (i.e., Employee Retirement Income Security Act ("ERISA"), Patient Protection Affordable Care Act ("PPACA"), COBRA, Health Insurance Portability and Accountability Act ("HIPAA") and IRS Sections 123, etc.), including and tax law newsletters or special advisories released. d) Review plan design documents of self -funded medical and IRS Section 125 flexible benefits plans, for compliance with applicable governing laws. e) Obtain IRS private letter rulings for the City, as necessary and applicable, at the discretion of the City, in consultation with the Successful Proposer. f) Ensure compliance with all PPACA provisions/requirements. g) Provide necessary and supporting calculations for any benefits related to IRS payments / fees. 4. Development of Request for Proposals (RFP) / Request for Qualifications (RFQ) Proposal / Qualifications Review and Negotiations a) Provide assistance and technical expertise in the development of RFP's/RFQ's to be issued by the City on behalf of Risk. b) Provide assistance and technical expertise in reviewing competitive RFP's/RFQ's, including the establishment of appropriate performance standards, in development by the City. c) Assist in the formulation of technical responses to clarifications inquiries received from prospective proposers to be issued via addenda to an RFP/RFQ. d) Provide assistance in assessing qualifications and analyzing data provided in proposals received from prospective proposers. Successful Proposer may be required to participate as a 8/20/2024 9:24 AM p. 51 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 technical expert/non-voting member in the Evaluation/Selection Committee meetings as deemed necessary by the City, at its sole discretion. e) Test the adequacy of proposed provider and pharmacy networks, analyze hospital, physical and pharmacy discounts, perform geographic -access match studies and conduct medical provider/prescription disruption analyses. f) Provide assistance to the City, as deemed necessary by the City, in assessing the rates and fees proposed by the Proposers — and in negotiation strategy for competitive rates, discounts and services for current and future projects. 5. Other Related Duties The Successful Proposer Shall: a) Provide ongoing support, review and interpretation of plan provisions and IRS regulations for Section 125 flexible benefits plan; b) Develop employee communications, including formulation of employee surveys, and focus groups, as deemed necessary by the City. All findings and statistical analyses conducted shall be presented, in writing, to the Project Manager upon completion; c) Conduct Benefit Plan modeling, as requested by the City; d) Work collaboratively with other City consultants, and the Office of the City Attorney, and any other City representatives as deemed necessary by the City; e) Attend meetings with various providers under contract with the City, or with City staff not directly involved with the Employee Benefits Program, at the Project Manager's request; f) At the City's request, but not less than semi-annually, present to the City for consideration, a list of three (3) to five (5) critical topics that are relevant to employee benefit programs and health/welfare. The City will identify the topics that best align with its objectives, at the City's sole discretion. The Successful Proposer shall prepare an analysis that identifies observations and recommendations for the City to consider; Provide ad -hoc analysis and benefits related reporting to the City, as deemed necessary by the City; and h) Provide other related consulting services, as identified by the City. g) B. Meetings Successful Proposer shall be available for periodic meetings where deliverables are discussed. 8/20/2024 9:24 AM p. 52 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 4. Submission Requirements 4.1. SUBMISSION REQUIREMENTS Proposers shall carefully follow the format and instruction outlined below, observing format requirements as indicated. Proposals should contain the information itemized below and in the order indicated. This information should be provided for the Proposer and any sub -consultants to be utilized for the work contemplated by this Solicitation. Proposals submitted which do not include the following items may be deemed non -responsive and may not be considered for contract award. The Proposal shall be written in sufficient detail to permit the City to conduct a meaningful evaluation of the proposed services. However, overly elaborate responses are neither requested nor desired. Proposals must be submitted through BidSync Electronic Bidding System ("BidSync") no later than the date and time indicated within the RFP, in order to be considered. Faxed documents are not acceptable. Emailed submissions are not acceptable. Hardcopy submissions are not acceptable. Proposals must be timely submitted through BidSync, or the Proposal will be disqualified. Untimely or misdelivered submittals will not be considered. NO EXCEPTIONS. The responses to this solicitation shall be presented in the following format. Failure to do so may deem your Proposal non -responsive. A. Include the signed RFP Certification Statement. B. Include in detail, evidence that clearly demonstrates Proposer meets or exceeds the minimum qualification requirements, pursuant to Section 2.7, Proposer's Minimum Qualifications C. Include the completed and signed Attachment F, Anti -Human Trafficking Affidavit 1. Cover Page The Cover Page should include the Proposer's name; Contact Person for the RFP; Firm's Liaison for the Contract; Primary Office Location; Local Business Address, if applicable; Business Phone and Fax Numbers, if applicable Email addresses; Title of RFP; RFP Number; and Federal Employer Identification Number. 2. Table of Contents The table of contents should outline, in sequential order, the major sections of the Proposal as listed below, including all other relevant documents requested for submission. All pages of the Proposal, including the enclosures, should be clearly and consecutively numbered and correspond to the table of contents. 3. Executive Summary A signed and dated summary of not more than two (2) pages containing Proposer's overall Qualifications and Experience and Technical Qualifications, as contained in the submittal. Proposer shall include the name of the organization, business phone and contact person and a summary of the work to be performed. 4. Proposer's, Relevant Experience, Qualifications. and Past Performance a) Describe the Proposer's organizational history and structure, past performance and state the 8/20/2024 9:24 AM p. 53 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 number of years the Proposer has been in business, using the same FEIN, providing a similar service(s). Provide the number of employees and the primary markets served, b) Provide a list of all principals, partners, officers, owners and/or directors of Proposer, including joint ventures and/or sub-consultant(s), if applicable. c)Indicate whether the City has previously awarded any contracts to the Proposer. If so, discuss the nature of the contract, types of services performed, and the term of the contract. d)Provide a list of five (5) comparable contract (similar in scope of services to those requested herein), which Proposer has either ongoing, or has completed within the past ten (10) years. The description should identify for each project: i. Client ii. Description of work iii. Total dollar value of the contract iv. Dates covering the term of the contract v. Client contact person and phone number vi. Statement of whether Proposer is/was the prime contractor or subcontractor; if Proposer was the subcontractor, name the Prime vii. Detail Proposer's responsibilities and the results of the project Specify whether or not the scheduled completion time for each project was met; if not met, please provide an explanation. Where possible, list and describe those projects performed for government clients or similar size private entities (excluding and work performed for the City of Miami). In the event that Proposer has not performed five (5) comparable contracts within the past ten (10) years, Proposer should provide information that demonstrates its ability to perform the required services, as detailed within Section 3, Scope of Services. e) Provide information concerning any prior or pending litigation or proceedings, either civil or criminal, involving Proposer, its partners, managers, other key staff members, and its professional activities or performance, that Proposer has been involved in which may affect the performance of the services to be rendered herein, if applicable. State the nature of the litigation, a brief description of each case, the outcome or projected outcome, and the monetary amounts involved. Discuss any bankruptcies involving Proposer, its partners, manager(s), or other key staff members, if applicable. 1) Provide a minimum of three (3) references on Attachment B, Reference Submittal form, of clients to whom services of a similar nature were provided, as described within Section 2.8, References. The City reserves the right to contact any reference as part of the qualification process. g) Provide information or documentation to Proposer's qualifications and experience from which the City can benefit under this contract. 8/20/2024 9:24 AM p. 54 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 h) Describe any relevant industry/subject matter expertise, including any experience in the requested services listed herein, and any unique or proprietary project methodologies relevant to the requested services. 5. Relevant Experience and Qualifications of Key Personnel and Subcontractors Performing Services a) Provide an organizational chart showing the Proposer's Lead Managing Consultant and all key personnel, including their titles, to be assigned to this project. All key personnel include all partners, managers, seniors and other professional staff that will perform work and/or services in the project resulting from this solicitation. The chart must clearly identify the Proposer's employees and any subcontractors or sub -consultants. This information shall include the general functions to be performed by key individuals and the subcontractors or sub -consultants. b) Describe the experience, qualifications and other vital information, including number of years of relevant experience on previous similar projects, of the Lead Managing Consultant and all key personnel, who will be assigned to this project. c) . Provide resumes, if available, with job descriptions and other detailed qualification information on the Lead Managing Consultant and all key personnel who will be assigned to this project. Note: After proposal submission, but prior to the award of any contract issued as a result of this Solicitation, the Proposer has a continuing obligation to advise the City of any changes, intended or otherwise, to the Lead Managing Consultant and key personnel identified in its proposal. 6. Proposed Approach to Providing the Services a)Describe Proposer's approach to project organization and management, including the responsibilities of Proposer's Lead Managing Consultant and Proposer's key personnel, and key personnel of any subcontractor or sub -consultant, that will perform work in this project. b) Provide Proposer's operational plan that clearly indicates how the Proposer plans to provide the services requested in this Solicitation. The Proposer's operational plan must detail how the Proposer intends to fully satisfy all service requirements outlined within Item A, General Requirements and Services to be Provided, of Section 3.1, Specifications/Scope of Work, of this RFP. c) Describe in detail the manner in which Proposer will monitor the performance of the City's self -funded medical plan. d)Provide the recent, current, and projected workload of the Proposer, and the general workload of those key employees to be assigned to this engagement. Discuss in general the anticipated percentage of time to be dedicated to this engagement by each assigned staff member. e) Describe the methodology that will be used in order to audit the plan's compliance with all contractual / regulatory requirements. tj Describe how Proposer has applied the proposed project approach in comparable contracts to make 8/20/2024 9:24 AM p. 55 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 recommendations to improve programs and describe the net effects of those recommendations. g) Provide a list of any additional services, not included in this Solicitation, that the Proposer can offer to the City. If Proposer is offering any additional, describe the services in detail. Note that services will be paid at the hourly rates provided on Form A, Price Proposal Schedule. The City has a right to negotiate said price. Note: The Evaluation Committee will use the information provided in the Proposal to determine the Proposer's understanding and ability to address the City's unique needs. 7. Price Proposal Proposer shall state its price for providing all services as stated within this Solicitation. Proposer shall submit pricing stated as a flat, fixed fee per year, which shall include all expenses necessary for the requested services. Proposer must use Attachment E - Price Proposal Form. 8/20/2024 9:24 AM p. 56 City of Miami Solicitation RFP 1896386 Request for Proposals No. 1896386 5. Evaluation Criteria 5.1. EVALUATION CRITERIA Each proposal will be reviewed to determine of the proposal is responsive to the submission requirements outlined in this solicitation. A responsive proposal is one which follows the requirements of the solicitation, includes all required documentation, is submitted in the format outlined in this solicitation, is of timely submission, and has appropriate signatures as applicable. failure to comply with these requirements may result in the proposals being deemed non -responsive. Proposals will be evaluated by an Evaluation Committee ("Committee") which shall evaluate and rank proposals on criteria listed below. The Committee will be comprised of appropriate City personnel and members of the community, as deemed necessary, with the appropriate experience and/or knowledge. The criteria are itemized with their respective weights for a maximum of one hundred (100) points per Committee member. Below are the criteria and weight: CRITERIA AND POINTS Proposer's Relevant Experience, Qualifications and Past Performance: Relevant Experience and Qualifications of Key Personnel and Subcontractors Performing Services: Proposer's approach to providing the services requested in this Solicitation: Price Proposal (25 Points) (20 Points) (35 Points) (20 Points) Five percent evaluation criterion in favor of Proposers who Maintain a local office as defined in Section 18-73," Definitions" of the City's Procurement Code will be applied to those who meet (4 Points) the criteria Pursuant to Section 2.10, Local Preference. Maximum Points Available: 104 Points The Price Proposal will be evaluated subjectively in combination with the technical proposal, including an evaluation of how well it matches Proposer's understanding of the City's needs. The pricing evaluation is used as part of the evaluation process to determine the highest ranked Proposer. The City reserves the right negotiate the terms, conditions, and pricing as may be in the best interest of the City. 8/20/2024 9:24 AM p. 57 City of Miami Solicitation RFP 1896386 ATTACHMENT A CITY OF MIAMI LIVING WAGE ORDINANCE ARTICLE X. - LIVING WAGE REQUIREMENTS FOR SERVICE CONTRACTS AND CITY EMPLOYEESIL Footnotes: --- (9) --- Now— Section 5 of Ord. No. 12787 states that this article shall be effective October 1, 2006. Editor's note— Prior to the adoption of Ord. No. 12787, Ord. No. 12623, § 2, adopted December 9, 2004, repealed article X, divisions 1-4, in its entirety, which pertained to the economic development financing authority and derived from Ord. No. 12062, § 3, adopted May 10, 2001. Sec. 18-556. - Definitions. City means the government of the City of Miami or any authorized agents, any board, agency, commission, department, or other entity thereof, or any successor thereto. Contract means any contract to provide services to the city in which the total value of the contract exceeds $100,000.00 per year. Contractor means any "for profit" individual, business entity, corporation, partnership, limited liability company, joint venture, or similar business entity which meets the following criteria: (1) The contractor is paid in whole or part from one or more of the city's general funds, capital project funds, special revenue funds, or any other funds, including, but not limited to, grants, donations, and the like, whether by competitive bid process, requests for proposals, or some other form of competitive solicitation, negotiation, or agreement, or any other decision to enter into a contract; and (2) The contractor is engaged in the business of or part of a contract to provide services for the benefit of the city. This section shall apply to employees of the contractor who spend the majority of their time on covered City of Miami service contracts. If the contract is for both goods and services it shall only apply to the services portion of such contract. This section shall not apply to contracts which are primarily for the sale or leasing of goods. Goods are defined in section 18-73 of the City Code. Covered employee means anyone employed by the city working more than 35 hours per week or any service contractor employee, working full or part-time, with or without benefits, that is involved in providing services under the service contractor's contract with the city. Covered employer means the city and any and all service contractors and subcontractors of a service contractor. Living wage means a wage that is as defined in section 18-557 of this Code. The living wage may be adjusted once annually by an amount equivalent to the cost of living adjustment for Miami -Dade County as published by the United States Department of Labor, Bureau of Labor Statistics. Language so stating will be included in all request for proposals, or other competitive solicitation documents, issued by the city for the procurement of services (unless the living wage provisions are excluded as provided in section 18-557 herein). New service contracts means those having contracts competitively solicited and awarded on or after January 1, 2017. Page 1 8/20/2024 9:24 AM p. 58 City of Miami Solicitation RFP 1896386 Service contract means a contract to provide services to the city excluding, however, professional services as defined by the "Consultants Competitive Negotiation Act" set forth in F.S. § 287.055, and section 18-87 of the City Code and/or the other exclusions provided by section 18-557 of the City Code. (Ord. No. 12787, § 2, 4-6-06; Ord. No. 13648, § 2, 11-17-16) Sec. 18-557. - Living wage. (a) Living wage paid. (1) New service contractors. All new service contracts shall pay to all its employees who provide covered services a living wage of no less than $15.00 per hour without health benefits; or a wage of no less than $13.19 an hour with health benefits as defined in this section unless otherwise excluded pursuant to this article. (2) Existing service contracts. Service contracts awarded and effective or competitively solicited prior to January 1, 2017, shall not be subject to the payment of the living wage set forth in this section and shall continue to be governed by the terms and conditions of the respective solicitation and resulting contractual documents, when applicable. The living wage provisions shall apply to all contracts covered by this section unless specifically excluded by one or more subsections below: a. The living wage provision is disallowed by a federal or state law or regulation, grant requirements, or by a contract the city is accessing by "piggybacking", and which contract does not include a living wage provision; b. Funding sources for the contract disallow the living wage provision or provide contradictory funding requirements, or are contained in a contract awarded or solicited prior to the effective date of January 1, 2017, and which contract includes renewals or extensions; c. Professional service contracts awarded under the "Consultants Competitive Negotiation Act", F.S. § 287.055, for the professional services within the scope of the practice of architecture, professional engineering, landscape architecture, registered surveying, and/or mapping; d. The living wage provision is waived by the city commission by resolution, prior to issuance of the competitive solicitation document, upon written recommendation of the city manager or authorized designee, when the city commission finds it is in the best interest(s) of the city to approve such waiver, in which case the living wage provision shall not apply in the competitive solicitation document; or e. All responsible wage construction contracts covered by section 18-120 of this Code. (4) City employees. For covered employees of the city, the city will begin to pay the living wage on a phase - in basis over a nine-year period beginning with the 2006-2007 city budget year to be implemented in the 2014-2015 fiscal year. The city manager, in his sole discretion, without further city commission approval, shall have the option to consider whether it is in the city's best interest to complete the phase -in payment of living wage to city employees on a four-year period. Thereafter, the living wage to be paid by the city shall be subject to negotiations within the collective bargaining structure. (b) Health benefits; eligibility period. For a covered employer to comply with this article by choosing to pay the lower wage scale available when a covered employer also provides a standard health benefit plan, such health benefit plan shall consist of a payment of at least $1.81 per hour toward the provision of health benefits for covered employees and their dependents and shall be approved by the city. If the health benefit plan of the covered employer requires an initial period of employment for a new employee to be eligible for health benefits (the "eligibility period"), a covered employer may qualify to pay the $13.19 per hour wage scale for a term not to exceed the new employee's eligibility period, provided the new employee will be paid health benefits upon completion of the eligibility period, which period shall not exceed 90 days. (c) Certification required before payment. Any and all service contracts subject to this article shall be void, and no funds may be released, unless prior to entering any such contract with the city, the service contractor certifies to the city that it will pay each of its covered employees no less than the living wage. A copy of this Page 2 (3) 8/20/2024 9:24 AM p. 59 City of Miami Solicitation RFP 1896386 certificate must be made available to the public upon request. The certificate, at a minimum, must include the following: (1) The name, address, and phone number of the employer, a contact person, and the specific project for which the service contract is sought; (2) The amount of the service contract and the city department the contract will serve. (3) A brief description of the project or service provided; (4) A statement of the wage levels for all covered employees; and (5) A commitment to pay all covered employees the living wage. (d) Observation of other laws. Every covered employee shall be paid without subsequent deduction or rebate on any account (except as such payroll deductions as are directed or permitted by law or by a collective bargaining agreement). The service contractor shall pay covered employees wage rates in accordance with federal and all other applicable laws such as overtime and similar wage laws. (e) Posting. A copy of the living wage rate shall be kept posted by the service contractor subject to this article, at the site of the work in a prominent place where it can easily be seen and read by the covered employees and shall be supplied to such employees within a reasonable time after a request to do so. Additionally, service contractors subject to this article, shall furnish a copy of the requirements of this article to any entity submitting a bid for a subcontract on any service contract subject to this article. Posting requirements will not be required where the service contractor subject to this article, prints the following statements on the front of the covered employee's first paycheck and every six months thereafter. "You are required by the City of Miami Living Wage Ordinance to be paid a living wage. If you do not believe you are being paid at the living wage rate, contact your employer, an attorney, or the City of Miami." All notices will be printed in English, Spanish and Creole. (f) Collective bargaining. Nothing in this article shall be read to require or authorize any service contractor subject to this article, to reduce wages set by a collective bargaining agreement or as required under any prevailing wage law. (Ord. No. 12787, § 2, 4-6-06; Ord. No. 13110, § 2, 10-22-09; Ord. No. 13405, § 2, 9-26-13; Ord. No. 13648, § 2, 11-17-16) Sec. 18-558. - Implementation. (a) Maintenance of payroll records. Each service contractor to which living wage requirements apply, as described in this article, shall maintain payroll record for all covered employees and basic records relating thereto and shall preserve them for a period of three years from the date of termination or expiration of the service contract. The records shall contain: (1) The name and address of each covered employee; (2) The job title and classification; (3) The number of hours worked each day; (4) The gross wages earned and deductions made; (5) Annual wages paid; (6) A copy of the social security returns and evidence of payment thereof; (7) A record of fringe benefit payments including contributions to approved plans; and (8) Any other data or information the city shall require from time to time. (b) Reporting payroll. Every six months, the service contractor to which living wage requirements apply, as described in this article, shall file with the city's procurement director a listing of all covered employees together with a certification of compliance with this article. Upon request from the city, the service contractor shall produce for inspection and copying its payroll records for any or all of its covered employees for any Page 3 8/20/2024 9:24 AM p. 60 City of Miami Solicitation RFP 1896386 period covered by the service contract. The city may examine payroll records as needed to ensure compliance. (Ord. No. 12787, § 2, 4-6-06; Ord. No. 13110, § 2, 10-22-09) Sec. 18-559. - Compliance and enforcement. (a) Service contractor to cooperate. The service contractor shall permit city employees, agents, or representatives to observe work being performed at, in or on the project or matter for which the service contractor has a contract. The city representatives may examine the books and records of the service contractor relating to the employment and payroll of covered employees and may survey covered employees to determine if the service contractor is in compliance with the provisions of this article. (b) Complaint procedures and sanctions. An employee who believes that he/she is a covered employee of a service contractor and that the service contractor is or was not complying with the requirements of this article has a right to file a complaint with the procurement director of the city. Such complaints may be made at any time and shall be investigated within a reasonable period of time by the city. Written and oral statements by any such employee shall be treated as confidential and shall not be disclosed without the written consent of the employee to the extent allowed by the Florida Statutes. (c) Private right of action against service contractor. Any covered employee or former covered employee of a service contractor may, instead of utilizing the city administrative procedure set forth in this article, but not in addition to such procedure, bring an action by filing suit against the service contractor in any court of competent jurisdiction to enforce the provisions of this article and may be awarded back pay, benefits, attorneys fees, and costs. The applicable statute of limitations for such a claim will be two years as provided in F.S. § 95.11(4)(c) as may be amended from time to time for an action for payment of wages. The court may also impose sanctions on the service contractor, including those persons or entities aiding or abetting the service contractor, to include wage restitution to the affected covered employee and damages payable to the covered employee in the sum of up to $500.00 for each week the service contractor is found to have violated this article. (d) Sanctions against service contractors. For violations of this article, the city shall sanction a service contractor by requiring the service contractor to pay wage restitution at its expense for each affected employee. The city may also sanction the service contractor in at least one of the following additional ways: (1) The city may impose damages in the sum of $500.00 for each week for each covered employee found to have not been paid in accordance with this article; (2) The city may suspend or terminate payment under the service contract or terminate the contract with the service contractor; and The city may declare the service contractor ineligible for future service contracts for three years or until all penalties and restitution have been paid in full, whichever is longer. In addition, any employer shall be ineligible for a service contract where principal officers of such employer were principal officers of a service contractor who has been declared ineligible under this article. (4) If the contract has been awarded under the city procurement ordinance, the city may debar or suspend the contractor as provided therein. (e) Public record of sanctions. All such sanctions recommended or imposed shall be a matter of public record. (f) Sanctions for aiding and abetting. The sanctions contained in this article shall also apply to any party or parties aiding and abetting in any violation of this article. Retaliation and discrimination barred. A service contractor shall not discharge, reduce the compensation, or otherwise discriminate against any covered employee for making a complaint to the city, or otherwise asserting his or her rights under this article, participating in any of its proceedings or using any civil remedies to enforce his or her rights under this article. Allegations of retaliation or discrimination, if found true in a city administrative proceeding or by a court of competent jurisdiction, shall result in an order of restitution and reinstatement of a discharged covered employee with back pay to the date of the violation or such other relief as deemed appropriate. (3) (g) Page 4 8/20/2024 9:24 AM p. 61 City of Miami Solicitation RFP 1896386 (h) Remedies herein non-exclusive. No remedy set forth in this article is intended to be exclusive or a prerequisite for asserting a claim for relief to enforce the rights under this article or in a court of law. This article shall not be construed to limit an employee's right to bring a common law cause of action for wrongful termination. (Ord. No. 12787, § 2, 4-6-06; Ord. No. 13648, § 2, 11-17-16) Sec. 18-560. - Employers receiving direct tax abatement or subsidy. The city reserves the right to impose the living wage requirements of this article on or after January 1, 2017 on any employer as a condition of that employer receiving a direct tax abatement or subsidy from the city. (Ord. No. 13648, § 2, 11-17-16) Secs. 18-561-18-599. - Reserved. Page 5 8/20/2024 9:24 AM p. 62 City of Miami Solicitation RFP 1896386 RFP NO.: 1896386 Attachment B Reference Submittal Form CATEGORY: Employee Benefiit Consulting Services FIRM NAME: Reference Section Summarized Requirements: Refer to the details in Section 2.8, References, to verify that the information provided will suffice as proof of meeting the requirements of this solicitation. Past Performance Reference Check #1 Company/Organization Name: Address: Contact Person: Contact Phone Number: Contact E-mail (if applicable): Date of Contract or Sale: Past Performance Reference Check #2 Company/Organization Name: Address: Contact Person: Contact Phone Number: Contact E-mail (if applicable): Date of Contract or Sale: Past Performance Reference Check #3 Company/Organization Name: Address: Contact Person: Contact Phone Number: Contact E-mail (if applicable): Date of Contract or Sale: 1 8/20/2024 9:24 AM p. 63 Attachment C City of Miami Solicitation RFP 1896386 CITY OF MIAMI LOCAL OFFICE CERTIFICATION (City Code, Chapter 18, Article III, Section 18-73) Solicitation Type and Number: (i.e. IFQ/IFB/RFP/RFQ/RFLI No. 123456) Solicitation Title: (Bidder/Proposer) hereby certifies compliance with the Local Office requirements stated under Chapter 18/Article III, Section 18-73, of the Code of the City of Miami, Florida, as amended. Local office means a business within the city which meets all of the following criteria: (1) Has had a staffed and fixed office or distribution point, operating within a permanent structure with a verifiable street address that is located within the corporate limits of the city, for a minimum of twelve (12) months immediately preceding the date bids or proposals were received for the purchase or contract at issue; for purposes of this section, "staffed" shall mean verifiable, full-time, on -site employment at the local office for a minimum of forty (40) hours per calendar week, whether as a duly authorized employee, officer, principal or owner of the local business; a post office box shall not be sufficient to constitute a local office within the city; (2) If the business is located in the permanent structure pursuant to a lease, such lease must be in writing, for a term of no less than twelve (12) months, been in effect for no less than the twelve (12) months immediately preceding the date bids or proposals were received, and be available for review and approval by the chief procurement officer or its designee; for recently -executed leases that have been in effect for any period less than the twelve (12) months immediately preceding the date bids or proposals were received, a prior fully -executed lease within the corporate limits of the city that documents, in writing, continuous business residence within the corporate limits of the city for a term of no less than the twelve (12) months immediately preceding the date bids or proposals were received shall be acceptable to satisfy the requirements of this section, and shall be available for review and approval by the chief procurement officer or its designee; further requiring that historical, cleared rent checks or other rent payment documentation in writing that documents local office tenancy shall be available for review and approval by the chief procurement officer or its designee; (3) Has had, for a minimum of twelve (12) months immediately preceding the date bids or proposals were received for the purchase or contract at issue, a current business tax receipt issued by both the city and Miami - Dade County, if applicable; and (4) Has had, for a minimum of twelve (12) months immediately preceding the date bids or proposals were received for the purchase or contract at issue, any license or certificate of competency and certificate of use required by either the city or Miami -Dade County that authorizes the performance of said business operations; and (5) Has certified in writing its compliance with the foregoing at the time of submitting its bid or proposal to be eligible for consideration under this section; provided, however, that the burden of proof to provide all supporting documentation in support of this local office certification is borne by the business applicant submitting a bid or proposal. 1 FORM -City of Miami Local Office Certification 8/26Q94 AM p. 64 City of Miami Solicitation RFP 1896386 PLEASE PROVIDE THE FOLLOWING INFORMATION: Bidder/Proposer Local Office Address: Does Bidder/Proposer conduct verifiable, full- time, on -site employment at the local office for a minimum of forty (40) hours per calendar week? YES NO ❑ ❑ If Bidder/Proposer's Local Office tenancy is pursuant to a lease, has Bidder/Proposer enclosed a copy of the lease? ❑ YES ❑ NO ❑ N/A Has Bidder/Proposer enclosed a copy of the Business Tax Receipt (BTR) issued by the City of Miami and Miami -Dade County? City of Miami: Cite Exemption: NO Exempt ❑ YES ❑ ❑ Miami -Dade County: Cite Exemption: ❑ YES ❑ NO ❑ Exempt Has Bidder/Proposer enclosed a copy of the license, certificate of competency and certificate of use that authorizes the performance of Bidder/Proposer's business operations? YES NO ❑ ❑ Bidder/Proposer's signature below certifies compliance with the Local Office requirements stated under Chapter 18/Article III, Section 18-73, of the Code of the City of Miami, Florida, as amended. Print Name (Bidder/Proposer Authorized Representative) Signature Date 2 FORM -City of Miami Local Office Certification 8/26gRt9 24 AM p. 65 City of Miami Solicitation RFP 1896386 STATE OF FLORIDA COUNTY OF Certified to and subscribed before me this day of , 20 , by (NOTARY SEAL) (Signature of Notary Public -State of Florida) (Name of Notary Typed, Printed, or Stamped) Personally Known OR Produced Identification Type of Identification Produced FORM -City of Miami Local Office Certification 8/26gRt9 24 AM 3 p. 66 City of Miami Solicitation RFP 1896386 ATTACHMENT D INSURANCE DEFINITIONS, CONDITIONS, AND ADDITIONAL REQUIREMENTS The Successful Proposer agrees to provide and maintain throughout the life of this contract and at Successful Proposer's expense insurance coverage outlined herewith as applicable insuring all operations related to the contract and any extensions thereof. Workers Compensation and Employers Liability Statutory requirements per Chapter 440, Florida Statutes, as amended, are applicable, and this coverage is subject to the Laws of the State of Florida. This coverage protects against lawsuits stemming from workplace accidents. It provides for medical care to injured employees, along with compensation for lost income. Commercial General Liability It protects against accidents and injuries that occur on company property or the property of a customer. It compensates an injured person or owner of property for injuries and property damages, and the cost of defending lawsuits, including legal settlements or investigations. This policy also covers claims resulting from products exposures, libel, slander, copyright infringement, and other personal and advertisement injuries. Commercial Automobile Liability It protects against liability, no fault, medical payments, uninsured and underinsured motorists claims, collision and other than collision physical damage. In addition, this policy affords coverage on autos that are hired or borrowed or non -owned for use in the business. The non -owned can be autos owned by employees or members of their households. Non -Owned Auto exposures can be endorsed or added under the Commercial General Liability Policy. Professional/Errors and Omissions Liability Used by many professionals such as engineers, lawyers, accountants, stock brokers, financial advisers, insurance agents, court reports, dentists, nurses and teachers. It 8/20/2024 9:24 AM p. 67 City of Miami Solicitation RFP 1896386 protects against the financial effects of liability lawsuits filed by clients. It basically protects professionals who cause harm to a client due to incompetence, errors , or negligence. Umbrella Liability It protects against liability and losses after primary insurance benefits have been exhausted. This supplemental coverage kicks in only after the underlined liability policies have paid their maximum benefits. Environmental Liability It protects against the financial costs of claims of injury or damage due to pollution, and other costs of cleaning up pollutants. These policies are designed to cover both property and liability risks. Directors and Officers Liability This coverage protects against claims from stockholders, employees and clients that are also aimed individually at directors and officers. These claims typically stem from errors in judgement, breaches of duty and wrongful acts in connection with company business. Cyber Liability It protects against costs of the theft, destruction or unauthorized use of electronic data through computer viruses or network intrusions. It also adds protection to a business against such costs if a business fails to safeguard another party's electronic data. Companies sharing data outside their internal network benefit from this coverage Commercial Property It protects against claims or damages to the insured's buildings, business personal property and personal property of others. It can also provide for loss of business income coverage or extra expenses incurred because of physical loss by a covered peril to the insured's property. Commercial Crime It protects against loss of money, securities and other property because of a variety of criminal acts such as employee theft or embezzlement, burglary, robbery, forgery, 8/20/2024 9:24 AM p. 68 City of Miami Solicitation RFP 1896386 computer fraud, kidnapping and extortion. Crime insurance also covers money and securities against damage or destruction by almost any cause of loss, not just crime. Builders Risk It protects against damage to or destruction of buildings or other structures during their construction. Any party with a financial interest in a construction, remodeling, or repair project benefits from this coverage. Surety Bonds Surety bonds are three party contracts. The principal, the party that undertakes the obligation, pays for the issuance of a bond by a surety company. The bond provides capital to guarantee the obligation will be performed. The obligee is the party that receives the benefit of the bond If the obligation is improperly performed. If payment and performance bonds are required such bonds must be substantially in the form prescribed by Florida Statutes 255.05, as amended, and will be subject to the approval of the City of Miami Director of the Department of Risk Management. Valuable Papers It pays for the cost to reconstruct damaged or destroyed valuable papers and records. Typically is defined to include almost all forms of printed documents or records with the exception of money or securities, and data and media which is usually excluded. Additional Requirements The Successful Proposer must furnish the City of Miami, Department of Procurement, and Risk Management located at 444 S.W. 2nd Avenue Miami, Florida 33130, original Certificates of insurance to be in force on the date of this Contract, and Renewal Certificates of insurance thereafter. All policies indicated on the certificate must be in compliance with all Contract requirements. The failure of the City to obtain the applicable or corresponding certificates from Contractor is not a waiver by the City of any requirements for the Successful Proposer. The Successful Proposer must furnish Certificates insurance listing the City of Miami as an additional insured. All insurance certificates must be signed, dated and reference the City contract number. The insurance must provide for sixty (30) days prior written notice to be given to the City in the event coverage is substantially changed, canceled, or non -renewed. 8/20/2024 9:24 AM p. 69 City of Miami Solicitation RFP 1896386 Any deductibles or self -insured retentions on referenced insurance coverages must be borne by Successful Proposer. The Successful Proposer further agrees to have insurers waive their rights of subrogation against the City of Miami, its employees, elected officials, agents, or representatives. The coverages and limits furnished by Successful Proposer in no way limit the Successful Proposer's liabilities and responsibilities specified within the Contract or law. Any insurance or self-insurance programs maintained by the City of Miami shall not contribute with insurance provided by the Successful Proposer under the Contract. The required insurance to be carried is not limited by any limitations expressed in the indemnification language in this Contract or any limitation placed on the indemnity in this Contract given as a matter of law. If the Successful Proposer is a joint venture or limited liability company, the insurance policies must name the joint venture or Limited Liability Company and each of its separate constituent entities as named insureds. The Successful Proposer must require all subcontractors to provide the insurance required herein. All subcontractors are subject to the same insurance requirements of the Successful Proposer unless otherwise specified in this Contract. If the Successful Proposer or subcontractor desire additional coverages, the party desiring the additional coverages is responsible for the acquisition and cost. Notwithstanding any provision in the Contract to the contrary, the City of Miami Risk Management Department maintains and reserves the right to modify, delete, alter or change these requirements. Note: The duty to carry and maintain insurance during the life of the contract will survive the cancellation or expiration, as applicable, under the Contract. 8/20/2024 9:24 AM p. 70 Employee Benefit Consulting Services City of Miami Solicitation RFP 1896386 RFP 1896386 EXHIBIT E PRICE PROPOSAL A. Employee Benefit Consulting Services The not -to -exceed price and estimated hours for providing all employee benefit consulting services as stated in the Scope of Services. The price includes all costs associated to provide these services. Term Estimated Hours Not -To -Exceed Price 1 Initial Term (Years 1-3) 2 First 1-year OTR Period 3 Second 1-year OTR Period Note: The City will pay the Consultant at the hourly rate indicated below for any work involved to complete the City's request if the work significantly exceeds the hours stated. Similarly, the fee shall be reduced if there is significantly less work than anticipated. B. Not -to -Exceed Hourly Rate for Additional Work Below is the not -to -exceed hourly rate for additional work not included within the Scope of Services. Breakdown of Not to Exceed Price Staff Position/ Classification Proposed Maximum Hourly Rates Initial Term Years 1 - 3 OTR 1 Year 4 OTR 1 Year 5 Lead Consultant $ $ $ $ $ $ $ $ $ Notes: 1) The not -to exceed price in Section A, and the hourly rates in Section B, shall remain firm and fixed for the term of the Contract, including any renewals or extensions thereof. 2) The hourly rates above include all costs to include normal administrative fees, such as telephone, mailing, faxes, duplication charges, overnight mail, and including all out of pocket expenses, such as travel incurred in connection with the services (refer to CH.112.061 of the Florida Statutes regarding travel expenses), per diem, and miscellaneous costs and fees, and is incorporated in this price schedule, as they will not be reimbursed separately by the City. 3) The City will pay the Consultant at the hourly rate indicated within Section B, for any work involved to complete the City's request for work that is not included within the Scope of Services. The City reserves the right to negotiate the final pricing for this work on a project by project basis, at the City's sole discretion. 8/20/2024 9:24 AM p. 71 ATTACHMENT F ANTI -HUMAN TRAFFICKING AFFIDAVIT 1. The undersigned affirms, certifies, attests, and stipulates as follows: Solicitation RFP 1896386 a. The entity is a non -governmental entity authorized to transact business in the State of Florida and in good standing with the Florida Department of State, Division of Corporations. b. The nongovernmental entity is either executing, renewing, or extending a contract (including, but not limited to, any amendments, as applicable) with the City of Miami ("City") or one of its agencies, authorities, boards, trusts, or other City entity which constitutes a governmental entity as defined in Section 287.138(1), Florida Statutes (2024). c. The nongovernmental entity is not in violation of Section 787.06, Florida Statutes (2024), titled "Human Trafficking " d. The nongovernmental entity does not use "coercion" for labor or services as defined in Section 787.06, Florida Statutes (2024), attached and incorporated herein as Exhibit Affidavit-1. 2. Under penalties of perjury, I declare the following: a. I have read and understand the foregoing Anti -Human Trafficking Affidavit and that the facts, statements and representations provided in Section 1 are true and correct. b. I am an officer or a representative of the nongovernmental entity authorized to execute this Anti - Human Trafficking Affidavit. Nongovernmental Entity: Name: Signature of Officer: Office Address: Email Address: Officer Title: FEIN No. / - / / / / / / STATE OF FLORIDA COUNTY OF MIAMI-DADE Main Phone Number: The foregoing instrument was swom to and subscribed before me by means of O physical presence or O online notarization, this day of by , as the authorized officer or representative for the nongovernmental entity.. He/she is personally known to me or has produced as identification. (NOTARY PUBLIC SEAL) My Commission Expires: Signature of Person Taking Oath (Printed, Typed, or Stamped Name of Notary Public) 8/20/2024 9:24 AM p. 72 City of Miami Solicitation RFP 1896386 EXHIBIT AFFIDAVIT-1 SECTION 787.06, FLORIDA STATUTES (2024) 8/20/2024 9:24 AM p. 73 City of Miami Solicitation RFP 1896386 Select Year: 2024 v The 2024 Florida Statutes Go Title Chapter 787 View Entire XLVI KIDNAPPING; CUSTODY OFFENSES; HUMAN TRAFFICKING; AND RELATED Chapter CRIMES OFFENSES 787.06 Human trafficking.— (1)(a) The Legislature finds that human trafficking is a form of modern-day slavery. Victims of human trafficking are young children, teenagers, and adults. Thousands of victims are trafficked annually across international borders worldwide. Many of these victims are trafficked into this state. Victims of human trafficking also include citizens of the United States and those persons trafficked domestically within the borders of the United States. The Legislature finds that victims of human trafficking are subjected to force, fraud, or coercion for the purpose of sexual exploitation or forced labor. (b) The Legislature finds that while many victims of human trafficking are forced to work in prostitution or the sexual entertainment industry, trafficking also occurs in forms of labor exploitation, such as domestic servitude, restaurant work, janitorial work, sweatshop factory work, and migrant agricultural work. (c) The Legislature finds that traffickers use various techniques to instill fear in victims and to keep them enslaved. Some traffickers keep their victims under lock and key. However, the most frequently used practices are less obvious techniques that include isolating victims from the public and family members; confiscating passports, visas, or other identification documents; using or threatening to use violence toward victims or their families; telling victims that they will be imprisoned or deported for immigration violations if they contact authorities; and controlling the victims' funds by holding the money ostensibly for safekeeping. (d) It is the intent of the Legislature that the perpetrators of human trafficking be penalized for their illegal conduct and that the victims of trafficking be protected and assisted by this state and its agencies. In furtherance of this policy, it is the intent of the Legislature that the state Supreme Court, The Florida Bar, and relevant state agencies prepare and implement training programs in order that judges, attorneys, law enforcement personnel, investigators, and others are able to identify traffickers and victims of human trafficking and direct victims to appropriate agencies for assistance. It is the intent of the Legislature that the Department of Children and Families and other state agencies cooperate with other state and federal agencies to ensure that victims of human trafficking can access social services and benefits to alleviate their plight. (2) As used in this section, the term: (a) "Coercion" means: 1. Using or threatening to use physical force against any person; 2. Restraining, isolating, or confining or threatening to restrain, isolate, or confine any person without lawful authority and against her or his will; 3. Using lending or other credit methods to establish a debt by any person when labor or services are pledged as a security for the debt, if the value of the labor or services as reasonably assessed is not applied toward the liquidation of the debt, the length and nature of the labor or services are not respectively limited and defined; 4. Destroying, concealing, removing, confiscating, withholding, or possessing any actual or purported passport, visa, or other immigration document, or any other actual or purported government identification document, of any person; 5. Causing or threatening to cause financial harm to any person; 6. Enticing or luring any person by fraud or deceit; or 8/20/2024 9:24 AM p. 74 City of Miami Solicitation RFP 1896386 7. Providing a controlled substance as outlined in Schedule I or Schedule II of s. 893.03 to any person for the purpose of exploitation of that person. (b) "Commercial sexual activity" means any violation of chapter 796 or an attempt to commit any such offense, and includes sexually explicit performances and the production of pornography. (c) "Financial harm" includes extortionate extension of credit, loan sharking as defined in s. 687.071, or employment contracts that violate the statute of frauds as provided in s. 725.01. (d) "Human trafficking" means transporting, soliciting, recruiting, harboring, providing, enticing, maintaining, purchasing, patronizing, procuring, or obtaining another person for the purpose of exploitation of that person. (e) "Labor" means work of economic or financial value. (f) "Maintain" means, in relation to labor or services, to secure or make possible continued performance thereof, regardless of any initial agreement on the part of the victim to perform such type service. (g) "Obtain" means, in relation to labor, commercial sexual activity, or services, to receive, take possession of, or take custody of another person or secure performance thereof. (h) "Services" means any act committed at the behest of, under the supervision of, or for the benefit of another. The term includes, but is not limited to, forced marriage, servitude, or the removal of organs. (i) "Sexually explicit performance" means an act or show, whether public or private, that is live, photographed, recorded, or videotaped and intended to arouse or satisfy the sexual desires or appeal to the prurient interest. (j) "Unauthorized alien" means an alien who is not authorized under federal law to be employed in the United States, as provided in 8 U.S.C. s. 1324a(h)(3). The term shall be interpreted consistently with that section and any applicable federal rules or regulations. (k) "Venture" means any group of two or more individuals associated in fact, whether or not a legal entity. (3) Any person who knowingly, or in reckless disregard of the facts, engages in human trafficking, or attempts to engage in human trafficking, or benefits financially by receiving anything of value from participation in a venture that has subjected a person to human trafficking: (a)1. For labor or services of any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. 2. Using coercion for labor or services of an adult commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (b) Using coercion for commercial sexual activity of an adult commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (c)1. For labor or services of any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age who is an unauthorized alien commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. 2. Using coercion for labor or services of an adult who is an unauthorized alien commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (d) Using coercion for commercial sexual activity of an adult who is an unauthorized alien commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (e)1. For labor or services who does so by the transfer or transport of any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age from outside this state to within this state commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. 2. Using coercion for labor or services who does so by the transfer or transport of an adult from outside this state to within this state commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (f)1. For commercial sexual activity who does so by the transfer or transport of any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age from outside this state to within this state commits a felony of the first degree, punishable by imprisonment for a term of years not exceeding life, or as provided in s. 775.082, s. 775.083, or s. 775.084. 8/20/2024 9:24 AM p. 75 City of Miami Solicitation RFP 1896386 2. Using coercion for commercial sexual activity who does so by the transfer or transport of an adult from outside this state to within this state commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (g) For commercial sexual activity in which any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age, or in which any person who is mentally defective or mentally incapacitated as those terms are defined in s. 794.011(1), is involved commits a life felony, punishable as provided in s. 775.082(3)(a)6., s. 775.083, or s. 775.084. For each instance of human trafficking of any individual under this subsection, a separate crime is committed and a separate punishment is authorized. (4)(a) Any parent, legal guardian, or other person having custody or control of a minor who sells or otherwise transfers custody or control of such minor, or offers to sell or otherwise transfer custody of such minor, with knowledge or in reckless disregard of the fact that, as a consequence of the sale or transfer, the minor will be subject to human trafficking commits a life felony, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (b) Any person who, for the purpose of committing or facilitating an offense under this section, permanently brands, or directs to be branded, a victim of an offense under this section commits a second degree felony, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. For purposes of this subsection, the term "permanently branded" means a mark on the individual's body that, if it can be removed or repaired at all, can only be removed or repaired by surgical means, laser treatment, or other medical procedure. (5) The Criminal Justice Standards and Training Commission shall establish standards for basic and advanced training programs for law enforcement officers in the subjects of investigating and preventing human trafficking crimes. Every basic skills course required for law enforcement officers to obtain initial certification must include training on human trafficking crime prevention and investigation. (6) Each state attorney shall develop standards of instruction for prosecutors to receive training on the investigation and prosecution of human trafficking crimes and shall provide for periodic and timely instruction. (7) Any real property or personal property that was used, attempted to be used, or intended to be used in violation of this section may be seized and shall be forfeited as provided by the Florida Contraband Forfeiture Act. After satisfying any liens on the property, the remaining proceeds from the sale of any property seized under this section and owned by a defendant convicted of a violation of this section must first be allocated to pay any order of restitution of a human trafficking victim in the criminal case for which the owner was convicted. If there are multiple human trafficking victims in the criminal case, the remaining proceeds must be allocated equally among the victims to pay restitution. If the proceeds are sufficient to pay any such order of restitution, any remaining proceeds must be disbursed as required by s. 932.7055(5)-(9). (8) The degree of an offense shall be reclassified as follows if a person causes great bodily harm, permanent disability, or permanent disfigurement to another person during the commission of an offense under this section: (a) A felony of the second degree shall be reclassified as a felony of the first degree. (b) A felony of the first degree shall be reclassified as a life felony. (9) In a prosecution under this section, the defendant's ignorance of the victim's age, the victim's misrepresentation of his or her age, or the defendant's bona fide belief of the victim's age cannot be raised as a defense. (10)(a) Information about the location of a residential facility offering services for adult victims of human trafficking involving commercial sexual activity, which is held by an agency, as defined in s. 119.011, is confidential and exempt from s. 119.07(1) and s. 24(a), Art. I of the State Constitution. This exemption applies to such confidential and exempt information held by an agency before, on, or after the effective date of the exemption. (b) Information about the location of a residential facility offering services for adult victims of human trafficking involving commercial sexual activity may be provided to an agency, as defined in s. 119.011, as necessary to maintain health and safety standards and to address emergency situations in the residential facility. (c) The exemptions from s. 119.07(1) and s. 24(a), Art. I of the State Constitution provided in this subsection do not apply to facilities licensed by the Agency for Health Care Administration. 8/20/2024 9:24 AM p. 76 City of Miami Solicitation RFP 1896386 (11) A victim's lack of chastity or the willingness or consent of a victim is not a defense to prosecution under this section if the victim was under 18 years of age at the time of the offense. (12) The Legislature encourages each state attorney to adopt a pro -prosecution policy for human trafficking offenses, as provided in this section. After consulting the victim, or making a good faith attempt to consult the victim, the state attorney shall determine the filing, nonfiling, or diversion of criminal charges even in circumstances when there is no cooperation from a victim or over the objection of the victim, if necessary. (13) When a contract is executed, renewed, or extended between a nongovernmental entity and a governmental entity, the nongovernmental entity must provide the governmental entity with an affidavit signed by an officer or a representative of the nongovernmental entity under penalty of perjury attesting that the nongovernmental entity does not use coercion for labor or services as defined in this section. For purposes of this subsection, the term "governmental entity" has the same meaning as in s. 287.138(1). History.—s. 2, ch. 2004-391; s. 1, ch. 2006-168; s. 5, ch. 2012-97; s. 300, ch. 2014-19; s. 7, ch. 2014-160; s. 96, ch. 2015-2; s. 2, ch. 2015-147; s. 3, ch. 2016-24; s. 25, ch. 2016-105; s. 4, ch. 2016-199; s. 2, ch. 2020-49; s. 2, ch. 2021-189; s. 3, ch. 2023-86; s. 7, ch. 2024- 184. Copyright © 1995-2024 The Florida Legislature • Privacy Statement • Contact Us 8/20/2024 9:24 AM p. 77 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 PROFESSIONAL SERVICES AGREEMENT By and Between The City of Miami. Florida CONSULTANT This Professional Services Agreement ("Agreement") is entered into this day of , 2024 by and between the City of Miami, a municipal corporation of the State of Florida, whose address is 444 S.W. 2nd Avenue, 10th Floor, Miami, Florida 33130 ("City"), and, company, qualified to do business in the State of Florida whose principal address is hereinafter referred to as the ("Consultant"). RECITALS: WHEREAS, the City of Miami issued Request for Proposals No. 1896386, on August 16, 2024 (the "RFP" attached hereto, incorporated hereby, and made a part of as Exhibit A) for the provision of leasing, property management, and construction management services ("Services" as more fully set forth in the scope of work "Scope" attached hereto as Exhibit B) for the City of Miami's Department of Risk Management ("Risk"), and Consultant's Response and Price Proposal ("Price Proposal", attached hereto, incorporated hereby, and made part of hereof as Exhibit C), in response thereto, has been selected as the most qualified proposal for the provision of the Services. WHEREAS, the Evaluation Committee appointed by the City Manager determined that the Proposal submitted by the Consultant was responsive to the RFP requirements, and recommended that the City Manager negotiate with the Consultant; and WHEREAS, the City wishes to engage the Services of Consultant, and Consultant wishes to perform the Services for the City; and 1 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 78 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 WHEREAS, the City and the Consultant desire to enter into this Agreement under the terms and conditions set forth herein; NOW THEREFORE, in consideration of the mutual covenants and promises herein contained, Consultant and the City agree as follows: TERMS: 1. RECITALS AND INCORPORATIONS: DEFINITIONS: The recitals are true and correct and are hereby incorporated into and made a part of this Agreement. The City's RFP is hereby incorporated into and made a part of this Agreement and attached hereto as Exhibit "A". The Services and Scope of Work are hereby incorporated into and made a part of this Agreement and attached as Exhibit "B". The Consultant's Response and Price Schedule, dated , 2024 in response to RFP 1896386, is hereby incorporated into and made a part of this Agreement as attached Exhibit "C". The Consultant's Insurance Certificate is hereby incorporated into and made a part of this Agreement as attached Exhibit "D". The order of precedence whenever there is conflicting or inconsistent language between documents is as follows in descending order of priority: (1) Professional Services Agreement ("PSA") (2) Addenda/Addendum to the RFP, if any; (3) RFP; and (4) Consultant's Response and Price Schedule, dated 2024 acknowledging Services and Scope of Work and pricing component of services and, response to the Request for Proposals. 2. TERM: The Agreement shall become effective on the date on the first page and shall be for an initial term of three (3) years with an option to renew for two (2) additional one (1) year periods. The City, acting by and through its City Manager, shall have the option to extend or terminate the Agreement for convenience, that is, for any or no cause. 2 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 79 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 3. SCOPE OF SERVICES: A. Consultant agrees to provide the Services as specifically described, and under the special terms and conditions set forth in Exhibits "A" and "B" hereto, which by this reference is incorporated into and made a part of this Agreement. B. Consultant represents to the City that: (i) it possesses all qualifications, licenses, certificates, authorizations, and expertise required for the performance of the Services, including but not limited to full qualification to do business in Florida, and meet all requirements of section 468.385, et seq., Florida Statutes; (ii) it is not delinquent in the payment of any sums due the City, including payment of permits, fees, occupational licenses, etc., nor in the performance of any obligations or payment of any monies to the City; (iii) all personnel assigned to perform the Services are and shall be, at all times during the term hereof, fully qualified and trained to perform the tasks assigned to each and possess the licenses , registrations, and certifications required by law to perform such tasks ; (iv) the Services will be performed in the manner described in Exhibit "A"; and (v) each person executing this Agreement on behalf of Consultant has been duly authorized to so execute the same and fully bind Consultant as a party to this Agreement. C. Consultant shall always provide fully qualified, competent, and physically capable employees to perform the Services under this Agreement. Consultant shall possess and maintain any required licenses, permits and certifications to perform the Services under this Agreement. City may require Consultant to remove any employee the City deems careless, incompetent, insubordinate, intoxicated on the job, or otherwise objectionable and whose continued services under this Agreement is not in the best interest of the City. 4. COMPENSATION: A. Consultant, as its sole compensation for the Services provided, shall receive compensation as indicated in Exhibit "C", which by this reference is incorporated into and made a part of this Agreement. 3 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 80 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 B. Prices shall remain firm and fixed for the term of the Contract, including any renewal or extension periods. Consultant represents, warrants and guarantees to the City that Consultant shall completely, timely and properly perform the Work and all of its obligations under the Agreement, in accordance therewith, for the Contract Price agreed upon by the parties. This Contract Price shall constitute Guaranteed Maximum Cost to the Owner for performing the Work inclusive of labor, materials, equipment, supplies, and any allowable overhead and profit. The City shall (absent a prior Amendment with a justifiable compelling cause approved as an Amendment to this Agreement) have no liability or obligation to pay any amount in excess of the stated Contract Price and Consultant shall have no recourse in that respect except to seek an Amendment to the Agreement. All costs in excess of the Contract Price shall be paid solely by Consultant without reimbursement or additional compensation from the City. 5. OWNERSHIP OF DOCUMENTS: Consultant understands and agrees that any information, document, report, data or other digital record, or any other material whatsoever which is given by the City to Consultant, its employees, or any subconsultant, or which is otherwise obtained or prepared by Consultant solely and exclusively for the City pursuant to or under the terms of this Agreement, is and shall always remain the property of the City. Consultant agrees not to use any such information, document, report, data, or material for any other purpose whatsoever without the written consent of the City Manager, which may be withheld or conditioned by the City Manager in his/her sole discretion. Consultant is permitted to make and to maintain duplicate copies of the files, records, documents, etc. if Consultant determines copies of such records are necessary after the termination of this Agreement; however, in no way shall the confidentiality as permitted by applicable laws be breached. The City shall maintain and retain ownership of any and all documents which result upon the completion of the work and Services under this Agreement as per the terms of this Section 5. 4 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 81 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 6. AUDIT AND INSPECTION RIGHTS AND RECORDS RETENTION: A. Consultant agrees to provide access to the City or to any of its duly authorized representatives, to any books, documents, papers, and records of Consultant which are directly pertinent to this Agreement, for the purpose of audit, examination, excerpts, and transcripts. The City may, at reasonable times, and for a period of up to three (3) years following the date of final payment by the City to Consultant under this Agreement, audit and inspect, or cause to be audited and inspected, those books, documents, papers, and records of Consultant which are related to Consultant's performance under this Agreement. Consultant agrees to maintain all such books, documents, papers, and records at its principal place of business in Miami -Dade County, or its local office in Miami -Dade County or to otherwise make them available in Miami -Dade County for a period of three (3) years after final payment is made under this Agreement and all other pending matters are closed. Consultant's failure to adhere to, or refusal to comply with, this condition shall result in the immediate cancellation of this Agreement by the City. B. The City may, at reasonable times during the term hereof, inspect the Consultant's facilities and perform such tests, as the City deems reasonably necessary, to determine whether the goods or services required to be provided by Consultant under this Agreement conform to the terms hereof. Consultant shall make available to the City all reasonable facilities and assistance to facilitate the performance of tests or inspections by City representatives. All audits, tests and inspections shall be subject to, and made in accordance with, the provisions of Sections 18-100, 18-101, and 18-102 of the Code of the City of Miami, Florida ("City Code"), which Sections apply to this Agreement, as same may be amended or supplemented, from time to time. 7. AWARD OF AGREEMENT: Consultant represents and warrants to the City that it has not employed or retained any person or company employed by the City to solicit or secure this Agreement and that it has not 5 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 82 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 offered to pay, paid, or agreed to pay any person any fee, commission, percentage, brokerage fee, or gift of any kind contingent upon or in connection with, the award of this Agreement. 8. PUBLIC RECORDS: A. Consultant understands that the public shall have access, at all reasonable times, to all documents and information pertaining to City Agreements, subject to the provisions of Chapter 119, Florida Statutes, and agrees to allow access by the City and the public to all documents subject to disclosure under applicable laws. Consultant's failure or refusal to comply with the provisions of this section shall result in the immediate cancellation of this Agreement by the City. B. Consultant shall additionally comply with Section 119.0701, Florida Statutes, including without limitation: (1) keep and maintain public records that ordinarily and necessarily would be required by the City to perform this service; (2) upon request from the City's custodian of public records, provide the City with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in Chapter 119, Florida Statutes, or as otherwise provided by law; (3) ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the Agreement if the Consultant does not transfer the records to the City; (4) upon completion of the Agreement, transfer, at no cost, to the City all public records in possession of the Consultant or keep and maintain public records required by the City to perform the service, if the Consultant transfers all public records to the City upon completion of the Agreement, the Consultant shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements, if the Consultant keeps and maintains public records upon completion of the Agreement, the Consultant shall meet all applicable requirements for retaining public records, all records stored electronically must be provided to the City, upon 6 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 83 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 request from the City's custodian of public records, in a format that is compatible with the information technology systems of the City. Notwithstanding the foregoing, Consultant shall be permitted to retain any public records that make up part of its work product solely as required for archival purposes, as required by law, or to evidence compliance with the terms of the Agreement. C. Should Consultant determine to dispute any public access provision required by Florida Statutes, then Consultant shall do so at its own expense and at no cost to the City. IF THE CONSULTANT HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONSULTANT'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THE CONTRACT, CONTACT THE DIVISION OF PUBLIC RECORDS AT (305) 416-1800, VIA EMAIL AT PUBLICRECORDS@MIAMIGOV.COM, OR REGULAR MAIL AT CITY OF MIAMI OFFICE OF THE CITY ATTORNEY, 444 SW 2ND AVENUE, 9TH FLOOR, MIAMI, FL 33130. THE CONSULTANT MAY ALSO CONTACT THE RECORDS CUSTODIAN ATTHE CITY OF MIAMI DEPARTMENT WHO IS ADMINISTERING THIS CONTRACT. 9. COMPLIANCE WITH FEDERAL. STATE AND LOCAL LAWS: Consultant understands that agreements with local governments are subject to certain laws and regulations, including laws pertaining to public records, conflict of interest, record keeping, etc. City and Consultant agree to comply with and observe all such applicable federal, state and local laws, rules, regulations, codes, and ordinances, as they may be amended from time to time. Consultant further agrees to include in all of Consultant's agreements with subconsultants for any Services related to this Agreement this provision requiring subconsultants to comply with and observe all applicable federal, state, and local laws rules, regulations, codes, and ordinances, as they may be amended from time to time. Local laws in accordance with this Section shall mean the applicable laws of the City of Miami, and Miami -Dade County. 7 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 84 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 10. JNDEMNIFICATION: Consultant shall indemnify, hold and save harmless, and defend (at its own cost and expense), the City, its officers, agents, directors, and/or employees, from all liabilities, damages, losses, judgements, and costs, including, but not limited to, reasonable attorney's fees, to the extent caused by the negligence, recklessness, negligent act or omission, or intentional wrongful misconduct of Consultant and persons employed or utilized by Consultant in the performance of this Contract. Consultant shall further, hold the City, its officials and employees, indemnify, save and hold harmless for, and defend (at its own cost), the City its officials and/or employees against any civil actions, statutory or similar claims, injuries or damages arising or resulting from the permitted Work, even if it is alleged that the City, its officials, and/or employees were negligent. In the event that any action or proceeding is brought against the City by reason of any such claim or demand, the Consultant shall, upon written notice from the City, resist and defend such action or proceeding by counsel satisfactory to the City. The Consultant expressly understands and agrees that any insurance protection required by this Contract or otherwise provided by the Consultant shall in no way limit the responsibility to indemnify, keep and save harmless and defend the City or its officers, employees, agents and instrumentalities as herein provided. The indemnification provided above shall obligate the Consultant to defend, at its own expense, to and through trial, administrative, appellate, supplemental or bankruptcy proceeding, or to provide for such defense, at the City's option, any and all claims of liability and all suits and actions of every name and description which may be brought against the City, whether performed by the Consultant, or persons employed or utilized by Consultant. These duties will survive the cancellation or expiration of the Contract. This Section will be interpreted under the laws of the State of Florida, including without limitation and interpretation, which conforms to the limitations of Sections 725.06 and/or 725.08, Florida Statutes, as applicable and as amended. 8 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 85 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 Consultant shall require all sub -consultant agreements to include a provision that each sub -consultant will indemnify the City in substantially the same language as this Section. The Consultant agrees and recognizes that the City shall not be held liable or responsible for any claims which may result from any actions or omissions of the Consultant in which the City participated either through review or concurrence of the Consultant's actions. In reviewing, approving or rejecting any submissions by the Consultant or other acts of the Consultant, the City, in no way, assumes or shares any responsibility or liability of the Consultant or sub -consultant under this Contract. Ten dollars ($10) of the payments made by the City constitute separate, distinct, and independent consideration for the granting of this Indemnification, the receipt and sufficiency of which is voluntarily and knowingly acknowledged by the Consultant. 11. DEFAULT: If Consultant fails to comply with any term or condition of this Agreement, or fails to perform in any material way any of its obligations hereunder, and fails to cure such failure after reasonable notice from the City, then Consultant shall be in default. Consultant understands and agrees that termination of this Agreement under this section shall not release Consultant from any obligation(s) accruing prior to the effective date of termination. Should Consultant be unable or unwilling to commence to perform the Services within the time provided or contemplated herein, then, in addition to the foregoing, Consultant shall be liable to the City for all expenses incurred by the City in preparation and negotiation of this Agreement, as well as all costs and expenses incurred by the City in the re -procurement of the Services, including consequential and incidental damages. Upon the occurrence of a default hereunder the City, in addition to all remedies available to it by law, may immediately, upon written notice to Consultant, terminate this Agreement whereupon all payments, advances, or other compensation paid by the City to Consultant while Consultant was in default shall be immediately returned to the City. 9 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 86 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 If the City fails to comply with any term or condition of this Agreement, or fails to perform in any material way any of its obligations hereunder, and fails to cure such failure after reasonable notice from Consultant, the City shall be in default, which shall be treated as a termination pursuant to Section 13. 12. RESOLUTION OF AGREEMENT DISPUTES: Consultant understands and agrees that all disputes between Consultant and the City based upon an alleged violation of the terms of this Agreement by the City shall be submitted to the City Manager for his/her resolution, prior to Consultant being entitled to seek judicial relief in connection therewith. In the event that the amount of compensation hereunder exceeds Twenty - Five Thousand Dollars and No/Cents ($25,000), the City Manager's decision shall be approved or disapproved, as applicable, by the City Commission, whose decision shall be final. Consultant shall not be entitled to seek judicial relief, recourse, remedy or to file a civil action unless: (i) it has first received City Manager's written decision, approved or disapproved, as applicable, by the City Commission if the amount of compensation hereunder exceeds Twenty -Five Thousand Dollars and No/Cents ($25,000), or (ii) a period of sixty (60) days has expired, after submitting to the City Manager a detailed statement of the dispute, accompanied by all supporting documentation one hundred twenty (120) days if City Manager's decision is subject to City Commission approval); or (iii) City has waived compliance with the procedure set forth in this section by a written instrument clearly waiving compliance , signed by the City Manager. In no event may the amount of compensation under this Section exceed the total compensation set forth in Section 4 (A) of this Agreement. The adherence to this Section is the condition precedent to the institution of any civil action by the Consultant against the City. 10 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 87 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 13. TERMINATION: OBLIGATIONS UPON TERMINATION: A. The City, acting by and through its City Manager, shall have the right to terminate this Agreement, in its sole discretion, and without penalty, at any time, by giving written notice to Consultant at least thirty (30) calendar days prior to the effective date of such termination. In such event, the City shall pay to Consultant compensation for Services rendered and approved expenses incurred prior to the effective date of termination. In no event shall the City be liable to Consultant for any additional compensation and expenses incurred, other than that provided herein, and in no event shall the City be liable for any consequential or incidental damages. The Consultant shall have no recourse or remedy against the City for a termination under this subsection except for payment of fees due prior to the effective date of termination. B. The City, by and acting through its City Manager, shall have the right to terminate this Agreement, in its sole discretion, and without penalty, upon the occurrence of an event of a material breach hereunder, and failure to cure the same within thirty (30) days after written notice of default. In such event, the City shall not be obligated to pay any amounts to Consultant for Services rendered by Consultant after the date of termination, but the parties shall remain responsible for any payments that have become due and owing as of the effective date of termination. In no event shall the City be liable to Consultant for any additional compensation and expenses incurred, other than that provided herein, and in no event shall the City be liable for any direct, indirect, special, consequential, or incidental damages. 14. JNSURANCE: A. Consultant shall, always during the term hereof, maintain such insurance coverage(s) as may be required by the City. The insurance coverage(s) required as of the Effective Date of this Agreement are attached hereto as Exhibit "D" and incorporated herein by this reference. The City RFP number and title of the RFP must appear on each certificate of insurance. The Consultant shall add the City of Miami as an additional insured to its commercial 11 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 88 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 general liability, and auto liability policies, and as a named certificate holder on all policies. Consultant shall correct any insurance certificates as requested by the City's Risk Management Administrator. All such insurance, including renewals, shall be subject to the approval of the City for adequacy of protection and evidence of such coverage(s) and shall be furnished to the City Risk Management Administrator on Certificates of Insurance indicating such insurance to be in force and effect and any cancelled or non -renewed policy will be replaced with no coverage gap and a current Certificate of Insurance will be provided. Completed Certificates of Insurance shall be filed with the City prior to the performance of Services hereunder, provided, however, that Consultant shall at any time upon request file duplicate copies of the Certificate of Insurance with the City. B. If, in the judgment of the City, prevailing conditions warrant the provision by Consultant of additional liability insurance coverage or coverage which is different in kind, the City reserves the right to require the provision by Consultant of an amount of coverage different from the amounts or kind previously required and shall afford written notice of such change in requirements thirty (30) days prior to the date on which the requirements shall take effect. Should the Consultant fail or refuse to satisfy the requirement of changed coverage within thirty (30) days following the City's written notice, this Agreement shall be considered terminated on the date that the required change in policy coverage would otherwise take effect. C. Consultant understands and agrees that all liabilities regarding the use of any of Consultant's employees or any of Consultant's subconsultants for Services related to this Agreement shall be borne solely by Consultant throughout the term of this Agreement and that this provision shall survive the termination of this Agreement. Consultant further understands and agrees that insurance for each employee of Consultant and each subconsultant providing Services related to this Agreement shall be maintained in good standing and approved by the City Risk Management Director throughout the duration of this Agreement. 12 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 89 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 D. Consultant shall be responsible for assuring that the insurance certificates required under this Agreement remain in full force and effect for the duration of this Agreement, including any extensions hereof. If insurance certificates are scheduled to expire during the term of this Agreement and any extension hereof, Consultant shall be responsible for submitting new or renewed insurance certificates to the City's Risk Management Administrator as soon as coverages are bound with the insurers. In the event that expired certificates are not replaced, with new or renewed certificates which cover the term of this Agreement and any extension thereof: (i) the City shall suspend this Agreement until the new or renewed certificate(s) are received in acceptable form by the City's Risk Management Administrator; or (ii) the City may, at its sole discretion, terminate the Agreement for cause and seek re -procurement damages from Consultant in conjunction with the violation of the terms and conditions of this Agreement. E. Compliance with the foregoing requirements shall not relieve Consultant of its liabilities and obligations under this Agreement. 15. NONDISCRIMINATION: Consultant represents to the City that Consultant does not and will not engage in discriminatory practices and that there shall be no discrimination in connection with Consultant's performance under this Agreement on account of race, color, sex, religion, age, handicap, marital status, or national origin. Consultant further covenants that no otherwise qualified individual shall, solely due to his/her race, color, sex, religion, age, handicap, marital status, or national origin, be excluded from participation in, be denied services, or be subject to discrimination under any provision of this Agreement. 13 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 90 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 16. ASSIGNMENT: The Consultant's services are considered specialized and unique. This Agreement shall not be assigned, sold, transferred, pledged, or otherwise conveyed by Consultant, in whole or in part, and Consultant shall not assign or otherwise subcontract any part of its operations performing these services under this Agreement, without the prior written consent of the City Manager, which may be withheld or conditioned, in the City Manager's sole discretion. 17. NOTICES: All notices or other communications required under this Agreement shall be in writing and shall be given by hand -delivery or by registered or certified U.S. Mail, return receipt requested, addressed to the other party at the address indicated herein or to such other address as a party may designate by notice given as herein provided. Notice shall be deemed given on the day on which personally delivered; or, if by mail, on the fifth day after being posted or the date of actual receipt, whichever is earlier. TO CONSULTANT: TO THE CITY OF MIAMI: 14 Arthur Noriega V City Manager 444 SW 2nd Avenue, 10th Floor Miami, FL 33130-1910 George K. Wysong, III City Attorney 444 SW 2nd Avenue, 9th Floor Miami, FL 33130-1910 Ann -Marie Sharpe Director, Department of Risk Management 444 SW 2nd Avenue, 9th Floor Miami, FL 33130-1910 Annie Perez, CPPO Procurement Director/Chief Procurement Officer 444 SW 2nd Avenue, 6th Floor Miami, FL 33130-1910 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 91 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 18. JVIISCELLANEOUS PROVISIONS: A. This Agreement shall be construed and enforced according to the laws of the State of Florida. Venue in any proceedings between the parties shall be in Miami -Dade County, Florida. Each party shall bear its own attorney's fees. Each party waives any defense, whether asserted by motion or pleading, that the aforementioned courts are an improper or inconvenient venue. Moreover, the parties consent to the personal jurisdiction of the aforementioned courts and irrevocably waive any objections to said jurisdiction. The parties irrevocably, knowingly and voluntarily waive any rights to a jury trial in any action or proceeding between them arising out of this Agreement. B. No waiver or breach of any provision of this Agreement shall constitute a waiver of any subsequent breach of the same or any other provision hereof, and no waiver shall be effective unless made in writing. C. Should any provision, paragraph, sentence, word or phrase contained in this Agreement be determined by a court of competent jurisdiction to be invalid, illegal or otherwise unenforceable under the laws of the State of Florida or the City of Miami, such provision, paragraph, sentence, word or phrase shall be deemed modified to the extent necessary in order to conform with such laws, or if not modifiable, then the same shall be deemed severable, and in either event, the remaining terms and provisions of this Agreement shall remain unmodified and in full force and effect or limitation of its use. D. Consultant shall comply with all applicable laws, rules, and regulations in the performance of this Agreement, including but not limited to licensure, and certifications required by law for professional service Consultants. E. No modification or amendment hereto shall be valid unless in writing and executed by properly authorized representatives of the parties hereto. Except as otherwise set forth in Section 2 above, the City Manager shall have the sole authority to extend, amend, or modify this Agreement on behalf of the City. 15 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 92 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 19. SUCCESSORS AND ASSIGNS: This Agreement shall be binding upon the parties hereto, their heirs, executors, legal representatives, successors, or assigns, if any. 20. JNDEPENDENT CONTRACTORS: Consultant has been procured and is being engaged to provide Services to the City as an independent contractor, and not as an agent or employee of the City. Accordingly, neither Consultant, nor its employees, nor any subconsultant hired by Consultant to provide any Services under this Agreement shall attain, nor be entitled to, any rights, emoluments, or benefits under the Civil Service or Pension Ordinances of the City, nor any rights afforded classified or unclassified employees of the City. Consultant further understands that Florida Workers' Compensation benefits available to employees of the City are not available to Consultant, its employees, or any subconsultant hired by Consultant to provide any Services hereunder, and Consultant agrees to provide or to require subconsultant(s) to provide, as applicable, workers' compensation insurance for any employee or agent of Consultant rendering Services to the City under this Agreement. Consultant further understands and agrees that Consultant's or subconsultants' use or entry upon City properties shall not in any way change its or their status as an independent contractor. 21. CONTINGENCY CLAUSE: Funding for this Agreement is contingent on the availability of funds and continued authorization for program activities and the Agreement is subject to amendment or termination due to lack of funds, reduction of funds, failure to allocate or appropriate funds, and/or change in program directions, applicable laws or regulations, upon thirty (30) days written notice. 16 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 93 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 22. FORCE MAJEURE: A "Force Majeure Event" shall mean an act of God, act of governmental body or military authority, fire, explosion, power failure, flood, storm, hurricane, sink hole, other natural disasters, epidemic, riot or civil disturbance, war or terrorism, sabotage, insurrection, blockade, or embargo not within the control of the Consultant. In the event that either party is delayed in the performance of any act or obligation pursuant to or required by the Agreement because of a Force Majeure Event as herein defined, the time for required completion of such act or obligation shall be extended by the number of days equal to the total number of days, if any, that such Force Majeure Event actually delay such party. The party seeking delay in performance shall give notice to the other party in writing, within two (2) days of the Force Majeure Event, specifying the anticipated duration of the delay, and if such delay shall extend beyond the duration specified in such notice, additional notice shall be repeated no less than monthly so long as such delay due to a Force Majeure Event continues. Any party seeking delay in performance due to a Force Majeure Event shall use its best efforts to rectify any condition causing such delay and shall cooperate with the other party to overcome any delay that has resulted. 23. CITY NOT LIABLE FOR DELAYS: Consultant hereby understands and agrees that in no event shall the City be liable for, or responsible to Consultant or any subconsultant, or to any other person, firm, or entity for or on account of, any stoppages or delay(s) in work herein provided for, or any damages whatsoever related thereto, because of any injunction or other legal or equitable proceedings or on account of any delay(s) for any cause over which the City has no control. The sole remedy which may be granted to the Consultant, in the reasonable discretion of the City Manager, following a prompt and detailed request to be officially transmitted by the Consultant is an extension of time. No other recourse or remedy will be available to the Consultant against the 17 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 94 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 City. 24. USE OF NAME: Consultant understands and agrees that the City is not engaged in research for advertising, sales promotion, or other publicity purposes. Consultant is allowed, within the limited scope of normal and customary marketing and promotion of its work, to use the general results of this project and the name of the City. The Consultant agrees to protect any confidential information provided by the City and will not release information of a specific nature without prior written consent of the City Manager or the City Commission. 25. NO CONFLICT OF INTEREST: Pursuant to City of Miami Code Section 2-611, as amended ("City Code"), regarding conflicts of interest, Consultant hereby certifies to the City that no individual member of Consultant, no employee, and no subconsultant under this Agreement nor any immediate family member of any of the same is also a member of any board, commission, or agency of the City. Consultant hereby represents and warrants to the City that throughout the term of this Agreement, Consultant, its employees, and its subconsultants will abide by this prohibition of the City Code. 26. NO THIRD -PARTY BENEFICIARY: No persons other than the Consultant and the City (and their successors and assigns) shall have any rights as an express or implied third -party beneficiary whatsoever under this Agreement. 27. SURVIVAL: All obligations (including but not limited to indemnity and obligations to defend, save and hold harmless) and rights of any party arising during or attributable to the period prior to expiration 18 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 95 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 or earlier termination of this Agreement shall survive such expiration or earlier termination. 28. TRUTH -IN -NEGOTIATION CERTIFICATION. REPRESENTATION AND WARRANTY: Consultant hereby certifies, represents and warrants to the City that on the date of Consultant's execution of this Agreement, and so long as this Agreement shall remain in full force and effect, the wage rates and other factual unit costs supporting the compensation to Consultant under this Agreement are and will continue to be accurate, complete, and current. Consultant understands, agrees, and acknowledges that the City shall adjust the amount of the compensation and any additions thereto to exclude any significant sums by which the City determines the contract price of compensation hereunder was increased due to inaccurate, incomplete, or non- current wage rates and other factual unit costs. All such contract adjustments shall be made within one (1) year of the end of this Agreement, whether naturally expiring or earlier terminated pursuant to the provisions hereof. 29. COUNTERPARTS/ELECTRONIC SIGNATURES: This Agreement and any amendments hereto may be executed in counterparts and all such counterparts taken together shall be deemed to constitute one and the same instrument, each of which shall be an original as against either party whose signature appears thereon, but all of which taken together shall constitute but one and the same instrument. An executed facsimile or electronic scanned copy of this Agreement shall have the same force and effect as an original. The parties shall be entitled to sign and transmit an electronic signature on this Agreement (whether by facsimile, PDF or other email transmission), which signature shall be binding on the party whose name is contained therein. Any party providing an electronic signature agrees to promptly execute and deliver to the other parties an original signed Agreement upon request. 30. ENTIRE AGREEMENT: This instrument and its attachments constitute the sole and final agreement of the parties 19 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 96 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 relating to the subject matter hereof and correctly set forth the rights, duties, and obligations of each to the other as of its date. Any prior agreements, promises, negotiations, or representations not expressly set forth in this Agreement are of no force or effect. 31. ANITRUST VIOLATOR VENDORS: A person or an affiliate who has been placed on the Antitrust Violator Vendors List following a conviction or being held civilly liable for an antitrust violation may not submit a bid, proposal, or reply on any agreement to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on any agreement with a public entity for the construction or repair of a public building or public work; may not submit a bid, proposal, or reply on leases of real property to a public entity; may not be awarded or perform work as a grantee, supplier, subcontractor, or consultant under an agreement with a public entity; and may not transact new business with a public entity. 32. ANTI -HUMAN TRAFFICKING: Consultant confirms and certifies that it is not in violation of Section 787.06, Florida Statutes, and that it does not and shall not use "coercion" for labor or services as defined in Section 787.06, Florida Statutes. The Advisor shall execute and submit to the City an Affidavit, of even date herewith, in compliance with Section 787.06(13), Florida Statutes, attached an incorporated herein as Exhibit "F." If the Advisor fails to comply with the terms of this Section, the City may suspend or terminate this Agreement immediately, without prior notice, and in no event shall the City be liable to Advisor for any additional compensation or for any consequential or incidental damages. 20 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 97 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 IN WITNESS WHEREOF, the Parties have executed this Agreement, or have caused the same to be executed, as of the date and year first above written. "Consultant" a Florida profit corporation ATTEST: By: By: Print Name: Name: Title: Title: ATTEST: "CITY" CITY OF MIAMI, a Florida municipal corporation By: By: Todd B. Hannon Arthur Noriega V City Clerk City Manager APPROVED AS TO LEGAL FORM AND APPROVED AS TO INSURANCE CORRECTNESS: REQUIREMENTS: By: By: Geroge K. Wysong, III Anne Marie Sharpe, Director City Attorney Risk Management 21 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 98 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 CORPORATE RESOLUTION (This Resolution must authorize the signatory to sign) WHEREAS, ., a corporation, desires to enter into an agreement with the City of Miami for the purpose of performing the work described in the contract to which this resolution is attached; and WHEREAS, the Board of Directors at a duly held corporate meeting has considered the matter in accordance with the bylaws of the corporation; NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF DIRECTORS that this corporation is authorized to enter into the Agreement with the City, and the President and the Secretary are hereby authorized and directed to execute the Agreement in the name of this Corporation and to execute any other document and perform any acts in connection therewith as may be required to accomplish its purpose. IN WITNESS WHEREOF, this day of , 202_ ("Consultant") A (State) Corporation By: (sign) Print Name: TITLE: (sign) Print Name: 22 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 99 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 EXHIBIT A RFP No. 1896386 23 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 100 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 EXHIBIT B SCOPE OF WORK Provide employee benefit consulting services per specifications 24 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 101 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 EXHIBIT C CONSULTANT'S RESPONSE AND PRICE PROPOSAL 25 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 102 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 EXHIBIT D INSURANCE REQUIREMENTS EMPLOYEE BENEFIT CONSULTING SERVICES Commercial General Liability A. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence General Aggregate Limit Personal and Adv. Injury Products/Completed Operations B. Endorsements Required City of Miami listed as an additional insured Contingent and Contractual Liability Premises and Operations Liability Primary Insurance Clause Endorsement II. Business Automobile Liability $1,000,000 $2,000,000 $1,000,000 $1,000,000 A. Limits of Liability Bodily Injury and Property Damage Liability Combined Single Limit Any Auto Including Hired, Borrowed or Non -Owned Autos Any One Accident B. Endorsements Required City of Miami listed as an additional insured III. Worker's Compensation Limits of Liability Statutory -State of Florida Waiver of Subrogation Employer' s Liability $ 1,000,000 A. Limits of Liability $100,000 for bodily injury caused by an accident, each accident $100,000 for bodily injury caused by disease, each employee $100,000 for bodily injury caused by disease, policy limit 26 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 103 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 IV. Professional Liability/Errors and Omissions Coverage Combined Single Limit Each Claim $5,000,000 General Aggregate Limit $5,000,000 Retro Date Included V. Umbrella Liability A. Each Claim $2,000,000 Policy Aggregate $2,000,000 B. Endorsements Required City of Miami listed as additional insured Coverage is excess follow form over all applicable liability policies contained herein Successful Proposer agrees to maintain professional liability / Errors & Omissions coverage, for a minimum of two (2) years after termination of the contract period subject to continued availability of commercially reasonable terms and conditions of such coverage. BINDERS ARE UNACCEPTABLE. The insurance coverage required shall include those classifications, as listed in standard liability insurance manuals, which most nearly reflect the operations of the bidder. All insurance policies required above shall be issued by companies authorized to do business under the laws of the State of Florida, with the following qualifications: The Company must be rated no less than "A-" as to management, and no less than "Class V" as to financial strength, by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent. All policies and/or certificates of insurance are subject to review and verification by Risk Management prior to insurance approval. Certificates will indicate no modification or change in insurance shall be made without thirty (30) days written advance notice to the certificate holder. NOTE: CITY RFP NUMBER AND/OR TITLE OF RFP MUST APPEAR ON EACH CERTIFICATE. Compliance with the foregoing requirements shall not relieve the bidder of his liability and obligation under this section or under any other section of this Agreement. - -If insurance certificates are scheduled to expire during the contractual period, the Successful Proposer shall be responsible for submitting new or renewed insurance certificates to the City at a minimum of ten (10) calendar days in advance of such expiration. - -In the event that expired certificates are not replaced with new or renewed certificates which 27 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 104 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 cover the contractual period, the City shall: (1) Suspend the contract until such time as the new or renewed certificates are received by the City in the manner prescribed in the Request for Proposal. (2) The City may, at its sole discretion, terminate this contract for cause and seek re -procurement damages from the Successful Proposer in conjunction with the General and Special Terms and Conditions of the Request for Proposal. The Successful Proposer shall be responsible for assuring that the insurance certificates required in conjunction with this Section remain in force for the duration of the contractual period; including any and all option terms that may be granted to the Successful Proposer. The above policies shall provide the City of Miami with written notice of cancellation or material change from the insurer in accordance to policy provisions. 28 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 105 City of Miami Solicitation RFP 1896386 City of Miami, Florida RFP 1896386 EXHIBIT E CORPORATE RESOLUTIONS AND EVIDENCE OF QUALIFICATION TO DO BUSINESS IN FLORIDA (To be provided upon document execution) 29 Employee Benefit Consulting Services 8/20/2024 9:24 AM p. 106 EXHIBIT F ANTI -HUMAN TRAFFICKING AFFIDAVIT 1. The undersigned affirms, certifies, attests, and stipulates as follows: Solicitation RFP 1896386 a. The entity is a non -governmental entity authorized to transact business in the State of Florida and in good standing with the Florida Department of State, Division of Corporations. b. The nongovernmental entity is either executing, renewing, or extending a contract (including, but not limited to, any amendments, as applicable) with the City of Miami ("City") or one of its agencies, authorities, boards, trusts, or other City entity which constitutes a governmental entity as defined in Section 287.138(1), Florida Statutes (2024). c. The nongovernmental entity is not in violation of Section 787.06, Florida Statutes (2024), titled "Human Trafficking " d. The nongovernmental entity does not use "coercion" for labor or services as defined in Section 787.06, Florida Statutes (2024), attached and incorporated herein as Exhibit Affidavit-1. 2. Under penalties of perjury, I declare the following: a. I have read and understand the foregoing Anti -Human Trafficking Affidavit and that the facts, statements and representations provided in Section 1 are true and correct. b. I am an officer or a representative of the nongovernmental entity authorized to execute this Anti - Human Trafficking Affidavit. Nongovernmental Entity: Name: Signature of Officer: Office Address: Email Address: Officer Title: FEIN No. / - / / / / / / STATE OF FLORIDA COUNTY OF MIAMI-DADE Main Phone Number: The foregoing instrument was swom to and subscribed before me by means of O physical presence or O online notarization, this day of by , as the authorized officer or representative for the nongovernmental entity.. He/she is personally known to me or has produced as identification. (NOTARY PUBLIC SEAL) My Commission Expires: Signature of Person Taking Oath (Printed, Typed, or Stamped Name of Notary Public) 8/20/2024 9:24 AM p. 107 City of Miami Solicitation RFP 1896386 EXHIBIT AFFIDAVIT-1 SECTION 787.06, FLORIDA STATUTES (2024) 8/20/2024 9:24 AM p. 108 City of Miami Solicitation RFP 1896386 Select Year: 2024 v The 2024 Florida Statutes Go Title Chapter 787 View Entire XLVI KIDNAPPING; CUSTODY OFFENSES; HUMAN TRAFFICKING; AND RELATED Chapter CRIMES OFFENSES 787.06 Human trafficking.— (1)(a) The Legislature finds that human trafficking is a form of modern-day slavery. Victims of human trafficking are young children, teenagers, and adults. Thousands of victims are trafficked annually across international borders worldwide. Many of these victims are trafficked into this state. Victims of human trafficking also include citizens of the United States and those persons trafficked domestically within the borders of the United States. The Legislature finds that victims of human trafficking are subjected to force, fraud, or coercion for the purpose of sexual exploitation or forced labor. (b) The Legislature finds that while many victims of human trafficking are forced to work in prostitution or the sexual entertainment industry, trafficking also occurs in forms of labor exploitation, such as domestic servitude, restaurant work, janitorial work, sweatshop factory work, and migrant agricultural work. (c) The Legislature finds that traffickers use various techniques to instill fear in victims and to keep them enslaved. Some traffickers keep their victims under lock and key. However, the most frequently used practices are less obvious techniques that include isolating victims from the public and family members; confiscating passports, visas, or other identification documents; using or threatening to use violence toward victims or their families; telling victims that they will be imprisoned or deported for immigration violations if they contact authorities; and controlling the victims' funds by holding the money ostensibly for safekeeping. (d) It is the intent of the Legislature that the perpetrators of human trafficking be penalized for their illegal conduct and that the victims of trafficking be protected and assisted by this state and its agencies. In furtherance of this policy, it is the intent of the Legislature that the state Supreme Court, The Florida Bar, and relevant state agencies prepare and implement training programs in order that judges, attorneys, law enforcement personnel, investigators, and others are able to identify traffickers and victims of human trafficking and direct victims to appropriate agencies for assistance. It is the intent of the Legislature that the Department of Children and Families and other state agencies cooperate with other state and federal agencies to ensure that victims of human trafficking can access social services and benefits to alleviate their plight. (2) As used in this section, the term: (a) "Coercion" means: 1. Using or threatening to use physical force against any person; 2. Restraining, isolating, or confining or threatening to restrain, isolate, or confine any person without lawful authority and against her or his will; 3. Using lending or other credit methods to establish a debt by any person when labor or services are pledged as a security for the debt, if the value of the labor or services as reasonably assessed is not applied toward the liquidation of the debt, the length and nature of the labor or services are not respectively limited and defined; 4. Destroying, concealing, removing, confiscating, withholding, or possessing any actual or purported passport, visa, or other immigration document, or any other actual or purported government identification document, of any person; 5. Causing or threatening to cause financial harm to any person; 6. Enticing or luring any person by fraud or deceit; or 8/20/2024 9:24 AM p. 109 City of Miami Solicitation RFP 1896386 7. Providing a controlled substance as outlined in Schedule I or Schedule II of s. 893.03 to any person for the purpose of exploitation of that person. (b) "Commercial sexual activity" means any violation of chapter 796 or an attempt to commit any such offense, and includes sexually explicit performances and the production of pornography. (c) "Financial harm" includes extortionate extension of credit, loan sharking as defined in s. 687.071, or employment contracts that violate the statute of frauds as provided in s. 725.01. (d) "Human trafficking" means transporting, soliciting, recruiting, harboring, providing, enticing, maintaining, purchasing, patronizing, procuring, or obtaining another person for the purpose of exploitation of that person. (e) "Labor" means work of economic or financial value. (f) "Maintain" means, in relation to labor or services, to secure or make possible continued performance thereof, regardless of any initial agreement on the part of the victim to perform such type service. (g) "Obtain" means, in relation to labor, commercial sexual activity, or services, to receive, take possession of, or take custody of another person or secure performance thereof. (h) "Services" means any act committed at the behest of, under the supervision of, or for the benefit of another. The term includes, but is not limited to, forced marriage, servitude, or the removal of organs. (i) "Sexually explicit performance" means an act or show, whether public or private, that is live, photographed, recorded, or videotaped and intended to arouse or satisfy the sexual desires or appeal to the prurient interest. (j) "Unauthorized alien" means an alien who is not authorized under federal law to be employed in the United States, as provided in 8 U.S.C. s. 1324a(h)(3). The term shall be interpreted consistently with that section and any applicable federal rules or regulations. (k) "Venture" means any group of two or more individuals associated in fact, whether or not a legal entity. (3) Any person who knowingly, or in reckless disregard of the facts, engages in human trafficking, or attempts to engage in human trafficking, or benefits financially by receiving anything of value from participation in a venture that has subjected a person to human trafficking: (a)1. For labor or services of any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. 2. Using coercion for labor or services of an adult commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (b) Using coercion for commercial sexual activity of an adult commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (c)1. For labor or services of any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age who is an unauthorized alien commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. 2. Using coercion for labor or services of an adult who is an unauthorized alien commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (d) Using coercion for commercial sexual activity of an adult who is an unauthorized alien commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (e)1. For labor or services who does so by the transfer or transport of any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age from outside this state to within this state commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. 2. Using coercion for labor or services who does so by the transfer or transport of an adult from outside this state to within this state commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (f)1. For commercial sexual activity who does so by the transfer or transport of any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age from outside this state to within this state commits a felony of the first degree, punishable by imprisonment for a term of years not exceeding life, or as provided in s. 775.082, s. 775.083, or s. 775.084. 8/20/2024 9:24 AM p. 110 City of Miami Solicitation RFP 1896386 2. Using coercion for commercial sexual activity who does so by the transfer or transport of an adult from outside this state to within this state commits a felony of the first degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (g) For commercial sexual activity in which any child younger than 18 years of age or an adult believed by the person to be a child younger than 18 years of age, or in which any person who is mentally defective or mentally incapacitated as those terms are defined in s. 794.011(1), is involved commits a life felony, punishable as provided in s. 775.082(3)(a)6., s. 775.083, or s. 775.084. For each instance of human trafficking of any individual under this subsection, a separate crime is committed and a separate punishment is authorized. (4)(a) Any parent, legal guardian, or other person having custody or control of a minor who sells or otherwise transfers custody or control of such minor, or offers to sell or otherwise transfer custody of such minor, with knowledge or in reckless disregard of the fact that, as a consequence of the sale or transfer, the minor will be subject to human trafficking commits a life felony, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. (b) Any person who, for the purpose of committing or facilitating an offense under this section, permanently brands, or directs to be branded, a victim of an offense under this section commits a second degree felony, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. For purposes of this subsection, the term "permanently branded" means a mark on the individual's body that, if it can be removed or repaired at all, can only be removed or repaired by surgical means, laser treatment, or other medical procedure. (5) The Criminal Justice Standards and Training Commission shall establish standards for basic and advanced training programs for law enforcement officers in the subjects of investigating and preventing human trafficking crimes. Every basic skills course required for law enforcement officers to obtain initial certification must include training on human trafficking crime prevention and investigation. (6) Each state attorney shall develop standards of instruction for prosecutors to receive training on the investigation and prosecution of human trafficking crimes and shall provide for periodic and timely instruction. (7) Any real property or personal property that was used, attempted to be used, or intended to be used in violation of this section may be seized and shall be forfeited as provided by the Florida Contraband Forfeiture Act. After satisfying any liens on the property, the remaining proceeds from the sale of any property seized under this section and owned by a defendant convicted of a violation of this section must first be allocated to pay any order of restitution of a human trafficking victim in the criminal case for which the owner was convicted. If there are multiple human trafficking victims in the criminal case, the remaining proceeds must be allocated equally among the victims to pay restitution. If the proceeds are sufficient to pay any such order of restitution, any remaining proceeds must be disbursed as required by s. 932.7055(5)-(9). (8) The degree of an offense shall be reclassified as follows if a person causes great bodily harm, permanent disability, or permanent disfigurement to another person during the commission of an offense under this section: (a) A felony of the second degree shall be reclassified as a felony of the first degree. (b) A felony of the first degree shall be reclassified as a life felony. (9) In a prosecution under this section, the defendant's ignorance of the victim's age, the victim's misrepresentation of his or her age, or the defendant's bona fide belief of the victim's age cannot be raised as a defense. (10)(a) Information about the location of a residential facility offering services for adult victims of human trafficking involving commercial sexual activity, which is held by an agency, as defined in s. 119.011, is confidential and exempt from s. 119.07(1) and s. 24(a), Art. I of the State Constitution. This exemption applies to such confidential and exempt information held by an agency before, on, or after the effective date of the exemption. (b) Information about the location of a residential facility offering services for adult victims of human trafficking involving commercial sexual activity may be provided to an agency, as defined in s. 119.011, as necessary to maintain health and safety standards and to address emergency situations in the residential facility. (c) The exemptions from s. 119.07(1) and s. 24(a), Art. I of the State Constitution provided in this subsection do not apply to facilities licensed by the Agency for Health Care Administration. 8/20/2024 9:24 AM p. 111 City of Miami Solicitation RFP 1896386 (11) A victim's lack of chastity or the willingness or consent of a victim is not a defense to prosecution under this section if the victim was under 18 years of age at the time of the offense. (12) The Legislature encourages each state attorney to adopt a pro -prosecution policy for human trafficking offenses, as provided in this section. After consulting the victim, or making a good faith attempt to consult the victim, the state attorney shall determine the filing, nonfiling, or diversion of criminal charges even in circumstances when there is no cooperation from a victim or over the objection of the victim, if necessary. (13) When a contract is executed, renewed, or extended between a nongovernmental entity and a governmental entity, the nongovernmental entity must provide the governmental entity with an affidavit signed by an officer or a representative of the nongovernmental entity under penalty of perjury attesting that the nongovernmental entity does not use coercion for labor or services as defined in this section. For purposes of this subsection, the term "governmental entity" has the same meaning as in s. 287.138(1). History.—s. 2, ch. 2004-391; s. 1, ch. 2006-168; s. 5, ch. 2012-97; s. 300, ch. 2014-19; s. 7, ch. 2014-160; s. 96, ch. 2015-2; s. 2, ch. 2015-147; s. 3, ch. 2016-24; s. 25, ch. 2016-105; s. 4, ch. 2016-199; s. 2, ch. 2020-49; s. 2, ch. 2021-189; s. 3, ch. 2023-86; s. 7, ch. 2024- 184. Copyright © 1995-2024 The Florida Legislature • Privacy Statement • Contact Us 8/20/2024 9:24 AM p. 112 City of Miami, Florida EXHIBIT A City of Miami Contract No. RFP678384 Solicitation RFP 1896386 PROFESSIONAL SERVICES AGREEMENT By and Between The City of Miami. Florida And CONSULTANT This Professional Services Agreement ("Agreement") is entered into this 15* lay of N, cv.e_ 'l bex- , 2017 by and between the City of Miami, a municipal corporation of the State of Florida, whose address is 444 S.W. 2nd Avenue, 10t'' Floor, Miami, Florida 33130 ("City"), and, USI Insurance Services, LLC a foreign limited liability company, qualified to do business in the State of Florida whose principal address is 200 Summit Lake Drive, Suite 350, Valhalla, NY 10595, hereinafter referred to as the ("Consultant"). RECITALS: WHEREAS, the City of Miami issued Request for Proposal No. 678384, on February 8, 2017 (the "RFP" attached hereto, incorporated hereby, and made a part of as Exhibit A) for the provision of Employee Benefit Consulting Services, ("Services" as more fully set forth in the scope of work "Scope" attached hereto as Exhibit B) for the City of Miami's Risk Management Department, and Consultant's proposal ("Proposal", attached hereto, incorporated hereby, and made part of hereof as Exhibit C), in response thereto, has been selected as the most qualified proposal for the provision of the Services. WHEREAS, the Evaluation/Selection Committee appointed by the City Manager determined that the Proposal submitted by the Consultant was responsive to the RFP requirements, and recommended that the City Manager negotiate with the Consultant; and WHEREAS, the City wishes to engage the Services of Consultant, and Consultant wishes to perform the Services for the City; and 1 Employee Benefit Consulting Services Revised 6. 15 2017 8/20/2024 9:24 AM p. 113 City of Miami, Florida City of Miami Contract No. RFP678384 °citation RFP 1896386 WHEREAS, the City and the Consultant desire to enter into this Agreement under the terms and conditions set forth herein. NOW, THEREFORE, in consideration of the mutual covenants and promises herein contained, Consultant and the City agree as follows: TERMS: 1. RECITALS AND INCORPORATIONS: DEFINITIONS: The recitals are true and correct and are hereby incorporated into and made a part of this Agreement. The City's RFP is hereby incorporated into and made a pad of this Agreement and attached hereto as Exhibit "A". The Services and Scope of Work are hereby incorporated into and made a part of this Agreement and attached as Exhibit "B". The Consultant's Response and Price Schedule, dated March 7, 2017, in response to RFP 678384, is hereby incorporated into and made a part of this Agreement as attached Exhibit "C". The Consultant's Insurance Certificate is hereby incorporated into and made a part of this Agreement as attached Exhibit "D". The order of precedence whenever there is conflicting or inconsistent language between documents is as follows in descending order of priority: (1) Professional Services Agreement ("PSA") (2) Addenda/Addendum to the RFP, if any; (3) RFP; and (4) Consultant's response and Price Schedule, dated March 7, 2017, acknowledging scope of services and pricing component of services and, response to the Request for Proposals. 2. TERM: The Agreement shall become effective on the date on the first page, and shall be for the duration of five (5) years: Initial term of three (3) years with an option to renew for two (2) additional one (1) year periods. The City, acting by and through its City Manager, shall have the option to extend or terminate the Agreement for convenience, that is, for any or no cause. Employee Benefit Con,ulting Services Revised 6 15 2017 8/20/2024 9:24 AM p. 114 City of Miami, Florida City of Miami Contract No. RFP67838sif Iicitation RFP 1896386 3. SCOPE OF SERVICES: A. Consultant agrees to provide the Services as specifically described, and under the special terms and conditions set forth in Exhibits "A" and ."B" hereto, which by this reference is incorporated into and made a part of this Agreement. B. Consultant represents to the City that: (i) it possesses all qualifications, licenses, certificates, authorizations, and expertise required for the performance of the Services, including but not limited to full qualification to do business in Florida; (ii) it is not delinquent in the payment of any sums due the City, including payment of permits, fees, occupational licenses, etc., nor in the performance of any obligations or payment of any monies to the City; (iii) all personnel assigned to perform the Services are and shall be, at all times during the term hereof, fully qualified and trained to perform the tasks assigned to each and possess the licenses , registrations, and certifications required by law to perform such tasks ; (iv) the Services will be performed in the manner described in Exhibit "A"; and (v) each person executing this Agreement on behalf of Consultant has been duly authorized to so execute the same and fully bind Consultant as a party to this Agreement. C. Consultant shall always provide fully qualified, competent, and physically capable employees to perform the Services under this Agreement. Consultant shall possess and maintain any required licenses, permits and certifications to perform the Services under this Agreement. City may require Consultant to remove any employee the City deems careless, incompetent, insubordinate, intoxicated on the job, or otherwise objectionable and whose continued services under this Agreement is not in the best interest of the City. 4. COMPENSATION: A. The amount of compensation payable by the City to the Consultant will be based upon the rates quoted in Exhibit °C" hereto, which by this reference is incorporated into and made a part of this Agreement. Employee Benefit Consulting Services 3 Revised 6 i5 2I 17 8/20/2024 9:24 AM p. 115 City of Miami, Florida City of Miami Contract No. RFP67838--Poiioitation RFP 1896386 B. Payment shall be made in arrears based upon work performed to the satisfaction of the City within thirty (30) days after receipt of Consultant's invoice for Services performed, which shall be accompanied by sufficient supporting documentation and contain sufficient detail, to allow a proper audit of expenditures, should the City require one to be performed. Invoices shall be sufficiently detailed so as to comply with the "Florida Prompt Payment Act'', §218.70. - 218.79, Florida Statutes, and other applicable laws. No advance or future payments shall be made at any time. C. Consultant agrees and understands that (i) any and all subcontractors providing Services related to this Agreement shall be paid through Consultant and not paid directly by the City, as the City is solely contracting with the Consultant, and (ii) any and all liabilities or debts regarding payment to or use of subcontractors for any of the Services related to this Agreement shall be borne solely by Consultant. D. Prices shall remain firm and fixed for the term of the Contract, including any renewal or extension periods 5. OWNERSHIP OF DOCUMENTS: Consultant understands and agrees that any information, document, report, data or other digital record, or any other material whatsoever which is given by the City to Consultant, its employees, or any subcontractor, or which is otherwise obtained or prepared by Consultant solely and exclusively for the City pursuant to or under the terms of this Agreement, is and shall always remain the property of the City. Consultant agrees not to use any such information, document, report, data, or material for any other purpose whatsoever without the written consent of the City Manager, which may be withheld or conditioned by the City Manager in his/her sole discretion. Consultant is permitted to make and to maintain duplicate copies of the files, records, documents, etc. if Consultant determines copies of such records are necessary after the termination of this Agreement; however, in no way shall the confidentiality as permitted by applicable laws be 4 Employee Benefit Consulting Sery ices Revis, d 6 15 2017 8/20/2024 9:24 AM p. 116 City of Miami, Florida City of Miami Contract No. RFP678388Policitation RFP 1896386 breached. The City shall maintain and retain ownership of any and all documents which result upon the completion of the work and Services under this Agreement as per the terms of this Section 5. 6. AUDIT AND INSPECTION RIGHTS AND RECORDS RETENTION: A. Consultant agrees to provide access to the City or to any of its duly authorized representatives, to any books, documents, papers, and records of Consultant which are directly pertinent to this Agreement, for the purpose of audit, examination, excerpts, and transcripts. The City may, at reasonable times, and for a period of up to three (3) years following the date of final payment by the City to Consultant under this Agreement, audit and inspect, or cause to be audited and inspected, those books, documents, papers, and records of Consultant which are related to Consultant's performance under this Agreement. Consultant agrees to maintain all such books, documents, papers, and records at its principal place of business in Miami -Dade County, or its local office in Miami -Dade County or to otherwise make them available in Miami -Dade County for a period of three (3) years after final payment is made under this Agreement and all other pending matters are closed, Consultant's failure to adhere to, or refusal to comply with, this condition shall result in the immediate cancellation of this Agreement by the City. B. The City may, at reasonable times during the term hereof, inspect the Consultant's facilities and perform such tests, as the City deems reasonably necessary, to determine whether the goods or services required to be provided by Consultant under this Agreement conform to the terms hereof. Consultant shall make available to the City ail reasonable facilities and assistance to facilitate the performance of tests or inspections by City representatives. All audits, tests and inspections shall be subject to, and made in accordance with, the provisions of Sections 18-100, 18-101, and 18-102 of the Code of the City of Miami, Florida, which Sections apply to this Agreement, as same may be amended or supplemented, from time to time. 5 Employee Benefit Consulting Services Revised 6 15 2017 8/20/2024 9:24 AM p. 117 City of Miami, Florida City of Miami Contract No. RFP678381soiicitation RFP 1896386 7. AWARD OF AGREEMENT: Consultant represents and warrants to the City that it has not employed or retained any person or company employed by the City to solicit or secure this Agreement and that it has not offered to pay, paid, or agreed to pay any person any fee, commission, percentage, brokerage fee, or gift of any kind contingent upon or in connection with, the award of this Agreement. 8. PUBLIC RECORDS: A. Consultant understands that the public shall have access, at all reasonable times, to all documents and information pertaining to City Agreements, subject to the provisions of Chapter 119, Florida Statutes, and agrees to allow access by the City and the public to all documents subject to disclosure under applicable laws. Consultant's failure or refusal to comply with the provisions of this section shall result in the immediate cancellation of this Agreement by the City. B. Consultant shall additionally comply with Section 119.0701, Florida Statutes, including without limitation: (1) keep and maintain public records that ordinarily and necessarily would be required by the City to perform this service; (2) provide the public with access to public records on the same terms and conditions as the City would at the cost provided by Chapter 119, Florida Statutes, or as otherwise provided by law; (3) ensure that public records that are exempt or confidential and exempt from disclosure are not disclosed except as authorized by law; (4) meet all requirements for retaining public records and transfer, at no cost, to the City all public records in its possession upon termination of this Agreement and destroy any duplicate public records that are exempt or confidential and exempt from disclosure requirements; and, (5) provide all electronically stored public records that must be provided to the City in a format compatible with the City's information technology systems. Notwithstanding the foregoing, Consultant shall be permitted to retain any public records that make up part of its work product solely as required 6 Employee Benefit Consulting. yen ices Revised 6 15 2017 8/20/2024 9:24 AM p. 118 City of Miami, Florida City of Miami Contract No. RFP678384Soiicitation RFP 1896386 for archival purposes, as required by law, or to evidence compliance with the terms of the Agreement. C. Should Consultant determine to dispute any public access provision required by Florida Statutes, then Consultant shall do so at its own expense and at no cost to the City. If the Consultant has questions regarding the application of Chapter 119, Florida Statutes, to the Consultant's duty to provide public records relating to the contract, contact the Custodian of Public Records at PublicRecordsmiamigov.com, or regular mail at City of Miami Office of the City Attorney, 444 SW 2nd Avenue, 9th Floor, Miami, FL 33130. 9. COMPLIANCE WITH FEDERAL, STATE AND LOCAL LAWS: Consultant understands that agreements with docal governments are subject to certain laws and regulations, including laws pertaining to public records, conflict of interest, record keeping, etc. City and Consultant agree to comply with and observe all such applicable federal, state and local laws, rules, regulations, codes, and ordinances, as they may be amended from time to time. Consultant further agrees to include in all of Consultant's agreements with subcontractors for any Services related to this Agreement this provision requiring subcontractors to comply with and observe ail applicable federal, state, and local laws rules, regulations, codes, and ordinances, as they may be amended from time to time. Local laws in accordance with this Section shall mean the applicable laws of the City of Miami, and Miami -Dade County. 10. INDEMNIFICATION: Consultant shall indemnify, hold/ save harmless, and defend at its own costs and expense, the City, City agencies and instrumentalities, their officials and employees from claims (collectively referred to as "Indemnitees") and each of them from and against all loss, costs, penalties, fines, damages, claims, expenses (including attorney's fees) or liabilities (collectively 7 Employee Benefit Consulting yen, ices R,nised 6 15 2017 8/20/2024 9:24 AM p. 119 City of Miami, Florida City of Miami Contract No. RFP67838 solicitation RFP 1896386 referred to as "Liabilities') by reason of any injury to or death of any person or damage to or destruction or loss of any property arising out of, resulting from, or in connection with (i) the negligent performance or non-performance of the Services contemplated by this Agreement (whether active or passive) of Consultant or its employees or subcontractors (collectively referred to as "Consultant') which is directly caused, in whole or in part, by any act, omission, default or negligence (whether active or passive or in strict liability) of the Indemnitees, or any of them, or (ii) the failure of the Consultant to comply materially with any of the requirements herein, or the failure of the Consultant to conform to statutes, ordinances, codes, rules, or other regulations or requirements of any governmental authority, local, federal or state, in connection with the performance of this Agreement including, without limitation, its subject matter , or failure of the Consultant to comply with a known standard of care in the rendition of its services , even if it is alleged that the City, its officials and/or employees were negligent. Consultant expressly agrees to indemnify, hold/ save harmless, and defend at its own costs and expense, the Indemnitees, or any of them, from and against all liabilities which may be asserted by an employee or former employee of Consultant, or any of its subcontractors, as provided above, for which the Consultant's liability to such employee or former employee would otherwise be limited to payments under state Workers' Compensation, Unemployment Benefits, or similar laws. Consultant further agrees indemnify, hold/ save harmless, and defend at its own costs and expense, the Indemnitees from and against (i) any and all Liabilities imposed on account of the violation of any law, ordinance, order, rule, regulation, condition, or requirement, related directly to Consultant's negligent performance under this Agreement, compliance with which is left by this Agreement to Consultant, and (ii) any and all claims, and/or suits for labor, materials, equipment, furnishings, and materials furnished by Consultant or utilized in the performance of this Agreement or otherwise. 8 Employee Benoit Consulting Servvit:es R.n iced b 15 2017 8/20/2024 9:24 AM p. 120 City of Miami, Florida City of Miami Contract No. RFP678384olicitation RFP 1896386 Consultant's obligations to indemnify, indemnify, hold/ save harmless, and defend at its own costs and expense, the Indemnitees shall survive the termination/expiration of this Agreement. Consultant understands and agrees that any and all liabilities regarding the use of any subcontractor for Services related to this Agreement shall be borne solely by Consultant throughout the duration of this Agreement and that this provision shall survive the termination or expiration of this Agreement, as applicable. 11, DEFAULT: If Consultant fails to comply with any term or condition of this Agreement, or fails to perform in any material way any of its obligations hereunder, and fails to cure such failure after reasonable notice from the City, then Consultant shall be in default. Consultant understands and agrees that termination of this Agreement under this section shall not release Consultant from any obiigation(s) accruing prior to the effective date of termination. Should Consultant be unable or unwilling to commence to perform the Services within the time provided or contemplated herein, then, in addition to the foregoing, Consultant shall be liable to the City for all expenses incurred by the City in preparation and negotiation of this Agreement, as well as all costs and expenses incurred by the City in the re -procurement of the Services, including consequential and incidental damages. 12. RESOLUTION OF AGREEMENT DISPUTES: Consultant understands and agrees that all disputes between Consultant and the City based upon an alleged violation of the terms of this Agreement by the City shall be submitted to the City Manager for his/her resolution, prior to Consultant being entitled to seek judicial relief in connection therewith. In the event that the amount of compensation hereunder exceeds Twenty - Five Thousand Dollars and No/Cents ($25,000), the City Manager's decision shall be approved 9 Employee Benefit Consulting= Sei- ices R.nised 6 15 D 117 8/20/2024 9:24 AM p. 121 City of Miami, Florida City of Miami Contract No. RFP678384soiicitation RFP 1896386 or disapproved, as applicable, by the City Commission, whose decision shall be final. Consultant shall not be entitled to seek judicial relief, recourse, remedy or to file a civil action unless: (i) it has first received City Manager's written decision, approved or disapproved, as applicable, by the City Commission if the amount of compensation hereunder exceeds Twenty -Five Thousand Dollars and No/Cents (S25,000), or (ii) a period of sixty (60) days has expired, after submitting to the City Manager a detailed statement of the dispute, accompanied by all supporting documentation one hundred twenty (120) days if City Manager's decision is subject to City Commission approval); or (iii) City has waived compliance with the procedure set forth in this section by a written instrument clearly waiving compliance signed by the City Manager. In no event may the amount of compensation under this Section exceed the total compensation set forth in Section 4 (A) of this Agreement. 13. TERMINATION; OBLIGATIONS UPON TERMINATION: A. The City, acting by and through its City Manager, shall have the right to terminate this Agreement, in its sole discretion, and without penalty, at any time, by giving written notice to Consultant at least thirty (30) calendar days prior to the effective date of such termination. In such event, the City shall pay to Consultant compensation for Services rendered and approved expenses incurred prior to the effective date of termination. In no event shall the City be liable to Consultant for any additional compensation and expenses incurred, other than that provided herein, and in no event shall the City be liable for any consequential or incidental damages. The Consultant shall have no recourse or remedy against the City for a termination under this subsection except for payment of fees due prior to the effective date of termination. B. The City, by and acting through its City Manager, shall have the right to terminate this Agreement, in its sole discretion, and without penalty, upon the occurrence of an event of a material breach hereunder, and failure to cure the same within thirty (30) days after written notice of default.. In such event, the City shall not be obligated to pay any amounts to Consultant for 10 Employee Benefit Consulting Senlees R,nied h 15 20i 8/20/2024 9:24 AM p. 122 City of Miami, Florida City of Miami Contract No. RFP67838-Solicitation RFP 1896386 Services rendered by Consultant after the date of termination, but the parties shall remain responsible for any payments that have become due and owing as of the effective date of termination. In no event shall the City be liable to Consultant for any additional compensation and expenses incurred, other than that provided herein, and in no event shall the City be liable for any direct, indirect, special, consequential, or incidental damages. 14. INSURANCE: A. Consultant shall, always during the term hereof, maintain such insurance coverage(s) as may be required by the City. The insurance coverage(s) required as of the Effective Date of this Agreement are attached hereto as Exhibit "D" and incorporated herein by this reference. The City RFP number and title of the RFP must appear on each certificate of insurance. The Consultant shall add the City of Miami as an additional insured to its commercial general liability, and auto liability policies, and as a named certificate holder on all policies. Consultant shall correct any insurance certificates as requested by the City's Risk Management Administrator. Ail such insurance, including renewals, shall be subject to the approval of the City for adequacy of protection and evidence of such coverages) and shall be furnished to the City Risk Management Administrator on Certificates of Insurance indicating such insurance to be in force and effect and any cancelled or non -renewed policy will be replaced with no coverage gap and a current Certificate of Insurance will be provided. Completed Certificates of Insurance shall be filed with the City prior to the performance of Services hereunder, provided, however, that Consultant shall at any time upon request file duplicate copies of the Certificate of Insurance with the City. B. Consultant understands and agrees that all liabilities regarding the use of any of Consultant's employees or any of Consultant's subcontractors for Services related to this Agreement shall be borne solely by Consultant throughout the term of this Agreement and that this provision shall survive the termination of this Agreement. Consultant further understands and 1.1. Employee B, netitCinsultingSenic`s Re isc1i 6 15 01" 8/20/2024 9:24 AM p. 123 City of Miami, Florida City of Miami Contract No. RFP67838Poiioitation RFP 1896386 agrees that insurance for each employee of Consultant and each subcontractor providing Services related to this Agreement shall be maintained in good standing and approved by the City Risk Management Director throughout the duration of this Agreement. C. Consultant shall be responsible for assuring that the insurance certificates required under this Agreement remain in full force and effect for the duration of this Agreement, including any extensions hereof. If insurance certificates are scheduled to expire during the term of this Agreement and any extension hereof, Consultant shall be responsible for submitting new or renewed insurance certificates to the City's Risk Management Administrator as soon as coverages are bound with the insurers. In the event that expired certificates are not replaced, with new or renewed certificates which cover the term of this Agreement and any extension thereof: (i) the City shall suspend this Agreement until the new or renewed certificate(s) are received in acceptable form by the City's Risk Management Administrator; or (ii) the City may, at its sole discretion, terminate the Agreement for cause and seek re -procurement damages from Consultant in conjunction with the violation of the terms and conditions of this Agreement. D. Compliance with the foregoing requirements shall not relieve Consultant of its liabilities and obligations under this Agreement. 15. NONDISCRIMINATION: Consultant represents to the City that Consultant does not and will not engage in discriminatory practices and that there shall be no discrimination in connection with Consultant's performance under this Agreement on account of race, color, sex, religion, age, handicap, marital status, or national origin. Consultant further covenants that no otherwise qualified individual shall, solely due to his/her race, color, sex, religion, age, handicap, marital status, or national origin, be excluded from participation in, be denied services, or be subject to discrimination under any provision of this Agreement. t? Employee B nefit Consisting Sco.kes RWsised 6.15 ?I) l 7 8/20/2024 9:24 AM p. 124 City of Miami, Florida City of Miami Contract No. RFP67838 solicitation RFP 1896386 16. ASSIGNMENT: The Consultant's services are considered specialized and unique. This Agreement shall not be assigned, sold, transferred, pledged, or otherwise conveyed by Consultant, in whole or in part, and Consultant shall not assign or otherwise subcontract any part of its operations performing these services under this Agreement, without the prior written consent of the City Manager, which may be withheld or conditioned, in the City Manager's sole discretion. 17. NOTICES: All notices or other communications required under this Agreement shall be in writing and shall be given by hand -delivery or by registered or certified U.S. Mail, return receipt requested, addressed to the other party at the address indicated herein or to such other address as a party may designate by notice given as herein provided. Notice shall be deemed given on the day on which personally delivered; or, if by mail, on the fifth day after being posted or the date of actual receipt, whichever is earlier. TO CONSULTANT: Jose Gonzalez Vice President, Employee Benefits 201 Alhambra Circle Suite 801 Coral Gables, FL 33134 13 Employee Benefit Consulting Sep. ices TO THE CITY: Daniel J. Alfonso City Manager 444 SW 2"d Avenue, 10th Floor Miami, FL 33130-1910 Ann -Marie Sharpe Risk Management Director 444 SW 2nd Avenue, 9th Floor Miami, FL 33130-1910 Annie Perez, CPPO Procurement Director 444 SW 2nd Avenue, 6th Floor Miami, FL 33130-1910 Reti iced 6 15 2017 8/20/2024 9:24 AM p. 125 City of Miami, Florida City of Miami Contract No. RFF67833-solicitation RFP 1896386 18. MISCELLANEOUS PROVISIONS: A. This Agreement shall be construed and enforced according to the laws of the State of Florida. Venue in any proceedings between the parties shall be in Miami -Dade County, Florida. Each party shall bear its own attorneys fees. Each party waives any defense, whether asserted by motion or pleading, that the aforementioned courts are an improper or inconvenient venue. Moreover, the parties consent to the personal jurisdiction of the aforementioned courts and irrevocably waive any objections to said jurisdiction. The parties irrevocably, knowingly and voluntarily waive any rights to a jury trial in any action or proceeding between them arising out of this Agreement. B. No waiver or breach of any provision of this Agreement shall constitute a waiver of any subsequent breach of the same or any other provision hereof, and no waiver shall be effective unless made in writing. C. Should any provision, paragraph, sentence, word or phrase contained in this Agreement be determined by a court of competent jurisdiction to be invalid, illegal or otherwise unenforceable under the laws of the State of Florida or the City of Miami, such provision, paragraph, sentence, word or phrase shall be deemed modified to the extent necessary in order to conform with such laws, or if not modifiable, then the same shall be deemed severable, and in either event, the remaining terms and provisions of this Agreement shall remain unmodified and in full force and effect or limitation of its use. D. Consultant shall comply with all applicable laws, rules, and regulations in the performance of this Agreement, including but not limited to licensure, and certifications required by law for professional service Consultants. E. This Agreement constitutes the sole and entire agreement between the parties hereto. No modification or amendment hereto shall be valid unless in writing and executed by properly authorized representatives of the parties hereto. Except as otherwise set forth in Section [4 Employee Benefit Consulting Scnices R. iscd 6 15 2i31' 8/20/2024 9:24 AM p. 126 City of Miami, Florida City of Miami Contract No. RFP67838iolicitation RFP 1896386 2 above, the City fvlanager shall have the sole authority to extend, amend, or modify this Agreement on behalf of the City. 19. SUCCESSORS AND ASSIGNS: This Agreement shall be binding upon the parties hereto, their heirs, executors, legal representatives, successors, or assigns. 20. INDEPENDENT CONTRACTORS: Consultant has been procured and is being engaged to provide Services to the City as an independent contractor, and not as an agent or employee of the City. Accordingly, neither Consutant, nor its employees, nor any subcontractor hired by Consultant to provide any Services under this Agreement shall attain, nor be entitled to, any rights, emoluments, or benefits under the Civil Service or Pension Ordinances of the City, nor any rights afforded classified or unclassified employees of the City. Consultant further understands that Florida Workers' Compensation benefits available to employees of the City are not available to Consultant, its employees, or any subcontractor hired by Consultant to provide any Services hereunder, and Consultant agrees to provide or to require subcontractor(s) to provide, as applicable, workers' compensation insurance for any employee or agent of Consultant rendering Services to the City under this Agreement. Consultant further understands and agrees that Consultant's or subcontractors' use or entry upon City properties shall not in any way change its or their status as an independent contractor. 21. CONTINGENCY CLAUSE: Funding for this Agreement is contingent on the availability of funds and continued authorization for program activities and the Agreement is subject to amendment or termination 15 Emp!o e Benefit Consulting 5ettii.:es RoWiscil 6 15 2017 8/20/2024 9:24 AM p. 127 City of Miami, Florida City of Miami Contract No. RFP678384Policitation RFP 1896386 due to lack of funds, reduction of funds, failure to allocate or appropriate funds, and/or change in applicable laws or regulations, upon thirty (30) days written notice. 22. FORCE MAJEt1RE: A "Force Majeure Event" shall mean an act of God, act of governmental body or military authority, fire, explosion, power failure, flood, storm, hurricane, sink hole, other natural disasters, epidemic, riot or civil disturbance, war or terrorism, sabotage, insurrection, blockade, or embargo not within the control of the Consultant. In the event that either party is delayed in the performance of any act or obligation pursuant to or required by the Agreement because of a Force Majeure Event as herein defined, the time for required completion of such act or obligation shall be extended by the number of days equal to the total number of days, if any, that such Force Majeure Event actually delay such party. The party seeking delay in performance shall give notice to the other party specifying the anticipated duration of the delay, and if such delay shall extend beyond the duration specified in such notice, additional notice shall be repeated no less than monthly so long as such delay due to a Force Majeure Event continues. Any party seeking delay in performance due to a Force Majeure Event shall use its best efforts to rectify any condition causing such delay and shall cooperate with the other party to overcome any delay that has resulted. 23. CITY NOT LIABLE FOR DELAYS: Consultant hereby understands and agrees that in no event shall the City be liable for, or responsible to Consultant or any subcontractor, or to any other person, firm, or entity for or on account of, any stoppages or delay(s) in work herein provided for, or any damages whatsoever related thereto, because of any injunction or other legal or equitable proceedings or on account of any delay(s) for any cause over which the City has no control. 16 Emplo±. ee Btne it Consulting Scr ices Ren iset16 15 2017 8/20/2024 9:24 AM p. 128 City of Miami, Florida City of Miami Contract No. RFP678384oiicitation RFP 1896386 24. USE OF NAME: Consultant understands and agrees that the City is not engaged in research for advertising, sales promotion, or other publicity purposes. Consultant is allowed, within the limited scope of normal and customary marketing and promotion of its work, to use the general results of this project and the name of the City. The Consultant agrees to protect any confidential information provided by the City and will not release information of a specific nature without prior written consent of the City Manager or the City Commission. 25. NO CONFLICT OF INTEREST: Pursuant to City of fvliami Code Section 2-611, as amended ("City Code"), regarding conflicts of interest, Consultant hereby certifies to the City that no individual member of Consultant, no employee, and no subcontractor under this Agreement nor any immediate family member of any of the same is also a member of any board, commission, or agency of the City. Consultant hereby represents and warrants to the City that throughout the term of this Agreement, Consultant, its employees, and its subcontractors will abide by this prohibition of the City Code. 26. NO THIRD -PARTY BENEFICIARY: No persons other than the Consultant and the City (and their successors and assigns) shall have any rights as an express or implied third -party beneficiary whatsoever under this Agreement. 27. SURVIVAL: All obligations (including but not limited to indemnity and obligations to defend and hold harmless) and rights of any party arising during or attributable to the period prior to expiration or earlier termination of this Agreement shall survive such expiration or earlier termination. 17 Einployee Benefit Consulting Services R.ti iset.1 h 15 1'0[ 8/20/2024 9:24 AM p. 129 City of Miami, Florida City of Miami Contract No. RFP678384solicitation RFP 1896386 28. TRUTH -IN -NEGOTIATION CERTIFICATION, REPRESENTATION AND WARRANTY: Consultant hereby certifies, represents and warrants to the City that on the date of Consultant's execution of this Agreement, and so long as this Agreement shall remain in full force and effect, the wage rates and other factual unit costs supporting the compensation to Consultant under this Agreement are and will continue to be accurate, complete, and current. Consultant understands, agrees, and acknowledges that the City shall adjust the amount of the compensation and any additions thereto to exclude any significant sums by which the City determines the contract price of compensation hereunder was increased due to inaccurate, incomplete, or non -current wage rates and other factual unit costs. All such contract adjustments shall be made within one (1) year of the end of this Agreement, whether naturally expiring or earlier terminated pursuant to the provisions hereof. 29. COUNTERPARTS: This Agreement may be executed in three or more counterparts, each of which shall constitute an original, but all of which, when taken together, shall constitute the same agreement. 30. ENTIRE AGREEMENT: This instrument and its attachments constitute the sole and only agreement of the parties relating to the subject matter hereof and correctly set forth the rights, duties, and obligations of each to the other as of its date. Any prior agreements, promises, negotiations, or representations not expressly set forth in this Agreement are of no force or effect. 18 Emplo ee Benelit Consulting Sen ices Re%ised 6 15 2017 8/20/2024 9:24 AM p. 130 City of Miami Solicitation RFP 1896386 City of Miami, Florida Contract No. RFP678384 IN WITNESS WHEREOF, the parties hereto have caused this instrument to be executed by their respective officials thereunto duly authorized, this the day and year above written. ATTEST: By: Todd B. Hannon, City Clerk ATTEST: Print Name: C 'tictve\ 6 • L+ viQ ✓ems "City" CITY OF MIAMI, a municipal corporation Daniel J. Alfo sager "Consultant" USI Insurance Services LLC, a for -profit Corp • ation By: Print Name: Jos- Gonzalez Title: \Y c_ Title: (Corporate Seal) OTMARA 9. LINARES MY COMMISSION # FF 955210 • ag EXPIRES: March 20, 2020 Bonded Thru Notary Public Underwriters APPROVED AS TO LEGAL FORM AND CORRECTNESS: 1 V'c oria M-ndez City Attorney Z?-1//Y1-r-- 19 Employee Benefit Consulting Services (Authorized Corporate Offices /7 APPRO ED AS O I► URANCE REQU i4EMEN Ann -Marie hart e Risk Management Director Revised 6/28/2017 8/20/2024 9:24 AM p. 131 City of Miami Solicitation RFP 1896386 City of Miami, Florida Contract No. RFP678384 CORPORATE RESOLUTION (This Resolution must authorize the signatory to sign) WHEREAS, ')5L SJr air Ser•4/0 a Qua-vvsu-K. corporation, desires to enter into an agreement with the City of Miami for the purpose of performing the work described in the contract to which this resolution is attached; and WHEREAS, the Board of Directors at a duly held corporate meeting has considered the matter in accordance with the bylaws of the corporation; NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF DIRECTORS that this corporation is authorized to enter into the Agreement with the City, and the President and the Secretary are hereby authorized and directed to execute the Agreement in the name of this Corporation and to execute any other document and perform any acts in connection therewith as may be required to accomplish its purpose. IN WITNESS WHEREOF, this 3c.' day of 1& L , 2017. (1S +s ,cam Pir ,-,;c ,,,, (-Provider") A Peo,,, e- -Q (State) Corporation Print Name: p eo o TI (sign) '-D - trekker (sign) Print Name: V V /►'?t% 'ItJ Y4 rr %E is Thomas Anthony Vinciguerra NOTARY PUBLIC STATE OF FLORIDA Comm# GG079823 Expires 3/6/2021 • 20 Employee Benefit Consulting Serviecs Revised 6 15 2017 8/20/2024 9:24 AM p. 132 City of Miami, Florida City of Miami Contract No. RFP67838-olicitation RFP 1896386 Employee Benefit Consulting Services EXI-iIBIT A RFP No. 678384 21 R�%ised 6 1511017 8/20/2024 9:24 AM p. 133 City of Miami Solicitation RFP 1896386 Aiizttni A,NNIE PEREZ, CPPO DANIEL J. ALFON5O Pr,cur2rner.t O'rectvr Cite Mara gef ADDENDUM NO, 7 DATE: March 29, 2017 TO: ALL PROSPECTIVE PROPOSERS SUBJECT: REQUEST FOR PROPOSALS (RFP) NO,: 678334 TITLE: Employee Benefit Consulting Services This Addendum becomes a part of the subject solicitation. A. Al! references to "Sections 457(b) and 401(a) tax deferred retirement plans" are hereby deleted in their entirety from Section 3.1, Specifications/Scope of Work, as these plans are not included in the Scope. B. Section 3.1, Subsections 5a(2); 5d, and 5e are also being deleted in their entirety as these subsections are associated with the supplemental retirement benefits in A above. ALL OTHER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME. Sincerely, nie Perez, CPPO Director of Procurement AP:cj c. Ann -Marie Sharpe, Director, Risk Management Lydia Osborne, CPPO, Assistant Director of Procurement /t4/ 8/20/2024 9:24 AM p. 134 City of Miami Solicitation RFP 1896386 ANNIE PEREZ, CPPO Procurement Director Titu gliatni ADDENDUM NO. 6 DATE: March 28, 2017 TO: ALL PROSPECTIVE PROPOSERS SUBJECT: REQUEST FOR PROPOSAL (RFP) NO.: 678384 TITLE: Employee Benefit Consulting Services DANIELJ. ALFONSO City Iwtanager This Addendum becomes a part of the subject solicitation. The deadline for submission of proposals has been extended until Wednesday, April 5 at 3:00 PM, in order to allow adequate time to respond to inquiries submitted by potential proposers. APPROVED: A Perez, CPPO, Direcjf of Procurement Date AP:Io c. Lydia Osborne, CPPO, Assistant Director of Procurement Ann -Marie Sharpe, Director, Risk Management 8/20/2024 9:24 AM p. 135 City of Miami Solicitation RFP 1896386 ANN'E PEREZ, CPFO Pr:-..:cureri2nt Dlrictar Cf itu .1f 4tinmi ADDENDUM NO. 5 DAMELJ. A-F3NSC Ci['/Mdna,,r DATE: March 24, 2017 TO: ALL PROSPECTIVE PROPOSERS SUBJECT: REQUEST FOR PROPOSAL (RFP) NO.: 678384 TITLE: Employee Benefit Consulting Services This Addendum becomes a part of the subject solicitation. The following are the inquiries received and the corresponding responses: I. Can fees and/or commissions be paid to the consultant awarded the contract if agreed upon in advance and fully disclosed? If so, any restrictions (e.g,, for non -self -funded coverages)? Answer: The City does not intend to pay commissions on the services listed within this RFP. 2. Who insures the disability plans? Answer: The answer to this question is not available at this time. The disability plans are administered by the employee unions. Risk Management has no involvement in the provision or management of this benefit. 3. Does the City use a data analytics vendor or tool currently? If so which toot, or was it designed in-house? Answer: The City does not use a data analytics vendor or tool. 4. Under General Terms — Section G — does this provision apply to this specific opportunity? Answer: This question is unclear, as the City is not sure which Section is being referred to. 5. How many specific administrator locations are there, (e.g. more than one for medical)? Answer: This question is unclear. 8/20/2024 9:24 AM p. 136 City of Miami Solicitation RFP 1896386 6. Is the first year of the contract that will result from this RFP part cf. a) a multi -year audit? b) a full year audit? c) semi-annual audits?, and d) Are the dental, vision and fife disability plans part of the semi-annual audits? Answer: a), b), c) The audit period(s) during the first year of the contract has not yet been defined. d) This has not yet been established. 7, Is the City open to a full rebate audit versus an audit to the rebate guarantee oniy? is the City interested in a full Rx audit versus an audit to the guarantee only? Answer: The City will consider full rebate and prescription audits, but only as part of contracted services, at the City's discretion. 8. Please describe the City's current wellness initiatives/program. a) Does the City have a formal wellness strategy? b) Does the City work with a vendor partner for wellness? c) Does the City use any wellness services provided by its health plan? Answer: a) Yes. See below: Strategic Wellness Plan (vision, mission statement) L7s,�r� — to continue being the objective resource through the City's Stay Active Miami (SAM`!I) workplace wellness program for health promotion in the workplace, aimed at providing employees and their families a pathway to embrace not only healthy behaviors, but also help them pursue healthier lifestyles choices and gain an increased sense of well-being. M ssicn Statement — to maintain and continue promoting and expanding the reach of the City's Stay Active Miami (SAM) workplace liveliness program, encouraging and promoting heath ar,areness for employees and their families, by providing empowering health education, accessible and engaging fitness events, with the tools and resources that will enable them strive to reach their optimal health through healthier lifestyle choices, thereby helping reduce the City's plan health costs, increase productivity, and fostering talent attraction and retention of a high quality workf0rce. b) Not at this time., and c) The City makes use of the following wellness services provided by its health plans: Client Engagement hflanager, Onsite Health Coach, and a Wellness Coordinator. 9. The City has requested that the consultant attend weekly wellness meetings. a) May attendance be by phone/web, or is cnsite attendance required?, b) Please describe the general purpose of the weekly wellness meetings., and c) Who is generally involved in them? Answer: a) The frequency of the meetings will be bi-weekly, and will be onsite. b) The general purpose of these meetings is to strategize, monitor wellness initiatives, and to address the concerns of union representatives. c) Meeting participants usually include: the CIGNA Team, City Human Resources, Risk Management, and a representative from each union except the Fraternal Order of Police. 8/20/2024 9:24 AM p. 137 City of Miami Solicitation RFP 1896386 10. a) Is there a summary description of the 401(1)/457 Plans available covering eligibility, contributions, plan investments, etc.? b) Does the general consulting support for the 401(a)/457 Plans include Investment Advisory Services for either or both of the Plans? Answer: a) For the 401(1) Plans, the City contributes 8% for eligible Executives (some participate in the City's Pension Plan); for the 457 Plans, the City neither matches, nor contributes; and b) Yes, the general consulting support includes Investment Advisory Services for both plans. 11. As it relates to "Develop employee communications..." ho',v would that requirement relate to the 457(b) or 401(a) Plans where the vendors provide communications as part of their service model? What type of issues are directly communicated by the City that your consultant would be expected to assist with? Answer: The answers to these questions are not readily available. 12. Can the City provide more detail for the services requested in "Other related Duties": a) Assist with retirement, investment, and annuity placement consulting for executive level management, as deemed necessary by the City. b) Provide specialized actuarial studies for supplemental retirement benefits. Answer: These will be determined at time of need. 13, Do both of these items refer to the same set of supplemental retirement benefits? Can the City describe the supplemental retirement benefits for which actuarial studies are required? How many people are deemed executive level management? What prompts the need for annuity placement for these benefits? Answer: This will be determined at time of need, and does not preclude Proposer from proposing. 14. Insurance Requirements: Please confirm if the City is willing to accept the Auto Liability our Auto limits are any one accident or loss? Answer: The automobile insurance coverage limit is on a per accident basis. 15. Insurance Requirements: Please confirm if the City is willing to accept that our Professional Liability limits are each wrongful act'annual aggregate and our policy has a S5 million retention. Our annual report is available online for the City to review. Answer: No. The coverages, endorsements and conditions expressed within Section 2- 10, insurance Requirements, are mandatory. 16. Insurance Requirements: With regards to Waiver of Subrogation, we would request that the waiver of the insurer's subrogation rights with Workers' Compensation, Employer's Liability, General Liability and Automobile Liability be removed or if not, will the City allow mutual waivers under the other party's policies? Answer: The Waiver of Subrogation in terms of Automobile Liability can be removed. The City is self -insured, and subject to the limitations and provisions as set forth in Section 768.28 of the Florida Statutes 17. Cancellation of insurance: Please confirm if the City would allow the Awardee to advise that a cancelled, ar non -renewed policy would be replaced with no coverage gap and a current Certificate of Insurance would be provided and not provide a cancellation notice, since coverage will be replaced with no gap. Answer: No. See the response to question 15 above. 8/20/2024 9:24 AM p. 138 City of Miami Solicitation RFP 1896386 13. In addition, other new services regarding the provision of specialized actuarial studies for supplemental retirement benefits. What 401(a) plans does the City have, Defined Benefit or Defined Contribution or bath? Is this part of the State of Florida plan? How many total plans are there? Also, are you wanting us to include the cost of such an audit in our proposal? Answer: This will be determined at time of need, and does not preclude Proposer from proposing. APPROVED: An Perez, CPPO, of Procurement Date AP: cj c. Lydia Osborne, CPPO, Assistant Director of Procurement Ann -Marie Sharpe, Director, Risk Management 8/20/2024 9:24 AM p. 139 City of Miami Solicitation RFP 1896386 ANN E PEEZ, CPPO Pr)Gur?mart $€r=e-zr 0...Tittj Aliarni ADDENDUM NO. 4 DATE: March 16, 2017 TO: ALL PROSPECTIVE PROPOSERS SUBJECT: REQUEST FOR PROPOSALS (RFP) NO.: 673334 TITLE: Employee Benefit Consulting Services D.ANIEL 1. ALFONSO Girt The following changes, additions. clarifications, and,'or deletions amend the RFP documents of the above captured RFP, and shall become an integral part of the Ri-P and Professional Services Agreement (PSA). Words and.br figures stricken through shall be deleted. Underscored words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein aid reflect same on the documents you have on hand. This Addendum becomes a part cf the subject solicitation. A. The following are the inquiries received and the corresponding responses: 1. What are the annual fees paid to the consultant for the work outlined in this RFP? Answer: The annual fees paid during the last year of the previous contract were S154,5000. Note that the previous contract included aotuarial services, which are not part of this RFP. 2. Is this RFP for services due to the end of the prior contract? Answer: Yes, the City wishes to continue the services. Is the City satisfied with current services being provided? Answer: Yes. The City was satisfied with the services under the previous contract. Notwithstanding, the City's focus is always on continued process and service improvements. 4. Can funds be required in vendor RFPs to help offset costs of select services (e.g., pre?post implementation audit, implementation support)? Answer: The Proposer's proposed price shall include all costs associated with the provision of the services requested through this RFP. 8/20/2024 9:24 AM p. 140 City of Miami Solicitation RFP 1896386 5. Who is the city's stop loss vendor? Answer: The City's stop loss vendor is Life Insurance Company of North America, Inc, (Cigna). 6. The City noted "Successful Proposer shall be available for periodic meetings adhere deliverables will be addressed." a) Will the City share the number of such meetings occurring during CY2016 and whether the number is expected to change? b) Does the City currently have or anticipate the need/desire to have regular statusiupdata calls? If so, what frequency is anticipated (e.g., weekly, monthly)? Answer: a) In 2016, over 36 meetings occurred. The number of meetings may increase/decrease depending upon operational needs. b) Regular status/update calls are anticipated to be held at least once monthly, at the City's discretion. 7. Does the Cty have a schedule for bidding the various benefits programs? Answer: Solicitations for benefit programs will be competitively procured, as applicable, as current contracts are due to expire. 8. \NR/il' the City share a sample RFP project plan that clarifies tasks performed by the Procurement Department and support provided consultants. Answer: This question is unclear. The City's Procurement Department procures the services needed by User Departments and does not perform tasks under project plans. 9. a) How does the pa't,Cipaticn breakdown between single/member plus spouselmember plus chi.lc(ren)imember plus family? b) How many active!retire=d members are eligible for the plans? c) How many participate? Answer: a) and c) See table below: b) As of September 30, 2016 (end of last fiscal year), there were approximately 4,10(3 eligible active/retired members.The breakdown of participating members is as fcliows: 141ernb2rs Active COBRA Retiree Over 65 Retiree Under 65 Grand Total Employee Employee +Child(ren) +Family 371 050 3 27 401 11 62 678 Employee Employee +Spouse Only 225 : 1082 2 1071 224 91 338 426 1645 Grand Total 2283 21 345 521 3151 10. a) Vlh rich unions represent the City's employees? b) In meeting with the unions, may the attendance be by phone/web or will onsite attendance be required? Answer: a) The City's Employees are represented by four (4) unions: 1) International Association of Fire Fighters Local 587 (Fire Fighters), American Federation of State, County and Municipal Employees (AFSCN1E) Local 871 (Solid Waste), AFSCME Local 1907 (General Employees), and Fraternal Order of Police (FOP) Miami Lodge 20 (Sworn Police Dept. Employees), FOP has its own health plan, which is unrelated to the services sought through this RFP. b) Onsite attendance shall be required for all union meetings 8/20/2024 9:24 AM p. 141 City of Miami Solicitation RFP 1896386 11. What have been the City's top 3 cost drivers in the past 2 years; both medical and pharmaceutical? Answer: The City's top three (3) cost drivers during the past two (2) years for medical are Diabetes, Asthma, and Psych/Neurotic Disorders; for pharmaceutical are Rernicade, Saizen, and Humira Pen. 12. Is the City willing to: a) Negotiate the Indemnification clause listed in the RFP requirements under Section 1.42 and in Section 2.10 so the proposing firm is not subject to an unlimited liability? b) !Naive the Bid Bond/Bad Security requirement or at a minimum negotiate the terms under Section 1.11? c) Negotiate provisions of the Professional Services Agreement provided with the RFP? Answer: a) Certain terms. (indemnity'hold harmless, insurance, cancellation for convenience, funding -cat cl= Jse, among others), are long-standing City requirements and may not be modified r yss of whether an exception is taken. b) Bid Bond ;' E d Security does not apply to this solicitation. As indicated within Section 1.11, these claases are only applicable if lister within Section 2, Special Terms and Conditions. c) See Section 2.8, Execution of an Agreement, on page 27 of the RFP. 13. li.Nhen will the City p.o'iiide the addendum with responses regarding tine questions asked? Answer: The City stri yes to respond to inq_lines, if applicable, within 48 hours. 14. Is the Cty open to alternate suggestions for the audit period — i.e. annual audits versus semi-annual for the same plan? Answer: The Proposer may make recommendations. 15. Does the City conduct an annual employee engagement survey? Or, does the City rely on periodic pulse surveys? Answer: The City conducts an annual employee satisfaction survey. 16, How frequently has the City conducted focus groups in the past? Answer: The City Manager's Office conducts annual focus groups as part of its Strategic Planning Initiative. 17. Is the City looking for communication support in any other specific areas? Answer: Not at this time. 18. As part of our retention policy, we must retain a copy of all work products. Please confirm if the City is wilting to allow Proposer to retain any public documents or confidential/exempt documents that make up part of our work product as required for document retention purposes, as well as, any such documents stored as a result of backup email systems that store ernails for emergency backup purposes. Answer: Refer to Articles 5, Ownership of Documents, and 6, Audit and inspection Rights and Records Retention of the Sample Professional Services Agreement attached tc this RFP. 8/20/2024 9:24 AM p. 142 City of Miami Solicitation RFP 1896386 19. Sect:on 3.1, Specifications/Scope of Work, includes conducting a semmi-annual onsite c'.aims audit of self -funded plans, and a semi-annual audit of the Pharmady Benefits Management (PBM) Program. Can you clarify as to whether you are asking if the Proposer can conduct these audits, or that you are requesting that the Proposer perform the audits, as well as, cover the cost of the audits? Answer: The Successful Proposer shall conduct the semi-annual onsite claims and PBM audits. Proposer's price shall Include all costs associated with the provision of the services requested through this RFP. 20. When was the last medical/PBM audit conducted? Answer: This information is not available at this time. 21. What is the audit periods) for the medical audit/PBM audit? Example: Incurred Claims: January 1, 2016 - June 30, 2016 Paid Claims: January 1, 2016 - July 31, 2016 Answer: At this time, no specific time period has been established. ALL OTHER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME. Sincerely, Annie Perez, CPPO Director of Procurement AP:cj c. Lydia Osborne, CPPO, Assistant Director of Procurement Ann -Marie Sharpe, Director, Risk Management 8/20/2024 9:24 AM p. 143 City of Miami Solicitation RFP 1896386 '•iEE PER EZ,CPPO Citittjof 4Thnmi `,,,, a „- r _ a• ADDENDUM NO. 3 DAi fIEL J. ALFO,NSO c,t/ 1,1j.i3J, r DATE; March 10, 2017 TO: ALL PROSPECTIVE PROPOSERS SUBJECT: REQUEST FOR PROPOSAL (RFP) NO.: 678384 TITLE: Employee Benefit Consulting Services This Addendum becomes a part of the subject solicitation. The deadline for submission of proposals has teen extended until Thursday, March 30, 2017 at 3:00 PM, in order to allow adequate time to respond to inquiries submitted by potential proposers. APPROVED: / An r le Perez, CPPO, Directorrrocurement Date AP:la c. Lydia Osborne, CPPO, Assistant Director of Procurement Ann -Marie Sharpe. Director, Risk Management 8/20/2024 9:24 AM p. 144 City of Miami Solicitation RFP 1896386 Attu of Aliami .ANN E PEREZ. CPPO DANIEL 1 .A.LFONSO chic( P.oc r 11 r € Ur'i:czr C'ic. N,lunx:_r ADDENDUM NO. 2 Request for Proposals - RFP No. 678384. Employee Benefit Consulting Services February 23, 2017 TO: ALL PROSPECTIVE PROPOSERS: The purpose o tills Addendum is to chann.t. the notification set:inns related to Addendum No. 1 from "Internal to Sourcir.LJ", to "To Supplier'". This Addendum No, 2,. contains the same information intended for Addendum No. I. ALL OT HER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME. Sincerely, inie Perez, CPPO Director:Chief Procurement Officer AP. c j Cc: RFP F`iI4 Paw*e 1 8/20/2024 9:24 AM p. 145 City of Miami Solicitation RFP 1896386 ANNIE PEREZ, CPPO D\NIFI J.:-ALFONSO Chi:f Proca ment O1fi: r Cir �ldnrseT ADDENDUM NO, 1 Request for Proposals- RFP No. 67838-I, Employee Benefit Consulting Services February 17, 2017 TO: ALL PROSPECTIVE PROPOSERS: The follow ir.? cl,ans,es, additions, clarifications, and or deletion amend the Request for Proposals ("RFP") documents of t'.-:e above captioned REP, and shall become an integral part of the RFP and Professional Services zreement ('°PS.V), Words and. or tiau:-es stricken through shall he deleted. Underscored words and,'or figures shall be added. The rernainin2. provisions are now in effect and remain unchanged. Please note the contents herein and reflect same on the documents you have on hand. L The sign -in sheet from the voluntary Pre -Proposal Conference held on February 16, 2017 has been attached._ B. The sample PS.-\ is being deleted in its entirety due to minor edits recommended by the City Attorney's office and replaced with the attached Revised Agreement, located under the Header Notes and Attachments section of this solicitation in the Oracle,'iSupplier Sourcing System. ALL OTIIER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME, Sincerely, t nie Perez, CPPO 1$irector'Chief Procurement Officer AP/cj Cc: RFP File Page 1 8/20/2024 9:24 AM p.146 City of Miami Solicitation RFP 1896386 City of Miami Request for Proposals (RFP) Procurement Department Miami ami Riverside Center 444 SW 21d Avenue, 6.h Floor Miami, Florida 33130 Web Site Address- ' n4a',v_r^iamigov con;cr,curen,_ert RFPNumber; Title: Issue Date/Time: RFPClosing Date/Time: Pre-Bid/Pre-Proposal Conference: Pre-Bid/Pre-Proposal Date/Time: Pre-Bid/Pre-Proposal Location: Deadline for Request for Clarification: Contracting Officer: Hard Copy Submittal Location: Contracting Officer E-Mail Address: Contracting Officer Facsimile: 678384,7 Request for Proposals for Employee Benefit Consulting Services 30-MAR-2017 05-APR-2017 r 15:00:00 Voluntary Thursday, February 16, 2017 at 10:00 AM 444 SW 2nd Avenue, 6th Floor South Conference Room Thursday, March 2, 2017 at 5:00 PM Johnson, Charles City of Miami - City Clerk 3500 Pan American Drive Miami FL 33133 US CJohnson miamigov.com 305-400-5373 Page [ of 40 8/20/2024 9:24 AM p. 147 City of Miami Solicitation RFP 1896386 Certification Statement Please quote on this form. if applicable. net prices for the itemfs) listed. Return signed original and retain a copy for your files. Prices should include all costs, including transportation to destination. The City reserves the right to accept or reject all or any part of this submission. Prices should be firm for a minimum of 1S0 days following the time set for closing of the submissions. In the event of errors in extension of totals, the unit prices shall govern in determining the quoted prices. We (1) certify that we have read your solicitation, completed the necessary documents, and propose to furnish and deliver, F.O.B. DESTINATION, the items or services specified herein. The undersigned hereby certifies that neither the contractual party nor any of its principal owners or personnel have been convicted of any of the violations, or debarred or suspended as set in section 18-107 or Ordinance No. 12271. All exceptions to this submission have been documented in the section below (refer to paragraph and section). EXCEPTIONS: We (I) certify that any and all information contained in this submission is true; and we (I) further certify that this submission is made without prior understanding. agreement, or connection with any corporation. film. or person submitting a submission for the same materials, supplies. equipment, or service, and is in all respects fair and without collusion or fraud. We (I) agree to abide by all terns and conditions of this solicitation and certify that I am authorized to sign this submission for the submitter. Please print the following and sign your name: PROPOSER NAME• ADDRESS' PHONE: FAX. EMAIL: CELL(Optional): SIGNED BY. TITLE: DATE: FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM SH-ALL DISOCALIFY THIS RESPONSE. Page 2 of40 8/20/2024 9:24 AM p. 148 City of Miami Solicitation RFP 1896386 Certifications Legal Name of Firm: Entity Type: Partnership, Sole Proprietorship, Corporation, etc. Year Established: Office Location: City of Miami, Miami -Dade County, or Other Business Tax Receipt / Occupational License Number: Business Tax Receipt! Occupational License Issuing Agency: Business Tax Receipt Occupational License Expiration Date: Will Subcontractor(s) be used? (Yes or No) Please list all addcnduin.'addenda received. List the addendum.'addenda number and date of receipt (i.e. Addendum No. 1, 7. 1/07). If no addenduni'addenda was. were issued, please insert N.'A. Has Proposer reviewed the attached Sample Professional Servic.es Agreement (PSA)? Does Proposer acknowledge that the attached PSA is an example of the standard Agreement used in conjunction with the provision of these sera ices? Page 3 of 40 8/20/2024 9:24 AM p. 149 City of Miami Solicitation RFP 1896386 Line: 1 Description: Proposers are not required to enter a unit price on this line. Proposers shall submit their proposed prices on Form B, Price Proposal Schedule, located under the Header/Notes and Attachments Section of this Solicitation, in the Oracle/iSupplier Sourcing System Category: 91800-00 Unit of Measure: Dollar [Exit Price: S Number of Units: 1 Total: S 8/20/2024 9:24 AM Page 4or40 p. 150 City of Miami Solicitation RFP 1896386 Table of Contents Request for Proposals (RFP) 678384,7 Terms and Conditions 6 1. General Conditions 6 1.1. GENERAL TERMS AND CONDITIONS 6 2. Special Conditions 16. 2.1. PURPOSE 16 2.2, VOLUNTARY PRE -PROPOSAL CONFERENCE 26 2.3. DEADLINE FOR RECEIPT OF REQUEST FOR ADDITIONAL ENTORMATION CLARIFICATION 2.4. TERM OF CONTRACT 16 2..5. CONDITIONS FOR RENEWAL 16 2.6. LIVING WAGE ORDINANCE 27 2.7. PROPOSER'S MINIMUM QUALIFICATIONS -17 2.8. EXECUTION OF AN AGREEMENT )7 2.9. NON -APPROPRIATION OF FUNDS 17 2.10. INSURANCE REQUIREMENTS 18 2.11. CONTRACT ADMINISTRATOR 29 2.12. SUBCONTRACTOR(S) OR SUBCONSULTANT(S) 19 2. El WORK ASSIGNMENTS 30 2.14. ADDITIONAL SERVICES 30 2.15. FAILURE TO PERFORM 30 2.16. TERMINATION 30 2.17. PRIMARY CLIENT (FIRST PRIORITY) 31 2.18. UNAUTHORIZED WORK 31 2.19. CHANGES:ALTERATIONS 31 2.20, METHOD OF PAYMENT 31 2.21. CO\ EPENSATION 31 1 11. EVALUATION. SELECTION PROCESS AND CONTRACT AWARD 32 2.23. RECORDS 32 2.24, TRUTH IN NEGOTIATION CERTIFICATE 13 2.25. ADDITIONAL TERMS AND CONDITIONS 33 3. Specifications34 3.1. SPECIFICATIONS:SCOPE OF WORK 34 4. Submission Requirements 37 4. I. SUBMISSION REQUIREMENTS 37 5. Evaluation Criteria 40 5.1. EVALUATION CRITERIA 40 Page 5 of 40 8/20/2024 9:24 AM p. 151 City of Miami Solicitation RFP 1896386 Request for Proposals i ftFP 16783 -4.7 Terms and Conditions 1. General Conditions 1.I. GENERAL TERMS AND CONDITIONS Intent: The General Term and Conditions described herein apply to the acquisition of goods equipment services with an estimated aggregate cost of S25,000.00 or more. Definition: A formal solicitation is defined as issuance of an Invitation for Bids, Request for Proposals. Request for Qualifications, or Request for Letters of Interest pursuant to the City of Miami Procurement Code and or Florida Law, as amended. Formal Solicitation and Solicitation shall be defined in the same manner herein. 1.1. ACCEPTANCE OF GOODS OR EQUIPMENT - Any good(s) or equipment delivered under this formal solicitation. if applicable. shall remain the property of the seller until a physical inspection and actual usage of the good is made. and thereafter is accepted as satisfactory to the City. It must comply with the terms herein and be fully in accordance with specifications and of the highest quality. In the event the goods:equipment supplied to the City are found to be defective or does not conform to specifications. the City resen es the right to cancel the order upon written notice to the Contractor and return the product to the Contractor at the Contractors expense. 1.2. ACCEPTANCE OF OFFER - The signed or electronic submission of your solicitation response shall be considered an offer on the part of the bidder proposer; such offer shall be deemed accepted upon issuance by the City of a purchase order. 1.3. ACCEPT.ANCE/REJECTION — The City reserves the right to accept or reject any or all responses or parts of after opening closing date and request re -issuance on the goods:'services described in the formal solicitation. In the event of such rejection. the Director of Purchasing shall notify all affected bidders 'proposers and make available a written explanation for the rejection. The City also reserves the right to reject the response of any bidder 'proposer who has previously- failed to properly perform under the terms and conditions of a contract, to deliver on time contracts ofa similar nature, and who is not in a position to perform the requirements defined in this formal solicitation. The City further reserves the right to waive any irregularities or minor informalities or technicalities in any or all responses and may, at its discretion, re -issue this formal solicitation. 1.4. ADDEND.\ — It is the bidder's proposer's responsibility to ensure receipt of all Addenda. Addenda are available at the City's vvebsite at: http:. www.ci.miami.fl.us;procurement 1.5. ALTERNATE RESPONSES WILL NOT BE CONSIDERED. 1.6. ASSIGNMENT - Contractor agrees not to subcontract, assign. transfer. convey, sublet. or otherwise dispose of the resulting Contract, or any or all of its right, title or interest herein.. without City of Miami's prior written consent. I.7.ATTORNEY'S FEES - In connection with any litigation, mediation and arbitration arising out of this Contract, each party shall bear their own attorney's fees through and including appellate litigation and any post judgment proceedings. 1.8. AUDIT RIGFITS AND RECORDS RETENTION - The Successful Bidder Proposer agrees to provide access at all reasonable times to the City, or to any of its duly authorized representatives, to any books, documents, papers, and records of Contractor which are directly pertinent to this formal solicitation, for the purpose of audit. examination, excerpts, and transcriptions. The Successful Bidder'Proposer shall maintain and retain any and all of Page 6 of 40 8/20/2024 9:24 AM p. 152 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384,7 the books, documents, papers and records pertinent to the Contract for three (3) years after the City makes final payment and all other pending matters are closed. Contractor's failure to or refusal to comply with this condition shall result in the immediate cancellation of this contract by the City. I.9. AV AJLA81L1TY OF CONTRACT STATE-WIDE - Any Governmental, not -for -profit or quasi -governmental entity in the State of Florida, may avail itself of this contract and purchase any and all goods services, specified herein from the successful bidder(s).proposer(s) at the contract price(s) established herein, when permissible by federal, state, and local laws, pules, and regulations. Each Governmental, not -for -profit or quasi -governmental entity- which uses this formal solicitation and resulting bid contract or agreement will establish its own contract agreement, place its own orders, issue its own purchase orders, be invoiced there from and make its own payments, determine shipping terms and issue its own exemption certificates as required by the successful bidder(s) proposer(s). 1.10. AWARD OF CONTRACT: A. The Formal Solicitation. Bidder's Proposers response, any addenda issued, and the purchase order shalt constitute the entire contract. unless modified in accordance with any ensuing contract agreement, amendment or addenda. B. The award of a contract where there are Tie Bids will be decided by the Director of Purchasing or designee in the instance that Tie Bids can't be determined by applying Florida Statute 287.087, Preference to Businesses with Drug -Free Workplace Programs, C. The award of this contract may be preconditioned on the subsequent submission of other documents as specified in the Special Conditions or Technical Specifications. Bidder Proposer shall be in default of its contractual obligation if such documents are not submitted in a timely manner and in the form required by the City. Where Bidder Proposer is in default of these contractual requirements, the City, through action taken by the Purchasing Department. will void its acceptance of the Bidder's Proposer's Response and may accept the Response from the next lowest responsive. responsible Bidder or Proposal most advantageous to the City or re -solicit the City's requirements. The City. at its sole discretion. may seek monetary restitution from Bidder Proposer and its bid. proposal bond or guaranty, if applicable, as a result of damages or increased costs sustained as a result of the Bidder's,Proposer's default. D. The term of the contract shall be specified in one of three documents which shall be issued to the successful BidderProposer. These documents may either be a purchase order, notice of award and or contract award sheet. E. The City reserves the right to automatically extend this contract for up to one hundred twenty (120) calendar days beyond the stated contract term in order to provide City departments with continual service and supplies while a new contract is being solicited, evaluated, and. or awarded. It -the right is exercised, the City- shall notify the Bidder Proposer, in writing. of its intent to extend the contract at the same price. terns and conditions for a specific number of days. Additional extensions over the first one hundred twenty (120) day extension may occur, if, the City and the Successful Bidder Proposer are in mutual agreement of such extensions. F. Where the contract involves a single shipment of goods to the City, the contract term shall conclude upon completion of the expressed or implied warranty periods. G. The City reserves the right to award the contract on a split -order, lump sum or individual -item basis, or such combination as shall best serve the interests of the City unless otherwise specified. I-1. A Contract Agreement may be awarded to the Bidder'Proposer by the City Commission based upon the minimum qualification requirements reflected herein. As a result of a RFP, RFQ, or RFLI, the City reserves the right to execute or not execute, as applicable, an Agreement with the Proposer, whichever is determined to be in the Page 7 of40 8/20/2024 9:24 AM p. 153 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384.7 City's best interests. Such agreement will be htrnished by the City. will contain certain terms as are in the C'ity.-'s best interests. and will be subject to approval as to legal form by the City Attorney. 1.11. BID BOND; BID SECURITY - A cashier's or certified check. or a Bid Bond signed by a recognized surety company- that is licensed to do business in the State of Florida. payable to the City of Miami. for the amount bid is required from all bidders proposers. if so indicated under the Special Conditions. This check or bond guarantees that a bidder proposer will accept the order or contract agreement, as bid proposed, if it is awarded to bidder proposer. Bidder Proposer shall forfeit bid deposit to the City should City award contract agreement to Bidder Proposer and Bidder Proposer fails to accept the award. The City reserves the right to reject any and all surety tendered to the City. Bid deposits are returned to unsuccessful bidders. proposers within ten (10) days after the award and successful bidder's proposers acceptance of award. If sixty (60) days have passed after the date of the formal solicitation closing date. and no contract has been awarded, all bid deposits will be returned on demand. 1.12. RESPONSE FORM (HARDCOPY FORMAT) - AlI forms should be completed. signed and submitted accordingly. 1.13. BID SECURITY- FORFEITED LIQUIDATED DAMAGES - Failure to execute an Agreement and. or file an acceptable Performance Bond, when required. as provided herein, shall be just cause for the annulment of the award and the forfeiture of the Bid Security to the City" which forfeiture shad be considered, not as a penalty, but in mitigation ofdamaues sustained. Award may then be made to the next lowest responsive. responsible Bidder or Proposal most advantageous to the City- or all responses may be rejected. 1.14. BRAND NAMES - If and wherever in the specifications brand names. makes, models, names of any manufacturers. trade names, or bidder proposer catalog numbers are specified. it is for the purpose ofestablishing the type. function. minimum standard of design. efficiency. grade or quality of goods only When the City does not wish to rule out other competitors' brands or makes. the phrase OR EQUAL- is added. When bidding proposing an approved equal, Bidders. Proposers will submit, with their response, complete sets of necessary data (factory information sheets. specifications. brochures, etc.) in order for the City to evaluate and determine the equality of the itenm(s) bid proposed. The City- shall be the sole judge of equality- and its decision shall be final. Unless otherwise specified. evidence in the form of samples may be requested if the proposed brand is other than specified by the City. Such samples are to be furnished after formal solicitation opening'closing only upon request of the City. If samples should be requested, such samples must be received by the City no later than seven (7) calendar days after a formal request is made. 1.15. CANCELLATION - The City reserves the right to cancel all formal solicitations before its openinv.'closing. [n the event of bid proposal cancellation, the Director of Purchasing shall notify all prospective bidders 'proposers and make available a written explanation for the cancellation. 1.16. CAPITAL EXPENDITURES - Contractor understands that any capital expenditures that the firm makes, or prepares to make, in order to deliver perform the goods. services required by the City, is a business risk which the contractor must assume. The City will not be obligated to reimburse amortized or unamortized capital expendintres, or to maintain the approved status of any contractor. If contractor has been unable to recoup its capital expenditures during the time it is rendering such goods 'services. it shall not have any claim upon the City. 1.17. CITY- NOT LIABLE FOR DELAYS - It is further expressly agreed that in no event shall the City be liable for, or responsible to, the Bidder Proposer Consultant, any sub -contractor sub -consultant. or to any other person for, or on account of. any stoppages or delay in the work herein provided for by injunction or other legal or equitable proceedings or on account of any delay for any cause over which the City has no control. 1.18. COLLUSION —Bidder Proposer, by submitting a response, certifies that its response is made without previous understanding, agreement or connection either with any person, firm or corporation submitting a response Page 8 of40 8/20/2024 9:24 AM p. 154 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384.7 for the same items services or with the City of Miami's Purchasing Department or initiating department. The Bidder Proposer certifies that its response is fair. without control, collusion, fraud or other illegal action. Bidder Proposer certifies that it is in compliance with the Conflict of Interest and Code of Ethics Laws. The City will investigate all potential situations where collusion may have occurred and the City reserves the right to reject any and all bids. responses where collusion may have occurred. 1.19. COMPLIANCE WITH FEDERAL, STATE AND LOCAL LAWS - Contractor understands that contracts between privare entities and local governments are subject to certain laws and regulations, including laws pertaining to public records, conflict of interest. records keeping, etc. City and Contractor agree to comply with and observe all applicable laws, codes and ordinances as that may in any way affect the !goods or equipment offered. including but not limited to: A. Executive Order 11246, which prohibits discrimination against any employee. applicant, or client because of race. creed, color, national origin, sex, or age with regard to, but not limited to, the following_: employment practices, rate of pay- or other compensation methods, and training selection. B. Occupational. Safety and Elealth Act (OSHA). as applicable to this Formal Solicitation. C. The State of Florida Statutes, Section 287.133(3)tA) on Public Entity Crimes. D. Environment Protection Agency (EPA), as applicable to this Formal Solicitation. E. Uniform Commercial Code (Florida Statutes. Chapter 672). F. Americans with Disabilities Act of 1990, as amended. G. National Institute of Occupational Safety Hazards (NIOSII), as applicable to this Formal Solicitation. EL National Forest Products Association (NEPA), as applicable to this Formal Solicitation. I. City Procurement Ordinance City Code Section 18, Article III. J. Conflict of Interest. City Code Section 2-611;61. K. Cone of Silence. City Code Section 18-74. L. The Florida Statutes Sections 218.73 and 218.74 on Prompt Payment. Lack of knowledge by the bidder -proposer will in no way be a cause for relief from responsibility. Non-compliance with all local. state, and federal directives, orders, and laws may be considered grounds for temaination of conrract(s). Copies of the Ciro Ordinances may be obtained from the City Clerk's Office. 1.20. CONE OF SILENCE - Pursuant to Section 18-74 of the City of Miami Code, a "Cone of Silence" is imposed upon each RFP, RFQ. RFLL or IFB after advertisement and terminates at the time the City Manager issues a written recommendation to the Miami City Commission. The Cone of Silence shall be applicable only to Contracts for the provision of goods and services and public works or improvements for amounts greater than S200,000. The Cone of Silence prohibits any communication regarding RFPs, RFQs, RFLI or IFBs (bids) between. among others: Potential vendors, service providers, bidders, lobbyists or consultants and the City's professional staff including, but not limited to, the City Manager and the City Manager's staff; the Mayor, City Commissioners, or their respective staffs and any member of the respective selection'evaluation committee. The provision does not apply to. among other communications: Page 9 of40 8/20/2024 9:24 AM p. 155 City of Miami Solicitation RFP 1896386 Request for Proposals (REP) 678384,7 oral conununications wvith the City purchasing staff, provided the communication is limited strictly to matters of process or procedure already contained in the formal solicitation document; the provisions of the Cone of Silence do not apply- to oral communications at duly noticed site visits, inspections. pre -proposal or pre -bid conferences. oral presentations before selection. evaluation committees, contract negotiations during anv duly noticed public meeting. or public presentations made to the Miami City Commission during a duly noticed public meeting: or communications in writing or by email at any time with any City employee, official or member of the City Commission unless specifically prohibited by the applicable RFP, RFQ. RFLI or IFB (bid) documents (See Section 2.2. of the Special Conditions): or communications in connection with the collection of industry comments or the performance or -market research regarding a particular RFP, RFQ, RFLI OR IFB by City Purchasing staff. Proposers or bidders must file a copy of any written communications with the Office of the City Clerk, which shall be made available to any person upon request. The City .shah respond in writing and file a copy with the Office of the City Clerk. which shall be made available to any person upon request. 1A-ritten communications may be in the form of e-mail, with a copy to the Office of the City Clerk. In addition to any other penalties provided by law, violation of the Cone of Silence by any proposer or bidder shall render any award voidable. A violation by a particular Bidder, Proposer. Offeror, Respondent, lobbyist or consultant shall subject same to potential penalties pursuant to the City Code. Any person having personal knowledge ofa violation of these provisions shall report such violation to the State Attorney and. or may file a complaint with the Ethics Commission. Proposers or bidders should reference Section 18-74 of the City of Miami Code for further clarification. This language is only a summary of the kev provisions of the Cone of Silence. Please review City of Miami Code Section 18-74 fora complete and thorough description of the Cone of Silence. You may contact the City Clerk at 305-250-5360, to obtain a copy of same. 1.21. CONFIDENTIALITY - As a political subdivision. the City of Nliami is subject to the Florida Sunshine Act and Public Records Law. If this Contract. Agreement contains a confidentiality provision, it shall have no application when disclosure is required by Florida law or upon court order. 1,22. CONFLICT OF INTEREST — Bidders Proposers. by responding to this Formal Solicitation, certify- that to the best of their knowledge or belief, no elected appointed official or employee of the City of Miami is financially interested, directly or indirectly-, in the purchase of goods, services specified in this Formal Solicitation. Any such interests on the part of the Bidder Proposer or its employees must be disclosed in writing to the City. Further, you must disclose the name of any City employee who owns, directly or indirectly, an interest of five percent (S 0) or more of the total assets of capital stock in your firm. A. Bidder Proposer further agrees not to use or attempt to use any knowledge, property or resource which may be within his. her'its trust, or perform his her'its duties. to secure a special privilege. benefit, or exemption for himself herself itself, or others. Bidder Proposer may not disclose or use information not available to members of the general public and gained by reason of his. her'its position, except for information relating exclusively to governmental practices, for his. her'its personal gain or benefit or for the personal gain or benefit of any other person or business entity. B. Bidder Proposer hereby acknowledges that he.'she. it has not contracted or transacted any business with the City or any person or agency acting for the City, and has not appeared in representation of any third party before any - board. commission or agency of the City within the past two years. Bidder.Proposer further warrants that he she it is not related. specifically the spouse, son, daughter, parent, brother or sister, to: (i) any member of the commission; (ii) the mayor; (iii) any city employee; or (iv) any member of anv board or agency- of the City. C. A violation of this section may subject the Bidder Proposer to immediate termination of any professional services agreement with the City, imposition of the maximum fine and or any penalties allowed by law. Page 10 of 40 8/20/2024 9:24 AM p. 156 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384,7 Additionally. violations may be considered by and subject to action by the Miami -Dade County Commission on Ethics. 1.23. COPYRIGHT OR PATENT RIGHTS — Bidders Proposers warrant that there has been no violation of copyright or patent rights in manufacturing. producing, or selling the goods shipped or ordered and or sere.• ices provided as a result of this formal solicitation, and bidders, proposers agree to hold the City harmless from any and all liability, loss, or expense occasioned by any such violation. 1.24. COST INCURRED BY BIDDER,"PROPOSER- All expenses involved with the preparation and submission of Responses to the City, or any work perfommed in connection therewith shall be borne by the Bidder(s )• Proposer( s). 1.25. DEBARMENT AND SUSPENSIONS (Sec 1S-107) (a) Authority and requirement to debar and suspend. After reasonable notice to an actual or prospective Contractual Party, and after reasonable opportunity for such party to be heard. the City Manager. after consultation with the Chief Procurement Officer and the city attorney, shall have the authority to debar a Contractual Party, for the causes listed below. from consideration for award of city Contracts. The debarment shall be for a period of not fewer than three years. The City Manager shall also have the authority- to suspend a Contractual Party from consideration for award of city Contracts. if there is probable cause for debarment, pending the debarment determination. The authority to debar and suspend contractors shall be exercised in accordance with regulations which shall be issued by the Chief Procurement Officer after approval by the City- Manager, the city attorney, and the City Commission. (b) Causes for debarment or suspension. Causes for debarment or suspension include the following: (1) Conviction for commission of a criminal offense incident to obtaining or attempting, to obtain a public or private Contract or subcontract, or incident to the perfomlance of such Contract or subcontract. (2) Conviction under state or federal statutes of embezzlement. theft, forgery. bribery, falsification or destruction of records. receiving stolen property, or any other offense indicating a lack of business integrity or business honesty, (3) Conviction under state or federal antitrust stanutes.arisino out of the submission of Bids or Proposals. (4) Violation of Contract provisions, which is regarded by the Chief Procurement Officer to be indicative ofnonresponsibility. Such violation may include failure without good cause to perform in accordance with the terms and conditions of a Contract or to perform within the time limits provided in a Contract, provided that failure to perform caused by acts beyond the control of a party shall not be considered a basis for debamient or suspension. (5) Debarment or suspension of the Contractual Party by any federal, state or other governmental entity. (6) False certification pursuant to paragraph (c) below. (7) Found in violation of a zoning ordinance or any other city- ordinance or regulation and for which the violation remains noncompliant. (8) Found in violation of a zoning ordinance or any other ciy ordinance or regulation and for which a civil penalty or tine is due and owing to the city. (9) Any other cause judged by the City Manager to be so serious and compelling as to affect the Page 11 of40 8/20/2024 9:24 AM p. 157 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 67S3S4,7 responsibility of the Contractual Party performing city Contracts. (c) Certification. All Contracts for goods and services, sales, and leases by the city shall contain a certification that neither the Contractual Party nor any of its principal owners or personnel have been convicted of any of the violations set forth above or debarred or suspended as set forth in paragraph (b 5). (d) Debarnment and suspension decisions. Subject to the provisions of paragraph (a). the City Manager shall render a written decision stating the reasons for the debarment or suspension. A copy of the decision shall be provided promptly to the Contractual Party, along with a notice of said party's right to seek judicial relief. 1,26. DEBARREDISCSPENDED VENDORS —An entity or affiliate who has been placed on the State of Florida debarred or suspended vendor list may not submit a response on a contract to provide goods or services to a public entity. may not submit a response on a contract with a public entity for the construction or repair of a public building or public wvork, may not submit response or, leases of real property to a public entity, may not award or perform wvork as a contractor. supplier, subcontractor, or consultant under contract with any public entity, and may not transact business with any public entity-. 1.27. DEFAULT/FAILURE TO PERFORM - The City shall be the sole judge of nonperformance. which shall include any failure on the part of the successful Bidder Proposer to accept the award, to furnish required documents, and, or to fulfill any portion of this contract within the time stipulated. Upon default by the successful Bidder Proposer to meet any terms of this agreement, the City will notify the Bidder Proposer of the default and wiil provide the contractor three (3) days (weekends and holidays excluded) to remedy the default. Failure on the contractor's pan to correct the default within the required three (3) days shall result in the Contract being temninated and upon the Cirr notifying in writing the contractor of its intentions and the effective date of the termination, The following shall constintte default: A. Failure to perform the worn or deliver the goods services required under the Contract and or within the time required or failing to use the subcontractors. entities and personnel as identified and set forth, and to the degree specified in the Contract. B. Failure to begin the work under this Contract within the time specified. C. Failure to perform the work with sufficient workers and equipment or with sufficient materials to ensure timely completion. D. tieulecting or refusing to remove materials or perform new work where prior work has been rejected as nonconforming. with the terms of the Contract, E. Becoming insolvent, being declared bankrupt, or committing any act of bankruptcy or insolvency, or making an assignment for the benefit of creditors. if the insolvency, bankruptcy, or assignment renders the successful Bidder Proposer incapable of performing- the work in accordance with and as required by the Contract. F. Failure to comply with any of the terms of the Contract in any material respect. All costs and charges incurred by the City as a result of a default or a default incurred beyond the time limits stated, together with the cost of completing the work. shall be deducted from any monies due or which may become due on this Contract. 1.2S. DETERMINATION OF RESPONSIVENESS - Each Response will be reviewed to determine if it is responsive to the submission requirements outlined in the Formal Solicitation. A "responsive" response is one which follows the requirements of the formal solicitation, includes all documentation, is submitted in the format outlined in the formal solicitation, is of timely submission, and has appropriate signatures as required on each document. Failure Page 12 of 40 8/20/2024 9:24 AM p. 158 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384.7 to comply with these requirements may deem a Response non -responsive. A. Responsible Bidder shall mean a bidder proposer who has submitted a bidprposai and who has the capability, as determined under the City Procurement Ordinance. in all respects to fully perform the contract requirements. and the integrity and reliability of which give reasonable assurance of good faith and performance. 1.29. DISCOUNTS OFFERED DURING TERM OF CONTRACT - Discount Prices offered in the response shall be fixed after the award by the Commission, unless otherwise specified in the Special Terms and Conditions. Price discounts off the original prices quoted in the response will be accepted from successhul Bidders). Proposer(s) during the term of the contract. Such discounts shall remain in effect for a minimum of 120 days from approval by the City Commission Any discounts offered by a manufacturer to Bidder Proposer will be passed on to the City. 1.30. DISCREPANCIES, ERRORS, AND OMISSIONS - Any discrepancies, errors, or ambiguities in the Formal Solicitation or addenda (if anvil should be reported in writing to the City's Purchasing Department. Should it be found necessary, a written addendum will be incorporated in the Formal Solicitation and will become part of the purchase agreement (contract documents). The City will not be responsible for any oral instructions. clarifications, or other communications. A. Order of Precedence — Any inconsistency in this formal solicitation shall be resolved by giving precedence to the following documents, the first of such list being the governing documents. I) Addenda (as applicable) 2) Specifications 3) Special Conditions 4) General Terms and Conditions 1.31. EMERGENCY / DISASTER PERFORMANCE - In the event of a hurricane or other emergency or disaster situation. the successful vendor shall provide the City with the commodities, services defined within the scope of this formal solicitation at the price contained within vendor's response. Further. successful vendor shall deliverperform for the city on a priority basis during such times of emergency-. 1.32. ENTIRE BID CONTRACT OR AGREEMENT - The Bid Contract or Agreement consists of this City of Miami Formal Solicitation and specifically this General Conditions Section, Contractor's Response and any written agreement entered into by the City of Miami and Contractor in cases involving RFPs, RFQs, and RFLIs, and represents the entire understanding and agreement between the parties with respect to the subject matter hereof and supersedes all other negotiations, understanding and representations, if any, made by and between the parties. To the extent that the agreement conflicts with. modifies, alters or changes any of the terms and conditions contained in the Formal Solicitation and, or Response. the Formal Solicitation and then the Response shall control. This Contract may be modified only by a written agreement signed by the City of Miami and Contractor. 1.33. ESTIMATED QUANTITIES —Estimated quantities or estimated dollars are provided for your guidance only. No guarantee is expressed or implied as to quantities that wi11 be purchased during the contract period. The City is not obligated to place an order for any given amount subsequent to the award of this contract. Said estimates may be used by the City for purposes of deterntining the low bidder or most, advantageous proposer meeting specifications. The City reserves the right to acquire additional quantities at the prices bid proposed or at lower prices in this Formal Solicitation. 1,34. EVALUATION OF RESPONSES A.Rejection of Responses The City may reject a Response for any of the following reasons: Page I3of40 8/20/2024 9:24 AM p. 159 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678 84,7 I) Bidder Proposer fails to acknowledge receipt of addenda; 2) Bidder Proposer mistates or conceals any material fact in the Response ; 3) Response does not conform to the requirements of the Formal Solicitation: 4) Response requires a conditional award that conflicts with the method of award: 5) Response does not include required samples, certificates. licenses as required: and. 6) Response was not executed by the Bidders, Proposerfs) authorized agent. The foregoing is not an all inclusive list of reasons for which a Response may be rejected, The City may reject and re -advertise for all or any part of the Formal Solicitation whenever it is deemed in the best interest of the City. B. Elimination From Consideration 1) A contract shall not be awarded to any person or firm which is in arrears to the City upon any debt or contract, or which is a defaulter as surety or otherwise upon any obligation to the City. 2) A contract may not be awarded to any person or firm which has failed to perform under the terms and conditions of anv previous contract with the City- or deliver on time contracts of a similar nanire. 3) A contract may not be awarded to any person or firm which has been debarred by the City in accordance with the City's Debamtent and Suspension Ordinance. C. Determination of Responsibility 1) Responses will only be considered from entities who are regularly' engaged in the business of providing the goods. equipment services required by the Formal Solicitation. Bidder Proposer must be able to demonstrate a satisfactory record of performance and integrity: and. have sufficient financial, material. equipment, facility. personnel resources, and expertise to meet all contractual requirements. The terms "equipment and organization" as used herein shall be construed to mean a fully equipped and well established entity- in line with the best industry practices in the industry as determined by the City. 2) The City may consider any evidence available regarding the financial, technical and other qualifications and abilities of a Bidder Proposer, including- past performance (experience) with the City or any other governmental entity in making the award. 3) The City may require the Bidder(s). Proposer(s) to show proof that they have been designated as an authorized representative of a manufacturer or supplier which is the actual source of supply, if required by the Formal Solicitation. 1.35. EXCEPTIONS TO GENERAL AND OR SPECIAL CONDITIONS OR SPECIFICATIONS - Exceptions to the specifications shall be listed on the Response and shall reference the section. Any exceptions to the General or Special Conditions shall be cause for the bid (IFB) to be considered non -responsive. It also may be cause for a RFP, RFQ, or RFLI to be considered non -responsive; and. if exceptions are taken to the terms and conditions of the resulting agreement it may lead to terminating negotiations. 1.36. F.O.B. DESTINATION - Unless otherwise specified in the Formal Solicitation, all prices quoted proposed by the bidder proposer must be F.O.B. DESTINATION, inside delivery, with all delivery costs and charges included in the bid proposal price. unless otherwise specified in this Formal Solicitation. Failure to do so may be cause for rejection of bid'proposal. 1.37. FIRM PRICES - The bidder proposer warrants that prices, terms, and conditions quoted in its response will be firm throughout the duration of the contract unless otherwise specified in the Formal Solicitation. Such prices wilt remain firm for the period of performance or resulting. purchase orders or contracts, which are to be performed Page 14 of40 8/20/2024 9:24 AM p. 160 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384.7 or supplied over a period of time. 1.38. FLORIDA \IINIMIC `1 WAGE - The Constitution of the State of Florida, Article X, Section 24. states that employers shall pay employee wages no less than the minimum wage for all hours worked in Florida. Accordingly, it is the contractor's and its' subcontractors) responsibility to understand and comply with this Florida constitutional minimum wage requirement and pay its employees the current established hourly minimum wage rate, which is subject to change or adjusted by the rate of inflation using. the consumer price index for urban wage earners and clerical workers. CPI-1\, or a successor index as calculated by the United States Department of Labor. Each adjusted minimum wage rate calculated shall be determined and published by the Agency Workforce Innovation on September 30th of each year and take effect on the following January 1st. At the time of responding. it is bidder'proposer and his. her subcontractor(s), if applicable, full responsibility to determine whether any of its employees may be impacted by this Florida Law at any given point in time during the terns of the contract. If impacted, bidder proposer must furnish employee name; s), job title(s), job description(s), and current pay rate(s). Failure to submit this information at the time of submitting a response constitute successful bidder's. proposer's acknowledgement and understanding, that the Florida Minimum Wage Law will not impact its prices throughout the term of contract and waiver of any contractual price increase request(s). The City reserves the right to request and successfitl bidder proposer must provide for any and all information to make a wage and contractual price increases) determination. 1.39. GOVERNING LAW AND VENUE - The validity and effect of this Contract shall be governed by the laws of the State of Florida. The parties agree that any action. mediation or arbitration arising,- out of this Contract shall take place in Miami -Dade County, Florida. In any action or proceeding each party shall bear their own respective attorney's fees. 1.40. HEADINGS AND TERMS - The headings to the various paragraphs of this Contract have been inserted for convenient reference only and shall not in any manner be construed as modifying, amending or affecting in any way the expressed terms and provisions hereof. 1.41. HEALTFI INSUR_1NCE PORTABILITY AND _ACCOUNT.ABILITI ACT (HIPPA) - Any person or entity than performs or assists the City of Miami with a function or activity involving the use or disclosure of --individually identifiable health information (IIHI) and. or Protected Health Information (PHI) shall comply with the Health Insurance Portability and Accountability Act (fIIPAA) of 1996 and the City of Miami Privacy Standards. IIIPAA mandates for privacy, security and electronic transfer standards, which include but are not limited to: A. Use of information only for performing services required by the contract or as required by law; 13. Use of appropriate safeguards to prevent non -permitted disclosures; C. Reporting to the City of Miami of any non -permitted use or disclosure, D. Assurances that any agents and subcontractors agree to the same restrictions and conditions that apply to the Bidder Proposer and reasonable assurances that HIII PH( will be held confidential; E. Making Protected Health Information (PHI) available to the customer: F. Making PHI available to the customer for review and amendment; and incorporating any amendments requested by the customer; G. ?Making PI -II available to the City of Miami for an accounting of disclosures: and I1. Making internal practices, books and records related to PI -II available to the City of Miami for compliance audits. PHI shall maintain its protected status regardless of the form and method of transmission (paper records, and, or electronic transfer of data). The Bidder' Proposer must give its customers written notice of its privacy information Page 15 of 40 8/20/2024 9:24 AM p. 161 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP; 678384,7 practices including specifically. a description of the types of uses and disclosures that would be made with protected health information. 1.42 INDEMNIFICATION - Contractor shall indemnify, hold save harmless and defend at its own costs and expense the City, its officials, officers. agents, directors. and employees. from liabilities. damages. fosses. and costs. including. but not limited to reasonable attorney's fees. to the extent caused by the negligence_ recklessness or intentional wrongful misconduct ofContractor and persons employed or utilized by Contractor in the performance of this Contract and will indemnify, hold hornless and defend the City, its officials, officers, agents. directors and employees against. any civil actions, statutory or similar claims, injuries or damages arising or resulting from the permitted work, even if it is alleged that the City, its officials and or employees were negligent. These indemnifications shall survive the term of this Contract. In the event that any action or proceeding is brought against City by reason of any such claim or demand. Contractor shall, upon written notice from City, resist and defend such action or proceeding by counsel satisfactory to City. The Contractor expressly understands and agrees that any insurance protection required by this Contract or otherwise provided by Contractor shall in no way limit the responsibility- to indemnif;,, keep and save harmless and defend the City or its officers, employees, agents and instnimentalities as herein provided. The indemnification provided above shall obligate Contractor to defend at its own expense to and through appellate, supplemental or bankruptcy proceeding. or to provide for such defense, at City's option, any and all claims of liability and all suits and actions of every name and description which may be brought against City whether performed by Contractor. or persons employed or utilized by Contractor. This indemnity- wwilI survive the cancellation or expiration of the Contract This indemnity will be interpreted under the laws of the State of Florida, including without limitation and which conforms to the limitations of§725,06 and, or r 725.08. Fla. Statues, as amended from time to time as applicable. Contractor shall require all Sub -Contractor agreements to include a provision that they will indemnify the City. The Contractor agrees and recognizes that the City shall not be held liable or responsible for any claims which may result from any actions or omissions of the Contractor in which the City participated either through review or concurrence of the Contractor's actions. In reviewing., approving or rejecting any submissions by the Contractor or other acts of the Contractor. the City in no way assumes or shares any responsibility or liability of the Contractor or Sub -Contractor, under this Agreement. 1.43. FORMATION AND DESCRIPTiVE LITERATURE —Bidders Proposer must furnish all information requested in the spaces provided in the Formal Solicitation. Further, as may be specified elsewhere, each Bidder Proposer must submit for evaluation, cuts, sketches, descriptive literature, technical specifications, and Material Safety Data Sheets (MSDS}as required, covering the products offered. Reference to literature submitted with a previous response or on file with the Buyer will not satisfy this provision. 1.44. INSPECTIONS - The City may, at reasonable times during the term hereof, inspect Contractor's facilities and perform such tests, as the City deems reasonably necessary, to determine whether the goods and. or services required to be provided by the Contractor under this Contract conform to the terms and conditions of the Formal Solicitation. Contractor shall make available to the City all reasonable facilities and assistance to facilitate the performance of tests or inspections by City representatives. All tests and inspections shall be subject to. and made in accordance with, the provisions of the City of Miami Ordinance No. 12271 (Section 18-79), as same may be amended or supplemented from time to time. 1.45. INSPECTION OF RESPONSE - Responses received by the City pursuant to a For nal Solicitation will not be made available until such time as the City provides notice of a decision or intended decision or within 30 days after bid closing. whichever is earlier. Bid. Proposal results tivill be tabulated and may be furnished upon request via fax or e-mail to the Sr. Procurement Specialist issuing the Solicitation. Tabulations also are available on the City's Page 16 of 40 8/20/2024 9:24 AM p. 162 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384.7 Web Site following recommendation for award. 1.46. INSURANCE - Within ten ( 10) days after receipt of Notice of Award. the successful Contractor, shall furnish Evidence of insurance to the Purchasing. Department, if applicable. Submitted evidence of coverage shall demonstrate strict compliance to all requirements listed on the Special Conditions entitled "Insurance Requirements". The City shall be listed as an "Additional Insured." issuance of a Purchase Order is contingent upon the receipt of proper insurance documents. If the insurance certificate is received within the specified time frame but not in the manner prescribed in this Solicitation the Contractor shall be verbally notified of such deficiency and shall have an additional five (5) calendar days to submit a corrected certificate to the City. If the Contractor fails to submit the required insurance documents in the manner prescribed in this Solicitation within fifteen 15) calendar days after receipt Notice of Award, the contractor shall be in default orthe contractual terms and conditions and shall not be awarded the contract. Under such circumstances, the Bidder Proposer may be prohibited from submitting future responses to the City. Information regarding any insurance requirements shall be directed to the Risk Administrator,, Department of Risk Management, at 444 SW 2nd Avenue, 9th Floor, Miami, Florida 33130, 305-416-1604. The Bidder Proposer shall be responsible for assuring that the insurance certificates required in conjunction with this Section remain in effect for the duration of the contractual period: including any and all option terms that may be granted to the Bidder Proposer. 1.47. INVOICES - Invoices shall contain purchase order number and details of goods and. or services delivered ( i.e. quantity-. unit price, extended price, etc); and in compliance \kith Chapter 2I i5 of the Florida Statutes (Prompt Payment Act). 1.48. LOCAL PREFERENCE A. City Cade Section 18-8 . states...when a responsive. responsible non -local bidder submits the lowest bid price. and the bid submitted by one or more responsive. responsible local bidders who maintain a local office, as defined in Section 18-73, is within fifteen percent (15" o) of the price submitted by the non -local bidder, then that non -local bidder and each of the aforementioned responsive, responsible local bidders shall have the opportunity to submit a best and final bid equal to or lower than the amount of the low bid previously submitted by the non -local bidder. Contract award shall be made to the lowest responsive, responsible bidder submitting the lowest best and final hid. In the case of a tie in the best and final bid between a local bidder and a non -local bidder, contract award shall be made to the local bidder." B. City Code Section 18-86. states. "the RFP, RFLI or RFQ, as applicable. may, in the exercise of the reasonable professional discretion of the City Manager, director of the using agency. and the Chief Procurement Otticer, include a five (5° a) percent evaluation criterion in favor of proposers who maintain a local office, as defined in Section 18-73. In such cases, this five (5' of percent evaluation criterion in favor of proposers who maintain a Iocal office will be specifically defined in the RFP, RFLI or RFQ. as applicable: otherwise. it will not apply. 1.49. MANUFACTURER'S CERTIFICATION -The City reserves the right to request from bidders. proposers a separate Manufacturer's Certification of all statements nude in the bid, proposal. Failure to provide such certification may result in the rejection of bidproposal or termination of contract agreement, for which the bidder proposer mast bear full liability. 1.50. MODIFICATIONS OR CHANGES IN PURCHASE ORDERS AND CONTRACTS - No contract or understanding to modify this Formal Solicitation and resultant purchase orders or contracts. if applicable, shall be binding upon the City unless made in writing by the Director of Purchasing of the City of Miami. Florida through the issuance of a change order, addendum, amendment. or supplement to the contract, purchase order or award sheet Page 17 of 40 8/20/2024 9:24 AM p. 163 City of Miami Solicitation RFP 1896386 Request for Proposals ( RFP) 678384,7 as appropriate. 1.51. NO PARTNERSHIP OR JOINT VENTURE - Nothing contained in this Contract will be deemed or constnied to create a partnership or joint venture between the City of Miami and Contractor. or to create any other similar relationship between the parties. 1.52. NONCONFORMANCE TO CONTRACT CONDITIONS - Items may be tested for compliance with specifications under the direction of the Florida Department of Agriculture and Consumer Services or by other appropriate testing Laboratories as determined by the City. The data derived from any test for compliance with specifications is public record and open to examination thereto in accordance with Chapter l 19, Florida Statutes. Items delivered not conforming to specifications may be rejected and returned at Bidder's, Proposer's expense. These non -conforming items not delivered as per delivery date in the response and. or Purchase Order may result in bidder proposer being found in default in which event any and all re -procurement costs may be charged against the defaulted contractor. Any violation of these stipulations may also result in the supplier's name being removed from the City of Miami's Supplier's list. 1.53. NONDISCRIMINATION —Bidder Proposer agrees that it shall not discriminate as to race. sex. color, age, religion. national origin, marital status, or disability in connection Evith its performance under this formal solicitation. Furthermore. Bidder Proposer agrees that no otherwise qualified individual shall solely by reason of his,her race. sex, color, age. religion. national origin. marital status or disability be excluded from the participation in. be denied benefits of. or be subjected to, discrimination under any program or activity. In connection with the conduct of its business. including performance of services and employment of personnel. Bidder Proposer shall not discriminate against any person on the basis of race. color, religion. disability. age. sex. marital status or national origin. All persons having appropriate qualifications shall be afforded equal opportunity for employment. 1,54. NON-E\CLUSIVE CONTRACT/ PIGGYBACK PROVISION - At such times as rnav serve its best interest, the City of Miami reserves the right to advertise for. receive. and award additional contracts for these herein goods and. or services. and to make use of other competitively- bid (governmental) contracts. agreement;, or other similar sources for the purchase of these goods and or services as may be available. It is hereby agreed and understood that this formal solicitation does not constitute the exclusive rights of the successful bidder(s) proposer(s) to receive all orders that may be generated by the City in conjunction with this Formal Solicitation. In addition, any and all commodities, equipment, and services required by the City in conjunction with construction projects are solicited under a distinctly different solicitation process and shall not be purchased under the terms. conditions and awards rendered under this solicitation, unless such purchases are determined to be in the best interest of the City. 1.55. OCCUPATIONAL LICENSE - Any person, firm, corporation or joint v-ensure. with a business location in the City of Miami and is submitting a Response under this Formal Solicitation shall meet the City's Occupational License Tax requirements in accordance with Chapter 31.1, Article I of the City- of N[iami Charter. Others with a location outside the City of yliami shall meet their local Occupational License Tax requirements. A copy of the license must be submitted with the response; however, the City may at its sole option and in its best interest allow the Bidder Proposer to supply the license to the City during the evaluation period„ but prior to award. 1.56. ONE PROPOSAL - Only one (1) Response from an individual, turn, partnership, corporation or joint venture will be considered in response to this Formal Solicitation. Page 18 of 40 8/20/2024 9:24 AM p. 164 City of Miami Solicitation RFP 1896386 Request for Proposals (REP) 678384,7 1.57. OWNERSHIP OF DOCUMENTS - It is understood by and between the parties that any documents, records, files. or any other matter whatsoever which is given by the City to the successful Bidder Proposer pursuant to this formal solicitation shall at all times remain the property of the City and shall not be used by the Bidder Proposer for any other purposes whatsoever without the written consent of the City. 1.58. PARTIAL INVALIDITY - It -any provision of this Contract or the application thereof to any person or circumstance shall to any extent be held invalid. then the remainder of this Contract or the application of such provision to persons or circumstances other than those as to which it is held invalid shall not be affected thereby, and each provision of this Contract shall be valid and enforced to the fullest extent permitted by law. 1.59. PERFORMANCE/PAYMENT BOND —.A Contractor may be required to furnish a Performance Payment Bond as part of the requirements of this Contract. in an amount equal to one hundred percent (100" ti) of the contract price. 1.60. PREPARATION OF RESPONSES (I-I,&RDCOP\ FORMAT} —Bidders. Proposers are expected to examine the specifications, required delivery. drawings, and all special and general conditions. All bid. proposed amounts. if required. shall be either typewritten or entered into the space provided with ink. Failure to do so will be at the Bidders. Proposer's risk. A. Each Bidder Proposer shall furnish the information required in the Formal Solicitation. The Bidder Proposer shall sign the Response and print in ink or type the name of the Bidder Proposer, address. and telephone number on the face pt 7e and on each continuation sheet thereof on which he. she makes an entry, as required. B. Ifso required. the unit price for each unit offered shall be shown, and such price shall include packaging. handling and shipping. and F.O.B. y[iami delivery inside City- premises unless otherwise specified. Bidder Proposer shall include in the response all taxes. insurance. social security, workmens compensation. and any other benefits normally paid by the Bidder Proposer to its employees. If applicable, a unit price shall be entered in the -Unit Price" column for each item, Based upon estimated quantity, an extended price shall be entered in the "Extended Price" column for each item offered. In case c f a discrepancy between the unit price and extended price. the unit price will be presumed correct. C. The Bidder Proposer must state a definite time. if required. in calendar days for delivery of goods and or services. D. The Bidder Proposer should retain a copy ()Call response documents for future reference. E. All responses. as described, must be fitlly completed and typed or printed in ink and must be signed in ink with the f rnt's name and by an officer or employee havint authority to bind the company or firm by his her signature. Bids.Proposals having any erasures or corrections must be initialed in ink by person signing the response or the response may be rejected. F. Responses are to remain valid for at least 180 days. Upon award of a contract. the content of the Successful Bidders Proposer's response may be included as part of the contract, at the Citv's discretion. G. The City of Miami's Response Forms shall be used when Bidder Proposer is submitting its response in hardcopy format. Use of any other forms will result in the rejection of the response. IF SUBMITTING 1-IAPDCOPY FORMAT, THE ORIGINAL AND THREE (3) COPIES OF THESE SETS OF FORMS, UNLESS OTHERWISE SPECIFIED, AND ANY REQUIRED ATTACHMENTS MUST BE RETURNED TO THE CITY OR YOUR RESPONSE MAY BE DEEMED NON -RESPONSIVE. 1.61. PRICE ADJUSTMENTS — Any price decrease effectuated during the contract period either by reason of Page 19 of40 8/20/2024 9:24 AM p. 165 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384,7 market change or on the part of the contractor to other customers shall be passed on to the City of -Miami. 1,62. PRODUCT SUBSTITUTES - In the event a particular awarded and approved manufacturer's product becomes una4ailable during the term of the Contract, the Contractor awarded that item may arrange with the Cin's authorized representatkels) to supply a substitute product at the awarded price or lower, provided that a sample is approved in advance of delivery and that the new product meets or exceeds all quality requirements. 1.63. CONFLICT OF INTEREST, AND UNETHICAL BUSINESS PRACTICE PROHIBITIONS - Contractor represents and warrants to the City that it has not employed or retained any person or company employed by the City- to solicit or secure this Contract and that it has not offered to pay, paid. or agreed to pay any person any fee. commission. percentage, brokerage fee. or gift of any kind contingent upon or in connection with. the award of this Contract. 1.64. PRO\IPT PAI \LENT —Bidders. Proposers may offer a cash discount for prompt payment: however, discounts shall not be considered in determining the lowest net cost for response evaluation purposes. Bidders Proposers are required to provide their prompt payment terms in the space provided on the Formal Solicitation. lino prompt payment discount is being offered, the Bidder Proposer must enter zero (0) for the percentage discount to indicate no discount. If the Bidder Proposer fails to enter a percentage. it is understood and agreed that the terms shall be 2" o 20 days, effective after receipt of invoice or final acceptance by the City, whichever is later. When the City is entitled to a cash discount, the period of computation will commence on the date of delivery-, or receipt of a correctly completed invoice. whichever is later, If an adjustment in payment is necessary due to damage, the cash discount period shall commence on the date final approval for payment is authorized. Ira discount is part of the contract. but the invoice does not reflect the existence of a cash discount, the City is entitled to a cash discount with the period commencing on the date it is determined by the City that a cash discount applies. Price discounts of; the original prices quoted on the Price Sheet will be accepted from successful bidders proposers during the term of the contract. 1.65. PROPERTY - Property owned by the City of \lianmi is the responsibility of the City- of Miami. Such property furnished to a Contractor for repair, modification, study, etc., shall remain the property of the City of Miami. Damages to such property occurring, while in the possession of the Contractor shall be the responsibility of the Contractor. Damages occurring to such property while in route to the City- of Miami shall be the responsibility of the Contractor. In the event that such property is destroyed or declared a total loss, the Contractor shall be responsible for replacement value of the property at the current market value, less depreciation of the property. if any. 1.66. PROVISIONS BINDING - Except as otherwise expressly provided in the resulting. Contract. all covenants. conditions and provisions of the resulting Contract shall be binding upon and shall inure to the benefit of the parties hereto and their respective heirs, legal representatives, successors and assigns. 1.67. PUBLIC ENTITY CRIMES - A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a response on a contract to provide any goods or services to a public entity, may not submit a response on a contract with a public entity for the construction or repair of a public building or public work. may not submit responses on leases of real property to a public entity-. may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO fora period of 36 months from the date of being placed on the convicted vendor list. Page 20 of40 8/20/2024 9:24 AM p. 166 City of Miami Solicitation RFP 1896386 Request for Proposals cRFP) 6783884.7 1.63. PUBLIC RECORDS - Contractor understands that the public shall have access, at all reasonable times, to all documents and information pertaining to City contracts, subject to the provisions of Chapter 1 l9, Florida Statutes. and City of Miami Cocle. Section l3. Article III, and agrees to allow access by the City and the public to all documents subject to disclosure under applicable law. Contractor shall additionally comply 1,vith the provisions of Section 119.0701. Florida Statutes. entitled "Contracts; public records". Contractor's failure or refusal to comply with the provision of this section shall result in the immediate cancellation of this Contract by the City. 1.69. QUALITY OF GOODS, N1. TERIALS, SUPPLIES, PRODUCTS, AND EQUIPMENTAll materials used in the rnanufacnring or constriction of supplies, materials, or equipment covered by this solicitation shall be new. The items bid. proposed must be of the latest make or model. of the best quality, and of the highest grade of workmanship. unless as otherwise specified in this Solicitation. 1.70. QUALITY OF WORK SERVICES - The work services performed must be of the highest quality and workmanship. Materials furnished to complete the service shall be new and of the highest quality' except as otherwise specified in this Solicitation, 1,71. RE%IEDIES PRIOR TO AWARD (Sec. 13-106) - If prior to Contract award it is determined that a formal solicitation or proposed award is in violation of law, then the solicitation or proposed award shall be cancelled by the City Commission, the City Manager or the Chief Procurement Officer, as may be applicable, or revised to comply with the lave. I.72. RESOLUTION OF CONTRACT DISPUTES (Sec. 18-105) (a) Authority to resolve Contract disputes. The City Manager, after obtaining the approval of the city attorney. shall have the authority to resolve controversies between the Contractual Party and the city which arise under, or by virtue of, a Contract between them: provided that, in cases involving an amount greater than S25.000. the City Commission must approve the City Manager's decision. Such authority extends, without limitation. to controversies based upon breach of Contract. mistake. misrepresentation or lack of complete performance, and shall be invoked by a Contractual Party by submission of a protest to the City- Manager. (b) Contract dispute decisions. [f a dispute is not resolved by mutual consent. the City \lanager shall promptly render a written report stating the reasons for the action taken by the City Commission or the City .Manager which shall be final and conclusive. A copy of the decision shall be immediately provided to the protesting party-, along with a notice of such party's right to seek judicial relief. provided that the protesting party shall not be entitled to such judicial relief without first having followed the procedure set forth in this section. 1.73. RESOLUTION OF PROTESTED SOLICITATION5 AND AWARDS (See. I8-104) (a) Right to protest. The following procedures shall be used for resolution of protested solicitations and awards except for purchases of goods, supplies, equipment, and services, the estimated cost ofwhich does not exceed 525,000. Protests thereon shall be governed by the Administrative Policies and Procedures of Purchasing. I.Protest of Solicitation. i. Any prospective proposer who perceives itself aggrieved in connection with the solicitation of a Contract may protest to the Chief Procurement Officer. A written notice of intent to file a protest shall be filed with the Chief Procurement Officer within three days after the Request for Proposals, Request for Qualifications or Request for Letters of Interest is published in a newspaper of general circulation. A notice of intent to file a protest is considered filed when received by the Chief Procurement Officer; or Page 2l of 40 8/20/2024 9:24 AM p. 167 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384,7 ii. Any prospective bidder who intends to contest the Solicitation Specifications or a solicitation may protest to the Chief Procurement Officer. A written notice of intent to file a protest shall be filed with the Chief Procurement Officer within three days after the solicitation is published in a newspaper of general circulation. A notice of intent to file a protest is considered filed when received by the Chief Procurement Officer. 2. Protest of Award. i. A written notice of intent to tile a protest shall be filed with the Chief Procurement Officer within two days after receipt by the proposer of the notice of the City Manager's recommendation for award of Contract, which will be posted on the City of Miami Purchasing Department website. in the Supplier Corner, Current Solicitations and Notice of Recommendation of Award Section. The notice of the City Manager's recommendation can be found by selecting the details of the solicitation and is listed as Recommendation of Award Posting Date and Recommendation of Award To fields. If "various" is indicated in the Recommendation of Award To field, the Bidder Proposer must contact the buyer for that solicitation to obtain the suppliers name. It shall be the responsibility of the Bidder Proposer to check this section of the website daily after responses are submitted to receive the notice; or ii. Any actual Responsive and Responsible Bidder whose Bid is lower than that of the recommended bidder may protest to the Chief Procurement Officer, A written notice of intent to file a protest shall be filed with the Chief Procurement Officer within two days after receipt by the bidder of the notice of the city's determination of non responsiveness or non responsibility. The receipt by bidder of such notice shall be confirmed by the city by facsimile or electronic mail or L`.S. mail. return receipt requested. A notice of intent to file a protest is considered filed when received by the Chief Procurement Officer. iii. A written protest based on any of the foregoing must be submitted to the Chief Procurement Officer within Live (d) days after the date the notice of protest was filed, A written protest is considered tiled when received by the Chief Procurement Officer. The written protest may not challenge the relative weight of the evaluation criteria or the formula for assigning points in making an award determination. The written protest shall state with particularity the specific facts and law upon which the protest of the solicitation or the award is based, and shall include all pertinent documents and evidence and shall be .accompanied by the required Filing Fee as provided in subsection (f). This shall form the basis for review of the written protest and no facts. grounds, documentation or evidence not contained in the protester's submission to the Chief Procurement Officer at the time of filing the protest shall be permitted in the consideration of the written protest. No time will be added to the above limits for set -vice by mail, In computing any period of time prescribed or allowed by this section, the day of the act. event or default from which the designated period of time begins to nun shall not be included. The last day of the period so computed shall be included unless it is a Saturday, Sunday or legal holiday in which event the period shall nm until the end of the next day which is neither a Saturday, Sunday or legal holiday. Intermediate Saturdays, Sundays and legal holidays shall be excluded in the computation of the time for filing. (b) Authority to resolve protests. The Chief Procurement Officer shall have the authority, subject to the approval of the City Manager and the city attorney, to settle and resolve any written protest. The Chief Procurement Officer shall obtain the requisite approvals and conummicate said decision to the protesting party and shall submit said decision to the City Commission within 30 days after he. she receives the protest. In cases involving more than S25,000, the decision of the Chief Procurement Officer shall be submitted for approval or disapproval thereof to the City Commission after a favorable recommendation by the city attorney and the City Manager. (c) Compliance with filing requirements. Failure of a party to tinily tile either the notice of intent to file a protest or Page 22 of 40 8/20/2024 9:24 AM p. 168 City of Miami Solicitation RFP 1896386 Request for Proposals iRFP) 67838-. 7 the written protest, together with the required Filin) Fee as provided in subsection in. with the Chief Procurement Officer within the time provided in subsection (a). above. shall constitute a forfeiture of such party's right to file a protest pursuant to this section. The protesting, party- shall not be entitled to seek judicial relief without first hm, inz followed the procedure set forth in this section (d) Stay of Procurements during protests. Upon receipt of a written protest filed pursuant to the requirements of this section, the city shall not proceed further with the solicitation or with the award of the Contract until the protest is resolved by the Chief Procurement Officer or the City Commission as provided in subsection (b) above, unless the City \Ianager makes a written determination that the solicitation process or the Contract award must be continued without delay in order to avoid an immediate and serious danger to the public health. safety or welfare. (e) Costs. All costs accruing from a protest shall be assumed by the protestor. (1) Filing Fee. The written protest must be accompanied by a filing_ fee in the form ofa money order or cashiers check payable to the city in an amount equal to one percent of the amount of the Bid or proposed Contract, or S5000.00, whichever is less, which fling fee shall guarantee the payment of all costs which may be adjudged against the protestor in any administrative or court proceeding. If a protest is upheld by the Chief Procurement Officer and. or the City Commission, as applicable, the filing fee shall be refunded to the protestor less any costs assessed under subsection (e) above. Tithe protest is denied. the filing fee shall be forfeited to the city in lieu of payment of costs for the administrative proceedings as prescribed by subsection (e) above. 1.74. SA\IPLES - Samples of items. when required. must be submitted within the time specified at no expense to the City. It -not destroyed by testing, bidders) proposers) will be notified to remove samples, at their expense, within 30 days after notification. Failure to remove the samples will result in the samples becoming the property of the City. 1.75. SELLING, TRANSFERRING OR ASSIGNING RESPONSIBILITIES - Contractor shall not sell, assign. transfer or subcontract at any time during the term of the Contract. or any part of its operations, or assign any portion of the performance required by this contract, except under and by virtue of written permission granted by the City through the proper officials. which may be withheld or conditioned, in the City's sole discretion. 1.76. SERVICE AND WARRANTY specified, the bidder proposer shall define all warranty. service and replacements that «ill be provided. Bidders. Proposer must explain on the Response to what extent warranty and service facilities are available. A copy of the manufacturer's warranty, if applicable. should be submitted with your response. 1.77. SILENCE OF SPECIFICATIONS - The apparent silence of these specifications and any supplemental specification as to any detail or the omission from it of detailed description concerning any point shall be regarded as meaning that only the best commercial practices are to prevail and that only materials of first quality. and correct type, size and design are to be used. All workmanship and services is to be first quality. All interpretations of these specifications shall be made upon the basis of this statement. If your firm has a current contract with the State of Florida, Department of General Services, to supply the items on this solicitation. the bidder proposer shall quote not more than the contract price; failure to comply with this request will result in disqualification of bid proposal. 1.78. Si.B),IISSION AND RECEIPT OF RESPONSES - Responses shall be submitted electronically via the Oracle System or responses may be submitted in hardcopy format to the City Clerk. City Ilall, 3500 Pan American Drive, Miami, Florida 33133-5504. at or before, the specified closing date and time as designated in the IFB, RFP, RFQ, or RFLI. NO EXCEPTIONS, Bidders.Proposers are welcome to attend the solicitation closing; however, no Page 23 of 40 8/20/2024 9:24 AM p. 169 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 6"8384.7 award will be made at that time. A. Hardcopy responses shall be enclosed in a sealed envelope, box package. The face of the envelope. box or package must show the hour and date specified for receipt of responses. the solicitation number and title. and the name and return address of the Bidder Proposer. Hardcopy responses not submitted on the requisite Response Forms may be rejected. Hardcopy responses received at any other location than the specified shall be deemed non -responsive. Directions to City Hall: FROM THE NORTH: I-95 SOUTH UNTIL IT TURNS INTO US1, US1 SOUTH TO 27TII AVE., TURN LEFT. PROCEED SOUTH TO SO. BAYSHORE DR. (3RD TRAFFIC LIGI IT), TURN LEFT. 1 BLOCK TURN RIGHT ON PAN AMERICAN DR. CITY HALL IS AT THE END OF PAN AMERICAN DR. PARKING IS ON RIGHT. FROM THE SOUTH. L'S1 NORTH TO 2TTEI AVENUE, TURN RIGHT. PROCEED SOUTH TO SO. BAYSIIORE DR. (3RD TRAFFIC LIGHT). TURN LEFT, I BLOCK TURN RIGHT ON PAN AMERICAN DR. CITY HALL IS AT THE END OF PAN AMERICAN DR. PARKING IS ON RIGHT. B. Facsimile responses will not be considered. C. Failure to follow these procedures is cause for rejection of bid proposal. D. The responsibility for obtaining, and submitting a response on or before the close date is solely and strictly the responsibility of Bidder Proposer. The City of yliami is not responsible for delays caused by the United States mail delivery or caused by any other occurrence. Responses received after the solicitation closing date and time will be returned unopened. and will not be considered for award. E. Late responses will be rejected. F. all responses are subject to the conditions specified herein. Those which do not comply with these conditions are subject to rejection. G. :Modification of responses already submitted will be considered only if received at the City before the time and date set for closin2 of solicitation responses. All modifications must be submitted via the Oracle System or in writing. Once a solicitation closes (closed date and or time expires), the City will not consider any subsequent submission which alters the responses. H. If hardcopy responses are submitted at the same time for different solicitations, each response must be placed in a separate envelope. box. or package and each envelope, box or package must contain the information previously stated in 1.82„A. 1.79. TAXES - The City- of Miami is exempt from any taxes imposed by the State and. or Federal Government. Exemption certificates will be provided upon request. Notwithstanding. Bidders.Proposers should be aware of the fact that all materials and supplies which are purchased by the Bidder Proposer for the completion of the contract is subject to the Florida State Sales Tax in accordance with Section 212.08, Florida Statutes, as amended and all amendments thereto and shall be paid solely by the Bidder Proposer. 1.80. TERIIIN.-#,ION —The City Manager on behalf of the City of yliami reserves the right to terminate this contract by written notice to the contractor effective the date specified in the notice should any of the following. apply: A. The contractor is determined by the City to be in breach of any of the terms and conditions of the contract. B. The City has determined that such termination will be in the best interest of the City to terminate the contract for Page 24 of -0 8/20/2024 9:24 AM p. 170 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384,7 its own convenience; C. Funds are not available to cover the cost of the goods and. or services. The Cir 's obligation is contingent upon the availability of appropriate funds. 1.81. TERMS OF PAYMENT - Payment will be made by the City- after the goods and. or services awarded to a Bidder Proposer have been received, inspected. and found to comply with award specifications. free of damage or defect, and properly invoiced. No advance payments of any kind will be made by the City of Miami. Payment shall be made after delivery. within 45 days of receipt of an invoice and authorized inspection and acceptance of the goods services and pursuant to Section 21.8,74, Florida Statutes and other applicable law. 1.82. TINIELY DELIVERY - Time will be of the essence for any orders placed as a result of this solicitation. The Citv reserves the right to cancel such orders, or any part thereof, without obligation. if delivery is not made within the times) specified on their Response. Deliveries are to be made during regular City business hours unless otherwise specified in the Special Conditions. 1.83. TITLE - Title to the goods or equipment shall not pass to the City until after the City has accepted the goods. equipment or used the goods, whichever comes first. I.84.TRADE SECRETS EXECUTION TO PUBLIC RECORDS DISCLOSURE- All Responses submitted to the City are subject to public disclosure pursuant to Chapter 1 19, Florida Statutes. An exception may be made for "trade secrets." It the Response contains information that constitutes a "trade secret', all material that qualifies for exemption from Chapter 119 nmust be submitted in a separate envelope, clearly identified as "TRADE SECRETS EXCEPTION," with your firm's name and the Solicitation number and title marked on the outside. Please be aware that the designation of an item as a trade secret by you may be challenged in court by any person. By your designation of material in your Response as a "trade secret" you agree to indemnify and hold harmless the City for any award to a plaintiff for damages, costs or attorney's fees and for costs and attomey's. fees incurred by the City by reason of any legal action challenging your claim. 1.85. UNAUTHORIZED WORK OR DELIVERY OF GOODS- Neither the qualified Bidder(s) Proposers) nor any of his -her employees shall perform any work or deliver any goods unless a change order or purchase order is issued and received by the Contractor. The qualified Bidders) Proposer(s) shall not be paid for any work performed or goods delivered outside the scope of the contract or any work performed by an employee not otherwise previously authorized. 1.86. USE OF NA-\IE - The City is not engaged in research for advertising, sales promotion, or other publicity put -poses. No advertising, sales promotion or other publicity materials containing information obtained from this Solicitation are to be mentioned, or imply the name of the City, without prior express written permission of the City Manager or the City Commission. 1.87. VARIATIONS OF SPECIFICATIONS - For purposes of solicitation evaluation, bidders.`proposers must indicate any variances from time solicitation specifications and. or conditions, no matter how slight. If variations are not stated on their Response, it will be assumed that the product fully complies with the City's specifications. Page 25 of 40 8/20/2024 9:24 AM p. 171 City of Miami Solicitation RFP 1896386 Request for Proposals 'REP) 678384,7 2. Special Conditions 2.1. PURPOSE The purpose of this Solicitation is to establish a contract. for Employee Benefits Consulting Services. as specified herein. from a source's). Cully compliant with the terms. conditions and stipulations of the solicitation. 2.2. VOLUNTARY PRE -PROPOSAL CONFERENCE Potential Proposers are encouraged to attend the (Voluntary) Pre -Proposal Conference. which will occur on Thursday. Febnrary 16, 2017 at 10:00 AM, at -l-l-1 SW 2nd Avenue, 6th Floor South Conference Room. A discussion of the requirements of the solicitation will occur at that time. The purpose of the pre -proposal conference is to allow potential Proposers an oppomrnity to present questions to staff and obtain clarification of the requirements of the solicitation documents. Each potential Proposer is required, prior to submitting a Proposal, to acquaint itself thoroughly with any and all conditions and or requirements that may in any manner affect the work to be perforated. No allowances will be made because of lack of knowledge of these conditions. 2.3. DEADLINE FOR RECEIPT OF REQUEST FOR ADDITIONAL. INFORMATION/CLARIFICATION Any questions or clarifications concerning. this solicitation shall be submitted by email or facsimile to the Procurement Department, Attn: Charles F. Johnson: fax: (305) 41)0-5373 or email: CJohnson miamigov.com. and a copy filed with the Office of the City Clerk. pursuant to Section 1.20. Cone of Silence. The solicitation title and number shall be referenced on all correspondence. All questions must be received no later than Thursday, March 2, 2017 at 5:00 PM. All responses to questions will be sent to all prospective bidders proposers in the form of an addendum. NO QUESTIONS GVILL BE RECEIVED VERBALLY OR AFTER SAID DEADLINE. 2.4. TERM OF CONTRACT The Proposer's) qualified to provide the sel-vicels) requested herein (the "Successful Proposer( sr) shall be required to execute a contract ("Contract-) with the City, which shall include, but not he limited to. the following, terms: (11 The term of the Contract(s) shall be for three (3 } years with an option to renew for two (2) additional one (1) year periods. (2) The City shall have the option to extend or terminate the Contract. Continuation of -the contract beyond the initial period is a City prerogative: not a right of the Proposer. This prerogative will be exercised only when such continuation is clearly in the best interest of the City. 2.5. CONDITIONS FOR RENEWAL Each renewal of this contract is subject to the following: (1) Continued satisfactory performance compliance with the specifications, temts and conditions established herein. Page 26 of40 8/20/2024 9:24 AM p. 172 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384.7 (2) Availability of funds 2.6. LIVING WAGE ORDINANCE The City of Miami adopted a Living. Wage Ordinance for City Service Contracts with a total contract value exceeding, S100,000 annually, and that have been competitively solicited and awarded on, or after January 1, 2017 by the City. "Service Contract" means a contract to provide services to the City, excluding, however, professional services as defined by the "Consultants Competitive ,Negotiation Act" set forth in F.S. § 287.055. and Section 18-87 of the City Code, and or the other exclusions provided by Section 18-557 of the City Code. Section 18-557 is attached as Attachment .A. Please see provisions in Attachment A. [t a solicitation requires services, effective on January 1. 2017, contractors must pay to all its employees, who provide services. a living wage Dino less than S 15.00 per hour without health benefits; or a wage of no less than S 13.19 an hour, with health benefits. This language is only a summary of the key provisions of the City- of Miami Living Wage Ordinance. Please review Attachment A. attached hereto. fora complete and thorough description of the City of \liarni LivingWaage Ordinance. 2.7. PROPOSER'S \IINI]IU\I QUALIFICATIONS 1. Proposers shall possess a minimum of ten (10) years of continuous experience providing health benefit consulting and similar services, for public sector groups of 3,000 employees or greater. 2. Proposer's Lead Managing Consultant, shall possess a minimum of seven (7) years of experience in progressively responsible administrative oversight of public sector benefits, and the application of State of Florida regulations. Proposer's personnel performing these services shall possess knowledge of Florida lave as it pertains to employee benefits for political subdivisions of the State. Additionally. Proposer shall: 3. Not be in arrears or in default of any debt or contract involving the City, (as a party to a contract or otherwise): nor have failed to perform faithfully on any previous contract with the City. 4. Have no record of pending lawsuits. bankruptcies, or criminal activities and not have any conflicts of interest as defined by applicable law with the City. 2.S. EXECUTION OF AN AGREEMENT The SuccesshiI Proposer(s), evaluated and ranked in accordance with the requirements of this Solicitation. shall be awarded an opportunity to negotiate a Professional Services Agreement (Agreement) with the City. The City reserves the right to execute or not execute as applicable, an Agreement with the Successful Proposer(s), in substantially the same form as the draft Agreement included as a part of this Solicitation. Such Agreement will be furnished by the City, will contain certain terns as are in the City's best interests, and will be subject to approval as to legal form by the City Attorney. 2.9. NON -APPROPRIATION OF FUNDS Page 27 of 40 8/20/2024 9:24 AM p. 173 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 6TS3,ti4.7 In the event no funds or insufficient funds are appropriated and budgeted or are otherwise unavailable in any fiscal period for payments due under this contract, then the City, upon written notice to the Successful Proposer(s) or his assignee of such occurrence, shall have the unqualified right to terminate the contract without any penalty or expense to the City. No guarantee. warranty or representation is made that any project(s) will be awarded to any firm(s). 2.10. INSURANCE REQL'IREME`TS INDFylNIFICATION Successful Proposer shall indemnify. hold save harmless. and defend at its own costs and expense. the City, its officials and employees from and against any and all claims. liabilities, losses, and causes of action, which may arise out of Proposer's performance under the provisions of the Contract, including all acts or omissions to act on the part of bidder. including any person performing under this Contract for or on Proposer's behalf, provided that any such claims, liabilities, losses and causes of such action are not attributable to the negligence or misconduct of the City and, from and against any orders, judgments or decrees which may be entered and which may result from this Contract, unless attributable to the negligence or misconduct of the City-, and from and against all costs. attorneys' fees, expenses and liabilities inclined in the defense of any such claim, or the investigation thereof. The Successful Proposer shall furnish to City of Miami.. c'o Procurement Department, 444 SW 2nd Avenue. 6th Floor, Miami, Florida 33130, Certificate(s) of Insurance which indicate that insurance coverage has been obtained which meets the requirements as outlined below: (1) (2) (3) Worker's Compensation A. Limits of Liability - Statutory - State of Florida Commercial General Liability (Primary and Non -Contributory): A. Limits of Liability Bodily Injury and Property Damage Liability - Each Occurrence: S 1.000.000 General Aggregate Limit: S2,000,000 Personal and Adv. Injury. Products and Completed Operations and Fire Damage: 51.000.000. B. Endorsements Required: City- of -Miami listed included as an additional insured. Contingent and Contractual Liability. Premises and Operations Liability. Primary Insurance Clause BusinessAutorobile Liability A. Limits of Liability Bodily injury and property damage liability combined single limit. Any Auto, including hired, borro\ved or owned, or non -owned autos used in connection with the work - Any One Accident S 1.000.000 B. Endorsements Required: City at -Miami included as an Additional Insured (-1) Employer's Liability - A. Limits of Liability S 100,000 for bodily injury caused by an accident, each accident S 100,000 for bodily injury caused by disease, each employee $500,000 for bodily injury- caused by disease, policy limit Page 28 of 40 8/20/2024 9:24 AM p. 174 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 67838-1,7 (5) Professional Liability/Errors and Omissions Coverage Combined Single Limit Each Claim S2,000,000 General Aggregate Limit S2.000,000 Retro Date Included BINDERS ARE UNACCEPTABLE. The insurance coverage required shall include those classifications, as listed in standard liability insurance manuals. which most nearly reflect the operations of the Proposer, All insurance policies required above shall be issued by companies authorized to do business under the laws of the State of Florida, with the following qualifications: The Company must be rated no less than "A-" as to management, and no less than -'Class V' as to financial strength, by the latest edition of Best's Insurance Guide, published by A.I. Best Company, Oldwick, New Jersey. or its equivalent. Alt policies and. or certificates of insurance are subject to review and verification by Risk Management prior to insurance approval. The above policies shall provide the City of Miami with written notice of cancellation or material change from the insurer not less than (30) days prior to any such cancellation or material change, on in accordance to policy provisions. NOTE: CITY RFP NUyIBER AND OR TITLE OF RFP MUST APPEAR ON EACH CERTIFICATE, Compliance with the foregoing requirements shall not relieve the Proposer of his liability and obligation under this section or under any other section of this Agreement. --If insurance certificates are scheduled to expire during the contractual period. the Proposer shall be responsible for submitting new or renewed insurance certificates to the City at a minimum of ten (10) calendar days in advance of such expiration. --In the event that expired certificates are not replaced with new or renewed certificates which cover the contractual period, the City shall: (4) Suspend the contract until such time as the new or renewed certificates are received by the City_ in the manner prescribed in the RFP. (5) The City may. at its sole discretion, terminate this Contract for cause and seek re -procurement damages from the Bidder in conjunction with the General and Special Terms and Conditions of the RFP. The Proposer shall be responsible for assuring that the insurance certificates required in conjunction with this Section remain in force for the duration of the contractual period. including any and all option terms that may be granted to the Proposer. 2.11. CONTRACT ADMINISTRATOR Upon award, Successful Bidder "Proposer shall report and work directly with the Director, Risk Management. or designee, who shall be designated as the Contract Administrator(s) for the City. 2,12. SUBCONTRACTOR(S) OR SC'BCONSULTANT(S) Page 29 of 40 8/20/2024 9:24 AM p. 175 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384,7 A Sub -Consultant, herein known as Sub-Contractor(s) is an individual or firm contracted by the Proposer or Proposer's firm to assist in the performance of services required under this Solicitation. A Sub -Contractor shall be paid through Proposer or Proposer's brut and not paid directly by the City. Sub -Contractors are allowed by the City in the performance of the services delineated within this Solicitation. Proposer must clearly reflect in its Proposal the major Sub -Contractors to be utilized in the performance of required services. The City retains the right to accept or reject any Sub -Contractors proposed in the response of Successful Proposer or prior to contract execution. Any and all liabilities regarding the use of a Sub -Contractor shall be borne solely by the Successful Proposer and insurance for each Sub -Contractors must be maintained in good standing and approved by the City throughout the duration of the Contract. Neither Successful Proposer nor any of its Sub -Contractors are considered to be employees or agents of the City. Failure to list all Sub --Contractors and provide the required information may disqualify any proposed Sub -Contractors from performing work under this Solicitation. Proposers shall include in their Responses the requested Sub -Contractor information and include all relevant information required of the Proposer. In addition, within five (5) working days after the identification of the award to the Successful Proposer, the Successful Proposer shall provide a list confirming the Sub -Contractors that the Successful Proposer intends to utilize. in the Contract. if applicable. The list shall include. at a minimum. the name. location of the place of business for each Sub -Contractor, the services Sub -Contractor will provide relative to any contract that may result from this Solicitation. any applicable licenses, references, ownership, and other information required of Proposer. 2.13. WORK ASSIGNMENTS Any specific service assignments during the contract period will be on an "as -needed" basis, compkir r with notification requirements. The City offers no guarantee as to the number or frequency of work assignments, or the amount of payments under the terms of this Agreement. Any specific service assignment which commences prior to the termination date of the contract and which will extend beyond the termination date shall, unless terminated by muntal agreement by both parties, continue until completion at the same rates, terms and conditions set forth. 2.14. ADDITIONAL SERVICES Services not specifically identified in this Solicitation, may be added to any resultant contract upon successful negotiation and mutual consent of the contracting parties. 2.15. FAILURE TO PERFORM Should it not be possible to reach the Successful Proposer and. or should remedial action not be taken within 43 hours of any failure to perform according to specifications, the City reserves the right to declare Successful Proposer in default of the contract. 2.I6. TERMINATION A. FOR DEFAULT Page .ill of 40 8/20/2024 9:24 AM p. 176 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 6:8384,7 [f Successful Proposer defaults in its performance under this Contract and does not cure the default within 30 days after written notice of default. the City Manager may terminate this Contract, in whole or in part, upon written notice without penalty to the City of Miami. In such event the Successful Proposer shall be liable for damages including the excess cost of procuring similar services: provided that if. (1) it is determined for any reason that the Successful Proposer was not in default or (2) the Successful Proposer's failure to perform is without his or his Subcontractor's control, fault or negligence, the termination will be deemed to be a termination for the convenience of the City of Miami. B. FOR CONVENIENCE The City- Manager may terminate this Contract, in whole or in part, upon 30 days prior written notice when it is in the best interest of the City of Miami. To the extent that this Contract is for services and so terminated. the City of Miami shall be liable only for payment in accordance with the payment provisions of -the Contract for those services rendered prior to termination. 2.17. PRIMARY CLIENT (FIRST PRIORITY) The Successful Proposer agrees upon award of this Contract, that the City of Miami shall be its primary client, and shall provide services first during a schedule conflict arising between this Contract, and any other contract. Successful Proposer may have with other cities and or counties, to perform similar services as a result of any catastrophic events such as tornadoes, hurricanes, severe storms or any other public emergency impacting various areas during. or approximately the same time. 2.18. I NACTHORIZED WORK The Successful Proposerls) shall not begin work until a Purchase Order, and or a Notice to Proceed are received. 2.19. CHANGES/ALTERATIONS Proposer may change or withdraw a Proposal at anv time prior to Proposal submission deadline: however, no oral modifications will be allowed. Written modifications shall not be allowed following the proposal deadline. 2.20. METHOD OF PAYMENT Payment will be made upon receipt and acceptance of invoices. No partial payments will be made. 2.21. COMPENSATION Each Proposer shall detail any and all fees and costs to provide the required services as detailed in Section 3, Scope of Services herein. on Form B. Price Proposal Schedule. The City reserves the right to add or delete any service, at anv time. Should the City determine to add an additional service, for which pricing was not previously secured, the City- will ask the Successful Proposer to provide reasonable cost(s) for same. Should the City determine the pricing to be unreasonable, the City reserves the right to negotiate costs(s), to seek another vendor for the provision of said service(s). Failure to submit compensation proposal, as required, may disqualify Proposer from consideration. Page 31 of40 8/20/2024 9:24 AM p. 177 City of Miami Solicitation RFP 1896386 Request for Proposals (RFPJ 6783S4,7 2.22. EV.AL[ATIONISELECTION PROCESS AND CONTRACT AWARD The procedure for response evaluation, selection and award is as follows: (1) Solicitation issued; (2) Receipt of responses; (3) Opening and listing. of all responses received; (4) Procurement staff will review- each submission for compliance with the submission requirements of the solicitation. including verifying that each submission includes all documents required: 15.) An Evaluation Committee ("Committee"). appointed by the City Manager. comprised of appropriate City Staff and members of the community, as deemed necessary, with the appropriate technical expertise and or knowledge, shall meet to evaluate each response in accordance with the requirements of this solicitation and based upon the evaluation criteria as specified herein; (6) The Committee reserves the right. in its sole discretion, to request Proposers to make oral presentations before the Committee as part of the evaluation process. The presentation may be scheduled at the convenience of the Committee and shall be recorded; (7) The Committee reserves the right to rank the proposals and shall make its recommendation to the City Manager requesting the authorization to negotiate. No Proposer(s) shall have any rights against the City- arising from such negotiations thereof; (S) The City Manager reserves the right to reject the Committee's recommendation to negotiate, and instntct the Committee to re-evaluate and make another recommendation, or reject all proposals. No Proposer(s) shall have any rights against the City arising from such termination thereof; (9) If the City Manager accepts the Committee's recommendation to negotiate. Procurement will negotiate a final contract with the Successlirl Proposer, and submit a recommendation to award a contract (s) to the City Manager; (10) The City Manager shall then submit his or her award recommendation and negotiated contract (s) to the City Commission for approval. Written notice shall be provided to all proposers. (1 1) If the City Manager accepts the award recommendation, the City Manager's recommendation for award of contract will be posted on the City of yliami Procurement Department website, in the Supplier Corner, Current Solicitations and Notice of Recommendation of Award Section. The notice of the City Manager's recommendation can be found by selecting the details of the solicitation and is listed as Recommendation of Award Posting Date and Reconunendation of "Award To" fields. If "various" is indicated in the Recommendation of "Award To" field. the Proposer must contact the Contracting Officer for that solicitation to obtain the suppliers names. (12) After reviewing the City Manager's recommendation. the City Commission may: 1. Approve the City Manager's award recommendation and negotiated contract(s); 2. Reject all proposals; 3. Reject all proposals and instruct the City Manager to reissue a solicitation or; 4. Reject ail proposals and instruct the City Manager to enter into competitive negotiations with at least three (3) individuals or firms possessing the ability to perform such services and obtain information from said individuals or firms relating to experience, qualifications and the proposed cost or fee for said services, and make a recommendation to the City Commission. The decision of the City Commission shall be final. Written notice of the award shall be given to the Successful Proposer. 2.23. RECORDS Page 32 of 40 8/20/2024 9:24 AM p. 178 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384.7 During- the contract period. and for a least five (5) subsequent years thereafter. Successful Proposer shall provide City access to all tiles and records maintained on the City's behalf. 2.24. TRLTFI IN NEGOTIATION CERTIFICATE Execution of the resulting- agreement by the Successful Proposer shalt act as the execution of truth -in -negotiation certificate stating that wage rates and other factual unit costs supporting- the compensation of the resulting Agreement are accurate, complete. and current at the time of contracting. The original contract price and any additions thereto shall be adjusted to exclude any significant sums by which City determines the contract price was increased due to inaccurate, incomplete, or non -current wage rates and other factual unit costs. Ali such contract adjustments shall be made within one ( I) year following the end of the Agreement. 2.25. ADDITIONAL TERMS AND CONDITIONS No additional terms and conditions included as part of your solicitation response shall be evaluated or considered. and any and alI such additional terms and conditions shall have no force or effect and are inapplicable to this Solicitation. If submitted either purposely, through intent or design, or inadvertently. appearing separately in transmittal letters. specifications. literature. price lists or warranties, it is understood and agreed that the General Conditions and Special Conditions in this Solicitation are the only conditions applicable to this Solicitation and that the Proposer's authorized signature affixed to the Proposer's acknowledgment form attests to this. If a Professional Services Agreement (PSG.) or other Agreement is provided by the City and is expressly included as part of this Solicitation, no additional terns or conditions wvhich materially or substantially yarn. modify or alter the terms or conditions of the PSA or Agreement. in the sole opinion and reasonable discretion of the City will be considered. Any and all such additional terms and conditions shall have no force or effect and are inapplicable to this PSA or Agreement. Page 33 of 40 8/20/2024 9:24 AM p. 179 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678334,7 3. Specifications 3.1. SPECIFICATIONS/SCOPE OF WORK Backgrounc[ The Ciro o f Miami. ("City"), is contracting for the provision of a broad range of benefits consulting services in support of the City's Employee Benefits Program. The City's Employee Benefits program. administered by the Group Benefits Division of the City's Risk Management Department. provides a wide array- of benefits to eligible employees. retirees, Consolidated Omnibus Budget Reconciliation ('COBRA") participants, and eligible dependents, Benefit plans include group medical. dental, vision. term life, supplemental lice, disability. pension benefits. Internal Revenue Service (''IRS-) Section 12.5 flexible spending accounts, and Sections 457(b) and 401(a) tax -deferred retirement plans. A. General Requirements and Services to be Provided The Successful Proposer's responsibilities shall include. but are not limited to: I, Self -Funded Plan Performance Monitoring and Auditing The Successful Proposer Shall: a) Monitor the performance cf. and compliance with, all established contractual requirements of the self -funded medical plan. b) Secure statistical reports, ete„ directly from the third -party administrator's depository to evaluate and ensure compliance with contracted performance standard levels. Successful Proposer shall ascertain whether or not financial penalties for performance non-compliance have been properly recorded, and liquidated damages assessed against third -party administrator. c) Conduct semi-annual onsite claims audit of self -funded plans at administrator's facility, as deemed necessary by the City, to include review and compliance with contractually -established: i Performance Standards ii Payment Accuracy of Claims iii Coding Accuracy of Claims iv Claims turnaround time c Plan provisions accuracy Any errors identified by Successful Proposer, must be properly classified as financial or non -financial, and presented in a written findings report semi-annually, or upon completion of the audit, to the Contract Administrator. d) Conduct a semi-annual audit of the Pharmacy Benefits Management Program ("PBM-) Agreement, for the review and compliance of all fomiulary- rebates, to determine if the City receives guaranteed rebate amounts, in accordance with contractual obligations. e) Request directly from the City's Third -Party Administrator, the Quarterly Rebate and Annual Reconciliation Report, for the purpose of its review and subsequent briefing of the Contract Administrator on findings and conclusions. 2. Strategic Review of Benefit Plan Designs The Successful Proposer shalt: a) Analyze current City plan designs and recommend changes as necessary, based upon market analysis, legislation. Page 34 of 40 8/20/2024 9:24 AM p. 180 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384,7 and availability, to better meet the City's Employee Benefits Program's service objectives. and to provide opportunities for cost containment. b) Assist in the preparation of and participate in, the meetings held between labor bargaining units and the City to discuss benefit contract issues. such as cost estimates for new or upgraded downgraded benefit programs and methodology for rate calculations: facilitate discussions between the two parties — addressing emerging trends, critical success factors, and the potential impact to the City: be available to conduct educational workshops presentations on key legislation affecting employee benefits for the benefit of City Risk Management employees, union officials, fiduciary administrators and other service providers. c} Provide technical support, as deemed necessary, to the City Employee Benefits Program, in identifying and incorporating best plan, and funding- designs, for all Group Benefits offered to City employees. d) Provide professional consulting support, and advice on the review of recommended plan amendments. and for other benefits -relayed matters. as necessary, to ensure compliance with federal and state legislation. e) Advise the City on short -tens and long-term direction of benefits plan design and funding, and advise of any significant variations that would warrant redesign. f) Advise the City in establishing strategic goals with respect to employee benefits and the Employee Wellness Management Program. for the purpose of improving the overall health of the employee population, while managing cost-effectiveness. g) Attend weekly wellness meetings: assist in procuring health and n-ellness vendors for City of Miami Group Benefits sponsored events, such as employee Health Fairs, educational seminars and. or similar events. 3. Federal. State and Local Legal Compliance, Research Services and Related Requirements The Successful Proposer shall: al Provide research. advice, and interpretation of federal, state and local benefit regulations and legislation, upon the City's request. b) Provide professional consulting- support and advice on specific research, compliance -related issues. and other general matters. as deemed necessary by the City. c) Provide timely updates of proposed and effectuated changes in the legal environment that affect employee benefits (i.e., Employee Retirement Income Security Act ("ERISA"), Patient Protection Affordable Care Act ("PPACA"). COBRA, [Iealth Insurance Portability and Accountability Act ("HIPAA") and [RS Sections 123, 457(b). -101(a). etc.), including and tax law newsletters or special advisories released. d) Review plan design documents of self -funded medical and IRS Section 125 flexible benefits plans, and Sections -157ib). and 401(a) tax -deferred retirement plans, for compliance with applicable governingg laws. e) Obtain [RS private letter rulings for the City, as necessary and applicable, at the discretion of the City, in consultation with the Successful Proposer. f) Ensure compliance with all provisions requirements of the Patient Protection and Affordable Care Act. g) Provide necessary and supporting calculations for any benefits related to IRS payments r fees. 4. Development of Request for Proposals (RFP) / Request for Qualifications (RFQ) Proposal / Qualifications Review and Negotiations Successful Proposer shall: a) Provide assistance and technical expertise in reviewing competitive RFP's, RFQ's, including the establishment of appropriate performance standards. in development by the City. Page 35 of 10 8/20/2024 9:24 AM p. 181 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384,7 b) Assist in the formulation of technical responses to clarifications inquiries received from prospective proposers to be issued via addenda to an RFP, RFQ. c) Provide assistance in assessing qualifications and analyzing data provided in proposals received from prospective proposers. Successful Proposer may be required to participate as a technical expert non -voting member in the Evaluation. Selection Committee meetings as deemed necessary by the City, at its sole discretion. di Test the adequacy of proposed provider and pharmacy networks, analyze hospital. physical and pharmacy discounts. perform geographic -access match studies and conduct medical provider prescription disruption analyses. el Provide assistance to the City. as deemed necessary by the City, in assessing the rates and fees proposed by the Proposers — and in negotiation strategy for competitive rates, discounts and services for current and future projects. 5. Other Related Duties Successful Proposer shall: a) Provide ongoing support, review, and interpretation of plan provisions and IRS regulations for: 1) Section 125 flexible benefits plan; 2, IRS regulations for Sections 437(b) and 401la) tax -deferred retirement plans. Successful Proposer shall provide the City with key observations from the portfolio information. 13) Provide ongoing- support review and interpretation of plan provisions. c) Develop employee communications, including formulation of employee surveys. and focus groups, as deemed necessary- by the City. All findings and statistical analyses conducted shall be presented. in writing, to the Contract Administrator upon completion. d) Assist with retirement. investment, and annuity- placement consulting. for executive level management, as deemed necessary by the City. of Provide specialized actuarial studies for supplemental retirement benefits. f) Conduct Benefit Plan modeling. as requested by the City. gi \Vork collaboratively with other City consultants. and the Office of the City Attorney. hi .attend meetings with various providers under contract with the City, or with City staff not directly involved with the Employee Benefits Program, at the Contract Administrator's request. i) At the City's request, but not less than semi-annually, present to the City- for consideration, a list of three (3) to five (5 ) critical topics that are relevant to employee benefit programs and health welfare. The City will identify the topics that best align with its objectives. at the City's sole discretion. The Successful Proposer shall prepare an analysis that identifies observations and recommendations for the City to consider. j) Provide ad -hoc analysis and benefits related reporting to the City, as deemed necessary by the City. k) Provide other related consulting services, as identified by the City. B. i1 [eetings Successful Proposer shall be available for periodic meetings where deliverables will be addressed. Page 36 of 40 8/20/2024 9:24 AM p. 182 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384.7 4. Submission Requirements 4.1. SUBMISSION REQL"IREAIENTS Proposers shall carefully follow the format and instruction outlined below, observing format requirements where indicated. Proposals should contain the information itemized below and in the order indicated. This information should be provided for the Proposer and any sub -consultants to be utilized for the work contemplated by this Solicitation. Proposals submitted vs hich do not include the following items may be deemed non -responsive and may not be considered for contract award. :ILL RESPONSES WILL BE SUB\UITTED IN HARDCOPY FORMAT ONLY TO INCLUDE ONE ORIGIN.\L. ALONG WITH SEVEN (7) COPIES, IN ADDITION TO AN ELECTRONIC COPY (FLASH DRIVE). NO ON-LINE SUB\IITTALS %V1LL BE ACCEPTED. The responses to this solicitation shall be presented in the following format. Failure to do so may deem our Proposal non -responsive. A. Include the signed RFP Certification Statement. B. Include in detail, evidence that clearly demonstrates Proposer meets the minimum qualification requirements, pursuant to Section 2.7, Proposer's Minimum Qualifications I. Cover Paz:. The Cover Page should include the Proposer's name; Contact Person for the RFP' Firm's Liaison for the Contract: Primary Office Location: Local Business Address. if applicable; Business Phone and Fax Numbers, ifapplicable Email addresses; Title of RFP; RFP Number: Federal Employer Identification Number or Social Security Number. 2. Table of Contents The table of contents should outline. in sequential order, the major sections of the Proposal as listed below, including all other relevant documents requested for submission. All pages of the Proposal. including the enclosures, should be clearly and consecutively numbered and correspond to the table of contents. 3. E'ecutive Sttmmars A signed and dated summary of not more than two (2) pages containing Proposers overall Qualifications and Experience and Technical Qualifications. as contained in the submittal. Proposer shall include the name of the organization, business phone and contact person and a summary of the work to be performed. 4. Proposer's Experience / Oualificatinns / Past Performance 1) Describe the Proposer's organizational history and stnicture, past performance and state the number of years Proposer and. or firm has been in business providing a similar service(s). Provide number of employees and the primary markets served. 2) Provide a detailed list of five (5) comparable contracts (similar in scope of services to those requested herein) which the Proposer has either ongoing or completed within the past ten (10) years. The description should identify,- for each project: Client Page 37 of 40 8/20/2024 9:24 AM p. 183 City of Miami Solicitation RFP 1896386 Request for Proposals (RFP) 678384.7 ii. Description of work Total dollar value of the contract iv. Dates covering the term of the contract Client contact person and phone number vi. Statement of whether proposer is. -was the prime contractor or subcontractor. If Proposer was the subcontractor. name the prime, vii. Detail Proposer's responsibilities and the results of the project Specify whether or not the scheduled completion time for each project was met; if not niet. please provide an explanation. 3) Where possible, list and describe those projects performed for government clients or similar size private entities. (excluding any work performed for the City- of Miami) In the event that the Proposer has not performed five (5) comparable contracts within the past five (5) years. the Proposer should provide information that demonstrates its ability to perform the required services. 4) Provide information concerning any prior or pending litigation. either civil or criminal, involving a governmental agency or which may affect the performance of the services to be rendered herein, in which the Proposer, any of its employees is or has been involved within the last five years. 5) Provide a minimum of two (2) references on the letterhead of the client to whom serve ices ofa similar nature were provided. The City- reserves the right to contact any reference as part of tl.e qualification process. 6) Provide a copy of Proposer's current Business Tax ReceiptOccupational License 7) Describe any relevant industrv'subject matter expertise, including any experience in the requested services listed herein, and any unique or proprietary project methodologies relevant to the requested services. 8) Identify if Proposer has taken any exception to the terms of this solicitation. If so, indicate what alternative(s) is being offered and the cost implications of the exception(s). 5. Kev Personnel Performinn Services I. Provide an organizational chart showing the Proposers Lead Managing Consultant and all key personnel, including their titles, to be assigned to this project. All key personnel include all partners, managerss. seniors and other professional staff that will perform work and.or services in the project resulting from this solicitation. The chart must clearly identify the Proposers employees and any subcontractors or sub -consultants. This infomiation shall include the general functions to be performed by key individuals and the subcontractors or sub -consultants. 2. Describe the experience, qualifications and other vital information, including number of years of relevant experience on previous similar projects, of the Lead Managing Consultant and all key personnel, who will be assigned to this project. Page 38 of 40 8/20/2024 9:24 AM p. 184 City of Miami Solicitation RFP 1896386 Request for Proposals (RIP) 67834.7 3. Provide information or documentation to Proposer's qualifications and experience from which the City- of Miami can benefit under this contract. 4. Provide resumes. if available. with job descriptions and other detailed qualification information on the Lead Nlanagin = Consultant and all key personnel who will be assigned to this project. Note: After proposal submission, but prior to the award of any contract issued as a result of this Solicitation, the Proposer has a continuing obliu,ation to advise the City of any changes, intended or otherwise, to the Lead Managing Consultant and key personnel identified in its proposal. 6. Proposed .Approach to Providin,= the Services 1. Describe Proposer's approach to project organization and management. including the responsibilities of Proposer's Lead NIana iir,a Consultant and Proposer's key personnel, and keg personnel of subcontractor or sub -consultant. that will perform work in this project. 2. Provide Proposer's operational plan that clearly- indicates how the Proposer plans to provide the services requested in this Solicitation. The Proposer's aperation.al plan must detail how the Proposer intends to fully satisfy - the service requirements outlined within Item A, General Requirements and Services to be Provided. of Section 3.1, Specifications. Scope of Work. of this RFP. 3. Describe- in detail the manner in which Proposer will monitor the performance of the City'sself-funded medical plan. 4. Describe the methodology that will be used in order to audit the plan's compliance tvith all contractual regulatory requirements. 5. Describe how Proposer has applies the proposed project approach in comparable contracts to make recommendations to improve programs, and describe the net effect of those recommendations. 6. Provide a list of any additional services, not included in this Solicitation, that the Proposer can offer to the City. If Proposer is offering any additional, describe the services in detail. Note that services will he paid at the hourly rates provided on Form A, Price Proposal Schedule. The City has a right to negotiate said price. Note: The Evaluation Committee will use the infomtation provided in the proposal to determine the Proposer's understanding and ability to address the City's unique needs. Proposed Price: Proposer shall state its price for providing all services as stated within this Solicitation. Proposer shall submit pricing stated as a flat, fixed fee per year, which shall include all expenses necessary for the requested services. Proposer must use the Price Proposal Form. Page 39 of 40 8/20/2024 9:24 AM p. 185 City of Miami Solicitation RFP 1896386 5. Evaluation Criteria Request For Proposals (REP) 678384,7 S.I. EVALUATION CRITERIA Each proposal will be reviewed to determine whether or not it is responsive to the submission requirements outlined in this solicitation. A responsive proposal is one which follows the requirements of the solicitation, includes all required documentation, is submitted in the format outlined in this solicitation, is of timely submission. and has appropriate signatures as applicable. Failure to comply with these requirements may result in the proposals being - deemed non -responsive. Proposals will be evaluated by an Evaluation Selection Committee (Committee) which will evaluate and rank proposals on criteria listed below. The Committee will be comprised of appropriate City personnel and members of the community, as deemed necessary, with the appropriate experience and or knowledge. The criteria are itemized with their respective weights for a maximum of one hundred ( 100) points per Committee member, Below are the. criteria and weight. Technical Criteria and Points Proposer's relevant experience, qualifications, and past performance 35 points Relevant experience and qualifications of Lead Mlanavement Consultant and key personnel that will be assigned to the project. IO points Proposer's approach to providing the services requested in this solicitation and ability to meet schedules. 30 points Price Criteria and Points Proposer's proposed price. 25 points Page 40 of 40 8/20/2024 9:24 AM p. 186 City of Miami, Florida City of Miami Solicitation RFP 1896386 Contract No. RFP678384 Background EXHIBIT B SCOPE OF WORK The City of Miami, ("City"). has contracted with a Consultant for the provision of a broad range of benefits consulting services in support of the City's Employee Benefits Program (Program"). The City's Employee Benefits program, administered by the Group Benefits Division of the City's Risk Management Department ("Risk"), provides a wide array of benefits to eligible employees, retirees, Consolidated Omnibus Budget Reconciliation ("COBRA") participants, and eligible dependents. Benefit plans include group medical, dental, vision, teen life, supplemental life, disability. pension benefits, Internal Revenue Service ("IRS") Section 125 flexible spending accounts. A. General Requirements and Services to be Provided The Consultant's responsibilities shall include, but are not limited to: 1) Self -Funded Plan Performance Monitoring and Auditing The Consultant Shall: a) Monitor the performance of, ancl compliance with, all established contractual requirements of the self -funded medical plan. b) Secure statistical reports, etc., directly- from the Third -Party Administrator ("TPA")'s depository to evaluate and ensure compliance with contracted performance standard levels. Consultant shall ascertain whether or not financial penalties for performance non-compliance have been properly recorded, and liquidated damages assessed against TPA. c) Conduct semi-annual onsite claims audit of self -funded plans at administrator's facility, as deemed necessary by the City, to include review and compliance with contractually -established: i. Performance Standards ii. Payment Accuracy of Claims iii. Coding Accuracy of Claims iv. Claims turnaround time v. Plan provisions accuracy Any errors identified by Consultant, must be properly classified as financial or non -financial, and presented in a written findings report semi-annually, or upon completion of the audit, to the Contract Administrator. d) Conduct a semi-annual audit of the Pharmacy Benefits Management Program ("PBM") Agreement. for the review and compliance of all formulary rebates, to Y) Employee Benellz Consuliing Services R.ise1 6 15 2017 8/20/2024 9:24 AM p. 187 City of Miami, Florida City of Miami Solicitation RFP 1896386 Contract No. RFP678384 determine if the City receives guaranteed rebate amounts, in accordance with contractual obligations. e) Request directly from the City's TPA, the Quarterly Rebate and Annual Reconciliation Report, for the purpose of its review and subsequent briefing of the Contract Administrator on findings and conclusions. 2) Strategic Reviell of Benefit Plan Designs The Consultant shall: a) Analyze current City plan designs and recommend changes as necessary, based upon market analysis. legislation, and availability, to better meet the Program's service objectives, and to provide opportunities for cost containment. b) Assist in the preparation of, and participate in, the meetings held between labor bargaining units and the City to discuss benefit contract issues. such as cost estimates tbr new or upgraded. downgraded benefit programs and methodology for rate calculations; facilitate discussions between the two parties — addressing emerging trends, critical success factors, and the potential impact to the City; be available to conduct educational workshops 'presentations on key legislation affecting employee benefits for the benefit of Risk Employees, union officials. fiduciary administrators and other service providers. c) Provide technical support. as deemed necessary, to the Program, in identifying and incorporating best plan, and fiinding designs. for all group benefits offered to City employees. d) Provide professional consulting support, and advice on the review of recommended plan amendments, and for other benefits -related matters, as necessary, to ensure compliance with federal and state legislation. e) Advise the City on short-teran and long-term direction of benefits plan design and funding. and advice of any significant variations that would warrant redesign. t) Advise the City in establishing strategic goals with respect to employee benefits and the Employee Wellness Management Program, for the purpose of improving the overall health of the employee population, while managing cost-effectiveness. g) Attend weekly wellness meetings; assist in procuring health and wellness vendors for City Group Benefits sponsored events, such as employee Health Fairs, educational seminars and/or similar events. 3) Federal, State and Local Legal Compliance, Research Services and Related Requirements The Consultant shall: Frplo e Benetit Corbulting S r ices Re%.is«1h I52017 8/20/2024 9:24 AM p. 188 City of Miarrli, Florida City of Miami Solicitation RFP 1896386 Contract No. RFP678384 a) Provide research. advice. and interpretation of federal. state and local benefit regulations and legislation, upon the City's request. b) Provide professional consulting support and advice on specific research, compliance - related issues, and other general matters, as deemed necessary by the City. c) Provide timely updates of proposed and effectuated changes in the legal environment that affect employee benefits (i.e., Employee Retirement Income Security Act ("ERISA"), Patient Protection Affordable Care Act ("PPACA"), COBRA, Health Insurance Portability and Accountability Act ("HIPAA") and IRS Sections 123, etc,), including and tax law newsletters or special advisories released. d) Review plan designn documents of self -funded medical and IRS Section 125 flexible benefits plans for compliance with applicable governing laws. e) Obtain IRS private letter rulings for the City, as necessary and applicable, at the discretion of the City, in consultation with the Consultant. f) Ensure compliance with all provisions'requirements of the Patient Protection and Affordable Care Act. g) Provide necessary and supporting calculations for any benefits related to IRS payments / fees. 4) Development of Request for Proposals (RFP) / Request for Qualifications (RFQ) Proposal / Qualifications Review and Negotiations Consultant shall: a) Provide assistance and technical expertise in reviewing competitive RFP's'RFQ's, including the establishment of appropriate performance standards, in development by the City. b) Assist in the formulation of technical responses to clarifications inquiries received from prospective proposers to be issued via addenda to an RFP/REQ. c) Provide assistance in assessing qualifications and analyzing data provided in proposals received from prospective proposers. Consultant may be required to participate as a technical expert/non-voting member in the Evaluation'Selection Committee meetings as deemed necessary by the City, at its sole discretion. d) Test the adequacy of proposed provider and pharmacy- networks, analyze hospital, physical and pharmacy discounts, perform geographic -access match studies and conduct medical provider.'prescription disruption analyses. e) Provide assistance to the City, as deemed necessary by the City, in assessing the rates and fees proposed by the proposers — and in negotiation strategy for competitive rates, discounts and services for current and future projects. Empho�ee Benefit Cunsulling Services Rin ised 6 15 21)17 8/20/2024 9:24 AM p. 189 City of Miami, Florida City of Miami Solicitation RFP 1896386 Contract No. RFP678384 5) Other Related Duties Consultant shall: a) Provide ongoing support, review, and interpretation of plan provisions and IRS regulations for Section 125 flexible benefits plan. b) Provide ongoing support review and interpretation of plan provisions. c) Develop employee communications, including formulation of employee surveys, and focus groups. as deemed necessary by the City. All findings and statistical analyses conducted shall be presented, in writing, to the Contract Administrator upon completion. d) Conduct benefit plan modeling. as requested by the City. e) Work collaboratively with other City consultants, and the Office of the City Attorney. t) Attend meetings Nrvith various providers under contract with the City, or with City staff not directly involved with the Program, at the Contract Administrator's request. g) At the City's request, but not less than semi-annually, present to the City for consideration, a list of three (3) to five (5) critical topics that are relevant to employee benefit programs and health'welfare. The City will identify the topics that best align with its objectives, at the City's sole discretion. The Consultant shall prepare an analysis that identifies observations and recommendations for the City to consider. h) Provide ad -hoc analysis and benefits related reporting to the City. as deemed necessary by the City. i) Provide other related consulting services, as identified by the City. B. Meetings s Consultant shall be available for periodic meetings where deliverables will be addressed. 25 EnipI i}. 8enetit Consulting Sep, lees Revised b. I52017 8/20/2024 9:24 AM p. 190 Employee Benefit Consulting Services City of Miami Solicitation RFP 1896386 Contract No. RFP678384 EXHIBIT C PRICE SCHEDULE A. Employee Benefit Consulting Services The not -to -exceed price and estimated hours for providing all employee benefit consulting services as stated in the Scope of Services. The price includes all costs associated to provide these services. Term 1 2 3 Initial Term (Years 1-3) First 1-year OTR Period Second 1-year OTR Period Estimated Hours 3,288 1,096 1,096 Not -To -Exceed Price $510,000 $175,000 $175,000 Note: The City will pay the Consultant at the hourly rate indicated below for any work involved to complete the City's request if the work significantly exceeds the hours stated. Similarly, the fee shall be reduced if there is significantly less work than anticipated. B. Not -to -Exceed Hourly Rate for Additional Work Below is the not -to -exceed hourly rate for additional work not included within the Scope of Services. Breakdown of Not to Exceed Price Staff Position/ Classification USICG Lead Consultant Proposed Maximum Hourly Rates Initial Term Years 1 - 3 $250 $ OTR 1 Year 4 $250 $ OTR 1 Year 5 $250 Notes: 1) The not -to exceed price in Section A, and the hourly rates in Section B, shall remain firm and fixed for the term of the Contract, including any renewals or extensions thereof. 2) The hourly rates above include all costs to include normal administrative fees, such as telephone, mailing, faxes, duplication charges, overnight mail, and including all out of pocket expenses, such as travel incurred in connection with the services (refer to CH.112,061 of the Florida Statutes regarding travel expenses), per diem, and miscellaneous costs and fees, and is incorporated in this price schedule, as they will not be reimbursed separately by the City. 3) Notwithstanding the rates above, compensation to the Consultant shall be based on the miscellaneous work assigned. The City reserves the right to negotiate the final pricing on a project by project basis, at the City's sole discretion. 4) The City will pay the Consultant at the hourly rate indicated within Section B, for any work involved to complete the City's request for work that is not included within the Scope of Services. 8/20/2024 9:24 AM p. 191 City of Miami, Florida City of Miami Contract No. RFP678384 Solicitation RFP 1896386 EXHIBIT D INSURANCE REQUIREMENTS INSURANCE REQUIREMENTS -PROFESSIONAL SERVICES .AGREEMENT EEIPLOYEE BENEFIT CONSULTING SERVICES I. Commercial General Liability A. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence General Aggreg.*ate Limit Personal and Adv. Injure Products Complied Operations B. Endorsements Required City- of \liami listed as an additional insured Contingent and Contractual Liability Premises and Operations Liability Primary Insurance Clause II. Business Automobile Liability S 1.000,000 S2.000,000 S 1,000,000 S 1.000,000 A. Limits of Liability Bodily Injury and Property Damaae Liability Combined Single Limit Any Auto Including Hired, Borrowed or Non -Owned Autos Any One Accident S 1,000,000 B. Endorsements Required City of Miami listed as an additional insured III. Worker's Compensation Limits of Liability Statutory -State of Florida IV. Employer's Liability A. Limits of Liability S 100,000 for bodily injury caused by an accident, each accident S 100,000 for bodily injury caused by disease. each employee S500.000 for bodily injury caused by disease, policy limit 27 Empk ec Btnctii SM. ices R.\ i;c,d h-1 S 21; l ' 8/20/2024 9:24 AM p. 192 City of Miami, Florida City of Miami Solicitation RFP 1896386 Contract No. RFP678384 Professional Liability,/Errors and Omissions Coverage Combined Single Limit Each Claim General Aggregate Limit Retro Date Included S2.000.000 S2.000,000 The above policies shall provide the City of Miami with written notice of cancellation or material change from the insurer not less than (30) clays prior to any such cancellation or material change, on in accordance to policy provisions. Companies authorized to do business in the State of Florida, with the following qualifications, shall issue all insurance policies required above: The company must be rated no less than "A as to mana_rement. and no less than "Class ti`'' as to Financial Stren2Tth, by the latest edition ofBest's Insurance Guide, published by A.M. Best Conipan\. Oidwick. New Jersey, or its equivalent. all policies and or certificates of insurance are subject to review and terification by Risk ylana Yefnent prior to insurance approval. 28 Eniprr��� 8knctit C.•n;ulun_s S,2n,ices Rid 7 15 20 8/20/2024 9:24 AM p. 193 City of Miami, Florida City of Miami EXHIBIT E CORPORATE RESOLUTIONS AND EVIDENCE OF QUALIFICATION TO DO BUSINESS IN FLORIDA (To be provided upon document execution) 29 E>nrh B ncli[ Con.ui[in_ 5cIA i. R,:!‘ r .d h 15 2 )1' Solicitation RFP 1896386 Contract No. RFP678384 8/20/2024 9:24 AM p. 194 6/21/2017 Detail by Entity Name City of Miami Solicitation RFP 1896386 Dn,.er7-1art of 57)re i Dv 3'Cr ;f Crrmcrat:rs Detail by Entity Name Foreign Limited Liability Company USI INSURANCE SERVICES LLC Filing Information Document Number M07000006357 FEI/EfN Number 13-3771734 Date Filed 10/23/2007 State DE Status ACTIVE Last Event CORPORATE MERGER Event Date Filed 06/23/2008 Event Effective Date 06/30/2008 Principal Address 200 Summit Lake Drive, Suite 350 Valhalla, NY 10595 Changed: 04/20/2016 Mailing Address 200 Summit Lake Drive, Suite 350 Valhalla, NY 10595 Changed: 04/20/2016 Registered Agent Name & Address C T CORPORATION SYSTEM 1200 SOUTH PINE ISLAND ROAD PLANTATION, FL 33324 Authorized Person(s) Detail Name & Address Title MGR NEWBORN, ERNEST JII 555 PLEASANTVILLE ROAD, SUITE 160 BRIARCLIFF MANOR, NY 10510 Annual Reports Report Year Filed Date 21115 05/n6/2015 htt 2Q aQ a3diPYgInquiry/CorperationSearch/SearchResultfletail'inquirytype=EntityName&directionType=Initial&searchNameOrder=USIINSURANCES... P2195 6/21/2017 2016 04/20/2016 2017 01/12/2017 Detail by Entity Name City of Miami Solicitation RFP 1896386 Document Images in PD..= fcrTat View image in PD7 fcrmat 3 — P.EPORT 'few irnage in PDF 1=31 '71:13 PDF femrat evi iirac:9 View image in PDF 1;r-rat ' — REPORT View image. in P-,D.F Vfe,i irnai3e. in PE,' :f.7i--rat — • 2, %flew image in PL7,- Fcr-at — Yew image in PDF fcrmat 2008 A _ Vew irrace in PDF format \l",ew image in PDF fcrrat htWN/APIlligelhk4-gelrquiry:CorporationSearchiSearchResJtDelal"?inquirytype=EntityNarre&directionry pe= In Nal &sear 7.1-11\1Arn eOrder = U SIIN SU R AN IC ES R.2196 Solicitation RFP 1896386 AGREEMENT FOR PROPERTY AND CASUALTY INSURANCE BROKERAGE AND CONSULTING SERVICES THIS AGREEMENT, made this 22nd day of April 2022, is by and between the City of Fort Lauderdale, a Florida municipality, ("City"), whose address is 100 North Andrews Avenue, Fort Lauderdale, Florida 33301-1016, and Risk Management Associates, Inc, a Florida corporation d/b/a Public Risk Insurance Advisors, ("Contractor"), whose address is 300 North Beach Street, Daytona Beach, Florida 32114 Email: mmontgomery@bbpria.com; Phone: 386-239-7245 (collectively "Parties"). NOW THEREFORE, for and in consideration of the mutual promises and covenants set forth herein and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the City and the Contractor covenant and agree as follows: WITNESSETH: I. DOCUMENTS The following documents (collectively "Contract Documents") are hereby incorporated into and made part of this Agreement: (1) Request for Proposals No. 12536-525 — Property and Casualty Insurance Brokerage and Consulting Services, including any and all exhibits and addenda prepared by the City of Fort Lauderdale, ("RFP" or "Exhibit A"); (2) The Contractor's response to the RFP, dated July 7, 2021, ("Exhibit B"). All Contract Documents may also be collectively referred to as the "Documents." In the event of any conflict between or among the Documents or any ambiguity or missing specifications or instruction, the following priority is established: First, this Agreement dated April22, 2022, and any attachments; Second, Exhibit A; Third, Exhibit B. II. SCOPE The Contractor shall perform the work under the general direction of the City as set forth in the Contract Documents. Unless otherwise specified herein, the Contractor shall perform all work identified in this Agreement. The Parties agree that the scope of services is a description of Contractor's obligations and responsibilities, and is deemed to include preliminary considerations and prerequisites, and all labor, materials, equipment, and tasks which are such an inseparable part of the work described that exclusion would render performance by Contractor impractical, illogical, or unconscionable. Contractor acknowledges and agrees that the City's Contract Administrator has no authority to make changes that would increase, decrease, or otherwise modify the Scope of Services to be provided under this Agreement. Any change orders to the Scope of Services or amendments to the Contract Documents must be authorized by the City Manager, or his designee, and approved 8/20/2024 9:24 AM p. 197 City of Miami Solicitation RFP 1896386 by the City Commission whenever required in compliance with the Charter and Code of Ordinances for the City of Fort Lauderdale. By signing this Agreement, the Contractor represents that it has thoroughly reviewed the documents incorporated into this Agreement by reference and that it accepts the description of the work and the conditions under which the work is to be performed. III. TERM OF AGREEMENT The initial term of this Agreement shall commence on December 20, 2021, and shall end on December 19, 2022. The City reserves the right to extend this Agreement for four (4) additional one (1) year terms, provided all terms, conditions and specifications contained herein remain the same, and the extension is mutually agreed to in writing and signed by both Parties. This Agreement supersedes and rescinds ab initio the extensions dated December 9, 2021, and February 15, 2022, of the previous Agreement for Property & Casualty Insurance Brokerage & Consulting Services, Contract No. 12067-585, dated March 29, 2018, between the City and the Contractor, from December 20, 2021, through April 17, 2022. In the event the term of this Agreement extends beyond the end of any fiscal year of the City, to wit, September 30th, the continuation of this Agreement beyond the end of the City's fiscal year shall be subject to and conditioned upon both the appropriation and the availability of funds. IV. COMPENSATION The Contractor agrees to provide the services and/or materials as specified in the Contract Documents at the cost specified in Exhibit B. It is acknowledged and agreed by Contractor that this amount is the maximum payable and constitutes a limitation upon City's obligation to compensate Contractor for Contractor's services related to this Agreement. This maximum amount, however, does not constitute a limitation of any sort upon Contractor's obligation to perform all items of work required by or which can be reasonably inferred from the Scope of Services. Except as otherwise provided in the solicitation, no amount shall be paid to Contractor to reimburse Contractor's expenses. V. METHOD OF BILLING AND PAYMENT The City will accept invoices no more frequently than once per month but also has the option to accept a lump sum invoice payment at the inception of each contract year. Each invoice shall fully detail the related costs and shall specify the status of the particular task or project as of the date of the invoice with regard to the accepted schedule for that task or project. Payment will be made within forty-five (45) days after the City's receipt of the Contractor's proper invoice, as provided in the Florida Local Government Prompt Payment Act, as may be amended from time to time. To be deemed proper, all invoices must comply with the requirements set forth in this Agreement and must be submitted on the form and pursuant to instructions prescribed by the City's Contract Administrator. Payment may be withheld for failure of Contractor to comply with a term, condition, or requirement of this Agreement. If, at any time during the contract, the City shall not approve or accept the Contractor's work product, and agreement cannot be reached between the City and the Contractor to resolve the problem to the City's satisfaction, the City shall negotiate with the Contractor on a payment for the work completed and usable to the City. If billed monthly, an original invoice plus one copy are due within fifteen (15) days of the end of the month except the final invoice which must be received no later than sixty (60) days after this Agreement expires. Invoices shall designate the nature of the services performed and/or the goods provided. 2 8/20/2024 9:24 AM p. 198 City of Miami Solicitation RFP 1896386 Notwithstanding any provision of this Agreement to the contrary, the City may withhold, in whole or in part, payment to the extent necessary to protect itself from loss on account of inadequate or defective work that has not been remedied or resolved in a manner satisfactory to the City's Contract Administrator or failure to comply with this Agreement. The amount withheld shall not be subject to payment of interest by City. VI. GENERAL CONDITIONS A. Indemnification Contractor shall protect and defend at Contractor's expense, counsel being subject to the City's approval, and indemnify and hold harmless the City and the City's officers, employees, volunteers, and agents from and against any and all losses, penalties, fines, damages, settlements, judgments, claims, costs, charges, expenses, or liabilities, including any award of attorney fees and any award of costs, in connection with or arising directly or indirectly out of any act or omission by the Contractor or by any officer, employee, agent, invitee, subcontractor, or sublicensee of the Contractor. The provisions and obligations of this section shall survive the expiration or earlier termination of this Agreement. To the extent considered necessary by the City Manager, any sums due Contractor under this Agreement may be retained by City until all of City's claims for indemnification pursuant to this Agreement have been settled or otherwise resolved, and any amount withheld shall not be subject to payment of interest by City. B. Intellectual Property Contractor shall protect and defend at Contractor's expense, counsel being subject to the City's approval, and indemnify and hold harmless the City from and against any and all losses, penalties, fines, damages, settlements, judgments, claims, costs, charges, royalties, expenses, or liabilities, including any award of attorney fees and any award of costs, in connection with or arising directly or indirectly out of any infringement or allegation of infringement of any patent, copyright, or other intellectual property right in connection with the Contractor's or the City's use of any copyrighted, patented or un-patented invention, process, article, material, or device that is manufactured, provided, or used pursuant to this Agreement. If the Contractor uses any design, device, or materials covered by letters, patent or copyright, it is mutually agreed and understood without exception that the bid prices shall include all royalties or costs arising from the use of such design, device, or materials in any way involved in the work. C. Termination for Cause The aggrieved party may terminate this Agreement for cause if the party in breach has not corrected the breach within ten (10) days after written notice from the aggrieved party identifying the breach. The City Manager may also terminate this Agreement upon such notice as the City Manager deems appropriate under the circumstances in the event the City Manager determines that termination is necessary to protect the public health or safety. The Parties agree that if the City erroneously, improperly, or unjustifiably terminates for cause, such termination shall be deemed a termination for convenience, which shall be effective thirty (30) days after such notice of termination for cause is provided. This Agreement may be terminated for cause for reasons including, but not limited to, Contractor's repeated (whether negligent or intentional) submission for payment of false or incorrect bills or invoices, failure to perform the work to the City's satisfaction; or 3 8/20/2024 9:24 AM p. 199 City of Miami Solicitation RFP 1896386 failure to continuously perform the work in a manner calculated to meet or accomplish the objectives as set forth in this Agreement. D. Termination for Convenience The City reserves the right, in its best interest as determined by the City, to cancel this Agreement for convenience by giving written notice to the Contractor at least thirty (30) days prior to the effective date of such cancellation. In the event this Agreement is terminated for convenience, Contractor shall be paid for any services performed to the City's satisfaction pursuant to the Agreement through the termination date specified in the written notice of termination. Contractor acknowledges and agrees that he/she/it has received good, valuable, and sufficient consideration from City, the receipt and adequacy of which are hereby acknowledged by Contractor, for City's right to terminate this Agreement for convenience. E. Cancellation for Unappropriated Funds The City reserves the right, in its best interest as determined by the City, to cancel this Agreement for unappropriated funds or unavailability of funds by giving written notice to the Contractor at least thirty (30) days prior to the effective date of such cancellation. The obligation of the City for payment to a Contractor is limited to the availability of funds appropriated in a current fiscal period, and continuation of the Agreement into a subsequent fiscal period is subject to appropriation of funds, unless otherwise provided by law. F. Insurance As a condition precedent to the effectiveness of this Agreement, during the term of this Agreement and during any renewal or extension term of this Agreement, the Contractor, at the Contractor's sole expense, shall provide insurance of such types and with such terms and limits as noted below. Providing proof of and maintaining adequate insurance coverage are material obligations of the Contractor. The Contractor shall provide the City a certificate of insurance evidencing such coverage. The Contractor's insurance coverage shall be primary insurance for all applicable policies. The limits of coverage under each policy maintained by the Contractor shall not be interpreted as limiting the Contractor's liability and obligations under this Agreement. All insurance policies shall be from insurers authorized to write insurance policies in the State of Florida and that possess an A.M. Best rating of A-, VII or better. All insurance policies are subject to approval by the City's Risk Manager. The coverages, limits, and endorsements required herein protect the interests of the City, and these coverages, limits, and endorsements may not be relied upon by the Contractor for assessing the extent or determining appropriate types and limits of coverage to protect the Contractor against any loss exposure, whether as a result of this Agreement or otherwise. The requirements contained herein, as well as the City's review or acknowledgement, are not intended to and shall not in any manner limit or qualify the liabilities and obligations assumed by the Contractor under this Agreement. The following insurance policies and coverages are required: Commercial General Liability Coverage must be afforded under a Commercial General Liability policy with limits not less than: 4 8/20/2024 9:24 AM p. 200 City of Miami Solicitation RFP 1896386 • $1,000,000 each occurrence and $2,000,000 aggregate for Bodily Injury, Property Damage, and Personal and Advertising Injury • $1,000,000 each occurrence and $2,000,000 aggregate for Products and Completed Operations Policy must include coverage for Contractual Liability and Independent Contractors. The City and the City's officers, employees, and volunteers are to be covered as additional insureds with a CG 20 26 04 13 Additional Insured — Designated Person or Organization Endorsement or similar endorsement providing equal or broader Additional Insured Coverage with respect to liability arising out of activities performed by or on behalf of the Contractor. The coverage shall contain no special limitation on the scope of protection afforded to the City or the City's officers, employees, and volunteers. Professional Liability and/or Errors and Omissions Coverage must be afforded for Wrongful Acts in an amount not less than $5,000,000 each claim and $5,000,000 aggregate. Business Automobile Liability Coverage must be afforded for all Owned, Hired, Scheduled, and Non -Owned vehicles for Bodily Injury and Property Damage in an amount not less than $1,000,000 combined single limit each accident. If the Contractor does not own vehicles, the Contractor shall maintain coverage for Hired and Non -Owned Auto Liability, which may be satisfied by way of endorsement to the Commercial General Liability policy or separate Business Auto Liability policy. Workers' Compensation and Employer's Liability Coverage must be afforded per Chapter 440, Florida Statutes. Any person or entity performing work for or on behalf of the City must provide Workers' Compensation insurance. Exceptions and exemptions will be allowed by the City's Risk Manager, if they are in accordance with Florida Statutes. The Contractor waives, and the Contractor shall ensure that the Contractor's insurance carrier waives, all subrogation rights against the City and the City's officers, employees, and volunteers for all losses or damages. The City requires the policy to be endorsed with WC 00 03 13 Waiver of our Right to Recover from Others or equivalent. The Contractor must be in compliance with all applicable State and federal workers' compensation laws, including the U.S. Longshore Harbor Workers' Act and the Jones Act, if applicable. Insurance Certificate Requirements a. The Contractor shall provide the City with valid Certificates of Insurance (binders are unacceptable) no later than thirty (30) days prior to the start of work contemplated in this Agreement. b. The Contractor shall provide to the City a Certificate of Insurance having a thirty (30) day notice of cancellation; ten (10) days' notice if cancellation is for nonpayment of premium. 5 8/20/2024 9:24 AM p. 201 City of Miami Solicitation RFP 1896386 c. In the event that the insurer is unable to accommodate the cancellation notice requirement, it shall be the responsibility of the Contractor to provide the proper notice. Such notification will be in writing by registered mail, return receipt requested, and addressed to the certificate holder. d. In the event the Agreement term goes beyond the expiration date of the insurance policy, the Contractor shall provide the City with an updated Certificate of Insurance no later than ten (10) days prior to the expiration of the insurance currently in effect. The City reserves the right to suspend the Agreement until this requirement is met. e. The Certificate of Insurance shall indicate whether coverage is provided under a claims -made or occurrence form. If any coverage is provided on a claims -made form, the Certificate of Insurance must show a retroactive date, which shall be the effective date of the initial Agreement or prior. f. The City shall be named as an Additional Insured on all liability policies, with the exception of Workers' Compensation. g. The City shall be granted a Waiver of Subrogation on the Contractor's Workers' Compensation insurance policy. h. The title of the Agreement, Bid/Contract number, event dates, or other identifying reference must be listed on the Certificate of Insurance. The Certificate Holder should read as follows: City of Fort Lauderdale 100 North Andrews Avenue Fort Lauderdale, FL 33301 The Contractor has the sole responsibility for the payment of all insurance premiums and shall be fully and solely responsible for any costs or expenses as a result of a coverage deductible, co-insurance penalty, or self -insured retention; including any loss not covered because of the operation of such deductible, co-insurance penalty, self -insured retention, or coverage exclusion or limitation. Any costs for adding the City as an Additional Insured shall be at the Contractor's expense. If the Contractor's primary insurance policy/policies do not meet the minimum requirements, as set forth in this Agreement, the Contractor may provide evidence of an Umbrella/Excess insurance policy to comply with this requirement. The Contractor's insurance coverage shall be primary insurance as applied to the City and the City's officers, employees, and volunteers. Any insurance or self-insurance maintained by the City covering the City, the City's officers, employees, or volunteers shall be non-contributory. Any exclusion or provision in the insurance maintained by the Contractor that excludes coverage for work contemplated in this Agreement shall be unacceptable and shall be considered breach of contract. All required insurance policies must be maintained until the contract work has been accepted by the City, or until this Agreement is terminated, whichever is later. Any lapse in coverage shall be considered breach of contract. In addition, Contractor must provide to the City confirmation of coverage renewal via an updated certificate should any policies expire prior to the expiration of this Agreement. The City reserves the right to review, at any time, coverage forms and limits of Contractor's insurance policies. 6 8/20/2024 9:24 AM p. 202 City of Miami Solicitation RFP 1896386 The Contractor shall provide notice of any and all claims, accidents, and any other occurrences associated with this Agreement shall be provided to the Contractor's insurance company or companies and the City's Risk Management office as soon as practical. It is the Contractor's responsibility to ensure that any and all of the Contractor's independent contractors and subcontractors comply with these insurance requirements. All coverages for independent contractors and subcontractors shall be subject to all of the applicable requirements stated herein. Any and all deficiencies are the responsibility of the Contractor. G. Environmental, Health and Safety Contractor shall place the highest priority on health and safety and shall maintain a safe working environment during performance of the Work. Contractor shall comply, and shall secure compliance by its employees, agents, and subcontractors, with all applicable environmental, health, safety and security laws and regulations, and performance conditions in this Agreement. Compliance with such requirements shall represent the minimum standard required of Contractor. Contractor shall be responsible for examining all requirements and determine whether additional or more stringent environmental, health, safety and security provisions are required for the Work. Contractor agrees to utilize protective devices as required by applicable laws, regulations, and any industry or Contractor's health and safety plans and regulations, and to pay the costs and expenses thereof, and warrants that all such persons shall be fit and qualified to carry out the Work. H. Standard of Care Contractor represents that it is qualified to perform the work, that Contractor and his/her/its subcontractors possess current, valid state and/or local licenses to perform the work, and that their services shall be performed in a mariner consistent with that level of care and skill ordinarily exercised by other qualified contractors under similar circumstances. I. Rights in Documents and Work Any and all reports, photographs, surveys, and other data and documents provided or created in connection with this Agreement are and shall remain the property of City; and Contractor disclaims any copyright in such materials. In the event of and upon termination of this Agreement, any reports, photographs, surveys, and other data and documents prepared by Contractor, whether finished or unfinished, shall become the property of City and shall be delivered by Contractor to the City's Contract Administrator within seven (7) days of termination of this Agreement by either Party. Any compensation due to Contractor shall be withheld until Contractor delivers all documents to the City as provided herein. J.Audit Right and Retention of Records City shall have the right to audit the books, records, and accounts of Contractor and Contractor's subcontractors that are related to this Agreement. Contractor shall keep, and Contractor shall cause Contractor's subcontractors to keep, such books, records, and accounts as may be necessary in order to record complete and correct entries related to this Agreement. All books, records, and accounts of Contractor and Contractor's subcontractors shall be kept in written form, or in a form capable of conversion into written form within a reasonable time, and upon request to do so, Contractor or 7 8/20/2024 9:24 AM p. 203 City of Miami Solicitation RFP 1896386 Contractor's subcontractor, as applicable, shall make same available at no cost to City in written form. Contractor and Contractor's subcontractors shall preserve and make available, at reasonable times for examination and audit by City in Broward County, Florida, all financial records, supporting documents, statistical records, and any other documents pertinent to this Agreement for the required retention period of the Florida public records law, Chapter 119, Florida Statutes, as may be amended from time to time, if applicable, or, if the Florida Public Records Act is not applicable, for a minimum period of three (3) years after termination of this Agreement. If any audit has been initiated and audit findings have not been resolved at the end of the retention period or three (3) years, whichever is longer, the books, records, and accounts shall be retained until resolution of the audit findings. If the Florida public records law is determined by City to be applicable to Contractor and Contractor's subcontractors' records, Contractor and Contractor's subcontractors shall comply with all requirements thereof; however, Contractor and Contractor's subcontractors shall violate no confidentiality or non -disclosure requirement of either federal or state law. Any incomplete or incorrect entry in such books, records, and accounts shall be a basis for City's disallowance and recovery of any payment upon such entry. Contractor shall, by written contract, require Contractor's subcontractors to agree to the requirements and obligations of this Section. The Contractor shall maintain during the term of the Agreement all books of account, reports and records in accordance with generally accepted accounting practices and standards for records directly related to this Agreement. K. Public Entity Crime Act Contractor represents that the execution of this Agreement will not violate the Public Entity Crime Act, Section 287.133, Florida Statutes, as may be amended from time to time, which essentially provides that a person or affiliate who is a contractor, consultant, or other provider and who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a bid on a contract to provide any goods or services to City, may not submit a bid on a contract with City for the construction or repair of a public building or public work, may not submit bids on leases of real property to City, may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under an Agreement with City, and may not transact any business with City in excess of the threshold amount provided in Section 287.017, Florida Statutes, as may be amended from time to time, for category two purchases for a period of 36 months from the date of being placed on the convicted vendor list. Violation of this section shall result in termination of this Agreement and recovery of all monies paid by City pursuant to this Agreement and may result in debarment from City's competitive procurement activities. 8 8/20/2024 9:24 AM p. 204 City of Miami Solicitation RFP 1896386 L. Independent Contractor Contractor is an independent contractor under this Agreement. Services provided by Contractor pursuant to this Agreement shall be subject to the supervision of the Contractor. In providing such services, neither Contractor nor Contractor's agents shall act as officers, employees, or agents of City. No partnership, joint venture, or other joint relationship is created hereby. City does not extend to Contractor or Contractor's agents any authority of any kind to bind City in any respect whatsoever. M. Inspection and Non -Waiver Contractor shall permit the representatives of CITY to inspect and observe the Work at all times. The failure of the City to insist upon strict performance of any other terms of this Agreement or to exercise any rights conferred by this Agreement shall not be construed by Contractor as a waiver of the City's right to assert or rely on any such terms or rights on any future occasion or as a waiver of any other terms or rights. N. Assignment and Performance Neither this Agreement nor any right or interest herein shall be assigned, transferred, or encumbered without the written consent of the other Party. In addition, Contractor shall not subcontract any portion of the work required by this Agreement, except as provided in the Schedule of Subcontractor Participation. City may terminate this Agreement, effective immediately, if there is any assignment, or attempted assignment, transfer, or encumbrance, by Contractor of this Agreement or any right or interest herein without City's prior written consent. Contractor represents that each person who will render services pursuant to this Agreement is duly qualified to perform such services by all appropriate governmental authorities, where required, and that each such person is reasonably experienced and skilled in the area(s) for which he or she will render his or her services. Contractor shall perform Contractor's duties, obligations, and services under this Agreement in a skillful and respectable manner. The quality of Contractor's performance and all interim and final product(s) provided to or on behalf of City shall be comparable to the best local and national standards. In the event Contractor engages any subcontractor in the performance of this Agreement, Contractor shall ensure that all of Contractor 's subcontractors perform in accordance with the terms and conditions of this Agreement. Contractor shall be fully responsible for all of Contractor's subcontractors' performance, and liable for any of Contractor's subcontractors' non-performance and all of Contractor's subcontractors' acts and omissions. Contractor shall defend at Contractor's expense, counsel being subject to City's approval or disapproval, and indemnify and hold City and City's officers, employees, and agents harmless from and against any claim, lawsuit, third party action, fine, penalty, settlement, or judgment, including any award of attorney fees and any award of costs, by or in favor of any of Contractor's subcontractors for payment for work performed for City by any of such subcontractors, and from and against any claim, lawsuit, third party action, fine, penalty, settlement, or judgment, including any award of attorney fees and any award of costs, occasioned by or arising out of any act or omission by any of Contractor 's subcontractors or by any of Contractor's subcontractors' officers, agents, or employees. Contractor's use of subcontractors in connection with this 9 8/20/2024 9:24 AM p. 205 City of Miami Solicitation RFP 1896386 Agreement shall be subject to City's prior written approval, which approval City may revoke at any time. O. Conflicts Neither Contractor nor any of Contractor's employees shall have or hold any continuing or frequently recurring employment or contractual relationship that is substantially antagonistic or incompatible with Contractor's loyal and conscientious exercise of judgment and care related to Contractor's performance under this Agreement. Contractor further agrees that none of Contractor's officers or employees shall, during the term of this Agreement, serve as an expert witness against City in any legal or administrative proceeding in which he, she, or Contractor is not a party, unless compelled by court process. Further, Contractor agrees that such persons shall not give sworn testimony or issue a report or writing, as an expression of his or her expert opinion, which is adverse or prejudicial to the interests of City in connection with any such pending or threatened legal or administrative proceeding unless compelled by court process. The limitations of this section shall not preclude Contractor or any persons in any way from representing themselves, including giving expert testimony in support thereof, in any action or in any administrative or legal proceeding. In the event Contractor is permitted pursuant to this Agreement to utilize subcontractors to perform any services required by this Agreement, Contractor agrees to require such subcontractors, by written contract, to comply with the provisions of this section to the same extent as Contractor. P. Schedule and Delays Time is of the essence in this Agreement. By signing, Contractor affirms that it believes the schedule to be reasonable; provided, however, the Parties acknowledge that the schedule might be modified as the City directs. Q. Materiality and Waiver of Breach City and Contractor agree that each requirement, duty, and obligation set forth herein was bargained for at arm's-length and is agreed to by the Parties in exchange for quid pro quo, that each is substantial and important to the formation of this Agreement and that each is, therefore, a material term hereof. City's failure to enforce any provision of this Agreement shall not be deemed a waiver of such provision or modification of this Agreement. A waiver of any breach of a provision of this Agreement shall not be deemed a waiver of any subsequent breach and shall not be construed to be a modification of the terms of this Agreement. R. Compliance With Laws Contractor shall comply with all applicable federal, state, and local laws, codes, ordinances, rules, and regulations in performing Contractor's duties, responsibilities, and obligations pursuant to this Agreement. S. Severance In the event a portion of this Agreement is found by a court of competent jurisdiction to be invalid or unenforceable, the provisions not having been found by a court of competent jurisdiction to be invalid or unenforceable shall continue to be effective. 10 8/20/2024 9:24 AM p. 206 City of Miami Solicitation RFP 1896386 T. Limitation of Liability The City desires to enter into this Agreement only if in so doing the City can place a limit on the City's liability for any cause of action for money damages due to an alleged breach by the City of this Agreement, so that its liability for any such breach never exceeds the sum of $1,000. Contractor hereby expresses its willingness to enter into this Agreement with Contractor's recovery from the City for any damage action for breach of contract or for any action or claim arising from this Agreement to be limited to a maximum amount of $1,000 less the amount of all funds actually paid by the City to Contractor pursuant to this Agreement. Accordingly, and notwithstanding any other term or condition of this Agreement, Contractor hereby agrees that the City shall not be liable to Contractor for damages in an amount in excess of $1,000 which amount shall be reduced by the amount actually paid by the City to Contractor pursuant to this Agreement, for any action for breach of contract or for any action or claim arising out of this Agreement. Nothing contained in this paragraph or elsewhere in this Agreement is in any way intended to be a waiver of the limitation placed upon City's liability as set forth in Section 768.28, Florida Statutes (2021), as may be amended or revised. U. Jurisdiction, Venue, Waiver, Waiver of Jury Trial This Agreement shall be governed by and construed in accordance with the laws of the State of Florida. Venue for any lawsuit by either party against the other party or otherwise arising out of this Agreement, and for any other legal proceeding, shall be in the Seventeenth Judicial Circuit in and for Broward County, Florida, or in the event of federal jurisdiction, in the Southern District of Florida. THE PARTIES EXPRESSLY WAIVE ANY AND ALL RIGHTS TO A TRIAL BY JURY OF ANY ISSUES SO TRIABLE UNDER THIS AGREEMENT. V. Amendments No modification, amendment, or alteration in the terms or conditions contained herein shall be effective unless contained in a written document prepared with the same or similar formality as this Agreement and executed by the City's Mayor and/or City Manager, as determined by City Charter and Ordinances, and Contractor or others delegated authority to or otherwise authorized to execute same on their behalf. W. Prior Agreements This document represents the final and complete understanding of the Parties and incorporates or supersedes all prior negotiations, correspondence, conversations, agreements, and understandings applicable to the matters contained herein. The Parties agree that there is no commitment, agreement, or understanding concerning the subject matter of this Agreement that is not contained in this written document. Accordingly, the Parties agree that no deviation from the terms hereof shall be predicated upon any prior representation or agreement, whether oral or written. X. Payable Interest Except as required and provided for by the Florida Local Government Prompt Payment Act, City shall not be liable for interest for any reason, whether as prejudgment interest or for any other purpose, and in furtherance thereof Contractor waives, rejects, disclaims and surrenders any and all entitlement it has or may have to receive interest in connection with a dispute or claim based on or related to this Agreement. 11 8/20/2024 9:24 AM p. 207 City of Miami Solicitation RFP 1896386 Y. Representation of Authority Each individual executing this Agreement on behalf of a party hereto hereby represents and warrants that he or she is, on the date he or she signs this Agreement, duly authorized by all necessary and appropriate action to execute this Agreement on behalf of such party and does so with full legal authority. Z. Uncontrollable Circumstances ("Force Majeure") The City and Contractor will be excused from the performance of their respective obligations under this Agreement when and to the extent that their performance is delayed or prevented by any circumstances beyond their control including, fire, flood, explosion, strikes or other labor disputes, act of God or public emergency, war, riot, civil commotion, malicious damage, act or omission of any governmental authority, delay or failure or shortage of any type of transportation, equipment, or service from a public utility needed for their performance, provided that: 1. The non -performing party gives the other party prompt written notice describing the particulars of the Force Majeure including, but not limited to, the nature of the occurrence and its expected duration, and continues to furnish timely reports with respect thereto during the period of the Force Majeure; 2. The excuse of performance is of no greater scope and of no longer duration than is required by the Force Majeure; 3. No obligations of either party that arose before the Force Majeure causing the excuse of performance are excused as a result of the Force Majeure; and 4. The non -performing party uses its best efforts to remedy its inability to perform. Notwithstanding the above, performance shall not be excused under this Section for a period in excess of two (2) months, provided that in extenuating circumstances, the City may excuse performance for a longer term. Economic hardship of the Contractor will not constitute Force Majeure. The term of the Agreement shall be extended by a period equal to that during which either Parry's performance is suspended under this Section. AA. Scrutinized Companies The Contractor certifies that it is not on the Scrutinized Companies that Boycott Israel List created pursuant to Section 215.4725, Florida Statutes (2021), as may be amended or revised, and that it is not engaged in a boycott of Israel. The City may terminate this Agreement at the City's option if the Contractor is found to have submitted a false certification as provided under subsection (5) of Section 287.135, Florida Statutes (2021), as may be amended or revised, or been placed on the Scrutinized Companies that Boycott Israel List created pursuant to Section 215.4725, Florida Statutes (2021), as may be amended or revised, or is engaged in a boycott of Israel. BB. Public Records IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC 12 8/20/2024 9:24 AM p. 208 City of Miami Solicitation RFP 1896386 RECORDS RELATING TO THIS AGREEMENT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT CITY CLERK'S OFFICE, 100 N. ANDREWS AVENUE, FORT LAUDERDALE, FLORIDA, 33301, PHONE: 954-828-5002, EMAIL: PRRCONTRACT(&,FORTLAUDERDALE.GOV. Contractor shall comply with public records laws, and Contractor shall: 1. Keep and maintain public records required by the City to perform the service. 2. Upon request from the City's custodian of public records, provide the City with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in Chapter 119, Florida Statutes (2021), as may be amended or revised, or as otherwise provided by law. 3. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the Agreement if the Contractor does not transfer the records to the City. 4. Upon completion of the Agreement, transfer, at no cost, to the City all public records in possession of the Contractor or keep and maintain public records required by the City to perform the service. If the Contractor transfers all public records to the City upon completion of the Agreement, the Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the Contract, the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the City, upon request from the City's custodian of public records, in a format that is compatible with the information technology systems of the City. CC. Non -Discrimination The Contractor shall not discriminate against its employees based on the employee's race, color, religion, gender, gender identity, gender expression, marital status, sexual orientation, national origin, age, disability, or any other protected classification as defined by applicable law. 1. The Contractor certifies and represents that the Contractor offers the same health benefits to the domestic partners of its employees as are offered its employees' spouses or offers its employees the cash equivalent of such health benefits because it is unable to provide health benefits to its employees' domestic partners, and that the Contractor will comply with Section 2-187, Code of Ordinances of the City of Fort Lauderdale, Florida, (2021), as may be amended or revised, ("Section 2-187"), during the entire term of this Agreement. 2. The failure of the Contractor to comply with Section 2-187 shall be deemed to be a material breach of this Agreement, entitling the City to pursue any remedy stated below or any remedy provided under applicable law. 13 8/20/2024 9:24 AM p. 209 City of Miami Solicitation RFP 1896386 3. The City may terminate this Agreement if the Contractor fails to comply with Section 2-187. 4. The City may retain all monies due or to become due until the Contractor complies with Section 2-187. 5. The Contractor may be subject to debarment or suspension proceedings. Such proceedings will be consistent with the procedures in section 2-183 of the Code of Ordinances of the City of Fort Lauderdale, Florida. DD. E-Verify As a condition precedent to the effectiveness of this Agreement, pursuant to Section 448.095, Florida Statutes (2021), as may be amended or revised, the Contractor and its subcontractors shall register with and use the E-Verify system to electronically verify the employment eligibility of newly hired employees. 1. The Contractor shall require each of its subcontractors, if any, to provide the Contractor with an affidavit stating that the subcontractor does not employ, contract with, or subcontract with an unauthorized alien. The Contractor shall maintain a copy of the subcontractor's affidavit for the duration of this Agreement and in accordance with the public records requirements of this Agreement. 2. The City, the Contractor, or any subcontractor who has a good faith belief that a person or entity with which it is contracting has knowingly violated Subsection 448.09(1), Florida Statutes (2021), as may be amended or revised, shall terminate the contract with the person or entity. 3. The City, upon good faith belief that a subcontractor knowingly violated the provisions of Subsection 448.095(2), Florida Statutes (2021), as may be amended or revised, but that the Contractor otherwise complied with Subsection 448.095(2), as may be amended or revised, shall promptly notify Contractor and order the Contractor to immediately terminate the contract with the subcontractor, and the Contractor shall comply with such order. 4. A contract terminated under Subparagraph 448.095(2)(c)1. or 2., Florida Statutes (2021), as may be amended or revised, is not a breach of contract and may not be considered as such. If the City terminates this contract under Paragraph 448.095(2)(c), Florida Statutes (2021), as may be amended or revised, the Contractor may not be awarded a public contract for at least one year after the date on which the contract was terminated. The Contractor is liable for any additional costs incurred by the City as a result of termination of this Agreement. 5. Contractor shall include in each of its subcontracts, if any, the requirements set forth in this Section VI.DD., including this subparagraph, requiring any and all subcontractors, as defined in Subsection 448.095(1)(j), Florida Statutes (2021), as may be amended or revised, to include all of the requirements of this Section VI.DD. in their subcontracts. Contractor shall be 14 8/20/2024 9:24 AM p. 210 City of Miami Solicitation RFP 1896386 responsible for compliance by any and all subcontractors, as defined in Subsection 448.095(1)(j), Florida Statutes (2021), as may be amended or revised, with the requirements of Section 448.095, Florida Statutes (2021), as may be amended or revised. IN WITNESS WHEREOF, the City and the Contractor execute this Agreement as follows: City of Fort uderdale, a Florida municipality By: Christopher J. Lagerbloom, ICMA-CM City Manager Approved as to form: 5,-. Assistan y Attorney WITNESSES: Risk Management Associates, Inc., a Florida corporation d/b/a Pp}ilic Risk Insyance Advisors Si nature ibbin R. u5S-e) t Print Signature mafi+-hpw rr omer1 Print Name (CORPORATE SEAL) By: P. Barrett Brown, President ATT Robe Lloyd, Secre ry 15 8/20/2024 9:24 AM p. 211 City of Miami Solicitation RFP 1896386 STATE OF F I cx; doa COUNTY OF \jo Iasi o. The foregoing instrument was acknowledged before me by means of 19' physical presence or ❑ online notarization, this I a-44' day of Apri 1 , 2022, by P. Barrett Brown as President for Risk Management Associates, Inc, a Florida corporation d/b/a Public Risk Insurance Advisors. Notary Public, (Signature of Notary Public) P-).6A -e N Ze,1►ch (Print, Type, or Stamp Commissioned Name of Notary Public) Personally Known /OR Produced Identification Type of Identification Produced 16 8/20/2024 9:24 AM p. 212 City aifyodf EAiattdrdale EXHIBIT A IERdF P2E616586 Solicitation 12536-525 Property and Casualty Insurance Brokerage and Consulting Services Bid Designation: Public CIITY OF FORT LAUDER'DALE City of Fort Lauderdale 3/2(20024I 9:24 FtM p. PI1$ City dlifjodfIAiattdrdale SolicitationFIP2 586 Bid 12536-525 Property and Casualty Insurance Brokerage and Consulting Services Bid Number Bid Title Bid Start Date Bid End Date Question & Answer End Date Bid Contact 12536-525 Property and Casualty Insurance Brokerage and Consulting Services Jun 9, 2021 4:10:19 PM EDT Jul 7, 2021 2:00:00 PM EDT Jun 23, 2021 5:00:00 PM EDT AnnDebra Diaz, CPPB Procurement Administrator Procurement 954-828-5949 adiaz@fortlauderdale.gov Contract Duration 1 year Contract Renewal 4 annual renewals Prices Good for 120 days Bid Comments Addendum # 1 The City of Fort Lauderdale, Florida (City) is seeking qualified, experienced and licensed firm(s) to provide property and casualty insurance brokerage and consulting services for the City, in accordance with the terms, conditions, and specifications contained in this Request for Proposals (RFP). Added on Jun 28, 2021: Refer to Addendum No. 1 for change to Section 4.2.4. All other terms, conditions and specifications remain unchanged. Added on Jun 30, 2021: Attachments A, B and C have been provided for review purposes only. Attachment A - Attachment B - U - Insu Item Quantity Unit Price Delivery Location Item Response Form 12536-525--01-01 - Property & Casualty Insurance Brokerage & Consulting Services 1 lump sum City of Fort Lauderdale No Location Specified 3/2(20024 2:24 FRM P. 1214 City dlifjodfbAiattdrdale SolicitationERdFIP23116586 Qty 1 Description Proposer shall provide Total Firm, Fixed, cost of Services (as stated in Section VI - Cost Proposal Page) per complete specifications contained in this RFP. 3/2(20024 2:24 FRM p.P15 City dlifjodfIAiattdrdale SolicitationERdFIP23116586 City of Fort Lauderdale Property and Casualty Insurance Brokerage and Consulting Services RFP # 12536-525 SECTION I — INTRODUCTION AND INFORMATION 1.1 Purpose The City of Fort Lauderdale, Florida (City) is seeking qualified, experienced and licensed firm(s) to provide property and casualty insurance brokerage and consulting services for the City, in accordance with the terms, conditions, and specifications contained in this Request for Proposals (RFP). 1.2 BidSync The City of Fort Lauderdale uses BidSync (www.bidsync.com) to administer the competitive solicitation process, including but not limited to soliciting proposals, issuing addenda, posting results and issuing notification of an intended decision. There is no charge to register and download the RFP from BidSync. Proposers are strongly encouraged to read the various vendor Guides and Tutorials available in BidSync well in advance of their intention of submitting a proposal to ensure familiarity with the use of BidSync. The City shall not be responsible for a Proposers inability to submit a Proposal by the end date and time for any reason, including issues arising from the use of BidSync. It is the sole responsibility of the Bidder to ensure that their bid is submitted electronically through BidSync at www.bidsync.com no later than the time and date specified in this solicitation. PAPER BID SUBMITTALS WILL NOT BE ACCEPTED. BIDS MUST BE SUBMITTED ELECTRONICALLY VIA WWW.BIDSYNC.COM. 1.3 Electronic Bid Openings Please be advised that effective immediately, and until further notice, all Invitation to Bids, Request For Proposals, Request For Qualifications, and other solicitations led by the City of Fort Lauderdale will be opened electronically via BIDSYNC.COM at the date and time indicated on the solicitation. All openings will be held on the BIDSYNC.COM platform. Anyone requesting assistance or having further inquiry in this matter must contact the Procurement Administrator indicated on the solicitation, via the Question and Answer forum on BidSync.com before the Last Day for Questions indicated in the Solicitation. 1.4 Point of Contact For information concerning procedures for responding to this solicitation, contact Procurement Administrator, AnnDebra Diaz at (954) 828-5949 or email at adiaz©fortlauderdale.gov. Such contact shall be for clarification purposes only. For information concerning technical specifications, please utilize the question / answer feature provided by BidSync at www.bidsync.com. Questions of a material nature must be received prior to the cut-off date specified in the RFP Schedule. Material changes, if any, to the scope of services or bidding procedures will only be transmitted by written addendum. (See addendum section of BidSync Site). Contractors please note: Proposals shall be submitted as stated in PART IV — Submittal Requirements. No part of your proposal can be submitted via FAX. No variation in price or conditions shall be permitted based upon a claim of ignorance. Submission of a proposal will be considered evidence that the Contractor has familiarized themselves with the nature and extent of the work, and the equipment, materials, and labor required. The entire proposal must be submitted in accordance with all specifications contained in this solicitation. The questions and answers submitted in BidSync shall become part of any contract that is created from this RFP. 3/2(20024 2:24 FRM p. P16 City dlifjodfbAiattdrdale SolicitationFIP2 586 1.5 Pre -proposal Conference and Site Visit There will not be a pre -bid conference or site visit for this Request for Proposal. It will be the sole responsibility of the Contractor to become familiar with the scope of the City's requirements and systems prior to submitting a proposal. No variation in price or conditions shall be permitted based upon a claim of ignorance. Submission of a proposal will be considered evidence that the proposer has familiarized themselves with the nature and extent of the work, equipment, materials, and labor required. END OF SECTION Version 10-2020 3/2(20024 2:24 FRM p.P15 City d3i6odfSolicitationFIP2 586 SECTION II - SPECIAL TERMS AND CONDITIONS 2.1 General Conditions RFP General Conditions (Form G-107, Rev. 02/20) are included and made a part of this RFP. 2.2 Addenda, Changes, and Interpretations It is the sole responsibility of each firm to notify the Buyer utilizing the question / answer feature provided by BidSync and request modification or clarification of any ambiguity, conflict, discrepancy, omission or other error discovered in this competitive solicitation. Requests for clarification, modification, interpretation, or changes must be received prior to the Question and Answer (Q & A) Deadline. Requests received after this date may not be addressed. Questions and requests for information that would not materially affect the scope of services to be performed or the solicitation process will be answered within the question / answer feature provided by BidSync and shall be for clarification purposes only. Material changes, if any, to the scope of services or the solicitation process will only be transmitted by official written addendum issued by the City and uploaded to BidSync as a separate addendum to the RFP. Under no circumstances shall an oral explanation given by any City official, officer, staff, or agent be binding upon the City and should be disregarded. All addenda are a part of the competitive solicitation documents and each firm will be bound by such addenda. It is the responsibility of each to read and comprehend all addenda issued. 2.3 Changes and Alterations Proposer may change or withdraw a Proposal at any time prior to Proposal submission deadline; however, no oral modifications will be allowed. Modifications shall not be allowed following the Proposal deadline. 2.4 Proposer's Costs The City shall not be liable for any costs incurred by proposers in responding to this RFP. 2.5 Pricing/Delivery All pricing should be identified on the Cost Proposal page provided in this RFP. No additional costs may be accepted, other than the costs stated on the Cost Proposal page. Failure to use the City's Cost Proposal page and provide costs as requested in this RFP may deem your proposal non- responsive. Contractor shall quote a firm, fixed price for all services stated in the RFP. All costs including travel shall be included in your proposal. The City shall not accept any additional costs including any travel associated with coming to the City of Fort Lauderdale. 2.6 Price Validity Prices provided in this Request for Proposals (RFP) shall be valid for at least One -Hundred and Twenty (120) days from time of RFP opening unless otherwise extended and agreed upon by the City and Bidder. The City shall award contract within this time period or shall request to the recommended awarded vendor an extension to hold pricing, until products/services have been awarded. 2.7 Invoices/Payment The City will accept invoices no more frequently than once per month but also has the option to accept a lump sum invoice payment at the inception of each contract year. Each invoice shall fully detail the related costs and shall specify the status of the particular task or project as of the date of the invoice with regard to the accepted schedule for that task or project. Payment will be Version 10-2020 3/2(20024 2:24 FRM p.P16 City dlifjodfbAiattdrdale SolicitationFIP2 586 made within forty-five (45) days after receipt of an invoice acceptable to the City, in accordance with the Florida Local Government Prompt Payment Act. If, at any time during the contract, the City shall not approve or accept the Contractor's work product, and agreement cannot be reached between the City and the Contractor to resolve the problem to the City's satisfaction, the City shall negotiate with the Contractor on a payment for the work completed and usable to the City. 2.8 Related Expenses/Travel Expenses All costs including travel are to be included in your proposal. The City will not accept any additional costs. 2.9 Payment Method The City of Fort Lauderdale has implemented a Procurement Card (P-Card) program which changes how payments are remitted to its vendors. The City has transitioned from traditional paper checks to payment by credit card via MasterCard or Visa. This allows you as a vendor of the City of Fort Lauderdale to receive your payment fast and safely. No more waiting for checks to be printed and mailed. Payments will be made utilizing the City's P-Card (MasterCard or Visa). Accordingly, firms must presently have the ability to accept credit card payment or take whatever steps necessary to implement acceptance of a credit card before the commencement of a contract. See Contract Payment Method form attached. 2.10 Mistakes The consultant shall examine this RFP carefully. The submission of a Proposal shall be prima facie evidence that the consultant has full knowledge of the scope, nature, and quality of the work to be performed; the detailed requirements of the specifications; and the conditions under which the work is to be performed. Ignorance of the requirements will not relieve the consultant from liability and obligations under the Contract. 2.11 Acceptance of Proposals / Minor Irregularities 2.11.1 The City reserves the right to accept or reject any or all proposals, part of proposals, and to waive minor irregularities or variances to specifications contained in proposals which do not make the proposal conditional in nature and minor irregularities in the solicitation process. A minor irregularity shall be a variation from the solicitation that does not affect the price of the contract or does not give a respondent an advantage or benefit not enjoyed by other respondents, does not adversely impact the interests of other firms or, does not affect the fundamental fairness of the solicitation process. The City also reserves the right to reissue a Request for Proposal. 2.11.2 The City reserves the right to disqualify Proposer during any phase of the competitive solicitation process and terminate for cause any resulting contract upon evidence of collusion with intent to defraud or other illegal practices on the part of the Proposer. 2.12 Modification of Services 2.12.1 While this contract is for services provided to the department referenced in this Request for Proposals, the City may require similar work for other City departments. Successful Proposer agrees to take on such work unless such work would not be considered reasonable or become an undue burden to the Successful Proposer. 2.12.2 The City reserves the right to delete any portion of the work at any time without cause, and if such right is exercised by the City, the total fee shall be reduced in the same ratio as the estimated cost of the work deleted bears to the estimated cost of the work originally planned. If work has already been accomplished and approved by the City on any Version 10-2020 3/2(20024 2:24 FRM p.P1g City i pdfbAiattdrdale SolicitationERdFIP23116586 portion of a contract resulting from this RFP, the Successful Proposer shall be paid for the work completed on the basis of the estimated percentage of completion of such portion to the total project cost. 2.12.3 The City may require additional items or services of a similar nature, but not specifically listed in the contract. The Successful Proposer agrees to provide such items or services and shall provide the City prices on such additional items or services. If the price(s) offered are not acceptable to the City, and the situation cannot be resolved to the satisfaction of the City, the City reserves the right to procure those items or services from other vendors, or to cancel the contract upon giving the Successful Proposer thirty (30) days written notice. 2.12.4 If the Successful Proposer and the City agree on modifications or revisions to the task elements, after the City has approved work to begin on a particular task or project, and a budget has been established for that task or project, the Successful Proposer will submit a revised budget to the City for approval prior to proceeding with the work. 2.13 No Exclusive Contract Proposer agrees and understands that the contract shall not be construed as an exclusive arrangement and further agrees that the City may, at any time, secure similar or identical services from another vendor at the City's sole option. 2.14 Sample Contract Agreement A sample of the formal agreement template, which may be required to be executed by the awarded vendor can be found at our website: https://www.fortlauderdale.qov/home/showdocument?id=1 21 2 2.15 Responsiveness In order to be considered responsive to the solicitation, the firm's proposal shall fully conform in all material respects to the solicitation and all its requirements, including all form and substance. 2.16 Responsibility In order to be considered as a responsible firm, firm shall be fully capable to meet all of the requirements of the solicitation and subsequent contract, must possess the full capability, including financial and technical, to perform as contractually required, and must be able to fully document the ability to provide good faith performance. 2.17 Minimum Qualifications Proposers shall be in the business of property and casualty insurance brokerage and consulting services and must possess sufficient financial support, equipment and organization to ensure that it can satisfactorily perform the services if awarded a Contract. Proposers must demonstrate that the key staff assigned to the City's account, have successfully provided services with similar magnitude to those specified in the scope of services to at least three entities similar in size and complexity to the City's self -insured and fully -insured property and casualty program, and have the managerial and financial ability to successfully perform the services. Proposers shall satisfy each of the following requirements cited below. Failure to do so may result in the proposal being deemed non -responsive. 2.17.1 Proposer or principals shall have at least ten (10) years of relevant experience in property and casualty insurance brokerage and consulting services. Consultant/Broker assigned as the primary consultant on the account must have at least ten (10) years of experience Version 10-2020 3/2(20024 2:24 FRM p. 1220 City i pdfbAiattdrdale SolicitationERdFIP23116586 in property and casualty insurance brokerage and consulting services with governmental entities of similar size and complexity as the City, and have served as Consultant/Broker on similar accounts. 2.17.2 Before awarding a contract, the City reserves the right to require that a Proposer submit such evidence of qualifications as the City may deem necessary. Further, the City may consider any evidence of the financial, technical, and other qualifications and abilities of a firm or principals, including previous experiences of same with the City and performance evaluation for services, in making the award in the best interest of the City. 2.17.3 Firm or principals shall have no record of judgments, pending lawsuits against the City or criminal activities involving moral turpitude and not have any conflicts of interest that have not been waived by the City Commission. 2.17.4 Neither firm nor any principal, officer, or stockholder shall be in arrears or in default of any debt or contract involving the City, (as a party to a contract, or otherwise); nor have failed to perform faithfully on any previous contract with the City. 2.17.5 Firm and those performing the services must be properly licensed and registered in the State of Florida. 2.18 Lobbying Activities ALL CONTRACTORS PLEASE NOTE: Any contractor submitting a response to this solicitation must comply, if applicable, with City of Fort Lauderdale Ordinance No. C-11-42 & Resolution No. 07-101, Lobbying Activities. Copies of Ordinance No. C-11-42 and Resolution No. 07-101 may be obtained from the City Clerk's Office on the 7th Floor of City Hall, 100 N. Andrews Avenue, Fort Lauderdale, Florida. The ordinance may also be viewed on the City's website at https://www.fortlauderdale.gov/home/showdocument?id=6036. 2.19 Local Business Preference 2.19.1 Section 2-186, Code of Ordinances of the City of Fort Lauderdale, provides for a local business preference. In order to be considered for a local business preference, a proposer must include the Local Business Preference Certification Statement of this RFP, as applicable to the local business preference class claimed at the time of Proposal submittal: 2.19.2 Upon formal request of the City, based on the application of a Local Business Preference the Proposer shall within ten (10) calendar days submit the following documentation to the Local Business Preference Class claimed: a. Copy of City of Fort Lauderdale current year business tax receipt, or Broward County current year business tax receipt, and b. List of the names of all employees of the proposer and evidence of employees' residence within the geographic bounds of the City of Fort Lauderdale or Broward County, as the case may be, such as current Florida driver license, residential utility bill (water, electric, telephone, cable television), or other type of similar documentation acceptable to the City. 2.19.3 Failure to comply at time of Proposal submittal shall result in the Proposer being found ineligible for the local business preference. Version 10-2020 3/2(20024 2:24 FRM p. p2s City d3i6odfSolicitationERdFIP23116586 2.19.4 The complete local business preference ordinance may be found on the City's web site at the following link: https://library.municode.com/fl/fort Lauderdale/codes/code of ordinances?nodeld=COOR CH2AD ARTVFI DIV2PR S2-186LOBUPRPR 2.19.5 Definitions a. The term "Class A business" shall mean any business that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the city, and shall maintain a staffing level for the proposed work of at least fifty percent (50%) who are residents of the City of Fort Lauderdale. b. The term "Class B business" shall mean any business that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the city, or shall maintain a staffing level for the proposed work of at least fifty percent (50%) who are residents of the City of Fort Lauderdale. c. The term "Class C business" shall mean any business that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of Broward County. d. The term "Class D business" shall mean any business that does not qualify as a Class A, Class B, or Class C business. 2.20 Disadvantaged Business Enterprise Preference 2.20.1 Section 2-185, Code of Ordinances of the City of Fort Lauderdale, provides for a disadvantaged business preference. In order to be considered for a disadvantaged business preference, a proposer must include a certification from a government agency, as applicable to the disadvantaged business preference class claimed at the time of Proposal submittal: 2.20.2 Upon formal request of the City, based on the application of a Disadvantaged Business Preference the Proposer shall within ten (10) calendar days submit the following documentation to the Disadvantaged Business Enterprise Preference Class claimed: a. Copy of City of Fort Lauderdale current year business tax receipt, or the Tri-County (Broward, Dade, West Palm Beach) current year business tax receipt, or proof of active Sunbiz status and b. List of the names of all employees of the proposer and evidence of employees' residence within the geographic bounds of the City of Fort Lauderdale or the Tri- County, as the case may be, such as current Florida driver license, residential utility bill (water, electric, telephone, cable television), or other type of similar documentation acceptable to the City. 2.20.3 Failure to comply at time of Proposal submittal shall result in the Proposer being found ineligible for the Disadvantaged Business Enterprise Preference business preference. 2.20.4 The complete disadvantaged business preference ordinance may be found on the City's web site at the following link: https://www.fortlauderdale.gov/home/showpublisheddocument?id=56883 Version 10-2020 3/2(20024 2:24 FRM pp220 City d3i6odfSolicitationERdFIP23116586 2.20.5 Definitions a. The term "disadvantaged class 1 enterprise" shall mean any disadvantaged business enterprise that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the city, and provides supporting documentation of its City of Fort Lauderdale business tax and disadvantaged certification as established in the city's Procurement Manual. The term "Class B business" shall mean any business that has established and agrees to maintain a permanent place of business located in a non- residential zone, staffed with full-time employees within the limits of the city, or shall maintain a staffing level for the proposed work of at least fifty percent (50%) who are residents of the City of Fort Lauderdale. b. The term "disadvantaged class 2 enterprise" shall mean any disadvantaged business enterprise that has established and agrees to maintain a permanent place of business within the limits of the city with a full-time employee(s) and provides supporting documentation of its City of Fort Lauderdale business tax and disadvantaged certification as established in the city's Procurement Manual. The term "Class D business" shall mean any business that does not qualify as a Class A, Class B, or Class C business. c. The term "disadvantaged class 3 enterprise" shall mean any disadvantaged business enterprise that has established and agrees to maintain a permanent place of business located in a CAM #21-0053 Exhibit 1 Page 6 of 10 non-residential zone, staffed with full-time employees within the limits of the Tri-County area and provides supporting documentation of its City of Fort Lauderdale business tax and disadvantaged certification as established in the City's Procurement Manual. d. The term "disadvantaged class 4 enterprise" shall mean any disadvantaged business enterprise that does not qualify as a Class A, Class B, or Class C business, but is located in the State of Florida and provides supporting documentation of its disadvantaged certification as established in the City's Procurement Manual. 2.21 Protest Procedure 2.21.1 Any Bidder who is not recommended for award of a contract and who alleges a failure by the city to follow the city's procurement ordinance or any applicable law, may follow the protest procedure as found in the city's procurement ordinance within five (5) days after a notice of intent to award is posted on the city's web site at the following link: http://www.fortlauderdale.gov/departments/finance/procurement-services/notices-of- intent-to-award. 2.21.2 The complete protest ordinance may be found on the city's web site at the following link: https://library.municode.com/fl/fort Lauderdale/codes/code of ordinances?nodeld=C OOR CH2AD ARTVFI DIV2PR S2-182DIREPR 2.22 Public Entity Crimes Proposer, by submitting a proposal, certifies that neither the proposer nor any of the Proposer's principals has been placed on the convicted vendor list as defined in §287.133, Florida Statutes (2018), as may be amended or revised. A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a bid, proposal, or reply on a contract to provide any goods or services to a public entity; may not submit a bid, proposal, or reply on a contract with a public entity for the construction or repair of a public building or public work; may not submit bids, proposals, or replies on leases of Version 10-2020 3/2(20024 2:24 FRM pp222 City dlifjodfbAiattdrdale SolicitationERdFIP23116586 real property to a public entity; may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in §287.017 for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 2.23 Subcontractors 2.23.1 If the Contractor proposes to use subcontractors in the course of providing these services to the City, this information shall be a part of the bid response. Such information shall be subject to review, acceptance and approval of the City, prior to any contract award. The City reserves the right to approve or disapprove of any subcontractor candidate in its best interest and to require Contractor to replace subcontractor with one that meets City approval. 2.23.2 Contractor shall ensure that all of Contractor's subcontractors perform in accordance with the terms and conditions of this Contract. Contractor shall be fully responsible for all of Contractor's subcontractors' performance, and liable for any of Contractor's subcontractors' non-performance and all of Contractor's subcontractors' acts and omissions. Contractor shall defend, at Contractor's expense, counsel being subject to the City's approval or disapproval, and indemnify and hold harmless the City and the City's officers, employees, and agents from and against any claim, lawsuit, third -party action, or judgment, including any award of attorney fees and any award of costs, by or in favor of any Contractor's subcontractors for payment for work performed for the City. 2.23.3 Contractor shall require all its subcontractors to provide the required insurance coverage as well as any other coverage that the contractor may consider necessary, and any deficiency in the coverage or policy limits of said subcontractors will be the sole responsibility of the contractor. 2.24 Proposal Security — N/A 2.25 Payment and Performance Bond — N/A 2.26 Insurance Requirements 2.26.1 As a condition precedent to the effectiveness of this Agreement, during the term of this Agreement and during any renewal or extension term of this Agreement, the Contractor, at the Contractor's sole expense, shall provide insurance of such types and with such terms and limits as noted below. Providing proof of and maintaining adequate insurance coverage are material obligations of the Contractor. The Contractor shall provide the City a certificate of insurance evidencing such coverage. The Contractor's insurance coverage shall be primary insurance for all applicable policies. The limits of coverage under each policy maintained by the Contractor shall not be interpreted as limiting the Contractor's liability and obligations under this Agreement. All insurance policies shall be from insurers authorized to write insurance policies in the State of Florida and that possess an A.M. Best rating of "A-" VII or better. All insurance policies are subject to approval by the City's Risk Manager. 2.26.2 The coverages, limits, and endorsements required herein protect the interests of the City, and these coverages, limits, and endorsements may not be relied upon by the Contractor for assessing the extent or determining appropriate types and limits of coverage to protect the Version 10-2020 3/2(20024 2:24 FRM pp224 City d3i6odfSolicitationERdFIP23116586 Contractor against any loss exposure, whether as a result of this Agreement or otherwise. The requirements contained herein, as well as the City's review or acknowledgement, are not intended to and shall not in any manner limit or qualify the liabilities and obligations assumed by the Contractor under this Agreement. 2.26.3 The following insurance policies and coverages are required: Commercial General Liability Coverage must be afforded under a Commercial General Liability policy with limits not less than: • $1,000,000 each occurrence and $2,000,000 aggregate for Bodily Injury, Property Damage, and Personal and Advertising Injury • $1,000,000 each occurrence and $2,000,000 aggregate for Products and Completed Operations Policy must include coverage for Contractual Liability and Independent Contractors. The City and the City's officers, employees, and volunteers are to be covered as additional insureds with a CG 20 26 04 13 Additional Insured — Designated Person or Organization Endorsement or similar endorsement providing equal or broader Additional Insured Coverage with respect to liability arising out of activities performed by or on behalf of the Contractor. The coverage shall contain no special limitation on the scope of protection afforded to the City or the City's officers, employees, and volunteers. Professional Liability and/or Errors and Omissions Coverage must be afforded for Wrongful Acts in an amount not less than $5,000,000 each claim and $5,000,000 aggregate. Contractor must keep insurance in force until the third anniversary of expiration of this Agreement or the third anniversary of acceptance of work by the City. Business Automobile Liability Coverage must be afforded for all Owned, Hired, Scheduled, and Non -Owned vehicles for Bodily Injury and Property Damage in an amount not less than $1,000,000 combined single limit each accident. If the Contractor does not own vehicles, the Contractor shall maintain coverage for Hired and Non -Owned Auto Liability, which may be satisfied by way of endorsement to the Commercial General Liability policy or separate Business Auto Liability policy. Workers' Compensation and Employer's Liability Coverage must be afforded per Chapter 440, Florida Statutes. Any person or entity performing work for or on behalf of the City must provide Workers' Compensation insurance. Exceptions and exemptions will be allowed by the City's Risk Manager, if they are in accordance with Florida Statute. The Contractor waives, and the Contractor shall ensure that the Contractor's insurance carrier waives, all subrogation rights against the City and the City's officers, employees, and volunteers for all losses or damages. The City requires the policy to be endorsed with WC 00 03 13 Waiver of our Right to Recover from Others or equivalent. The Contractor must be in compliance with all applicable State and federal workers' compensation laws. Version 10-2020 3/2(20024 2:24 FRM pp225 City dlifjodfbAiattdrdale SolicitationERdFIP23116586 2.26.4 Insurance Certificate Requirements a. The Contractor shall provide the City with valid Certificates of Insurance (binders are unacceptable) no later than thirty (30) days prior to the start of work contemplated in this Agreement. b. The Contractor shall provide to the City a Certificate of Insurance having a thirty (30) day notice of cancellation; ten (10) days' notice if cancellation is for nonpayment of premium. c. In the event that the insurer is unable to accommodate the cancellation notice requirement, it shall be the responsibility of the Contractor to provide the proper notice. Such notification will be in writing by registered mail, return receipt requested, and addressed to the certificate holder. d. In the event the Agreement term goes beyond the expiration date of the insurance policy, the Contractor shall provide the City with an updated Certificate of Insurance no later than ten (10) days prior to the expiration of the insurance currently in effect. The City reserves the right to suspend the Agreement until this requirement is met. e. The Certificate of Insurance shall indicate whether coverage is provided under a claims -made or occurrence form. If any coverage is provided on a claims -made form, the Certificate of Insurance must show a retroactive date, which shall be the effective date of the initial contract or prior. f. The City shall be named as an Additional Insured on the General Liability policy. g. The City shall be granted a Waiver of Subrogation on the Contractor's Workers' Compensation insurance policy. h. The title of the Agreement, Bid/Contract number or other identifying reference must be listed on the Certificate of Insurance. The Certificate Holder should read as follows: City of Fort Lauderdale Procurement Services Division 100 N. Andrews Avenue Fort Lauderdale, FL 33301 2.26.5 The Contractor has the sole responsibility for the payment of all insurance premiums and shall be fully and solely responsible for any costs or expenses as a result of a coverage deductible, co-insurance penalty, or self -insured retention; including any loss not covered because of the operation of such deductible, co-insurance penalty, self -insured retention, or coverage exclusion or limitation. Any costs for adding the City as an Additional Insured shall be at the Contractor's expense. 2.26.6 If the Contractor's primary insurance policy/policies do not meet the minimum requirements, as set forth in this Agreement, the Contractor may provide evidence of an Umbrella/Excess insurance policy to comply with this requirement. 2.26.7 The Contractor's insurance coverage shall be primary insurance as applied to the City and the City's officers, employees, and volunteers. Any insurance or self-insurance maintained by the City covering the City, the City's officers, employees, or volunteers shall be non-contributory. 2.26.8 Any exclusion or provision in the insurance maintained by the Contractor that excludes coverage for work contemplated in this Agreement shall be unacceptable and shall be considered breach of contract. Version 10-2020 3/2(20024 2:24 FRM pp226 City d3i6odfSolicitationERdFIP23116586 2.26.9 All required insurance policies must be maintained until the contract work has been accepted by the City, or until this Agreement is terminated, whichever is later. Any lapse in coverage shall be considered breach of contract. In addition, Contractor must provide to the City confirmation of coverage renewal via an updated certificate should any policies expire prior to the expiration of this Agreement. The City reserves the right to review, at any time, coverage forms and limits of Contractor's insurance policies. 2.26.10The Contractor shall provide notice of any and all claims, accidents, and any other occurrences associated with this Agreement shall be provided to the Contractor's insurance company or companies and the City's Risk Management office as soon as practical. 2.26.111t is the Contractor's responsibility to ensure that any and all of the Contractor's independent contractors and subcontractors comply with these insurance requirements. All coverages for independent contractors and subcontractors shall be subject to all of the applicable requirements stated herein. Any and all deficiencies are the responsibility of the Contractor. 2.27 Award of Contract A Contract (the "Agreement") may be awarded by the City Commission. The City reserves the right to execute or not execute, as applicable, a contract with the Proposer(s) that is determined to be in the City's best interests. The City reserves the right to award a contract to more than one Proposer, at the sole and absolute discretion of the City. 2.28 Unauthorized Work The Successful Proposer(s) shall not begin work until a Contract has been awarded by the City Commission and a notice to proceed has been issued. Proposer(s) agree and understand that the issuance of a Purchase Order and/or Task Order shall be issued and provided to the Successful Proposer(s) following Commission award; however, receipt of a purchase order and/or task order shall not prevent the Successful Proposer(s) from commencing the work once the City Commission has awarded the contract and notice to proceed is issued. 2.29 Damage to Public or Private Property — N/A 2.30 Safety — N/A 2.31 Uncontrollable Circumstances ("Force Majeure") The City and Contractor will be excused from the performance of their respective obligations under this agreement when and to the extent that their performance is delayed or prevented by any circumstances beyond their control including, fire, flood, explosion, strikes or other labor disputes, act of God or public emergency, war, riot, civil commotion, malicious damage, act or omission of any governmental authority, delay or failure or shortage of any type of transportation, equipment, or service from a public utility needed for their performance, provided that: 2.31.1 The non -performing party gives the other party prompt written notice describing the particulars of the Force Majeure including, but not limited to, the nature of the occurrence and its expected duration, and continues to furnish timely reports with respect thereto during the period of the Force Majeure; 2.31.2 The excuse of performance is of no greater scope and of no longer duration than is required by the Force Majeure; Version 10-2020 3/2(20024 2:24 FRM pp223 City dlifjodfbAiattdrdale SolicitationERdFIP23116586 2.31.3 No obligations of either party that arose before the Force Majeure causing the excuse of performance are excused as a result of the Force Majeure; and 2.31.4 The non -performing party uses its best efforts to remedy its inability to perform. Notwithstanding the above, performance shall not be excused under this Section for a period in excess of two (2) months, provided that in extenuating circumstances, the City may excuse performance for a longer term. Economic hardship of the Contractor will not constitute Force Majeure. The term of the agreement shall be extended by a period equal to that during which either party's performance is suspended under this Section. 2.32 Canadian Companies In the event Contractor is a corporation organized under the laws of any province of Canada or is a Canadian federal corporation, the City may enforce in the United States of America or in Canada or in both countries a judgment entered against the Contractor. The Contractor waives any and all defenses to the City's enforcement in Canada, of a judgment entered by a court in the United States of America. All monetary amounts set forth in this Contract are in United States dollars. 2.33 News Releases/Publicity News releases, publicity releases, or advertisements relating to this contract or the tasks or projects associated with the project shall not be made without prior City approval. 2.34 Manufacturer/Brand/Model Specific Request — N/A 2.35 Contract Period The initial contract term shall commence upon date of award by the City or December 20, 2021, whichever is later, and shall expire one (1) year from that date. The City reserves the right to extend the contract for four (4), additional one-year terms, providing all terms conditions and specifications remain the same, both parties agree to the extension, and such extension is approved by the City. In the event services are scheduled to end because of the expiration of this contract, the Contractor shall continue the service upon the request of the City as authorized by the awarding authority. The extension period shall not extend for more than 180 days beyond the expiration date of the existing contract. The Contractor shall be compensated for the service at the rate in effect when this extension clause is invoked by the City. 2.36 Cost Adjustments Prices quoted shall be firm for the initial contract term of one (1) year. No cost increases shall be accepted in this initial contract term. Please consider this when providing pricing for this request for proposal. Thereafter, any extensions which may be approved by the City shall be subject to the following: costs for any extension terms shall be subject to an adjustment only if increases or decreases occur in the industry. Such adjustment shall be based on the latest yearly percentage increase in the All Urban Consumers Price Index (CPI-U) as published by the Bureau of Labor Statistics, U.S. Dep't. of Labor and shall not exceed five percent (5%). The yearly increase or decrease in the CPI shall be that latest Index published and available for Version 10-2020 3/2(20024 2:24 FRM pp226 City dlifjodfbAiattdrdale SolicitationERdFIP23116586 the calendar year ending 12/31, prior to the end of the contract year then in effect, as compared to the index for the comparable month, one-year prior. Any requested adjustment shall be fully documented and submitted to the City at least ninety (90) days prior to the contract anniversary date. Any approved cost adjustments shall become effective on the beginning date of the approved contract extension. The City may, after examination, refuse to accept the adjusted costs if they are not properly documented, or considered to be excessive, or if decreases are considered to be insufficient. In the event the City does not wish to accept the adjusted costs and the matter cannot be resolved to the satisfaction of the City, the Contract will be considered cancelled on the scheduled expiration date. 2.37 Service Test Period — N/A 2.38 Contract Coordinator The City may designate a Contract Coordinator whose principal duties shall be: Liaison with Contractor. Coordinate and approve all work under the contract. Resolve any disputes. Assure consistency and quality of Contractor's performance. Schedule and conduct Contractor performance evaluations and document findings. Review and approve for payment all invoices for work performed or items delivered. 2.39 Contractor Performance Reviews and Ratings The City Contract Coordinator may develop a Contractor performance evaluation report. This report shall be used to periodically review and rate the Contractor's performance under the contract with performance rating as follows: Excellent Far exceeds requirements. Good Exceeds requirements. Fair Just meets requirements. Poor Does not meet all requirements and contractor is subject to penalty provisions under the contact. Non-compliance Either continued poor performance after notice or a performance level that does not meet a significant portion of the requirements. This rating makes the Contractor subject to the default or cancellation for cause provisions of the contract. The report shall also list all discrepancies found during the review period. The Contractor shall be provided with a copy of the report and may respond in writing if he takes exception to the report or wishes to comment on the report. Contractor performance reviews and subsequent reports will be used in determining the suitability of contract extension. 2.40 Substitution of Personnel It is the intention of the City that the Contractor's personnel proposed for the contract will be available for the contract term. In the event the Contractor wishes to substitute personnel, they shall propose personnel of equal or higher qualifications and all replacement personnel are subject to City approval. In the event substitute personnel are not satisfactory to the City and the matter cannot be resolved to the satisfaction of the City, the City reserves the right to cancel the Version 10-2020 3/2(20024 2:24 FRM pp22O City d3i6odfSolicitationERdFIP23116586 Contract for cause. See Section 5.09 General Conditions. 2.41 Ownership of Work The City shall have full ownership and the right to copyright, otherwise limit, reproduce, modify, sell, or use all the work or product produced under this contract without payment of any royalties or fees to the Contractor above the agreed hourly rates and related costs. 2.42 Condition of Trade -In Equipment — N/A 2.43 Conditions of Trade -In Shipment and Purchase Payment — N/A 2.44 Verification of Employment Status Any Contractor/Consultant assigned to perform responsibilities under its contract with a State agency is required to utilize the US Department of Homeland Security's E-Verify system (per Executive Order Number 11-02) to verify the employment eligibility of: (a) all persons employed during the contract term by the Contractor to perform employment duties within Florida; and (b) all persons (including subcontractors) assigned by the Contractor to perform work pursuant to the contract with the State agency. E-VERIFY Affirmation Statement (Attachment "A") should be completed and submitted with Proposer's response to this RFP. 2.45 Service Organization Controls — N/A 2.46 Warranties of Usage — N/A 2.47 PCI (Payment Card Industry) Compliance Contractor agrees to comply with all applicable state, federal and international laws, as well as industry best practices, governing the collection, access, use, disclosure, safeguarding and destruction of protected information. Contractor and/or any subcontractor that handles credit card data must be, and remain, PCI compliant under the current standards and will provide documentation confirming compliance upon request by the City of Fort Lauderdale, failure to produce documentation could result in termination of the contract. END OF SECTION Version 10-2020 3/2(20024 2:24 FRM pp228 City d3i6odfSolicitationFIP2 586 SECTION III - TECHNICAL SPECIFICATIONS/SCOPE OF SERVICES 3.1 Consultation Consultant/Broker will work closely with the City's Risk Manager in risk analysis, preparation of underwriting submissions/specifications, marketing, program design and carrier selection. It is expected that the Consultant/Broker will be actively involved to ensure the proper coverage for whatever the program may require; maintain contact with global insurance markets, which are interested, available, and qualified to provide insurance; and provide loss prevention services to the City. 3.2 Risk Management Policy Development Support the City's efforts in continual development of risk management policies. This would include: presentation of industry standard practices; assistance in development of policies that support the goals of the City toward use of local resources; innovation in the design of risk funding for the City; and assist in presentations to policy and decision making authorities. Inform the City of applicable federal and State compliance legislation, legislative trends and issues, and necessary governmental filings. 3.3 Risk Assessment Assist in the identification and evaluation of risk exposures the City faces and provide support and coordination with actuarial efforts on behalf of the City. Assist in the determination of the level of risk retention that is appropriate and recommend proper limits and coverages for risks/exposures common to similar size cities. 3.4 Risk Control Provide resources to assist Risk Management in the development and maintenance of a comprehensive risk control program, which will adapt to variations in scope and level of governmental services offered by the City. Provide recommendations on loss control measures based on claims history prepared by the Risk Management Division and the City's insurance carriers. 3.5 Risk Financing Provide support to the City in development of risk financing plans that enable the City to succeed in its overall financial planning and budgeting. Coordinate with actuarial efforts and provide comprehensive information on market conditions and trends. Support innovation in design of financing mechanisms. 3.6 Marketing No less than 90 calendar days prior to renewal of individual coverages, meet with the City's Risk Manager to present a marketing report. This report is to provide the City with: current program evaluation; marketing timetable; ratings of markets to be approached; Consultant/Broker recommendations and reasons; and anticipated rates and premium. Organize the presentation of the risk financing plan and exposures to the appropriate markets. Review the presentation plan and documents with the City's Risk Manager for approval to proceed. Advise the City on methods of optimizing and developing high -quality relationships with the markets as a trusted client. Negotiate best terms, rates, and conditions. Monitor the financial condition of insurers, including their ability to pay claims promptly, and advise the City whenever any insurer is downgraded by any rating agency. Version 10-2020 3/2(20024 2:24 FRM pp222 City d3i6odfSolicitationERff P2E113E6586 3.7 Insurance Proposals Prior to submission, prepare a matrix of insurance proposals received, to include an evaluation of coverage, limits, and cost. Submit recommendations no less than 45 days prior to the policy expiration dates. Please confirm that you can adhere to these dates or advise as to exceptions. 3.8 Policy Language Be responsible for verification of policy language, checking for: accuracy, appropriate form, and compliance with requirements, proper application to risk, and client's intended needs as specified. Provide expertise in the interpretation and preparation of manuscript insurance policy forms and endorsements. 3.9 Insurance Policies Work with the City's Risk Manager to negotiate and purchase the following insurances (but not limited to the following): Accidental Death and Dismemberment, Active Shooter, All Risk Property & Terrorism (See Attachment A & B for SOV), Automobile Liability, Aviation General Liability & Terrorism, Blanket Crime, Cyber Liability, Event Cancellation, Excess Workers' Compensation, Firefighter Cancer, Police Professional Liability, Pollution Liability, Public Officials/Employment Practices Liability, and Watercraft Liability. See Attachment C for a summary of the City's current policies. Provide the City with certain reports, at appropriate policy intervals, to include the following: loss reports and loss prevention programs/recommendations; insurance market trends and outlook; and risk retention recommendations and philosophy. 3.10 Loss Management Assist the City in proper management of information regarding losses. Provide expert assistance in the settlement of major claims and losses. Serve as liaison between the City and the insurance carriers to assist in the timely and proper resolution of claims. Assist the City in periodic evaluation of claims handling and administration, and reserves for self -insured retentions. Comment and make recommendations regarding major losses incurred by the City during the previous and current policy periods. 3.11 Billing Responsible for the billing of premiums to the City. Consultant/Broker's invoiced insurance premiums are to be net of commission, except where required by federal and/or State law/rule. All invoices are to be e-mailed to acctspayable@fortlauderdale.gov with a copy to Risk Management. The fee paid to the selected Consultant/Broker is to be the only remuneration accepted by the Consultant/Broker for services in relation to this Agreement. Any exceptions must be clearly disclosed in Section VI — Cost Proposal Page. 3.12 Annual Report Responsible for producing an annual report within 45 days of the end of the fiscal year for the City. This report is to include: a schedule of policies in force, premiums, losses, commissions and fees earned or waived, developments and trends in the markets for these coverages; and proposals for change in the City's coverages. 3.13 Availability Consultant/Broker and team assigned to the City are to be able to accommodate consultation on an as -needed basis. Version 10-2020 3/2(20024 2:24 FRM pp230 City dlifjodfbAiattdrdale SolicitationERdFIP23116586 3.14 Contract Review Provide a thorough review and recommendation on contracts, leases and other agreements to assess the adequacy of insurance, assumption of liability and other risk management issues. For purposes of RFPs, the Consultant/Broker will receive a draft of the RFP that is scheduled to be issued and will be asked to suggest how the insurance section should be worded. Consultant/Broker will also need to advise if the indemnity and hold harmless provisions are adequately worded to protect the interests of the City. Consultant/Broker should anticipate a consistent volume of these reviews and at times, they may need to be completed the same day. Assistance on review of certificates of insurance will also be requested on an as -needed basis. 3.15 Special Events Consultant/Broker will be asked to comment and recommend what coverage requirements should be required of third parties requesting use of City owned property. 3.16 Loss Development Support the City with resources for trending, forecasting, and premium calculation and allocation in cooperation with actuarial services used by the City. 3.17 Loss Prevention/Engineering Services Review all insurance companies' loss prevention/engineering reports and provide the City with written recommendations for compliance within 30 days from the date the reports are issued by the companies. Represent the City's position/interest concerning recommendations made by insurance companies and, if requested, conduct research and develop documentation to support the City's position/interest. END OF SECTION Version 10-2020 3/2(20024 2:24 FRM pp232 City d3i6odfSolicitationERff P2E113E6586 SECTION IV — SUBMITTAL REQUIREMENTS 4.1 Instructions 4.1.1 The City of Fort Lauderdale uses BidSync (www.bidsync.com) to administer the competitive solicitation process, including but not limited to soliciting proposals, issuing addenda, responding to questions / requests for information. There is no charge to register and download the RFP from BidSync. Proposers are strongly encouraged to read the various vendor Guides and Tutorials available in BidSync well in advance of their intention of submitting a proposal to ensure familiarity with the use of BidSync. The City shall not be responsible for a Proposer's inability to submit a proposal by the end date and time for any reason, including issues arising from the use of BidSync. 4.1.2 Careful attention must be given to all requested items contained in this RFP. Proposers are invited to submit proposals in accordance with the requirements of this RFP. Please read entire solicitation before submitting a proposal. Proposers must provide a response to each requirement of the RFP. Proposals should be prepared in a concise manner with an emphasis on completeness and clarity. Notes, exceptions, and comments may be rendered on an attachment, provided the same format of this RFP text is followed. 4.1.3 All information submitted by Proposer shall be typewritten or provided as otherwise instructed to in the RFP. Proposers shall use and submit any applicable or required forms provided by the City and attach such to their proposal. Failure to use the forms may cause the proposal to be rejected and deemed non -responsive. 4.1.4 Proposals shall be submitted by an authorized representative of the firm. Proposals must be submitted in the business entities name by the President, Partner, Officer or Representative authorized to contractually bind the business entity. Proposals shall include an attachment evidencing that the individual submitting the proposal, does in fact have the required authority stated herein. 4.1.5 All proposals will become the property of the City. The Proposer's response to the RFP is a public record pursuant to Florida law, which is subject to disclosure by the City under the State of Florida Public Records Law, Florida Statutes Chapter 119.07 ("Public Records Law"). The City shall permit public access to all documents, papers, letters or other material submitted in connection with this RFP and the Contract to be executed for this RFP, subject to the provisions of Chapter 119.07 of the Florida Statutes. Any language contained in the Proposer's response to the RFP purporting to require confidentiality of any portion of the Proposer's response to the RFP, except to the extent that certain information is in the City's opinion a Trade Secret pursuant to Florida law, shall be void. If a Proposer submits any documents or other information to the City which the Proposer claims is Trade Secret information and exempt from Florida Statutes Chapter 119.07 ("Public Records Laws"), the Proposer shall clearly designate that it is a Trade Secret and that it is asserting that the document or information is exempt. The Proposer must specifically identify the exemption being claimed under Florida Statutes 119.07. The City shall be the final arbiter of whether any information contained in the Proposer's response to the RFP constitutes a Trade Secret. The city's determination of whether an exemption applies shall be final, and the Proposer agrees to defend, indemnify, and hold harmless the city and the city's officers, employees, and agent, against any loss or damages incurred by any person or entity as a result of the city's treatment of records as public records. In the event of Contract award, all documentation produced as part of the Contract shall become the exclusive property of the City. Version 10-2020 3/2(20024 2:24 FRM pp234 City d3i6odfSolicitationERdFIP23116586 IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT PRRCONTRACT@FORTLAUDERDALE.GOV, 954-828-5002, CITY CLERK'S OFFICE, 100 N. ANDREWS AVENUE, FORT LAUDERDALE, FLORIDA 33301. Contractor shall: 1. Keep and maintain public records required by the City in order to perform the service. 2. Upon request from the City's custodian of public records, provide the City with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in Chapter 119, Florida Statutes (2018), as may be amended or revised, or as otherwise provided by law. 3. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of this contract if the Contractor does not transfer the records to the City. 4. Upon completion of the Contract, transfer, at no cost, to the City all public records in possession of the Contractor or keep and maintain public records required by the City to perform the service. If the Contractor transfers all public records to the City upon completion of this Contract, the Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of this Contract, the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the City, upon request from the City's custodian of public records, in a format that is compatible with the information technology systems of the City. 4.1.6 By submitting a response Proposer is confirming that the firm has not been placed on the convicted vendors list as described in §287.133(2)(a) Florida Statutes; that the only person(s), company or parties interested in the proposal as principals are named therein; that the proposal is made without collusion with any other person(s), company or parties submitting a proposal; that it is in all respects fair and in good faith, without collusion or fraud; and that the signer of the proposal has full authority to bind the firm. 4.2 Contents of the Proposal The City deems certain documentation and information important in the determination of responsiveness and for the purpose of evaluating proposals. Proposals should seek to avoid information in excess of that requested, must be concise, and must specifically address the issues of this RFP. The City prefers that proposals be no more than 50 pages in one complete pdf document. The proposals should be organized, divided and indexed into the sections indicated herein. These are not inclusive of all the information that may be necessary to properly evaluate the proposal and meet the requirements of the scope of work and/or specifications. Additional Version 10-2020 3/2(20024 2:24 FRM pp235 City d3i6odfSolicitationERdFIP23116586 documents and information should be provided as deemed appropriate by the respondent in proposal to specific requirements stated herein or through the RFP. 4.2.1 Table of Contents The table of contents should outline in sequential order the major areas of the submittal, including enclosures. All pages should be consecutively numbered and correspond to the Table of Contents. 4.2.2 Executive Summary Each Offeror must submit an executive summary that identifies the business entity, its background, main office(s), and office location that will service this contract. Identify the officers, principals, supervisory staff and key individuals who will be directly involved with the work and their office locations. The executive summary should also summarize the key elements of the proposal. 4.2.3 Experience and Qualifications Indicate the firm's number of years of experience in providing the professional services as it relates the work contemplated. Provide details of past projects for agencies of similar size and scope, including information on your firm's ability to meet time and budget requirements. Indicate the firm's initiatives towards its own sustainable business practices that demonstrate a commitment to conservation. Indicate business structure, IE: Corp., Partnership, LLC. Firm should be registered as a legal entity in the State of Florida; Minority or Woman owned Business (if applicable); Company address, phone number, fax number, E-Mail address, website, contact person(s), etc. Relative size of the firm, including management, technical and support staff; licenses and any other pertinent information shall be submitted. 4.2.4 Approach to Scope of Work Provide in concise narrative form, your understanding of the City's needs, goals and objectives as they relate to the project, and your overall approach to accomplishing the project. Give an overview on your proposed vision, ideas and methodology. Describe your proposed approach to the project. As a part of the response, a design plan and diagram(s) shall be presented to the City for approval. The proposer shall also propose a scheduling methodology (timeline) for effectively managing and executing the services to be performed. Also provide information on your firm's current workload and how these services will fit into your workload. Describe available facilities, technological capabilities and other available resources you offer for these services. Consultant/Broker and team assigned to the City are to be able to accommodate consultation availability on an as -needed basis. Please offer information as to what can reasonably be expected for a turn -around time for phone calls and e-mails. Specifically advise as to who the City's first point of contact will be and the resume/qualifications of that person. Consultant/Broker will be asked to comment and recommend what coverage requirements should be required of third parties requesting use of City owned property. In your Version 10-2020 3/2(20024 2:24 FRM pp236 City dlifjodfbAiattdrdale SolicitationERdFIP23116586 response, please offer a narrative of your experience with various types of events and your methodology behind how you determine the types of coverages and limits that may be required. 4.2.5 References Provide at least three references (from government agencies) for services with similar scope as listed in this RFP. Information should include: • Client Name, address, contact person telephone and E-mail addresses. • Description of the services and identification of the primary consultant providing services. • Years the services were rendered. • Total cost of the service. Note: Do not include City of Fort Lauderdale work or staff as references to demonstrate your capabilities. The Committee is interested in work experience and references other than the City of Fort Lauderdale. 4.2.6 Minority/Women (M/WBE) Participation If your firm is a certified minority business enterprise as defined by the Florida Small and Minority Business Assistance Act of 1985, provide copies of your certification(s). If your firm is not a certified M/WBE, describe your company's previous efforts, as well as planned efforts in meeting M/WBE procurement goals under Florida Statutes 287.09451. 4.2.7 Subcontractors Proposer must clearly identify any subcontractors that may be utilized during the term of this contract. 4.2.8 Required Forms A. Proposal Certification Complete and attach the Proposal Certification provided herein. B. Cost Proposal Provide firm, fixed, costs for all services/products using the form provided in this request for proposal. These firm fixed costs for the project include any costs for travel and miscellaneous expenses. No other costs will be accepted. C. Non -Collusion Statement This form is to be completed, if applicable, and inserted in this section. D. Non -Discrimination Certification Form This form is to be completed and inserted in this section. E. Local Business Preference (LBP) This form is to be completed, if applicable, and inserted in this section. F. Disadvantaged Business Enterprise Preference (DBEP) This form is to be completed, if applicable, and inserted in this section. Version 10-2020 3/2(20024 2:24 FRM pp233 City d3i6odfSolicitationERdFIP23116586 G. Contract Payment Method This form must be completed and returned with your proposal. Proposers must presently have the ability to accept these credit cards or take whatever steps necessary to implement acceptance of a card before the start of the contract term, or contract award by the City. H. Sample Insurance Certificate Demonstrate your firm's ability to comply with insurance requirements. Provide a previous certificate or other evidence listing the Insurance Companies names for the required coverage and limits. I. W-9 for Proposing Firm This form must be completed and returned with your proposal. J. Active Status Page from Division of Corporations — Sunbiz.org Provide PDF of current page with your proposal. K. Florida General Lines Property and Casualty Insurance License Provide a current copy of this license in this section END OF SECTION Version 10-2020 3/2(20024 2:24 FRM pp236 City dlifjodfbAiattdrdale SolicitationFIP2 586 SECTION V — EVALUATION AND AWARD 5.1 Evaluation Procedure 5.1.1 Bid Tabulations/Intent to Award Notice of Intent to Award Contract/Bid, resulting from the City's Formal solicitation process, requiring City Commission action, may be found at: http://www.fortlauderdale.gov/departments/finance/procurement-services/notices-of-intent- to-award. Tabulations of receipt of those parties responding to a formal solicitation may be found at: http://www.fortlauderdale.gov/departments/finance/procu rement-services/bid- results, or any interested party may call the Procurement Services Division at 954-828- 5933. 5.1.2 Evaluation of proposals will be conducted by an Evaluation Committee, consisting of a minimum of three members of City Staff, or other persons selected by the City Manager or designee. All committee members must be in attendance at scheduled evaluation meetings. Meetings may be in person or virtual. Proposals shall be evaluated based upon the information and references contained in the responses as submitted. 5.1.3 The Committee may short list Proposals that it deems best satisfy the weighted criteria set forth herein. The committee may then conduct virtual interviews and/or require virtual oral presentations from the short-listed Proposers. The Evaluation Committee shall then re -score and re -rank the short-listed firms in accordance with the weighted criteria. 5.1.4 The City may require visits to the Proposer's facilities to inspect record keeping procedures, staff, facilities and equipment as part of the evaluation process. 5.1.5 The final ranking and the Evaluation Committee's recommendation may then be reported to the City Manager for consideration of contract award. 5.2 Evaluation Criteria 5.2.1 The City uses a mathematical formula to determine the scoring for each individual responsive and responsible firm based on the weighted criteria stated herein. Each evaluation committee member will rank each firm by criteria, giving their first ranked firm a number 1, the second ranked firm a number 2, and so on. The City shall multiply that average ranking by the weighted criterion identified herein to determine the total the points for each proposer. The lowest average final ranking score will determine the recommendation by the evaluation committee to the City Manager. 5.2.2 Weighted Criteria Understands the scope of the project 35% References, past performance, years in business 35% Total Project Cost 30% TOTAL PERCENT AVAILABLE: 100% 5.3 Contract Award The City reserves the right to award a contract to that Consultant who will best serve the interest Version 10-2020 3/2(20024 2:24 FRM pp23O City dlifjodfbAiattdrdale SolicitationERdFIP23116586 of the City. The City reserves the right, based upon its deliberations and in its opinion, to accept or reject any or all proposals. The City also reserves the right to waive minor irregularities or variations of the submittal requirements and RFP process. END OF SECTION Version 10-2020 3/2(20024 2:24 FRM pp246 City dlifjodfbAiattdrdale SolicitationFIP2 586 SECTION VI - COST PROPOSAL PAGE Proposer Name: Proposer agrees to supply the products and services at the prices bid below in accordance with the terms, conditions and specifications contained in this RFP. Cost to the City: Contractor shall quote firm, fixed, costs for all services identified in this request for proposal. These firm fixed costs for the project include any costs for travel and miscellaneous expenses. No other costs will be accepted. Total Firm, Fixed, Cost of Services $ Submitted by: Name (printed) Signature Date Title Version 10-2020 3/2(20024 2:24 FRM pp242 City 03i6odfbAiatttirdale SolicitationERff P2313E6586 CITY OF FORT LAUDERDALE GENERAL CONDITIONS These instructions and conditions are standard for all contracts for commodities or services issued through the City of Fort Lauderdale Procurement Services Division. The City may delete, supersede, or modify any of these standard instructions for a particular contract by indicating such change in the Invitation to Bid (ITB) Special Conditions, Technical Specifications, Instructions, Proposal Pages, Addenda, and Legal Advertisement. In this general conditions document, Invitation to Bid (ITB), Request for Qualifications (RFQ), and Request for Proposal (RFP) are interchangeable. PART I BIDDER PROPOSAL PAGE(S) CONDITIONS: 1.01 BIDDER ADDRESS: The City maintains automated vendor address lists that have been generated for each specific Commodity Class item through our bid issuing service, BidSync. Notices of Invitations to Bid (ITB'S) are sent by e-mail to the selection of bidders who have fully registered with BidSync or faxed (if applicable) to every vendor on those lists, who may then view the bid documents online. Bidders who have been informed of a bid's availability in any other manner are responsible for registering with BidSync in order to view the bid documents. There is no fee for doing so. If you wish bid notifications be provided to another e-mail address or fax, please contact BidSync. If you wish purchase orders sent to a different address, please so indicate in your bid response. If you wish payments sent to a different address, please so indicate on your invoice. 1.02 DELIVERY: Time will be of the essence for any orders placed as a result of this ITB. The City reserves the right to cancel any orders, or part thereof, without obligation if delivery is not made in accordance with the schedule specified by the Bidder and accepted by the City. 1.03 PACKING SLIPS: It will be the responsibility of the awarded Contractor, to attach all packing slips to the OUTSIDE of each shipment. Packing slips must provide a detailed description of what is to be received and reference the City of Fort Lauderdale purchase order number that is associated with the shipment. Failure to provide a detailed packing slip attached to the outside of shipment may result in refusal of shipment at Contractor's expense. 1.04 PAYMENT TERMS AND CASH DISCOUNTS: Payment terms, unless otherwise stated in this ITB, will be considered to be net 45 days after the date of satisfactory delivery at the place of acceptance and receipt of correct invoice at the office specified, whichever occurs last. Bidder may offer cash discounts for prompt payment but they will not be considered in determination of award. If a Bidder offers a discount, it is understood that the discount time will be computed from the date of satisfactory delivery, at the place of acceptance, and receipt of correct invoice, at the office specified, whichever occurs last. 1.05 TOTAL BID DISCOUNT: If Bidder offers a discount for award of all items listed in the bid, such discount shall be deducted from the total of the firm net unit prices bid and shall be considered in tabulation and award of bid. 1.06 BIDS FIRM FOR ACCEPTANCE: Bidder warrants, by virtue of bidding, that the bid and the prices quoted in the bid will be firm for acceptance by the City for a period of one hundred twenty (120) days from the date of bid opening unless otherwise stated in the ITB. 1.07 VARIANCES: For purposes of bid evaluation, Bidder's must indicate any variances, no matter how slight, from ITB General Conditions, Special Conditions, Specifications or Addenda in the space provided in the ITB. No variations or exceptions by a Bidder will be considered or deemed a part of the bid submitted unless such variances or exceptions are listed in the bid and referenced in the space provided on the bidder proposal pages. If variances are not stated, or referenced as required, it will be assumed that the product or service fully complies with the City's terms, conditions, and specifications. By receiving a bid, City does not necessarily accept any variances contained in the bid. All variances submitted are subject to review and approval by the City. If any bid contains material variances that, in the City's sole opinion, make that bid conditional in nature, the City reserves the right to reject the bid or part of the bid that is declared by the City as conditional. 1.08 NO BIDS: If you do not intend to bid please indicate the reason, such as insufficient time to respond, do not offer product or service, unable to meet specifications, schedule would not permit, or any other reason, in the space provided in this ITB. Failure to bid or return no bid comments prior to the bid due and opening date and time, indicated in this ITB, may result in your firm being deleted from our Bidder's registration list for the Commodity Class Item requested in this ITB. 1.09 MINORITY AND WOMEN BUSINESS ENTERPRISE PARTICIPATION AND BUSINESS DEFINITIONS: The City of Fort Lauderdale wants to increase the participation of Minority Business Enterprises (MBE), Women Business Enterprises (WBE), and Small Business Enterprises (SBE) in its procurement activities. If your firm qualifies in accordance with the below definitions please indicate in the space provided in this ITB. Minority Business Enterprise (MBE) "A Minority Business" is a business enterprise that is owned or controlled by one or more socially or economically disadvantaged persons. Such disadvantage may arise from cultural, racial, chronic economic circumstances or background or other similar cause. Such persons include, but are not limited to: Blacks, Hispanics, Asian Americans, and Native Americans. The term "Minority Business Enterprise" means a business at least 51 percent of which is owned by minority group members or, in the case of a publicly owned business, at least 51 percent of the stock of which is owned by minority group members. For the purpose of the preceding sentence, minority group members are citizens of the United States who include, but are not limited to: Blacks, Hispanics, Asian Americans, and Native Americans. Women Business Enterprise (WBE) a "Women Owned or Controlled Business" is a business enterprise at least 51 percent of which is owned by females or, in the case of a publicly owned business, at least 51 percent of the stock of which is owned by females. Small Business Enterprise (SBE) "Small Business" means a corporation, partnership, sole proprietorship, or other legal entity formed for the purpose of making a profit, which is independently owned and operated, has either fewer than 100 employees or less than $1,000,000 in annual gross receipts. BLACK, which includes persons having origins in any of the Black racial groups of Africa. WHITE, which includes persons whose origins are Anglo-Saxon and Europeans and persons of Indo-European decent including Pakistani and East Indian. HISPANIC, which includes persons of Mexican, Puerto Rican, Cuban, Central and South American, or other Spanish culture or origin, regardless of race. NATIVE AMERICAN, which includes persons whose origins are American Indians, Eskimos, Aleuts, or Native Hawaiians. ASIAN AMERICAN, which includes persons having origin in any of the original peoples of the Far East, Southeast Asia, the Indian subcontinent, or the Pacific Islands. Rev. 9/2019 3/2(20024 2:24IRM Page 1 pp2g0 City dlifjodfbAiattdrdale SoIicitationFIP2I386 1.10 MINORITY -WOMEN BUSINESS ENTERPRISE PARTICIPATION It is the desire of the City of Fort Lauderdale to increase the participation of minority (MBE) and women -owned (WBE) businesses in its contracting and procurement programs. While the City does not have any preference or set aside programs in place, it is committed to a policy of equitable participation for these firms. Proposers are requested to include in their proposals a narrative describing their past accomplishments and intended actions in this area. If proposers are considering minority or women owned enterprise participation in their proposal, those firms, and their specific duties have to be identified in the proposal. If a proposer is considered for award, he or she will be asked to meet with City staff so that the intended MBE/WBE participation can be formalized and included in the subsequent contract. SCRUTINIZED COMPANIES As to any contract for goods or services of $1 million or more and as to the renewal of any contract for goods or services of $1 million or more, subject to Odebrecht Construction, Inc., v. Prasad, 876 F.Supp.2d 1305 (S.D. Fla. 2012), affirmed, Odebrecht Construction, Inc., v. Secretary, Florida Department of Transportation, 715 F.3d 1268 (l lth Cir. 2013), with regard to the "Cuba Amendment," the Contractor certifies that it is not on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, and that it does not have business operations in Cuba or Syria, as provided in section 287.135, Florida Statutes (2019), as may be amended or revised. As to any contract for goods or services of any amount and as to the renewal of any contract for goods or services of any amount, the Contractor certifies that it is not on the Scrutinized Companies that Boycott Israel List created pursuant to Section 215.4725, Florida Statutes (2019), and that it is not engaged in a boycott of Israel. The City may terminate this Agreement at the City's option if the Contractor is found to have submitted a false certification as provided under subsection (5) of section 287.135, Florida Statutes (2019), as may be amended or revised, or been placed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List or the Scrutinized Companies that Boycott Israel List created pursuant to Section 215.4725, Florida Statutes (2019), or is engaged in a boycott of Israel, or has been engaged in business operations in Cuba or Syria, as defined in Section 287.135, Florida Statutes (2019), as may be amended or revised. 1.12 DEBARRED OR SUSPENDED BIDDERS OR PROPOSERS The bidder or proposer certifies, by submission of a response to this solicitation, that neither it nor its principals and subcontractors are presently debarred or suspended by any Federal department or agency. Part II DEFINITIONS/ORDER OF PRECEDENCE: 2.01 BIDDING DEFINITIONS The City will use the following definitions in its general conditions, special conditions, technical specifications, instructions to bidders, addenda and any other document used in the bidding process: INVITATION TO BID (ITB) The solicitation document used for soliciting competitive sealed bids for goods or services. INVITATION TO NEGOTIATE (ITN) All solicitation documents, regardless of medium, whether attached to or incorporated by reference in solicitations for responses from firms that invite proposals from interested and qualified firms so the city may enter into negotiations with the firm(s) determined most capable of providing the required goods or services. REQUEST FOR PROPOSALS (RFP) A solicitation method used for soliciting competitive sealed proposals to determine the best value among proposals for goods or services for which price may not be the prevailing factor in award of the contract, or the scope of work, specifications or contract terms and conditions may be difficult to define. Such solicitation will consider the qualifications of the proposers along with evaluation of each proposal using identified and generally weighted evaluation criteria. RFPs may include price criteria whenever feasible, at the discretion of the city. REQUEST FOR QUALIFICATIONS (RFQ) A solicitation method used for requesting statements of qualifications in order to determine the most qualified proposer for professional services. BID — a price and terms quote received in response to an ITB. PROPOSAL — a proposal received in response to an RFP. BIDDER — Person or firm submitting a Bid. PROPOSER — Person or firm submitting a Proposal. RESPONSIVE BIDDER — A firm who has submitted a bid, offer, quote, or response which conforms in all material respects to the competitive solicitation document and all of its requirements. RESPONSIBLE BIDDER — A firm who is fully capable of meeting all requirements of the solicitation and subsequent contract. The respondent must possess the full capability, including financial and technical, ability, business judgment, experience, qualifications, facilities, equipment, integrity, capability, and reliability, in all respects to perform fully the contract requirements and assure good faith performance as determined by the city. FIRST RANKED PROPOSER — That Proposer, responding to a City RFP, whose Proposal is deemed by the City, the most advantageous to the City after applying the evaluation criteria contained in the RFP. SELLER — Successful Bidder or Proposer who is awarded a Purchase Order or Contract to provide goods or services to the City. CONTRACTOR — Any firm having a contract with the city. Also referred to as a "Vendor". CONTRACT — All types of agreements, including purchase orders, for procurement of supplies, services, and construction, regardless of what these agreements may be called. CONSULTANT — A firm providing professional services for the city. 2.02 SPECIAL CONDITIONS: Any and all Special Conditions contained in this ITB that may be in variance or conflict with these General Conditions shall have precedence over these General Conditions. If no changes or deletions to General Conditions are made in the Special Conditions, then the General Conditions shall prevail in their entirety, PART III BIDDING AND AWARD PROCEDURES: 3.01 SUBMISSION AND RECEIPT OF BIDS: To receive consideration, bids must be received prior to the bid opening date and time. Unless otherwise specified, Bidders should use the proposal forms provided by the City. These forms may be duplicated, but failure to use the forms may cause the bid to be rejected. Any erasures or corrections on the bid must be made in ink and initialed by Bidder in ink. All information submitted by the Bidder shall be printed, typewritten or filled in with pen and ink. Bids shall be signed in ink. Separate bids must be submitted for each ITB issued by the City in separate sealed envelopes properly marked. When a particular ITB or RFP requires multiple copies of bids or proposals they may be included in a single envelope or package properly sealed and identified. Only send bids via facsimile transmission (FAX) if the ITB specifically states that bids sent via FAX will be considered. If such a statement is not included in the ITB, bids sent via FAX will be rejected. Bids will be publicly opened in the Procurement Office, or other designated area, in the presence of Bidders, the public, and City staff. Bidders and the public are invited and encouraged to attend bid openings. Bids will be tabulated and made available for review by Bidder's and the public in accordance with applicable regulations. Rev. 9/2019 3/2(20024 2:24 PtM Page 2 pp233 City d3i6odfI atttirdale SolicitationERdFIP213116586 3.02 MODEL NUMBER CORRECTIONS: If the model number for the make specified in this ITB is incorrect, or no longer available and replaced with an updated model with new specifications, the Bidder shall enter the correct model number on the bidder proposal page. In the case of an updated model with new specifications, Bidder shall provide adequate information to allow the City to determine if the model bid meets the City's requirements. 3.03 PRICES QUOTED: Deduct trade discounts, and quote firm net prices. Give both unit price and extended total. In the case of a discrepancy in computing the amount of the bid, the unit price quoted will govern. All prices quoted shall be F.O.B. destination, freight prepaid (Bidder pays and bears freight charges, Bidder owns goods in transit and files any claims), unless otherwise stated in Special Conditions. Each item must be bid separately. No attempt shall be made to tie any item or items contained in the ITB with any other business with the City. 3.04 TAXES: The City of Fort Lauderdale is exempt from Federal Excise and Florida Sales taxes on direct purchase of tangible property. Exemption number for EIN is 59-6000319, and State Sales tax exemption number is 85-8013875578C-1. 3.05 WARRANTIES OF USAGE: Any quantities listed in this ITB as estimated or projected are provided for tabulation and information purposes only. No warranty or guarantee of quantities is given or implied. It is understood that the Contractor will furnish the City's needs as they arise. 3.06 APPROVED EQUAL: When the technical specifications call for a brand name, manufacturer, make, model, or vendor catalog number with acceptance of APPROVED EQUAL, it shall be for the purpose of establishing a level of quality and features desired and acceptable to the City. In such cases, the City will be receptive to any unit that would be considered by qualified City personnel as an approved equal. In that the specified make and model represent a level of quality and features desired by the City, the Bidder must state clearly in the bid any variance from those specifications. It is the Bidder's responsibility to provide adequate information, in the bid, to enable the City to ensure that the bid meets the required criteria. If adequate information is not submitted with the bid, it may be rejected. The City will be the sole judge in determining if the item bid qualifies as an approved equal. 3.07 MINIMUM AND MANDATORY TECHNICAL SPECIFICATIONS: The technical specifications may include items that are considered minimum, mandatory, or required. If any Bidder is unable to meet or exceed these items, and feels that the technical specifications are overly restrictive, the bidder must notify the Procurement Services Division immediately. Such notification must be received by the Procurement Services Division prior to the deadline contained in the ITB, for questions of a material nature, or prior to five (5) days before bid due and open date, whichever occurs first. If no such notification is received prior to that deadline, the City will consider the technical specifications to be acceptable to all bidders. 3.08 MISTAKES: Bidders are cautioned to examine all terms, conditions, specifications, drawings, exhibits, addenda, delivery instructions and special conditions pertaining to the ITB. Failure of the Bidder to examine all pertinent documents shall not entitle the bidder to any relief from the conditions imposed in the contract. 3.09 SAMPLES AND DEMONSTRATIONS: Samples or inspection of product may be requested to determine suitability. Unless otherwise specified in Special Conditions, samples shall be requested after the date of bid opening, and if requested should be received by the City within seven (7) working days of request. Samples, when requested, must be furnished free of expense to the City and if not used in testing or destroyed, will upon request of the Bidder, be returned within thirty (30) days of bid award at Bidder's expense. When required, the City may request full demonstrations of units prior to award. When such demonstrations are requested, the Bidder shall respond promptly and arrange a demonstration at a convenient location. Failure to provide samples or demonstrations as specified by the City may result in rejection of a bid. 3.10 LIFE CYCLE COSTING: If so specified in the ITB, the City may elect to evaluate equipment proposed on the basis of total cost of ownership. In using Life Cycle Costing, factors such as the following may be considered: estimated useful life, maintenance costs, cost of supplies, labor intensity, energy usage, environmental impact, and residual value. The City reserves the right to use those or other applicable criteria, in its sole opinion that will most accurately estimate total cost of use and ownership. 3.11 BIDDING ITEMS WITH RECYCLED CONTENT: In addressing environmental concerns, the City of Fort Lauderdale encourages Bidders to submit bids or alternate bids containing items with recycled content. When submitting bids containing items with recycled content, Bidder shall provide documentation adequate for the City to verify the recycled content. The City prefers packaging consisting of materials that are degradable or able to be recycled. When specifically stated in the ITB, the City may give preference to bids containing items manufactured with recycled material or packaging that is able to be recycled. 3.12 USE OF OTHER GOVERNMENTAL CONTRACTS: The City reserves the right to reject any part or all of any bids received and utilize other available governmental contracts, if such action is in its best interest. 3.13 QUALIFICATIONS/INSPECTION: Bids will only be considered from firms normally engaged in providing the types of commodities/services specified herein. The City reserves the right to inspect the Bidder's facilities, equipment, personnel, and organization at any time, or to take any other action necessary to determine Bidder's ability to perform. The Procurement Director reserves the right to reject bids where evidence or evaluation is determined to indicate inability to perform. 3.14 BID SURETY: If Special Conditions require a bid security, it shall be submitted in the amount stated. A bid security can be in the form of a bid bond or cashier's check. Bid security will be returned to the unsuccessful bidders as soon as practicable after opening of bids. Bid security will be returned to the successful bidder after acceptance of the performance bond, if required; acceptance of insurance coverage, if required; and full execution of contract documents, if required; or conditions as stated in Special Conditions. 3.15 PUBLIC RECORDS/TRADE SECRETS/COPYRIGHT: The Proposer's response to the RFP is a public record pursuant to Florida law, which is subject to disclosure by the City under the State of Florida Public Records Law, Florida Statutes Chapter 119.07 ("Public Records Law"). The City shall permit public access to all documents, papers, letters or other material submitted in connection with this RFP and the Contract to be executed for this RFP, subject to the provisions of Chapter 119.07 of the Florida Statutes. Any language contained in the Proposer's response to the RFP purporting to require confidentiality of any portion of the Proposer's response to the RFP, except to the extent that certain information is in the City's opinion a Trade Secret pursuant to Florida law, shall be void. If a Proposer submits any documents or other information to the City which the Proposer claims is Trade Secret information and exempt from Florida Statutes Chapter 119.07 ("Public Records Laws"), the Proposer shall clearly designate that it is a Trade Secret and that it is asserting that the document or information is exempt. The Proposer must specifically identify the exemption being claimed under Florida Statutes 119.07. The City shall be the final arbiter of whether any information contained in the Proposer's response to the RFP constitutes a Trade Secret. The city's determination of whether an exemption applies shall be final, and the proposer agrees to defend, indemnify, and hold harmless the City and the City's officers, employees, and agents, against any loss or damages incurred by any person or entity as a result of the City's treatment of records as public records. In addition, the proposer agrees to defend, indemnify, and hold harmless the City and the City's officers, employees, and agents, against any loss or damages incurred by any person or entity as a Rev. 9/2019 3/2(20024 2:241RM Page 3 pp2d4 City d1i6odfIAiattdrdale SolicitationERdFIP23116586 result of the City's treatment of records as exempt from disclosure or confidential. Proposals bearing copyright symbols or otherwise purporting to be subject to copyright protection in full or in part may be rejected. The proposer authorizes the City to publish, copy, and reproduce any and all documents submitted to the City bearing copyright symbols or otherwise purporting to be subject to copyright protection. EXCEPT FOR CLEARLY MARKED PORTIONS THAT ARE BONA FIDE TRADE SECRETS PURSUANT TO FLORIDA LAW, DO NOT MARK YOUR RESPONSE TO THE RFP AS PROPRIETARY OR CONFIDENTIAL. DO NOT MARK YOUR RESPONSE TO THE RFP OR ANY PART THEREOF AS COPYRIGHTED. 3.16 PROHIBITION OF INTEREST: No contract will be awarded to a bidding firm who has City elected officials, officers or employees affiliated with it, unless the bidding firm has fully complied with current Florida State Statutes and City Ordinances relating to this issue. Bidders must disclose any such affiliation. Failure to disclose any such affiliation will result in disqualification of the Bidder and removal of the Bidder from the City's bidder lists and prohibition from engaging in any business with the City. 3.17 RESERVATIONS FOR AWARD AND REJECTION OF BIDS: The City reserves the right to accept or reject any or all bids, part of bids, and to waive minor irregularities or variations to specifications contained in bids, and minor irregularities in the bidding process. The City also reserves the right to award the contract on a split order basis, lump sum basis, individual item basis, or such combination as shall best serve the interest of the City. The City reserves the right to make an award to the responsive and responsible bidder whose product or service meets the terms, conditions, and specifications of the ITB and whose bid is considered to best serve the City's interest. In determining the responsiveness of the offer and the responsibility of the Bidder, the following shall be considered when applicable: the ability, capacity and skill of the Bidder to perform as required; whether the Bidder can perform promptly, or within the time specified, without delay or interference; the character, integrity, reputation, judgment, experience and efficiency of the Bidder; the quality of past performance by the Bidder; the previous and existing compliance by the Bidder with related laws and ordinances; the sufficiency of the Bidder's financial resources; the availability, quality and adaptability of the Bidder's supplies or services to the required use; the ability of the Bidder to provide future maintenance, service or parts; the number and scope of conditions attached to the bid. If the ITB provides for a contract trial period, the City reserves the right, in the event the selected bidder does not perform satisfactorily, to award a trial period to the next ranked bidder or to award a contract to the next ranked bidder, if that bidder has successfully provided services to the City in the past. This procedure to continue until a bidder is selected or the contract is re -bid, at the sole option of the City. 3.18 LEGAL REQUIREMENTS: Applicable provisions of all federal, state, county laws, and local ordinances, rules and regulations, shall govern development, submittal and evaluation of all bids received in response hereto and shall govern any and all claims and disputes which may arise between person(s) submitting a bid response hereto and the City by and through its officers, employees and authorized representatives, or any other person, natural or otherwise; and lack of knowledge by any bidder shall not constitute a cognizable defense against the legal effect thereof. 3.19 BID PROTEST PROCEDURE: Any proposer or bidder who is not recommended for award of a contract and who alleges a failure by the city to follow the city's procurement ordinance or any applicable law may protest to the chief procurement officer, by delivering a letter of protest to the director of finance within five (5) days after a notice of intent to award is posted on the city's web site at the following url: https://www.fortlauderdale.gov/departments/finance/procurement-services/notices-of-intent-to-award The complete protest ordinance may be found on the city's web site at the following url: https://library.municode.com/fl/fort lauderdale/codes/codeof ordinances?nodeid=coor ch2ad artvfidiv2prs2-182direpr PART IV BONDS AND INSURANCE 4.01 PERFORMANCE BOND: If a performance bond is required in Special Conditions, the Contractor shall within fifteen (15) working days after notification of award, furnish to the City a Performance Bond, payable to the City of Fort Lauderdale, Florida, in the face amount specified in Special Conditions as surety for faithful performance under the terms and conditions of the contract. If the bond is on an annual coverage basis, renewal for each succeeding year shall be submitted to the City thirty (30) days prior to the termination date of the existing Performance Bond. The Performance Bond must be executed by a surety company of recognized standing, authorized to do business in the State of Florida and having a resident agent. Acknowledgement and agreement is given by both parties that the amount herein set for the Performance Bond is not intended to be nor shall be deemed to be in the nature of liquidated damages nor is it intended to limit the liability of the Contractor to the City in the event of a material breach of this Agreement by the Contractor. 4.02 INSURANCE: The Contractor shall assume full responsibility and expense to obtain all necessary insurance as required by City or specified in Special Conditions. The Contractor shall provide to the Procurement Services Division original certificates of coverage and receive notification of approval of those certificates by the City's Risk Manager prior to engaging in any activities under this contract. The Contractor's insurance is subject to the approval of the City's Risk Manager. The certificates must list the City as an ADDITIONAL INSURED for General Liability Insurance, and shall have no less than thirty (30) days written notice of cancellation or material change. Further modification of the insurance requirements may be made at the sole discretion of the City's Risk Manager if circumstances change or adequate protection of the City is not presented. Bidder, by submitting the bid, agrees to abide by such modifications. PART V PURCHASE ORDER AND CONTRACT TERMS: 5.01 COMPLIANCE WITH SPECIFICATIONS, LATE DELIVERIES/PENALTIES: Items offered may be tested for compliance with bid specifications. Items delivered which do not conform to bid specifications may be rejected and returned at Contractor's expense. Any violation resulting in contract termination for cause or delivery of items not conforming to specifications, or late delivery may also result in: Bidder's name being removed from the City's bidder's mailing list for a specified period and Bidder will not be recommended for any award during that period. All City Departments being advised to refrain from doing business with the Bidder. All other remedies in law or equity. 5.02 ACCEPTANCE, CONDITION, AND PACKAGING: The material delivered in response to ITB award shall remain the property of the Seller until a physical inspection is made and the material accepted to the satisfaction of the City. The material must comply fully with the terms of the ITB, be of the required quality, new, and the latest model. All containers shall be suitable for storage and shipment by common carrier, and all prices shall include Rev. 9/2019 3/2(20024 2:241RM Page 4 pp2g5 City dlifjodfIAiattdrdale SolicitationERdFIP23116586 standard commercial packaging. The City will not accept substitutes of any kind. Any substitutes or material not meeting specifications will be returned at the Bidder's expense. Payment will be made only after City receipt and acceptance of materials or services. 5.03 SAFETY STANDARDS: All manufactured items and fabricated assemblies shall comply with applicable requirements of the Occupation Safety and Health Act of 1970 as amended. 5.04 ASBESTOS STATEMENT: All material supplied must be 100% asbestos free. Bidder, by virtue of bidding, certifies that if awarded any portion of the ITB the bidder will supply only material or equipment that is 100% asbestos free. 5.05 OTHER GOVERNMENTAL ENTITIES: If the Bidder is awarded a contract as a result of this ITB, the bidder may, if the bidder has sufficient capacity or quantities available, provide to other governmental agencies, so requesting, the products or services awarded in accordance with the terms and conditions of the ITB and resulting contract. Prices shall be F.O.B. delivered to the requesting agency. 5.06 VERBAL INSTRUCTIONS PROCEDURE: No negotiations, decisions, or actions shall be initiated or executed by the Contractor as a result of any discussions with any City employee. Only those communications which are in writing from an authorized City representative may be considered. Only written communications from Contractors, which are assigned by a person designated as authorized to bind the Contractor, will be recognized by the City as duly authorized expressions on behalf of Contractors. 5.07 INDEPENDENT CONTRACTOR: The Contractor is an independent contractor under this Agreement. Personal services provided by the Proposer shall be by employees of the Contractor and subject to supervision by the Contractor, and not as officers, employees, or agents of the City. Personnel policies, tax responsibilities, social security, health insurance, employee benefits, procurement policies unless otherwise stated in this ITB, and other similar administrative procedures applicable to services rendered under this contract shall be those of the Contractor. 5.08 INDEMNITY/HOLD HARMLESS AGREEMENT: Contractor shall protect and defend at Contractor's expense, counsel being subject to the City's approval, and indemnify and hold harmless the City and the City's officers, employees, volunteers, and agents from and against any and all losses, penalties, fines, damages, settlements, judgments, claims, costs, charges, expenses, or liabilities, including any award of attorney fees and any award of costs, in connection with or arising directly or indirectly out of any act or omission by the Contractor or by any officer, employee, agent, invitee, subcontractor, or sublicensee of the Contractor. Without limiting the foregoing, any and all such claims, suits, or other actions relating to personal injury, death, damage to property, defects in materials or workmanship, actual or alleged violations of any applicable statute, ordinance, administrative order, rule or regulation, or decree of any court shall be included in the indemnity hereunder. 5.09 TERMINATION FOR CAUSE: If, through any cause, the Contractor shall fail to fulfill in a timely and proper manner its obligations under this Agreement, or if the Contractor shall violate any of the provisions of this Agreement, the City may upon written notice to the Contractor terminate the right of the Contractor to proceed under this Agreement, or with such part or parts of the Agreement as to which there has been default, and may hold the Contractor liable for any damages caused to the City by reason of such default and termination. In the event of such termination, any completed services performed by the Contractor under this Agreement shall, at the option of the City, become the City's property and the Contractor shall be entitled to receive equitable compensation for any work completed to the satisfaction of the City. The Contractor, however, shall not be relieved of liability to the City for damages sustained by the City by reason of any breach of the Agreement by the Contractor, and the City may withhold any payments to the Contractor for the purpose of setoff until such time as the amount of damages due to the City from the Contractor can be determined. 5.10 5.11 TERMINATION FOR CONVENIENCE: The City reserves the right, in the City's best interest as determined by the City, to cancel any contract by giving written notice to the Contractor thirty (30) days prior to the effective date of such cancellation. CANCELLATION FOR UNAPPROPRIATED FUNDS: The obligation of the City for payment to a Contractor is limited to the availability of funds appropriated in a current fiscal period, and continuation of the contract into a subsequent fiscal period is subject to appropriation of funds, unless otherwise authorized by law. 5.12 RECORDS/AUDIT: The Contractor shall maintain during the term of the contract all books of account, reports and records in accordance with generally accepted accounting practices and standards for records directly related to this contract. The Contractor agrees to make available to the City Auditor or the City Auditor's designee, during normal business hours and in Broward, Miami -Dade or Palm Beach Counties, all books of account, reports, and records relating to this contract. The Contractor shall retain all books of account, reports, and records relating to this contract for the duration of the contract and for three years after the final payment under this Agreement, until all pending audits, investigations or litigation matters relating to the contract are closed, or until expiration of the records retention period prescribed by Florida law or the records retention schedules adopted by the Division of Library and Information Services of the Florida Department of State, whichever is later. 5.13 PERMITS, TAXES, LICENSES: The successful Contractor shall, at his/her/its own expense, obtain all necessary permits, pay all licenses, fees and taxes, required to comply with all local ordinances, state and federal laws, rules and regulations applicable to business to be carried out under this contract. 5.14 LAWS/ORDINANCES: The Contractor shall observe and comply with all Federal, state, local and municipal laws, ordinances rules and regulat that would apply to this contract. ons NON-DISCRIMINATION: The Contractor shall not, in any of its activities, including employment, discriminate against any individual on the basis of race, color, national origin, age, religion, creed, sex, disability, sexual orientation, gender, gender identity, gender expression, marital status, or any other protected classification as defined by applicable law. 1. The Contractor certifies and represents that the Contractor will comply with Section 2-187, Code of Ordinances of the City of Fort Lauderdale, Florida, (2019), as may be amended or revised, ("Section 2-187"), during the entire term of this Agreement. 2. The failure of the Contractor to comply with Section 2-187 shall be deemed to be a material breach of this Agreement, entitling the City to pursue any remedy stated below or any remedy provided under applicable law. 3. The City may terminate this Agreement if the Contractor fails to comply with Section 2-187. 4. The City may retain all monies due or to become due until the Contractor complies with Section 2-187. 5. The Contractor may be subject to debarment or suspension proceedings. Such proceedings will be consistent with the procedures in section 2-183 of the Code of Ordinances of the City of Fort Lauderdale, Florida. 5.15 UNUSUAL CIRCUMSTANCES: If during a contract term where costs to the City are to remain firm or adjustments are restricted by a percentage or CPI cap, unusual circumstances that could not have been foreseen by either party of the contract occur, and those circumstances significantly affect the Contractor's cost in providing the required prior items or services, then the Contractor may request adjustments to the costs to the City to reflect the changed circumstances. The circumstances must be beyond the control of the Contractor, and the requested adjustments must be fully documented. The Rev. 9/2019 3/2(20024 2:241RM Page 5 pp2e6 City dlifjodfIAiattdrdale SolicitationERdFIP23116586 City may, after examination, refuse to accept the adjusted costs if they are not properly documented, increases are considered to be excessive, or decreases are considered to be insufficient. In the event the City does not wish to accept the adjusted costs and the matter cannot be resolved to the satisfaction of the City, the City will reserve the following options: 1. The contract can be canceled by the City upon giving thirty (30) days written notice to the Contractor with no penalty to the City or Contractor. The Contractor shall fill all City requirements submitted to the Contractor until the termination date contained in the notice. 2. The City requires the Contractor to continue to provide the items and services at the firm fixed (non -adjusted) cost until the termination of the contract term then in effect. 3. If the City, in its interest and in its sole opinion, determines that the Contractor in a capricious manner attempted to use this section of the contract to relieve Contractor of a legitimate obligation under the contract, and no unusual circumstances had occurred, the City reserves the right to take any and all action under law or equity. Such action shall include, but not be limited to, declaring the Contractor in default and disqualifying Contractor from receiving any business from the City for a stated period of time. If the City does agree to adjusted costs, these adjusted costs shall not be invoiced to the City until the Contractor receives notice in writing signed by a person authorized to bind the City in such matters. 5.16 ELIGIBILITY: If applicable, the Contractor must first register with the Florida Department of State in accordance with Florida Statutes, prior to entering into a contract with the City. 5.17 PATENTS AND ROYALTIES: The Contractor, without exception, shall defend, indemnify, and hold harmless the City and the City's employees, officers, employees, volunteers, and agents from and against liability of any nature and kind, including cost and expenses for or on account of any copyrighted, patented or un-patented invention, process, or article manufactured or used in the performance of the contract, including their use by the City. If the Contractor uses any design, device, or materials covered by letters, patent or copyright, it is mutually agreed and understood without exception that the bid prices shall include any and all royalties or costs arising from the use of such design, device, or materials in any way involved in the work. 5.18 ASSIGNMENT: Contractor shall not transfer or assign the performance required by this ITB without the prior written consent of the City. Any award issued pursuant to this ITB, and the monies, which may become due hereunder, are not assignable except with the prior written approval of the City Commission or the City Manager or City Manager's designee, depending on original award approval. 5.19 GOVERNING LAW; VENUE: The Contract shall be governed by and construed in accordance with the laws of the State of Florida. Venue for any lawsuit by either party against the other party or otherwise arising out of the Contract, and for any other legal proceeding, shall be in the courts in and for Broward County, Florida, or in the event of federal jurisdiction, in the Southern District of Florida. 5.20 PUBLIC RECORDS: IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT PRRCONTRACT@FORTLAUDERDALE.GOV, 954-828-5002, CITY CLERK'S OFFICE, 100 N. ANDREWS AVENUE, FORT LAUDERDALE, FLORIDA 33301. Contractor shall comply with public records laws, and Contractor shall: 1. Keep and maintain public records required by the City to perform the service. 2. Upon request from the City's custodian of public records, provide the City with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in Chapter 119, Florida Statutes (2019), as may be amended or revised, or as otherwise provided by law. 3. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the Contractor does not transfer the records to the City. 4. Upon completion of the Contract, transfer, at no cost, to the City all public records in possession of the Contractor or keep and maintain public records required by the City to perform the service. If the Contractor transfers all public records to the City upon completion of the Contract, the Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the Contract, the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the City, upon request from the City's custodian of public records, in a format that is compatible with the information technology systems of the City. Rev. 9/2019 3/2(20024 2:241RM Page 6 pp2g3 City ceifyodf niaat®rdale SolicitationBdFRP21 326 NON -COLLUSION STATEMENT: By signing this offer, the vendor/contractor certifies that this offer is made independently and free from collusion. Vendor shall disclose below any City of Fort Lauderdale, FL officer or employee, or any relative of any such officer or employee who is an officer or director of, or has a material interest in, the vendor's business, who is in a position to influence this procurement. Any City of Fort Lauderdale, FL officer or employee who has any input into the writing of specifications or requirements, solicitation of offers, decision to award, evaluation of offers, or any other activity pertinent to this procurement is presumed, for purposes hereof, to be in a position to influence this procurement. For purposes hereof, a person has a material interest if they directly or indirectly own more than 5 percent of the total assets or capital stock of any business entity, or if they otherwise stand to personally gain if the contract is awarded to this vendor. In accordance with City of Fort Lauderdale, FL Policy and Standards Manual, 6.10.8.3, 3.3. City employees may not contract with the City through any corporation or business entity in which they or their immediate family members hold a controlling financial interest (e.g. ownership of five (5) percent or more). 3.4. Immediate family members (spouse, parents and children) are also prohibited from contracting with the City subject to the same general rules. Failure of a vendor to disclose any relationship described herein shall be reason for debarment in accordance with the provisions of the City Procurement Code. NAME RELATIONSHIPS In the event the vendor does not indicate any names, the City shall interpret this to mean that the vendor has indicated that no such relationships exist. Authorized Signature Title Name (Printed) Date Rev 05-2020 2/2f2992412:24 RQM pp236 City dlifjodfbAiattdrdale SolicitationFIP2 586 CONTRACTOR'S CERTIFICATE OF COMPLIANCE WITH NON-DISCRIMINATION PROVISIONS OF THE CONTRACT The completed and signed form should be returned with the Contractor's submittal. If not provided with submittal, the Contractor must submit within three business days of City's request. Contractor may be deemed non -responsive for failure to fully comply within stated timeframes. Pursuant to City Ordinance Sec. 2-17(a)(i)(ii), bidders must certify compliance with the Non -Discrimination provision of the ordinance. (a) Contractors doing business with the City shall not discriminate against their employees based on the employee's race, color, religion, gender (including identity or expression), marital status, sexual orientation, national origin, age, disability or any other protected classification as defined by applicable law. Contracts. Every Contract exceeding $100,000, or otherwise exempt from this section shall contain language that obligates the Contractor to comply with the applicable provisions of this section. The Contract shall include provisions for the following: (i) The Contractor certifies and represents that it will comply with this section during the entire term of the contract. (ii) The failure of the Contractor to comply with this section shall be deemed to be a material breach of the contract, entitling the City to pursue any remedy stated below or any remedy provided under applicable law. Authorized Signature Print Name and Title Date 3/2(20024 2:24 FRM pp2gO City dlifjodfbAiattdrdale SolicitationERdFIP23116586 CONTRACT PAYMENT METHOD The City of Fort Lauderdale has implemented a Procurement Card (P-Card) program which changes how payments are remitted to its vendors. The City has transitioned from traditional paper checks to credit card payments via MasterCard or Visa as part of this program. This allows you as a vendor of the City of Fort Lauderdale to receive your payments fast and safely. No more waiting for checks to be printed and mailed. In accordance with the contract, payments on this contract will be made utilizing the City's P-Card (MasterCard or Visa). Accordingly, bidders must presently have the ability to accept the credit card or take whatever steps necessary to implement acceptance of a card before the start of the contract term, or contract award by the City. All costs associated with the Contractor's participation in this purchasing program shall be borne by the Contractor. The City reserves the right to revise this program as necessary. By signing below you agree with these terms. Please indicate which credit card payment you prefer: ❑ MasterCard ❑ Visa Company Name Name (Printed) Signature Date Title 3/2(20024 2:24 FRM pp258 City dlifjodfIAiattdrdale SolicitationERdFIP2EagE6586 LOCAL BUSINESS PREFERENCE Section 2-199.2, Code of Ordinances of the City of Fort Lauderdale, (Ordinance No. C-12-04), provides for a local business preference. In order to be considered for a local business preference, a bidder must include the Local Business Preference Certification Statement of this ITB, as applicable to the local business preference class claimed at the time of bid submittal. Upon formal request of the City, based on the application of a Local Business Preference the Bidder shall, within ten (10) calendar days, submit the following documentation to the Local Business Preference Class claimed: A) Copy of City of Fort Lauderdale current year business tax receipt, or Broward County current year business tax receipt, and B) List of the names of all employees of the bidder and evidence of employees' residence within the geographic bounds of the City of Fort Lauderdale or Broward County, as the case may be, such as current Florida driver license, residential utility bill (water, electric, telephone, cable television), or other type of similar documentation acceptable to the City. Failure to comply at time of bid submittal shall result in the bidder being found ineligible for the local business preference. THE COMPLETE LOCAL BUSINESS PREFERENCE ORDINANCE MAY BE FOUND ON THE CITY'S WEB SITE AT THE FOLLOWING LINK: https://library.municode.com/fl/fortlauderdale/codes/codeofordinances?nodeld=COORCH2ADA RTVFI DIV2PR S2-186LOBUPRPR Definitions: The term "Business" shall mean a person, firm, corporation or other business entity which is duly licensed and authorized to engage in a particular work in the State of Florida. Business shall be broken down into four (4) types of classes: 1. Class A Business — shall mean any Business that has established and agrees to maintain a permanent place of business located in a non-residential zone and staffed with full-time employees within the limits of the City and shall maintain a staffing level of the prime contractor for the proposed work of at least fifty percent (50%) who are residents of the City. 2. Class B Business - shall mean any Business that has established and agrees to maintain a permanent place of business located in a non-residential zone and staffed with full-time employees within the limits of the City or shall maintain a staffing level of the prime contractor for the proposed work of at least fifty percent (50%) who are residents of the City. 3. Class C Business - shall mean any Business that has established and agrees to maintain a permanent place of business located in a non-residential zone and staffed with full-time employees within the limits of Broward County. 4. Class D Business — shall mean any Business that does not qualify as either a Class A, Class B, or Class C business. Forms Non -ISO Revision 03/31/2021 3/2(20024 2:24 FRM pp252 City dlifjodfIAiattdrdale SolicitationERdFIP23116586 LOCAL BUSINESS PREFERENCE CERTIFICATION STATEMEN.1 The Business identified below certifies that it qualifies for the local business price preference classification as indicated herein, and further certifies and agrees that it will re -affirm its local preference classification annually no later than thirty (30) calendar days prior to the anniversary of the date of a contract awarded pursuant to this ITB. Violation of the foregoing provision may result in contract termination. (1) (2) (3) (4) (5) Business Name Business Name Business Name Business Name Business Name (6) Business Name BIDDER'S COMPANY: is a Class A Business as defined in City of Fort Lauderdale Ordinance No. C-17- 26, Sec.2-186. A copy of the City of Fort Lauderdale current year Business Tax Receipt and a complete list of full-time employees and evidence of their addresses shall be provided within 10 calendar days of a formal request by the City. is a Class B Business as defined in the City of Fort Lauderdale Ordinance No. C- 17-26, Sec.2-186. A copy of the Business Tax Receipt or a complete list of full- time employees and evidence of their addresses shall be provided within 10 calendar days of a formal request by the City. is a Class C Business as defined in the City of Fort Lauderdale Ordinance No. C- 17-26, Sec.2-186. A copy of the Broward County Business Tax Receipt shall be provided within 10 calendar days of a formal request by the City. requests a Conditional Class A classification as defined in the City of Fort Lauderdale Ordinance No. C-17-26, Sec.2-186. Written certification of intent shall be provided within 10 calendar days of a formal request by the City. requests a Conditional Class B classification as defined in the City of Fort Lauderdale Ordinance No. C-17-26, Sec.2-186. Written certification of intent shall be provided within 10 calendar days of a formal request by the City. is considered a Class D Business as defined in the City of Fort Lauderdale Ordinance No. C-17-26, Sec.2-186 and does not qualify for Local Preference consideration. AUTHORIZED COMPANY PERSON: PRINT NAME SIGNATURE DATE Forms Non -ISO Revision 03/31/2021 3/2(20024 2:24 FRM pp230 City dlifjodfIAiattdrdale SolicitationERdFIP23116586 DISADVANTAGED BUSINESS ENTERPRISE (DBE) PREFERENCE Section 2-185, Code of Ordinances of the City of Fort Lauderdale, provides for a disadvantaged business preference. In order to be considered for a DBE Preference, a bidder must include a certification from a government agency, as applicable to the DBE Preference class claimed at the time of bid submittal. Upon formal request of the City, based on the application of a DBE Preference the Bidder shall, within ten (10) calendar days, submit the following documentation to the DBE Class claimed: A) Copy of City of Fort Lauderdale current year business tax receipt, or Broward County current year business tax receipt, or State of Florida active registration and/or B) List of the names of all employees of the bidder and evidence of employees' residence within the geographic bounds of the City of Fort Lauderdale or Broward County, as the case may be, such as current Florida driver license, residential utility bill (water, electric, telephone, cable television), or other type of similar documentation acceptable to the City. Failure to comply at time of bid submittal shall result in the bidder being found ineligible for the disadvantaged business preference. THE COMPLETE DBE PREFERENCE ORDINANCE MAY BE FOUND ON THE CITY'S WEB SITE AT THE FOLLOWING LINK: https://www.fortlauderdale.gov/home/showpublisheddocument?id=56883 Definitions a. The term "disadvantaged class 1 enterprise" shall mean any disadvantaged business enterprise that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the city, and provides supporting documentation of its City of Fort Lauderdale business tax and disadvantaged certification as established in the City's Procurement Manual. The term "Class B business" shall mean any business that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the city, or shall maintain a staffing level for the proposed work of at least fifty percent (50%) who are residents of the City of Fort Lauderdale. b. The term "disadvantaged class 2 enterprise" shall mean any disadvantaged business enterprise that has established and agrees to maintain a permanent place of business within the limits of the city with a full-time employees and provides supporting documentation of its City of Fort Lauderdale business tax and disadvantaged certification as established in the City's Procurement Manual. The term "Class D business" shall mean any business that does not qualify as a Class A, Class B, or Class C business. c. The term "disadvantaged class 3 enterprise" shall mean any disadvantaged business enterprise that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the Tri- County area and provides supporting documentation of its City of Fort Lauderdale business tax and disadvantaged certification as established in the City's Procurement Manual. d. The term "disadvantaged class 4 enterprise" shall mean any disadvantaged business enterprise that does not qualify as a Class A, Class B, or Class C business, but is located in the State of Florida and provides supporting documentation of its disadvantaged certification as established in the City's Procurement Manual. Forms Non -ISO 03/17/2021 3/2(20024 2:24 FRM pp232 City dlifjodfIAiattdrdale SolicitationERdFIP23116586 DISADVANTAGED BUSINESS ENTERPRISE CERTIFICATION STATEMENT The Business identified below certifies that it qualifies for the disadvantaged business enterprise price preference classification as indicated herein, and further certifies and agrees that it will re -affirm its preference classification annually no later than thirty (30) calendar days prior to the anniversary of the date of a contract awarded pursuant to this solicitation. Violation of the foregoing provision may result in contract termination. (1) (2) (3) (4) (5) Business Name Business Name Business Name Business Name Business Name BIDDER'S COMPANY: is a disadvantaged class 1 enterprise as defined in the City of Fort Lauderdale Ordinance Section 2-185 disadvantaged business enterprise that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the city, and provides supporting documentation of its City of Fort Lauderdale business tax and disadvantaged certification as established in the City's Procurement Manual. The term "Class B business" shall mean any business that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the city, or shall maintain a staffing level for the proposed work of at least fifty percent (50%) who are residents of the City of Fort Lauderdale. is a disadvantaged class 2 enterprise as defined in the City of Fort Lauderdale Ordinance Section 2-185 disadvantaged business enterprise that has established and agrees to maintain a permanent place of business within the limits of the city with a full-time employee(s) and provides supporting documentation of its City of Fort Lauderdale business tax and disadvantaged certification as established in the City's Procurement Manual. The term "Class D business" shall mean any business that does not qualify as a Class A, Class B, or Class C business. is a disadvantaged class 3 enterprise as defined in the City of Fort Lauderdale Ordinance Section 2-185 disadvantaged business enterprise that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the Tri-County area and provides supporting documentation of its City of Fort Lauderdale business tax and disadvantaged certification as established in the City's Procurement Manual. is a disadvantaged class 4 enterprise as defined in the City of Fort Lauderdale Ordinance Section 2-185 disadvantaged business enterprise that does not qualify as a Class A, Class B, or Class C business, but is located in the State of Florida and provides supporting documentation of its disadvantaged certification as established in the City's Procurement Manual. is not considered a Disadvantaged Enterprise Business as defined in the City of Fort Lauderdale Ordinance Sec.2-185 and does not qualify for DBE Preference consideration. AUTHORIZED COMPANY PERSON: PRINT NAME SIGNATURE DATE Forms Non -ISO 03/17/2021 3/2(20024 2:24 FRM pp234 City alifjodfIAiattdrdale SolicitationFIP2 586 RFP/Bid /Contract No: Project Description: E-VERIFY AFFIRMATION STATEMENT Contractor/Proposer/Bidder acknowledges and agrees to utilize the U.S. Department of Homeland Security's E-Verify System to verify the employment eligibility of, (a) all persons employed by Contractor/Proposer/Bidder to perform employment duties within Florida during the term of the Contract, and, (b) all persons (including subcontractors/vendors) assigned by Contractor/Proposer/Bidder to perform work pursuant to the Contract. The Contractor/Proposer/Bidder acknowledges and agrees that use of the U.S. Department of Homeland Security's E-Verify System during the term of the Contract is a condition of the Contract. Contractor/Proposer/ Bidder Company Name: Authorized Company Person's Signature: Authorized Company Person's Title: Date: 3/2(20024 2:24 FRM pp2g5 City dlifjodfIAiattdrdale SolicitationFIP2 586 BID/PROPOSAL CERTIFICATION Please Note: It is the sole responsibility of the bidder to ensure that his bid is submitted electronically through www.BidSync.com prior to the bid opening date and time listed. Paper bid submittals will not be accepted. All fields below must be completed. If the field does not apply to you, please note N/A in that field. If you are a foreign corporation, you may be required to obtain a certificate of authority from the department of state, in accordance with Florida Statute §607.1501 (visit http://www.dos.state.fl.us/). Company: (Legal Registration) EIN (Optional): Address: City: State: Zip: Telephone No.: FAX No.: Email: Delivery: Calendar days after receipt of Purchase Order (section 1.02 of General Conditions): Total Bid Discount (section 1.05 of General Conditions): Check box if your firm qualifies for MBE / SBE / WBE (section 1.09 of General Conditions): ❑ ADDENDUM ACKNOWLEDGEMENT - Proposer acknowledges that the following addenda have been received and are included in the proposal: Addendum No. Date Issued Addendum No. Date Issued Addendum No. Date Issued VARIANCES: If you take exception or have variances to any term, condition, specification, scope of service, or requirement in this competitive solicitation you must specify such exception or variance in the space provided below or reference in the space provided below all variances contained on other pages within your response. Additional pages may be attached if necessary. No exceptions or variances will be deemed to be part of the response submitted unless such is listed and contained in the space provided below. The City does not, by virtue of submitting a variance, necessarily accept any variances. If no statement is contained in the below space, it is hereby implied that your response is in full compliance with this competitive solicitation. If you do not have variances, simply mark N/A. You must also click the "Take Exception" button. The below signatory hereby agrees to furnish the following article(s) or services at the price(s) and terms stated subject to all instructions, conditions, specifications addenda, legal advertisement, and conditions contained in the bid/proposal. I have read all attachments including the specifications and fully understand what is required. By submitting this signed proposal, I will accept a contract if approved by the City and such acceptance covers all terms, conditions, and specifications of this bid/proposal. The below signatory also hereby agrees, by virtue of submitting or attempting to submit a response, that in no event shall the City's liability for respondent's direct, indirect, incidental, consequential, special or exemplary damages, expenses, or lost profits arising out of this competitive solicitation process, including but not limited to public advertisement, bid conferences, site visits, evaluations, oral presentations, or award proceedings exceed the amount of Five Hundred Dollars ($500.00). This limitation shall not apply to claims arising under any provision of indemnification or the City's protest ordinance contained in this competitive solicitation. Submitted by: Name (printed) Signature Date Title revised 04/2020 3/2(20024 2:24 FRM pp236 City dlifjodfIAiattdrdale SolicitationERff P2E113E6586 City of Fort Lauderdale • Procurement Services Division 100 N. Andrews Avenue, 619 • Fort Lauderdale, Florida 33301 954-828-5933 Fax 954-828-5576 purchase(a�fortlauderdale.gov ADDENDUM NO. 1 RFP No. 12536-525 TITLE: Property and Casualty Insurance Brokerage and Consulting Services ISSUED: June 28, 2021 This addendum is being issued to make the following change(s): Section 4.2.4 Approach to Scope of Work, below sentence has been deleted: "As a part of the response, a design plan and diagram(s) shall be presented to the City for approval." All other terms, conditions, and specifications remain unchanged. AnnDebra Diaz, CPPB Procurement Administrator Company Name: (please print) Bidder's Signature: Date: 3/2(20024 2:24 FRM pp233 City egiCyoa#bliad rdale Ft. Lauderdale Non -Utility Property Schedule 21-22 So l is itati o n BdtF fP2W963,586 Site Code Site Name Building Code Department Building Name Street City Postal Code ISO Const Age Sq Ft Year Updated Age of Roof Storm Protection # story Sprinkler % Flood Zone 2-14-19 Flood Policy 5 City Hall 1 City Hall City Hall 100 North Andrews Ave. Fort Lauderdale 33301-1016 6 1967 83,276 1995 1995 Plywood 8 100 AH Yes 6 Police Station 1 Police Police Station 1300 W. Broward Blvd. Fort Lauderdale 33312-1643 6 1958 88,607 1981 2007 Storm Shutters 3 0 X500 Yes 7 Jail 1 Police Police Jail 1320 W. Broward Blvd. Fort Lauderdale 33312-1643 6 1982 26,979 1988 1987 Metal Screens 2 100 X500 Yes 8 Building Services 1 Sustainable Development Building Services 700 NW 19th Ave. Fort Lauderdale 33311-7834 6 2005 36,665 2005 2005 Impact Glass/Doors 1 100 AH Yes 10 Downtown Parking Garage 1 Transportation & Mobility Downtown Parking Garage 100 SE 1st Street Fort Lauderdale 33301-1875 6 1985 442,400 1991 2001 Not Applicable 5 100 AH Yes 11 Aquatics Center 1 Parks & Rec Bathhouse and Training 501 Seabreeze Blvd. Fort Lauderdale 33316-1623 6 1965 8,136 1990 2006 Impact Glass/Shutters 1, 2 0 X500 Yes 11 Aquatics Center 2 Parks & Rec Entry and Life Guard Office 501 Seabreeze Blvd. Fort Lauderdale 33316-1623 6 1968 8,856 1968 1968 None 1 0 X500 Yes 11 Aquatics Center 3 Parks & Rec ISHOF - Museum - Retail 501 Seabreeze Blvd. Fort Lauderdale 33316-1623 6 1968 12,395 1991 1991 Storm Shutters (Partial) 1, 2 0 X500 Yes 11 Aquatics Center 4 Parks & Rec ISHOF - Museum Social Hall 501 Seabreeze Blvd. Fort Lauderdale 33316-1623 6 1968 4,297 1991 1995 Storm Shutters (Intercoastal Side) 1 0 X500 Yes 11 Aquatics Center 5 Parks & Rec ISHOF - Museum Arquitectonica 501 Seabreeze Blvd. Fort Lauderdale 33316-1623 6 1991 8,328 1993 1994 Impact Glass/Shutters 2 100 X500 Yes 11 Aquatics Center 6 Parks & Rec PROPERTY IN THE OPEN 501 Seabreeze Blvd. Fort Lauderdale 33316-1623 N/A N/A N/A N/A N/A Not Applicable N/A N/A X500 12 Arts & Science Garage 1 Transportation & Mobility Arts & Science Garage 101 SW 5th Ave. Fort Lauderdale 33312-7112 6 1990 300,000 1990 1990 Not Applicable 3 0 AH 13 Parking and TAM - Administration 1 Transportation & Mobility Parking and TAM - Administration 290 NE 3rd Ave. Fort Lauderdale 33301-1041 4 1960 14,449 1990 1990 None 2 0 X500 Yes 16 Executive Airport 1 Executive Airport Administration Building 6000 NW 21st Ave. Fort Lauderdale 33309-6642 5 2001 10,000 2001 2001 Impact Glass/Doors/Shutters 1 100 AH 16 Executive Airport 2 Airport Executive Customs Building 5301 E. Perimeter Rd. Fort Lauderdale 33309-2701 4 2015 8,074 2015 2015 None 1 100 AH 16 Executive Airport 3 Executive Airport Electrical Vault 5550 NW 23rd Ave Fort Lauderdale 33309-6642 6 1984 791 2002 2002 None 1 0 X500 16 Executive Airport 4 Airport Executive Maintenance - Building E 5505 E. Perimeter Rd. Fort Lauderdale 33309-6642 6 1976 1,656 1976 1976 Storm Shutters 1 0 X500 16 Executive Airport 7 Executive Airport New Maintenance Building 2020 Executive Airport Way Fort Lauderdale 33309-6642 6 2006 7,745 2006 Impact Glass 1 100 AH 17 Beach Community Center 1 Parks & Rec Beach Community Center 3351 NE 33rd Ave. Fort Lauderdale 33308-7197 2 2001 12,573 2001 2001 Impact Glass 1 0 X500 18 Croissant Park 1 Parks & Rec Pool/Recreation Center 245 West Park Dr. Fort Lauderdale 33315-2114 4 2001 5,354 2001 2001 Impact Glass 1 0 AH 18 Croissant Park 2 Parks & Rec Pool 245 West Park Dr. Fort Lauderdale 33315-2114 6 2001 3,800 N/A N/A Not Applicable 1 0 AH 19 Holiday Park 1 Parks & Rec Social Center 1300 E. Sunrise Blvd. Fort Lauderdale 33304-2802 4 1965 4,140 1981 1991 Impact Glass 1 0 AH 19 Holiday Park 2 Parks & Rec Tennis Center 1300 E. Sunrise Blvd. Fort Lauderdale 33304-2802 6 1997 2,200 1997 1997 Impact Glass 1 0 AH 19 Holiday Park 3 Parks & Rec Gymnasium 1300 E. Sunrise Blvd. Fort Lauderdale 33304-2802 4 1950 18,000 2004 2004 Impact Glass 1 100 AH 19 Holiday Park 4 Parks & Rec Concession Phase 1 (South) 1300 E. Sunrise Blvd. Fort Lauderdale 33304-2802 4 1998 2,940 1998 1998 Impact Glass 1 0 AH 19 Holiday Park 5 Parks & Rec Concession Phase 2 (North) 1300 E. Sunrise Blvd. Fort Lauderdale 33304-2802 4 2000 2,210 2000 2000 Impact Glass 1 0 AH 19 Holiday Park 6 Parks & Rec Press Box 1300 E. Sunrise Blvd. Fort Lauderdale 33304-2802 2 1998 1,194 1998 1998 Impact Glass 1 0 AH Page 1 of 14 S/2f1992419:24 AM pp286 City eiCyodbliad rdale Ft. Lauderdale Non -Utility Property Schedule 21-22 So I is itatio nBd9FfP2ti3iB 7586 Site Code Site Name Building Code Department Building Name Building Value Contents Value Property in the Open Value Total Insured Value Roof Covering Roof Shape Roof Pitch 5 City Hall 1 City Hall City Hall $ 11,931,200.00 $ 6,750,000.00 $ 174,000.00 $ 18,855,200.00 Single Ply Membrane Flat Flat 6 Police Station 1 Police Police Station $ 12,850,600.00 $ 775,000.00 $ 185,000.00 $ 13,810,600.00 Single Ply Membrane Flat Flat 7 Jail 1 Police Police Jail $ 4,619,900.00 $ 285,000.00 $ - $ 4,904,900.00 Gran Mod Bit. Flat Flat 8 Building Services 1 Sustainable Development Building Services $ 9,270,000.00 $ 796,000.00 $ 44,700.00 $ 10,110,700.00 Gran Mod Bit. Flat Flat 10 Downtown Parking Garage 1 Transportation & Mobility Downtown Parking Garage $ 38,600,000.00 $ 69,200.00 $ 65,000.00 $ 38,734,200.00 Not Applicable Not Applicable Not Applicable 11 Aquatics Center 1 Parks & Rec Bathhouse and Training $ 1,632,300.00 $ 225,000.00 $ - $ 1,857,300.00 Built -Up Flat Flat 11 Aquatics Center 2 Parks & Rec Entry and Life Guard Office $ 1,744,200.00 $ 550,000.00 $ - $ 2,294,200.00 Concrete Flat Flat 11 Aquatics Center 3 Parks & Rec ISHOF - Museum - Retail $ 2,677,400.00 $ - $ - $ 2,677,400.00 Built -Up Flat Flat 11 Aquatics Center 4 Parks & Rec ISHOF - Museum Social Hall $ 763,100.00 $ 25,000.00 $ - $ 788,100.00 Built -Up Flat Flat 11 Aquatics Center 5 Parks & Rec ISHOF - Museum Arquitectonica $ 2,801,500.00 $ 25,000.00 $ - $ 2,826,500.00 Single Ply Membrane Irregular High (> 30) 11 Aquatics Center 6 Parks & Rec PROPERTY IN THE OPEN $ - $ - $ 1,642,100.00 $ 1,642,100.00 12 Arts & Science Garage 1 Transportation & Mobility Arts & Science Garage $ 21,500,000.00 $ 72,000.00 $ 35,000.00 $ 21,607,000.00 Not Applicable Not Applicable Not Applicable 13 Parking and TAM - Administration 1 Transportation & Mobility Parking and TAM - Administration $ 1,330,400.00 $ 369,300.00 $ 8,500.00 $ 1,708,200.00 Gran Mod Bit. Flat Flat 16 Executive Airport 1 Executive Airport Administration Building $ 1,530,400.00 $ 296,000.00 $ 57,200.00 $ 1,883,600.00 Single Ply Membrane Flat Flat 16 Executive Airport 2 Executive Airport Customs Building $ 1,574,400.00 $ - $ - $ 1,574,400.00 Membrane Flat Flat 16 Executive Airport 3 Executive Airport Electrical Vault $ 159,500.00 $ 498,000.00 $ - $ 657,500.00 Single Ply Membrane Flat Flat 16 Executive Airport 4 Executive Airport Maintenance - Building E $ 176,900.00 $ 65,000.00 $ - $ 241,900.00 Gran Mod Bit. Flat Flat 16 Executive Airport 7 Executive Airport New Maintenance Building $ 658,300.00 $ 150,000.00 $ 20,000.00 $ 828,300.00 Concrete T's Flat Flat 17 Beach Community Center 1 Parks & Rec Beach Community Center $ 2,087,900.00 $ 167,900.00 $ 44,000.00 $ 2,299,800.00 Standing Seam / Gran Mod bit. Hip/Flat Flat/Medium (10 to 30) 18 Croissant Park 1 Parks & Rec Pool/Recreation Center $ 749,000.00 $ 88,500.00 $ 256,000.00 $ 1,093,500.00 Gran Mod Bit. Hip Medium (10 to 30) 18 Croissant Park 2 Parks & Rec Pool $ 1,197,000.00 $ - $ - $ 1,197,000.00 Not Applicable Not Applicable Not Applicable 19 Holiday Park 1 Parks & Rec Social Center $ 760,000.00 $ 150,000.00 $ - $ 910,000.00 Gran Mod Bit. Flat Flat 19 Holiday Park 2 Parks & Rec Tennis Center $ 560,700.00 $ 87,300.00 $ 4,415,000.00 $ 5,063,000.00 Gran Mod Bit. Flat Flat 19 Holiday Park 3 Parks & Rec Gymnasium $ 2,323,000.00 $ 75,300.00 $ - $ 2,398,300.00 Standing Seam Flat Flat 19 Holiday Park 4 Parks & Rec Concession Phase 1 (South) $ 269,600.00 $ 25,500.00 $ - $ 295,100.00 Standing Seam Gable Medium (10 to 30) 19 Holiday Park 5 Parks & Rec Concession Phase 2 (North) $ 267,100.00 $ 22,700.00 $ - $ 289,800.00 Standing Seam Gable Medium (10 to 30) 19 Holiday Park 6 Parks & Rec Press Box $ 129,600.00 $ 8,500.00 $ - $ 138,100.00 Metal Gable Medium (10 to 30) Page 2 of 14 8/2f31992419:24 AM pp289 City egiCyodINAiiad rdale Ft. Lauderdale Non -Utility Property Schedule 21-22 SolicitationBdtFP2 933,586 Site Code Site Name Building Code Department Building Name Street City Postal Code ISO Const Age Sq Ft Year Updated Age of Roof Storm Protection # story Sprinkler % Flood Zone 2-14-19 Flood Policy 19 Holiday Park 7 Parks & Rec Play Shelter 1300 E. Sunrise Blvd. Fort Lauderdale 33304-2802 3 2007 1,000 2007 2007 None 1 0 AH 19 Holiday Park 8 Parks & Rec Activity Center 1300 E. Sunrise Blvd. Fort Lauderdale 33304-2802 4 1968 17,500 1995 1995 None 1 0 AH 20 Carter Park 1 Parks & Rec Annex / Library 1450 W. Sunrise Blvd. Fort Lauderdale 33304-2325 4 1986 1,800 1986 1994 None 1 0 AH 20 Carter Park 2 Parks & Rec Bathhouse 1450 W. Sunrise Blvd. Fort Lauderdale 33304-2325 6 1953 1,850 1986 1986 Impact Glass 1 0 AH 20 Carter Park 3 Parks & Rec Concession / Press Box 1450 W. Sunrise Blvd. Fort Lauderdale 33304-2325 6 2002 2,800 2002 2002 Impact Glass 2 0 AH 20 Carter Park 4 Parks & Rec Gym 1450 W. Sunrise Blvd. Fort Lauderdale 33304-2325 4 1968 12,000 2000 2000 Metal Screens 1 0 AH 20 Carter Park 5 Parks & Rec Activity Center 1450 W. Sunrise Blvd. Fort Lauderdale 33304-2325 6 1957 2,140 1989 1986 Impact Glass 1 0 AH 20 Carter Park 6 Parks & Rec Social Center 1450 W. Sunrise Blvd. Fort Lauderdale 33304-2325 6 1968 1,856 2000 2000 Metal Screens 1 0 AH 20 Carter Park 7 Parks & Rec Recreation Center 1450 W. Sunrise Blvd. Fort Lauderdale 33304-2325 4 1,800 2001 2001 None 1 0 AH 20 Carter Park 8 Parks & Rec Carter Pavilion 1450 W. Sunrise Blvd. Fort Lauderdale 33304-2325 2 2005 500 2006 2006 None 1 0 AH 21 Floyd Hull Park 1 Parks & Rec Big League Press 2800 SW 8th Ave. Fort Lauderdale 33312-2109 2, 4, 5 1969 1,983 1986 1986 None 2 0 AH 21 Floyd Hut Park 2 Parks & Rec Morton Act Center and Concession 2800 SW 8th Ave. Fort Lauderdale 33312-2109 2, 4, 5 1986 6,600 1994 1994 None 1 0 AH 21 Floyd Hull Park 3 Parks & Rec Little League Press 2800 SW 8th Ave. Fort Lauderdale 33312-2109 2 1970 1,200 1986 1986 None 2 0 AH 21 Floyd Hull Park 4 Parks & Rec Minor League Press 2800 SW 8th Ave. Fort Lauderdale 33312-2109 2 1986 450 1986 1986 None 2 0 AH 21 Floyd Hull Park 5 Parks & Rec Football 2800 SW 8th Ave. Fort Lauderdale 33312-2109 2 1970 1,600 1986 1986 None 2 0 AH 21 Floyd Hull Park 6 Parks & Rec Storage 2800 SW 8th Ave. Fort Lauderdale 33312-2109 6 1970 2,000 1986 1986 None 1 0 AH 22 Riverland Park 1 Parks & Rec Activity Center 950 SW 27th Ave. Fort Lauderdale 33312-2908 4 2004 8,585 2004 2004 Impact Glass 1 0 X500 22 Riverland Park 2 Parks & Rec Pool 950 SW 27th Ave. Fort Lauderdale 33312-2908 6 2004 5,750 N/A N/A Not Applicable 1 0 X500 22 Riverland Park 3 Parks & Rec Restroom Building 950 SW 27th Ave. Fort Lauderdale 33312-2908 2 2018 384 2018 2018 None 1 0 X500 22 Riverland Park 4 Parks & Rec Pavilion 950 SW 27th Ave. Fort Lauderdale 33312-2908 3 2018 884 2018 2018 None 1 0 X500 23 Fire Station No. 35 1 Fire Rescue Fire Station No. 35 1969E Commercial Blvd Fort Lauderdale 33308-3767 6 2012 12,689 2012 2012 Impact Glass/Doors 2 100 X500 24 Fire Station No. 2 & Administration 1 Fire Rescue Fire Station No. 2 & Administration 528 NW 2nd St. Fort Lauderdale 33311-9108 6 2002 32,864 2002 2002 Impact Glass/Doors 1 & 3 100 X500 Yes 25 Fire Station No. 47 1 Fire Rescue Fire Station No. 47 1000 SW 27th Ave. Fort Lauderdale 33312-2837 6 2008 15,242 2008 2008 Impact Glass/Doors 2 100 X500 26 Fire Station No. 53 1 Fire Rescue Fire Station No. 53 2200 Executive Airport Way Fort Lauderdale 33309-1733 6 2008 26,410 2008 2008 Impact Glass/Doors 1 & 2 100 X500 27 Fire Station No. 54 1 Fire Rescue Fire Station No. 54 3211 NE 32nd St. Fort Lauderdale 33308-7102 4 2018 9,382 2018 2018 None 2 100 AE 29 Police Annex Bldg. 1 Police Police Annex Bldg. 1350 W. Broward Blvd. Fort Lauderdale 33312-1643 4 1964 6,000 1984 2002 Plywood 1 0 X500 Yes 31 South Beach 1 Parks & Rec Beach Restrooms 640 Seabreeze Blvd. Fort Lauderdale 33139 4 1991 1,292 1991 1991 None 1 0 AE Page 3 of 14 8/2f1992419:24 AM pp26B City egiCyoa#Ebiad rdale Ft. Lauderdale Non -Utility Property Schedule 21-22 SolicitationB88rP2 933,586 Site Code Site Name Building Code Department Building Name Building Value Contents Value Property in the Open Value Total Insured Value Roof Covering Roof Shape Roof Pitch 19 Holiday Park 7 Parks & Rec Play Shelter $ 73,500.00 $ - $ - $ 73,500.00 Metal Gable Low (< 10) 19 Holiday Park 8 Parks & Rec Activity Center $ 1,990,500.00 $ 275,000.00 $ - $ 2,265,500.00 Gran Mod Bit Flat Flat 20 Carter Park 1 Parks & Rec Annex / Library $ 350,000.00 $ 45,200.00 $ - $ 395,200.00 Standing Seam Gable Low (< 10) 20 Carter Park 2 Parks & Rec Bathhouse $ 283,000.00 $ 18,500.00 $ - $ 301,500.00 Gran Mod Bit. Flat Flat 20 Carter Park 3 Parks & Rec Concession / Press Box $ 377,500.00 $ 46,300.00 $ - $ 423,800.00 Single Ply Membrane Flat Flat 20 Carter Park 4 Parks & Rec Gym $ 1,746,800.00 $ 164,900.00 $ - $ 1,911,700.00 Gran Mod Bit. Flat Flat 20 Carter Park 5 Parks & Rec Activity Center $ 284,000.00 $ 42,800.00 $ - $ 326,800.00 Standing Seam / Gran Mod bit. Flat Flat 20 Carter Park 6 Parks & Rec Social Center $ 277,050.00 $ 37,400.00 $ 1,015,000.00 $ 1,329,450.00 Gran Mod Bit. Flat Flat 20 Carter Park 7 Parks & Rec Recreation Center $ 255,600.00 $ 29,600.00 $ - $ 285,200.00 Gran Mod Bit. Flat Flat 20 Carter Park 8 Parks & Rec Carter Pavilion $ 40,500.00 $ - $ - $ 40,500.00 Metal Gable Low (< 10) 21 Floyd Hull Park 1 Parks & Rec Big League Press $ 298,600.00 $ 52,000.00 $ - $ 350,600.00 Single Ply Membrane Flat Flat 21 Floyd Hull Park 2 Parks & Rec Morton Act Center and Concession $ 1,045,600.00 $ 124,400.00 $ 1,210,000.00 $ 2,380,000.00 Built -Up Flat Flat 21 Floyd Hull Park 3 Parks & Rec Little League Press $ 61,900.00 $ 12,000.00 $ - $ 73,900.00 Metal Sloped Low (< 10) 21 Floyd Hull Park 4 Parks & Rec Minor League Press $ 34,150.00 $ 16,000.00 $ - $ 50,150.00 Built -Up Flat Flat 21 Floyd Hull Park 5 Parks & Rec Football $ 91,400.00 $ 35,400.00 $ - $ 126,800.00 Built -Up Flat Flat 21 Floyd Hull Park 6 Parks & Rec Storage $ 75,400.00 $ 125,000.00 $ - $ 200,400.00 Not Applicable Not Applicable Not Applicable 22 Riverland Park 1 Parks & Rec Activity Center $ 1,453,500.00 $ 132,700.00 $ 105,000.00 $ 1,691,200.00 Standing Seam Gable end without bracing Medium (10 to 30) 22 Rivet -land Park 2 Parks & Rec Pool $ 1,842,100.00 $ - $ - $ 1,842,100.00 Not Applicable Not Applicable Not Applicable 22 Riverand Park 3 Parks & Rec Restroom Building $ 85,000.00 $ - $ - $ 85,000.00 Metal Flat Flat 22 Riverland Park 4 Parks & Rec Pavilion $ 40,000.00 $ 1,000.00 $ 41,000.00 Metal Arch 5/12 23 Fire Station No. 35 1 Fire Rescue Fire Station No. 35 $ 2,528,000.00 $ 379,200.00 $ 10,000.00 $ 2,917,200.00 Single Ply Membrane Flat Flat 24 Fire Station No. 2 & Administration 1 Fire Rescue Fire Station No. 2 & Administration $ 7,023,100.00 $ 1,362,400.00 $ 119,100.00 $ 8,504,600.00 Steel/Single Ply Membrane Flat/Gable Flat/Medium (10 to 30) 25 Fire Station No. 47 1 Fire Rescue Fire Station No. 47 $ 3,334,100.00 $ 514,500.00 $ 33,100.00 $ 3,881,700.00 Asphalt Roll/Clay Tile Flat/Gable Flat/Medium (10 to 30) 26 Fire Station No. 53 1 Fire Rescue Fire Station No. 53 $ 6,099,400.00 $ 1,006,800.00 $ 162,000.00 $ 7,268,200.00 Asphalt Roll/Ceramic Tile Flat Flat 27 Fire Station No. 54 1 Fire Rescue Fire Station No. 54 $ 3,325,000.00 $ 125,000.00 $ - $ 3,450,000.00 Membrane Flat Flat 29 Police Annex Bldg. 1 Police Police Annex Bldg. $ 871,400.00 $ 169,100.00 $ 7,300.00 $ 1,047,800.00 Standing Seam/Built- Hip/Flat Flat/Low (<10) 31 South Beach 1 Parks & Rec Beach Restrooms $ 195,000.00 $ 3,500.00 $ 190,800.00 $ 389,300.00 Standing Seam Hip Low (< 10) Page 4 of 14 B/2f1992419:24 AM pp269 City egiCyoa#bliad rdale Ft. Lauderdale Non -Utility Property Schedule 21-22 SolisitationBdiFW2b 67586 Site Code 32 Site Name Coast Guard Auxiliary Building Code 1 Department Parks & Rec Building Name McVey Station Street 601 Seabreeze Blvd. City Fort Lauderdale Postal Code 33316-1625 ISO Const 2 Age 1950 Sq Ft 2,020 Year Updated 1985 Age of Roof 1985 Storm Protection Plywood # story 1 Sprinkler % 0 Flood Zone 2-14-19 X500 Flood Policy Yes 33 Cooley's Landing 1 Parks & Rec Administration/Bath House 450 SW 7th Ave. Fort Lauderdale 33312-2567 2 1992 2,110 1992 1992 Storm Shutters 1 0 AE 33 Cooley's Landing 2 Parks & Rec Pavilion 450 SW 7th Ave. Fort Lauderdale 33312-2567 2 1992 576 1992 1992 None 1 0 AE 33 Cooley's Landing 3 Parks & Rec Restroom Building 450 SW 7th Ave. Fort Lauderdale 33312-2567 2 1992 429 1992 1992 None 1 0 AE 34 Fire Prevention Bureau 1 Fire Rescue Fire Prevention Bureau 2000 NE 16th St. Fort Lauderdale 33304-1419 2 1980 4,378 1993 1986 Storm Shutters 1 100 AE Yes 36 Fire Station No. 3 1 Fire Rescue Fire Station No. 3 2801 SW 4th Ave. Fort Lauderdale 33315-3033 6 2010 8,742 2010 2010 Impact Glass/Doors 1 100 X500 37 Fire Station (Old No. 08 / Fire Museum) 1 Fire Rescue Museum 1022 W. Las Olas Blvd. Fort Lauderdale 33312-7152 2 1927 3,020 1998 1989 Impact Glass 2 100 X500 Yes 37 Fire Station (Old No. 08 / FireMuseum) 2 Fire Rescue Fire Alarm Building 1022 W. Las Olas Blvd. Fort Lauderdale 33312-7152 6 1927 413 1927 1980 None 1 0 X500 38 Fire Station No. 13 1 Fire Rescue Fire Station No. 13 2871 E. Sunrises Blvd. Fort Lauderdale 33304-3327 4 1971 8,672 2003 1987 Storm Shutters 1 0 X Yes 39 Fire Station No. 46 1 Fire Rescue Fire Station No. 46 1515 NW 191h Street Fort Lauderdale 33311-6222 6 2012 10,491 2012 2012 Impact Glass/Doors 1 100 X500 41 Las Olas Marina 1 Parks & Rec Marina Administrative Office/Comfort Station 240 E. Las Olas Circle Fort Lauderdale 33316-1616 4 1998 3,000 1998 1998 Impact Glass/Doors/Shutters 1 0 AE Yes 42 Bass Park 1 Parks & Rec Pool House 2750 NW 191h St. Fort Lauderdale 33311-3302 6 1975 1,568 1999 1991 None 1 0 X500 42 Bass Park 2 Parks & Rec Recreation Center 2750 NW 19th St. Fort Lauderdale 33311-3302 2 1991 4,344 1991 1991 Storm Shutters 1 0 X500 42 Bass Park 3 Parks & Rec Pool 2750 NW 191h St. Fort Lauderdale 33311-3302 6 1997 3,744 N/A N/A Not Applicable 1 0 X500 43 Bayview Park 1 Parks & Rec Concession/Restrooms 4400 Bayview Dr. Fort Lauderdale 33308-5329 2 2004 1,935 2004 2004 Storm Shutters 1 0 X500 43 Bayview Park 2 Parks & Rec Gazebo 4400 Bayview Dr. Fort Lauderdale 33308-5329 3 1990 509 1990 1990 None 1 0 X500 45 Floranada Park 1 Parks & Rec Restrooms 5251 NE 14th Way Fort Lauderdale 33334-4912 2 1962 448 1988 1989 None 1 0 X500 45 Floranada Park 2 Parks & Rec Pavilion 5251 NE 14th Way Fort Lauderdale 33334-4912 1 1992 842 1992 1992 None 1 0 X500 46 George English Park 1 Parks & Rec Recreation Center 1101 Bayview Dr. Fort Lauderdale 33304-2504 2 1989 8,327 1990 1990 Impact Glass 1 0 AE Yes 46 George English Park 2 Parks & Rec Play Shelter 1101 Bayview Dr. Fort Lauderdale 33304-2504 1 2007 200 2007 2007 None 1 0 AE 47 Hardy Park 1 Parks & Rec Pump House 25 SW 9th St. Fort Lauderdale 33301-2047 4 1930 576 1930 1970 None 1 0 X500 Yes 47 Hardy Park 2 Parks & Rec Tennis Center (Courts) 25 SW 9th St. Fort Lauderdale 33301-2047 6 1938 24,780 1938 N/A Not Applicable 1 0 X500 Yes 47 Hardy Park 3 Parks & Rec Old Lawn Bowling Club Building 25 SW 9th St. Fort Lauderdale 33301-2047 6 1935 1,242 1935 1970 Impact Glass 1 0 X500 47 Hardy Park 4 Parks & Rec Restroom Building 25 SW 9th St. Fort Lauderdale 33301-2047 2 1966 576 2000 2000 None 1 0 X500 47 Hardy Park 5 Parks & Rec Pavilion 25 SW 9[h St. Fort Lauderdale 33301-2047 2 2009 840 2009 2009 None 1 0 X500 48 Lauderdale Manors Park 1 Parks & Rec Pool Building 1340 Chateau Park Dr. Fort Lauderdale 33311 2 2001 857 2001 2001 Impact Glass 1 0 X500 48 Lauderdale Manors Park 2 Parks & Rec Recreation Center 1340 Chateau Park Dr. Fort Lauderdale 33311 4 2001 3,500 2001 2001 Impact Glass 1 0 X500 Page 5 of 14 8/2f1992419:24 AM pp269 City eiCyodbliad rdale Ft. Lauderdale Non -Utility Property Schedule 21-22 So l is itatio nBd)FW2ti3iB 7586 Site Code Site Name Building Code Department Building Name Building Value Contents Value Property in the Open Value Total Insured Value Roof Covering Roof Shape Roof Pitch 32 Coast Guard Auxiliary 1 Parks & Rec McVey Station $ 215,800.00 $ - $ 22,400.00 $ 238,200.00 Rolled Asphalt Flat Flat 33 Cooley's Landing 1 Parks & Rec Administration/Bath House $ 285,100.00 $ 28,600.00 $ 207,300.00 $ 521,000.00 Clay Tile Hip/Gable Low (< 10) 33 Cooley's Landing 2 Parks & Rec Pavilion $ 30,100.00 $ - $ - $ 30,100.00 Clay Tile Hip Low (< 10) 33 Cooley's Landing 3 Parks & Rec Restroom Building $ 77,300.00 $ 1,000.00 $ - $ 78,300.00 Clay Tile Hip Low (< 10) 34 Fire Prevention Bureau 1 Fire Rescue Fire Prevention Bureau $ 568,900.00 $ 16,200.00 $ - $ 585,100.00 Built -Up Flat Flat 36 Fire Station No. 3 1 Fire Rescue Fire Station No. 3 $ 1,873,300.00 $ 368,400.00 $ 91,700.00 $ 2,333,400.00 Asphalt Roll Flat Flat 37 Fire Station (Old No. 08 / Fire Museum) 1 Fire Rescue Museum $ 373,300.00 $ - $ 15,600.00 $ 388,900.00 Clay Tile Gable Low (< 10) 37 Fire Station (Old No. 08 / Fire Museum) 2 Fire Rescue Fire Alarm Building $ 29,500.00 $ - $ - $ 29,500.00 Single Ply Membrane Flat Flat 38 Fire Station No. 13 1 Fire Rescue Fire Station No. 13 $ 1,582,300.00 $ 221,400.00 $ 80,100.00 $ 1,883,800.00 Single Ply Membrane/Steel Flat/Gable Flat/Medium (10 to 30) 39 Fire Station No. 46 1 Fire Rescue Fire Station No. 46 $ 2,165,300.00 $ 231,400.00 $ 31,900.00 $ 2,428,600.00 Single ply Membrane 41 Las Olas Manna 1 Parks & Rec Marina Administrative Office/Comfort Station $ 287,600.00 $ 39,700.00 $ 4,000.00 $ 331,300.00 Standing Seam Gable Medium (10 to 30) 42 Bass Park 1 Parks & Rec Pool House $ 192,400.00 $ 38,400.00 $ 208,500.00 $ 439,300.00 Single Ply Membrane Flat Flat 42 Bass Park 2 Parks & Rec Recreation Center $ 594,100.00 $ 72,200.00 $ - $ 666,300.00 Clay Tile Hip Medium (10 to 30) 42 Bass Park 3 Parks & Rec Pool $ 237,300.00 $ - $ - $ 237,300.00 Not Applicable Not Applicable Not Applicable 43 Bayview Park 1 Parks & Rec Concession/Restrooms $ 234,500.00 $ 7,300.00 $ 402,100.00 $ 643,900.00 Standing Seam Hip Low (< 10) 43 Bayview Park 2 Parks & Rec Gazebo $ 34,300.00 $ - $ - $ 34,300.00 Metal Hip Medium (10 to 30) 45 Floranada Park 1 Parks & Rec Restrooms $ 53,300.00 $ 500.00 $ 146,500.00 $ 200,300.00 Gran Mod Bit. Flat Flat 45 Floranada Park 2 Parks & Rec Pavilion $ 31,800.00 $ - $ - $ 31,800.00 Asphalt Shingle Hip Low (< 10) 46 George English Park 1 Parks & Rec Recreation Center $ 1,329,000.00 $ 148,200.00 $ 1,320,000.00 $ 2,797,200.00 Standing Seam Hip Medium (10 to 30) 46 George English Park 2 Parks & Rec Play Shelter $ 44,100.00 $ - $ - $ 44,100.00 Metal Gable Low (< 10) 47 Hardy Park 1 Parks & Rec Pump House $ 31,500.00 $ 1,000.00 $ 421,000.00 $ 453,500.00 Tar & Gravel Flat Flat 47 Hardy Park 2 Parks & Rec Tennis Center (Courts) $ 134,900.00 $ 68,100.00 $ - $ 203,000.00 Not Applicable Not Applicable Not Applicable 47 Hardy Park 3 Parks & Rec Old Lawn Bowling Club Building $ 152,100.00 $ - $ - $ 152,100.00 Tar & Gravel Flat Flat 47 Hardy Park 4 Parks & Rec Restroom Building $ 228,000.00 $ - $ - $ 228,000.00 Tar & Gravel Flat Flat 47 Hardy Park 5 Parks & Rec Pavilion $ 33,600.00 $ 1,000.00 $ - $ 34,600.00 Tile Hip 5/12 48 Lauderdale Manors Park 1 Parks & Rec Pool Building $ 74,600.00 $ 6,500.00 $ 75,000.00 $ 156,100.00 Metal Gable Medium (10 to 30) 48 Lauderdale Manors Park 2 Parks & Rec Recreation Center $ 667,000.00 $ 78,500.00 $ 85,000.00 $ 830,500.00 Coal Tar Gravel Hip Medium (10 to 30) Page 6 of 14 8/2f1992419:24 AM pp263 City dfiCyodE ad rdale Ft. Lauderdale Non -Utility Property Schedule 21-22 So l is itatio nBd1FW2ti3iB 7586 Site Code 48 Site Name Lauderdale Manors Park Building Code 3 Department Parks & Rec Building Name Pool Street 1340 Chateau Park Dr. City Fort Lauderdale Postal Code 33311 ISO Const 6 Age 2001 Sq Ft 5,900 Year Updated 2001 Age of Roof 2001 Storm Protection Not Applicable # story 1 Sprinkler % 0 Flood Zone 2 14 19 X500 Flood Policy 49 Mills Pond Park 1 Parks & Rec Batting Ticket Booth 2201 NW 9th Ave. Fort Lauderdale 33311-3729 2 2000 192 2000 2000 Storm Shutters 1 0 AH Yes 49 Mills Pond Park 2 Parks & Rec Recreation Office 2201 NW 9th Ave. Fort Lauderdale 33311-3729 1 1987 5,240 1987 1987 None 1 0 AH Yes 49 Mills Pond Park 3 Parks & Rec Restrooms / Concession 2201 NW 9th Ave. Fort Lauderdale 33311-3729 2 2000 1,247 2000 2000 Storm Shutters 1 0 AH Yes 49 Mills Pond Park 4 Parks & Rec Pavilion 1 2201 NW 9th Ave. Fort Lauderdale 33311-3729 1 2000 314 2000 2000 None 1 0 AH 49 Mills Pond Park 5 Parks & Rec Pavilion 2 2201 NW 9th Ave. Fort Lauderdale 33311-3729 1 2000 314 2000 2000 None 1 0 AH 49 Mills Pond Park 6 Parks & Rec Pavilion 3 2201 NW 9th Ave. Fort Lauderdale 33311-3729 1 2000 314 2000 2000 None 1 0 AH 49 Mills Pond Park 7 Parks & Rec Pavilion 4 2201 NW 9th Ave. Fort Lauderdale 33311-3729 1 2000 314 2000 2000 None 1 0 AH 49 Mills Pond Park 8 Parks & Rec Pavilion 5 2201 NW 9th Ave. Fort Lauderdale 33311-3729 1 2000 314 2000 2000 None 1 0 AH 49 Mills Pond Park 9 Parks & Rec Pavilion 6 2201 NW 9th Ave. Fort Lauderdale 33311-3729 1 2000 314 2000 2000 None 1 0 AH 49 Mills Pond Park 10 Parks & Rec Ticket Booth 2201 NW 9th Ave. Fort Lauderdale 33311-3729 3 2000 63 1994 1994 None 1 0 AH 49 Mills Pond Park 11 Parks & Rec Baseball/Softball Concession/Restroom Building 2201 NW 9th Ave. Fort Lauderdale 33311-3729 1 2000 474 2000 2000 Storm Shutters 1 0 AH 49 Mills Pond Park 12 Parks & Rec Maintenance Building 2201 NW 9th Ave. Fort Lauderdale 33311-3729 3 2012 2,907 2012 2012 None 1 0 AH 50 Osswald Park 1 Parks & Rec Activities Center 2220 NW 21st Ave. Fort Lauderdale 33311-2960 4, 5 1991 6,000 1991 1991 None 1 0 AH 50 Osswald Park 2 Parks & Rec Old Library 2220 NW 21st Ave. Fort Lauderdale 33311-2960 2 1991 6,000 1991 1991 None 1 0 AH 50 Osswald Park 3 Parks & Rec Restrooms East 2220 NW 21st Ave. Fort Lauderdale 33311-2960 2 1991 750 2007 2007 None 1 0 AH 50 Osswald Park 4 Parks & Rec Restrooms West 2220 NW 21st Ave. Fort Lauderdale 33311-2960 2 1991 750 2007 2007 None 1 0 AH 50 Osswald Park 5 Parks & Rec Basketball Court Shelter 2220 NW 21st Ave. Fort Lauderdale 33311-2960 3 2010 10,000 2010 2010 None 1 0 AH 50 Osswald Park 6 Parks & Rec West Pavilion 2220 NW 21st Ave. Fort Lauderdale 33311-2960 1 2006 1,200 2006 2006 None 1 0 AH 50 Osswald Park 7 Parks & Rec East Pavilion 2220 NW 21st Ave. Fort Lauderdale 33311-2960 1 2006 1,200 2006 2006 None 1 0 AH 51 Riverside Park 1 Parks & Rec Activity Center 555 SW 11th Ave. Fort Lauderdale 33312-2519 3 2004 2,048 2004 2004 Impact Glass 1 0 AH Yes 52 Snyder Park 1 Parks & Rec Caldwell Pavilion 3299 SW 4th Avenue Fort Lauderdale 33315-3014 2 1989 3,828 1989 1989 None 1 0 X Yes 52 Snyder Park 2 Parks & Rec Beach Restroom Building 1 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1972 400 1989 1989 None 1 0 X ? 52 Snyder Park 3 Parks & Rec Boat Rental Shed 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 2000 48 2000 2000 None 1 0 X Yes 52 Snyder Park 4 Parks & Rec Maintenance Building 3299 SW 4th Avenue Fort Lauderdale 33315-3014 2 2000 800 2000 2000 None 1 0 X Yes 52 Snyder Park 5 Parks & Rec Office/Administration Building 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1977 2,464 1974 1974 None 1 0 X Yes 52 Snyder Park 6 Parks & Rec Restroom Building 1 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1972 400 1972 1972 None 1 0 X ? Page 7 of 14 8/2f1992419:24 AM pp261f City eiCyodbliad rdale Ft. Lauderdale Non -Utility Property Schedule 21-22 SoIisitationBd8FW2W 7586 Site Code Site Name Building Code Department Building Name Building Value Contents Value Property in the Open Value Total Insured Value Roof Covering Roof Shape Roof Pitch 48 Lauderdale Manors Park 3 Parks & Rec Pool $ 1,222,600.00 $ - $ - $ 1,222,600.00 Not Applicable Not Applicable Not Applicable 49 Mills Pond Park 1 Parks & Rec Batting Ticket Booth $ 21,900.00 $ 4,500.00 $ 1,101,500.00 $ 1,127,900.00 Standing Seam Hip Low (< 10) 49 Mills Pond Park 2 Parks & Rec Recreation Office $ 604,600.00 $ 10,200.00 $ - $ 614,800.00 Asphalt Shingle Hip Medium (10 to 30) 49 Mills Pond Park 3 Parks & Rec Restrooms / Concession $ 152,700.00 $ 8,100.00 $ - $ 160,800.00 Standing Seam Hip Low (< 10) 49 Mills Pond Park 4 Parks & Rec Pavilion 1 $ 11,900.00 $ - $ - $ 11,900.00 Asphalt Shingle Hip Low (< 10) 49 Mills Pond Park 5 Parks & Rec Pavilion 2 $ 11,900.00 $ - $ - $ 11,900.00 Asphalt Shingle Hip Low (< 10) 49 Mills Pond Park 6 Parks & Rec Pavilion 3 $ 11,900.00 $ - $ - $ 11,900.00 Asphalt Shingle Hip Low (< 10) 49 Mills Pond Park 7 Parks & Rec Pavilion 4 $ 11,900.00 $ - $ - $ 11,900.00 Asphalt Shingle Hip Low (< 10) 49 Mills Pond Park 8 Parks & Rec Pavilion 5 $ 11,900.00 $ - $ - $ 11,900.00 Asphalt Shingle Hip Low (< 10) 49 Mills Pond Park 9 Parks & Rec Pavilion 6 $ 11,900.00 $ - $ - $ 11,900.00 Asphalt Shingle Hip Low (< 10) 49 Mills Pond Park 10 Parks & Rec Ticket Booth $ 5,100.00 $ - $ - $ 5,100.00 Metal Shingle Hip Low (< 10) 49 Mills Pond Park 11 Parks & Rec Baseball/Softball Concession/Restroom Building $ 64,600.00 $ 6,100.00 $ - $ 70,700.00 Asphalt Shingle/Asphalt Roll Flat/Gable Flat/Low (<10) 49 Mills Pond Park 12 Parks & Rec Maintenance Building $ 249,500.00 $ 85,000.00 $ 334,500.00 Metal 50 Osswald Park 1 Parks & Rec Activities Center $ 765,600.00 $ 136,300.00 $ 754,000.00 $ 1,655,900.00 Gran Mod Bit. Flat Flat 50 Osswald Park 2 Parks & Rec Old Library $ 666,100.00 $ 96,200.00 $ - $ 762,300.00 Single Ply Membrane Sloped Medium (10 to 30) 50 Osswald Park 3 Parks & Rec Restrooms East $ 126,800.00 $ - $ - $ 126,800.00 Metal Gable Medium (10 to 30) 50 Osswald Park 4 Parks & Rec Restrooms West $ 126,900.00 $ - $ - $ 126,900.00 Metal Gable Medium (10 to 30) 50 Osswald Park 5 Parks & Rec Basketball Court Shelter $ 182,500.00 $ - $ - $ 182,500.00 Metal Sloped Low (< 10) 50 Osswald Park 6 Parks & Rec West Pavilion $ 65,900.00 $ - $ - $ 65,900.00 Metal Gable Low (< 10) 50 Osswald Park 7 Parks & Rec East Pavilion $ 65,900.00 $ - $ - $ 65,900.00 Metal Gable Low (< 10) 51 Riverside Park 1 Parks & Rec Activity Center $ 380,100.00 $ 30,900.00 $ 84,600.00 $ 495,600.00 Standing Seam Hip Medium (10 to 30) 52 Snyder Park 1 Parks & Rec Caldwell Pavilion $ 242,100.00 $ - $ 520,300.00 $ 762,400.00 Standing Seam Hip Medium (10 to 30) 52 Snyder Park 2 Parks & Rec Beach Restroom Building 1 $ 58,100.00 $ 500.00 $ - $ 58,600.00 Standing Seam Hip Low (< 10) 52 Snyder Park 3 Parks & Rec Boat Rental Shed $ 2,000.00 $ 800.00 $ - $ 2,800.00 Rolled Asphalt Sloped Low (< 10) 52 Snyder Park 4 Parks & Rec Maintenance Building $ 40,700.00 $ 17,500.00 $ - $ 58,200.00 Asphalt Shingle Hip Low (< 10) 52 Snyder Park 5 Parks & Rec Office/Administration Building $ 184,700.00 $ 7,500.00 $ - $ 192,200.00 Standing Seam Hip Low (< 10) 52 Snyder Park 6 Parks & Rec Restroom Building 1 $ 58,000.00 $ 500.00 $ - $ 58,500.00 Standing Seam Hip Low (< 10) Page 8 of 14 8/2f1992419:24 AM pp265 City egiCyoa#bliad rdale Ft. Lauderdale Non -Utility Property Schedule 21-22 So l is itati o n BdiF W21i3i8 7586 Site Code Site Name Building Code Department Building Name Street City Postal Code ISO Const Age Sq Ft Year Updated Age of Roof Storm Protection # story Sprinkler % Flood Zone 2-14-19 Flood Policy 52 Snyder Park 7 Parks & Rec Ticket Booth 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1982 50 1982 1982 None 1 0 X Yes 52 Snyder Park 8 Parks & Rec Metering Room 1 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1974 50 1974 1974 None 1 0 X 52 Snyder Park 9 Parks & Rec Metering Room 2 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1974 50 1974 1974 None 1 0 X 52 Snyder Park 10 Parks & Rec Metering Room 3 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1974 50 1974 1974 None 1 0 X 52 Snyder Park 11 Parks & Rec Restroom Building 2 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1974 576 1974 1974 None 1 0 X ? 52 Snyder Park 12 Parks & Rec Beach Restroom Building 2 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 2010 80 2010 2010 None 1 0 X 2 52 Snyder Park 13 Parks & Rec Caldwell Restroom Building 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 578 1989 1989 None 1 0 X Yes 52 Snyder Park 14 Parks & Rec Caldwell Kitchen Building 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 1,320 1989 1989 None 1 0 X 52 Snyder Park 15 Parks & Rec Lifeguard Building 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 210 1989 1989 None 1 0 X 52 Snyder Park 16 Parks & Rec Pavilion 1 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 676 1989 1989 None 1 0 X 52 Snyder Park 17 Parks & Rec Pavilion 2 (Viewing Deck) 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 160 1989 N/A None 1 0 X 52 Snyder Park 18 Parks & Rec Pavilion 3 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 100 1989 1989 None 1 0 X 52 Snyder Park 19 Parks & Rec Pavilion 4 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 100 1989 1989 None 1 0 X 52 Snyder Park 20 Parks & Rec Pavilion 5 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 576 1989 1989 None 1 0 X 52 Snyder Park 21 Parks & Rec Pavilion 6 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 676 1989 1989 None 1 0 X 52 Snyder Park 22 Parks & Rec Pavilion 7 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 100 1989 1989 None 1 0 X 52 Snyder Park 23 Parks & Rec Pavilion 8 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 100 1989 1989 None 1 0 X 52 Snyder Park 24 Parks & Rec Pavilion 9 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 100 1989 1989 None 1 0 X 52 Snyder Park 25 Parks & Rec Pavilion 10 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 100 1989 1989 None 1 0 X 52 Snyder Park 26 Parks & Rec Pavilion 11 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 100 1989 1989 None 1 0 X 52 Snyder Park 27 Parks & Rec Pavilion 12 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 100 1989 1989 None 1 0 X 52 Snyder Park 28 Parks & Rec Pavilion 13 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 100 1989 1989 None 1 0 X 52 Snyder Park 29 Parks & Rec Pavilion 14 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 100 1989 1989 None 1 0 X 52 Snyder Park 30 Parks & Rec Pavilion 15 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 676 1989 1989 None 1 0 X 52 Snyder Park 31 Parks & Rec Pavilion 16 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 676 1989 1989 None 1 0 X 52 Snyder Park 32 Parks & Rec Pavilion 17 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 550 1989 1989 None 1 0 X 52 Snyder Park 33 Parks & Rec Pavilion 18 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1989 100 1989 1989 None 1 0 X Page 9 of 14 8/2f1992419:24 AM pp26@ City eiCyodbliad rdale Ft. Lauderdale Non -Utility Property Schedule 21-22 So l is itatio nBd8Ffl'2W B 7586 Site Code Site Name Building Code Department Building Name Building Value Contents Value Property in the Open Value Total Insured Value Roof Covering Roof Shape Roof Pitch 52 Snyder Park 7 Parks & Rec Ticket Booth $ 5,300.00 $ 1,500.00 $ - $ 6,800.00 Standing Seam Hip Low (< 10) 52 Snyder Park 8 Parks & Rec Metering Room 1 $ 5,400.00 $ - $ - $ 5,400.00 Standing Seam Hip Low (< 10) 52 Snyder Park 9 Parks & Rec Metering Room 2 $ 5,400.00 $ - $ - $ 5,400.00 Standing Seam Hip Low (< 10) 52 Snyder Park 10 Parks & Rec Metering Room 3 $ 5,400.00 $ - $ - $ 5,400.00 Standing Seam Hip Low (< 10) 52 Snyder Park 11 Parks & Rec Restroom Building 2 $ 81,900.00 $ 500.00 $ - $ 82,400.00 Standing Seam Hip Low (< 10) 52 Snyder Park 12 Parks & Rec Beach Restroom Building 2 $ 12,700.00 $ 200.00 $ - $ 12,900.00 Concrete Gable Medium (10 to 30) 52 Snyder Park 13 Parks & Rec Caldwell Restroom Building $ 77,400.00 $ 600.00 $ - $ 78,000.00 Asphalt Shingle Hip Low (< 10) 52 Snyder Park 14 Parks & Rec Caldwell Kitchen Building $ 87,400.00 $ 3,400.00 $ - $ 90,800.00 Asphalt Shingle Hip Low (< 10) 52 Snyder Park 15 Parks & Rec Lifeguard Building $ 19,900.00 $ 1,600.00 $ - $ 21,500.00 Sta Up nding Seam/Built- Flat/Hip Flat/Low (<10) 52 Snyder Park 16 Parks & Rec Pavilion 1 $ 31,100.00 $ - $ - $ 31,100.00 Standing Seam Hip Low (< 10) 52 Snyder Park 17 Parks & Rec Pavilion 2 (Viewing Deck) $ 5,800.00 $ - $ - $ 5,800.00 Not Applicable Not Applicable Not Applicable 52 Snyder Park 18 Parks & Rec Pavilion 3 $ 5,400.00 $ - $ - $ 5,400.00 Standing Seam Hip Low (< 10) 52 Snyder Park 19 Parks & Rec Pavilion 4 $ 5,400.00 $ - $ - $ 5,400.00 Standing Seam Hip Low (< 10) 52 Snyder Park 20 Parks & Rec Pavilion 5 $ 31,100.00 $ - $ - $ 31,100.00 Standing Seam Hip Low (< 10) 52 Snyder Park 21 Parks & Rec Pavilion 6 $ 31,100.00 $ - $ - $ 31,100.00 Standing Seam Hip Low (< 10) 52 Snyder Park 22 Parks & Rec Pavilion 7 $ 5,700.00 $ - $ - $ 5,700.00 Standing Seam Hip Low (< 10) 52 Snyder Park 23 Parks & Rec Pavilion 8 $ 5,700.00 $ - $ - $ 5,700.00 Standing Seam Hip Low (< 10) 52 Snyder Park 24 Parks & Rec Pavilion 9 $ 5,700.00 $ - $ - $ 5,700.00 Standing Seam Hip Low (< 10) 52 Snyder Park 25 Parks & Rec Pavilion 10 $ 5,700.00 $ - $ - $ 5,700.00 Standing Seam Hip Low (< 10) 52 Snyder Park 26 Parks & Rec Pavilion 11 $ 5,700.00 $ - $ - $ 5,700.00 Standing Seam Hip Low (< 10) 52 Snyder Park 27 Parks & Rec Pavilion 12 $ 5,700.00 $ - $ - $ 5,700.00 Standing Seam Hip Low (< 10) 52 Snyder Park 28 Parks & Rec Pavilion 13 $ 5,700.00 $ - $ - $ 5,700.00 Standing Seam Hip Low (< 10) 52 Snyder Park 29 Parks & Rec Pavilion 14 $ 5,700.00 $ - $ - $ 5,700.00 Standing Seam Hip Low (< 10) 52 Snyder Park 30 Parks & Rec Pavilion 15 $ 31,100.00 $ - $ - $ 31,100.00 Standing Seam Hip Low (< 10) 52 Snyder Park 31 Parks & Rec Pavilion 16 $ 31,100.00 $ - $ - $ 31,100.00 Standing Seam Hip Low (< 10) 52 Snyder Park 32 Parks & Rec Pavilion 17 $ 31,100.00 $ - $ - $ 31,100.00 Standing Seam Hip Low (< 10) 52 Snyder Park 33 Parks & Rec Pavilion 18 $ 5,700.00 $ - $ - $ 5,700.00 Standing Seam Hip Low (< 10) Page 10 of 14 8/2f1992419:24 AM pp265 City iCyod5 ad rdale Ft. Lauderdale Non -Utility Property Schedule 21-22 SolicitationBdiFf 2b1910586 Site Code Site Name Building Code Department Building Name Street City Postal Code ISO Const Age Sq Ft Year Updated Age of Roof Storm Protection # story Sprinkler % Flood Zone 2-14-19 Flood Policy 52 Snyder Park 34 Parks & Rec Pet Shelter 1 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1985 316 1989 1989 None 1 0 X 52 Snyder Park 35 Parks & Rec Pet Shelter 2 3299 SW 4th Avenue Fort Lauderdale 33315-3014 1 1985 397 1989 1989 None 1 0 X 53 Warfield Park 1 Parks & Rec Recreation Building 1000 North Andrews Ave. Fort Lauderdale 33316-1038 4 1997 5,184 2002 2002 None 1 0 X500 54 Police Harbor Patrol & Bathrooms 1 Police Police Harbor Patrol & Bathrooms 1784 SE 15th St. Fort Lauderdale 33316-3002 6 1980 1,680 1995 1980 Storm Shutters 1 0 AE 55 Police Horse Barn 1 Police Police Horse Barn 700 N. Federal Hwy Fort Lauderdale 33304-2802 4 1993 6,010 1993 1993 Storm Shutters 1 0 AH 58 Records Center - Print Shop 1 Information & Technology Records Center - Print Shop 401 SE 21st St. Fort Lauderdale 33316-3426 6 1948 2,278 1986 1991 None 1 0 AH 59 Fire Station No. 29 1 Fire Rescue Fire Station No. 29 2002 NE 16th St. Fort Lauderdale 33304 6 2010 10,267 2010 2010 Impact Glass/Doors 2 100 X 60 Fire Station No. 49 1 Fire Rescue Fire Station No. 49 1015 Seabreeze Blvd. Fort Lauderdale 33316 6 2010 11,820 2010 2010 Impact Glass/Doors 2 100 X500 61 Southside School 1 Parks & Rec Southside School 701 South Andrews Ave. Fort Lauderdale 33301 2 1950 12,147 2010 2010 Impact Glass 2 0 X500 63 HCD Transitional Triplex 1 Housing Comm Dev Triplex 1200 NW 3rd St. Fort Lauderdale 33311 1 1964 1,826 1964 1990 None 1 0 X500 65 HCD Transactional Duplex 1 Housing Comm Dev Duplex 1145 NW 5th Ave. Fort Lauderdale 33311 1 1965 2,084 1965 1990 None 1 0 AH 66 The ouse Restaurant 1 Parks & Rec Restaurant 301 SW 3 Avenue Fort Lauderdale 33312 2 1968 11,609 2000 2000 None 2 100 AH 67 Eula Johnson House 1 Comm Redev Agcy Eula Johnson House 1100 NW 6th Street Fort Lauderdale 33311 2 1953 1,576 2007 2007 Impact Glass 1 0 X500 70 Hortt Park 1 Parks & Rec Community Center 1700 SW 14th Court Fort Lauderdale 33312 4 2012 1,989 2012 2012 impact glass 1 100 X500 72 History Center 1 Parks & Rec Hoch Heritage 219 SW 2nd Ave Fort Lauderdale 33301 2 1949 6,780 2,012 2012 Impact Glass 1 0 AH 72 History Center 2 Parks & Rec Philemon Bryan House 227 SW 2nd Ave Fort Lauderdale 33301 2 1905 1,580 2,001 2001 None 2 100 AH 72 History Center 3 Parks & Rec King-Cromartie Building 229 SW 2nd Ave Fort Lauderdale 33301 1 1907 1,945 1,994 1994 None 2 0 AH 72 History Center 4 Parks & Rec New River Inn 231 SW 2nd Ave Fort Lauderdale 33301 2 1905 9,100 1,994 1994 None 3 100 AH 72 History Center 5 Parks & Rec School House 230 SW 3rd Ave Fort Lauderdale 33301 1 1976 600 1,993 1993 None 1 0 X500 72 History Center 6 Parks & Rec Acetylene Building 231 SW 2nd Ave Fort Lauderdale 33301 2 1905 160 1,994 1994 None 1 0 AH 72 History Center 7 Parks & Rec Pavilion 219 SW 2nd Ave Fort Lauderdale 33301 1 1976 408 1,976 1976 None 1 0 AH 73 Lewis Landing Pavilion 1 Parks & Rec Pavilion 630 SW 9th Ave Fort Lauderdale 33315 AE 74 Las Olas Parking Garage 1 Transportation & Mobility Parking Garage 200 E. Las Olas Circle Fort Lauderdale 33316 2018 2018 2018 5 AE 75 Fire Station No. 8 1 Fire Rescue Fire Station No. 8 1717 SW 1st St Fort Lauderdale 33315 4 2020 10,191 2020 2020 None 1 100 AH 76 Mangurian Park 1 Parks & Rec Restroom Building 3850 N Federal Hwy Fort Lauderdale 33308 2 2010 120 2010 2010 None 1 0 X 77 Dottie Mancini Park 1 Parks & Rec Restroom Building 6520 NE 22nd Ave Fort Lauderdale 33308 6 2000 80 2000 2000 None 1 0 AH 78 Victoria Park 1 Parks & Rec Pavilion 2 N Victoria Park Rd Fort Lauderdale 33301 1 2010 106 2016 2016 None 1 0 X Page 11 of 14 8/2f1992419:24 AM pp266 City egiCyodbliad rdale Ft. Lauderdale Non -Utility Property Schedule 21-22 So l is itatio nB8IFW2ti3iB 7586 Site Code Site Name Building Code Department Building Name Building Value Contents Value Property in the Open Value Total Insured Value Roof Covering Roof Shape Roof Pitch 52 Snyder Park 34 Parks & Rec Pet Shelter 1 $ 13,600.00 $ - $ - $ 13,600.00 Wood Shingles Hip Low (< 10) 52 Snyder Park 35 Parks & Rec Pet Shelter 2 $ 17,000.00 $ - $ - $ 17,000.00 Wood Shingles Hip Low (< 10) 53 Warfield Park 1 Parks & Rec Recreation Building $ 679,100.00 $ 68,500.00 $ 99,000.00 $ 846,600.00 Clay Shingles Hip/Flat Flat/Low (<10) 54 Police Harbor Patrol & Bathrooms 1 Police Police Harbor Patrol & Bathrooms $ 183,100.00 $ 35,000.00 $ 6,000.00 $ 224,100.00 Gran Mod Bit. Flat Flat 55 Police Horse Barn 1 Police Police Horse Barn $ 536,600.00 $ 74,900.00 $ 37,200.00 $ 648,700.00 Standing Seam Gable High (> 30) 58 Records Center - Print Shop 1 Information & Technology Records Center - Print Shop $ 282,200.00 $ 75,000.00 $ - $ 357,200.00 Gran Mod Bit. Flat Flat 59 Fire Station No. 29 1 Fire Rescue Fire Station No. 29 $ 2,283,500.00 $ 414,900.00 $ 72,200.00 $ 2,770,600.00 Asphalt Roll/Clay Tile Flat/Gable Flat/Low (<10) 60 Fire Station No. 49 1 Fire Rescue Fire Station No. 49 $ 2,670,100.00 $ 433,100.00 $ 120,400.00 $ 3,223,600.00 Asphalt Roll/Steel Flat Flat 61 Southside School 1 Parks & Rec Southside School $ 1,314,000.00 $ - $ 14,600.00 $ 1,328,600.00 Gran Mod Bit. Flat Flat 63 HCD Transitional Triplex 1 Housing Comm Triplex $ 123,900.00 $ 2,400.00 $ 1,200.00 $ 127,500.00 Rolled Asphalt Flat Flat 65 HCD Transactional Duplex 1 Housing Comm Dev Duplex $ 127,500.00 $ 1,900.00 $ 1,300.00 $ 130,700.00 Asphalt Shingle Gable Low (< 10) 66 The Riverhouse Restaurant 1 Parks & Rec Restaurant $ 2,241,533.00 $ - $ - $ 2,241,533.00 Metal Gable Medium 67 Eula Johnson House 1 Comm Redev Eula Johnson House $ 291,500.00 $ 45,000.00 $ - $ 336,500.00 70 Hortt Park 1 Parks & Rec Community Center $ 415,600.00 $ 2,000.00 $ 50,000.00 $ 467,600.00 Standing Seam gable medium 72 History Center 1 Parks & Rec Hoch Heritage $ 878,700.00 $ - $ - $ 878,700.00 Single Ply Membrane Flat Flat 72 History Center 2 Parks & Rec Philemon Bryan House $ 215,400.00 $ - $ - $ 215,400.00 Metal Pitched 72 History Center 3 Parks & Rec King-Cromartie Building $ 246,800.00 $ - $ - $ 246,800.00 Shingles 72 History Center 4 Parks & Rec New River Inn $ 2,090,808.00 $ - $ - $ 2,090,808.00 Metal Shingles Pitched 72 History Center 5 Parks & Rec School House $ 60,500.00 $ - $ - $ 60,500.00 Shingles 72 History Center 6 Parks & Rec Acetylene Building $ 7,500.00 $ - $ - $ 7,500.00 Metal 72 History Center 7 Parks & Rec Pavilion $ 12,600.00 $ - $ - $ 12,600.00 Metal 73 Lewis Landing Pavilion 1 Parks & Rec Pavilion $ 80,372.00 $ - $ - $ 80,372.00 Metal 74 Las Olas Parking Garage 1 Transportation & Mobility Parking Garage $ 22,600,000.00 $ - $ - $ 22,600,000.00 75 Fire Station No. 8 1 Fire Rescue Fire Station No. 8 $ 3,595,000.00 $ 125,000.00 $ 30,000.00 $ 3,750,000.00 Membrane Flat Flat 76 Mangurian Park 1 Parks & Rec Restroom Building $ 30,000.00 $ - $ - $ 30,000.00 Shingle Pitched 5/12 77 Dottie Mancini Park 1 Parks & Rec Restroom Building $ 20,000.00 $ - $ - $ 20,000.00 Concrete Flat Flat 78 Victoria Park 1 Parks & Rec Pavilion $ 10,000.00 $ - $ - $ 10,000.00 Shingle Pitched 5/12 Page 12 of 14 8/201992419:24 AM pp269 City egiCyoa#bliad rdale Ft. Lauderdale Non -Utility Property Schedule 21-22 So l is itati o n S88r W2W067586 Site Code Site Name Building Code Department Building Name Street City Postal Code ISO Const Age Sq Ft Year Updated Age of Roof Storm Protection # story Sprinkler % Flood Zone 2-14-19 Flood Policy 79 Riverland Preserve 1 Parks & Rec Main House 2681 Riverland Rd Fort Lauderdale 33312 2 1952 2,273 2000 2000 None 1 0 AH 79 Riverland Preserve 2 Parks & Rec Guest House 2681 Riverland Rd Fort Lauderdale 33312 2 1952 800 2000 2000 None 1 0 AH 79 Riverland Preserve 3 Parks & Rec Pump House 2681 Riverland Rd Fort Lauderdale 33312 6 1952 140 2000 2000 None 1 0 AH 79 Riverland Preserve 4 Parks & Rec Storage Bldg 2681 Riverland Rd Fort Lauderdale 33312 1 2000 240 2000 2000 None 1 0 AH 79 Riverland Preserve 5 Parks & Rec Carport / Shelter 2681 Riverland Rd Fort Lauderdale 33312 2 2000 800 2000 2000 None 1 0 AH 80 Middle River Terrace Park 1 Parks & Rec Annie Beck House 1329 NE 7th Ave Fort Lauderdale 33304 1 1916 944 2008 2008 None 1 0 AH 80 Middle River Terrace Park 2 Parks & Rec Pavilion 1329 NE 7th Ave Fort Lauderdale 33304 3 2010 864 2010 2010 None 1 0 AH 81 Esplanade Park 1 Parks & Rec Restroom Building 400 SW 2nd St Fort Lauderdale 33312 4 2006 1596 2006 2006 None 1 0 AH 82 Palm Aire Village Park 1 Parks & Rec Restroom Building 6401 NW 21st Ave Fort Lauderdale 33309 4 1992 824 1992 2002 None 1 0 X500 82 Palm Aire Village Park 2 Parks & Rec Pavilion 6401 NW 21st Ave Fort Lauderdale 33309 3 1992 864 1992 2002 None 1 0 X500 83 Sunset Memorial Admin 1 Parks & Rec Sunset Memorial Admin 3201 NW 191h St Fort Lauderdale 33311 6 1954 2156 2000 2000 None 1 100 X500 83 Sunset Memorial Admin 2 Parks & Rec Storage Bldg 3201 NW 191h St Fort Lauderdale 33311 1 2000 1064 2000 2000 None 1 0 X500 84 SW 11th Ave Swing Bridge 1 Parks & Rec Bridge Tender Office 500 SW 11th Ave Fort Lauderdale 33312 2 1925 224 2010 2010 None 1 0 AH 84 SW 11th Ave Swing Bridge 2 Parks & Rec Restroom Building 500 SW 11th Ave Fort Lauderdale 33312 1 1925 120 2010 2010 None 1 0 AH 85 Las Olas Oceanside Park 1 Parks & Rec Restroom Building 3000 E Las Olas Blvd Fort Lauderdale 33316 4 2018 1,900 2018 2018 None 1 0 X 85 Las Olas Oceanside Park 2 Parks & Rec Pump House 3001 E Las Olas Blvd Fort Lauderdale 33316 4 2018 1,292 2018 2018 None 1 0 X 86 Lauderdale Memorial Park 1 Parks & Rec Cemetery Office 2001 SW 4th Ave. Fort Lauderdale 33315 6 1968 4,476 2000 2000 None 1 0 X500 86 REPORT Lauderdale Memorial Park TOTALS: 2 Parks & Rec Pump House 2001 SW 4th Ave. Fort Lauderdale 33315 3 1998 2,200 1998 2000 None 1 0 X500 Page 13 of 14 8/2f1992419:24 AM pp258 City eiCyodEaiad rdale Ft. Lauderdale Non -Utility Property Schedule 21-22 SolisitationB88rW2b 93a586 Site Code Site Name Building Code Department Building Name Building Value Contents Value Property in the Open Value Total Insured Value Roof Covering Roof Shape Roof Pitch 79 Riverland Preserve 1 Parks & Rec Main House $ 375,100.00 $ 5,000.00 $ 20,000.00 $ 400,100.00 Metal Pitched 5/12 79 Riverland Preserve 2 Parks & Rec Guest House $ 100,000.00 $ - $ - $ 100,000.00 Shingle Pitched 5/12 79 Riverland Preserve 3 Parks & Rec Pump House $ 20,000.00 $ 10,000.00 $ - $ 30,000.00 Concrete Flat Flat 79 Riverland Preserve 4 Parks & Rec Storage Bldg $ 8,000.00 $ 10,000.00 $ - $ 18,000.00 Metal Pitched 5/12 79 Rivedand Preserve 5 Parks & Rec Carport / Shelter $ 24,000.00 $ - $ - $ 24,000.00 Metal Pitched 5/12 80 Middle ddle River Terrace rk 1 Parks & Rec Annie Beck House $ 195,000.00 $ - $ - $ 195,000.00 Shingle Pitched 5/12 80 ddle River Terrace2 Middle rk Parks & Rec Pavilion $ 27,500.00 $ 1,000.00 $ - $ 28,500.00 Metal Pitched 5/12 81 Esplanade Park 1 Parks & Rec Restroom Building $ 438,900.00 $ - $ - $ 438,900.00 Metal Pitched 5/12 82 Palm Aire Village Park 1 Parks & Rec Restroom Building $ 165,000.00 $ - $ - $ 165,000.00 Metal Pitched 5/12 82 Palm Aire Village Park 2 Parks & Rec Pavilion $ 40,000.00 $ 1,000.00 $ - $ 41,000.00 Metal Arch 5/12 83 Sunset Memorial Admin 1 Parks & Rec Sunset Memorial Admin $ 398,500.00 $ 100,000.00 $ - $ 498,500.00 Membrane Flat Flat 83 Sunset Memorial Admin 2 Parks & Rec Storage Bldg $ 45,000.00 $ 20,000.00 $ - $ 65,000.00 Built-up Wood Pitched 5/12 84 SW 11th Ave Swing Bridge 1 Parks & Rec Bridge Tender Office $ 50,400.00 $ 75,000.00 $ - $ 125,400.00 Metal Pitched 5/12 84 SW 11th Ave Swing Bridge 2 Parks & Rec Restroom Building $ 26,000.00 $ - $ - $ 26,000.00 Metal Pitched 5/12 85 Las Olas Oceanside Park 1 Parks & Rec Restroom Building $ 522,500.00 $ 3,000.00 $ - $ 525,500.00 Membrane Flat Flat 85 Las Olas Oceanside Park 2 Parks & Rec Pump House $ 323,000.00 $ 200,000.00 $ - $ 523,000.00 Membrane Flat Flat 86 Lauderdale Memorial Pa 1 Parks & Rec Cemetery Office $ 828,000.00 $ 125,000.00 $ - $ 953,000.00 Membrane Flat Flat 86 REPORT Lauderdale Memorial Park TOTALS: 2 Parks & Rec Pump House $ 92,500.00 $ 218,426,513.00 $ 50,000.00 $ 19,912,900.00 $ - $ 15,822,200.00 $ 142,500.00 $ 254,161,613.00 Built-up Flat Flat Page 14 of 14 8/201992419:24 AM pp259 City d3ifyodf LAiattdrdale Ft. Lauderdale Utility Property Schedule 21-22 SolicitationERffIP2 586 Site Code Site Name Building Code Department Building Name Street City Postal Code ISO Const Age Sq Ft Year Updated Age of Roof Storm Protection # story o Sprinkler /o Flood Zones as of 1-4-18 1 Peele Dixie Water Treatment Plant 1 Public Works Old - Clearwell Pump House 1500 South State Road 7 Lauderhill 33313-5808 6 1927 240 1927 1927 None 1 0 X 1 Peele Dixie Water Treatment Plant 2 Public Works Old - Filter Gallery 1500 South State Road 7 Lauderhill 33313-5808 6 1927 7,500 1927 1927 None 2 0 X 1 Peele Dixie Water Treatment Plant 3 Public Works Old - Fluoride Building 1500 South State Road 7 Lauderhill 33313-5808 6 1927 120 1927 1927 None 1 0 X 1 Peele Dixie Water Treatment Plant 4 Public Works New - FPL Switchgear House 1500 South State Road 7 Lauderhill 33313-5808 6 1927 1,120 1927 1927 None 1 0 X 1 Peele Dixie Water Treatment Plant 5 Public Works Old - Lime House 1500 South State Road 7 Lauderhill 33313-5808 6 1927 9,600 1927 1927 None 3 0 X 1 Peele Dixie Water Treatment Plant 6 Public Works Old - Main Building 1500 South State Road 7 Lauderhill 33313-5808 6 1927 14,400 1927 1927 None 2, 3 0 X 1 Peele Dixie Water Treatment Plant 7 Public Works Old - Plant 1500 South State Road 7 Lauderhill 33313-5808 6 1927 13,100 1927 1927 None 2 0 X 1 Peele Dixie Water Treatment Plant 8 Public Works New - Administration / Membrane 1500 South State Road 7 Lauderhill 33313-5808 6 2008 26,283 2008 2008 None 2 0 X 1 Peele Dixie Water Treatment Plant 9 Public Works New - Chemical 1500 South State Road 7 Lauderhill 33313-5808 6 2008 4,755 2008 2008 None 1 0 X 1 Peele Dixie Water Treatment Plant 10 Public Works New - Generator 1500 South State Road 7 Lauderhill 33313-5808 6 2008 1,615 2008 2008 None 1 0 X 1 Peele Dixie Water Treatment Plant 11 Public Works New - Clearwell 1500 South State Road 7 Lauderhill 33313-5808 6 2008 2,582 2008 2008 None 1 0 X 1 Peele Dixie Water Treatment Plant 12 Public Works New - Storage Tank 1500 South State Road 7 Lauderhill 33313-5808 6 2008 16,513 2008 2008 None 1 0 X 1 Peele Dixie Water Treatment Plant 13 Public Works New - Storage Tank 1500 South State Road 7 Lauderhill 33313-5808 6 2008 16,513 2008 2008 None 1 0 X 1 Peele Dixie Water Treatment Plant 14 Public Works Concentrate Pump Station 1500 South State Road 7 Lauderhill 33313-5808 6 2008 720 2008 2008 None 1 0 X 1 Peele Dixie Water Treatment Plant 15 Public Works Injection Well 1500 South State Road 7 Lauderhill 33313-5808 6 2008 225 2008 2008 None 1 0 X 1 Peele Dixie Water Treatment Plant 16 Public Works Monitoring Well 1500 South State Road 7 Lauderhill 33313-5808 6 2008 N/A 2008 2008 None 1 0 X 1 Peele Dixie Water Treatment Plant 17 Public Works High Service Pump Station 1500 South State Road 7 Lauderhill 33313-5808 6 2008 N/A 2008 2008 None 1 0 X 1 Peele Dixie Water Treatment Plant 18 Public Works Air Stripper/Transfer Pump Station 1500 South State Road 7 Lauderhill 33313-5808 6 1927 2,624 2008 2008 None 1 0 X 1 Peele Dixie Water Treatment Plant 19 Public Works Sample Testing Building 1500 South State Road 7 Lauderhill 33313-5808 6 1950 162 1950 1950 None 1 0 X 1 Peele Dixie Water Treatment Plant 20 Public Works PROPERTY IN THE OPEN 1500 South State Road 7 Lauderhill 33313-5808 N/A N/A N/A N/A N/A None N/A N/A X 2 Five Ash Water Treatment Plant 1 Public Works Administration Building 938 Northwest 38th Street Oakland Park 33309-5921 6 1980 9,208 1984 1995 None 2 0 AH 2 Five Ash Water Treatment Plant 2 Public Works Ammonia Building 938 Northwest 38th Street Oakland Park 33309-5921 6 2005 2,184 2005 2005 None 1 0 AH 2 Five Ash Water Treatment Plant 3 Public Works Chemical Building 938 Northwest 38th Street Oakland Park 33309-5921 6 1955 9,930 1955 1995 Impact Glass 3 0 AH 2 Five Ash Water Treatment Plant 4 Public Works Chlorine Building 938 Northwest 38th Street Oakland Park 33309-5921 6 1955 1,588 1955 1995 Impact Glass 1 0 AH 2 Five Ash Water Treatment Plant 5 Public Works Diesel Pump Building 938 Northwest 38th Street Oakland Park 33309-5921 6 1994 10,787 1994 1994 Storm Shutters 1 0 AH 2 Five Ash Water Treatment Plant 6 Public Works Main Filter Building 938 Northwest 38th Street Oakland Park 33309-5921 6 1955 61,938 1980 1995 Impact Glass 2 0 AH 2 Five Ash Water Treatment Plant 7 Public Works Maintenance Building 938 Northwest 38th Street Oakland Park 33309-5921 6 1965 2,484 1965 1995 None 1 0 AH 2 Five Ash Water Treatment Plant 8 Public Works Sludge Pit 938 Northwest 38th Street Oakland Park 33309-5921 6 1993 240 1993 2005 Not Applicable 1 0 AH Page 1 of 10 3/2(20024 2:24 FRM pp28@ City d3ifyodf Miattdrdale Ft. Lauderdale Utility Property Schedule 21-22 SolicitationERffIP2 586 Site Code Site Name Building Code Department Building Name Flood Policy Building Value Contents Value Property in the Open Value Total Insured Value Roof Covering Roof Shape Roof Pitch 1 Peele Dixie Water Treatment Plant 1 Public Works Old - Clearwell Pump House $ 52,700.00 $ - $ - $ 52,700.00 Concrete Flat Flat 1 Peele Dixie Water Treatment Plant 2 Public Works Old - Filter Gallery $ 1,692,000.00 $ - $ - $ 1,692,000.00 Concrete Flat Flat 1 Peele Dixie Water Treatment Plant 3 Public Works Old - Fluoride Building $ 25,000.00 $ - $ - $ 25,000.00 Clay Tile Gable Low (< 10) 1 Peele Dixie Water Treatment Plant 4 Public Works New - FPL Switchgear House $ 188,000.00 $ 125,000.00 $ - $ 313,000.00 Clay Tile Gable Low (< 10) 1 Peele Dixie Water Treatment Plant 5 Public Works Old - Lime House $ 2,257,900.00 $ 95,000.00 $ - $ 2,352,900.00 Clay Tile Gable end without bracing Medium (10 to 30) 1 Peele Dixie Water Treatment Plant 6 Public Works Old - Main Building $ 3,663,400.00 $ 189,000.00 $ - $ 3,852,400.00 Clay Tile Gable end without bracing Medium (10 to 30) 1 Peele Dixie Water Treatment Plant 7 Public Works Old - Plant $ 3,458,400.00 $ 185,000.00 $ - $ 3,643,400.00 Not Applicable Flat Flat 1 Peele Dixie Water Treatment Plant 8 Public Works New - Administration / Membrane $ 6,086,400.00 $ 10,085,000.00 $ $ 16,171,400.00 Clay Tile Hip Medium (10 to 30) 1 Peele Dixie Water Treatment Plant 9 Public Works New - Chemical $ 1,117,400.00 $ 1,961,300.00 $ - $ 3,078,700.00 Clay Tile Gable Low (< 10) 1 Peele Dixie Water Treatment Plant 10 Public Works New - Generator $ 341,300.00 $ 1,525,000.00 $ - $ 1,866,300.00 Clay Tile Gable Low (< 10) 1 Peele Dixie Water Treatment Plant 11 Public Works New - Clearwell $ 483,600.00 $ 365,000.00 $ - $ 848,600.00 Concrete Flat Flat 1 Peele Dixie Water Treatment Plant 12 Public Works New - Storage Tank $ 1,928,100.00 $ - $ - $ 1,928,100.00 Concrete Dome Low (< 10) 1 Peele Dixie Water Treatment Plant 13 Public Works New - Storage Tank $ 1,928,100.00 $ - $ - $ 1,928,100.00 Concrete Dome Low (< 10) 1 Peele Dixie Water Treatment Plant 14 Public Works Concentrate Pump Station $ 15,500.00 $ 115,000.00 $ - $ 130,500.00 Concrete Flat Flat 1 Peele Dixie Water Treatment Plant 15 Public Works Injection Well $ 2,500.00 $ 12,000.00 $ - $ 14,500.00 Not Applicable Not Applicable Not Applicable 1 Peele Dixie Water Treatment Plant 16 Public Works Monitoring Well $ 5,000.00 $ 35,000.00 $ - $ 40,000.00 Not Applicable Not Applicable Not Applicable 1 Peele Dixie Water Treatment Plant 17 Public Works High Service Pump Station $ $ 1,025,000.00 $ $ 1,025,000.00 Not Applicable Not Applicable Not Applicable 1 Peele Dixie Water Treatment Plant 18 Public Works Air Stripper/Transfer Pump Station $ 65,600.00 $ 657,000.00 $ - $ 722,600.00 Not Applicable Not Applicable Not Applicable 1 Peele Dixie Water Treatment Plant 19 Public Works Sample Testing Building $ 13,500.00 $ 5,000.00 $ - $ 18,500.00 Not Applicable Not Applicable Not Applicable 1 Peele Dixie Water Treatment Plant 20 Public Works PROPERTY IN THE OPEN $ $ $ 181,250.00 $ 181,250.00 Not Applicable Not Applicable Not Applicable 2 Treatment Plant Five Ash Water 1 Public Works Administration Building $ 2,430,900.00 $ 2,150,000.00 $ $ 4,580,900.00 Gran Mod Bit. Flat Flat 2 Five Ash Water Treatment Plant 2 Public Works Ammonia Building $ 524,500.00 $ 455,000.00 $ - $ 979,500.00 Clay Tile Gable Low (< 10) 2 Five Ash Water Treatment Plant 3 Public Works Chemical Building $ 2,716,850.00 $ 2,775,000.00 $ - $ 5,491,850.00 Built -Up Flat Flat 2 Five Ash Water Treatment Plant 4 Public Works Chlorine Building $ 147,700.00 $ 190,000.00 $ - $ 337,700.00 Built -Up Flat Flat 2 Five Ash Water Treatment Plant 5 Public Works Diesel Pump Building $ 2,433,500.00 $ 3,280,000.00 $ - $ 5,713,500.00 Built -Up Flat Flat 2 Five Ash Water Treatment Plant 6 Public Works Main Filter Building $ 13,378,600.00 $ 14,500,000.00 $ - $ 27,878,600.00 Built -Up Flat Flat 2 Five Ash Water Treatment Plant 7 Public Works Maintenance Building $ 392,600.00 $ 225,000.00 $ - $ 617,600.00 Tar & Gravel Flat Flat 2 Five Ash Water Treatment Plant 8 Public Works Sludge Pit $ 15,000.00 $ 235,000.00 $ - $ 250,000.00 Concrete Flat Flat Page 2 of 10 3/2(20024 2:24 FRM pp2833 City d3ifyodf Miattdrdale Ft. Lauderdale Utility Property Schedule 21-22 SolicitationERffIP2 586 Site Code Site Name Building Code Department Building Name Street City Postal Code ISO Const Age Sq Ft Year Updated Age of Roof Storm Protection # story o Sprinkler /o Flood Zones as of 1-4-18 2 Five Ash Water Treatment Plant 9 Public Works Electrical Substation 938 Northwest 38th Street Oakland Park 33309-5921 6 1963 1,358 1963 1995 None 1 0 AH 2 Five Ash Water Treatment Plant 10 Public Works Hydrotreater 1-2 938 Northwest 38th Street Oakland Park 33309-5921 6 1955 7,906 1955 N/A Not Applicable 1 0 AH 2 Five Ash Water Treatment Plant 11 Public Works Hydrotreater 3 938 Northwest 38th Street Oakland Park 33309-5921 6 1964 5,026 1964 N/A Not Applicable 1 0 AH 2 Five Ash Water Treatment Plant 12 Public Works Hydrotreater 4 938 Northwest 38th Street Oakland Park 33309-5921 6 1980 5,026 1980 N/A Not Applicable 1 0 AH 2 Five Ash Water Treatment Plant 13 Public Works Aeration Basin 1-2 938 Northwest 38th Street Oakland Park 33309-5921 6 1963 2,436 1963 N/A Not Applicable 1 0 AH 2 Five Ash Water Treatment Plant 14 Public Works Recarbonation Basin 1-2 938 Northwest 38th Street Oakland Park 33309-5921 6 1953 1,456 1953 N/A Not Applicable 1 0 AH 2 Five Ash Water Treatment Plant 15 Public Works Recarbonation Basin 3-4938 Northwest 38th Street Oakland Park 33309-5921 6 1964- 1980 1,119 1980 1964 Not Applicable 1 0 AH 2 Five Ash Water Treatment Plant 16 Public Works Ground Water Storage Tank (Steel-5M Gallon) 938 Northwest 38th Street Oakland Park 33309-5921 6 1955 21,382 1955 1955 Not Applicable 1 0 AH 2 Five Ash Water Treatment Plant 17 Public Works Ground Water Storage Tank (Reinforced Concrete-5M Gallon) 938 Northwest 38th Street Oakland Park 33309-5921 6 1980 20,106 1980 1980 Not Applicable 1 0 AH 2 Five Ash Water Treatment Plant 18 Public Works Ground Water Storage Tank (Reinforced Concrete-7M Gallon) 938 Northwest 38th Street Oakland Park 33309-5921 6 1998 26,880 1998 1998 Not Applicable 1 0 AH 2 Treatment Plant Five Ash Water 19 Public Works High Service Pump Station 12-16 938 Northwest 38th Street Oakland Park 33309-5921 6 1993 3,456 1993 1993 Not Applicable 1 0 AH 2 Treatment Plant Five Ash Water 20 Public Works Transfer/Recovery Pump Station 938 Northwest 38th Street Oakland Park 33309-5921 6 1965 2,016 1965 N/A Not Applicable 1 0 AH 2 Treatment Plant Five Ash Water 21 Public Works Washwater Recovery Basin 938 Northwest 38th Street Oakland Park 33309-5921 6 1994 8,100 1994 1994 Not Applicable 1 0 AH 2 Five Ash Water Treatment Plant 22 Public Works Sludge Pump Station Tank 938 Northwest 38th Street Oakland Park 33309-5921 6 2005 474 2005 None Not Applicable 1 0 AH 2 Five Ash Water Treatment Plant 23 Public Works ASR Well Station 938 Northwest 38th Street Oakland Park 33309-5921 6 2002 648 2002 2002 Not Applicable 1 0 AH 2 Five Ash Water Treatment Plant 24 Public Works Monitor Well Station 938 Northwest 38th Street Oakland Park 33309-5921 6 2002 240 2002 2002 Not Applicable 1 0 AH 2 Five Ash Water Treatment Plant 25 Public Works Old Clearwell 938 Northwest 38th Street Oakland Park 33309-5921 6 2002 4,700 1963 1963 Not Applicable 1 0 AH 2 Five Ash Water Treatment Plant 26 Public Works Diesel Storage Building 938 Northwest 38th Street Oakland Park 33309-5921 6 1975 N/A 2009 2009 Not Applicable 1 0 AH 2 Five Ash Water Treatment Plant 27 Public Works PROPERTY IN THE OPEN 938 Northwest 38th Street Oakland Park 33309-5921 N/A N/A N/A N/A N/A Not Applicable N/A N/A AH 3 Transfer Station 1 Public Works Guard House 2101 NW 6th Street Fort Lauderdale 33311-7719 4 1963 196 1995 1995 Storm Shutters 1 0 AH 3 Transfer Station 2 Public Works Plant A 2101 NW 6th Street Fort Lauderdale 33311-7719 5 1950 12,000 2001 2001 None 2 0 AH 3 Transfer Station 3 Public Works Repump Building 2101 NW 6th Street Fort Lauderdale 33311-7719 5 1950 3,600 2000 2000 None 1 0 AH 4 Lohmeyer Wastewater Treatment Plant 1 Public Works Administration Building 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1984 6,643 2003 2003 Storm Shutters 1 0 X 4 Lohmeyer Wastewater Treatment Plant 2 Public Works Dewatering Building 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1984 16,117 1984 2006 Storm Shutters 3 0 X 4 Lohmeyer Wastewater Treatment Plant 3 Public Works Effluent Building 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1984 27,267 1984 2006 Impact Glass/Shutters 3 0 X Page 3 of 10 3/2(20024 2:24 FRM pp284 City d3ifyodf Miattdrdale Ft. Lauderdale Utility Property Schedule 21-22 SolicitationERffIP2 586 Site Code Site Name Building Code Department Building Name Flood Policy Building Value Contents Value Property in the Open Value Total Insured Value Roof Covering Roof Shape Roof Pitch 2 Five Ash Water Treatment Plant 9 Public Works Electrical Substation $ 228,100.00 $ 1,150,000.00 $ - $ 1,378,100.00 Tar & Gravel Flat Flat 2 Five Ash Water Treatment Plant 10 Public Works Hydrotreater 1-2 $ 985,900.00 $ 685,000.00 $ - $ 1,670,900.00 Not Applicable Not Applicable Not Applicable 2 Five Ash Water Treatment Plant 11 Public Works Hydrotreater 3 $ 844,900.00 $ 1,200,000.00 $ - $ 2,044,900.00 Not Applicable Not Applicable Not Applicable 2 Five Ash Water Treatment Plant 12 Public Works Hydrotreater 4 $ 844,900.00 $ 1,200,000.00 $ - $ 2,044,900.00 Not Applicable Not Applicable Not Applicable 2 Five Ash Water Treatment Plant 13 Public Works Aeration Basin 1-2 $ 315,600.00 $ 425,000.00 $ - $ 740,600.00 Not Applicable Not Applicable Not Applicable 2 Five Ash Water Treatment Plant 14 Public Works Recarbonation Basin 1-2 $ 300,400.00 $ 45,000.00 $ - $ 345,400.00 Not Applicable Not Applicable Not Applicable 2 Five Ash Water Treatment Plant 15 Public Works Recarbonation Basin 3-4 $ 231,000.00 $ 75,000.00 $ - $ 306,000.00 Concrete- Partial/Tan k-Open Not Applicable Not Applicable 2 Five Ash Water Treatment Plant 16 Public Works Ground Water Storage Tank (Steel-5M Gallon) $ 2,413,500.00 $ - $ - $ 2,413,500.00 Metal Dome Low (< 10) 2 Five Ash Water Treatment Plant 17 Public Works Ground Water Storage Tank (Reinforced Concrete-5M Gallon) $ 2,264,200.00 $ - $ - $ 2,264,200.00 Concrete Dome Low (< 10) 2 Five Ash Water Treatment Plant 18 Public Works Ground Water Storage Tank (Reinforced Concrete-7M Gallon) $ 2,969,000.00 $ - $ - $ 2,969,000.00 Concrete Dome Low (< 10) 2 Treatment Plant Five Ash Water 19 Public Works High Service Pump Station 12-16 $ 601,000.00 $ 1,850,000.00 $ $ 2,451,000.00 Concrete Flat Flat 2 Five Ash Water Treatment Plant 20 Public Works Transfer/Recovery Pump Station $ 401,000.00 $ 675,000.00 $ $ 1,076,000.00 Not Applicable Not Applicable Not Applicable 2 Five Ash Water Plant 21 Public Works Washwater Recovery Basin Basin $ 972,000.00 $ 110,000.00 $ - $ 1,082,000.00 Concrete Flat Flat 2 Five Ash Water Treatment Plant 22 Public Works Sludge Pump Station Tank $ 202,000.00 $ 175,000.00 $ $ 377,000.00 Not Applicable Not Applicable Not Applicable 2 Five Ash Water Treatment Plant 23 Public Works ASR Well Station $ 6,500.00 $ 85,000.00 $ - $ 91,500.00 Concrete Flat Flat 2 Five Ash Water Treatment Plant 24 Public Works Monitor Well Station $ 12,000.00 $ 24,000.00 $ - $ 36,000.00 Concrete Flat Flat 2 Five Ash Water Treatment Plant 25 Public Works Old Clearwell $ 564,000.00 $ 50,000.00 $ - $ 614,000.00 Concrete Flat Flat 2 Five Ash Water Treatment Plant 26 Public Works Diesel Storage Building $ 114,000.00 $ - $ - $ 114,000.00 Concrete Flat Flat 2 Five Ash Water Treatment Plant 27 Public Works PROPERTY IN THE OPEN $ $ $ 376,000.00 $ 376,000.00 N/A N/A N/A 3 Transfer Station 1 Public Works Guard House $ 27,100.00 $ 10,000.00 $ - $ 37,100.00 Standing Seam Flat Flat 3 Transfer Station 2 Public Works Plant A $ 1,505,000.00 $ 169,500.00 $ 19,600.00 $ 1,694,100.00 Gran Mod Bit. Flat Flat 3 Transfer Station 3 Public Works Repump Building $ 472,700.00 $ 1,515,000.00 $ - $ 1,987,700.00 Gran Mod Bit. Flat Flat 4 Lohmeyer Wastewater Treatment Plant 1 Public Works Administration Building $ 1,525,600.00 $ 3,075,000.00 $ - $ 4,600,600.00 Gran Mod Bit.Flat Flat 4 Lohmeyer Wastewater Treatment Plant 2 Public Works Dewatering Building $ 5,647,400.00 $ 20,230,000.00 $ - $ 25,877,400.00 Gran Mod Bit.Flat Flat 4 Lohmeyer Wastewater Treatment Plant 3 Public Works Effluent Building $ 7,460,300.00 $ 12,950,600.00 $ - $ 20,410,900.00 Gran Mod Bit. Flat Flat Page 4 of 10 3/2(20024 2:24 FRM pp285 City d3ifyodf Miattdrdale Ft. Lauderdale Utility Property Schedule 21-22 SolicitationER4FIP2 586 Site Code Site Name Building Code Department Building Name Street City Postal Code ISO Const Age Sq Ft Year Updated Age of Roof Storm Protection # story o Sprinkler /o Flood Zones as of 1-4-18 4 Lohmeyer Wastewater Treatment Plant 4 Public Works Generator Plant 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 2,219 1977 2006 Storm Shutters 1 0 X 4 Lohmeyer Wastewater Treatment Plant 5 Public Works Cooling Towers/Oxygen Tanks, Col Box (Lox) 1765 SE 18 Street Fort Lauderdale 33316-3007 3 1977 N/A 1977 N/A Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 6 Public Works Mechanical Shop 1765 SE 18 Street Fort Lauderdale 33316-3007 1 1977 716 1977 1995 None 1 0 X 4 Lohmeyer Wastewater Treatment Plant 7 Public Works Pretreatment Building 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1984 29,472 1984 2006 Storm Shutters 2 part 3 0 X 4 Lohmeyer Wastewater Treatment Plant 8 Public Works Sludge Pump Station 2 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 1,604 1977 2006 Storm Shutters 2 0 X 4 Lohmeyer Wastewater Treatment Plant 9 Public Works Sludge Pump Station 1 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 2,300 1977 2006 Storm Shutters 2 0 X 4 Lohmeyer Wastewater Treatment Plant 10 Public Works Sludge Pump Station 3 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1984 8,892 1984 2008 Storm Shutters 2 0 X 4 Lohmeyer Wastewater Treatment Plant 11 Public Works Clarifier Distribution 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1980 1,030 1980 1980 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 12 Public Works Oxygen Reactor 1 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1978 16,588 1980 1980 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 13 Public Works Oxygen Reactor 2 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1978 16,588 1984 1978 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 14 Public Works Clarifier 1 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 9,025 1977 1977 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 15 Public Works Clarifier 2 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 9,025 1977 1977 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 16 Public Works Clarifier 3 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 9,025 1977 1977 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 17 Public Works Clarifier 4 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 9,025 1977 1977 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 18 Public Works Clarifier 5 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 9,025 1977 1977 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 19 Public Works Clarifier 6 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 9,025 1977 1977 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 20 Public Works Clarifier 7 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 9,025 1977 1977 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 21 Public Works Clarifier 8 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1989 5,026 1977 1977 Not Applicable 1 0 X Page 5 of 10 3/2(20024 2:24 FRM pp286 City d3ifyodf Miattdrdale Ft. Lauderdale Utility Property Schedule 21-22 SolicitationERffIP2 586 Site Code Site Name Building Code Department Building Name Flood Policy Building Value Contents Value Property in the Open Value Total Insured Value Roof Covering Roof Shape Roof Pitch 4 Lohmeyer Wastewater Treatment Plant 4 Public Works Generator Plant $ 479,300.00 $ 1,850,000.00 $ - $ 2,329,300.00 Gran Mod Bit. Flat Flat 4 Lohmeyer Wastewater Treatment Plant 5 Public Works Cooling Towers/Oxygen Tanks, Col Box (Lox) $ $ 5,250,000.00 $ $ 5,250,000.00 Not Applicable Not Applicable Not Applicable 4 Lohmeyer Wastewater Treatment Plant 6 Public Works Mechanical Shop $ 83,000.00 $ 100,000.00 $ - $ 183,000.00 Built- Up/Wood Deck Flat Flat 4 Lohmeyer Wastewater Treatment Plant 7 Public Works Pretreatment Building $ 10,195,300.00 $ 10,730,000.00 $ - $ 20,925,300.00 Gran Mod Bit. Flat Flat 4 Lohmeyer Wastewater Treatment Plant 8 Public Works Sludge Pump Station 2 $ 408,100.00 $ 455,000.00 $ - $ 863,100.00 Gran Mod Bit. Flat Flat 4 Lohmeyer Wastewater Treatment Plant 9 Public Works Sludge Pump Station 1 $ 474,500.00 $ 525,000.00 $ - $ 999,500.00 Gran Mod Bit. Flat Flat 4 Lohmeyer Wastewater Treatment Plant 10 Public Works Sludge Pump Station 3 $ 2,347,500.00 $ 1,115,000.00 $ - $ 3,462,500.00 Gran Mod Bit. Flat Flat 4 Lohmeyer Wastewater Treatment Plant 11 Public Works Clarifier Distribution $ 173,250.00 $ 165,000.00 $ - $ 338,250.00 Concrete Flat Flat 4 Lohmeyer Wastewater Treatment Plant 12 Public Works Oxygen Reactor 1 $ 3,424,500.00 $ 825,000.00 $ - $ 4,249,500.00 Concrete Flat Flat 4 Lohmeyer Wastewater Treatment Plant 13 Public Works Oxygen Reactor 2 $ 3,424,500.00 $ 825,000.00 $ - $ 4,249,500.00 Concrete Flat Flat 4 Lohmeyer Wastewater Treatment Plant 14 Public Works Clarifier 1 $ 1,604,700.00 $ 350,000.00 $ - $ 1,954,700.00 Not Applicable Not Applicable Not Applicable 4 Lohmeyer Wastewater Treatment Plant 15 Public Works Clarifier 2 $ 1,604,700.00 $ 350,000.00 $ - $ 1,954,700.00 Not Applicable Not Applicable Not Applicable 4 Lohmeyer Wastewater Treatment Plant 16 Public Works Clarifier 3 $ 1,526,300.00 $ 350,000.00 $ - $ 1,876,300.00 Not Applicable Not Applicable Not Applicable 4 Lohmeyer Wastewater Treatment Plant 17 Public Works Clarifier 4 $ 1,689,500.00 $ 350,000.00 $ - $ 2,039,500.00 Not Applicable Not Applicable Not Applicable 4 Lohmeyer Wastewater Treatment Plant 18 Public Works Clarifier 5 $ 1,689,500.00 $ 350,000.00 $ - $ 2,039,500.00 Not Applicable Not Applicable Not Applicable 4 Lohmeyer Wastewater Treatment Plant 19 Public Works Clarifier 6 $ 1,689,500.00 $ 350,000.00 $ - $ 2,039,500.00 Not Applicable Not Applicable Not Applicable 4 Lohmeyer Wastewater Treatment Plant 20 Public Works Clarifier 7 $ 1,689,500.00 $ 350,000.00 $ - $ 2,039,500.00 Not Applicable Not Applicable Not Applicable 4 Lohmeyer Wastewater Treatment Plant 21 Public Works Clarifier 8 $ 1,083,400.00 $ 320,000.00 $ - $ 1,403,400.00 Not Applicable Not Applicable Not Applicable Page 6 of 10 3/2(20024 2:24 FRM pp28S City dlitjjodf LAiattdrdale Ft. Lauderdale Utility Property Schedule 21-22 SolicitationERffIP2 586 Site Code Site Name Building Code Department Building Name Street City Postal Code ISO Const Age Sq Ft Year Updated Age of Roof Storm Protection # story o Sprinkler /o Flood Zones as of 1-4-18 4 Lohmeyer Wastewater Treatment Plant 22 Public Works Clarifier 9 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1989 5,026 1977 1977 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 23 Public Works Clarifier 10 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1984 5,026 1977 1977 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 24 Public Works Clarifier 11 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1984 5,026 1977 1977 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 25 Public Works Oxygen Control & Compressor 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 22,095 1977 1995 Storm Shutters 1 0 X 4 Lohmeyer Wastewater Treatment Plant 26 Public Works Sludge Handling Tank 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1961- 96 7 7,934 1971 2009 Not Applicable 1, 2 0 X 4 Lohmeyer Wastewater Treatment Plant 27 Public Works Sanitary Pump Station 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 100 1977 1977 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 28 Public Works Traveling Water Screen 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1984 3,047 1984 1984 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 29 Public Works Chlorine Flash Mix 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1984 1,092 1984 1984 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 30 Public Works Scum Pumping Tank 4 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 64 1977 1977 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 31 Public Works Scum Pumping Tank 10- 11 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 64 1977 1977 Not Applicable 1 0 X 4 Lohmeyer Wastewater Treatment Plant 32 Public Works Butler Building 1401 SW 21st Street Fort Lauderdale 33316-3007 3 1981 8,244 1977 1977 Not Applicable 1 0 AE 4 Lohmeyer Wastewater Treatment Plant 33 Public Works Wellfield Control Building 1401A SW 21st Street Fort Lauderdale 33316-3007 6 1980 576 1977 1977 Not Applicable 1 0 AE 4 Lohmeyer Wastewater Treatment Plant 34 Public Works PROPERTY IN THE OPEN 1765 SE 18 Street Fort Lauderdale 33316-3007 N/A N/A N/A 2008 2008 Not Applicable N/A 0 X 4 Lohmeyer Wastewater Treatment Plant 35 Public Works Scum Pump Station 1 1765 SE 18 Street Fort Lauderdale 33316-3007 6 1977 64 1977 1977 Not Applicable 1 0 X 15 Central Maintenance Shop 1 Public Works Engine Shop 4250 Northwest 10th Avenue Fort Lauderdale 33309-4602 3 1968 6,480 1968 1968 Impact Glass 1 0 AH 15 Central Maintenance Shop 2 Public Works Central Maintenance Shop 4250 Northwest 10th Avenue Fort Lauderdale 33309-4602 5 1950 14,400 1961 1984 Storm Shutters 1 0 AH 16 Executive Airport 6 Public Works Repump Station E 2020 Executive Airport Way Fort Lauderdale 33309-6642 6 2,000 2008 2008 None 1 0 X500 30 Public Works Complex 1 Public Works Building 1 - Parks Maintenance 220 SW 14th Ave. Fort Lauderdale 33312-1643 6 1964 3,482 1964 2002 None 1 0 X500 30 Public Works Complex 2 Public Works Building 2 - Parks Office 220 SW 14th Ave. Fort Lauderdale 33312-1643 6 1964 2,636 1964 2002 None 1 0 X500 30 Public Works Complex 3 Public Works Building 3, 4A, 4B, General Services 220 SW 14th Ave. Fort Lauderdale 33312-1643 6 1964 14,460 1964 2002 None 1 0 X500 30 Public Works Complex 4 Public Works Building 5, 7, Radio- Survey 220 SW 14th Ave. Fort Lauderdale 33312-1643 6 1964 1,756 1979 2002 None 1 0 X500 Page 7 of 10 3/2(20024 2:24 FRM pp286 City d3ifyodf Miattdrdale Ft. Lauderdale Utility Property Schedule 21-22 SolicitationERffIP2 586 Site Code Site Name Building Code Department Building Name Flood Policy Building Value Contents Value Property in the Open Value Total Insured Value Roof Covering Roof Shape Roof Pitch 4 Lohmeyer Wastewater Treatment Plant 22 Public Works Clarifier 9 $ 1,083,400.00 $ 320,000.00 $ - $ 1,403,400.00 Not Applicable Not Applicable Not Applicable 4 Lohmeyer Wastewater Treatment Plant 23 Public Works Clarifier 10 $ 1,083,400.00 $ 320,000.00 $ - $ 1,403,400.00 Not Applicable Not Applicable Not Applicable 4 Lohmeyer Wastewater Treatment Plant 24 Public Works Clarifier 11 $ 1,083,400.00 $ 320,000.00 $ - $ 1,403,400.00 Not Applicable Not Applicable Not Applicable 4 Lohmeyer Wastewater Treatment Plant 25 Public Works Oxygen Control & Compressor $ 442,400.00 $ 925,000.00 $ $ 1,367,400.00 Built -Up Flat Flat 4 Lohmeyer Wastewater Treatment Plant 26 Public Works Sludge Handling Tank $ 1,485,300.00 $ 625,000.00 $ - $ 2,110,300.00 Built- Up/Metal Flat Flat 4 Lohmeyer Wastewater Treatment Plant 27 Public Works Sanitary Pump Station $ 12,000.00 $ 21,000.00 $ - $ 33,000.00 Concrete Flat Flat 4 Lohmeyer Wastewater Treatment Plant 28 Public Works Traveling Water Screen $ 481,600.00 $ 355,000.00 $ - $ 836,600.00 Concrete Flat Flat 4 Lohmeyer Wastewater Treatment Plant 29 Public Works Chlorine Flash Mix $ 194,000.00 $ 80,000.00 $ - $ 274,000.00 Concrete Flat Flat 4 Lohmeyer Wastewater Treatment Plant 30 Public Works Scum Pumping Tank 4 $ 7,500.00 $ 15,000.00 $ - $ 22,500.00 Concrete Flat Flat 4 Lohmeyer Wastewater Treatment Plant 31 Public Works Scum Pumping Tank 10- 11 $ 7,500.00 $ 15,000.00 $ $ 22,500.00 Concrete Flat Flat 4 Lohmeyer Wastewater Treatment Plant 32 Public Works Butler Building $ 728,200.00 $ 200,000.00 $ - $ 928,200.00 Concrete Flat Flat 4 Lohmeyer Wastewater Treatment Plant 33 Public Works Wellfield Control Building $ 157,700.00 $ 125,000.00 $ - $ 282,700.00 Concrete Flat Flat 4 Lohmeyer Wastewater Treatment Plant 34 Public Works PROPERTY IN THE OPEN $ 255,000.00 $ - $ - $ 255,000.00 Concrete Flat Flat 4 Lohmeyer Wastewater Treatment Plant 35 Public Works Scum Pump Station 1 $ 7,500.00 $ 15,000.00 $ - $ 22,500.00 Concrete Flat Flat 15 Central Maintenance Shop 1 Public Works Engine Shop $ 419,000.00 $ 157,400.00 $ - $ 576,400.00 metal roof Flat Flat 15 Central Maintenance Shop 2 Public Works Central Maintenance Shop $ 786,500.00 $ 458,100.00 $ 37,200.00 $ 1,281,800.00 99 Smooth mod bit Flat Flat 16 Executive Airport 6 Public Works Repump Station E $ 258,700.00 $ 1,325,000.00 $ 12,400.00 $ 1,596,100.00 Gran Mod Bit. Flat Flat 30 Public Works Complex 1 Public Works Building 1 - Parks Maintenance $ 327,300.00 $ 69,600.00 $ 154,400.00 $ 551,300.00 Rolled Asphalt Flat Flat 30 Public Works Complex 2 Public Works Building 2 - Parks Office $ 313,300.00 $ 38,500.00 $ - $ 351,800.00 Rolled Asphalt Flat Flat 30 Public Works Complex 3 Public Works Building 3, 4A, 4B, General Services $ 1,326,700.00 $ 359,100.00 $ - $ 1,685,800.00 Rolled Asphalt Flat Flat 30 Public Works Complex 4 Public Works Building 5, 7, Radio- Survey $ 243,900.00 $ 49,900.00 $ - $ 293,800.00 Rolled Asphalt Flat Flat Page 8 of 10 3/2(20024 2:24 FRM pp262 City 03i6odf Miattdrdale Ft. Lauderdale Utility Property Schedule 21-22 SolicitationERffIP2 586 Site Code Site Name Building Code Department Building Name Street City Postal Code ISO Const Age Sq Ft Year Updated Age of Roof Storm Protection # story o Sprinkler /o Flood Zones as of 1-4-18 30 Public Works Complex 5 Public Works Building 6 - Vehicle Write up 220 SW 14th Ave. Fort Lauderdale 33312-1643 6 1988 490 1988 2002 None 1 0 X500 30 Public Works Complex 6 Public Works Central Garage 220 SW 14th Ave. Fort Lauderdale 33312-1643 5 1964 35,944 1999 2002 None 1 0 X500 30 Public Works Complex 7 Public Works Electrical Distribution Building 220 SW 14th Ave. Fort Lauderdale 33312-1643 6 1964 886 1964 2002 None 1 0 X500 30 Public Works Complex 8 Public Works Fuel Station 220 SW 14th Ave. Fort Lauderdale 33312-1643 6 1996 15,768 1996 1996 None 1 100 X500 30 Public Works Complex 9 Public Works Vehicle Wash Station 220 SW 14th Ave. Fort Lauderdale 33312-1643 3 1996 1,000 1996 1996 None 1 0 X500 35 Repump Station B 1 Public Works Repump Station B 4000 NE 25th Ave. Fort Lauderdale 33308-5727 6 1964 4,500 2008 1996 None 1 0 X 44 Las Olas Repump Station 1 Public Works Repump Station D-37 305 Lido Dr. Fort Lauderdale 33301-2534 4 1950 1,800 1990 1990 Storm Shutters 1 0 AE 57 Poinciana Pump House 1 Public Works Pump House 2050 SE 4 Avenue Fort Lauderdale 33316 6 2006 2,400 2006 2006 Storm Shutters 1 0 AH 57 Poinciana Pump House 2 Public Works Ground Storage Tank 2050 SE 4 Avenue Fort Lauderdale 33316 6 2006 N/A 2006 2006 Not Applicable 1 0 AH 64 2nd Avenue Water Site2nd 1 Public Works Water Tower 625 NW 2nd Avenue Fort Lauderdale 33311 N/A 1950 N/A 2008 1950 None N/A N/A AH 64 Avenue Water Site 2 Public Works Pump Station 625 NW 2nd Avenue Fort Lauderdale 33311 6 1950 432 2008 2008 None 1 0 AH 68 Well Fields 1 Public Works Emergency Generator Building #1 3501 Prospect Avene Fort Lauderdale 33309 6 1990 2,080 1990 1990 None 1 0 AH 68 Well Fields 2 Public Works Emergency Generator Building #2 3501 Prospect Avene Fort Lauderdale 33309 6 1990 852 1990 1990 None 1 0 AH 68 Well Fields 3 Public Works Quonset Hut 3501 Prospect Avene Fort Lauderdale 33309 3 2008 2,160 2008 2008 None 1 0 AH 70 Mills Pond Park 1 Public Works Wind Turbines (4) 2201 NW 9th Avenue Fort Lauderdale 33311 5 2014 0 2014 2014 Not Applicable 1 0 AH 70 Mills Pond Park 2 Public Works Electrical Building 2201 NW 9th Avenue Fort Lauderdale 33311 6 2014 200 2014 2014 None 1 0 AH 71 Country Club/ Well Field 1 Public Works Generator Building for the Dixie Wellfield 5050 W. Broward Boulevard Plantation 33317 N/A 2008 1,200 2008 2008 Yes 1 0 X500 71 Country Club/ Well Field 2 Public Works Dixie Wellfield (8 wells with structures). 5050 W. Broward Boulevard Plantation 33317 N/A 2008 5,000 2008 N/A N/A N/A 0 REPORT TOTALS: Page 9 of 10 3/2(20024 2:24 FRM pp266 City 03ifyodf Miattdrdale Ft. Lauderdale Utility Property Schedule 21-22 SolicitationERffIP2 586 Site Code Site Name Building Code Department Building Name Flood Policy Building Value Contents Value Property in the Open Value Total Insured Value Roof Covering Roof Shape Roof Pitch 30 Public Works Complex 5 Public Works Building 6 - Vehicle Write up $ 59,400.00 $ 14,100.00 $ - $ 73,500.00 Rolled Asphalt Flat Flat 30 Public Works Complex 6 Public Works Central Garage $ 3,550,000.00 $ 1,870,000.00 $ - $ 5,420,000.00 Rolled Asphalt Flat Flat 30 Public Works Complex 7 public Works Electrical Distribution Building $ 110,500.00 $ 108,000.00 $ - $ 218,500.00 Rolled Asphalt Flat Flat 30 Public Works Complex 8 Public Works Fuel Station $ 99,200.00 $ 294,400.00 $ - $ 393,600.00 Metal Flat Flat 30 Public Works Complex 9 Public Works Vehicle Wash Station $ 63,900.00 $ 55,000.00 $ - $ 118,900.00 Metal Flat Flat 35 Repump Station B 1 Public Works Repump Station B $ 325,500.00 $ 2,400,000.00 $ - $ 2,725,500.00 Gran Mod Bit. Flat Flat 44 Las Olas Repump Station 1 Public Works Repump Station D-37 $ 379,500.00 $ 525,000.00 $ - $ 904,500.00 Asphalt Shingle Sloped Medium (10 to 30) 57 Poinciana Pump House 1 Public Works Pump House $ 564,500.00 $ 120,000.00 $ - $ 684,500.00 Built -Up Flat Flat 57 Poinciana Pump House 2 Public Works Ground Storage Tank $ 1,242,000.00 $ - $ - $ 1,242,000.00 Not Applicable Not Applicable Not Applicable 64 2nd Avenue Water Site 1 Public Works Water Tower $ 2,927,000.00 $ - $ - $ 2,927,000.00 Not Applicable Not Applicable Not Applicable 64 2nd Avenue Water Site 2 Public Works Pump Station $ 93,399.00 $ 45,000.00 $ - $ 138,399.00 Built -Up Flat Flat 68 Well Fields 1 Public Works Emergency Generator Building #1 $ 349,500.00 $ 750,000.00 $ $ 1,099,500.00 Built -Up Flat Flat 68 Well Fields 2 Public Works Emergency Generator Building #2 $ 143,100.00 $ 150,000.00 $ $ 293,100.00 Built -Up Flat Flat 68 Well Fields 3 Public Works Quonset Hut $ 135,000.00 $ 250,000.00 $ - $ 385,000.00 Metal Quonset Style Medium 70 Mills Pond Park 1 Public Works Wind Turbines (4) $ - $ - $ 570,000.00 $ 570,000.00 Not ApplicableNot Not Applicable Applicable 70 Mills Pond Park 2 Public Works Electrical Building $ 25,000.00 $ 20,000.00 $ - $ 45,000.00 Concrete Flat Flat 71 Country Club/ Well Field 1 Public Works Generator Building for the Dixie Wellfield $ 1,000,000.00 $ 500,000.00 $ $ 1,500,000.00 Built-up Flat Flat 71 REPORT Country Club/ Well Field TOTALS: 2 Public Works Dixie Wellfield (8 wells with structures). $ 3,000,000.00 $ 134,630,999.00 $ - $ 123,393,500.00 $ - $ 1,350,850.00 $ 3,000,000.00 $ 259,375,349.00 Concrete slabs on . rade N/A N?A Page 10 of 10 3/2(20024 2:24 PM pp262 C{TT OF FORT LAME EROAL£ City iCyodMiadlardale City of Fort Lauderdale SCHEDULE OF INSURANCE POLICIES 2021/2022 (As of 6/28/2021) So I ic FP2ESE6586 PRIA PUBLIC RISK'NSURANCE ADVISORS Line of Coverage Carrier Limits/Coverage Deductible/Retention Effective Expiration Premium Policy# Property (Non -Utility) Total Insured Value (TIV): $261,374,713 Lloyds of London $25,000,000 p/o $50,000,000 Primary $50,000 per occurrence, except 2/1/2021 2/1/2022 $ 674,039 B0507UP2100794 AmRisc $12,500,000 p/o $50,000,000 Primary $5,000,000 Named Storm and Hail 2/1/2021 2/1/2022 $ 366,166 809851 Arch Specialty Insurance Company $5,000,000 p/o $25,000,000 Primary 2/1/2021 2/1/2022 $ 241,004 ESP0038091-11 National Fire & Marine Ins Co (Berkshire) $3,750,000 p/o $25,000,000 Primary 2/1/2021 2/1/2022 $ 197,390 42 PRP 000137 08 Endurance American Ins. Co. $3,750,000 p/o $25,000,000 excess of $25,000,000 2/1/2021 2/1/2022 $ 54,004 ESP30001483101 Colony Insurance Company $5,000,000 p/o $25,000,000 excess of $25,000,000 2/1/2021 2/1/2022 $ 75,004 XP140469-0 Standalone Terrorism Lloyds of London $50,000,000 $25,000 2/1/2021 2/1/2022 $ 16,500 B0507TE2100742 Utilities Property ACE American Ins. Co. Total Insured Value (TIV): $271,071,232 $5,000,000 2/1/2021 2/1/2022 $ 649,369 EUT N1 43 38 85 8 $25,000,000 Policy Limit $ 2,273,476 Boiler & Machinery XL Insurance America, Inc $150,000,000 Policy Limit $25,000 2/1/2021 2/1/2022 $ 13,819 US00074528PR21A Crime Hiscox Insurance Company $1,000,000- Employee Dishonesty $200,000 each claim 4/21/2021 4/21/2022 $ 10,274 UC22184927.21 $1,000,000 - Forgery or Alteration $500,000 - On Premises $500,000 - In Transit $1,000,000 - Computer Fraud Not Covered - Money Orders and Counterfeit Paper Currency $1,000,000- Funds Transfer Fraud AD&D National Union Fire Ins. Co. of PA Florida Statutory Coverage 5/3/2020 5/3/2022 $ 42,587 SRG 0009154749-A NFIP Flood Wright National Flood Insurace 47 Policies all but one effective 05/20/21 Up to Maximum available by NFIP 5/20/2021 5/20/2022 $ 78,608 Various Aviation Liability ACE Property & Casualty Ins. Co. $20,000,000 Each Occurrence NIL 5/25/2021 5/25/2024 $ 21,975 AAP N11223308 008 $20,000,000 Hangarkeepers 3 Annual Includes War and TRIA Installments Adverse Weather Cancellation Beazley Insurance Company $96,000 N/A 7/4/2021 7/4/2021 $ 8,960 V2F560210101 July4th Fireworks Protection & Indemnity Argonaut Insurance Company $1,000,000 CSL $2,500 BI / $2,500 PD 6/30/2021 6/30/2022 $ 13,050 7260M2640-04 Excess Safety National Casualty Corp Statutory- Workers' Compensation $1,500,000- 7704 10/1/2020 10/1/2021 $ 402,556 SP 4063834 Workers' Compensation $1,000,000- Employers Liability $1,500,000 - 7720 $1,000,000 - All Other Public Officials Liability ACE American Ins. Co. $4,000,000 includes Choice of Counsel endorsement $100,000 POL 11/1/2020 11/1/2021 $ 192,865 EON M00609195 008 Employment Practices Liability $150,000 EPLI Cyber Liability Illinois Union Insurance Co. $2,000,000/$2,000,000 $100,000 11/1/2020 11/1/2021 $ 42,116 D94924157 General Liability Lloyds of London $5,000,000 $10,000 12/15/2020 12/15/2021 $ 33,150 RE00057420-193 Active Shooter Policy General Liability Indian Harbor Ins. Co. $5,000,000 $10,000 12/15/2020 12/15/2021 $ 55,123 US00093709SP20A Workplace Violence Consulting Fee 12/20/2020 12/20/2021 $ 65,000 This document is intended as a summary of insurance coverages only. Refer to the actual policy for coverage details. TOTAL PREMIUMS $ 3,253,559 g/21/222114M/IllpipM5.sharepoint.com/sites/bbpria/Shared Documents/CLIENTS/Ft Lauderdale, City of/21-22/Schedules/FTL SOI21-22 as of6-28-21.xlsx Page 1 of 1 6/28/2021 pp2g0 City agi6odf Eitiatitirdale SolicitationERdFIP23116586 Question and Answers for Bid #12536-525 - Property and Casualty Insurance Brokerage and Consulting Services Overall Bid Questions Question 1 Do the required forms count towards the 50-page limit on the response? (Submitted: Jun 23, 2021 11:34:32AM EDT) Answer - The City prefers that proposals be no more than 50 pages in one complete pdf document. (Answered: Jun 30, 2021 8:46:57AM EDT) Question 2 Please provide current schedule of insurance policies for the last three years including Retentions and Deductibles. (Submitted: Jun 23, 2021 11:35:21 AM EDT) Answer - Please see Attachment C for current schedule of policies. Please refer to historical Commission agenda items for prior insurance policy retention/deductible details at https://fortlauderdale.legistar.com/Legislation.aspx (Answered: Jun 30, 2021 8:54:31 AM EDT) Question 3 Please provide marketing summary for the past 3 years. (Submitted: Jun 23, 2021 11:35:38 AM EDT) Answer - No summary available. Please refer to historical Commission agenda items for prior insurance policy marketing/renewal details at https://fortlauderdale.legistar.com/Legislation.aspx (Answered: Jun 30, 2021 8:54:31 AM EDT) Question 4 Please provide renewal indications for 21-22 policy year if you have received. (Submitted: Jun 23, 2021 11:36:OOAM EDT) Answer - None received at this time. (Answered: Jun 30, 2021 8:54:31 AM EDT) Question 5 Please provide 3 years of loss runs. (Submitted: Jun 23, 2021 11:36:14AM EDT) Answer - Not available. Current policiesaTM underwriting limits/premiums incorporate the CityaTMs loss history. (Answered: Jun 30, 2021 8:54:31 AM EDT) Question 6 Please provide a copy of the current broker services contract to include scope of services. (Submitted: Jun 23, 2021 3/7(20024 2:24 FRM pp283 City ei6odf bliatitirdale SolicitationFIP2 586 11:36:46AM EDT) Answer - Please refer to Contract No. 12067-585 at https://www.fortlauderdale.gov/departments/finance/procurement- services/contract-documents-and-awards (Answered: Jun 30, 2021 8:54:31 AM EDT) Question 7 • Section 3.9 of the RFP references Attachment A&B for the Statement of Values and Attachment C for a summary of the current insurance program. Please provide these documents. • For the Summary of Insurance - please include premiums / carriers / and coverage limits and deductibles. • Please also provide the current fee, commission or compensation summary for the current program. (Submitted: Jun 23, 2021 2:20:55 PM EDT) Answer - 1.Please see Attachments A, B, and C. 2.Please see Attachment C. 3.Please see Attachment C And refer to Contract No. 12067-585 at https://www.fortlauderdale.gov/departments/finance/procurement-services/contract-documents-and-awards (Answered: Jun 30, 2021 8:54:31 AM EDT) 3/2(20024 2:24 PtM pp284 City dlit=yoolf EAiatttirdale EXHIBIT B F P2BiB3E6586 Public Risk Insurance Advisors Bid Contact Robin Russell rrussell@bbpria.com Ph 386-239-4044 Fax 386-239-4049 Address 220 S. Ridgewood Avenue, #210 Daytona Beach, FL 32114 Item # Line Item Notes Unit Price Qty/Unit Attch. Docs 12536-525--01-01 Property & Casualty Supplier First Offer - $65,000.00 1 / lump sum $65,000.00 Y Insurance Brokerage & Product Consulting Services Code: Supplier Total $65,000.00 3/2(20024 9:24 AM BidSync p. �8� City dlirwolfEAiaattirdale Solicitation RFD:21313E6586 Public Risk Insurance Advisors Item: Property & Casualty Insurance Brokerage & Consulting Services Attachments Sol 12536-525 - PRIA Response 2021.pdf 3/2(20024 9:24 AM BidSync p. �88 Cit dIi .„ 1Aiatttirdale Solicitation RFD:2E113E6586 CITY OF FORT LAUDERDALE Solicitation 12536-525 Property and Casualty Insurance Brokerage and Consulting Services Response Prepared By: Risk Management Associates, Inc. dba Public Risk Insurance Advisors A wholly owned subsidiary of Brown & Brown, Inc. Paul Dawson, ARM-P - Senior Vice President 300 North Beach Street Daytona Beach, FL 32114 (407) 496-0989 Submittal Date: July 7, 2021 at 2:00 PM PRIA PUBLIC RISK INSURANCE ADVISORS 3/2(20024 9:24 AM BidSync p. 1283 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Section 4.2.1 Table of Contents City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS City of Fort Lauderdale Request for Proposals #12536-525 Property & Casualty Insurance Brokerage and Consulting Services Page # Section 4.2.1: Table of Contents 1 Section 4.2.2: Executive Summary 2 Section 4.2.3: Experience & Qualifications 3 Section 4.2.4: Approach to Scope of Work 15 Section 4.2.5: References 36 Section 4.2.6 & 4.2.7: Minority/Women (M/WBE) Participation 37 Subcontractors 37 Section 4.2.8: Required Forms Proposal Certification 38 Cost Proposal 39 Non -Collusion Statement 40 Non -Discrimination Certification Form 41 Local Business Preference (LBP) 42 Disadvantaged Business Enterprise Preference (DBEP) 44 Contract Payment Method 46 E-Verify Affirmation Statement 47 Sample Insurance Certificate 48 W-9 for Proposing Firm 50 Active Status Page from Division of Corporations - Sunbiz.org 51 Florida General Lines Property &Casualty Insurance License 52 Pag City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Section 4.2.2 Executive Summary City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Section 4.2.2: Executive Summary It is with great pleasure that Public Risk Insurance Advisors (PRIA), a wholly owned subsidiary of Brown & Brown, Inc., submits this response to the City's RFP for Property and Casualty Insurance Brokerage and Consulting Services. We trust that you will find the response contained herein to be concise in demonstrating our understanding of the City's solicitation for a qualified professional insurance firm. Our parent company, Brown & Brown, Inc. was founded in 1939 in Daytona Beach and has since grown to be the largest insurance intermediary in Florida and the 6th largest in the world. That growth has pushed our company beyond 300 offices nationwide, housing more than 12,000 teammates. In Florida, our more than 50 offices, are comprised of 2,500 teammates responsible for the design, placement, and servicing of annual insurance premiums in excess of $2.5 Billion. PRIA has excelled in the public entity niche business for more than 29 years and represents the lion's- share of Brown & Brown's governmental practice within the State. Our experience includes representing more than 100 Florida Cities, Counties and School Districts. That includes highly complex program management for more than 40 clients which utilize large, layered property paired with self -insured casualty and workers compensation programs. Our operations include 24 dedicated insurance professionals located in the company's Daytona Beach headquarters. It is our intent to demonstrate our firm's willingness and ability to provide the requested services as outlined in our RFP response. PRIA's philosophy is and always will be to exceed our clients' expectations while maintaining high professional and ethical standards. PRIA is uniquely qualified to provide the services outlined in this RFP and to exceed the expectations of the City. PRIA has had the distinct pleasure of managing the City's Property, Casualty and Excess Workers Compensation insurance program since 2009. During our tenure, we have provided the City with: 1. Significant program improvements 2. Lowered insurance costs 3. Provided unwavering support to the risk staff Enclosed are all required documents and information. Every effort was made to concisely provide all requested information, all required completed forms, and succinctly illustrate our understanding of the required scope of services as well as other services provided by or recommended by PRIA. Most importantly, we ask you to take special note of the references included in this response. Our written response to the RFP does not speak as loud as those for whom we have delivered exceptional year -over -year results. We challenge you to call our references, ask probing questions, and determine for yourself the real -world impact of our expertise, proactive service commitment, and dedication to the continuous improvement of our client's risk management programs. Specific detail of the service team assigned to the City can be found in Section 4.2.3. Pag- 12 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Section 4.2.3 Experience & Qualifications City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Section 4.2.3: Experience & Qualifications Indicate the firm's number of years of experience in providing the professional services as it relates the work contemplated. PRIA has provided insurance placement and risk management consulting services to Florida public entities for 29 years. Our operations and procedures are designed specifically and solely for the public sector. Provide details of past projects for agencies of similar size and scope, including information on your firm's ability to meet time and budget requirements. PRIA is fully dedicated to the Public Entity insurance sector. Our experience with large public entities is extensive and includes highly complex program management for more than 40 clients which utilize large, layered property paired with self -insured casualty and workers compensation programs. Many of these clients have longevity with PRIA of 10+ years. The Team Leader for the City is Paul Dawson. Mr. Dawson has over 26 years of experience in managing risk management programs for Florida's public entities. Our entire organization handles countless other similar programs nationwide. Hands on experience and the results of that experience speak volumes for an insurance broker. Evidence of our abilities and experience with Florida's governmental entities is not solely in a statement trumpeting our greatness but in our recent past performance on behalf other public entities. On the following pages you will find a few client highlights which are relevant as it relates to our proactive approach and the results of our diligent efforts in protecting our clients' financial assets. Our successful strategy is to never let a program become stagnant. We constantly take a fresh unbiased approach to the design of an insurance program. The processes used to achieve these results are no different than those that we have and will implement on behalf of the City of Fort Lauderdale. There are many other similar examples available, and we are very proud of our long track record of delivering positive results to every client. Pag- 3 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS City of Tallahassee PRIA was awarded Broker of Record in 2014 and 2017 as a result of a statewide RFQ. PRIA manages all property, casualty, and workers' compensation insurance programs. • Reduced the Casualty premium by $42,000 (11%) in the first renewal handled by PRIA (2014). This included several significant coverage improvements. • Conducted claims advocacy work on a large Workers Compensation claim ($1.5M) in 2018 and expedited claims payments to the City. • Coordinated cyber coverage in the property and cyber liability policies to maximize coverage and reduce premiums with custom language. This eliminated the potential coverage reduction in the "other insurance" policy clause. • Reduced the insurance premium for Consolidated Dispatch Agency for over 20% in the first renewal and significantly improved the coverage. • In the most recent property renewal, we saved the City $340,000 through the introduction of new capacity and separately insuring the non -utility from the utility structures. This also increased the insured loss limit by $250M. • Total property and casualty premium savings to the City driven by PRIA is now more than $2,100,000. Brevard County BOCC PRIA was awarded as the County's Agent of Record in a statewide Request for Qualifications process in March 2014 and again in 2019. The former agent was Arthur J. Gallagher. PRIA manages all property, casualty, and workers' compensation insurance programs. In six years, we have accomplished the following: • In the first property insurance renewal (2014), PRIA reduced the overall property premium by $282,948 through negotiating and realigning carriers. This was a 15% rate reduction. • Reduced the number of carriers on the program from 9 to 5. • Greatly improved the property coverage terms by: o Upgraded loss valuation from Margin Clause to Blanket coverage o Fixed the property schedule to remove erroneous values for contents that the previous agent added to the property schedule o Improved the Inland Marine policy by eliminating the audit requirement thereby saving the County significant premium o Reduced the High and Low Hazard flood deductible o Increased several coverage sublimits o Provided a Claims Preparation Expense limit of $100,000 (zero prior) • Conducted a thorough Flood Audit and placed flood coverage for 19 properties. • Total savings to the County in six years is well over $500,000. Pags ;4l City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS City of Jacksonville PRIA was awarded Broker of Record in 2018 as a result of a statewide RFQ process. PRIA currently manages all the casualty, excess liability, and excess workers compensation insurance programs. Accomplishments and improvements include: • Renewed 8 general liability and two excess workers compensation policies with mostly flat rates and provided significant coverage improvements. • Provided rate stabilization with several multi -year policy options. • Cyber Security & Privacy - Secured, placed and service this additional line of coverage. • Special Event - Secured, placed and service this additional line of coverage to provide effective risk transfer from the self -insured fund. • Marine - Through an RFP process successfully secured and placed coverage for the City's marine exposures. This currently includes the various department's watercraft, wharfinger liability and excess. • Special Excess Medical Professional Liability - Through an RFP process, secured and placed $10M limit policy for detention centers and jails. • In each of the above cases, we were able to achieve premium reductions and broader coverage terms and conditions. • Property - Through a separate RFP process, Brown & Brown was chosen as the City's Broker of Record in late 2019/20, with successes to include claims advocacy for Hurricane Michael claims. Coordination of property claims adjusters, and direct client/underwriting meetings. City of Miami Gardens PRIA managed the Property and Casualty program from 2014 to 2020. Below is a summary of the improvements that we achieved on behalf of the City. • Reduced the City's premium every year despite increasing exposures and a hardening market. Total savings in 5 years was well over $500,000. Competitors have taken credit for premium reductions but that is wholly inaccurate. • PRIA identified 7 major coverage deficiencies in the previous package policy and corrected each one. • Reduced the experience modification factor by 18 points in three years with aggressive safety training, claim management and creation of an effective safety committee. • Established insurance requirements in contracts that provided better protection to the City. • Successfully managed numerous large and contentious claims. • Established a single source/turnkey catastrophic claim team. • In 2020 the City issued a RFQ for a qualified insurance broker. PRIA was ranked #1 by the committee overall and in each category. Despite our superior ranking the Mayor choose to award the bid to a lower ranked respondent. The insurance was also moved to carrier with inferior coverage at zero premium savings. Pags City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Our organization provides insurance placement and risk management services to over 250 of Florida's public entities. Below is a short summary of some of our larger public entity property insurance placements. The entities in bold are directly managed by the City's proposed Team Leader, Paul Dawson. PRIA Property Placements $500M+ in Total Insured Value (TIV) State of Florida $24,000,000,000 City of Jacksonville $3,700,000,000 Lee County Public Schools $2,200,000,000 Lee County BOCC $1,894,500,000 Osceola County Public Schools $1,750,000,000 City of Tallahassee $1,590,000,000 Pasco County Public Schools $1,590,850,000 Collier County Public Schools $1,330,650,000 Leon County School Board $948,000,000 City of Miami $828,000,000 Brevard County BOCC $833,000,000 City of Fort Lauderdale $628,000,000 Marion County BOCC $566,000,000 Perhaps the best testament to our experience relevant to the City of Fort Lauderdale representation of more than 75 other great Florida Cities, including. ✓ City of Miami ✓ City of Jacksonville ✓ City of Ft. Lauderdale ✓ City of Naples ✓ Town of Jupiter ✓ City of Lake Worth Beach ✓ City of Ocala ✓ City of Tallahassee ✓ City of Daytona Beach ✓ City of Marco Island ✓ City of Sarasota ✓ City of North Miami ✓ City of North Port ✓ City of Palm Bay ✓ City of Coconut Creek ✓ City of Weston ✓ City of Sweetwater ✓ City of Deltona ✓ City of Punta Gorda ✓ City of St. Cloud is our Pags City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Indicate the firm's initiatives towards its own sustainable business practices that demonstrate a commitment to conservation. Brown & Brown is committed to a sustainable and environmentally sensitive business model. All our offices have gone 100% paper free in 2011. Our new corporate headquarters in Daytona Beach was constructed with an emphasis on a minimal environmental impact with an energy reduction through high efficiency mechanical systems throughout the building. Operations include a robust recycling in all business centers as well as "green" packaging wherever possible. As a financial/insurance services business our carbon footprint and impact on the environment is very small. Time and Budget Requirements Paul Dawson and his service team possess the highest level of experience and expertise in managing large complex public risk management programs. Our client retention rate over the last five years is 97% which speaks volumes for our ability to stay ahead of our competition and continuously deliver better than average results. The very heart of our success starts with creating budget estimates and managing timelines for each insurance renewal. After 26 years of practice we execute each renewal proficiently by establishing realistic expectations and timeframes that are reflective of the current market conditions. We set primary and backup deadlines for supplication submission, carrier quotes, proposal evaluation and agenda preparation. As an example, when the hardening of cyber markets accelerated in 2020, we engaged all our underwriters and learned that several carriers would be raising rates by up to 100% and dramatically increasing retentions. We prepared our clients with realistic expectations for adverse terms and conditions, adjusted budgets accordingly and started the renewal process 5 months ahead of expiration. None of our clients were unprepared for the change in conditions imposed by cyber carriers. We will never present the City with last minute surprises of dramatic premium increases or unexpected adverse results. Our approach to the changing property and casualty markets has always been consistent with this proactive approach. Indicate business structure, IE: Corp., Partnership, LLC. Firm should be registered as a legal entity in the State of Florida PRIA is a wholly owned subsidiary of Brown & Brown, Inc. Brown & Brown is Florida domiciled, public corporation. Our stock is traded on the New York Stock Exchange. Minority or Woman owned Business (if applicable) Not Applicable Pags City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Company address, phone number, fax number, E-Mail address, website, contact person(s), etc. Physical Address: 300 North Beach Street Daytona Beach, FL 32114 Main Contact: Phone Number: Fax Number: Email Address: Paul Dawson, ARM-P (386) 239-4045 (386) 239-4049 pdawson@bbpria.com Mailing Address: P.O. Box 2416 Daytona Beach, FL 32115 Relative size of the firm, including management, technical and support staff; licenses and any other pertinent information shall be submitted. The Public Risk Insurance Advisors (PRIA) team is a highly specialized unit of insurance advisors 100% trained to deliver industry -leading brokerage services to public entities in the State of Florida. Since 1992, we have continuously refined that specialization and enhanced our services en -route to becoming the largest public entity brokerage in Florida. We have proven over those nearly three decades of service to local governments that we are a highly organized and accountable team of insurance professionals, laser -focused on providing both world - class brokerage services and concierge -level support to our clients. We have built our strong reputation by empowering our governmental clients to outperform their industry peers, lower total cost of risk, and enhance risk management programs - all within annual budgetary constraints. These capabilities are only enhanced by our team's commitment to serve those who serve the public - and providing truly concierge -level service to our clients. PRIA's Florida Public Entity Footprint PUBLIC ENTITY MARKET LEADERS • 70+ Cities • 20+ Counties • 6 School Districts • State of Florida • 100+ Special Districts EXPERIENCE • 80 Years in Business • 28 Years - Governments • $135 Million in Florida Annual Premiums Placed - Public Entity SERVICE & EXPERTISE • Public Sector Only • Risk Management Program Design • Contractual Liability Experts • Hands-on Claims Advocacy Brown & Brown, Inc. and the PRIA team are located at, and propose to perform all work associated with the scope of this RFP from our Corporate Headquarters: 300 North Beach Street, Daytona Beach, Florida. Pags City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Team Leader Paul Dawson, ARM-P Senior Vice President/ Public Risk Advisor LOCATION: Corporate Headquarters Daytona Beach, FL Paul Dawson will act as the Team Leader and Project Manager for the execution of the City's risk management plan. He will direct our team providing deliverables for this project. Paul's professionalism and expertise in the industry has been exemplified by his commitment to and representation of Florida's large self -insured governmental entities over the past 26 years. Throughout the contract year, Paul will oversee insurance submissions, marketing, negotiation, and presentation of insurance program design. He will be directly involved and responsible for the delivery of related resources including claims advocacy, asset and other insurable financial analysis and valuations, loss control, property appraisal, and other services. It is important to note that Paul's workload has been tailored to provide the extra attention deserved by our VIP accounts. His ability to effectively manage these projects have been developed from a unique background and subject -matter focus highlighted below. » Lead Account Executive for 12 Florida public entity self - insureds » 26 years' experience includes sole focus on public entity program management, catastrophic claims advocacy, » Large multi -layered property design and placement » Insurance and self-insurance program and policy design » Local government financing and budgeting » Public entity law (FL Statues, procurement, court rulings, etc.) » Claims advocacy, including extensive hurricane recovery experience. » Informational and educational presentations to public entities and industry organizations. » Involved and committed to keeping on the cutting edge of our business and client interests via industry organizations, including PRIMA, FCCMA, FLC and RIMS. Paul's qualifications include the following: Associates in Risk Management for Public Entities (ARM-P) Risk Management for Public Entities (RMPE) PRIA / Brown & Brown - 1995 to Present 2-20 General Lines Agent License, State of Florida Pags ;Ei City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Matt Montgomery PRIA Executive Vice President LOCATION: Corporate Headquarters Daytona Beach, FL Michelle Martin, CIC Senior Vice President / Public Risk Advisor LOCATION: Corporate Headquarters Daytona Beach, FL Mr. Montgomery leads PRIA with almost 20 years of experience in Federal and State Government. Matt's expertise is particularly valuable for direct assistance with government agencies, presentations to executive staff and Boards, and other executive meetings as needed. Matt also provides high-level support to all aspects of client services. Matt's qualifications include the following: Florida State University, BS Degree, Philosophy PRIA / Brown & Brown - 2013 to Present Florida DHSMV - 2012 to 2013 Southern Strategy Group - 2007 to 2012 US Senate Office - 2002 to 2007 2-20 General Lines Agent License, State of Florida 2-15 Life, Health, & Variable Annuities License, State of Florida 8 years Florida Public Entity Insurance Focus 19 years of Florida Governmental Experience Ms. Martin will serve as back up to the Team Leader and Project Manager for the execution of the City's risk management services. She will act as the primary contact on the rare occasions when Mr. Dawson is unavailable. Michelle's professionalism and expertise in the industry is well known among Florida public sector risk managers. She has been successfully serving the needs of large self -insured public entities for over 20 years. Michelle will assist in ensuring all aspects of our deliverables exceed the City's expectations. » Lead Account Executive for 11 FL public entity self -insureds » 30 years' experience includes Marketing Manager for corporate office, negotiation, and placement of alternative risk transfer mechanisms for US and European commercial business. Since 2005, sole focus on public entity program management. » Large multi -layered property design and placement » Insurance and self-insurance program and policy design » Local government financing and budgeting » Public entity law (FL Statues, procurement, court rulings, etc.) » Claims advocacy, including extensive hurricane experience » Informational and educational presentations to both public entities and industry organizations » Involved and committed to keeping on the cutting edge of our business and client interests via industry organizations, including PRIMA, FERMA, FCCMA, FLC and RIMS. Page ;ii) City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Critical Support and Service Team Robin Russell, ARM-P, CISR, CSRM Director of Operations LOCATION: Corporate Headquarters Daytona Beach, FL As Primary Account Manager, Ms. Russell would oversee day-to-day customer service for the City. With a Risk Management degree from Florida State University, Robin has focused in public entity insurance and risk management for 17 years. She is also charged to constantly improve PRIA's service offerings, including technological efficiencies to assist our clients. Her individual account workload is limited to just a few VIP accounts. This special focus allows for immediate resolution of unique needs of our clients. Ms. Russell is well versed in providing solutions for large accounts with the utmost professionalism, including: / Customized service delivery plan / Asset schedule and policy management / Contract and coverage expertise / Legal and quality control Ms. Russell's qualifications include the following: Florida State University, B.S. Risk Management/Insurance & Finance PRIA - 2004 to Present State Farm - 1998 to 2004 Certified Insurance Service Representative (CISR) Certified School Risk Management (CSRM) Associate in Risk Management for Public Entities (ARM-P) 2-20 General Lines Agent License, State of Florida 2-15 Life, Health, & Variable Annuities License, State of Florida 1-20 Surplus Lines License, State of Florida 17 years of Florida Public Entity Experience Page 01 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Danielle Coggon, CISR Public Risk Specialist LOCATION: Corporate Headquarters Daytona Beach, FL Kyle Stoekel, CIC, ARM-P Public Risk Advisor LOCATION: Corporate Headquarters Daytona Beach, FL Danielle will be responsible for the daily service support needs of the City. She will serve as a support teammate for routine service functions, and will respond to service requests, issue certificates of insurance, maintain property, vehicle, and equipment schedules, facilitate claims handling as well as handle general requests for service in a multitude of other areas. Key functions include but are not limited to: / Quote/Proposal/Binder/Policy review, correction, and delivery / Quality Control / Invoicing, certificates, and general inquiries / Audits and premium adjustments / Insured asset schedule maintenance management Danielle's qualifications include the following: University of Middle Tennessee State University B.S. Business Administration Certified Insurance Service Representative (CISR) PRIA - 2016 to Present LRA Ins. Co. - 2014 to 2016 2-20 General Lines Agents License, State of Florida 7 years Commercial Insurance Experience 5+ years of Florida Public Entity Experience Kyle will provide support to the team with insurance submissions, marketing, financial analysis, coverage analysis, and program design. In addition, Kyle will assist with special projects including benchmarking and Cost of Risk Analysis. Kyle has extensive experience with insurance marketing, specialty risk placement, and risk management for high catastrophe prone exposures. Kyle's qualifications include the following: University of Florida, B. S. Interdisciplinary Studies PRIA/Brown & Brown - 2014 to Present Certified Insurance Counselor (CIC) Associate in Risk Management for Public Entities (ARM-P) 2-20 General Lines Agents License, State of Florida 7+ years of Florida Public Entity Experience Page 02 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Christopher Kittleson, ARM, CPSI Director of Loss Control Services LOCATION: Boca Raton, FL Public Risk Underwriters of Florida, Inc., a wholly owned subsidiary of Brown & Brown, Inc., provides Safety and Loss Control Services to over 400 public entities in Florida. Mr. Kittleson provides expert advice regarding risk identification and control in the field and at the employee level. His work has been focused to South Florida public entities for 13 years. Areas of focus include: » Safety Training » Safety Inspections » Safety Program Review & Evaluation » Safety Committee Development and Guidance » Accident Review Board Development and Guidance » Specialized Programs and Services Christopher's qualifications include the following: St. Cloud State University, MN B.S. Engineering Technology Public Risk Underwriters - 2007 to Present OSHA Certified Educator American Society of Safety Engineers National Safety Council Certified Defensive Driving Instructor Certified Playground Safety Inspector 30 Years' Experience *Please see Section 4.2.8 Required Forms, for copies of our required licenses. Page ;i3 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Advocacy and Catastrophic Loss Consultation Resource Another unique resource within our family is Procor Solutions + Consulting which provides a full suite of Property -related support services. Procor was founded around a simple goal - identify, rethink, and improve how the risk management, disaster planning and response, and the claims industry interacts, collaborates, and adds value for its participants and impacted communities. Frank Russo, MBA, CRIS, ARM, CyRM PRocoR Principal/Executive Vice President, Procor Solutions + Consulting LOCATION: Brooklyn, NY SOLUTIONSCONSULTING Mr. Russo is a recognized global thought leader on business resiliency strategies. He provides professional analysis and quantification of disputes and claims for Physical Damage, Business Interruption, Builders Risk, Crime, Fidelity, and Cyber Breach. He has actively guided clients through major large-scale disasters over the last twenty (20) years including the terrorist acts of 9/11/01, 2017 Hurricane Season, Hurricane Katrina, the Gulf Oil Disaster, the Japan Earthquake/Tsunami, and the 2020 Covid-19 Pandemic to name a few. Mr. Russo is available for presentations and consultation for Disaster Preparedness, Recovery, Claims Advocacy, FEMA advice and more. Joe Critelli, CPA, CRIS, CFF, CGMA Senior Vice President Forensic Accounting, Procor Solutions + Consulting LOCATION: Brooklyn, NY A graduate of Villanova University and prior corporate Chief Financial Officer, Mr. Critelli's background has set the stage for a 29-year career of forensic accounting services and claims advocacy. Specific areas of expertise include financial investigation support, commercial property claim preparation, business interruption, and builders' risk. Major catastrophe claims work includes Superstorm Sandy; Hurricanes Michael, Irma, Maria, Katrina, Rita, and Wilma; 9/11 terrorist attaches, and 2018 California Wildfires. Mr. Critelli is a valuable team member to provide forensic accounting expertise, evaluate loss of revenue exposure, and other proactive claim preparation and recovery protocol. Additional fees may apply depending on the complexity of services requested. Page City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Section 4.2.4 Approach to Scope of Work City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Section 4.2.4: Approach to Scope of Work Provide in concise narrative form, your understanding of the City's needs, goals and objectives as they relate to the project, and your overall approach to accomplishing the project. Give an overview on your proposed vision, ideas and methodology. Describe your proposed approach to the project. 3.1 Consultation Consultant/Broker will work closely with the City's Risk Manager in risk analysis, preparation of underwriting submissions/specifications, marketing, program design and carrier selection. It is expected that the Consultant/Broker will be actively involved to ensure the proper coverage for whatever the program may require; maintain contact with global insurance markets, which are interested, available, and qualified to provide insurance; and provide loss prevention services to the City. Our approach is focused on proven insurance industry and risk management strategies which reduce your Total Cost of Risk. These can be broken down into 4 categories: Client Vision, Risk Assessment, Market Research & Negotiation, and Insurance Placement. Client Vision Every PRIA client relationship begins with listening. Our success in designing an effective risk management program requires the input of each client's decision makers. And our responsibilities begin with listening to those decision makers to understand the history of the risk management program, future goals, budget constraints, program design requirements and risk tolerance. We will conduct a pre -renewal meeting to establish our mutual strategic plan and program objectives. PRIA will use this information and more to develop Budget Estimates for the conceptual renewal program desired. Risk Assessment Our analysis method involves a detailed structured identification of current and future loss exposures. We assess our client's exposure to risk in many ways and degrees of intensity, which vary from detailed property appraisals to comprehensive continued -operation studies. We use risk identification and exposure analysis as the foundation of our risk management program design and to analytically base our recommendations. This process is used to design and implement insurance and self-insurance programs as to continually monitor the effectiveness of these programs. Any recommendations for program designs, loss control, safety training, or new insurance policies are presented in written form with analytical support. We provide objective and subjective analysis so that the City can make informed decisions. We have extensive experience with the analysis of all exposures that local governments face. Page ;i5 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Market Research & Negotiation Property - PRIA runs RMS and AIR Probable Maximum Loss (PML) model for each large client to evaluate the large loss centers and the flood probabilities. We will provide the City with current RMS and AIR catastrophic modeling results at each property renewal to ensure that the insurance loss limits are adequate and will be considered "reasonable" by State regulators. We collect detailed property data relative to wind resistance for all locations. Our process involves identifying the roof covering, roof geometry, roof age and roof strapping (if any) of these locations. This additional data significantly increases the accuracy of PML models, which in turn better identifies and measures an insured's exposure to loss. This is further used negotiate better terms and conditions with carriers. Without the additional roof information, the PML model will default to a higher value and thereby increase the PML value resulting in higher premiums. Analysis of flood exposures is critical. FEMA will not provide public assistance for flood losses to structures that are in a High Hazard flood plain (Zones A and V) unless coverage is purchased through the National Flood Insurance Program (NFIP) or the commercial marketplace. Consequently, we determine flood zones for all locations on an annual basis. Structures that are in A or V zones should be insured with NFIP or commercial policies at appropriate levels. We also evaluate the need for and the proper levels of often overlooked property coverages such as: extra expense, boiler & machinery, increased cost of construction, building ordinance, equipment floaters, demolition costs, debris removal, utility interruption, pollution clean-up, sewer back up, property -in -the -open, etc. We accomplish all the above through various techniques, processes, and tasks such as: • Property Site Inspection and Building Appraisals • Catastrophic wind, flood, and storm surge models • Research (City's website and local sites) • Financial Record Research (CAFR, Budget) • Loss Run Reports • Current Program Analysis and Review (Coverage Forms and Policies) Liability Loss Exposures - Thoroughly identifying these exposures can be complex due to the broad litigious nature of citizens and businesses. However, we have seen many types of lawsuits and possess an intimate knowledge of the State and Federal Statutes that govern public entity operations and personnel. Consequently, our advice, counsel and recommendations are based on actual claims occurring here in Florida and many years of assisting other clients with similar issues. The basic methods of identifying exposures include claims analysis, review of financial reports, understanding of all operational functions, evaluating current and future contractual obligations, identifying key personnel, reviewing lease and other contracts, reviewing the City's policies and procedures manuals, and general practices. Page HS City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Workers' Compensation - Methods include analysis of loss run reports, financial reports, actuarial reports, incident reports and interviews with key personnel and management. We also review the return -to -work programs, disciplinary procedures and safety programs that are currently in place. Analytics play a large role in rate determination and retention levels. Internally we evaluate numerous factors, trends, and total cost of risk values to determine the best risk retention and transfer levels that minimize the City's financial exposures both long and short-term. Insurance Placement After negotiations and decisions have been made, PRIA will secure the placement of all chosen insurance policies, check all binders and policies, and deliver them directly to the City staff. 3.2 Risk Management Policy Development Support the City's efforts in continual development of risk management policies. This would include: presentation of industry standard practices; assistance in development of policies that support the goals of the City toward use of local resources; innovation in the design of risk funding for the City; and assist in presentations to policy and decision making authorities. Inform the City of applicable federal and State compliance legislation, legislative trends and issues, and necessary governmental filings. Risk Management Policies are typically dynamic in nature due to the ever -changing risk environment that local governments face. We utilize many industry and legal resources to ensure access to innovations in risk management and to learn of other public entity practices that may assist the City. As innovations become known we share these with the City for possible implementation. With over 200 clients we have the unique ability to tap into the experience of many Florida risk managers and gather other policy ideas and risk innovations in a short period of time. We have used this networking capability to our clients benefit many times. An examination of other public entity successes can be a key tool in establishing policy and protocols. To maintain knowledge of changes in Federal and State regulations we use industry watchdogs, daily email alerts and have regular contact with Tallahassee insiders when the State legislators are in session. We provide updates to our clients anytime a shift in the risk management landscape occurs. For example, we provided updates and summaries of the recent Florida Legislative session when SB 1678/ HB 1129 bills (sovereign immunity limit increases) were introduced. We also keep abreast of all current regulations enabling us to provide quick and accurate advice on compliance and potential noncompliance. These include not only regulations affecting the City's operations but also the operations of vendors and contractors. Page 1'0 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS 3.3 Risk Assessment Assist in the identification and evaluation of risk exposures the City faces and provide support and coordination with actuarial efforts on behalf of the City. Assist in the determination of the level of risk retention that is appropriate and recommend proper limits and coverages for risks/exposures common to similar size cities. This service function is similar to the methodology described in 3.1 above. We believe that risk management programs should be dynamic and flexible so that responses to changing and emerging risks are proactive and not solely reactive. The proper monitoring of risk transfers and retentions will reveal any deficiencies and potential areas of improvement. Twenty-six (26) years of experience in monitoring and designing these programs has given us the expertise necessary to recognize subtle and major changes in risk exposures. The current rapidly evolving insurance markets have created an environment that cannot be successfully navigated by the inexperienced broker. Nearly all insurance market segments are currently in a volatile state and require a much higher level of insurance savvy than that of a soft market. Hard market conditions coupled with new risks (i.e. cyber, COVID 19) and greater traditional risks (hurricane severity) put risk management programs under financial strain. Without continuous analysis and proper loss forecast a program's cost efficiency will degrade and performance will suffer. Our methodology is to keep abreast of ever -changing market conditions and risks. We manage complex self -insured liability and large property insurance placements for over 40 Florida public entities. We are constantly negotiating terms and conditions with underwriters, so we are never caught flat-footed when terms erode, and we never embarrass our clients with unexpected last- minute changes. 3.4 Risk Control Provide resources to assist Risk Management in the development and maintenance of a comprehensive risk control program, which will adapt to variations in scope and level of governmental services offered by the City. Provide recommendations on loss control measures based on claims history prepared by the Risk Management Division and the City's insurance carriers. Mitigating and reducing loss is a key objective of our program, and a tailored loss control plan is the key to lowering the long-term cost of risk. PRIA will coordinate our highly qualified loss control representative for training, safety audits, policy review, workers' compensation claim reduction and other activities at with your direction. We will be an active partner in assisting loss control, safety and claim reduction efforts, and are committed to providing meaningful risk control tools and analysis. As such, our efforts will be tailored to the specific needs of the City and measured for cost effectiveness. Page ;i3 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Our Safety & Risk Management Consultant can identify training needs, risk exposures, and deliver risk management resources. All our consultants have over 20 years of experience. Some of the standard training topics include (but are certainly not limited to): • Emergency and Hurricane Preparedness • Defensive Driving • Vehicle Crash Board • Return -to Work • Safety Committee Assistance and Attendance • Claims Analysis • Work from Home Best Practices • Supervisors Training - ADA, Civil Rights, Discrimination, Bullying, etc. • Workplace Ergonomics • Job Hazard Analysis PRIA will obtain, analyze, and monitor workers' compensation loss reports and establish meetings with staff to review loss trends. We participate in claims reviews, mitigate claim issues, work directly with adjusters and defense counsel when necessary, and always seek to serve as an extension of our client's risk staff. Online Training Resources Streamery is an online streaming solution provided to PRIA customers to facilitate the training of employees on the policies and procedures that build a safe workplace. This resource is provided to the City at no cost. Streamery serves as a leader in the distribution of Safety, Management, Technology, and Human Resource training programs. They offer a variety of tools and solutions to help organizations comply with HR regulations and requirements, including OSHA, DOT and the EEOC. The innovative training platform includes over 700 videos on demand that can be streamed anytime, anywhere. The included Training Support Materials make this valuable resource the perfect tool for instructor led or individual training. Notable subjects include: TRAININGNI TWORK * Defensive Driving * Emergency Planning * Active Shooter and Workplace Violence * Evacuation Procedures * Using Fire Extinguishers * First Aid- Until Help Arrives * Hazard Recognition * HIPPA Rules and Compliance Page 0::4 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS These work best when led by a supervisor or trainer from an individual department. The trainings are short (5-20 minutes on average), so are perfect for use in weekly safety meetings! OVERVIEW • Tra i n ery uses 402 'FIFA I4eA uaere.sllceo Jib Tb Lisa, id-r..In Ott.ar TOTAL WSERS TOTAL ENTITiES;6EPT. TOTAL =CRSES AC'TAL'E COURC`F;. TOTAL VIEWS UJEU TOP :9 USER 9Y dl OF LOGINS q.of 1 d LW. ID .1.30, • 9.11, :ate rap CEx.ai.d C *pps.; ..l �ai+.d.la 11-1 e.x.ldl..an .P 44-1 iv te I 131 Twntw]a... rj+n.4...L M S1 2121, 2 la 9S dlro EN.. Jo S.ka S1 5 5 Ju 1.4 Hui%CcronI 'Saks 3-1 3} 13 IS I.I kva.31n11. 1+1 1.01-1l 14 4 14 ,000 ENROLLMENTS Salt iSfS d.e ld apt RECENTLY VIEWED COURSES I0L lth.. ._o..ax-wn� ar��anv WC.. co..,a....l .+Jala... 41 Si..l +a5 uAt 9S n 13. 1, I. • award 354 411E 3E6 I]i..s Sabi, A,] N.'`:k TO Fix T1*.cn in .ln.}fn..s a59 994e - 1E6 Sour al 11..aa.w lLNwv.t.m a52 4'(4 Si* 1 6 2 COMPLETIONS 3.5 Risk Financing Provide support to the City in development of risk financing plans that enable the City to succeed in its overall financial planning and budgeting. Coordinate with actuarial efforts and provide comprehensive information on market conditions and trends. Support innovation in design of financing mechanisms. PRIA constantly monitors the industry for new risk transfer mechanisms and ideas. Our success has been in no small part due to our ability to evaluate and implement innovative risk transfer programs. We have explored and implemented new ideas for the City and will continue to pursue innovative risk solutions as opportunities and exposures arise. Our efforts will be to mitigate the volatile fluctuations inherent in the South Florida property insurance marketplace and provide predictability and stability. Updates on market trends will be provided whenever changes occur in the insurance marketplace or in the legislative space. For instance, we recently briefed the City's Insurance Advisory Board on the imminent changes in the commercial property insurance market. We assembled a summary of "white papers' from insurance experts and industry analytics to provide a concise summation and to accurately forecast the impact on the City. As the cost of traditional risk transfer continues to rise, we have responded to our clients' economic needs by approaching risk with potential alternatives. Page 12) City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS An alternate risk financing structure currently in place is the $5M flat wind deductible within the property insurance structure. This deductible provides a predictable and consistent retention of risk to the City and to the marketplace. Another alternative to traditional risk transfer is a Parametric Trigger Product, or Weather -Related Derivatives, to protect against indirect economic loss. Unlike traditional risk transfer that requires direct physical damage and a formal loss adjustment process, parametric coverage sets a defined trigger and if that trigger is met, the policy pays. There is no formal claims adjustment and the policy will pay regardless of the size of loss. This product continues to evolve in the alternative space and now many markets are offering narrowly defined triggers that lower the basis risk. Historically there have been concerns that an insured could suffer a loss, but the trigger would not be met so the policy would not pay (basis risk). To get more traction in the market, underwriters are offering a range of triggers including hurricane category, surge height, and value of industry losses in a given geographic area to better accommodate insured's exposure. This product can be used to top up wind coverage in your program for all locations at a discount as compared to traditional risk transfer. We can also use this product for a single location. With parametric insurance, public entities can... Protect Ensure against tax simple and revenue transparent loss claims Supplement traditional insurance Cover Secure Help the under- or quick most un-insured payout for vulnerable risk liquidity post -event ... and parametric insurance can pay -out in as little as 30 days. Comparing indemnity and Parametric insurance pay -out Parametric insurance Event Occurs Intensity verified by Pay -out issued within Confirm proof of loss third -party 30-days within a year Time Indemnity based Insurance Event Occurs Insured assesses Insured submits claim Insurer reviews claim Adjuster assesses and Claim is paid based validates claim an assesnzment � ast 6171111 Page ; 1 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS 3.6 Marketing No less than 90 calendar days prior to renewal of individual coverages, meet with the City's Risk Manager to present a marketing report. This report is to provide the City with: current program evaluation; marketing timetable; ratings of markets to be approached; Consultant/Broker recommendations and reasons; anticipated rates and premium. Organize the presentation of the risk financing plan and exposures to the appropriate markets. Review the presentation plan and documents with the City's Risk Manager for approval to proceed. Advise the City on methods of optimizing and developing high -quality relationships with the markets as a trusted client. Negotiate best terms, rates, and conditions. Monitor the financial condition of insurers, including their ability to pay claims promptly, and advise the City whenever any insurer is downgraded by rating agency. Our approach in formulating a marketing strategy begins with the City's short- and long- term priorities and budgetary needs. We use these priorities to determine how to realistically secure the most cost-effective program based upon market conditions. Premium expectations, timelines, marketing strategies and carrier profiles are submitted in written form. Analysis of the following information is typical in our pre -renewal process: » On -site pre -renewal discussion/stewardship approximately 4 months prior to insurance renewals to develop and confirm short and long-term objectives. » Detailed analysis of the current insurance program. » Continuous updates concerning market conditions/expectations. » Claims and Loss Reports - Analysis of loss runs/TPA download for each line of coverage. We recommend taking advantage of trend reports available from the TPA. » Identify Probable Maximum Loss (PML) statistics for property exposure via Catastrophe modeling and proprietary analytics. » Review of Budget / Financial Reports/Actuarial Reports/Grant, Bond, Lender Covenants. » Develop insurance applications and data required by the market. » Gather other beneficial Information - Formal policies and procedures, internal records and reports, information regarding new projects, loss control and safety programs, etc. » Initial and updates for budget/cost estimates and self -insured impacts for renewal conceptual programs desired. "Deep -dive" strategies include review of: » Effective use and availability of loss reports to produce consistent claims trend analyses. » Internal funding of tail liabilities - Commutation. » Self -insured loss risk transfer - Loss Portfolio Transfer. » Perspective of increased exposure/funding of future liabilities over the next 5 years. » Risk Identification and analysis of emerging casualty risk exposures for which insurance products are available vs. self -insured exposure such as Active Shooter and other types of Crisis Management. » Analysis of Retention Levels vs. Market Availability - included in this discussion is internal Claim reserving practices. Page 122 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Develop Market Submission We will assist you with annual updates required by insurers. Our review of updates includes (but is not limited to): current exposures, changes in operations, marketplace changes and current claims analysis. We assist in the preparation of required insurance company applications by pre -filling as much as possible and collecting data that is in the public domain. In addition to applications, the following items are and will be included within an underwriting submission: » Narrative/Underwriting Executive Summary - including exposure overview and risk management strategies. See below illustration of our template for Underwriting Executive Summary/Narrative providing an expansive view of your risk to the market. » Claims reports and analysis, including details for large claims and claim trends. » Supplemental information, including newsworthy articles, handbooks, procedural manuals, financials, and actuarial results. » Website links, photographs, assembly of special reports, and market narratives are developed to support reliable underwriting data and best represent the City in the marketplace. Underwriting Executive Summary - Property Insurance Coverages Effective 2/30/2019 - 2/30/2020 As of February 30, 2019 Brown & Brown is currently contracted with the City of XYZ for Insurance Brokerage Services relating to all lines of Property and Casualty Insurance. This Summary concerns Property, Inland Marine, Automobile Physical Damage, Terrorism, and Equipment Breakdown. CITY PROFILE: The City of ABC's website is very informative: http://www.abccitytbd.com. A snapshot of the City is below: Population: 750,000 Land Area: 50 square miles Payroll: $500,000,000 Employees: 7,500 General Fund: $750,000,000 Vehicles: 7,500 Total Insured Value: S5,000,000,000 The City has seven major operating departments: Utilities, Police, Fire, Solid Waste, Parks & Recreation, General Services, and Public Works. A Comprehensive Annual Financial Report and CIP plan has been provided with this submission. The City has consistently exercised strong financial controls and conservative budgeting and are rated A+ by Standard & Poor's, and Moody's primary bond rating is Aa2. COVERAGE OVERVIEW: Line of Coverage In su rer Limits/Coverage Deductible P rope rty See AracAed Property Wind: Flood: Other than SFHA: Flood: SFHA5 (ASV zones): All Other Paris: TN: assurance Smfearre d Lima Overview Included to $500,000.000 lodrded to 5500,000,000 Inducted to $250 000,000 Inducted t0 5750.000.000 5 5,0.30,000,000 $75 P0o Al Other eds, Eroopr 5100,000 b any other Flood Loss; 5% per lunation to Named Stare and SFHA5 per Iota;.^ with loss. Su6jaq to 51,000.000 Mitilaart and 3 t0.0Ce.-D Madman Terrorism (Certined and Mon -Certified) hest Insurance Co. 5 rer TN: 5000.000.000 Aggregate Property Damage SI,000,000r52,000.000 Lability 3 5,000.000000 310000 510,000 Daducerlalse. are Per Occurrence Inland Marine - Engineeird Risk Unfenced ASSuree:e Fantastic Insurance TN: 5125,000.000 pan 013250.000.000 Limit 5125.000.000 pan o1525.000.000 Limit S 5,000,000,000 5250.000 AOP; 3% Hared W d," Raid 5250.030 Mi imurn and $1.000.003 M atem,r Equpment Break down Wo dr ti Property & Oisualty TN: 5500,000,000 5 5.000.000.000 55.000 Pet otasroneet24 Hass BI Page ;2S City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Develop Market Submission (Cont'd) For the Property submission, it is important to secure accurate COPE data (Construction, Occupancy, Protection, Exposure), so we scrub the Property Statement of Values (SOV) annually. We will actively assist the city in identifying and obtaining complete and updated information, including site inspections if needed. With accurate and updated SOV information, we can assure that modeling software generates Probable Maximum Loss (PML) results which prove actionable. Below is a sampling of analytics utilized in the marketing negotiation process. Return Periods Avg Annual Loss Std Deviation 50 Year 100'Sear 250 Year 500 Year 1000 Year EV SD 2/ PE 1% PE 0.4% PE 0 2% PE 0.1°-6 PE RL1 S (2014) $3.798.991 $17.550.941 $50.591 025 879 773 939 S127 845 582 5172 692 391 S225 048 671 RMS (2015) 52.151,510 $11_006.813 530739316 S50 032 767 080665207 5106666738 S141 337685 RIOS (2016) $2.543.564 $14.375.583 S35.136.212 558.783 92E 593 379 351 S140 319 523 S192 388 427 RMS (2017) 52.346.247 513.468.600 $32 501 232 554.830.744 S93.128021 S131642.283 S180 588 210 RMS (2018) 02.115.180 S12 688.255 530 189 048 S52 095 964 583 340 082 5123 673.695 51 69.099 249 Rf.1 S (2019) S 1 659 543 S11 047 819 523 744 247 S47 203 395 584 571 081 5116 788 833 51 55 '780.003 RI S (2020) S 1 432 173 S12 620 671 S13 597 053 S46 253 963 5101 351 513 S 142.349.11 6 51 69 731 809 $ 2 50,000,000 $200,000,000 $150,000,000 $100,000,000 $ 50,000,000 • r Avg Annual Ste Deviation S9 Year Loss The RMS modeling is tieing provided to you as an illustration of modeling programs which may be used by the underwriters in evaluating a particular ris RMS (ID1G} RMS (A15) RMS (X116) ■ RMS (3117t • RMS (S 1S) • RMS (A20) Security Committee 100 Year 259 Year 500Year 100DYear Although we cannot predict the future results of any company, we offer only financially secure insurers to our clients. Per corporate mandate, Brown & Brown is not authorized to provide quotes to our clients from unauthorized insurers or insurers with a less than AM Best rating of A- or those not rated by AM Best without an authorized exception. However, since it may be in the best interest of our clients to review and bind quotes from certain alternative risk transfer providers, Brown & Brown has established a Market Security Committee which reviews and monitors insurers falling into these categories: Risk Retention Groups, Captives, Self -Insured Groups, Trusts, State Funds, and Joint Underwriting Associations. In addition, » Each team member monitors industry news from various sources daily » AM Best ratings are confirmed and provided formally any time a quote is presented. » Any discussion or further research regarding ratings or financial position is performed as necessary. Page 124 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS 3.7 Insurance Proposals Prior to submission, prepare a matrix of insurance proposals received, to include an evaluation of coverage, limits, and cost. Submit recommendations no less than 45 days prior to the policy expiration dates. Please confirm that you can adhere to these dates or advise as to exceptions. We can and have provided the requested service. Our proposals include all the requested data plus all actual quotes and responses from underwriters. 3.8 Policy Language Be responsible for verification of policy language, checking for: accuracy, appropriate form, and compliance with requirements, proper application to risk, and client's intended needs as specified. Provide expertise in the interpretation and preparation of manuscript insurance policy forms and endorsements. PRIA has a thorough and extensive quality control process that assures the quality and accuracy of all PRIA-Client-Insurer transactions and processes. This includes the review of all insurance policies, communications, and invoices. It is imperative to maintain strict controls and protocols in all facets of our business to ensure that our clients' requests, communications, and financial transactions are conducted with the utmost accuracy and consistency. PRIA's parent, Brown & Brown, utilizes a separate internal audit division to ensure that these protocols and procedures are strictly followed. This division is accountable to the CEO of Brown & Brown. It is our intent to handle each of our client's transactions as expeditiously and accurately as possible. We strive to not only meet our client's expectations but to exceed them. We carefully document all transactions and communications of each client's program so that any employee can review that file and understand what has been done and what needs to be done for that client. We review each policy for accuracy using a detailed checklist. Our checklist contains not only standard policy terms but also any custom terms and conditions that we have negotiated for our clients. We have extensive experience in developing and implementing custom policy language and have done so on behalf the City in the past. 3.9 Insurance Policies Work with the City's Risk Manager to negotiate and purchase the following insurances (but not limited to the following): Accidental Death and Dismemberment, Active Shooter, All Risk Property & Terrorism (See Attachment A & B for SOV), Automobile Liability, Aviation General Liability & Terrorism, Blanket Crime, Cyber Liability, Event Cancellation, Excess Workers' Compensation, Firefighter Cancer, Police Professional Liability, Pollution Liability, Public Officials/Employment Practices Liability, and Watercraft Liability. See Attachment C for a summary of the City's current policies. Provide the City with certain reports, at appropriate policy intervals, to include the following: loss reports and loss prevention programs/recommendations; insurance market trends and outlook; and risk retention recommendations and philosophy. Page 120 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Our ongoing service commitment includes the full marketing and evaluation of all current insurance policies and programs. We are also committed to analyzing the possible risk transfer of currently retained exposures and the retention of currently insured exposures. We will analyze and/or secure any new coverage at the direction of the City at no additional cost. Our fee will not be adjusted if we manage more insurance policies. 3.10 Loss Management Assist the City in proper management of information regarding losses. Provide expert assistance in the settlement of major claims and losses. Serve as liaison between the City and the insurance carriers to assist in the timely and proper resolution of claims. Assist the City in periodic evaluation of claims handling and administration, and reserves for self -insured retentions. Comment and make recommendations regarding major losses incurred by the City during the previous and current policy periods. Claims Advocacy PRIA does not employ a single national claims service employee to offer to all our clients. Instead we follow a successful team -approach of using resources that are readily available and the best specialists/negotiators/adjusters for any given situation. For Property, an important facet of pre -loss advocacy is a proactive discussion of expectations with the City's preferred remediation vendors and dedicated claims adjuster. For Casualty claims advocacy, we will work closely with staff, defense counsel, insurance carriers and Third Party Administrators (TPAs). We are willing and able to coordinate and attend claims meetings to resolve claims quickly and equitably. PRIA has extensive experience representing our clients' interest in claims resolution. We prefer to develop a working relationship with our clients' Third Party Administrator, or TPA. It is important for your broker to communicate policy information and reporting requirements for excess insurers at least annually. We also ensure that reports required by our carriers are formatted and delivered to excess insurers' satisfaction to proactively avoid any coverage issues. It is also important that your TPA is vetted by any potential new insurer to which the TPA will be reporting. This process can be quite extensive, and we will handle approval and any transition for you. The team proposed herein are well -versed in claims advocacy, and we have working relationships with many governmental defense specialists and Third Party Administrators in Florida. Our Claims Specialist, Alexa Gray, embraces her primary function to ensure that all claims submitted through our office (non -TPA reported) are received and acknowledged by an adjuster within 24 hours for non -TPA policies. She also provides follow up with adjusters on open claims to ensure claims handling is in step with the Client's objectives. Tasks included within this role include: » Claims reporting (for policies placed outside TPA contract) » Claims tracking/acknowledgement and closure » Coordinate claims review meetings » Liaise with adjusters, client departments and TPA Page ;2t City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS » Assist in coverage clarifications with underwriters as needed » Pre- and post -event communication Property Claim, Disaster Recovery, and FEMA Specialists Another unique resource within our family is Procor Solutions + Consulting which provides a full suite of Property -related support services. Procor was founded around a simple goal - identify, rethink, and improve how the risk management, disaster planning and response, and the claims industry interacts, collaborates, and adds value for its participants and impacted communities. PROCOR �iall]1'1 7\5 + Cr�N5i[l'I'f\r Disaster Planning & Response FEMA Claims/Grants Management Business Interruption Valuation & Claims Advocacy Complex Claims Recovery Asset Valuation & Insurance Appraisal Crime, Fraud & Cyber Claims Management Litigation Support Industry Thought Leadership and Communications (Perrin, RIMS, PRIMA) FEMA Consulting - Following a declared emergency or major disaster, public entities and some private non-profit organizations may be eligible for FEMA assistance through the Public Assistance (PA) Program. The PA program is designed to offer assistance to eligible entities but is not designed to make an entity "whole". FEMA assistance is subject to a cost share and is the payer of last resort. Therefore, eligible entities are required to turn to their insurance provider(s) and other possible funding sources (such as State grants) for further assistance. Cost indexing and claim submittals become more complex with each source, requiring unique and specific documentation submissions in order to prove a loss and then ultimately to release funds for reimbursement. A loss where there are available funds to support a recovery via insurance, FEMA, and other funding agents, requires a comprehensive claim strategy, timeline and most importantly, details to effectuate a positive and quick resolution. Procor has the experience, expertise, and technological support to coordinate and manage the recovery process. Procor's experts and strategic partners collaborate with all the interested parties, as well as insurance providers. FEMA representatives and other funding agents are utilized to identify eligible reimbursable costs, document, and support each component of loss, and effectively streamline the submittal process. Procor has assisted in the presentation and recovery of more than $1 Billion in public funding. Below are a few examples of Procor's successes: » Procor was engaged by one of the largest NYC public entities that experienced a major loss resulting from Hurricane Sandy. The Procor team supported the insurance claim preparation package of over $400 Million. In addition, our experts supported the overall FEMA claim and associated grants management for $3 Billion in overall economic damages. » Procor was engaged to quantify and present a $30 Million hurricane (Irma) claim for one of the largest school districts in the US. The Florida School District needed a complex analysis of Page 12 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS costs to be allocated across hundreds of individual building and campuses through the district. Procor set up an efficient data collection process and claim presentation format that allowed for multiple views of loss quantification allowing the district to analyze the loss as required. In addition to the insurance claim presentation, Procor also assisted in the determination and segregation of costs that could be eligible through FEMA reimbursement which expedited and made possible the release of funds that were stalled. PROCOR September 2017 Procor manages the largest Hurricane Irma claim in the Caribbean Procor resources will be made available to the City. However, additional fees may apply for specific projects. June 2018 Procor engaged one of the largest global contingent Business Interruption claims in history October 2018 Procor VP Frank Russo wins Finext Finance Innovator of the Year Award Y PMSin 8PMSat 8 PM Fri AI:. �^ 1 8 PM Thu 8 AM Thu 2 AM Wed 3.11 Billing Responsible for the billing of premiums to the City. Consultant/Broker's invoiced insurance premiums are to be net of commission, except where required by federal and/or State law/rule. All invoices are to be e-mailed to acctspayable@fortlauderdale.gov with a copy to Risk Management. The fee paid to the selected Consultant/Broker is to be the only remuneration accepted by the Consultant/Broker for services in relation to this Agreement. Any exceptions must be clearly disclosed in Section VI - Cost Proposal Page. Agreed. Page ;_':i City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS 3.12 Annual Report Responsible for producing an annual report within 45 days of the end of the fiscal year for the City. This report is to include: a schedule of policies in force, premiums, losses, commissions and fees earned or waived, developments and trends in the markets for these coverages; and proposals for change in the City's coverages. The Schedule of Policies is updated with each renewal and includes insurers, premiums, limits, retentions, and expiration dates. There is regular reconciliation of fees and commissions. Formal and informal market updates including trends and emerging exposures is provided multiple times per year and always prior to specific insurance renewals. 3.13 Availability Consultant/Broker and team assigned to the City are to be able to accommodate consultation on an as -needed basis. Agreed. We are nearly always accessible and during the rare times that the primary team is unavailable back up team members act as the primary contact to ensure seamless services. 3.14 Contract Review Provide a thorough review and recommendation on contracts, leases and other agreements to assess the adequacy of insurance, assumption of liability and other risk management issues. For purposes of RFPs, the Consultant/Broker will receive a draft of the RFP that is scheduled to be issued and will be asked to suggest how the insurance section should be worded. Consultant/Broker will also need to advise if the indemnity and hold harmless provisions are adequately worded to protect the interests of the City. Consultant/Broker should anticipate a consistent volume of these reviews and at times, they may need to be completed the same day. Assistance on review of certificates of insurance will also be requested on an as -needed basis. We believe that one of the most critical areas of risk exposure lies within contract liabilities; therefore, we provide contract analysis for our clients, including developing customized templates for vendor requirements for use by procurement and other departments. We can conduct training sessions with procurement personnel to ensure implementation of new standards is efficient and understood. In addition, we can assist in setting up a management system for certificate of insurance compliance and provide certificate review for compliance. There have been numerous court cases in recent years that resulted in a broadening of local government liability exposures as well constriction of sovereign immunity protections. It is therefore imperative to remain knowledgeable of these precedents and their impact on the City's risk management program. We remain vigilant in maintaining a level of knowledge of these cases and adjust our programs and consultation accordingly. We also make it a point to stay current with changes to ISO policy coverage forms. There have been many new forms introduced by ISO. Many provide less coverage for insureds and additional insureds. It is imperative to stay current as many of these forms do not provide the same level of protection to Page ;5'.) City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS the City as the older forms. Our recommendations include a requirement for a minimum level of coverage afforded by a specific form, such as the CG 20 26 04 13 Additional Insured endorsement. It is equally important to amend insurance requirements as new exposures emerge. For example, we have updated our insurance requirement recommendations to include cyber liability coverage and active shooter liability insurance mandates where appropriate. 3.15 Special Events Consultant/Broker will be asked to comment and recommend what coverage requirements should be required of third parties requesting use of City owned property. As we have stated in 3.14, contractual risk transfer is a critical component of risk management. Risks not properly transferred to third parties can expose the City to risk unnecessarily. The methodology used in establishing effective insurance requirements for the third -party use of City facilities is based on exposure to loss of City property, risk to the general public and the vicarious exposure to loss by a third party. Risks should be balanced with the City's desire to provide "fun and rewarding recreation programs" in a safe environment. A third party could be an invitee of the facility user, participant in a non -City sponsored activity or a third party injured by a facility user. All scenarios should be contemplated. The basic requirements should include an indemnification agreement signed by the third party indemnifying and holding the City harmless for all actions or inactions of the third party and losses arising out of the third party's event. Insurance requirements should be relative to the exposure i.e. general liability for bodily injury and property damage risks. The City should be an additional insured on all liability policies to protect the City from vicarious litigation and claims management costs. Limits for this insurance vary amongst cities in Florida but generally run between $500,000 and $1,000,000. For larger public gatherings we are recommending Active Shooter/Threat of Violence Liability. Recent events such as the Las Vegas shooting near the Mandalay Bay hotel warrant this new requirement in our opinion. There are various mechanisms available to the City to ensure users have proper insurance. One method is to develop a Tenant Users Liability Insurance Program (TULIP) can often help decrease the cost to third party users. Since the City would own the program, it would be easier to control the levels of insurance and adequacy of coverage. On-line programs are available that would require minimal administrative burden. We review the requirements for specific events that may be out of the ordinary. Recommended requirements for these events are based on level of hazard, number or participants, length of event, and exposure to the City. 3.16 Loss Development Support the City with resources for trending, forecasting, and premium calculation and allocation in cooperation with actuarial services used by the City. Page ;3J City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS PRIA is able and willing to assist actuaries with trending and forecasting for losses, claim reserves, future liabilities, premiums, and fixed costs. In addition to the assistance requested, PRIA can provide methodology to calculate and allocate premium among the various departments. We have assisted many clients with their annual premium allocation. Please see below an example of a complex premium and claims cost allocation that we recently developed for Citrus County. The workers compensation factors in the table are derived using the State rates for each class code, claims administration costs, excess insurance costs and actual losses for each class code or department. This methodology allocates the claims administration costs evenly among all departments. The loss factor is derived using actual losses including reserve amounts. The excess workers compensation insurance costs are weighted using the State class code rates which are calculated based on average statewide losses. All the factors can be amended or weighted to a client's preference. Actuarial based loss amounts can be included in the calculation as well. The concept is to allocate costs fairly among departments based on probability of loss (class codes) fixed costs (administration) and actual loss experience. Furthermore, loss experience factors can be averaged over multiyear intervals to eliminate "shock" loss years. Actuarial reserves can also be allocated using loss forecasts and actual losses. Adjustments may be needed to account for large loss reserves that may not pay out for several years. Ideally, departments should be motivated to operate safely to reduce operating costs. Class Code Payroll NCCI RATE Manual Premium XS WC premium factor XS WC Allocation rate Premium Allocation using NCCI rate TPA Charge Allocation using NCCI Rate Total Losses Total Cost Allocation Street or Road Maintenance 5509 $ 2,235,414 $ 9.57 $ 213,929 0.15875651 $ 1.519300 $ 33,962.64 $ 10,851.36 $ 19,891 $ 64,705.00 Excavation 6217 $ 228,665 $ 5.24 $ 11,982 0.15875651 $ 0.831884 $ 1,902.23 $ 607.78 $ 2,211 $ 4,721.01 Vessels NOC 7016 $ 99,208 $ 5.80 $ 5,754 0.15875651 $ 0.920788 $ 913.50 $ 291.87 $ - $ 1,205.36 Bus Co: All Other Employees & Drivers 7382 $ 497,654 $ 4.72 $ 23,489 0.15875651 $ 0.749331 $ 3,729.07 $ 1,191.47 $ 12,152 $ 17,072.55 Waterworks Operation 7520 $ 1,725,926 $ 3.58 $ 61,788 0.15875651 $ 0.568348 $ 9,809.27 $ 3,134.15 $ 2,492 $ 15,435.42 FireFighter 7704 $ 3,650,717 $ 5.10 $ 186,187 0.15875651 $ 0.809658 $ 29,558.33 $ 9,444.15 $ 30,900 $ 69,902.48 Automobile Repair 8380 $ 335,507 $ 2.54 $ 8,522 0.15875651 $ 0.403242 $ 1,352.90 $ 432.26 $ 3,896 $ 5,681.17 Salesperson/Collectors 8742 $ 103,455 $ 0.33 $ 341 0.15875651 $ 0.052390 $ 54.20 $ 17.32 $ - $ 71.52 Clerical 8810 $ 20,158,673 $ 0.16 $ 32,254 0.15875651 $ 0.025401 $ 5,120.51 $ 1,636.05 $ 23,200 $ 29,956.56 Attorney 8820 $ 291,509 $ 0.14 $ 408 0.15875651 $ 0.022226 $ 64.79 $ 20.70 $ - $ 85.49 Hospital -Veterinary 8831 $ 491,095 $ 1.61 $ 7,907 0.15875651 $ 0.255598 $ 1,255.23 $ 401.06 $ 7,928 $ 9,584.29 College Professional 8868 $ 114,999 $ 0.43 $ 494 0.15875651 $ 0.068265 $ 78.50 $ 25.08 $ - $ 103.59 Buildings NOC 9015 $ 912,378 $ 3.81 $ 34,762 0.15875651 $ 0.604862 $ 5,518.63 $ 1,763.25 $ - $ 7,281.88 Club Country /Golf/Fish/Yacht 9061 $ 21,224 $ 1.98 $ 420 0.15875651 $ 0.314338 $ 66.72 $ 21.32 $ - $ 88.03 Parks NOC 9102 $ 900,447 $ 3.77 $ 33,947 0.15875651 $ 0.598512 $ 5,389.28 $ 1,721.92 $ 1,500 $ 8,611.21 Garbage, Ashes or Refuse Collection 9403 $ 329,756 $ 6.06 $ 19,983 0.15875651 $ 0.962064 $ 3,172.47 $ 1,013.63 $ - $ 4,186.10 Municipal NOC 9410 $ 2,054,841 $ 2.52 $ 51,782 0.15875651 $ 0.400066 $ 8,220.73 $ 2,626.60 $ 10,500 $ 21,347.32 $ 34,151,468 - $ 35,200 $ 114,670 S 260,039 Manual Prer $ 693,950 TPA Charge XS WC Premium Average annual Losses Total Cost 260,039 Page ;3-i City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Citrus County Cost Allocation for General Liability including TPA charges, 5 yr average Losses and XS Liability Premium General Liablity Insurance Premiums 5 yr annual average GL Losses $ 43,428 Annual TPA Costs $ 18,500 XS GL Insurance Premium $ 73,767 Total $ 135,695 Total payroll $ 34,294,486 General Liability Cost Allocation per $100 of payroll 0.395675853 Department Loss Factor 0.24 Departe me nt' s GL Cost Allocation per $100 of Payroll 0.094962205 Other Liablity Insurance Premiums Crime $ 6,931 Public Officials Liability $ 70,957 CyberLiability $ 21,143 TOTAL $ 99,031 Allocation rate per $100of payroll for the above policies 0.288766538 This rate does not include any allocation for losses N/A 3.17 Loss Prevention/Engineering Services Review all insurance companies' loss prevention/engineering reports and provide the City with written recommendations for compliance within 30 days from the date the reports are issued by the companies. Represent the City's position/interest concerning recommendations made by insurance companies and, if requested, conduct research and develop documentation to support the City's position/interest. As stated in 3.4, PRIA is committed to loss prevention endeavors to effectively reduce loss exposures and costs. We will be actively involved in loss control resources provided by PRIA and those services provided by insurance carriers. We will act as the city's advocate in all insurer matters including inspection and engineering reports. We have experience in managing insurer compliance issues and have done so successfully on behalf of the City. In our experience, most insurance carrier issues, or mandates are negotiable. Page 132 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS The proposer shall also propose a scheduling methodology (timeline) for effectively managing and executing the services to be performed. Below is a proposed service and renewal timeline GENERAL WORK FLOW SCHEDULE 120+ days prior to policy expiration • Initiate Marketing Process • Current market conditions analysis • Estimate Pricing & Budget Goals • Written request for underwriting data • Assist in collection of UW information • Establish competitive markets to be approached • Identify desired coverage, terms, and conditions goals 90 to 120 Days prior to policy expiration • Scrub Statement of Values • Approval of Submission by client • Submit all underwriting data to all interested carriers • Update risk management on progress and early pricing indications 60 to 90 days prior to expiration • Written summary of quotes received, and markets responses • Provide Premium Comparison with expiring and renewal terms. • Include Cost of Risk Analysis • Obtain Catastrophic Modeling Results • Develop recommendation for most effective program 30 to 60 days prior to expiration • Attend Meetings and Workshops • Assist in preparation of Board Agenda items • Complete required signed documents • Submit Requests to Bind to chosen carriers Inside 30 days prior to expiration • Request, Review, and Issue Binders • Issue any recurring Certificates of Insurance • Issue Invoices 30 to 60 days after policy inception • Re -issue any expired binders • Review, correct and issue policies • Provide an annual summary of program terms and premiums. Ongoing • Daily Policy Maintenance and Client Service Requests • Claims Advocacy and Handling • Large Claim Reviews • Property appraisal management and implementation • Update and Scrub Statement of Values data • Stewardship Report • Review Risk Management Polices • Inspection/Loss Prevention Program Implementation • Flood Zone Audits for Property • Market Trend and Emerging Markets Identification • Legislative Change Tracking • Industry News Communications • Other Special Projects as agreed Page ;3 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Also provide information on your firm's current workload and how these services will fit into your workload. Describe available facilities, technological capabilities and other available resources you offer for these services. PRIA's systems and protocols are specifically tailored to meet the unique service needs of public entities. We are built to effectively manage the complex service requirements of public entities, so our workload is not effected by acquiring new clients or retaining current clients. We have always grown our business in a controlled and steady manner to not spread our resources too thin. Furthermore, we currently manage the property and casualty insurance program for the City. A continuation of our services will fit perfectly in our workload. Consultant/Broker and team assigned to the City are to be able to accommodate consultation availability on an as -needed basis. Please offer information as to what can reasonably be expected for a turn -around time for phone calls and e-mails. Specifically advise as to who the City's first point of contact will be and the resume/qualifications of that person. Our service history with the City as well as other large clients, reveals that our consultation expertise is near instantaneous and readily available at all times. We are reachable after hours, weekends and even during our vacations. There is rarely a time when not available. During those time when our access is limited, we will alert the City so that expectations are managed. Phone calls are returned in the same day received and email responses rarely take more than 24 hours. Also of note is our ability to provide professional consultation without need of exhaustive research. Paul Dawson's experience and knowledge of all aspects of public entity risk management is surpassed by few if any other Florida brokers. With 26 years of laser focus on public sector insurance and risk, Mr. Dawson's knowledge base is vast and invaluable. The City will have access to fast and accurate recommendations for all risk management projects. The City's primary The City's proposed Team Leader (first point of contact) is Paul Dawson. Mr. Dawson's resume can be found in Section 4.2.3 Page ;3a City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Consultant/Broker will be asked to comment and recommend what coverage requirements should be required of third parties requesting use of City owned property. In your response, please offer a narrative of your experience with various types of events and your methodology behind how you determine the types of coverages and limits that may be required. Contractual indemnification and insurance requirements should be primarily risk based. Risk management is considered more art than science so the factors that determine proper levels and types of insurance can vary greatly. Exposure to loss and the answer to the question "What could go wrong?" are the keys to determining proper insurance requirements. Our methodology consists of four criteria to protect the City's interest. ➢ Hold Harmless- Third Party agrees to hold the City harmless from any third -party liability. ➢ Indemnification- Third party agrees to indemnify the City for liabilities including legal fees. ➢ Insurance- Establishes financial assurance that the third party has the ability to comply with the hold harmless and indemnification promises. ➢ Evidence of Insurance -Proof that the third party has the required insurance coverage. Our experience in applying these four criteria is robust. Paul Dawson teaches a two-hour Risk Management & Insurance in Contracts class with details on proper insurance limits, effective indemnification and hold harmless language and "what is an acceptable certificate of insurance". In the last 5 years this workshop has been presented more than 20 times to over 15 local governments. Entities receiving this training include the cities of Ocala, Haines City, Edgewater, Fort Walton Beach, St Cloud; counties of Flagler, Okaloosa, Marion, Citrus; St Johns River WMD and Osceola County School Board. Our recommendation is to establish basic insurance requirements for the most frequent facility use scenarios and adjust coverage types and limits as risks require. The widely used standard insurance limits for traditional liability policies (auto, general, and professional) is $1M per occurrence/claim. Agreements that pose a higher risk to the City such as" design, build and operate" projects on City property would require higher limits of —$5M. Short term rentals of recreational property generally require Special Event Liability coverage or General Liability coverage. Limits should be based on risk factors. Birthday parties might require no insurance but events with attractions such as bounce houses should require a minimum of $1M in liability coverage. If alcohol is permitted, liquor liability coverage should be obtained with a minimum of $1M per occurrence limit. The City should be an additional insured on all liability policies. The different scenarios are nearly endless, but the key is to understand the risk of the event, identify the correct insurance for the risk to best protect the City from liability arising out the use or occupation of City property. Please see our response in 3.14 Contract Review and 3.15 Special Events for additional details on insurance coverage requirements. Page ;3i City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Section 4.2.5 References City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Section 4.2.5: References Client Name: Citrus County Address: 3600 W. Sovereign Path, Lecanto, FL 34461 Client Contact: Mary Glancy I 352-527-5363 I Mary.glancy@citrusbocc.com Description of Work: Manage all property, casualty & excess workers compensation insurance Years of Service: Continuous since 2005 Total Cost: $1,700,000 Client Name: Brevard County BOCC Address: 2725 Judge Fran Jamieson Way, Viera, FL 32940 Client Contact: Julie Jones (321) 617-7247 I julie.jones@brevardcounty.us Description of Work: Manage all property, casualty,& excess workers compensation insurance Years of Service: Continuous since 2014 Total Cost: $4,000,000 Client Name: Okaloosa County BOCC Address: 5479 B Old Bethel Road, Crestview, FL 32536 Client Contact: Kelly Bird I (850) 689-5978 I kbird@co.okaloosa.fl.us Description of Work: Manage all property, casualty & excess workers compensation insurance Years of Service: Continuous since 2010 Total Cost: $1,900,000 Client Name: City of Ocala Address: 110 SE Watula Ave, Ocala, FL 34471 Client Contact: Jared Sorenson I 352-401-3991 I jsorenson@ocalafl.org Description of Work: Manage all property, casualty & excess workers compensation insurance Years of Service: Continuous since 1998 Total Cost: $1,400,000 Client Name: City of Miami Gardens Address: 18605 NW 27th1 Avenue, Suite 126, Miami Gardens, FL 33056 Client Contact: Linda Bass I (305) 914-9010, ext. 2314 I lbass@miamigardens-fl.gov Description of Work: Managed all property, casualty & workers compensation insurance Years of Service: 2015 — 2020 Total Cost: N/A - Former Client Page ;3 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Section 4.2.6 & Minority/Women (M/WBE) Participation and Section 4.2.7 & Subcontractors City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Section 4.2.6: Minority/Women (M/WBE) Participation If your firm is a certified minority business enterprise as defined by the Florida Small and Minority Business Assistance Act of 1985, provide copies of your certification(s). If your firm is not a certified M/WBE, describe your company's previous efforts, as well as planned efforts in meeting M/WBE procurement goals under Florida Statutes 287.09451. Not Applicable Section 4.2.7: Subcontractors Proposer must clearly identify any subcontractors that may be utilized during the term of this contract. PRIA has no plans to use subcontractors for this agreement. Page ;3: City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS Section 4.2.8 Required Forms City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS BId1PROPOSAL CERTIFICATION Please Note.: It is the sole responsibility of the bidder to ensure that his bid is submitted electronically through _www.BidSync.com_ prior to the bid opening date and time listed. Paper bid submittals will not be accepted. All fields below must be completed. If the field does not apply to you, please note NIA in that field_ If you are a foreign corporation, you may be required to obtain a certificate of authority from the department of state, in accordance with Florida Statute §607.1501 (visit http:flwww_dos_state.fl.usf). Company: (Legal Registration) Risk Management Associates, Inc. Address: 300 North Beach Street City: Daytona Beach Telephone No.: (386) 239-7245 EIN (Optional): 59-2445801 State: FL Zip: 32114 FAX No: (386) 239-4049 Email: mmontgomeryAbbpria_com Delivery: Calendar days after receipt of Purchase Order (section 1.02 of General Conditions): N/A Total Bid Discount (section 1.05 of General Conditions)_ NrA Check box if your firm qualifies for MBE / SBE 1 WBE (section 1.09 of General Conditions): ❑ ADDENDUM ACKNOWLEDGEMENT - Proposer acknowledges that the following addenda have been received and are included in the proposal: Addendum No. Date Issued 1 6128/2021 Addendum Na_ Date Issued Addendum No. Date Issued VARIANCES: If you take exception or have variances to any term, condition, specification, scope of service, or requirement in this competitive solicitation you must specify such exception or variance in the space provided below or reference in the space provided below all variances contained on other pages within your response_ Additional pages may be attached if necessary_ No exceptions or variances will be deemed to be part of the response submitted unless such is listed and contained in the space provided below. The City does not, by virtue of submitting a variance, necessarily accept any variances. If no statement is contained in the below space, it is hereby implied that your response is in full compliance with this competitive solicitation. If you do not have variances, simply mark NIA. You must also click the "Take Exception' button. None The below signatory hereby agrees to furnish the following article(s) or services at the price(s) and terms stated subject to all instructions, conditions, specifications addenda, legal advertisement, and conditions contained in the bidlproposal_ 1 have read all attachments including the specifications and fully understand what is required. By submitting this signed proposal, I will accept a contract if approved by the City and such acceptance covers all terms, conditions, and specifications of this bidlproposal. The below signatory also hereby agrees, by virtue of submitting or attempting to submit a response, that in no event shall the City's liability for respondent's direct, indirect, incidental, consequential, special or exemplary damages, expenses, or lost profits arising out of this competitive solicitation process, including but not limited to public advertisement, bid conferences, site visits, evaluations, oral presentations, car award proceedings exceed the amount of Five Hundred Dollars ($500.00)_ This limitation shall not apply to claims arising under any provision of indemnification or the City's protest ordinance contained in this competitive solicitation. Submitted by: Matthew Montgomery Name (printed) 7/1 /2021 Date Signature Executive Vice President Title revised 04/2020 Page 13; City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS SECTION VI - COST PROPOSAL PAGE Proposer Name: Risk Management Associates, Inc. dba Public Risk Insurance Advisors Proposer agrees to supply the products and services at the prices bid below in accordance with the terms, conditions and specifications contained in this RFP. Cost to the City: Contractor shall quote firm, fixed, costs for all services identified in this request for proposal. These firm fixed costs for the project include any costs for travel and miscellaneous expenses. No other costs will be accepted. Total Firm, Fixed, Cost of Services $ 65,000* *PRIA will not accept compensation for the insurance program currently in place, other than the Fee proposed, except for flood policies placed through the National Flood Insurance Program. FEMA issued a memorandum in April 2012 prohibiting the "rebating" or return of commission practice for NFIP flood policies. PRIA adheres to this directive for all NFIP flood policies placed by PRIA. A copy of the FEMA directive is available on the FEMA website http://bsa.nfipstat.fema.gov/wyobull/2012/w-12026.pdf. Submitted by: Matthew Montgomery Name (printed) 7/1/2021 Date Executive Vice President Title Page ;3J City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS NON -COLLUSION STATEMENT: By signing this offer, the vendor contractor certifies that this offer is made independently and free from collusion. Vendor shall disclose below any City of Fort Lauderdale, FL officer or employee, or any relative of any such officer or employee who is an officer or director of; or has a material interest in; the vendor's business, who is in a position to influence this procurement. Any City of Fort Lauderdale, FL officer or employee avho has any input into the writing of specifications or requirements, solicitation of offers, decision to award; evaluation of offers; or any other activity pertinent to this procurement is presumed; for purposes hereof, to be in a position to influence this procurement_ For purposes hereof, a person has a material interest if they directly or indirectly own more than 5 percent of the total assets or capital stock of any business entity, or if they otherwise stand to personally gain if the contract is awarded to this vendor. In accordance with City of Fort Lauderdale, FL Policy and Standards Manual; 6.10.8.3, 3.3. City employees may not contract with the City through any corporation or business entity in which they or their immediate family members hold a controlling financial interest (e.g. ownership of five (5) percent or more). 3.4. Immediate family members (spouse, parents and children) are also prohibited from contracting with the City subject to the same general rules. Failure of a vendor to disclose any relationship described herein shall be reason for debarment in accordance with the provisions of the City Procurement Code. NAME. None RELATIONSHIPS In the event the vendor does not indicate any names, the City shall interpret this to mean that the vendor has indicated that no such relationships exist. Authorized Signature Matthew Montgomery Name (Printed) Executive Vice President Title lr l i2021 Date Rev 05-2020 Page 140 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS CONTRACTOR'S CERTIFICATE OF COMPLIANCE WITH NON-DISCRIMINATION PROVISIONS OF THE CONTRACT The completed and signed form should be returned with the Contractor's submittal_ If not provided with submittal, the Contractor must submit within three business clays of City's request_ Contractor may be deemed non -responsive for failure to fully comply within stated timefrnmes. Pursuant to City Ordinance Sec. 2-17(a)(i)(ii), bidders must certify compliance with the Non -Discrimination provision of the ordinance. (a) Contractors doing business with the City shall not discriminate against their employees based on the employee's race, color, religion, gender (including identity or expression), marital status, sexual orientation, national origin, age, disability or any other protected classification as defined by applicable law. Contracts. Every Contract exceeding $100,000; or otherwise exempt from this section shall contain language that obligates the Contractor to comply with the applicable provisions of this section. The Contract shall include provisions for the following: (i) The Contractor certifies and represents that it will comply with this section during the entire term of the contract. (ii) The failure of the Contractor to comply with this section shall be deemed to be a material breach of the contract, entitling the City to pursue any remedy stated below or any remedy provided under applicable law_ Matthew Montgomery, Executive Vice President Authorized Signature Print Name and Title 17%1.2021 Date Page 141 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS LOCAL BUSINESS PREFERENCE Section 2-199.2, Code of Ordinances of the City of Fort Lauderdale. (Ordinance No. C-12-04), provides for a local business preference. In order to be considered for a local business preference, a bidder must include the Local Business Preference Certification Statement of this ITB. as applicable to the local business preference class claimed at the time of bid submittal. Upon formal request of the City, based on the application of a Local Business Preference the Bidder shall. within ten (10) calendar days, submit the following documentation to the Local Business Preference Class claimed: A) Copy of City of Fort Lauderdale current year business tax receipt, or Broward County current year business tax receipt. and B) List of the names of all employees of the bidder and evidence of employees' residence within the geographic bounds of the City of Fort Lauderdale or Broward County. as the case may be, such as current Florida driver license, residential utility bill (water, electric, telephone, cable television), or other type of similar documentation acceptable to the City. Failure to comply at time of bid submittal shall result in the bidder being found ineligible for the local business preference. THE COMPLETE LOCAL BUSINESS PREFERENCE ORDINANCE MAY BE FOUND ON THE CITY'S WEB SITE AT THE FOLLOWING LINK: https:Illibrary.municode.comlfllfort Lauderdale/cod eslcode of ordinances?nodeld=COOR CH2AD A RTVFI DIV2PR S2-186LOBUPRPR Definitions: The term ''Business" shall mean a person, firm, corporation or other business entity which is duly licensed and authorized to engage in a particular work in the State of Florida. Business shall be broken down into four (4) types of classes: 1. Class A Business — shall mean any Business that has established and agrees to maintain a permanent place of business located in a non-residential zone and staffed with full-time employees within the limits of the City and shall maintain a staffing level of the prime contractor for the proposed work of at least fifty percent (50%) who are residents of the City. 2. Class B Business - shall mean any Business that has established and agrees to maintain a permanent place of business located in a non-residential zone and staffed with full-time employees within the limits of the City or shall maintain a staffing level of the prime contractor for the proposed work of at least fifty percent (509%0) who are residents of the City. 3. Class C Business - shall mean any Business that has established and agrees to maintain a permanent place of business located in a non-residential zone and staffed with full-time employees within the limits of Broward County. 4. Class D Business — shall mean any Business that does not qualify as either a Class A. Class B. or Class C business. Forms ?Jon -ISO Revision C3)3'J2021 Page 142 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS LOCAL BUSINESS PREFERENCE CERTIFICATION STATEMENT The Business identified below certifies that it qualifies for the local business price preference classification as indicated herein, and further certifies and agrees that it will re -affirm its local preference classification annually no later than thirty (30) calendar days prior to the anniversary of the date of a contract awarded pursuant to this ITB. Violation of the foregoing provision may result in contract termination. (1) N/A (2) N/A (3) (4) Business Name Business Name N/A Business Name NIA Business Name (5) N/A Business Name Risk Management Associates, Inc. dba Public Risk Insurance Advisors (6) Business Name BIDDER'S COMPANY: is a Class A Business as defined in City of Fort Lauderdale Ordinance No. C-17- 26, Sec.2-186. A copy of the City of Fort Lauderdale current year Business Tax Receipt and a complete list of full-time employees and evidence of their addresses shall be provided within 10 calendar days of a formal request by the City. is a Class B Business as defined in the City of Fort Lauderdale Ordinance No. C- 17-26, Sec.2-186. A copy of the Business Tax Receipt or a complete list of full- time employees and evidence of their addresses shall be provided within 10 calendar days of a formal request by the City_ isa Class C Business as defined in the City of Fort Lauderdale Ordinance No. C- 17-26, Sec2-186. A copy of the Broward County Business Tax Receipt shall be provided within 10 calendar days of a formal request by the City. requests a Conditional Class A classification as defined in the City of Fort Lauderdale Ordinance No. C-17-26, Sec2-186. Written certification of intent shall be provided within 10 calendar days of a formal request by the City. requests a Conditional Class B classification as defined in the City of Fort Lauderdale Ordinance No. C-17-26, Sec2-186. Written certification of intent shall be provided within 10 calendar days of a formal request by the City. is considered a Class D Business as defined in the City of Fort Lauderdale Ordinance No. C-17-26, Sec.2-186 and does not qualify for Local Preference consideration. Risk Management Associates, Inc. dba Public Risk Insurance Advisors AUTHORIZED COMPANY PERSON: Matthew Montgomery 71112021 PRINT NAME SIGNATURE DATE Fortes Non -ISO Revision D3131/2021 Page ;4 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS DISADVANTAGED BUSINESS ENTERPRISE (DBE) PREFERENCE Section 2-185, Code of Ordinances of the City of Fort Lauderdale, provides for a disadvantaged bus ness preference. In order to be considered for a DBE Preference. a bidder must include a certification from a government agency, as applicable to the DBE Preference class claimed at the time of bid submittal. Upon formal request of the City, based on the application of a DBE Preference the Bidder shall, within ten (10) calendar days, submit the following documentation to the DBE Class claimed: A) Copy of City of Fort Lauderdale current year business tax receipt, or Broward County current year business tax receipt, or State of Florida active registration and/or B) List of the names of all employees of the bidder and evidence of employees' residence within the geographic bounds of the City of Fort Lauderdale or Broward County, as the case may be, such as current Florida driver license, residential utility bill (water. electric, telephone, cable television), or other type of similar documentation acceptable to the City. Failure to comply at time of bid submittal shall result in the bidder being found ineligible for the disadvantaged business preference. THE COMPLETE DBE PREFERENCE ORDINANCE MAY BE FOUND ON THE CITY'S WEB SITE AT THE FOLLOWING LINK: https:Uwww.fortlauderdale.govlhome/showpublisheddocument?id=56883 Definitions a. The term "disadvantaged class 1 enterprise" shall mean any disadvantaged business enterprise that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the city, and provides supporting documentation of its City of Fort Lauderdale business tax and disadvantaged certification as established in the City's Procurement Manual. The term "Class B business" shall mean any business that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the city, or shall maintain a staffing level for the proposed work of at least fifty percent (50%) who are residents of the City of Fort Lauderdale. b. The term "disadvantaged class 2 enterprise" shall mean any disadvantaged business enterprise that has established and agrees to maintain a permanent place of business within the limits of the city with a full-time employees and provides supporting documentation of i:s City of Fort Lauderdale business tax and disadvantaged certification as established in the City's Procurement Manual. The term "Class D business" shall mean any business that does not qualify as a Class A. Class B, or Class C business. c, The term "disadvantaged class 3 enterprise" shall mean any disadvantaged business enterprise that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the Tri- County area and provides supporting documentation of its City of Fort Lauderdale business tax and disadvantaged certification as established in the City's Procurement Manual. d. The term "disadvantaged class 4 enterprise" shall mean any disadvantaged business enterprise that does not qualify as a Class A, Class B, or Class C business, but is located in the State of Florida and provides supporting documentation of its disadvantaged certification as established in the City's Procurement Manual. Fortes Non -ISO 0311712021 Page j4: City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS DISADVANTAGED BUSINESS ENTERPRISE CERTIFICATION STATEMENT The Business identified below certifies that it qualities for the disadvantaged business enterprise price preference classification as indicated herein, and further certifies and agrees that it will re -affirm its preference classification annually no later than thirty (30) calendar days prior to the anniversary of the date of a contract awarded pursuant to this solicitation. Violation of the foregoing provision may result in contract termination. (1) (2) (3) (4) (5) N/A Business Name N/A Business Name N/A Business Name N/A Business Name Risk Management Associates, Inc. dba Public Risk Insurance Advisors Business Name BIDDERS COMPANY: is a disadvantaged class 1 enterprise as defined in the City of Fort Lauderdale Ordinance Section 2-185 disadvantaged business enterprise that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the city, and provides supporting documentation of its City of Fort Lauderdale business tax and disadvantaged certification as established in the City's Procurement Manual The term "Class B business" shall mean any business that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the city, or shall maintain a staffing level for the proposed work of at least fifty percent (50%) who are residents of the City of Fort Lauderdale. is a disadvantaged class 2 enterprise as defined in the City of Fort Lauderdale Ordinance Section 2-185 disadvantaged business enterprise that has established and agrees to maintain a permanent place of business within the limits of the city with a full-time employees) and provides supporting documentation of its City of Fort Lauderdale business tax and disadvantaged certification as established in the City's Procurement Manual. The term "Class D business" shall mean any business that does not qualify as a Class A, Class B, or Class C business. is a disadvantaged class 3 enterprise as defined in the City of Fort Lauderdale Ordinance Section 2-185 disadvantaged business enterprise that has established and agrees to maintain a permanent place of business located in a non-residential zone, staffed with full-time employees within the limits of the Tri-County area and provides supporting documentation of its City of Fort Lauderdale business tax and disadvantaged certification as established in the City's Procurement Manual. is a disadvantaged class 4 enterprise as defined in the City of Fort Lauderdale Ordinance Section 2-185 disadvantaged business enterprise that does not qualify as a Class A, Class B, or Class C business, but is located in the State of Florida and provides supporting documentation of its disadvantaged certification as established in the City's Procurement Manual is not considered a Disadvantaged Enterprise Business as defined in the City of Fort Lauderdale Ordinance Sect-185 and does not qualify for DBE Preference consideration. Risk Management Associates. Inc. dba Public Risk Insurance Advisors AUTHORIZED COMPANY PERSON: Matthew Montgomery 7f 112021 PRINT NAME SIGNATURE Fortes Non -LSO D311712021 DATE Page ;43 City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS CONTRACT PAYMENT METHOD The City of Fort Lauderdale has implemented a Procurement Card (P-Card) program which changes how payments are remitted to its vendors. The City has transitioned from traditional paper checks to credit card payments via MasterCard or Visa as part of this program. This allows you as a vendor of the City of Fort Lauderdale to receive your payments fast and safely. No more waiting for checks to be printed and mailed. In accordance with the contract, payments on this contract will be made utilizing the City's P-Card (MasterCard or Visa). Accordingly, bidders must presently have the ability to accept the credit card or take whatever steps necessary to implement acceptance of a card before the start of the contract term, or contract award by the City. All costs associated with the Contractor's participation in this purchasing program shall be borne by the Contractor. The City reserves the right to revise this program as necessary. By signing below you agree with these terms. Please indicate which credit card payment you prefer: x- MasterCard KI Visa IRisk Management Associates, Inc Company Name 'Matthew Montgomery dba Public Risk Insurance Advisors Name (Printed) Signature 17.1 /2021 Date 1 Executive Vice President Title Page 14i; City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS RFP/Bid /Contract No: Project Description: E-VERIFY AFFIRMATION STATEMENT r 12536-525 Property & Casualty Insurance Brokerage and Consulting Services ContractorlProposer/Bidder acknowledges and agrees to utilize the U.S. Department of Homeland Security's E-Verify System to verify the employment eligibility of, (a) all persons employed by Contractor/Proposer/Bidder to perform employment duties within Florida during the term of the Contract, and. (b) all persons (including subcontractorsfvendors) assigned by Contractor`ProposeriBidder to perform work pursuant to the Contract. The Contractor/Proposer/Bidder acknowledges and agrees that use of the U.S. Department of Homeland Security's E-Verify System during the term of the Contract is a condition of the Contract. Contractor/Proposer/ Bidder Company Name: (Risk Management Associates, Inc_ dba Public Risk Insurance Advisors Authorized Company Person's Signature: I Authorized Company Person's Title: Date: 17/ l/2021 'Executive Vice President Page l4:' City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS ACC D® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYYI 01/12/2021 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE ACONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Brown & Brown of Florida, Inc. 300 N Beach Street Daytona Beach FL 32114 CONTACT Laurie DeSandre NAME: PHONE (386)239-7242 (AC. No, Ext): EE-M Lss: Ikohler1 tbadaytona.com FAX (AIC, NoI 386) 323-9159 INSURERIS) AFFORDING COVERAGE HNC 8 INSURER A: Travelers Property Casualty Company of America 25674 INSURED BROWN & BROWN INC ETAL PUBLIC RISK INSURANCE ADVISORS PO Box 2412 Daytona Beach FL 32115 INSURER B: The Continental Insurance Company 35289 INSURER C : XL Specialty Insurance Company 37885 INSURER D: The Charter Oak Fire Insurance Company 25615 INSURER E : The Travelers Indemnity Company 25658 INSURER F: Lloyds COVERAGES CERTIFICATE NUMBER: 21023 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LIR TYPE OF INSURANCE AUULSUeK INSD W1tD POLICY NUMBER POLICYEFF (MMJDwYYYY) POLICY EXP (hrhJDIXrfYY) OMITS A COM6NCiAL GENERAL LIABILITY T02J0L8A95271387421 01101/2021 01/0112022 EACH OCCURRENCE $ 1,000,000 CLAMS -MADE X CCCUR DAMAGE TO RENTED PREMISES IEa occurrence) 1,000,000 $ RED EXP (Any one person) $ 5,000 ALD'V PERSONA_ $ 1,000,000 GEM_ X AGGREGATE LIMIT APPLIES PER POJCY PRO- JECT LOC OTHER: GENERALAGGREGATE $ 113,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO OWED AUTDS ONLY HIRED AUTOS ONLY X SCHEDULED AUTOS NLV-OWNED AUTOS ONLY TC2JCAP9527B86221 01/01/2021 01/01/2022 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 BCISLY INJURY (Per person) $ BODILY INJURY(Per accident) $ PROPERTYDtiMAGE (Per accident} $ 50,000 B X UMBRELLAUAB EXCESS UAB X OCCUR CLAMSAVIDE 6011849429 01/01/2021 01/01/2022 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5000,000 DE➢ RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILnY Y I N ANY PROPRIETCRIPARTNERIEXECUTVE OFFICER/MEMBER EXCLUDED? /Mandatory in NH} If Yes, des«ae under DESCRIPTION OF OPERATIONS below'EL N7R UB1R8701982151K 01f01l2021 01l0112022 X PER OTH- STATUTE ER E.L.EACHACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 DISEASE - POLICY LIMIT $ 1,000.000 C INSAGENTSIBROKERS PROFESSIONALLIAB E&O ELU172413-.21 01/01/2021 01/01/2022 EA WRONGFUL ACT AGGREGATE 20,000,000 20.,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEIIICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) FOR INFORMATION CERTIFICATE HOLDER CANCELLATION PUBLIC RISK INSURANCE ADVISORS P O BOX 2416 DAYTONA BEACH FL 32115 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUIFIORILZED REPRESENTATIVE / J.V ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and toga are registered marks of ACORD Page ;4: City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS ACC]R©® AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY Brown & Brown of Florida, Inc. NAMED INSURED BROWN & BROWN INC ETAL POIJCY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance: Notes CYBER LIABILITY COVERAGE INSURER F-EFFECTIVE 1-1-21 TO 1-1-22. POLICY NO. B014ECYUSA2101554 10 MIL LIMIT POLICY NO. 80146CYUSA2001659 15 MILX 10 MIL LIMIT DATA BREACH = INFORMATION SECURITY & PRIVACY INSURANCE WITH ELECTRONIC MEDIA LIABILITY POLICY AGGREGATE $25600,000 INCLUDING COVERAGE FOR NETWORK SECURITY & PRIVACY LIABILITY; REGULATORY DEFENSE AND PENALTIES; CYBER EXTORTION INSURER E-WORKERS COMPENSATION -POLICY UB1R8612692151R-EFF 1-1-21 TO 1-1-22, LIMITS 1,000,000I1,000,00011,000,000 ACORD 101 (2008/01) G 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Page ;4J City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS �INrw F0rn1 ■ � IRev-Oclober2018) Eeparhrmit of the Treasury Internal Revenue Service Request for Taxpayer identification Number and Certification ■ Go to www.irs.govlfarmW9 for instructions and the latest information, Give Form to the requester. Do not send to the IRS. Print or type. See Specific Instructions on page 3. 1 tdame (as shown on your income tax return). Name is required on ibis line; tr0 sot leave this line blank. Risk Management Associates, Inc 2 Business nameldisregarded entity name, if different from above SBA Public Risk Insurance Advisors 3 check apprepn ate box for lodes) tax classification of the person whose name is entered on line 1, Check only ono of the following seven boxes. ❑ Individual/sole proprietor or ❑ C Corporation 0 S Corporation ❑ Partnership ❑ Truatlestate single -member LLC 4 Exenr.ptions IdodeS apply only 10 Certain entities. not individuals: see instructions on page 3): Exempt payee code lif any) 5 ❑ Limited liability company. Enter the tax exweilicatinn (C corporation, S=B corporation, P=Parinership)> Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check LLC if the LLC is classified as a single -member LLC that is disregarded from )lie owner unless the owner Qf Ih.e LLC is I1C that is disregarded from the for U.S. federal tax Otherwise, a single -member LLC that Exemption from FATCA reporting cOGte (if any) another not Owner purposes. is disregarded from the Owner should check the appropriate box for the tax classification of its owner. ❑ Omer (see instructions)► IA..+'+.s ro re taros Asa mom' mrad& me U.S.i 5 Address (number- street. and apt. or suite op..) See instructions. 3D0 North Beach Street Requester's name and address (optional) 0 City, state. and ZIP code Daytona Beach, FL, 32114 7 List account numeer(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid [ Soul security number backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities. It is your employer Identtficatlon number IEIN). If you do riot have a slumber. see How to oet a -! jl - 77N, later. Note: If the account is in more than one name, see the instructions for line 1. ALA see What Name and Number To Give the Requester for guidelines on whose number to enter. or Employer identification nurnber 5 9 2 4 4 5 8 d 1 Part II Certification Under penalties of perjury, 1 certify that: 1. The number shown on this form is my correct taxpayer identification num bar (or I am waiting for a number to be issued to me); and 2. I em not subject to backup withholding because: (a) em exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that t am subject to backup withholding as a result of a failure to report all interest or dividends, or (C) the IPS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S, citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross eul item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transacllons, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA], and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. Sae the instructions for Part II, later. Sign Here Signature of U.S. person ■ General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Fomt W-9 and its instructions, such as legislation enacted after they were published, go to www.rrs.gov1FarmiN9. Purpose of Form An Individual or entity (Form W-9 requester) who is required to fie an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (iTIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information retum the amount paid to you, or other amount reportable on an information return. Examples of Information returns include, but are not limited to. the following. • Farm 1099-jNT (interest earned or paid) Date* 3-1 • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-tv1ISC (various types of inoome, prizes, awards, or grass proceeds) • Form 1095-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from reef estate transactions) • Form 1099-K (merchant card and third party network transactions) • Forrn 1098 (horse mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Farm 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Lfse Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. !f you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholdirg. See What is backup withholding, later. Cat. Na. 10231X Farm W-9 (Rev. 10.2018) Page 16i) City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS ti Dr/Elul-1 1)J iur .ifirrnf 3taur uJ athatirr wrinar P dlorsd of 542r 1 1) r r R Re i Seaed. 0,0 MEIN Noodles 1 Detail by FEI/EIN Number Florida Profit Corporation RISK MANAGEMENT ASSOCIATES, INC. Filing Information Document Number FEVER,/ Number Date Filed State Statu s Last Event AMENDMENT Event Date Filed 04/1512003 Event Effective Date NONE prInclnal Address 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 H1€549 59-2445801 08/14/1984 FL ACTIVE NAME CHANGE Changed: 03/ 1812021 Mal I I na Address 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 Changed: 03/ 18,2021 &glistered Agent Name & Address CORPORATION SERVICE COMPANY 1201 HAYS STREET TALLAHASSEE, FL 32301-2525 Name Changed: 09/18/2019 Address Changed: 09/18/2019 Officer/Director Detail Name & Addresss Title DIRECTOR/PRESIDENT BROWN, P. BARRETT 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 Title VICE PRESIDENT WATTS, RICHARD ANDREW 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 Title VICE PRESIDENT/SECRETARY LLOYD, ROBERT W. 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 Title TREASURER DALY, WILLIAM R. 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 Annual Recoils Report Year Fi led Date 2019 03/21/2019 2020 04/22/2020 2021 03/18/2021 Document hums 0S'16202` —ANNUAL REPORT View image ,n POE fcmat 040222020 —MNUAL REPORT View envois. PCP format 0 116=19 —Res 0660 Ciiaaoe 0221/010 —ANNUAL REPORT 04r062016 — AV/ ' REPORT View image in PDF forme Viva irrege n PDF fcanat View image n PCP foetal 04,172017 —Av'.:a o-itr'C:Rf View Image in PCF femur Vvevrirnegien PDF foenai vewimage n PDF forat 040232014—A6v,.z .0...':t Ver image in PCF forme 040162013—ANN1)AWt Ft; ..` View irngen PDF fcanat 04272012—MNwL Rt1'URI View, urea In PDF feenat 02202012 —Re¢ Aceed1 Guano. View image in PCF frame 040292011 —ANNUAL REPORT View sages PCF formal 0a012010 —*Aura REPORT View image in PDF fosnet 040062009 —ANNUAL REPORT View stages POF 1mrna1 04012009—ANNUALL SPORT View Megan PDF foanel 0N242000 —MNU9L REPORT Vrew Mew In PDF feenet 04,172007 —MNUPL REPORT View image in PDF feenal 0216/2006 —A1VN A'LL REPORT View sages PCF formal 02262005 —MNUAL REPORT View mean PDF feenet 02102004 —ANNUAL REPORT View rages PCF fmane( 040152002—Name 4-3mrmf View siege is PDF Toms( 02062003—ANNu9L RE FUR r View image In PUF foanal 0206/002—ANNLIA_NL-I'42I4r View image in PDF foenei O 4010/2001 — ANNUA_liti'UFit View surge in PDF foenat O 20022000 —ANNUAL RE! 4391 View rrege in PCF fcana4 040221000—A6NU9L RE VD hi I' View image in PDF formi 0502141996— ANNUAL 1RE1'UFit View siege in PDF f%mat 001711997— ANY iLJiL-I't;R1 View trues In PEE fmanse O 42411096—ANNUA 1451'D View image in PCF foetal 901011996— ANNUAL Rt1'4; Fir View nmge In PDF foetal Page 15-, City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS DEPARTMENT of FINANCIAL SER j:17LES RISK MANAGEMENT ASSOCIATES, INC. DBA PUBLIC RISK INSURANCE ADVISORS 300 NORI11i BEACH ST DAYTONA BEACH FL 32114 Agency License Number LO1 8706 Location Number: 133164 Issued On 09/14/2006 Pursuant To Section 626,0428, Florida Statutes, This Agency Location Shall Be In The Active Full -Time Charge OfA Licensed And Appointed Agent Holding The Required Agent Licenses To Transact The Lines Of Insurance Being Handled At This Location. Pursuant To Subsection 626.172(4), Florida Statutes, Each Agency Location Must Display The License Prominently In A Manner That Makes It Clearly Visible To Any Customer Or Potential Customer Who Enters The Agency Location. Jimmy Patronia Chief Financial Officer State of Honda Page;;: City of Fort Lauderdale RFP NO. 12536-525 PRIA PUBLIC RISK INSURANCE ADVISORS FLORIDA DEPARTMENT OF FINANCIAL SERVICES MATT HEW ROBERT MONTGOMERY License Number : W161587 Resident Insurance License .0220 - GENERAL LINES THOR 8 LAS( 0215- LIFE INCL VAR ANHUI, HEALTH Please role_ To validate Me amracy d this lireree you may review the indi*lual n Grziess endy's license record undei•Licensee Search" m10e Fords Department of Fiu, 2Serures .ebsle n Ntp.nnrMyFlmd.F2merDihisimlAgen6. Issue Rate 01R1.21114 10.1.113 �p Y ClAiirmsocral Sea .Plada FLORIDA DEPARTMENT OF FINANCIAL SERVICES ROBIN LEE RUSSELL License Number A2959.36 Resident Insurance License Essue Drte .@15 - LIFE INCL VAR ANNUITY/I HEALTH 11101189002 .Ui211-SURPLUS LINES 10116,2000 .0220 -GENERAL LINES (PROP a CAS) W!@f1180 FLORIDA DEPARTMENT OF FINANCIAL SERVICES MICHELLE iVETTE.IL-IRITN License Nnarber:-(16655; Rp,deret wnnut Llunx .0220 • GE.ERALLRES IF'ROA8 CAS1 k.. DN. am Pane. aradar am FLORIDA DEPARTMENT OF FINANCIAL SERVICES WILLIAMPAUL DAWSON LicoW,r Nautber:.t85151.1 R.2Itl.Ot IR549101.0. Llpm. •OVA.. 0F1IF1L11 rHRS. (PR2 lCAft) law. 0*14 04 ,I1.5 rm. Tbvi S. sirra.rlmrar Eah. rYsr FLORIDA DEPARTMENT OF FINANCIAL SERVICES LEIGHKIBLINGER COGGON Lirenle Number: TF156015 R.YdHn Mws.0 .0 0- GE+EPJ44 040l00 i. CA81 I,s.s. Data srxem0.& FLORIDA DEPARTMENT OF FINANCIAL SERVICES KYLE ROBERTSTOEICEL Lkene Number: 02197IS Wcbanr InwrMHs L1O01106 .0220- CENCIA- UNES IPOCC 8 CAS, ISSN Dale 02062015 c W •m Per Sa kriN+ 41.5 Page ;5 City of Miami Solicitation RFP 1896386 EXHIBIT C CITY OF MIAMI AMENDMENT NO. 2 TO THE PROFESSIONAL SERVICES AGREEMENT BETWEEN THE CITY OF MIAMI AND CIGNA HEALTH AND LIFE INSURANCE COMPANY This Amendment No. 2 to the Professional Services Agreement dated January 1, 2014 ("Agreement"), by and between the City of Miami, a municipal corporation of the State of Florida ("City"), located at 444 S.W. 2nd Avenue, Miami, Florida 33130 and Cigna Health and Life Insurance Company, a foreign profit corporation authorized to conduct business in the State of Florida ("CIGNA"), or ("CHLIC"), located at 900 Cottage Grove Road, Bloomfield, CT, 06002, is entered into this 6th day of October 2023. RECITALS WHEREAS, on January 1, 2014, the City entered into an Agreement with CIGNA ("Agreement") for the provision of administrative services to the City's Group Benefit Health Plan ("Services""), pursuant to Request for Proposals No. 369325 and authorized by Resolution No. 13-0460; and WHEREAS, Pursuant to Amendment 1 to Agreement, executed on May 25, 2021, the City amended the above -mentioned Agreement to include the administration of an on -site virtual health clinic WHEREAS, the City wishes to amend the above -mentioned Agreement to allow for the use of the on -site virtual clinic by all City employees regardless of their enrollment in the City's Group Benefit Health Plan; NOW THEREFORE, for the considerations hereinafter as set forth, the Agreement is hereby amended as follows: 1. Exhibit B to the Agreement, titled "Administrative Services Only Agreement", Schedule of Financial Changes is hereby deleted in its entirety and replaced with Amended Schedule of Financial Changes, effective January 1, 2021, attached as Exhibit A to this Amendment: 2. Section 16 of the Agreement, titled Nondiscrimination, has been deleted in its entirety and replaced with the following language: The Provider represents and warrants to the City that Provider does not and will not engage in discriminatory practices and that there shall be no discrimination in connection with Provider's performance under this Agreement on account of race, color, gender, religion, age, disability, sexual orientation, marital status, or national origin. Provider further covenants that no otherwise qualified individual shall, solely by reason of their race, color, gender, religion, age, disability, sexual orientation, marital status, or national origin, be excluded from participation in, be denied services, or be subject to discrimination under any provision of this Agreement. 8/20/2024 9:24 AM p. 348 City of Miami Solicitation RFP 1896386 3. Section 32 of the Agreement, titled E-Verify Employment Verification, has been added with the following language: Provider shall E-Verify the employment status of all employees and subconsultants to the extent required by federal, state and local laws, rules and regulations. The City shall consider the employment by Provider of unauthorized aliens a violation of Section 247A(e) of the Immigration and Nationality Act. If the Provider knowingly employs unauthorized aliens, such violation shall be cause for termination of the Agreement. Furthermore, Provider agrees to utilize the U.S. Agency of Homeland Security's E-Verify System (https://e-verify.uscis.gov/emp), to verify the employment eligibility of all employees during the term of this Agreement. The Provider shall also utilize the E-Verify System to verify the employment eligibility of all employees of any subconsultants during the term of this Agreement. 4. Counterparts, Electronic Signatures: This Agreement may be executed in counterparts, each of which shall be an original as against either Party whose signature appears thereon, but all of which taken together shall constitute but one and the same instrument. An executed facsimile or electronic scanned copy of this Agreement shall have the same force and effect as an original. The parties shall be entitled to sign and transmit an electronic signature on this Agreement (whether by facsimile, PDF or other email transmission), which signature shall be binding on the party whose name is contained therein. Any party providing an electronic signature agrees to promptly execute and deliver to the other parties an original signed Agreement upon request. All other terms, covenants and conditions of the original Agreement issued thereto shall remain in full force and effect, except to the extent herein amended. 8/20/2024 9:24 AM p. 349 City of Miami Solicitation RFP 1896386 IN WITNESS WHEREOF, the parties have executed this Amendment to the Agreement. ATTEST: By: "CIGNA" Cigna Health and Life Insurance Company a Connecticut profit corporation By: Print Name: Deborah Coolidge, CPA Print Name: Aimee E. Burnham Title: Finance Officer 09/19/2023 01:29 PM CDT Title: Contractual Operations Manager (Corporate Seal) (Authorized Corporate Officer) ATTEST: ,,—DocuSigned by: By: `Eso_ Todd B. Hannon, City C k Arthur Noriega V, City Manager DocuSigned by: "City" CITY OF MIAMI, a Florida municipal corporation DocuSugn. by By: l u rvo LSbCFBE9?R6CMiA APPROVED AS TO LEGAL FORM APPROVED AS TO INSURANCE AND CORRECTNESS: DocuSpgrietl by: F, EF9gAFfi FEQAS].. � DS Pr Victoria Mendez (Matter 23-1967) City Attorney REQUIREMENTS: "—Dom/Signed by: Ann -Marie Sharpe Risk Management Director State of TEXAS County of TRAVIS This instrument was acknowledged before me on the 19th day of September, 2023 by Aimee E. Burnham, Contractual Operations Manager of CIGNA Health and Life Insurance Company, a Connecticut profit corporation, on behalf of said corporation. 09/19/2023 01:31 PM CDT Jeruz fer B 16yers Jennifer B. Rogers Notary Public State of Texas (Seal) „ J NNI pER�8 State ROGE a S ;<Nolary Notary Ill# 124513507 '`` MARCH28, 2027 Online Notary Public. This notarial act involved the use of online audio video communication technology. Notarization facilitated by SIGNiX® 8/20/2024 9:24 AM p. 350 City of Miami EXHIBIT A Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Schedule of Financial Charges Certain fees and charges identified in this Schedule of Financial Charges will be billed to Employer monthly in accordance with CBLIC's then standard billing practices. However, CHI..IC is authorized to pay all fees and charges from the Bank Account unless otherwise specified in this Agreement. Medical Medical Vision Network Point of Service Open Access (POSOA) with PHS Plus Medical Management (All Plans $16.73/employee/month Comprehensive with PHS Medical Management (AU Plans $17.06/employee/month Cigna Vision All Plans 1.4 Network POSOA Access Fee (All Plans Comprehensive Care Coordination Fee (All Plans Iftt $0.35/employee/month Charge' $19.53/employee/month $5. 73/employee/month Dependent Care Flexible Spendmg Account (DP SA) Administration Nor D1 SA _Products: $5 .90/employee/month Health Care Flexible Spending Account (FSA) Administration For FSA Products: $5.90/employee/month 09/19/2023 3 8/20/2024 9:24 AM p. 351 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Amounts paid by CliLIC with its own funds on behalf of Employer or the Plan with respect to charges for which Employer or the Plan is obligated to pay under this Agreement including Plan Benefits, Bank Account Payments (including fixed per person payments and pay -for -performance payments to Participating Providers), governmental taxes or assessments will be billed to Employer and CHLIC is authorized to pay all such amounts from the Bank Account. .,.. _ a 1; p' +dyrgiit -1>.yki t:MN ;r,yt3. 4$ fi 'ir r;L' '�. ihaSlt 4 F i'-:} ryLt.as t:,�S]_ l,:i '.ii,', Avs?:.,:, , :..Y :�,+4s Ei.;;\1ii''v ,11 ._.... , , ,.. - 4 Fri :.. -0 ._PHARMACY'AllIVIENISTRATION✓ '.EET1 ' F , c ,:.. t; .... _ ' , " - , ': Cigna Pharmacy Product Administration Fee, only if applicable, is separate from the Medical Administration Charge shown above, but included on same billing line as the Medical Administration Charge for billing purposes only. 3 �t7 A� .711.0 ;COVERED:1 NDERR�'THE PLAN'S PNAM44C1" EN 1CITk. s,- - -" er,rings D spensed 6y rea ome D iy�P . CHLI flt ara�tee t ae foliovu�ng or r gs ci s lensed `lay- -i a:.liome:' : live ,'. , Ski) rh 'tare ': , ° Brand Drug Claims: For all Cigna Home Delivery Pharmacy Bran Drug aims, t e Emp over s guarantee annua average iscount wi be AWP minus 25.00%. Generic Drug Claims: For all Cigna Home Delivery Pharmacy Generic Drug Claims, the Employer's guaranteed annual average discount will be AWP minus 82.00%. Dispensing Fees for Drug Claims: For all Cigna Home Delivery Pharmacy Brand Drug Claims and Generic Drug Claims the Employer's guaranteed annual average Dispensing Fee will be $0.00. ' ,'r „es F 1'�i • '.-. ' „� h --- aytev : " r _ ., �c � J= pp p�{ ...i s } fu�S ... v' Epp i1`Ct'.v" '' R'$•_■]: ws:# 4..: ma y'.' i�4 io �siZ i Ai QVNJ� A1a14,. 4 e � ,JM 1��, 6 1 � f 0V�`d 1 �, �1 �RrLj 9� t� �� � lyf L4;4e . ,� 79 yh y°.. e.',� y 9 sb� co � a: i pp re Pe ed: a., Ow . a ... ti ess__ air: ; ' a p Brand Drug Claims: For all Retail Pharmacy Brand Drug Claims, the Employer's guaranteed annual average discount will be AWP minus 18.50%. Generic Drug Claims: For all Retail Pharmacy Generic Drug Claims, the Employer's guaranteed annual average discount will be AWP minus 79.50%. Dispensing Fees for Both Brand Drue: Claims and Generic Dru2 Claims: For all Retail Phannacv Brand Drun Claims and Generic Dru 09/19/2023 4 8/20/2024 9:24 AM p. 352 City of Miami Solicitation RFP 1896386 CJient Name: City of Miami Administrative Services Only Agreement Claims, the Employer's guaranteed annual average Dispensing Fee will be $0.95. Covered- Drugg.Dsjensed' by Retail Pharmacies in'90-day** supplies: CHUG will guarantee the following charges for Covered Drugs -';dispensed byRetaillPharmacies in 90-day supplies, subject to the provisionsin the section titled "PBM Pricing - Additional Provisions": **A.9ti-day supply means any Covered Drug dispensed by a Re II4 harinacy in au, ain*Vi a to: or greater than an S lay supply. _:. , Brand Drug Claims: For all Retail Pharmacy Brand Drug Claims, the Employer's guaranteed annual average discount will be AWP minus 25.00%. Generic Drug Claims: For all Retail Pharmacy Generic Drug Claims, the Employer's guaranteed annual average discount will be AWP minus 82.00%. Dispensing Fees for Both Brand Drug Claims and Generic Drug Claims: For all Retail Pharmacy Brand Drug Claims and Generic Drug Claims, the Employer's guaranteed annual average Dispensing Fee will be $0.00. _ k i�..., d .�. Wiy rviVV n A i J "Fi. i1 `K R;i,.�P-.., h `. bJ^�£.r,:kd.'a.... 'L? YK .., � .. ... .. a .5d CHUC shall guarantee an aggregate annual average discount of AWP minus 17.75% for covered Specialty Drug prescriptions dispensed by Retail Pbannacies and Cigna Home Delivery Pharmacy. CHLIC's performance will be measured based on analysis of Plan -specific utilization for the contract year. IUt(\TI L{TI TStI II\ I.r"I 11tth2IN IUL\ I IUIN Ii. lit,.N.tIt.rr H htIVItINIUrmHIN Th it itS ( TiT ciTlt\: ( 4.14 ; (q J T(:::Tro Pricing Guarantee Calculation. The following calculation will be performed on an aggregated basis for all paid Claims for Covered Drugs processed during the applicable contract year in order to reconcile against the average annual ingredient cost discount guarantees set forth above: 1- [(the total ingredient cost charged to the Employer prior to application ofthe Plan's Member cost -share requirements)/ (the total AWP) for all Covered Drugs] For the purposes of the pricing guarantee calculation, and notwithstanding anything herein to the contrary, the total ingredient cost shall also include the ingredient cost for a Covered Drug for which a Member pays 100% in the form of cost -share. The application of brand and generic pricing may be subject to certain "dispensed as written" ("DAW") protocols and Employer defined plan design and coverage policies for adjudication and Member Copayment purposes. For example, DAW 5 (House Generic) claims will be considered a Generic Drug claim for pricing purposes. Pricine: Guarantee Exclusions. The followini,Claims or products shall be excluded from the calculation of an y pricing guarantee set forth in this 09/19/2023 5 8/20/2024 9:24 AM p. 353 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Agreement: - Specialty Drugs, unless otherwise noted in this Schedule of Financial Charges. - Workers' Compensation Claims. - Non-standard facility Claims (Indian Tribal, Veterans Administration, or Dep. of Defense facilities). - Limited Distribution Drugs and Exclusive Distribution Drugs. - Subrogation Claims. - Repackaged products. - Products filled through Pharmacies not participating in the network accessed by Employer under this Agreement (including a contracted pharmacy that does not participate in a sub -network or preferred network tier). - Over-the-counter (OTC) products. - Secondary Payer Claims. - Direct Member Reimbursement Claims. - Compound Drugs. - Claim reversals. - Products identified as prescriptions covered under the federal 340B drug pricing program. - Claims for Covered Drugs paid at the Retail Pharmacy's U&C Charge shall be included in the calculation of any Retail Pharmacy pricing guarantee set forth in this Agreement. Provided, however, that Claims for Covered Drugs at a U&C Charge shall not be included in the calculation of any Dispensing Fee guarantee, as no separate Dispensing Fee is charged for such Claims. ;;7,'.t ;Z'O2 -::8-1 .i :g:sz:. 1 gaN:elt1( wit) ffitOEESEl'S:}Q jl:N(m Gi.1J. ij ht: M15k i i4'k zj)h0A¥#1 CHLIC will report on the guaranteed amounts within one -hundred eighty (180) days following the end of each contract year. Upon reconciliation, CII1JC's performance with respect to each ingredient cost discount or Dispensing Fee guarantee offered under this Agreement will be individually measured and then reconciled in the aggregate across all ingredient cost discount or Dispensing Fee guarantees. PBM PRICING - ADDITIONAL PRM] SI ::' The amount paid by CHUC to the Retail Pharmacy for Claims for Covered Drugs may or may not be equal to the amount charged to Employer and/or Member, and CHUC will absorb or retain any difference. For a specific Claim for a Covered Drug dispensed by a Retail Phannacy or Cigna Home Delivery Pharmacy, and after application of any Plan cost -share requirements, CHUC shall charge the Employer the lowest ofthe following amounts: (I) The Prescription Drug Charge; or 09/19/2023 6 8/20/2024 9:24 AM p. 354 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement • (2) The pharmacy's submitted U&C Charge, if any. For a specific Claim for a Covered Drug dispensed by a Retail Pharmacy or Cigna Home Delivery Pharmacy, CHUC shall charge the Member in accordance with the terms of the Pharmacy Benefit. For example, for a Covered Drug subject to a fixed dollar copayment requirement, CHLIC shall charge the Member the lowest of the following amounts: (1) The fixed dollar copayment for the Covered Drug, if any; (2) The Prescription Drug Charge; and (3) The phannacy's submitted U&C Charge, if any. • Home Delivery Pharmacy Dispensing Fees and Dispensing Fee Guarantees are inclusive of shipping and handling. If carrier rates (i.e., U.S. mail and/or applicable commercial courier services) increase during the term of this Agreement, the Home Delivery Pharmacy Dispensing Fee and Home Delivery Pharmacy Dispensing Fee Guarantee will be increased to reflect such increase(s). • Unless specifically noted herein, the discounts to Employer for Covered Drugs set forth in this Agreement are not guaranteed to result in an average aggregate discount off the aggregate AWP of all such Covered Drugs. • Any pricing guarantees, including any ingredient cost discount or Dispensing Fee guarantee, set forth in this Agreement shall be rendered null and void in the event Employer terminates CHLICs administration of the Phannacy Benefit prior to completion of the then -current Plan Year. CHLIC's fees, Rebates (if any), discounts or guarantees (if any) are, among other conditions communicated in this Agreement or otherwise in writing to Employer, contingent on, and assume, adoption by Employer of a specific Fonnulaiy, Retail Phannacy network, and Plan design features (e.g. cost -share structure, utilization/cost management programs). • Notwithstanding any other provision of this Agreement. CHUC may, effective upon written notice to Employer, adjust any or all of the fees, Rebates (if any), discounts or guarantees (if any) in this Agreement to the extent reasonably necessary to preserve the economic value of this Agreement to CHUC as it existed immediately prior to any of the following events or changes: (a) there are any significant changes in the composition of the CHLIC pharmacy network utilized by Employer hereunder or in such pharmacy network's contract compensation rates, or the structure of the phannacy stores/chains/vendors that are contracted with CHUC, including but not limited to disruption in the retail pharmacy delivery model, or bankruptcy of a chain pharmacy; or there is a change in or to the phannacy network reflected in the phannacy pricing summary; or (b) there is a change in government laws or regulations which has a significant impact on pharmacy claim costs; or (c) any material manufacturer -rebate contracts with, or for the benefit of, CHUC are tenilinated or modified in whole or in part; or (d) there is any legal action or law that materially affects or could materially affect the manner in which CHLIC's rebate program.is 09/19/2023 7 8/20/2024 9:24 AM p. 355 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement administered or an existing law is interpreted so as to materially affect or potentially have a material effect, on CHLIC's administration of the Plan; (e) a major change in market conditions affecting the pharmaceutical or pharmacy benefit management market, a drug shortage in the market, an issue involving the safety of the drug supply, an unexpected introduction of a new drug (e.g. authorized generic), or similar market event occurs; (f) the Phannacy Benefit enrolhnent decreases by equal to or greater than 15% from the enrollment on which CHLIC's financial offer is based; or (g) there is material change in the Plan that is initiated by Employer (and which CHUC agrees to administer) such as a change in Formulary selection or pharmacy network, or Employer fails to disclose a material feature of the Plan or the Plan's Phannacy Benefit tf RU i&t< tl Jt JS GIJ: Jt 3b'J1 $tki %t f :,iifJt¥st Subject to the caveats below, CHLIC will remit to Employer the following portion of Rebates and Manufacturer Administrative Fees that CI11.,IC collects with respect to utilization of Covered Drugs under the Plan's Pharmacy Benefit: For All Products: The greater of: 100.00% of Rebates and Manufacturer Administrative Fees on such utilization dispensed in the full calendar year immediately preceding CHLIC's remittance, or the sum of $208.67 multiplied by the number of Retail Phannacy Brand Claims dispensed in 30-day* supplies plus $513.93 multiplied by the number of Retail Pharmacy Brand Claims dispensed in 90-day* * supplies plus $1,416.98 multiplied by the number of Cigna Home Delivery Pharmacy Brand Claims processed in such full calendar year. Caveats: (1) Upon termination of this Agreement, CHI.IC may use Rebates otherwise payable to Employer to offset payable Bank Account Payments or other payable fees or charges identified in this Agreement. CHUC may also use Rebate attributable to claims for which CHLIC has the financial responsibility under any applicable stop loss policy issued to Employer for purposes of paying or offsetting any stop loss reimbursement payments owed by CHLIC or its affiliates to Employer or otherwise to reconcile stop loss reimbursements. Should Employer terminate this Agreement before completion of the then -current Plan Year, no Rebates shall be due with respect to that Plan Year, and any Rebate minimum or fixed dollar guarantees shall be null and void, as payments of Rebates is conditioned on CHLIC exclusively ad.ministering the Pharmacy Benefits for the entire Plan Year. For percentage -based sharing arrangements, payout amount may differ slightly from the stated percentage when payout occurs before manufacturers' final reconciliations and payments are made to CHI.IC. For the purposes of clarity, C111.,IC shall reconcile its performance with respect to any ,Rebate payment Quarantees. includin Q. without limitation. an vmiOirnum or fixed dollar guarantees! in the aggregate. 09/19/2023 8 8/20/2024 9:24 AM p. 356 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Moreover, any amount directly or indirectly provided by a manufacturer or other third party that is allocated to reduce and/or wholly or partially satisfy a Member's cost -sharing obligation for a Covered Drug shall not be considered a "Rebate" for the purposes of Rebate payments to Employer but may be included when reconciling CHLIC's performance against any Rebate minimum guarantee set forth in this Agreement. (4) For percentage -based sharing arrangements, the percentage share payment of Rebates shall not include the payment of any Rebates received, if any, for Run -Out Claims, 340b Claims, Medical Specialty Claims, Direct Member Reimbursement Claims, Reversed Claims, and Compound Claims. (5) CID.JC or its agent contracts with drug manufacturers on CHLIC's own behalf, and not as agent of the Employer or the Plan. (6) The Rebate payment commitments, including any minimum or fixed dollar guarantees, if any, set forth in this Schedule of Financial Charges are, among any other conditions communicated in this Agreement or otherwise in writing to Employer, contingent on the availability of Rebates to CHLIC and Employer's Pharmacy Benefit applying a 90-day supply limit for Specialty Drugs. and standard days' supply limits. In the event that Employer has adopted, or adopts, a 30-day supply limit for Specialty Drugs, or participates in the Clinical Day Supply Program, CHLIC may revise on an equitable basis the stated Rebate minimum or fixed dollar guarantees, if any, to the extent necessary to reflect CHLIC's revised estimate of Rebates it may collect on a plan design having adopted a days' supply limit for Specialty Drug of less than 90 days or the Clinical Day Supply Program. Timing of Rebate Pay -Out: Remittance will be provided within ninety {90) days after the close of each applicable calendar quarter for the portion of such calendar quarter that coincides with the Plan Year. j ffi'. PA Lt1.SION$1„f i \ _;:: t ( i1 t;.; Jt -4. Yti;hl >_ I1 u/o . - The Rebate Guarantee payment obligations set forth in this Schedule of Financial Charges shall exclude the following types of claims and/or products: Claims paid pursuant to a Dispense as Written (DAW) S code. Direct Member Reimbursement Claims. Repackaged products. Pharmaceutical supplies. Biosimilar Claims. Multi -source Brand Drugs. Limited Distribution Drugs and Exclusive Distribution Drugs. Vaccines. Compound Drugs. Claim reversals. 09/19/2023 9 8/20/2024 9:24 AM p. 357 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Products identified as prescriptions covered under the federal 340B drug pricing program. Employer shall be solely responsible for ensuring that any pharmacy affiliated with or operated by Employer or its affiliate, such as an in-house pharmacy, systematically identifies 340B prescriptions on Claim transactions administered by CHLIC. If such pharmacy fails to systematically identify 340B prescriptions on Claim transactions submitted to CHLIC, then CHUC may withhold all Rebates, or modify any minimum or fixed dollar Rebate guarantee, otherwise attributable to utilization at such pharmacy. Run -Out Claims. Rebate guarantee reconciliation calculations will not include member -submitted coupon copay assistance. .:� .'_ r .., J� 1'w Bt;.kti Notwithstanding anything to the contrary in this Agreement or otherwise, the following terms and conditions shall apply to the administration of vaccines by CHUC under the Cigna Pharmacy Program. Vaccine Claims will adjudicate at the lower of the U&C Charge or the amounts shown in the Vaccine Pricing Schedule below. For Vaccine Claims, the U&C Charge shall be the retail price charged by an in -network participating retail pharmacy for the particular vaccine, including administration and dispensing fees, in a cash transaction on the date the vaccine is dispensed as reported to CHLIC by the in -network participating phannacy. "Vaccine Claim" means a claim for a Covered Drug which is a vaccine. "Pass Through Pricing" means the actual ingredient cost and dispensing fee amount paid by CHLIC for the Vaccine Claim when the Vaccine Clah"ll is adjudicated by an in -network participating pharmacy, as set forth in the specific in -network participating pharmacy remittances related to the Vaccine Claim. Notwithstanding anything to the contrary in this Agreement or otherwise, all Vaccine Claims shall be excluded from the calculation, measurement, and payment of any and all financial guarantees, including but not limited to rebate guarantees, ingredient cost guarantees, and dispensing fee guarantees set forth in this Agreement. Vaccine Pricing Schedule Retail Pharmacy INFLUENZA Retail Pharmacy Member Submitted Vaccine Claims ALL OTHER VACCINES Vaccine Administration Fee Pass -Through Pricing (Capped at $15 per in -network Vaccine Claim) Pass -Through Pricing (capped at $20 per in -network Vaccine Claim) Submitted amount 09/19/2023 10 8/20/2024 9:24 AM p. 358 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Ingredient Cost Retail Pharmacy Ingredient Cost as set forth in this Agreement Retail Pharmacy Ingredient Cost as set forth in this Agreement Submitted amount Dispensing Fee Retail Pharmacy Dispensing Fee as set forth in this Agreement Retail Phannacy Dispensing Fee as set Submitted amount forth in this Agreement v � m , v yi"5�. rfi e (V g, e, eo 24 Sin x' � fir., yw q q prvi .c as, it 1p5 qy 1Z tty �`' ^ -f � rwm i 8'i G-'�n Yi!' S Si LL'S Y V! i:11 kh�6 +"S �& T � � K �4} .^ V° �' 9 :O tF �b �fy„ C! }C iFi a. M,l1'T.� _��- i'" 9 u -t'- ," � ,,.f`.,w g 'S`. }!s S� � C :.4'.,' .. � - ; " ��chG ,, m y•b .,' -- ', � ,cab z , - 9i y - y t �.,„k + L ,Y�.,,,� �, f ., = ._ ..x � .L2 a- ?�..� 4.. .w'�.' �x a '�+-y�w� �����^�'i.S�.�,�-J s': �4a�xY��i�.r�2"a'[v�'' �'-rr� `�4x� .et'+" Z�,W.,,�'S.. - ,f. } arge �� ��il�ali 't�yys�: Cigna Home Delivery Pharmacy (a CI:11.,IC affiliated company(ies)) Specialty drugs Plan's medical "Cigna Home its affiliates, Delivery Pharmacy service arrangements Home Delivery its pharmacy Agreement without regard entities like payments received or other C! Iarges This rovision dispensed by Cigna Home Delivery benefit. Delivery Phannacy" means a duly Pharmacy and administered under the licensed pharmacy operated by CHLIC or via the mail service. Cigna Home discount arrangements and/or fee -for- and wholesale distributors. Cigna on its own account in support of to services provided outside of this arrangements and may be entered into of the formularies that CID.JC offers to plans. Discounts and fee -for -service are not part of the administrative fees CHLIC's services hereunder. of the Agreement. The drug's charge under a national specialty drug discount schedule that generates a 19.00% annual average aggregate discount off AWP across specialty drug claims dispensed at where prescriptions are filled and delivered may maintain product purchase with phannaceutical manufacturers Pharmacy contract for these arrangements operations. These arrangements relate and other pharmacy benefit management to whether a specific drug is on one Employer that sponsor group health by Cigna Home Delivezy Pharmacy paid to CHLIC in connection with shall survive tennination or expiration Cigna Home Delivery Pharmacy to CHLIC's self -funded and insured group -client book of business. Network POSOA, Comprehensive and Vision Run -Out Period of twelve (12) months No Additional Cost Pharutac ° Run -Out Period of three (3)?months for all pharmacy claims No Additional Cost - - %37, +-.+-+,k vsSti .C^C t" t;f5 ` CV..;.'P''I El 'i iFtby S,da ai`tik , t-';'r s ,rtr._ e z7---.'�' _ CIILIC administers the programs listed below to contain costs with respect to charges for health care service/supplies that are covered by the Plan 09/19/2023 11 8/20/2024 9:24 AM p. 359 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement (the "Cost -Containment Programs"),In administering these Cost -Containment Programs, CHUC may contract with vendors to perform various Cost -Containment Program related services. CHLIC's charge for administering a Cost -Containment Program is the percentage indicated in the table below of the: 1) "gross savings" (i.e., the difference between the charge the provider made and the allowable amount resulting from the Cost -Containment Program); 2) "'net savings" (i.e., the gross savings less the applicable vendor charge); or 3) "gross recovery" (i.e., the amount recovered as a result ofthe Cost -Containment Program) as applicable. CIII,IC will make a per claim charge to the Bank Account that includes both CHLIC's applicable Cost Containment Program charge, as shown in the table below, and the applicable vendor charge. CHUC will pay the vendor its charge. For charges for covered services received from a non -Participating Provider (including emergency/urgent care services that are covered at the in - network benefit level), CHLIC may apply discounts available under agreements with third parties or through negotiation of the non -Participating Provider's charges whether on a claim -by -claim basis or in advance of services being rendered. The programs for obtaining these discounts are identified in Section A of the table below as Non -Participating Provider Cost -Containment Programs. Applying these discounts may result in higher payments than if the maximum reimbursable charge is applied. Whereas application of the maximum reimbursable charge may result in the patient being balance billed for the entire unreimbursed amount, applying these discounts avoids balance billing and may substantially reduce the patient's out-of-pocket cost CHLIC's per claim charge for administering the Non -Participating Provider Cost -Containment Programs in Section A of the table below plus any per claim vendor charges associated with the Non -Participating Provider Cost -Containment Programs in Section A of the table shall not exceed $30,000.00 per claim. Vendor charges for the Non -Participating Provider Cost -Containment Programs in Section A of the table generally range from 7-11% of gross savings. Specific rates charged by vendors for the programs in Section A of the table are available upon request, subject to execution of a mutually agreed upon non -disclosure agreement to protect the proprietary vendor information from unauthorized use/disclosure. If no discount is available or negotiated, reimbursement will be based upon: (i) If charges are not subject to CHLIC's benefit enhancement policy - the plan's maximum reimbursable charge (in which c e the patient may be balance billed by the provider if the provider's charge exceeds the plan's maximwn reimbursable charge); or 09/19/2023 12 8/20/2024 9:24 AM p. 360 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement (ii) If charges are subject a. the amount (the 80th or federal, balance billed b. the provider's The administration of practices with respect to CHLIC's benefit enhancement policy -depending upon the Employer's election: Medicare allowable amount the amount required by state policy (patient may be with the claim administration of provider's billed charge not exceeding the greater of a CHLIC determined percentage of the percentile of the reasonable and customary charge if there is no Medicare allowable charge) or law (in the case of emergency room services) for charges subject to CHLIC's benefit enhancement by the provider if the provider's charge exceeds such amount), or billed charge. charges for covered services from non -Participating Providers described above is consistent to CHLIC's own health care insurance business where applicable. A. Non -Participating Provider Cost -Containment Programs 1. Network Savings Program 29% of net savines 2. Supplemental Network 29% of net savines 3 , Medical Bill Review -(Pre-payment Cost Containment for Non -contracted claims): Inpatient Hospital Bill Review • Professional Fee Negotiation 29% of net savings • Line Item Analysis Re -pricing 29% of net savings Outpatient Hospital Bill Review • Professional Fee Negotiation 29% of net savings • Line Item Analysis Re -pricing 29% of net savings Physician/Professional Bill Review • Professional Fee Negotiation 29% of net savings • Line Item Analysis Re -pricing 29% of net savings B. Other Cost -Containment Programs 1. Medical Bill Review - (Pre or Post -payment Cost Containment for Non -contracted and 09/19/2023 13 8/20/2024 9:24 AM p. 361 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Contracted claims): • Bill Audit 29% of the gross savings/gross recovery achieved plus hospital fees or expenses passed throueh Diagnosis Related Grouping (DRG) Validation/Audits and Recovery. An overpayment audit and recovery program in which CHUC or its vendors review paid claim data to identify overpayments based on inaccurate DRG coding. 29% of gross savings/gross recovery plus any fees or expenses passed through by the hospital or regulatory a ency Medical Implant Device Audits 29% of the gross savings/grossrecove 1-y 2. COB Vendor Recoveries [Exclusive of pharmacy programs where claims are adjudicated at time prescription is received.1 29% of the gross recovery 3. Secondary Vendor Recovery Program 29% of the gross recovery 4. Provider Credit Balance Recovery Program 29% of the gross recovery 5. High Cost Specialty Pharmaceutical Audits (this service is only provided with respect to Medical coverage) 29% of the gross recovery 6. Eligibility Overpayment Recovery Vendor Services. Identification and recovery of funds in situations where the overpayment is due to the late receipt of Member tennination infonnation. (This service is only provided with resoect to Medical coverat:!:e). 29% of the gross recovery 7. Class Action Recoveries 35°/a of the gross recovery 8. Subrogation/Conditional Claim Payment. Identification, investigation and recovery of claim payments involving other party liability or where another entity is responsible for payment (including by way of example but not by limitation automobile insurance, homeowner insurance, commercial property insurance, worker's compensation). (This service is only 5% of the gross recovery plus litigation costs if counsel is retained and an appearance is filed on 09/19/2023 14 8/20/2024 9:24 AM p. 362 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement provided with respect to Medical coverage.) behalf of CBLIC or Employer in any litigation, or a lawsuit is filed on their behalf; 29% of the gross recovery if no counsel is retained and in all other instances, including cases where state Jaw requires that employee benefit plans be named as party defendants or involuntary plaintiffs. - 3 �...ffi-1.V. w R4 ., CHLIC administers the following programs to contain costs with respect to charges for health care service/supplies that are covere ; by the Plan. In administering these programs, CHUC contracts with vendors to perform program related services. CJil.JC's charge for administering these prooTamsis the zercenta e (indicated below) ofthe "recovery" (i.e. the amount rec-Overedj as applicable. 1.1 gharmacy Vendor Recoveries. CHLIC perfonns periodic audits of contracted pharmacies in order to determine the accuracy of payments to the pharmacy(ies). CHLIC's recovery vendor collects and remits to CHUC all overpayments to pharmacy(ies), and CHUC remits to the Bank Account the balance collected from the recovery vendor, less the recovery fee set forth herein. j 30% of recovery 2. [ Class Action Recoveries. C1I1.,IC identifies, monitors and may (but is not required to) participate, on behalf of Employer, in class action lawsuits or similar legal proceedings against phannaceutical manufacturers, including, without limitation, lawsuits alleging legal 35% of recovery or equitable claims like fraud, anti-trust violations, or unfair trade practices by a manufacturer. As part of this authority, CHUC may participate in a settlement, exclude Employer from a settlement and/or otherwise represent Employer's interests outside the settlement. CJil.JC collects and retains as a recovery fee set forth herein of any recovery (net of attorneys' fees}attributable to Employer's Plan. 09/19/2023 15 8/20/2024 9:24 AM p. 363 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement • .i,iMP iJd,_.440 W- i�t:nCR,ir;,U rm ,Ee"1+, a ':„icsr r.i"7 4 e�€3s4 Z a t34.'.- ;'. rn m arc enelit '1'o provide financial protection tom the ig1 cost, CHL1C as contracted with an at iliiate, $O.9 per Member/per Protection eviCore ("eviCore" refers to eviCore healthcare MSI, LLC d/b/a/ eviCore healthcare and month. certain of its affiliates), to arrange for the provision of the following gene therapy drugs for Members when both drugs are covered by the Plan administered by C:m.JC, and medically If, across eviCore's entire necessary (as determined by CHLIC) to treat the conditions indicated: Embarc Benefit Protection book of business (Cigna i. Luxtuma® to treat inherited form of progressive blindness and non -Cigna clients), ii. Zolgensma® to treat children under 2 years old with spinal muscular dystrophy eviCore's cost for the two (Luxturna is the registered trademark of Spark Therapeutics, Inc. and Zolgensma is the registered trademark of AveXis, Inc.) (2) drugs provided in a given calendar year is lower than a As a result of this network contracting arrangement, evi.Core is in most cases the exclusive Predetermined percentage in -network Participating Provider of these drugs. eviCore arranges for the provision of these of the PMPM charges drugs through its network of specialty pharmacies (including its affiliate, Accredo), and received, eviCore will certain facilities authorized to administer the gene therapies by the drug manufacturers. refund the difference pro eviCore will reimburse these specialty pharmacies and facilities at negotiated reimbursement rata, after having fully rates. This network solution is called Em.bare Benefit Protection. recovered the outstanding balance created by any For arranging for the provision of these drugs, eviCore will be reimbursed by CHI.JC on a prior year deficits. The fixed Per Member Per Month (PMPM) basis. eviCore's PMPM fee (which is subject to refund, in any, will be change) will be charged to the Bank Account one month in arrears. (e.g., eviCore's charges determined on an eviCore for January will be made in February.) These Bank Account Payments will appear in Embarc benefit Protection Employer's monthly reporting. Embarc Benefit Protection does not provide financial book -of -business basis. protection from the cost of administering the to the drug costs. two drugs. These costs are small in comparison The refund will be provided by March 31 st of the following year. When covered under the Plan and determined by CHLIC to be medically necessary for the treatment of the specified conditions, Members will not incur any out-of-pocket costs for the Assuring Transparency: two drugs and the Plan will not be required to reimburse any expenses for the two drugs with two exceptions: After the refund is made for a particular calendar year, eviCore will, upon 09/19/2023 16 8/20/2024 9:24 AM p. 364 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Exceptions: request, provide Embarc Benefit Protection book- 1. For Members born before the date that Embarc Benefit Protection is effective for the of -business information Plan and receiving Zolgensma,® the Plan's in -network reimbursement and the Member's for that calendar year. in -network cost -sharing apply to either (as applicable): • eviCore's fee -for -service charge for Zolgensma® when provided through Accredo: Average Wholesale Price (AWP) minus 15.8% AWP (based on Medispan) = $2,550,000, or • the reimbursement rate of the participating facility or specialty pharmacy. 2. Members with an HSA must have met the applicable minimum deductible required for a high deductible health plan. eviCore's Embarc Benefit Protection and P.MPM charge do not apply to a plan that: i. does not cover either or both drugs; ii. covers both drugs under its pharmacy benefits which are not administered by CHLIC,or m. does not utilize a Cigna participating provider network. Upon Employer's request on or after the Effective Date, CHUC shall provide to Employer an updated drug list, if applicable. CHUC may revise charges/fees by giving Employer at least thirty (30) days' prior written notice. 09/19/2023 17 8/20/2024 9:24 AM p. 365 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement e`1rt�Rl -`11g0;0 `�`�{', 'g m';i,s 10Sao C4,ikai< el.' t 1 -- ' . "'`'4-ik'` -- 1.,Vp'� .,'. k;,. j��:`r; CHLIC arranges for third parties to provide care management services to: (i) contain the cost of specified health care services/items overall with respect to all plans insured and/or administered by CHUC, and/or (ii) improve adherence to evidence based guidelines designed to promote patient safety and efficient patient care. Charges for these services will be processed through the Bank Account. Specific vendor fees and care management program services are available upon request. Medical Management (inclusive of Medical Necessity Review) of Chiropractic seWVices. National Average is $0.16 PMPM; rates vary by market and are available 1 upon request. In addition to such third parties, CHLIC has arranged for an affiliate, eviCore, to provide the following care management/cost-containment programs (programs and charges identified below are not applicable to Participants who have elected PHS or Basic Low Medical Management (see Administrative Charges section above)): • Pre -certification of coverage of radiation therapy services. are c0 per episode of are(EOC • Pre -certification of coverage of diagnostic cardiology services (IfEmployer has elected Basic Standard Medical Management (see Administration Charges section above) this ,row am and char.r: e is not avvlicab/e to that membership). ' $0.19 PMPM $1,000.00 per episode of care(EOC) _ • Pre -certification of coverage of medical oncology services. I. Pre -certification of coverage of musculoskeletal therapy services (If Employer has elected Basic Standard Medical Management (see Administration Charges section above} this vro£Yam and char e is not applicable to that membership). [$0.39 PMPM Fee reimbursement method and rates may • Services related to the coverage of high tech radiology which may include pre- , certification. 09/19/2023 18 8/20/2024 9:24 AM p. 366 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement In certain instances, the Plan will pay eviCore a fee on a per member/per month basis for pre -certification, arranging care, and other services that eviCore may render. Such reimbursement will be in addition to the amount that the Plan pays to reimburse the provider through which eviCore arranged for the provision of the service or supply, which will be based on eviCore's contracted rate with that provider. In such instances, Plan Benefits and member cost -share will be detennined based on the rate that eviCore vary by market and are available upon request contracted to pay the provider for the provision of the service or supply. (If Employer has elected Basic Standard Medical Management (see Administration Charges section above) this program and a charge is not applicable to that membership). eviCore may also charge for services related to the provision of high tech radiology as described below in «other Vendors and Health Care Services Providers." • Pre -certification of coverage of sleep management services (If Employer has elected Basic Standard Medical Management (see Administration Charges section above) this prof tram and charfle is , wtaoulicable to that membership). $O.IOPMPM • Pre -certification of coverage of gastroenterology services (If Employer has elected Basic Standard Medical Management (see Administration Charges sect on above) this program and char e is not auvlicable to that membershiD). $0.09PMPM • Pre -certification of coverage for appropriate setting of care/service for high tech radiology services (If Empfoyer has elected Basic Standard Medical Management (see Administration Charges section above) this program and charge is not applicable to that membershir,). No more than $0.20 PMPM. Billing method may vary by market and is available upon request. • Pre -certification of coverage for appropriate setting of care/service for certain medical oncology drugs (redirection may be to Accredo, a CHUC affiliate). 30.00% of shared savings (where savings is derived from the difference between drug dose cost at higher cost provider initially requested and 09/19/2023 19 8/20/2024 9:24 AM p. 367 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement drug dose cost at lower cost provider). Fee shall not exceed $5,000.00 per dose for a maximum of three doses resulting in a maximum total of $15,000.00. Note: CHLIC may retain a portion of the shared savings fee before reimbursine eviCore. • Network management and care coordination of coverage of home health. durable medical equipment and home infusion services. $0.30PMPM CHLIC may revise charges/fees by giving Employer at least sixty (60) days' prior written notice. $S00-$1,500 Review When a Member elects an External Review (as that term is defined in the Patient Protection and Affordable Care Act (PPACA)) of a benefit determination by an independent third party, the cost of a specific third party review is dependent on the nature and complexity of the issue on appeal. Third party review charges will be commensurate with the level of expertise nee : and the time re . uired to corn . . lete the review. _.. - . _.._�_ _ ._ ' _" :' ?'"' a • .,,u.. , ...... ...,.__ ..._....... a¢c.c......u.a�_a.w.y .k __. ... Charges for vision care services will be paid as claims and will appear in Employer's standard Bank Account activity data reports. Such payments will be at CHLIC's applicable charges then in effect, which may be amended from time to time. The applicable charges made by in -network vision care roviders will be made available z, • ti re • uest. E' .5'- ` ,'"i'af'4�yt All Vision Products +fys^'i�Cfl.-.. _.- ...: ,c :. � 4+wS y_ __ te i �»' Y,.{ iS . i�✓` S F ''a}fir �t Fx i, i. 5�.. a.�r "�-' �. '�S.r.sG �` �r-y#� ; : �� :� Alm et; .t�" i �u�f v �Y�''�: �' �`ic�sw�r - CHLIC contracts directly or indirectly with other managed care entities aad third party network vendors for access to their provider networks and discounts. These third parties charge either a network access fee, which is included in CHLIC's monthly charges, or a percent.age of the savings realized on a claim by claim basis as a result of the application of their discounts. Charges based on percentage of savings may be paid from the Bank Account All Medical Products 09/19/2023 20 8/20/2024 9:24 AM p. 368 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement [Additional details regarding specific charges vill be provided uoon request. Mm me nx.ea per person per penoa ancuor ree-ror-service cnarges max UnuU has directly el i`'Au riuuucts indirectly negotiated with Participating Providers for in -network health care services and/or supplies will be charged to the Bank Account and will be used in calculating any applicable Member cost -sharing. In addition, performance -based payments to Participating Providers will be charged to the Bank Account. Such payments will be at the payment rates then in effect, which may be amended from time to time. For certain types of specialty care, including, but not limited to, home health care, durable medical equipment, sleep management, high tech radiology, chiropractic care, acupuncture, physical medicine (such as physical and occupational therapy), speech therapy, orthotics and prosthetics, implants, and hearing, in certain markets CHLIC may contract with various third parties and/or affiliated companies, including eviCore, ("Specialty Vendors") to arrange for the provision of care through their own networks of health care providers on a fee -for -service basis. In addition to arranging for care through their own networks of providers, these Specialty Vendors may also provide additional services. including utilization management services and case management services designed to (i) improve adherence to coverage guidelines; and (ii) contain overall healthcare costs to the Plan. Specialty Vendors are included within the definition of"Participating Provider" set forth in this Agreement and in any benefit booklet covering the Plan. When care is arranged through a Specialty Vendor's network of providers, the fonn of reimbursement to the Specialty Vendor will be through one ofthe following methods: • Fee -For -Service Payment: In certain instances, the Plan will pay the Specialty Vendor rather than the treating provider on a fee -for -service basis as a claim for Plan Benefits. The Specialty Vendors' fee -for -service charges may be higher than the amounts that the Specialty Vendor contracts to pay the provider for the provision of any particular service or supply, and some portion of the Specialty Vendor's charges may be attributable to the services that the Specialty Vendor provides in addition to those services or supplies provided by the Specialty Vendor's network of providers, including any utilization management services and case management services. In such instances, Plan Benefits and member cost -share will be determined based on the Specialty Vendor's charges 09/19/2023 21 8/20/2024 9:24 AM p. 369 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement according to Plan terms. Administration Capitation Payment: In certain instances, the Plan will pay the Specialty Vendor a fee on a per member/per month basis for arranging care and other services that the Specialty Vendor may render. Such reimbursement will be in addition to the amount that the Plan pays to reimburse the provider through which the• Specialty Vendor arranged for the provision of the service or supply, which will be based on the Specialty Vendor's contracted rate with that provider. In such instances, Plan Benefits and member cost -share will be determined based on the rate that the Specialty Vendor contracted to pay the provider for the provision of the service or supply. All -Inclusive Capitation Payment In certain instances, the Plan will pay the Specialty Vendor a fee on a per member/per month basis that covers (i) the services that the Specialty Vendor may render, including arranging care, and (ii) the fees charged by the provider through which the Specialty Vendor arranged for the provision of the service or supply. In such instances Plan Benefits and member cost -share will be determined based on the rate that the Specialty Vendor contracted to pay the provider for the provision of the service or supply. CHLIC's arrangements with Specialty Vendors are subject to change at any time, and upon request, additional information can be provided that identifies current Specialty Vendors, their area ofspecialty(ies), whether they are CHLIC affiliates, and the form of payment that they currently receive. Notwithstanding the terms of the Plan, CHLIC shall not administer Member cost -sharing with respect to charges made by Cricket Health. Inc. for its personalized, evidence -based approach to managing chronic kidney disease and end -stage renal disease for clinically eligible Members in CA and such cost -sharing expenses shall, instead, be reimbursed by the P an (not applicable if Employer has opted out}_. All Products (excluding BSA Products) Feb {r ate :it ,,, e x.�3 fus' + 574); E Fri .& : .=_ice Rebate and Other Remuneration Disclosure (Pharmacy CHLIC or its affiliates may contract with pharmaceutical manufacturers or other third parties f. r Rebates, Manufacturer Administrative Fees, and other remuneration on its or their own behalf and for • its and their own • benefit, and not on behalf of Employer or the Plan. Accordingly, unless otherwise specified in this Schedule of Financial Charges, CHLIC and its affiliates retain all right, title and interest to any and all actual Rebates,_ Manufacturer Administrative Fees, and other All Pharmacy Products 09/19/2023 22 8/20/2024 9:24 AM p. 370 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement remuneration received from manufacturers or other third parties; neither Employer, its Members, nor Employer's Plan retains any beneficial or proprietary interest in any such remuneration, which shall be considered part of the general assets of CHUC and its affiliates. As an example of the renumeration other than Rebates or Manufacturer Administrative Fees that CHLIC or its affiliates may earn, CHLIC or its affiliates may also directly or indirectly earn from pharmaceutical manufacturers remuneration in connection with value payments and/or services that CHUC provides to Employer ("Value -Based Payments"). Notwithstanding anything in this Agreement to the contrary, any Value -Based Payments earned by. CHUC or its affiliates are separate and apart from any Rebates or Manufacturer Administrative Fees that CHUC or its affiliates directly or indirectly earn from pharmaceutical manufacturers, and CHUC and its affiliates may retain any Value -Based Payments it earns. As examples of the value payments and/or services that CHLIC may provide to Employer in connection with Value -Based Payments that CHUC or its affiliates may earn, CIII,IC may provide care management or related services to Employer and/or remit to Employer monetary credits if Members discontinue therapy on certain pharmaceutical products. Information regarding any services, and/or monetary credits or other financial value. for which Employer may be eligible with respect to specific pharmaceutical products or therapeutic classes/conditions, including the products for which monetary credits or other financial value may be available to Employer, the amount of that value, and other payment terms, is available upon request. Any value payments and/or services provided by CHUC to Employer are subject to change or termination by CIB.,IC as the value program(s), if any, offered by CHLIC change(s) or tenninate(s). Information on the projected aggregate amount of such Rebates with respect to the Plan Pharmacy Benefit will be provided upon request. This provision shall survive tennination or expiration of the Agreement. Rebate and Other CHI.JC may directly or indirectly receive and retain payments under contracts with pharmaceuticalf All Medical Remuneration manufacturers or third parties with respect to Members' utilization of the manufacturer's products Products Disclosure (Medical) covered under the Employer's Plan medical benefit. These payments may include rebates, service fees (e.g. administrative fees), or other remuneration. CHUC directly or indirectly contracts with pharmaceutical manufacturers or other third parties or any remuneration on its own behalf and for its own benefit, and not on behalf of Employer or the Plan. Accordingly, CHUC retains all right, title and interest to any and all such remuneration received from manufacturer; neither Employer, its Members. nor- Employer' 1 reJa,ins anJ'.' beneficial rietaryj! }.ter st 11 a� such 09/19/2023 23 8/20/2024 9:24 AM p. 371 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement remuneration, which shall be considered part ofthe general assets ofCHLIC. This provision shall survive tennination or expiration ofthe Agreement. Implementation/Referra I Fee Disclosure From time totime, CHUC, directly or through its affiliates, arranges with third pl:U"lies (e.g., service vendors; provider network managers) to provide various services (e.g., cost -containment services or health care services) in connection with the Plan. CHLIC and its affiliates may receive payments from such third parties to help defray CHLIC's expenses associated with its implementation and/or ongoing administration of these arrangements or as a reimbursement for services or network access provided to such parties by CHLIC. CHLIC may also receive compensation from third -party vendors that Employer may retain based upon a referral from CHLIC or that Members may utilize following an introduction facilitated by CHLIC or an affiliate. CHLIC may also receive: • network administration fees from some providers participating in its provider network, • credits from banks on balances in accounts utilized to administer claims, • non -material incidental compensation/benefits from other source as a result of administering the Plan. All Products •c .a' ;u..'s_, �' x- ;_ _.f _ '. ? 1.' . ; :1' bR A 1 . . ~< u "x` L E',.` e'v fis :;• _:.. ., .. . Where applicable, the following California and PPACA fees/assessments/taxes attributable to th e Cigna Health Care of California group service agreement that provides in -network coverage for Members in California: • Comparative Effectiveness Research Fee • California Managed Care Organization Tax Network Products: • Network POSOA 09/19/2023 24 8/20/2024 9:24 AM p. 372 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement e . 77* 'OW' .r .. fi,..._. _. CHLIC shall provide the following services to assist - Employer in meeting its compliance obligations under section 2715 of the Pubic Health Service Act as added by the Patient Protection and Affordable Care Act and applicable regulations with respect to the provision of the Summary of Benefits and Coverage ("SBC"), translation notice and glossary. Applicable to all medical plans including HRA and FSA which are considered "group health plains" subject to the SBC requirements. _ 1.1 Preparation of SBC, translation notice. CHL1C will not be responsible tor any changes that 1 Employer makes to the SBC. No charge 2. [ Provide SBC, translation notices prepared by CHLIC to Employer electronically as well as any updates or material modifications. - No charge 3. [ Include in SBC a summary of benefits administered by carve -out vendor if Employer or carve -out S500 for each vendor provides CHLIC with necessary carve -out benefit information at least twelve (12) weeks benefit option prior to the date the SBCs are to be delivered to Employer. under the Plan for which carve - out vendor benefits are included in SBC v ��•� �Oi`S �'.•1 i�L:. �...,. +6 � MKS �. :s 5 p� �'�4'.'F_yl �T �n �S . !�' -�" s' 4• 5+`. 13'„^. " �.3'YC ''i- :7, `,-" d r.. {. .. ... L4f.4 [:4.. ?J 4J61 kt3 i..V RI .. G. ... ... !"borer^. Pharmacy Utilization Management Program (Opioid medications and Specialty Drugs) In administering the Pharmacy Benefit, CHUG shall apply quantity limits, prior authorization and/or step therapy requirements to certain Specialty Drugs, opioid medications, or other products identified for safety/clinical reasons. For All Products: Included in Pharmacy Administration Fee Clinical Program A targeted condition medication therapy management program in which CHLIC provides support for Members using specialty medications for certain chronic conditions and that are obtained or administered at retail pharmacies or outpatient, office or home health care settings. As part of the !Tram. Members are counseled on their condition. medication i<! e effects, and importance of Included at No Additional Cost 09/19/2023 25 8/20/2024 9:24 AM p. 373 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement adherence. For the sake of clarity, if a specialty pharmacy affiliate of CHLIC provides therapy management for specialty medications the pharmacy dispenses to Members, then it does so in its capacity as a specialty pharmacy and not on behalf ofCHLIC; CHLIC does not exert direction or control over the pharmacists at any specialty pharmacy affiliate. SafeGuardRx Program A medication therapy management and cost containment program for select therapeutic conditions Included at No such as but not limited to oncology, inflammatory conditions, and multiple sclerosis and select drugs within therapeutic categories. This program seeks to help reduce drug therapy costs through its program offerings. For example, Employers may qualify for the payment of discontinuation drug therapy credits and/or the reimbursement of drug therapy through drug cost caps, on select medications and therapeutic conditions. This program may also provide for Member outreach or counseling on select medications. CHLIC reserves the right to revise, modify, or terminate this program, in whole or in part, at any time. Additional and specific program information is available upon request. Additional Cost Your Health First A proactive health education and improvement program for Members with a chronic condition. For Network The program involves services that span across the Member's health needs. Behavioral coaching POSOA principles and evidence based medicine guidelines are utilized to optimize self -management skills Products: and foster sustained health improvements. Included in Medical Access The program targets a chronic population at high risk for near term and future high cost medical expenses. Members are identified as having a chronic condition through a variety of sources which may include: claims data, referrals, and self -identification. A variety of resources is provided to those with a chronic condition, including access to online tools, personalized support, and targeted materials. Fee The program includes the following components for those with a chronic condition: • Chronic condition -specific coaching • Pre- and post -discharge calls • Lifestyle management coaching: stress, weight management and tobacco cessation • Treatment decision support and coaching In order to continuously assess the effectiveness of the program and/or test new ideas to further 09/19/2023 26 8/20/2024 9:24 AM p. 374 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement engage Members around their health, a small sample of Members may be placed in a comparison group which for a defined period of time receives alternative services or is suppressed from receiving proactive outreach, such as engagement letters and/or calls. This could affect a few Members targeted for outreach during this limited time period. Claim and Appeals CHLIC will administer an optional second level of claim appeals Included in Medical Administration Charge Transparency in Coverage CHUC, within reason, will make certain data required under the Transparency in Coverage Rule available in machine readable file disclosures for Employer through CHLIC's web site, Cigna.com Included in Medical Administration Fee or CignaForEmployers,com, on a monthly basis. Virtual Health Center Cigna Health and Life Insurance Company ("CHLIC") will provide or arrange through a Cigna affiliate ("Cigna") a virtual health center for the City of Miami ("Employer"). Employer owns or leases a facility located at 444 SW 2nd Avenue, Miami, FL 33130 (the "Facility") and desires to provide an onsite virtual health center at the Facility for the benefit of its employees (the "Virtual Health Center"). CHUC and Employer are sometimes referred to herein individually as the "Party" or collectively as the "Parties." Employer shall provide a secured non -mobile trailer at the Facility to house the Virtual Health Center. Employer's project management team will ensure that the trailer is functional and compliant. Employer will obtain any needed permits and ensure Virtual Health Center is in accordance with all applicable federal, state and local laws and regulations, including but not limited to municipal Fire and Building Codes, American Disabilities Act and other statutes and regulations related to equal access and non-discrimination. Cigna will provide interactive audio visual communications via the Tyto Care platform within Epic, and will lease the peripheral equipment, the Tyto Clinic device (the "Device"), for patient examination on behalf of Employer. Employer shall be responsible for payment to Cigna for the cost of the leased Device. An estimate of the cost to lease the Device is included in the Operating Budget. Employer shall also be responsible for the costs of all maintenance, repairs, parts or other items necessazy for the functioning of the Device. 09/19/2023 27 8/20/2024 9:24 AM p. 375 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement 1. Services. Commencing on May 26, 2021, or such other date as may be mutually agreed to in writing by the Parties ("Virtual Health Center Commencement Date") and continuing for the Tenn, Cigna will operate and staff a Virtual Health Center at the Facility and provide or arrange for the provision of the Virtual Health Center Services ("Services") described below, for the benefit of Participants (as defined herein). The Services shall be rendered by medical provider(s) who shall be provided for or arranged for by Cigna ("Virtual Provider") through telemedicine interactive audio-visual communication with Participants. A Cigna Registered Nurse Health Coach ("Cigna Personnel") shall provide assistance making the appointment with the Virtual Provider, entering patient data and summary into the medical record and otherwise assisting with the telemedicine visits by initiating the call, assisting with the equipment and connection, obtaining vitals and assistance with use of peripheral medical equipment. The scope of Virtual Provider's services shall include the services set forth in herein. Virtual Provider shall not be required to provide any services, including those identified in herein, if in the Virtual Provider's medical judgment the services should not be provided through telemedicine in accordance with the standard of care. Employer understands and acknowledges that the Services shall be provided through Virtual Provider. Employer understands and agrees that Cigna shall not be required to provide the Services unless and until the Cigna has the Virtual Provider in place and available to perform. Should this not occur by the Virtual Health Center Commencement Date, Employer understands and agrees that Cigna will provide the Health Coach Services set forth below. Once Cigna has in place the required contract amendments, the Services.shall be provided through Virtual Provider. Cigna will adjust/prorate the Operating Budget set forth in herein and will not charge Employer for Virtual Provider expenses during the period Cigna is providing Coach Services only. a. Health and Wellness Services. Through this telemedicine model with Virtual Provider, Cigna will provide acute and episodic care and wellness visits. Additionally, the Cigna Personnel, under the supervision of Virtual Provider as applicable, shall provide the following services: 07/20/2023 28 8/20/2024 9:24 AM p. 376 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement b . Immunization Services. Cigna Personnel shall provide, or arrange for the provision of, immunizations, as agreed upon by the Parties, including: Annual flu vaccinations, Hepatitis A & B Series, Tetanus & Pertussis (Tdap), Tetanus (Td), Tuberculosis (TB PPD) (Test), Pneumovax, Measles, Mumps, and Rubella (MMR) (under age 26), Human Papilloma Virus (HPV) (under age 26), Shingrix (age 50 and old), Travel immunizations (as needed at Client's request). Pediatric vaccinations are excluded, except for annual flu vaccinations for Pediatric Participants age nine and older. c . Monitoring Chronic Conditions. Cigna Personnel shall verify that Participants with chronic medical conditions have appropriate community primary care provider relationships and collaborate with primary care provider and specialist, as needed; refer Participants with chronic conditions to appropriate Employer telephonic and online wellness programs; and encourage health lifestyle habits that address the chronic condition. d. Laboratory Services. Cigna Personnel shall conduct laboratory testing onsite at the Virtual Health Center including: CUA-waived testing (rapid testing); and specimen collection (blood draw station, urine collection, and collection of other specimens ordered by Virtual Provider or by community providers for pick up by contracted lab vendor). Results will be delivered to ordering provider. e. Biometric Screening. Cigna Personnel shall provide scheduled screenings that may include but not limited to; Height, Weight, Bivil, Body Composition, Blood Pressure, Total Cholesterol, HDL Cholesterol, LDL Cholesterol, Coronary Risk Ratio, Blood Glucose. f. Lifestyle Risk Assessment. Cigna Personnel shall conduct lifestyle risk assessments; facilitate a discussion of health improvement and preventive care opportunities; provide referrals and coordinate additional care for Participants, as required; and encourage Participant engagement in Employer -sponsored wellness programs (if any) as appropriate. _g_. Pharmacy. Cigna and Cigna Personnel shall make available to Participants as 07/20/2023 29 8/20/2024 9:24 AM p. 377 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement needed limited selection of first dose medications to treat acute aliments, if Cigna can reach agreement with Virtual Provider and do so in accordance with applicable law; and written prescription and/ore-prescribing by Provider, as allowed by law. h . Primary Care. Basic primary care performed in support of Participants' individual primary care physicians (excludes pediatric physicals). 2. Virtual Provider Scone of Services. In addition to the below, any additional conditions amenable to virtual treatment shall be based on the judgment of the Virtual Provider. Provider shall not provide virtual treatment for these or any other conditions if the provider believes in the provider's reasonable medical judgment that treannent cannot be provided within the standard of care. Injury Care (minor) Collaborating with patient's PCP Minor acute pain/strains Obtaining aooropriate labs Upper respiratory infection Ensure Evidenced -Based care is being provided to patients Sinus infection Closing Gaps in Care Ear infection Chronic Referring to appropriate Telephonic/Online programs Acute Episodes Sore throat Conditions Referring to Centers of Excellence and Preferred specialists (high quality/low cost) when needed Conjunctivitis Lifestyle and Behavioral modification to address conditions Urinary tract infection Diagnostics/ Individual biometric screenings/body fat analysis and subsequent Diagnoses ePrescribing/ Temp Med Refills Screenings Basic vision screening Preventive Wellness Review Cholesterol measurement / 09/19/2023 30 8/20/2024 9:24 AM p. 378 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Health dimrnosis Vaccinations, including: Diabetes screening/ dirumosis - Flu Shots Testing/basic checks (CLIA- waived, 'rapid' tests, or specimen collection for higher -level lab tests outsourced to preferred laboratories) including: - Immunizations (e.g.,- Tetanus) glucose Diabetes Education/ Management Lab Services - Cholesterol Medication Adherence - Rapid strep Weillht Management - Pre! ! 11 ancv test Personalized Smoking Cessation - Urine dipstick (UTI) Coaching Stress Management - Phlebotomy blood draw as required Other - Covid-19 Diagnostic Testing 3. Health Coach Services. The following health coaching and wellness promotion services ("Health Coach Services") will be provided by the Cigna Personnel for eligible Participants as follows: Nutrition a. Establish nutritional health goals collaboratively; b. Collaboratively (Participant and Cigna Personnel) establish coaching for a duration and at a frequency based on the coaching plan; and c. Deliver topic -specific education and referrals, as needed. Physical Activity 09/19/2023 31 8/20/2024 9:24 AM p. 379 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement a.. Establish coaching duration and :frequency collaboratively between Participant and Cigna Personnel based on the coaching plan; and b. Deliver topic specific education and referrals, as needed. Wellness Education and Referrals For: a. Prevention; b. Women's issues (includes mettopause, infertility); c. Children's health issues (includes the importance of vaccines, healthy eating, exercise, etc.); d. Men's health; e. Sleep; f. Stress; g. Weight; h. Other health topics and concerns; and i. Collaboratively (Participant and Health Coach) establish coaching for a duration and at a frequency based on the coaching plan. High Blood Pressure: a. Establish blood pressure reduction goals collaboratively (Participant, Physician and Health Coach); b. Collaboratively (Participant and Health Coach) establish coaching for a duration and at a frequency based on the coaching plan; 09/19/2023 32 8/20/2024 9:24 AM p. 380 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement c. Deliver condition -specific education and referrals, as needed; and d. Identify any Gaps in Care ("GIC") and educate and assist in closing the GICs. High Chole terol a. Establish cholesterol reduction goals collaboratively (Participant, Physician and Health Coach); b. Collaboratively (Participant and Health Coach) establish coaching for a duration and at a frequency based on the coaching plan; c. Deliver condition -specific education and referrals, as needed; and d. Identify any GIC and educate and assist in closing the GICs. Mattmi.i!y a. Education on and referrals to Health Pregnancy/Healthy Baby program (if purchased by Employer) or Healthy Babies; b. Education on the importance of prenatal care; c. Leverage clinical guidelines used in existing programs; and d. Coordinate with a lactation consultant. Benefits Navigation a. Deliver basic information concerning benefit resources and tools to maximize benefits, including cost and quality tools, mycigna.com resources, etc.; b. Refer to Employer Human Resources contact for detailed plan questions, concerns, and issues requiring escalation; 09/19/2023 33 8/20/2024 9:24 AM p. 381 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement c. Education and referrals to plan clinical programs (internal and external); and d. Assist employees •with health care professional referrals, (e.g., primary care physician or specialist referrals in the Cigna network). Wellness Promotion. Cigna Personnel shall support onsite wellness promotion events and activities for Employer employee population, as agreed upon by the Parties (i.e. completing health risk assessments, group seminars, etc.). 4. Particinants. Participants are individuals who are eligible to receive Clinical Services at the Virtual Health Center in accordance with this Agreement as determined by the Employer. Participants are classified into two eligible classes: Comprehensive and Limited Episodic Care. a. Comprehensive Care: City's CIGNA POS employee plan participants, under-65 retiree plan participants and their dependents age six (6) years and older, and former employees entitled to Clinical Services as Participants under the Consolidated Omnibus Budget Reconciliation Act (COBRA) b. Limited Episodic Care - Sworn Police, Sworn Fire, Part-time and Seasonal city employees ONLY (not their dependents) 5. Health Center Days and Hours of Operation. The Virtual Health Center will operate forty (40) hours per week, Monday, Wednesday, and Friday from 7:00 a.m. until 4:00 p.m. and on Tuesday and Thursday from 9:30 a.m. until 6:00 p.m. (..Virtual Health Center Operating Hours"). The Parties may change Days and Hours of Operation from time to time, as mutually agreed in writing. Electronic communication is deemed acceptable for such written agreement. 6. Virtual Health Center Closure. The Virtual Health Center will be closed on inclement weather days as determined by Employer, and on Cigna recognized holidays, including: New Year's Day, Martin Luther King Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, day after Thanksgiving, and Christmas Day. The Virtual Health Center may be closed during Cigna Personnel vacancies as further described herein. 09/19/2023 34 8/20/2024 9:24 AM p. 382 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement 7. Virtual Health Center Utilities and Services. Employer shall, at its sole expense, provide the following services and utilities necessary to the operation ofthe Virtual Health Center. a Telephone Services. Employer shall furnish a telephone system, that includes hardware and phone and fax vendor services for provision of the telephone solution. b. High Speed Internet Access. Employer shall ensure there are High Speed Internet seivices available to the building and extended to the Virtual Health Center. A minimum of 20 Mbps Down / 20 Mbps Up bandwidth to enable the Cigna Personnel to access the data tracking documentation and reporting system throughout the worksite and any other expanded services that require bandwidth. If no internet service providers have services established to the building or if services are not adequate to support the Virtual Health Center due to stability issues, Employer shall: Be responsible for all costs associated with establishing service to the building and installation of the line, including but not limited to trenching, wiring, materials and labor charges; or Provide connectivity to the Employer network and supply two (2) Public IP addresses. c. IT Resource for Internet Troubleshooting. Employer and Cigna shall identify IT resources to work collaboratively to: Prior to engaging Employer, Cigna will exhaust all troubleshooting activities on Cigna system and vendor services; Employer will assist in coordination with the internet service provider to resolve issues at the Virtual Health Center; Acknowledge notice of the issue within one (1) hour; and 09/19/2023 35 8/20/2024 9:24 AM p. 383 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Be available within a three (3) hour timeframe after acknowledgement, pro ided the timeframe is during normal business hours of the Employer. Em.Bloyer shall not be responsible to support Cigna's network, hardware, and bther user IT equipment. d. Utilities, Seiices and Supplies. Employer shall provide the following: adelate heating, ventilation, and air conditioning to maintain conditions and temperatures appropriate for the operation of the Virtual Health Cen r during Virtual Health Center Operating Hours; hot and cold running water; restrLm facilities and supplies for use by Cigna Personnel and Parttpants; electricity adequate for computer systems, lighting, normal office use and heatilig and air conditioning; air c nditioning adequate for computer systems within location of IT wiring closet; light Ig, and replacement of standard lamps when necessary; pest (control and extermination services in accordance with LEED stan s; cleanf g and janitorial services each day the Virtual Health Center is open that feet safety and exposure control requirements of Occupational Safety and. eal.th Regulations, including those relating to slip/trip/falls, blood born pathogens and toxic and hazardous material. Such cleaning and wast removal must be adequate to minimize or eliminate risk to Cigna Pers el and Participants from germs, unsanitary conditions and blood bom !hogens. Employer ees to r uirej itorial service to comply 09/19/2023 36 8/20/2024 9:24 AM p. 384 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement with Cigna specifications for cleaning; adequate security services for the Virtual Health Center and Facility and common areas around the Facility, including fire and burglar alann devices and guard protection. smoke detectors and fire extinguishers in the Virtual Health Center and elsewhere in the Facility. Employer shall also provide for the period maintenance and annual inspection of the Facility fire alarm system; adequate parking spaces as available for Cigna Personnel at no charge to Cigna or the Cigna Personnel; service availability contingent on construction timeframe deliverable. Employer shall provide a detailed timeline on constructions activities and completion dates; and telephone services. 8. .I£! : m: The initial term of this Agreement ("Initial Term") shall begin on the Virtual Center Commencement Date and shall continue for a period of thirty six (36) months. After the Initial Term, Employer has the option to renew for three (3) additional subsequent twelve (12) month terms by providing Cigna with ninety (90) days' prior notice of intent to renew (each a "Renewal Term"). The Initial Term and any Renewal Terms shall constitute the "Term" of the Agreement. This subsection is subject to the termination rights set forth elsewhere in this Agreement. Notwithstanding the above, the Initial Term shall not be longer than the term or extended term of Cigna's agreement with the Virtual Provider. 9. Termination. For Cause. Either Party may terminate this Agreement by written notice to the other Party if the other Party materially breaches this Agreement and does not cure such breach to reasonable satisfaction within sixty (60) calendar days after receiving a written notice of breach. Unless the breach has been cured the termination is effective on the sixty-first 09/19/2023 37 8/20/2024 9:24 AM p. 385 City of Miami Solicitation RFP 1896386 Client Name: Qty of Miami Administrative Services Only Agreement (61st) calendar day after the breach notice is received. For Convenience. This Agreement may also be terminated without cause by either Party, in its entirety or with respect to a specific Facility, at any time after the first twelve months of the Initial Term by providing ninety (90) days' written termination notice to the other party. Such termination is effective on the ninety-frrst (91 st) calendar day after the notice is received by the other Party. When terminating the Agreement for convenience, Employer shall pay a "Severance Fee" to Cigna in an amount equal to the actual severance obligation owed by Cigna to Cigna Personnel as of the date such termination of this Agreement is effective. The Severance Fee will be reduced to the extent that Cigna can recoup costs by successfully redeploying Cigna Personnel to a similar position within Cigna. Employer shall remain liable for any Operating Expenses incurred prior to the date of termination. For Financial Instability. This Agreement may also be terminated if either Party becomes insolvent, by providing ten (10) days' notice to the other Party provided that such termination shall be deemed effective as of the date said notice is delivered. 10. Operational Exnenses. Cigna will use the attached Operating Budget as the projected budget for Operational Expenses (Salaries and Benefits, Supplies. Other Direct Expenses, System Expenses) and Other Infrastructure Costs, estimated Implementation Costs and Management Fees related to the Virtual Health Center Services for the Initial Term. The Operating Budget may be modified based on any change in the Virtual Health Center Commencement Date, delay in providing a compliant Facility to house Vntual health Center, or modification of services requested by the Employer, as mutually agreed upon by the Employer and Cigna. Cigna shall use its best efforts to manage all Total Operational Expenses to those amounts listed in the Operating Budget. Employer acknowledges that said Operating Budget constitutes Cigna's good faith projection of anticipated operating costs and expenses for the Virtual Health Centers. Employer understands and acknowledges that the Operating Budget may change, based upon the volume of Participants seen at the Virtual Health Centers, charges by Virtual Provider, Cart maintenance and repairs, and other factors, such as a change in Cigna Personnel with respect to level of professional licensure or salary. Cigna agrees that prior to making any changes to the scope of services or delivery of care strategies that may materially impact the budget. Cj gna will discuss such changes with the Employer and obtain prior approval. 09/19/2023 38 8/20/2024 9:24 AM p. 386 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement 11. Payment. Employer shall pay and reimburse Cigna for the following as listed in the Operating Budget. In the event that Employer requests permanent additional clinical and/or administrative personnel to provide the Services at the Virtual Health Center or other services, the cost of which will exceed the estimates set forth in the Operating Budget, Employer shall pay to Cigna, in addition to all Management Fees and Operational Expenses, an amount equal to the additional expenses incurred in connection with the additional Services ("Additional Resource Charges"). In addition, Employer shall reimburse Cigna for all Virtual Provider -related charges, maintenance and repair costs, all which shall be paid by Cigna and passed through as expenses to Employer for Employer reimbursement. Employer shall also reimburse Cigna for any Additional Resource Charges incurred under this Scope of Services. Payments shall be sent to: Evernorth Direct Health, LLC, A Cigna Company, 25600 North Norterra Drive, Phoenix, AZ 85085. 12. Invoicing Procedures. On or before the 20th day of each month, Cigna will issue to Employer an invoice for Fees, Operational Expenses, Implementation Costs and Additional Resource Charges (collectively, "Virtual Health Center Fees") due and owing for Virtual Health Center Services performed during the preceding month. Employer shall pay Cigna's affiliate within forty-five (45) days of receipt of an invoice for Virtual Health Center Fees. Invoice charges for supplies shall reflect actual amounts billed to Cigna from the supply manufacturer/vendor and shall not be adjusted for any rebate Cigna may receive from an affiliated Group Purchasing Organization. 13. Renewal Terms. Sixty (60) days prior to the expiration of the Initial Term of the Agreement, Cigna shall present to Employer a proposed Operating Budget for the Virtual Health Center for any Renewal Tenn, and Employer and Cigna shall mutually agree on such Operating Budget. Thereafter during any Renewal Term of the Agreement, sixty (60) days prior to the expiration of the Renewal Tenn, Cigna shall present to Employer a proposed Operating Budget for the Virtual Health Center for the upcoming Renewal Term, and Employer and Cigna shall mutually agree on such Operating Budget. 14. Cigna Staffing. Cigna shall recruit, interview, engage, hire, supervise and discharge all Cigna Personnel needed to assist Virtual Provider with providing the Clinical Services. All employment related decisions, including but not limited to hiring, firing, and performance man emen h shall be at the sole discr tion _Qf Cigna Jmd not Employer. Such Cigna 09/19/2023 39 8/20/2024 9:24 AM p. 387 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Personnel shall in all events, and for all purposes, be employees or subcontractors of Cigna and not Employer. Cigna shall comply with all federal, state and local laws regulations and requirements relating to such employees and subcontractors. Cigna, and not Employer, shall be .fully responsible for the payment of all salaries, wages, payroll and other compensation, taxes, fees, workers compensation insurance and other charges or insurance levied or required by any federal, state, or local law, regulation or ordinance relating to the employment of the Cigna Personnel. Cigna, and not Employer, shall be solely responsible for determining salaries, bonuses, and other compensation of Cigna employees and subcontractors. 15. Use of Subcontractors. Cigna may use third party vendors contracted with Cigna, its Affiliates, for supplies and equipment without Employer's prior written consent, e.g. pharmacy providers, temporary labor, and laboratory service providers. 16. Cigna Personnel Performance. In the event that Employer is dissatisfied with the performance of any Cigna Personnel, or asserts that any Cigna Personnel has engaged in misconduct as defined by Employer or has materially failed to perform the Services in accordance with the Agreement, Employer shall so advise Cigna immediately and provide in writing the facts necessary to validate the concern or complaint. Cigna shall promptly consult with Employer as to the nature of the conduct complained of and the severity of Employer's dissatisfaction, and shall endeavor to resolve such issues to the satisfaction of Employer provided such resolution is non-discriminatoiy and otherwise legal. Employer acknowledges and agrees that the policies and procedures of Cigna or its Affiliates as to the perfonnance shall govern, including any confidentiality requirements contained therein. Employer agrees, where necessary, to cooperate with Cigna in conducting any investigation or inquiry, and in providing documentation and testimonial support in event of litigation concerning Cigna Personnel misconduct or failure to peiform. 17. Indenendent Contractors. The Parties are independent contractors, and no Party is or shall represent itself as having, and nothing in this Agreement shall be construed as creating between the Parties, a relationship as employer -employee, partners, principal - agent, joint ventures, or any relationship other than that of independent parties. 18. Provision of Sen-ices at Virtual Health Center. Clinical Services may only be provided 09/19/2023 40 8/20/2024 9:24 AM p. 388 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement by Virtual Provider with the assistance of Cigna Personnel, or any other professional provided by or arranged for through Cigna. Employer employees and contractors shall not be allowed to provide Clinical Services or any oth r health care services at the Virtual Health Center even if they are licensed to do so. 19. No Co-Emnlovment. All Cigna Personnel performing Services hereunder shall work under Cigna's supervision, provided, however, that the Cigna Personnel and Virtual Providers shall exercise independent professional judgment within the scope of their professions. Due to their status as contractor and not employee of Client, no Cigna Personnel shall be entitled to any employer fringe benefits. 20. Virtual Health Center Staffing. Cigna shall provide or arrange for the provision of one (I) full-time Registered Nurse who will assist with telemedicine visits with Virtual Provider and who will also act as a Health Coach ("Cigna Personnel"). Full -Time is defined as regularly working a forty (40) hour week. Employer acknowledges and agrees that, in addition to Cigna Holidays, as defined herein, Cigna Personnel shall be entitled to paid time off ("PTO") and Leave in accordance with applicable law and policies of Cigna or its Affiliates, or applicable contract between Cigna Personnel and Cigna. PTO and Leave shall include vacation days, personal days, sick days, military leave, family medical leave (FMLA), caregiver leave, disability leave, and other leave in accordance with applicable law or Cigna policy. The number of days of PTO is the same applicable to all employees of Cigna and its Affiliates but may vary based on the job level and number of years of employment with Cigna, and will be prorated for part- time work status. Cost of such PTO and Leave is included under the "Salary & Benefits" component listed in the Operating Budget. For any independent contractors that may be used, the number of days of PTO shall be defined in the contract between Cigna and applicable agency or individual. If Cigna Personnel is expected to take Paid Time Off or Leave or there is otherwise an inability to provide Services that is to be expected to be in excess often (10) business days ("Vacancy"), Cigna will inform Employer of such Vacancy, and will detennine in consultation with Employer if the position will be temporarily staffed. In the event that Employer elects to have such position filled on a temporary basis, Employer shall so notify 09/19/2023 41 8/20/2024 9:24 AM p. 389 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Cigna in writing. Cigna shall use best efforts to secure temporary labor to fill Vacancies within a reasonable amount of time. Employer shall be responsible for payment of temporary labor costs. Employer will remain responsible for the payment of the costs for the Cigna Personnel that has taken Paid Time Off or Leave. The health center will be closed and no onsite services will be provided if the Cigna Personnel is absent and there is no temporary or substitute labor. However. customers needing coaching will be directed to Cigna's telephonic coaching program, and customers needing medical services may utilize the Cigna Telehealth Connection services. Cigna shall not reduce the Compensation/Fees set forth in the Operating Budget for any absence of Cigna Personnel due to the following: PTO, sick time or short term disability leave under the then current Cigna policies; closure of the Employer's work site within which the Cigna Personnel provides services under this Agreement, due to Employer or other reasons beyond Cigna's control such as inclement weather, pandemic, acts of nature, or actus of the public enemy; or short term disability or caregiver leave for which the Cigna Personnel is paid. 21. Non -Solicitation. During the term of this Agreement, and for a period of one (1) year after expiration or tennination of this Agreement for any reason, Employer shall not directly or indirectly. alone or in concert with others, solicit or entice an employee or independent contractor engaged by Cigna to provide services under this Agreement, to leave the employment or engagement of Cigna in order to provide substantially similar services as those provided in this Agreement, to or on behalf of Employer, or to otherwise work in competition with Cigna. Should there be a termination of this Agreement and Employer desires to have a Cigna Personnel work for Employer or another health center vendor or otherwise serve in a similar capacity to benefit Employer within one (1) year following termination of this Agreement, Employer agrees that it shall reimburse Cigna all severance costs Cigna has paid to any and all Cigna Personnel resulting from a termination of this Agreement. 22. Indemnification. Section 11, Indemnification, of the ASO agreement applies to the Amendment as revised herein. For purposes of this Amendment only, and specific only to the services described beginning with the phrase "Virtual Health Center" starting on page 25 continuing through page 42. 'caused in w hole or in part" is removed and replaced with 09/19/2023 42 8/20/2024 9:24 AM p. 390 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Senices Only Agreement "to the extent caused by". Additionally, for the purpose of this Amendment only, and only for the "Virtual Health Center" services, the end of Section 11 shall include the following: "Cigna shall only be liable for indemnification to the extent caused by Cigna s acts or omissions as stated herein." Operating Budget 09/19/2023 43 8/20/2024 9:24 AM p. 391 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Evernorth Direct Health, LLC, A Cigna Company Cost Projection Prepared for: City of Miami (R.)- Virtual Standalone Estimaktilr Three FuH Yeas £VERNORT..._ mucipam. _ Eligible for Acmes 1,000 Pewnli111 Visits 2,500 2.500 2,600 Panelrlltlon Rafa 30.0% 37.5% 45.0'Xa Projeclvd Prevanlive/Acute Care Visits 750 931 1.126 FT Fs Coach-Re>rislereNurse TotalAE's 1.00 1.00 1.00 1.(JO 1.00 1.00 Salaries&Benefits 123,000 128,000 132,000 Supplies 21,000 21.000 21.000 PrwidurSenices Concierge Practice Fee 20,000 20,000 20,000 Fer'lisit cost 49,000 61,000 73,000 Olhes'-Dinct Lxnenses 14.000 12,000 12.,000 :pm Expenses 32, 32,000 32,000 I i mate .0/-l:: Li i8 :F: '..::: <::: 0 f: &1. ::. -: f:: tf::.2 '. \f:f h' Intratittuatire Co Idenagement Fee 10JJOO 10,000 11,000 a ffiff 35,OR0` :-'36,8041.Itf2ttJ f .J'i AVOPI Iron on sin& Virtual . 2Sa Doe , trap+ 1Cogria Contribution (Coach Annual Funding) I■_ 141,518 151,944 156.502 J W _ @_; Sc W _ tiThefaclily isstiffedaslndlcaled in!he REIIIIdiDr,ablMl 2J N-1111181sccnsiden111 be40 houlsperWliek:mdrepesenledb'j 1.00FfE,111tt8tllp laborlspuvldad d!mg 3smodeledtolncmaseat7 peryearup1o60'!4 4} Mm!fingforC011lflllri!:a to111 Dseelgibleflll'accesst>1 hede islllamedatS5000rnyeal'one1R1$2500ttleflllbm!I years 5} Reauilmenl alSt I'crSlalf is Ilfojedad atS!J(E house). MadlmV&any ex:!eulat mcrullmePte.11plllSeSillB 111U. dillntnallli!ed!allesslllc:Um!d. 6j Doesootlnclu:lelhe(Ostllffadlilyblifdol.t fl Does not Inclu:le Ih&cost Orlease 8) Assumes, !i0'Ir,afeligille iafiCipan15 R1t1!M!alu shot ii Ille CInit. 9)&11m:111abvenoorwllsu!3mltacla1111. 10J Ompr.ilePiaclredMedldne Iawand,Stilelelemtdr,ilei 1,nayaeedtotlereviewed...AddlllOnal chageslll;ll)'asipjyb COl.l,lillanr. a . 11} Thecm:toainnctl'ol"apadilicnerlDdeiwl" wilmllleJawmaybehil,llel" k1M1f11&'lpigectsd.adu;faJlts.119JJi198m1hRllgl. 12) Hgt,SpeedlnlBmelJ11U5lbeavailablelothebmmgaridextendedtudemartwitllSlwndDl"81!1ViatdslancerequiremarD. Addilimal ameaivly dlargaSb InfernefJOSUTelephcn,svas couldlllJPlylf clinic: cannot use dlenfs axlStilg seNkei,rovlders. 09/19/2023 44 8/20/2024 9:24 AM p. 392 City of Miami Solicitation RFP 1896386 Client Name: City of 1\'liami Administrative Services Only Agreement 'Cyj; 1 Health Improvement Fund For clinical/wellness/behavioral programs offered by CHLIC that are purchased, CHLIC will establish a Health Improvement Fund in the amount of $200,000.00. This fund will be used to defray the cost of CHLIC designated and arranged health and wellness improvement programs (e.g. biometric screenings, flu shots) for Employees of Employer and to reward participation in these programs. The Health Improvement Fund is a one-time credit to be used :from January 1, 2022 - December 31, 2022. Unused funds cannot be rolled over and the City can use the Health Improvement Fund at their discretion. The Health Improvement Fund shall. be extinguished upon tennination of this Agreement and any fund amount not used prior to tennination of this Agreement shall only be available to Employer for the purpose of funding the cost of those reimbursable services provided prior to such termination. 09/19/2023 45 8/20/2024 9:24 AM p. 393 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Exhibit B - Services .2- _ .1rk ,. $2'i'yl•6� � `>y � sY` �v ix�C �1�i {�; �'�'�i 4,+-a \��+¢I:: ..-.w. G4+..t, 'LA c._ ,C y`PZ� ,,, ._,i ,,� �11.� :iY..M ♦ '.. -- �.:'RT� •rn i ni y a F F._. (`i - R-r* .1. �..V. .Y.i .. 1 .1 � 0, ll ".' 1¥7 -�. -... -- Furnishing CHLIC's standard Bank Account activity data reports to -Employer as and when agreed 1 upon. CHLIC's administration of the Plan does not include performing obligations, if any, under state escheat or unclaimed property laws. It is Employer's responsibility to determine the extent to which these laws may apply to the Plan and to comply with such laws. All Products All Medical and Pharmacy Products If Employer has elected, pursuant to section 63 of the New York Health Care Reform Act of 19961 (section 2807-t of the Public Health Law) ("the Act"), to pay the assessment on covered lives set forth in section 63 and has consented to the conditions set forth in section 63, CHLIC shall file such forms and pay such surcharge and assessment on covered lives on behalf of Employer through the Banlc Account to the extent set forth in section 63. Such obligation shall end immediately upon Employer's failure to provide any information required by CHLIC to fulfill this obligation, the failure to comply with any requirement imposed upon Employer pursuant to the Aci or the failure of Employer to sufficiently fund the Bank Account. In addition, where permitted and agreed to by CHI.JC, CHLIC will file applicable forms and pay on behalf of Employer and/or the Plan any assessment, surcharge, tax or other similar charge which is required to be made by Employer and/or the Plan based on•covered lives and/or paid claims or otherwise in accordance with and as required by other applicable state and/or federal laws and regulations and the Bank Account will be charged for any such payments made by CHIJC. CHLIC's obligation to pay on behalf of Employer shall end immediately upon Employer's failure to sufficiently fund the Bank Account. Where permitted and agreed to by CHLIC, CHUC will file applicable fonns and pay on behalf of Employer and/or the Plan any assessment, surcharge, tax or other similar charge which is required to be made by Employer and/or the Plan based on covered lives and/or paid claims or otherwise in accordance with and as required by other applicable state and/or federal laws and regulations and the Bank Account will be charged for any such payments made by CHI.JC. CHUC's obligation to pay on behalf of Employer shall end immediately upon Employer's failure to sufficiently fund the Bank Account. All Vision Products 09/19/2023 46 8/20/2024 9:24 AM p. 394 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement �.. .. .-' $ti^'.w 4.9. d 'w§` k, d .... . S ,.h ttT W 9: � Jfa t L ..s' Rv-ery __ , .: ti ,-, 22excluding1 eaith S ngs A u Calculate benefits, check and/or electronic payments disbursed from the Bank Account. Bank TA11 Account payments will appear in Employer's standard Bank Account activity data reports. Products All Products CHLIC's generic claim forms are made available to Employer for individuals eligible to enroll in 1 the Plan. CHLIC's Special Investigations Unit will investigate, pend, recommend denial of claims in whole I or in part. and/or reprocess claims. as appropriate. AU Products [ All Products I All Products Discuss claims, \vll en appropriate, with providers of health services. Perform, based on CHLIC's book of business internal audits of plan benefit payments on a random sample basis. Claim control procedures reported annually in Statement on Standards for Attestation 1 Engagements (SSAE) No. 18 Report (or any applicable successor thereto). All Products All Products All Products All Products (excluding Pharmacy} All Products Resoond to Insurance D,.., .., .,.,..,.,,,.,r., Desfanated toll -free telephone line for Member and Provider calls to CHLIC Service Centers. Member Explanation ofBene it ("EOB") statements including, when applicable, notice of denied claims, denial reason(s) and appeal rights. Verify enrollment and eligibility using Member information submitted by Employer and/or its authorized agent. )".�, Medical Onh` CHLIC's generic enrollment form is made available to Employer ror individuals eligible to enrolll in the Plan. All Medical Products CHLIC's standard ID card with toll -free telephone number are prepared and mailed directly to Members. All Medical Products Administration of subrogation/conditional Claim Payment{terms described in Exhibit E. All Medical Products Vision Only (HLIC's standard ID card with toll -free telephone number are prepared and mailed directly to Members. Ali Vision Products .. -• liI : � rf"'.1' ..rems.. Providing generic enrollment forms and reimbursement request forms to Employer for use m connection with Health Care Flexible Spending Account ("FSA") and/or Dependent Care Flexible FSA and DFSA Products Spending Account {"DFSA") under which eligible employees (collectively "FSA Members") may 09/19/2023 47 8/20/2024 9:24 AM p. 395 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement elect to reduce their salary on a pre-tax basis up to the IRS maximum contribution allowed for deposit into a FSA and/or DFSA. At the end of each reimbursement period of the Plan Year, CHUC shall issue payments to the extent that funds remain in each FSA Member's account, for the amount that is detennined by it to FSA and DFSA Products be proper under the Plan. At the end of the final reimbursement period of the Plan Year, CHUC shall issue payments for any amount then due for those expenses that are determined by it to be proper under the Plan. Allowable expenses for reimbursement under a DFSA include all allowable expenses incurred for the care of dependents pursuant to I.RC. Sections 125 and 129. DFSA Products Allowable expenses for reimbursement under a FSA include all allowable health -related expenses, pursuant to I.R.C. Sections 125 and 213 except where reimbursement under a FSA is prohibited. FSA Products FSA Member accounts will remain open after conclusion of the Plan Year until March 31, (the "Run Out Period"), so that FSA Members can submit any remaining expenses incurred but not FSA and DFSA Products paid out during the Plan Year. Separate account balances will be maintained as per FSA Member's election for the new Plan Year. The amount allowed by Applicable Law (or a lesser amount as defined by the Employer, however not less than the Minimum Carryover amount allowed as defined by the Employer) will carry over FSA Products into the subsequent Plan Year causing the FSA Member to be automatically enrolled, regardless of FSA Member's election for the subsequent Plan Year. FSA Members will have the right to opt out of Carryover with notification of their intent to opt out to be given prior to the end of the Plan Year. The account balances for any FSA Members who have opted out of Canyover will remain open after conclusion of the Plan Year until March 31, (the "Run Out Period"), so that FSA Members can submit any remaining expenses incurred but not paid out during the Plan Year. FSA Members who have enrolled in a Health Savings Account for the new Plan Year will be assumed to be enrolled in a Limited Purpose FSA, if available. The Carried Over FSA balance will be available through the March 31 (the "Run Out Period"), so that FSA Members can submit any remaining expenses incurred during the Plan Year. The Carried Over balance will also be available both during and beyond the March 31 (the "Run Out Period"), for claims incurred during the new Plan Year, and will be supplemental to the FSA Member's current Plan Year contribution election, if aoolic able. Reimbursement requests of tenninating FSA Members will continue to be processed for 30 days following termination of FSA Membership for any expenses incurred prior to the FSA Membership tennination date. In the case of a DFSA, reimbursement will be up to the balance in FSA and DFSA Products 09/19/2023 48 8/20/2024 9:24 AM p. 396 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement the DFSA and in the case of a FSA, reimbursement will be to the originally selected goal amoun'/2 minus prior reimbursements. regardless of whether this amount has been funded. For FSA payments that are not made with a Debit Card but are a result of automatic claim forwarding ("AutoPay") of medical or dental claims from a medical or dental plan administered by CHLIC or Direct Submit Request For Reimbursement, an explanation of payment will be mailed to the FSA Member at their home address or, if elected, provided electronically. An explanation of payment is not issued for FSA payments that are issued to a pharmacy at the point of service as a result of automatic claim forwarding from the employee's pham lacv Plan. FSA Products For DFSA payments made as a result of a Direct Submit Request For Reimbursement, an explanation of payment will be mailed to the DFSA Member at their home address or, if elected, provided electronically. DFSA Products An 800 nwnber directly linked to CHLIC's Member Services will be available for FSA Members' questions and status inquiries. This 800 number will be listed in the instructions on the reimbursement request form as well as having access to account information via Internet. FSA and DFSA Products The Employer will identify through eligibility submission, FSA Members who elect to have medical and pharmacy claims processed but unpaid by CHLIC automatically submitted ("rolled over") to their FSA. Such rollover claims will be processed without additional submissions by the FSA Member and CHUC shall be entitled to rely on the Employer's submission of the FSA Member's rollover election that the submitted expenses were properly incurred, not reimbursable from any other source and are eligible for payment under the regulations governing flexible spending accounts. FSA Products When CHUC takes over a FSA administration mid -Plan Year, CHI.JC will provide administration services from the date CHLIC receives the FSA Plan information for claims incurred anytime during the Plan year. FSA and DFSA Products For employees enrolled in a health care FSA plan with a debit card, a debit card will be issued to each FSA Member (employees enrolled in both a health care FSA plan with a debit card and a Health Reimbursement Account plan with a debit card will only receive one debit card covering both plans). The card is pre -loaded with the FSA Member's annual Health Care FSA goal amount for the Plan Year. Plan Year FSA funds are available using the debit card for transactions actually processed during the Plan Year period. The card does not access funds from a prior Plan period unless the Plan has the extended claim period and the Employee re -enrolls in the FSA for the subsequent period. If an Employee terminates their FSA Plan or does not re -enroll in the FSA, the debit card will be de -activated and will not be available for use after the last day of the Employee's FSA Products 09/19/2023 49 8/20/2024 9:24 AM p. 397 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement FSA enrollment. The card is used by the FSA Member to access available FSA funds based upon the submitted goal amount less amount paid Plan Year to date from the fimd. Since debits made with the card are not submitted by the card vendor to CHLIC in real-time but only on a daily basis, Employer agrees to fund all debits made by the FSA Member through the daily feed from the card vendor that indicates the FSA Member account is exhausted. The card is restricted to specific merchant types that are considered health care related. Although the card is limited to these types of merchants, the card does not limit specific items within these merchants. When the debit card is used, funds are automatically deducted from the FSA. FSA Members may be required to submit receipts to CHLIC to substantiate debit card expenditures. If appropriate substantiation is not receiv the debit card will be suspended and no longer available for use. For employees enroUed in a health care FSA plan who have had no account activity for the prior two plan years, their account will be terminated as of the end of the prior plan year. FSA Member accounts will remain open after conclusion of the Plan Year until March 31, (the "Run Out Period"). so that FSA Members can submit any remaining expenses incurred but not paid out during the Plan Year. e.are and make accessible Member benefit booklet drafts to E toyer. 5500 Schedule C reporting. 5500 Schedule A or Annual Reconciliation Disclosure reporting (when applicable) CHLIC's standard Underwriting services: a) benefit desi:n anal sis b •ro'ected cost anal sis. ,Ittoduc uc Handling of requests from Members for access to, amendment and accounting of protected health information, and requests for restrictions and alternative communications as required under federal HIPAA law and regulations, as set out in this Agreement and its Exhibits. Maximum reimbursable charge determinations of non -Participating Provider charges for covere services. FSA Products Products Produc All Products All Products All Products d All Medical Products (with out -of -network benefits 09/19/2023 50 8/20/2024 9:24 AM p. 398 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement CHUC's standard cost containment controls: Application of non -duplication and coordination of benefits mies and coordination with Medicare. All Medical Products Delivery of information, as necessary, regarding standard application of non -duplication or coordination of benefits. All Medical Products Review of medical bills in accordance with CHLIC's then current Medical Bill Review program. AU Medical Products Network Savings Program, a national vendor network that provides discounted rates when a All Medical Products Member accesses care throufili a Network Savings Frogram contracted provider. Annual reporting of CHLIC's standard cost containment results upon Employer's request. AU Medical Products Pharmac Vendor Recoveries. All Pharmacy Products h a^..«!'y .. .: �, f.x^> D D b•. D Dew• p-. ar ,.4",y'. k ,± '" ,Y 1p^,+. J; fie... �1. .v ?kx='.k' ,+m ..... -+,....�....,`t�s fiM. $vrt § r$�*1,�y ;y *'vCt'^'.m '�":'v+�":wY''rm1�' Summary reports of medical and pharmacy cost and utilization experience (where app icable), upon completion of internal report generation, are available through Cigna's web site, All Medical and Pharmacy Products CignaforEmplovers.com. CHLIC's standard pharmacy utilization reports. Pharmacy Product On Claim Reporting: CHUC will provide standard banking and financial report information based All Medical and upon paid claim data. CHLIC will not provide information on incurred -but -not reported claims, Pharmacy Products projected claims, pre -certifications of coverage, case management information or information on a Member's prognosis or course of treatment. Stop Loss Reporting is an optional service provided at an additional fee to Employers who have All Medical Products stop loss through another entity other than CHLIC. CHLIC will provide its standard reporting only after the stop loss carrier and Employer have executed CHLIC's standard Hold Harmless/Confidentiality Agreement. CHLIC's standard management and statistical reports for Employer. FSA and DFSA Products CHLIC's standard Individual Summ Statements for ap.licable articipating Members. FSA and DFSA Products w""` Is..!,.': ,,..' .. r hc:c..rca ? -•. dCtb d ". ..:. ?�„ A.: su ",e,. 3 8 ss ,fir' s7^ "`,w r � � g� a", �.. � p �, 3i � �."S � tl I "t'v�1^• ». r�sG Xw�R�t�� � , °"4^...... ..... Emplover is CH JCm ".".adminisierni,".".ffielH tlf �a aO.:Flexible: s ndifrAc:count, :Heaft.li\ Awards, ;'. •i. % i filfll !{ ' tt!tfii ! Y• 011W 1 �B`� �}+, Each FSA Member who experiences a qualifying event and elects continuation of account I FSA Products coverage in accordance with COBRA will be maintained until the earlier of the end of the Plan Year, the exhaustion of the FSA balance or othertennination of the FSA. 09/19/2023 51 8/20/2024 9:24 AM p. 399 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement FSA Members electing continuation of FSA coverage under COBRA will continue contributions at FSA Products a rate not to exceed 102% of the applicable premium. The Employer may require after-tax contributions, or may allow the continuant to elect a lump -sum salazy reduction in the amount required in contributions for the remainder of the coverage period. FSA Members who continue under COBRA and whose contributions have been made as required may submit Reimbursement Requests for themselves and any eligible dependents, for expenses incurred before or after the date of the qualifying event but prior to the end of the coverage period. Requests may be submitted until the earlier of the end of the Plan Year or the termination of the FSA, including any as •licable Run -Out Period. FSA Products T. r . CHLIC contracts with a minimum of three (3) independent review organizations that meet the I Patient Protection and Affordable Care Act (PPACA) external review requirements. Members may appeal eligible claims requiring medical judgment to an external independent review organization which is selected by CII1.,IC on a random basis. If Employer has chosen not to participate in this program, the Employer may be responsible for making other arrangements to meet the Patient Protection and Affordable Gare .A.ct (PPACA) external review requirements. All Medical Products C IL.TC provides integrated medical management that includes (depending upon the terns of the Plain).the folloWing; core: services. Pre -Admission Certification andLontmued Stay Review (PAC/CSR) services to certify coverage of acute and sub -acute inpatient admissions/stays or provides guidance to appropriate alternative settings. Administered in accordance with CHLIC's then applicable medical management and claims administration policies, practices and procedures. All Medical Products [ All Medical Products Case Management, a service designed to provide assistance to a Member who is at risk of developing medical complexities or for whom a health incident has precipitated a need for rehabilitation or additional health care support. Assist providers with resources and tools to enable them to develop long term treatment plans in I the management of chronic or catastrophic cases. AU Medical Products The Cigna HealthCare Healthy Babies Program is an educational program which provides Participants with prenatal care education and resources to help them better manage their pregnancy. Other benefits of this program include the Health Information Line, high risk maternity and pregnancy information on mvCigna.com. [ All Medical Products 09/19/2023 52 8/20/2024 9:24 AM p. 400 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement HealthCare Cost and Quality tools available on myCigna.com and mvCi pa mobile app. All Medical Products All Medical Products All Medical Products All Medical Products A panel of physicians and other clinicians to assess the safety and effectiveness of new and emerging medical technologies. The panel meets monthly to review and update coverage policies. Health Information Line is a service that provides twenty-four (24) hour toll free access to nurses who provide convenient and confidential services. Health Information Line nurses can help guide Members in finding the right care, make informed decisions about symptom -based health issues the Member is experiencing when they call the Health Information Line and recommend appropriate settings for care. Health Information Line nurses can help inform and educate Members about a wide variety of health and medical information, including access to a library English and Spanish=podcasts. of Cigna LifeSOURCE Transplant Network® contracts with more than one hundred sixty-five (165) independent transplant facilities which includes over seven hundred fifty (750) transplant programs and provides access to solid organ and bone marrow/stem cell transplantation while improving cost containment and reducing financial risk. A health education program that delivers mailings to Members with certain conditions. All Medical Products Behavioral health services are provided/arranged by a CHUC affiliate (details available upon request), including utilization review and case management for both inpatient and outpatient, in- network behavioral health services. Network POSOA Products: (All Members) Implement a quality oversight process that includes monitoring of utilization management erformance measurements and a continuous juality improvement .rocess when warranted. All Medical Products All Medical Products Except Comprehensive andlndemni Transition of care services to allow Members with defined conditions to continue treatment with non -Participating Providers after enrollment for continued uninterrupted care for a limited time. Focused utilization management of outpatient procedures and identification of appropriate alternatives. Administered in accordance with CHLIC's then applicable medical management and claims administration policies, practices and procedures. All Medical Products with PBS Plus M • 09/19/2023 roviae or arrange access to the appncanie networx or rarticipatmg rroviaers to rumisn neaitn Alt ivie Ica i an care services/products to Members at ne2otiated rates and methods of reimbursement (e.g. fee -for Pharmacy Products 53 8/20/2024 9:24 AM p. 401 City of Miami Solicitation RFP 1896386 Client Nrune: City of Miami Administrative Services Only Agreement service, fixed per person per period, per diem charges, incentive bonuses, case rates, withholds etc.). The amount and type of negotiated reimbursement may vary depending upon the type of plan. For example, a hospital may accept less for patients enrolled in certain types of plans than others. In addition, CHLIC may contract with Participating Providers and other parties (for example Independent Practice Associations) for performance -based incentive payments to promote quality of care, patient safetv and cost e:fficiencv. Provide or arrange access to the applicable network of Participating Providers to furnish health care services/products to Members at negotiated rates and methods of reimbursement (e.g. fee -for service, •fixed per person per period, per diem charges, incentive bonuses, case rates, withholds etc.). In addition, CHLIC may contract with Participating Providers and other parties for performance -based incentive payments to promote quality of care, patient safety and cost efficiency; All Vision Products Credential and re -credential Participating Providers in accordance with CHLIC's credentialing requirements and ensure that third -party network vendors credential/re-credential Participating Providers in accordance with CHLIC's requirements; All Medical, Pharmacy and Vision Products Monitor Participating Provider compliance with protocols and procedures for quality, Member satisfaction, and grievance resolution; All Medical, Pharmacy and Vision Products Facilitate the identification of Participating Providers by Members; and All Medical, Pharmacy and Vision Products Designated toll -free telephone line for Member and Provider calls to CHI.JC Service Centers. All Medical, Pharmacy and Vision Products Access to online and/or on demand medical and health -related consultations via secure telecommunications technologies, telephones and internet are permitted and may include MDLive, a CHLIC affiliate (see details on mvCigna.com). All Medical Products 09/19/2023 54 8/20/2024 9:24 AM p. 402 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement CIII.JC has contracted with an affiliate (details available upon request), to provide or arrange for the provision of managed in -network behavioral health services, the affiliate is a Participating Provider, and is reimbursed primarily on a monthly fixed fee basis. This fixed fee for behavioral health services will be paid as claims and will appear in Employer's monthly reporting and on financial documents. Such payments will be at the relevant monthly rates then in effect. The monthly rates paid to the affiliate vary depending on geographic location of Members and on benefit design, and may be subject to change..The rates will be made available upon request. The fixed fee also includes lifestyle management programs, a cognitive behavioral modification program, a Complex Psychiatric Case Management program, and a Narcotics Therapy Management program. Behavioral claims from a client specific network are not included in the behavioral monthly flXed fee and will be paid from the Bank Account. In some states, payment for behavioral health services must be paid on a fee: -for -service basis. In these states, fee -for -service payments for behavioral health services and the behavioral health administrative fee (including the lifestyle management programs, a cognitive behavioral modification program a Complex Psychiatric Case Management program and a Narcotics Therapy Management program) will be aid from the Bank Account as claims and will a ear in Em to er's monthly reporting. 09/19/2023 55 These services are included in the following products: Network POSOA Products 8/20/2024 9:24 AM p. 403 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement 09/19/2023 56 8/20/2024 9:24 AM p. 404 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement The Cigna HealthCare of Arizona, Inc. staff model ("Cigna Medical Group" or "CMG") is a I All Medical Products multispecialty participating provider group located in metropolitan Phoenix, Arizona. CMG's integrated care delivery model and population health management team work together to facilitate the way in which patients and doctors communicate and interact in order to increase patient satisfaction and improve health outcomes. Plan Participants may at some time receive treatment from a CMG facility or provider even if they do not reside in Arizona (as when traveling). Plan Participants utilizing Cigna participating provider networks in Arizona may access certain specialty and/or ancillary services (such as imaging and urgent care services) through the CMG system. For covered services provided to Participants, CMG is paid at the rates in effect at the time of service (as may be revised from time to time). Representative rates for routinely performed services are attached to the Schedule of Financial Charges herein. A complete copy of the rates is available on request under a mutually agreed nondisclosure agreement ("'NDA"). If the Plan requires or allows Participants to select a primary care provider ("PCP"), Phoenix area Participants who do not select a PCP during open enrollment may be assigned to or otherwise encouraged to consider a CMG PCP. CMG has established collaborative referral relationships with specialty and ancillary providers in Cigna's participating provider networks, which includes affiliated entities. CMG may also receive applicable performance -based incentive payments for its participation in programs designed to improve quality, patient safety and affordability. The incentive payments that CMG may receive will be determined using the same performance measures and reward formula as used in determining the incentive payments made to similarly situated non -Cigna affiliated provider entities. The amount of the incentive payments made to CMG and attributable to the .lan will be .rovided upon request. 09/19/2023 57 8/20/2024 9:24 AM p. 405 City of Miami Solicitation RFP 1896386 Client Name: City ofMiami Administrative Services Only Agreement CIGNA HEALTHCARE OF ARIZONA- CIGNA MEDICAL GROUP (CMG) REPRESENTATIVE BATES FOR ROUTINELY PERFORMED MEDICAL SERVICES II EFFECTIVE JANUARY 1, 2020 OM Dqmrtmcnt CPT Descri.tion Code AH Departments 99213 OFFICE V1S1'1',ES'lEXP PROB FOC $95.41 Adult Medicine 99396 WELL EXAM EST. 40 64 YEARS $1.49.26 Pediatrics 99392 WELL EXAM, EST, 1-4 YEARS $124.36 Ophthalmology 66984 REMOVE CATARACT, INSERT LENSw Professional Fee only, at a facility $1,015.00 Podiatry 11721 DEBRIDEMENT NAIL SIX OR MORE $57.93 Radiology 71046 CHEST X-RAY, PA & LAT $43.54 Radiology 77067 & 77063 $278.56 SCREENING MAMMOGRAPIN DIGITAL General Surgery 47562 LAPAROSCOPY;CHOLECYSTECTOMY- Professional Fee only, at a facility $1,012.30 Optometry 92014 EYE EXAM & TREATMENT $158.56 ASC (Ambulatory surgical center) / Endoscopy Suite Grouper2 $469.00 ASC Endoscopy Suite Grotiper 8 $1,104.00 * Medicare does not assign (or may not yet have assigned) relative value units (RVUs) for certain service codes. Codes not valued by Medicare are referred to as "gap codes. "For example, Medicare does not assign values for wellness service codes (99381 99397). CMG refers to The Essential RBRVS (Annual) guide to obtain relative values for such gap codes for billing purposes. Typically, Cigna pays CMG for gap codes not valued by Medicare either at the discounted fee schedule referenced above or, for new codes not yet valued by Medicare, at the same rate it pays its other participating providers. The Urgent Care case rate excluding radiology and laboratory services is $135. 09/19/2023 58 8/20/202/1 9:2/1 AM p. 406 City of Miami Solicitation RFP 1896386 Client Name: City ofMiami Administrative Services Only Agreement Appendix A - Pharmacy Benefit Management Services ff::..:::J-is:Jii'c. iilff:t:: t2f}.i? i'}'.:Zi.I?f\. • •:'ip BE.NEM AGE T: 2DEUNtr1ONS- , t•fel:?J\i# O :.A(if:f ...:ill:: rtJ10::J<::.?f>ca..•.::; .:..; Definitions Any capitalized term not defined below shall have the meaning given•to such tenn in the Agreement. Any capitalized term utilized in the Schedule of Financial Charges or Exhibit B shall have the meaning given to such tenn in the Agreement, including the meanings set forth below. • "Actuarially Estimated" shall mean that the discount(s) listed in the Schedule of Financial Charges are estimated, but not guaranteed, to result in a particular average discount for Covered Drugs administered by CHLIC under this Agreement Actuarially estimated discounts are calculated based on evaluation of an expected distribution of drag utilization across C111,IC's aggregate group client book of business. As measured in the aggregate for Employer's Pharmacy Benefit, Employer's average discount results may vary based on the Plan -specific factors such as drug mix utilization. 1, e� � l • the Foo and Drug Administration A) uac er se t onnU5s(cl)dofthe reddera ooct, Umg anctUosmetit AYtl( UUA) that aslira et dy sold or distributed under a different labeler code, product code, trade name, trademark, or packaging (other than repackaging the listed drug for use in institutions) than the innovator brand name drug. • "Average Wholesale Price" or "AWP" shall mean the average wholesale price of a Covered Drug as established and reported by Medi- Span. The applied AWP of a Covered Drug shall be the AWP for the actual eleven (11) digit National Drug Code ("NDC"), Covered Drug specific, quantity appropriate actual package size (or the manufacturer -packaged quantity closest to the dispensed size), submitted by a Retail Pharmacy, Home Delivery Pharmacy, or Specialty Pharmacy at the time that the Covered Drug is adjudicated. Notwithstanding any other provision in this Agreement, in the event of any major change in market conditions affecting the pharmaceutical or pharmacy benefit management market, including, for example, any change in the markup, methodologies, processes or algorithms underlying the published AWP(s), CHLIC may adjust any or all of the Rebates, charges, rates, discounts, guarantees and/or fees in connection with CHLIC's administration of the Phannacy Benefit hereunder, including any that are based on AWP, as it reasonably deems necessary to preserve the economic value or benefit of this Agreement to CHLIC as it existed immediately prior to such change. Additionally, and notwithstanding any other provision in this Agreement. CHUC may replace AWP as its pharmaceutical pricing benchmark with an alternative benchmark and/or may replace Medi-Span, or other such publication, as its source for the AWP or alternative benchmark with a different pricing source, provided that CHUC adjusts any or all such AWP-based charges or such alternative benchmark -based charges as it reasonably deems necessary to preserve the economic value or benefit of this Agreement to CHLIC as it existed immediately prior to such replacement or immediately prior to the event(s) giving rise to such replacement, as the 09/19/2023 59 8/20/2024 9:24 AM p. 407 City of Miami Solicitation RFP 1896386 Client Name: City ofMiami Administrative Services Only Agreement • • • • • • • case maybe.�lal] },thatFDA(k� h ,,b Service Act, U. �Z(k)l,obased productpsnowing mat it slugiiIysimilar tbiosimilar lAulicense liologica ' product, "knoHealth reference product, and has no clinically meaningful differences compared to the reference product in terms of safety, purity, and potency. A biosimilar biological product may be licensed by the FDA as biosimilar or interchangeable, and in either case such biological product is a Biosimilar for the purposes of this Agreement. "Brand Drug" shall mean a pharmaceutical product, including a Covered Drug that is a prescription drug, including over-the-counter drugs dispensed pursuant to a prescription, medicine, agent, substance, device, supply or other therapeutic product that is not a Generic Drug. Except if and where the language expressly states otherwise, a Brand Drug does not include a Specialty Brand Drug for ingredient cost discount purposes. "Business Decision Team" shall mean a committee comprised of voting and non -voting representatives across various Cigna business units such as clinical, medical and business leadership that is duly authorized by Cigna to make decisions regarding coverage treatment of pharmaceutical products based on clinical findings provided by the P&T Committee, including, but not limited to, decisions regarding tier placement and application of utilization management to pharmaceutical products. "Cigna Home Delivery Pharmacy" shall mean a duly licensed pharmacy operated by CHUC or its affiliates, where prescriptions are filled and delivered via the mail service, which may include, for example, Accredo Health Group, Inc., ESI Mail Pharmacy Service, Inc., Express Scripts Pharmacy Inc., Tel -Drug of Pennsylvania LLC and Tel -Drug, Inc. "Claim," for purposes of this Appendix A, is a claim or request for coverage under the Pharmacy Benefit. "Compound Drug" shall mean a medication that (a) is comprised of two or more gaseous, solid, semi -solid, or liquid ingredients (other than water or flavoring added to any preparation) that are weighed or measured at a pharmacy and then prepared according to the prescriber's order and the pharmacist's art; (b) contains at least one FDA -approved federal legend drug as an active ingredient; (c) is not otherwise generally available in its compound fonn; and (d) is not a compound preparation administered by infusion or injection. "Covered Drugs" shall mean prescription drugs, including over-the-counter drugs dispensed pursuant to a prescription, biologics, medicines, agents. substances, devices, supplies, and other therapeutic products that are prescribed for Members and are covered under the Pharmacy Benefit and shall include all associated standard services usually and customarily rendered by a pharmacy or provider in the normal course of business, including dispensing, administration, counseling and product consultation. 09/19/2023 60 8/20/2024 9:24 AM p. 408 City of Miami Solicitation RFP 1896386 Client Name: City ofMiami Administrative Services Only Agreement "Dispensing Fee" means an amount paid to a pharmacy for providing professional services necessary to dispense a Covered Drug to a Member. • "FDA" shall mean the U.S. Food and Drug Administration. • • • "Formulary" shall mean the list of FDA -approved prescription drugs and supplies developed and managed by CHUC across its self - funded and insured group book of business and that is selected and adopted by Employer. The drugs and supplies included on the Formulary will be modified by CHUC from time to time as a result of factors including, but not limited to, economic and clinical factors like clinical appropriateness, manufacturer Rebate arrangements and patent expirations. Any changes CHUC makes to the Formulary are hereby adopted by Employer. "Generic Drug" means a pharmaceutical product, including a Covered Drug, whether identified by its chemical, proprietary, or non- proprietary name, that is accepted by the FDA as therapeutically equivalent and interchangeable with drugs having an identical amount of the same active ingredient(s), and which is identified as such in CHLIC's master drug file using indicators from First Databank, Medi- Span, or other nationally recognized source as used by CHUC across its book of business on the basis of a proprietary algorithm, a summary of which may be made available for review by Employer or, subject to CHLIC's consent, its auditor upon request in accordance with the terms set forth in this Appendix A. Employer and, as applicable, its auditor shall sign a confidentiality agreement acceptable to CHLIC relating specifically to such summary. The reference to a drug by its chemical name does not necessarily mean that the product is recognized as a generic for adjudication, pricing or copay purposes. Except if and where the language expressly states otherwise, a Generic Drug does not include a Specialty Generic Drug for ingredient cost discount purposes. For pricing purposes, a Generic Drug includes a Covered Drug that is otherwise identified as therapeutically equivalent and interchangeable with drugs having an identical amount of the same active ingredient(s) and is within its exclusivity period or other period of limited competition; provided that, notwithstanding the foregoing, a Generic Drug excludes an Authorized Generic identified as a brand name drug by the aforementioned proprietary algorithm used by CHI.JC. For pricing purposes, a Generic Drug also excludes a Biosimilar. "Limited Distribution Drug" or "Exclusive Distribution Drug" shall mean a Specialty Drug that is not generally available from most or all pharmacies but is restricted to select pharmacies as determined by a phannaceutical manufacturer. The list of Limited Distribution Drugs and Exclusive Distnbution Drugs will be maintained by CHLIC. • "Maximum Allowable Charge" shall mean the maximum unit price for a Covered Drug included on the applicable MAC List as set forth on such MAC List. • "MAC List" shall mean a then -current list maintained by CHLIC of prescription drugs, devices, supplies and over-the-counter drugs identified as readily available as a Generic DruJLQ! _generally equivalent to a Brand Drug (in which case it may also be on a MAC List) 09/19/2023 61 8/20/2024 9:24 AM p. 409 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement • • • • • • and that, in each case, are deemed to require or are otherwise capable of pricing management due to the number of manufacturers, utilization and/or pricing volatility. Manufacturer Administrative nistrative Fees" shalhl mean administrative fees paid by pharmaceutical n ufacturers to CHLIC or its affiliate or su contractor irectly m connection wit a mmistenng, mvoicmg allocating g ancollecting Kentes. "Phannacy Benefits" shall mean amounts payable for covered phannacy benefit services and products under the terms of the Plan; Pharmacy Benefits shall be considered Plan Benefits for purposes of this Agreement. "P&T Committee" shall mean a committee comprised of clinicians that represent a range of clinical specialties. The committee regularly reviews pharmaceutical products, new pharmaceutical products, for safety and efficacy, the findings of which clinical reviews inform coverage status decisions made by the Business Decision Team. The P&T Committee's review may be based on consideration of, without limitation, FDA -approved labeling, standard medical reference compendia, or scientific studies published in peer -reviewed English -language bio-medical journals. "PBM Proprietary Information" shall mean information relating to CHLIC's pharmacy benefit management products and services, including, without limitation, CHLIC's reporting and web -based applications, eligibility and adjudication systems and coding methodologies, system formats and databanks, clinical or fonnulary management operations or programs, information and agreements relating to Rebates and other financial information, prescription drug evaluation criteria and coverage policies, drug pricing information, including MAC List and Specialty Drug pricing, paid Claims information integrated into CHLIC's adjudication systems, and pharmaceutical manufacturer, vendor or pharmacy network agreements. "Prescription Drug Charge" shall mean the amount that, prior to application of the Plan's cost -share requirement(s), Employer is obligated to pay for a Covered Drug dispensed at a Retail Pharmacy or Cigna Home Delivery Pharmacy, including any ingredient cost, applicable Dispensing Fee, service fee, and tax. The ingredient cost charged to Employer may be expressed as, for example, a discount off of AWP or other benchmark price, or a MAC. "Rebate" shall mean retrospective fonnulary rebates received by CHLIC pursuant to the terms of a formulary rebate contract negotiated independently and directly attributable to or arising from the utilization by Members of certain Covered Drugs manufactured, sold, marketed, or distributed by a manufacturer. However, "Rebates" shall exclude: (i) pricing adjustments, payments and credits made in the ordinary course by any manufacturer on account of product returns, delivery errors or shipping damage or losses arising from drugs and other products purchased from such manufacturer by or on behalf of CHUC_(ii) pricing_di_sc:ounts paid or credited by a manufacturer to pharmacies affiliated with CHLIC for 09/19/2023 62 8/20/2024 9:24 AM p. 410 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement • • • prescription drugs and other products purchased from such manufacturer; {iii) any fees or other compensation paid by any manufacturer in consideration of any services, products, activities or programs performed, provided or implemented by CHLIC or any of its affiliates for such manufacturer; (iv) Manufacturer Administrative Fees; (v) Value -Based Payments; (vi) any rebates or other amounts th.at are allocated to reduce and/or partially or wholly satisfy a Member's cost -sharing obligation for a Covered Drug; and (vii) rebates or other amounts paid to CHLIC for prescription drugs that are administered or otherwise provided to Members in providers' offices, home health care settings, or outpatient clinics. "Retail Pharmacy" shall mean any licensed retail pharmacy with which CHUC has contracted directly or indirectly with a third party, to provide Covered Drugs to Members, and is not a mail order pharmacy. A mail order pharmacy is a pharmacy that primarily fills and delivers pharmaceutical products via the mail service. The term "Retail", when immediately preceding the term "Brand Drug Claim", "Generic Drug Claim", "Specialty Drug Claim", "Specialty Brand Drug Claim", or "Specialty Generic Drug Claim" means that the resulting term (e.g., naetail Brand Drug Claim") refers to such claim as dispensed by a Retail Pharmacy. "Specialty Dru.g" shall mean a pharmaceutical product, including a Covered Drug, considered by CHUC to be a Specialty Drug based on consideration of the following factors: (i) whether the pharmaceutical product is prescribed and used for the treatment of a complex, chronic or rare condition; (ii) whether the pharmaceutical product has a high acquisition cost; an (iii) whether the pharmaceutical product is subject to limited or restricted distribution, requires special handling and/or requires enhanced patient education, provider coordination or clinical oversight. A Specialty Drug may not possess all or most of the foregoing characteristics, and the presence of any one such characteristic does not guarantee that a pharmaceutical product will be considered a Specialty Drug. The term "Specialty," when immediately preceding the terms "Generic Drug" or "Brand Drug", means that the resulting term (e.g. "Specialty Generic Drug") refers to a Generic Drug or Brand Drug that is considered a Specialty Drug, respectively. "Specialty Pharmacy" shall mean a duly licensed phannacy designated by or operated by CHLIC or its affiliates that primarily dispenses Specialty Drugs or provides services related thereto; provided, however, that when the Cigna Home Delivery Phannacy dispenses a Specialty Drug, it shall be considered a Specialty Pharmacy hereunder. • "U&C Charge" shall mean the price the applicable Retail Pharmacy would charge a regular cash -paying customer for a Covered Drug (and any services related to the dispensing thereof) on the day on which the Covered Drug is dispensed. t3/4!111% 17T1' /4I1J 1-I 1i 111 1 XC1-> '11C,1NL1'1:1 J 1 \.41.,L1v1C,1tJ;; }; : JL xw( L Jr.1 111 K 1! Fa rr 1 it IItg t It:I;ItIlz zr 1. Retail Pharmacy Network. (a) General. CHUC shall maintain a Retail Pharmacy network. Retail Pharmacies included in the network shall provide Covered Drugs to which the Retail Phannacies have access to Members during their normal business hours. A list of the Retail Phannacies 09/19/2023 63 8/20/2024 9:24 AM p. 411 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement included in the network, as updated from time to time, shall be made available to Members online. CHLIC maintains multiple networks and/or sub -networks and may periodically consolidate networks and/or migrate clients, including Employer, between networks and sub -networks. CHLIC shall require each Retail Pharmacy included in the network to meet its requirements for participation in the Retail Pharmacy network, which include, but are not limited to, satisfaction of licensing and insurance requirements. (b) Retail Pharmacy Audits and Overpayments. CHUC shall review 100% of all claims, with each claim to be reviewed by either desk audit or field audit as determined through the use of random risk based predictive model to ensure that each Retail Phannacy is complying with the terms of its contract with CHLIC. In the event that CHI.JC discovers that an overpayment has been made to a Retail Pharmacy, CHUC shall talce reasonable steps to recover the overpayment pursuant to the terms of this Agreement. (c) Independent Contractors. The Retail Pharmacies are independent contractors, and as such CHUC does not direct or exercise any control over the pharmacists at Retail Phannacies or the professional judgement exercised by any pharmacies in the dispensing or filling of prescriptions or performing other pharmaceutical services. Neither CHLIC nor any CHLIC affiliate shall have any liability to Employer, any Member or any other person or entity for any act or omission of any Retail Pharmacy or it agents or employees. (d) Collection of Cost Sharing. CHI.JC shall require Retail Pharmacies to collect all applicable Plan cost shares from Members. 2. Cigna Home Delivery Pharmacy. (a) General. Members may submit new or refill prescription orders for fulfillment through Cigna Home Delivery Pharmacy or such other mail service pharmacy that CHLIC in its sole discretion may select from time to time. Such orders may be placed via mail, telephone, or electronic means. Subject to Applicable Law, Employer shall permit communication with Members regarding the availability and use of the Cigna Home Delivery Phannacy potential cost savings associated therewith, and the provision of supporting services (e g phannacist consultation) in connection with any prescription dispensed by the Cigna Home Delivery Phannacy. Cigna Home Delivery Pharmacy shall deliver all drugs to Members in accordance with its standard procedures. For the purposes of clarity, CHUC does not exert direction or control over the pharmacists at Cigna Home Delivery Pharmacy in filling prescriptions or performing other pharmaceutical services. (b) Cost Sharing. Members are responsible for the payment of the applicable cost sharing to Cigna Home Delivery Pharmacy for each prescription or prescription refill. Employer acknowledges that Cigna Horne Delivery Pharmacy may suspend services to a Member who is in default of any cost -sharing obligations, in accordance with Cigna Home Delivery Pharmacy's standard credit policy. If payment of such cost -sharing has not been received from the Member within one hundred twenty (120) days of 09/19/2023 64 8/20/2024 9:24 AM p. 412 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement dispensing of the product, the Plan will be billed for the outstanding amount following the one hundred twenty (120) day collection period. (c) Affiliation with CHUC. Accredo Health Group, Inc., ESI Mail Pharmacy Service, Inc., Express Scripts Pharmacy Inc., Tel -Drug of Pennsylvania LLC and Tel -Drug, Inc. are licensed pharmacy affiliates of CHLIC that fill and deliver Covered Drugs via the mail service. 3. Claims Processing. (a) General. CHLIC, in accordance with Section 2 of the Agreement, shall perform claims processing services for Covered Drugs dispensed by Retail Pharmacies or Cigna Home Delivery Pharmacy. In -network Claims shall be submitted via paper or electronically. Members using out -of -network covered services are required to submit a paper claim form. A separate charge shall apply for the submission of any paper claim form, whether in -network or out -of -network. CHUC is not required to provide coordination of benefits (COB) services for Claims for drugs dispensed, and electronically processed, at a pharmacy; Claims may be processed without consideration of a Member's coverage under another plan. (b) Drug Utilization Review. CHLIC shall perform a concurrent Drug Utilization Review ("DUR") analysis of each prescription submitted for processing. Such DUR Analysis may include, for example: (1) prescribed dosage within a safe range; (2) drug -to - drug interaction; (3) drug -to -allergy interaction; (4) age -to -drug interaction; (5) duplicate therapy; (6) quantity limitations; and (7) days' supply. DUR processes shall not override the prescriber's, the pharmacist's or other health care provider's professional judgment. 4. Utilization Management Program. CHUC shall, in accordance with Section 2 of the Agreement, administer the Pharmacy Benefit utilization management program(s) identified in this Agreement. Employer acknowledges that CHLIC's coverage policies and claims administration procedures, which are utilized across CHLIC's self -funded and insured book -of -business to adjudicate claims and administer appeals, may change periodically. As an example of the coverage criteria that may apply to a pharmaceutical product, a Member may have to try one or more preferred pharmaceutical products, or demonstrate why tiying the preferred pharmaceutical product(s) would be clinically inappropriate, in order to obtain coverage under the Plan for a given phannaceutical product Employer further authorizes CHUC to allow coverage for a use that otherwise would be excluded in the event of co -morbidities, complications and other factors not expressly addressed by the coverage policies utilized by CHLIC in reviewing Claims for coverage. CHUC may rely wholly upon infonnation about the Member and the prescn"ber's diagnosis of the Member's condition. CHLIC shall not substitute its judgment for the judgment of the prescribing physician, nor shall it determine medical necessity or make other medical determinations other than for coverage purposes. 09/19/2023 65 8/20/2024 9:24 AM p. 413 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement 5. R bate Management. CHLIC shall pay Employer amounts equal to the Rebate amounts specified in the Schedule of Financial Charges. 6. 1>1"u¢-Related Services. (a) Specialty Drugs. CHLIC shall process Claims regarding Specialty Drugs subject to the following provisions: (1) The Specialty Pharmacy shaH fill prescriptions for Specialty Drugs based on the professional judgment of the dispensing pharmacist, accepted pharmacy practices and product guidelines. (2) A list of Specialty Drugs available via the Specialty Pharmacy and the pricing for those Specialty Drugs shall be made available as in effect on the Effective Date, as set forth in Appendix B. After the Effective Date, Employer may request that CHUC provide it with an updated list of Specialty Drugs available via the Specialty Pharmacy and the pricing with respect thereto. (3) To the extent acting in the capacity as a mail order pharmacy, the Specialty Pharmacy shall ship Specialty Drugs to Members in accordance with its standard procedures. (4) Members are responsible for the payment of the applicable cost sharing to the Specialty Pharmacy for each prescription or prescription refill. Employer acknowledges that the Specialty Pharmacy may suspend services to a Member who is in default of any cost -sharing obligations, in accordance with the Specialty Pharmacy's standard credit policy. If payment has not been received from the Member within one hundred twenty (120) days of dispensing, the Plan will be billed following the one hundred twenty (120) day collection period. (5) For the purposes of clarity, CHI.JC does not exert direction or control over the pharmacists at the Specialty Pharmacy in filling prescriptions or performing other phannaceutical seivices. (b) Compound Drugs. CHLIC shall process prescribed Compound Drugs to the extent covered under the Plan. CHLIC shall treat as Covered Drugs only those components of a Compound Drug that would otherwise be treated as Covered Drugs were they not part of a Compound Drug. 7. Member Communkations and ,Services. (a) Member Communication. CHI.JC shall provide to Members an ID card and instructions to access Member materials online, including the Fonnulary, the Retail Pharmacy directory, CignaJ-IQme Delivery Pharmacy infonnatioll. and an out -of -network 09/19/2023 66 8/20/2024 9:24 AM p. 414 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Claim reimbursement form. (b) Rx Savings Messenger. CHLIC may send personalized mailings to Members regarding the Generic Drugs and preferred Brand Drugs and savings available from Cigna Home Delivery Pharmacy. (c) Call Center. CHUC shall maintain toll -free customer service lines twenty-four (24) hours per day, seven {7) days per week for the purpose of responding to inquiries from Members regarding Retail Pharmacy, Cigna Home Delivery Pharmacy or Claims issues. 8. Formulary Management: Clinical Programs: Other Services. CHLIC shall provide Formulary management services, which shall include implementing Formulary placement decisions and determinations to apply utilization management requirements made by CHI.JC's Business Decision Team. The Business Decision Team makes Formulary determinations based on consideration of clinical and economic factors. Clinical factors may include, but are not limited to, the CHLIC P&T Committee's evaluation of the place in therapy, relative safety or relative efficacy of the drug, as well as whether certain supply limits or other utilization management requirements should apply. Economic factors may include, but are not limited to, the drug's acquisition cost including, but not limited to, assessments on the cost effectiveness of the drug and available Rebates. Employer acknowledges that the Formulary, utilization management requirements, and coverage policies used by CHUC to perform coverage reviews, including any changes made thereto, are adopted by Employer. When considering a drug for Formulary placement or other coverage conditions, CHLIC's Business Decision Team reviews clinical and economic factors regarding enrollees as a general population across its relevant book -of -business. CHLIC may also provide the clinical, safety and/or trend programs, or other programs and services to Employer, some of which may require payment of additional fees by Employer. If additional fees are required for such a program or service, CHLIC shall include the fee in the Schedule of Financial Charges or otherwise communicate the same in writing to by Employer. : :1pu'As>ll11,t'A.•.c.•Y••.•.tit.N:rot'Vr•.J1'AN1,'A•litl'm:;N•1-rx•o.lr•ll::t•'111r.o „p•,pKA"..1••1•o•N•s••„ T r.I. 1. Implementation of Agreement. (a) Proiect Plan. Employer and CHLIC shall develop an agreed upon implementation project plan with respect to the Agreement prior to the Effective Date or prior to the implementation with respect to any new Pharmacy Benefit under this Agreement following the Effective Date. (b) Initial Data and Commencement of Pharmacy Benefit Management Services. Prior tO the Effective Date, Employer shall provide CHLIC with all data and/or documentation necessary for CHUC to provide the services specified in this Agreement. Such data and/or documentation shall include, but is not necessarily limited to, claims history and Member prior authorization history. 09/19/2023 67 8/20/2024 9:24 AM p. 415 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Assuming all data specified in the preceding sentence is received sufficiently in advance of the Effective Date, CHLIC shall commence providing services under this Agreement as of the Effective Date. 2. Timely Provision of Data by Emnlover. Employer acknowledges that CHI.JC shall not be held responsible for, and shall be released from, fulfilling any obligation or performing any seivice under this Agreement if Employer or its designee does not provide accurate information in a timely manner. 3. Renorting. CHUC shall make available to Employer CHLIC's standard reporting applications, subject to Applicable Law and Exhibit D, including, without limitation, HIPAA and state privacy laws. 4. Claims Data. (a) Retention. CHLIC shall retain data with respect to Claims for at least seven (7) years from the date the prescription is filled. Following the close of such retention period. CHLIC shall retain and dispose of such Claims data pursuant to its then -current standard policies and procedures, Applicable Law and the Business Associate Agreement described in the Agreement (b) Disclosure to Vendor. Upon Employer's written request and subject to execution of a non -disclosure agreement acceptable to CHLIC, CHUC shall provide prescription Claims data in its standard format to a vendor contracted with Employer and otherwise acceptable to CHLIC solely for the purposes of such vendor's support of Plan administration functions. Employer agrees that its vendors may not utilize Claims data for any other purpose, including, without limitation, developing products and services, analyzing the Claims data against market benchmarks or CHLIC competitors or adding to a normative database (even if de - identified and/or blinded as to Member and PBM/carrier) for the Employer's or vendor's commercial use. Employer shall be responsible for any use or disclosure of Claims data, or any services provided, by the vendor. Notwithstanding the foregoing, all audits of any pricing guarantees, Rebate -sharing obligations or Claims processing accuracy shall be conducted in accordance with the tenns in this Agreement specifically relating to such audits. (c) De -Identified Data. During and after the term of this Agreement, CHUC may use Claims, drug, and medical data that has been de -identified in accordance with IDPAA for research, provider evaluation, database maintenance, and other commercial purposes. This provision shall survive termination or expiration of the Agreement. 09/19/2023 68 8/20/2024 9:24 AM p. 416 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement S. Pharmacy Claims Processing Aqdits. (a) Employer may, to the extent specified below and at no additional charge, conduct a claims processing audit of CHLIC's administration of Plan Benefits, once every Plan Year. New audits shall not be initiated until all parties have agreed that any and all prior pharmacy -related audits are closed. In order to balance the need to adequately support the audit process for all CHLIC clients, with an efficient allocation of resources, Employer's who choose to audit one or more components of the phannacy arrangement must do so through a single annual audit. (b) Claims processing audits shall be subject to the following conditions: (1) the audit may take place while the Agreement is in effect or within one (1) year after the termination or expiration of the Agreement; (2) the initial audit period for a retrospective claims audit shall not exceed the twenty-four (24) months period immediately preceding CHLIC's receipt of the request to audit; (3) Employer shall provide to CID.JC at least forty-five (45) days prior written notice of its intent to audit; (4) Employer shall designate, with CHLIC's consent, such consent not to be unreasonably withheld, an independent, third party auditor to conduct the audit (the "Auditor"); (5) Employer shall be responsible for its incurred costs regarding the audit; (6) except as otherwise may be agreed to by the parties, in writing, and prior to the commencement of the audit, the audit shall be conducted in accordance with the terms of CHLIC's Audit Agreement attached hereto as Exhibit C2 which is hereby agreed to by Employer and which shall be signed by the Auditor prior to the start of the audit; (7) CHLIC will provide all data as reasonably necessary for Auditor to perform the claims processing audit within thirty (30) days following the latter of the audit kick-off call and the Audit Agreement being ful)y executed or, when applicable, as otherwise agreed upon by the Parties; (8) following Auditor's initial review of the claims, Auditor will provide CHLIC in writing with all suspected categories of claim errors, if any, together with an electronic data file, in a mutually agreed upon fonnat, containing up to three -hundred (300) claims, so that CHLIC may evaluate and investigate Auditor's suspected errors; (9) CHUC will respond to the suspected errors within sixty (60) days from Cffi.,IC's receipt of such written findings; (10) upon receipt and review of CHLIC's responses, Auditor will provide CHLIC with a written report of Auditor's findings and recommendations before or at the same time such audit report is provided to Employer; (11) CHLIC will respond to the audit report within thirty (30) days of the issuance of Auditor's report; (12) once both Parties have accepted the audit results, the audit shall be considered closed and final; (13) to the extent the mutually accepted audit results demonstrate claims errors, CHUC will reprocess the claims and make corresponding adjustments to Employer; (14) CHLIC's obligations to respond within the designated periods above is conditioned upon a good faith and cooperative working relationship between Employer. and/or its Auditor and CHLIC, including but not limited to no new or additional issues that appear in the final report that were not otherwise provided to CHUC during the preliminary review of suspected errors. This provision shall survive termination or expiration of the Agreement. 09/19/2023 69 8/20/2024 9:24 AM p. 417 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Pharmag Rebate Audits. (a) Employer may, to the extent specified below, in accordance with the following requirements, and at no additional charge while this Agreement is in effect, audit CHLIC's payment of Rebates. Any Rebate audit shall occur following CHLIC's issuance of the annual financial reconciliation to Employer once in each twelve (12) month period. New audits shall not be initiated until all parties have agreed that all prior pharmacy -related audits are closed. In order to balance the need to adequately support the audit process for all CHLIC clients, with an efficient allocation of resources, Employers who desire to audit one or more components of the phannacy arrangement must do so through a single annual audit. (b) Rebate audits shall be subject to the following conditions: (1) Employer and CHUC shall agree on a mutually acceptable, independent, third -party auditor to conduct the audit, including the individual(s) employed or contracted to perform the audit to ensure that they shall not have a conflict of interest that could reasonably diminish their impartiality (the "Auditor"); (2) Employer shall be responsible for its incurred costs regarding the audit; (3) Employer shall provide CfilIC with at least forty-five (45) days prior written notice of its intent to audit; (4) a mutually agreed upon nondisclosure/nonuse agreement for rebate audits shall be executed by Employer, the Auditor and CHUC; (5) the scope ofrecords to be audited as being necessary to determine CHLIC's compliance with its contractual Rebate payment obligations under the Agreement shall be as mutually agreed upon by the Auditor and CHLIC; (6) the Auditor may select for audit purposes the records of up to five (5) manufacturers for two (2) calendar quarters from the last reconciled plan year immediately preceding the written request to audit; (7) the audit shall be conducted at a mutually acceptable time during regular business hours at CHLIC's offices where such records are located; (8) records shall not be removed or photocopied without CfilIC's express written consent; (9) for the sole purpose of confirming compliance with the audit Confidentiality Agreement, Auditor will first submit in draft to CHUC, and prior to submission to Employer its Rebate audit report, so that CHUC can confirm that no terms of the applicable rebate agreements which are confidential, are disclosed in the audit report; (10) the Auditor shall provide its :final audit report to CfilIC and Employer at the same time; and (11) the Auditor may disclose the aggregate amount of Rebates due Employer but no other details of CHLIC's rebate contracts of which the Auditor is apprised, if any. This provision shall survive termination or expiration of the Agreement. 7. Phanuacv Financial Guarantee Recon iliationAudits. (a) Employer may, to the extent specified below and at no additional charge, conduct a Financial Guarantee Reconciliation audit once every Plan Year following CHLIC's issuance of the annual fmancial reconciliation to Employer. New audits shall not be initiated until all parties have agreed that all prior phannacv-related audits are closed. In order to balance the need to adequately supoort 09/19/2023 70 8/20/2024 9:24 AM p. 418 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement the audit process for all CHUC clients, with an efficient allocation of resources, Employers who choose to audit one or more components of the phannacy arrangement must do so through a single annual audit (b) Financial Guarantee audits shall be subject to the following conditions: (1) the audit may take place while the Agreement is in effect or within one (1) year after the termination or expiration of the Agreement; (2) such audit may cover up to two prior contract years to the extent such prior contract years have not previously been audited; (3) Employer shall provide CHUC with at least forty-five {45) days' prior written request for the audit; (4) Employer and CHUC shall agree on a mutually acceptable, independent, third party auditor to conduct the audit (the "Auditor"), and the individuals(s) employed or contracted to perform the audit shall not have a conflict of interest that could reasonably diminish their impartiality; (5) Employer shall be responsible for its incurred costs regarding the audit; (6) CHLIC will provide all data as reasonably necessary for Auditor to determine that CHUC has performed in accordance with its contractual obligations regarding the financial guarantees, and CHI.JC will provide such data within thirty (30) days following the latter of the audit kick-off call and the Audit Agreement being fully executed or, when applicable, as otherwise agreed upon by the Parties; (7) except as otherwise agreed to by the parties prior to the commencement of the audit, the audit shall be conducted in accordance with the terms hereof and a Pharmacy Financial Guarantee Audit Agreement, a sample of which is attached hereto as Exhibit C2, which shall be signed by CHLIC and the Auditor, and together with written authorization from the Employer prior to the start of such audit; (8) any adjustments resulting from the audit will be based upon the actual Claims reviewed and not upon statistical projections or extrapolations, as the Auditor will be furnished with 100% of the paid Claims processed during the applicable contract period for purposes of the audit; (9) following Auditor's initial review and prior to the submission of its written audit report, the Auditor will provide CHLIC in writing with all of the suspected errors, if any, and CHLIC will respond to such suspected errors within sixty (60) days from CHLIC's receipt of such preliminary :findings; (10) CHLIC will respond to any audit report issued by the Auditor within thirty (30) days of the issuance of same; and (11) CHLIC will reconcile mutually agreed upon amounts due to Employer within a reasonable period of time following mutual agreement regarding any amount due to the Employer. CHLIC's obligations to respond within the designated periods above is conditioned upon a good faith and cooperative working relationship between Employer and/or its Auditor and CHLIC, including but not limited to no new or additional issues that appear in the final report that were not otherwise provided to CHLIC during the preliminary review of suspected errors. This provision shall survive termination or expiration of the Agreement. 1 1 t 1; 1 tlj'tt itgJ r Yt tlttl tiles'/.i:1Nri.1 tV t S:t el ism 1. Funding and Payment of Claims. With respect to Pharmacy Benefits, (1) CHUC may withdraw funds from the Bank Account for the purposes specified in Section 3 of the Agreement five times per month, and (2) any recovered overpayments shall be credited to Employer via a line item on its invoice, less the fee set forth on the Schedule of Financial Charges. 09/19/2023 71 8/20/2024 9:24 AM p. 419 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement 2. Retroactive Member Changes and Terminations. Notwithstanding anything in the Agreement to the contrary, Employer shall remain responsible for all charges and Bank Account Payments incurred or charged through the date CHUC processed Employer's notice of a retroactive change or termination of a Member's enrollment in the Plan. Notwithstanding anything to the contrary in Section 4.c. of the Agreement, with respect to Phannacy Benefits, CHUC generally will implement eligibility updates received from Employer that adhere to CHLIC's standard electronic format as soon as reasonably practicable following receipt of such updates. k?li4)ft0±tt£.X:'}.t\.{tit:'.fitI:J§!p :t\J C' E'.NEM Giffi:N::ij mfue wiij Q El)GIfi:N:itsffl[f 1:?k:.:.: K('10 '}:.'ilL: CHUC offers pharmacy benefit management services for consideration by Employer and other entities. The general parameters of such services and the supporting systems have been developed by CHI.JC as part of CHLIC's administration of its general business as a pharmacy benefit manager for entities that sponsor group health plans. The Parties have negotiated the terms of this Agreement in an arm's-length fashion. Except to the extent Cli1JC conducts the final level of intern.al appeal as set forth in Section 2.c of the Agreement, the Parties assert that neither Party intends that CHLIC shall be a fiduciary with respect to Pharmacy Benefits for either ERISA (if applicable) or state law purposes. and neither Party shall name CHLIC or any of its affiliates as a "plan fiduciary" with respect to its management of Phannacy Benefits. Employer acknowledges and agrees that CHUC (i) does not have discretionary authority or control respecting management of the Pharmacy Benefits. and (ii) does not exercise any authority or control respecting management or disposition of the assets relating to Phannacy Benefits or of Employer. Rather, Employer retains all such authority and control. The Parties agree that, upon reasonable notice, CHUC shall have the right to terminate its Pharmacy Benefit services under this Agreement to any Plan andior Members located in a state that requires a pharmacy benefit manager to be a fiduciary to Employer, the Plan or a Member. This provision shall survive tennination or expiration of the Agreement. r 1 r lr% 1 i? i J,> ¥wBENEff1 tl' Nf{ GE S . 'tli 1 tW iJft 1. General. CHUC contracts with its PBM affiliate for the provision of pharmacy benefit services and financial arrangements. As such, CHLIC or its PBM affiliate, directly or indirectly contract on their own accounts with Retail Pharmacies and Cigna Home Delivezy Pharmacy to dispense covered phannaceutical products to Employer's Members, and not on behalf of, or for the benefit of, Employer or the Plan; accordingly, any discounts or other remuneration CHLIC or its PBM affiliate earns under an arrangement with a Retail Pharmacy or Cigna Home Delivezy Pharmacy are obtained for, and inure to, the sole and exclusive benefit of CHLIC or its PBM affiliate, and not the Employer or the Plan. Amounts paid by CHLIC or its PBM affiliate or by the PBM affiliate for Retail Pharmacy or Cigna Home Delivery Pharmacy for Brand Drug, Generic Drug, or Specialty Drug Claims may or may not be equal to the amount charged to Employer and/or Member. If the amount paid by Employer and/or Member does not equal the amount paid by CHLIC or its PBM affiliate or by the PBM affiliate to a particular phannacy, CHI.JC and its PBM affiliate will absorb or retain such difference. CHLIC may directly or indirectly contract for Rebates, Manufacturer Administrative Fees, and other remuneration on its own behalf and for its own benefit, and not on behalf of Employer or the Plan. As an example of other remuneration other than Rebates or Manufacturer 09/19/2023 72 8/20/2024 9:24 AM p. 420 City of Miami Solicitation RFP 1896386 Oient Name: City of Miami Administrative Services Only Agreement Administrative Fees that CII1..1C may earn, CHLIC may also directly or indirectly from pharmaceutical manufactuTers remuneration in connection with value payments and/or services that CHLIC provides to Employer ("Value -Based Payments"). Notwithstanding anything in this Agreement to the contrary, any Value -Based Payments earned by CHI.JC are separate and apart from any Rebates or Manufacturer Administrative Fees that CHUC directly or indirectly earns from pharmaceutical manufacturers, and CHI.JC may retain any Value -Based Payments it earns. As examples of the value payments and/or services that CHLIC may provide to Employer in connection with Value -Based Payments that CHUC may earn, CHUC may provide care management or other services to Employer and/or remit to Employer monetaty credits if Members discontinue therapy on certain pharmaceutical products. Information regarding any services. and/or monetary credits or other financial value, for which Employer may be eligible with respect to specific pharmaceutical products or therapeutic classes/conditions, including the products for which monetary credits or other financial value may be available to Employer, the amount of that value, and other payment terms, is available upon request. Any value payments and/or services provided by CHUC to Employer are subject to change or termination by CHUC as the value program(s), if any, offered by CHUC change(s) or tenninate(s). Accordingly, CHLIC retains all right, title and interest to any and all actual Rebates, ManufactuTer Administrative Fees, Value -Based Payments, and other remuneration directly or indirectly received from manufacturers. CHUC may provide Employer amounts equal to all or some portion of the Rebate and Manufacturer Administrative Fee amounts, or other financial value generated in connection with any value program(s), allocated to Employer, if any, and as specified on the Schedule of Financial Charges, from CHLIC's general assets (neither Employer, its Members, nor Employer's Plan retains any beneficial or proprietary interest in CHLIC's general assets). Rebate and Manufacturer Administrative Fee amounts received vary based on factors including, without limitation, Employer -specific utilization. the volume of utilization as well as Formulary position applicable to the drug or supplies, and adherence to various formulaiy management controls, benefit design requirements, and Claims volume. Employer acknowledges and agrees that neither it, its Members nor its Plan will have a right to interest on. or the time value of, any Claim payments charged by CHLIC to Employer or any Rebate, Manufacturer Administrative Fee or other payments received by CHUC during the collection period of moneys payable under this section. if any, and that CHUC shall retain any such remuneration. For purposes of this provision, the term CHUC shall also include and mean CHLIC's PBM affiliate, Express Scripts. Inc. 2. A:fl2Jiates. Cigna Home Delivery Pharmacy may maintain product purchase discount arrangements and/or fee -for -service arrangements with pharmaceutical manufacturers and wholesale distributors in its capacity as a mail service and/or specialty pharmacy. Cigna Home Delivery Pharmacy may contract for these arrangements on its own account in support of its pharmacy operations, and not on behalf o:t: or for the benefit of, Employer or the Plan. Accordingly, Cigna Home Delivery Pharmacy retains the sole and exclusive benefit of any difference between its acquisition cost for a pharmaceutical product and the amount charged to Employer under this Agreement. Further these arrangements relate to services provided outside of this Agreement and other pharmacy benefit management arrangements and may be entered into without regard to whether a specific drug is on one of the formularies that CHLIC offers to entities that sponsor group health plans_ Discounts and fee -for -service payments received by Cigna Home Delivery Pharmacy are not part of the pharmacy benefit management formulary rebates or associated administrative fees or charges paid to CHUC in connection with CHLIC's pharmacy benefit 09/19/2023 73 8/20/2024 9:24 AM p. 421 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement management formulary rebate programs. This provision shall survive termination or expiration of the Agreement. Itl lJlii:tif£Ifit}'..t:f [ 11t}1 ff.e :BE:NEffl: i13/4t 1 o» )]t£i:i'l@N'Si ijNiU i&i'18N:,,.7 i, ( ttfJ/J.jffJiiiiAfllt)Tr, 1:-1 Upon notice oftermination of this Agreement, the following provisions shall apply with respect to Pharmacy Benefits: a) Employer shall notify Members at least thirty (30) days prior to the termination of the Agreement becoming effective of any transition to a successor pharmacy benefit manager. b) If mutually agreed upon by CHLIC and Employer, CHUC sball provide services following termination of the Agreement at CHLIC's then -prevailing rate. Such services, if any, shall be determined by mutual agreement of CfihIC and Employer in advance of the termination of the Agreement becoming effective. c) Upon request by Employer and subject to execution of a nondisclosure agreement acceptable to CHUC, CHI.JC shall transition Claims files and/or history to the pharmacy benefit manager or other third party specified by Employer and otherwise acceptable to CHI.JC. Any disclosure of Claims files and/or histozy shall be limited to the information the successor phannacy benefit manager or other third party needs to implement or administer Employer's pharmacy benefits. CHUC shall not be required to directly or indirectly release, and Employer shall not release, PBM Proprietary Information to any such third party. d) Upon termination of the Agreement for any reason. the Parties shall handle Confidential Information, PBM Proprietary Information and Protected Health Information (as defined in the Business Associate Agreement attached as Exhibit D) pursuant to the terms of the Agreement. e) In the event that Clll.,IC terminates the Agreement pursuant to Section I.vi of the Agreement, CHLIC shall have no further obligation following the date of such termination to pay Employer any Rebates, or any other amount that may otherwise be payable by CIll.,IC to Employer. This provision shall survive termination or expiration of the Agreement. S>:2 Z£Ii@: £i:)......:;;J.....2:>.1 :i 41Jt CXBBNEEIT) *G 111£N"iHtcONFibEN!ctflL1TI'tkF[1:Z2s=::::SZ'.I7Jt .1 ::ts'rn:: T: r1{::'.::1':57""! 1. General. Employer acknowledges and agrees that CHLIC's PBM Proprietary Information constitutes competitively sensitive trade secrets, and that its misuse or mis-disclosure could result in material :financial and legal loss or liability to CHLIC, its affiliates and their respective subcontractors. CII1JC shall not he required to disclose PBM Pro Q! "ie !a.ry Information to Employer except to the extent 09/19/2023 74 8/20/2024 9:24 AM p. 422 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement necessary for Employer to exercise any audit rights expressly provided hereunder or perfonn other Plan administration functions. If CII1.,1C discloses PBM Proprietary Information to Employer, or, if CHUC consents, to the Employer's vendor or designee, CHLIC may require Employer, or its vendor or designee, to execute a non -disclosure agreement specifically relating to the requested PBM Proprietary Information. Employer agrees that it and its vendors may not utilize PBM Proprietary Information for any purpose other than performing Plan administration functions, including, without limitation, developing products and services, de -identifying, blinding or analyzing the PBM Proprietary Infonnation against market benchmarks or CHLIC competitors or adding to a normative database for the Employer's, or vendors or designee's, commercial use. For the purposes of clarity, information shall not cease to qualify as PBM Proprietary Information if Employer or its vendor or designee de -identifies and/or blinds the PBM Proprietary Information such that the information cannot be traced or identified to a Member or CHUC, its affiliates or their respective subcontractors. Employer shall be solely responsible for any disclosure of PBM Proprietary Infonnation by CHLIC to Employer or its vendor or designee, or any subsequent use or disclosure by Employer or its vendor or designee, or services provided by the same. Notwithstanding anything herein to the contrary, in no event will CHLIC be required to disclose to Employer, or its vendor or designee, information related to, or including, its pharmacy network agreements, vendor agreements or pharmaceutical manufacturer agreements. 2. Compelled Disclosures. If at any time Employer, or its vendor or designee, is required by law, court order or other valid legal process to disclose any Confidential Information, it will promptly notify CHLIC prior to any such compelled disclosure and, upon request, cooperate with CHLIC in seeking a protective order or other available relief to contest or limit the scope of such compelled disclosure. 3. Return or Destruction of Information. At any time upon C111.,IC's request or upon expiration or termination of this Appendix A or the Agreement, whichever occurs first, Employer will, at CHLIC's option, promptly deliver, or, as the case may be, compel its vendor or designee to deliver, to CHUC all PBM Proprietary Information or other Confidential Information (or such portion thereof as requested) and not retain any copies in whole or in part of such PBM Proprietary Information or other Confidential Information, or securely destroy or dispose, or, as the case may be, compel its vendor or designee to destroy or dispose, of those portions of documents and other materials in any form, including electronic form, prepared by or received by the Employer or its vendor or designee, that contain or reflect such PBM Proprietary Information or other Confidential lnfonnation. Employer, or its vendor or designee, shall certify such return and destruction, as the case may be, to CHLIC. 09/19/2023 75 8/20/2024 9:24 AM p. 423 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Appendix B - Cigna Home Delivery Pharmacy Specialty Drug List THIS SPECIALTY DRUG LIST IS CONFIDENTIAL, PROPRIETARY INFORMATION OF CHLIC. IT IS PROVIDED SOLELY FOR EMPLOYER'S PLAN ADMINISTRATION PURPOSES. RE -DISCLOSURE IS STRICTLY PROHIBITED EXCEPT AS OTHERWISE PROVIDED BY APPLICABLE LAW. CHLIC RESERVES ALL LEGAL RIGHTS AND REMEDIES TO ENFORCE THESE PROHIBITIONS ON USE AND DISCLOSURE. The Specialty Drug List shall be provided separately to Employer, and is hereby incorporated into the Agreement by reference, inclusive of any changes made subsequent to CHLIC's initial issuance of the Specialty Drug List to Employer to the pharmaceutical products included on the Specialty Drug List or the discounts pertaining to such pharmaceutical products. Upon Employer's request on or after the Effective Date, CID.,IC shall provide to Employer an updated Specialty Drug List. Currently Marketed SpeciallY Drugs on this Specialty Drug List. The discounts in this Specialty Drug List are the discounts that will be adjudicated in CHLIC's claim processing system for the drug indicated when dispensed by Cigna Home Delivery Pharmacy, subject to all of the following. • The discounts in this Specialty Drug List are based on the terms and design of the Pharmacy Benefit that Employer has adopted and disclosed to CHLIC. Accordingly, if Employer fails to disclose to CHLIC, for example, that it uses or intends to use a consumer -driven health plan, a major cost - sharing program, or a utilization management program promoting generic or OTC drugs over brand drugs, CHLIC may adjust the discounts as it reasonably deems necessary to preserve the economic value or benefit of this Agreement as CHUC anticipated based on the tenns and design of the Pharmacy Benefit previously disclosed to CHUC and prior to CHLIC's discovery of the Pharmacy Benefit design feature that materially impacts CID.JC's discounts in this Specialty Drug List • The discmmts in this Specialty Drug List shall not apply to Compound Drug claims, Claims that process at U&C, direct member reimbursement (DMR) Claims, and drugs adjudicated under the medical benefit. • Any or all of the discounts in this Specialty Drug List may be adjusted by CHLIC to the extent reasonably necessary to preserve the economic value of this Agreement as it existed immediately prior to the occurrence of any of the following events: (a) there are any significant changes in the composition ofCHLIC's pharmacy network or in CHLIC's phannacy network contract compensation rates, or the structure of the pharmacy stores/chains/vendorsthat are contracted with CHLIC, including but not limited to disruption in the retail pharmacy delivery model, or bankruptcy of a chain pharmacy; or (b) there is a change in government laws or regulations which has a significant impact on pharmacy claim costs; or (c) any material manufacturer -rebate contracts with or for the benefit of CHLIC are terminated or modified in whole or in part; or (d) there is any legal action or Law that materially affects or could materially affect the manner in which CHLIC's rebate program is administered or an existing Law is interpreted so as to materially affect or potentially have a material effect on CHLIC's administration of the Pharmacy Benefit; (e) there is a material change in the Plan or the Plan's Pharmacy Benefit that is initiated by Employer which impacts CHLIC's costs or (f) a major change in market conditions affecting the pharmaceutical or pharmacy benefit management market, a drug shortage in the market, an issue involving the safety of the drug supply, or similar market situation. 09/19/2023 76 8/20/2024 9:24 AM p. 424 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement New -to -Market Specialty Products. Specialty Drug Claims, excluding Limited Distribution Drugs and Exclusive Distribution Drugs, that are for new -to -market drugs will have a minimum market -introduction guaranteed discount of 11.45% off the drug's AWP. "Limited Distribution Drug" or "Exclusive Distribution Drug" shall mean a Specialty Drug that is not generally available from most or all pharmacies and is restricted to select pharmacies as detennined by a pharmaceutical manufacturer. The list of Limited Distribution Drugs and Exclusive Distribution Drugs will be maintained by CHLIC. 09/19/2023 77 8/20/2024 9:24 AM p. 425 City of Miami Solicitation RFP 1896386 SECRETARY'S CERTIFICATE CIGNA HEALTH AND LIFE INSURANCE COMPANY The undersigned, a duly elected Assistant Secretary of Cigna Health and Life Insurance Company (the "Company"), does hereby represent and certify that the following resolutions were adopted by the Board of Directors of the Company via written unanimous consent effective July 1, 2022 and that such resolutions remain in full force and effect as of the date hereof, not having been amended, modified or rescinded since the date of their adoption: Signature Authority RESOLVED, that any person holding the underwriter business title for Cigna Corporation and/or its subsidiaries and affiliates of Operations Director, Contractual Agreement Unit Manager or Operations Senior Manager is hereby authorized to enter into customer agreements, act as a registrar on insurance policies issued by the Company, and to sign such agreements and policies for and on behalf of the Company. FURTHER RESOLVED, that the foregoing resolution supersedes the resolution adopted by the Board effective as of December 19, 2018 with respect to the subject matter therein. The undersigned further certifies that the following individuals hold the business title indicated next to their respective name and are authorized to enter into customer agreements, act as a registrar on insurance policies issued by the Company, and to sign such agreements and policies for and on behalf of the Company: Victoria A. Sirica Aimee Burnham Anna Palmieri Operations Director Contractual Agreement Unit Manager Contractual Agreement Unit Manager IN WITNESSS WHEREOF, I hereunto set my hand and set the seal of the Company this 12th day of July, 2023. Assistant Secretary 8/20/2024 9:24 AM p. 426 City of Miami Solicitation RFP 1896386 CITY OF MIAMI AMENDMENT NO. 1 TO THE PROFESSIONAL SERVICES AGREEMENT BETWEEN THE CITY OF MIAMI AND CIGNA HEALTH AND LIFE INSURANCE COMPANY This Amendment No. 1 to the Professional Services Agreement dated January '1, 2014 ("Agreement"), by and between the City of Miami, a municipal corporation of the State of Florida ("City"), located at 444 S.W. 2nd Avenue, Miami, Florida 33130 and CIGNA Health and Life Insurance Company, a foreign profit corporation authorized to conduct business in the State of Florida ("CIGNA", or "CHLIC"), located at 900 Cottage Grove Road, Bloomfield, CT 06002, is entered into this 20th day of may 2021. RECITALS WHEREAS, an January 1, 2014, the City entered into an Agreement with CIGNA for the provision of administrative services to the City's Group Benefit Health Plan ("Services""), pursuant to Request for Proposals No. 369325 and authorized by Resolution No. 13-0460; and WHEREAS, the City wishes to amend the above -mentioned Agreement to include the administration of an on -site virtual health clinic; NOW THEREFORE, for the considerations hereinafteras set .forth, the Agreement- is hereby amended as follows; 1. All references to Connecticut Health and Life Insurance Company shall be stricken and replaced with Cigna Health and Life Insurance Company. 2. Section 30, titled "Counterparts", is hereby deleted In its entirety and replaced with the following language: This Agreement may be executed In counterparts, each of which shall be an original as against either Party whose signature appears thereon, but all of which taken together shall constitute but one and the same instrument. An executed facsimile or electronic scanned copy of this Agreement shall have the same force and effect as an original. The parties shall be entitled to sign and transrnit an electronic signature on this Agreement (whether by facsimile, PDF or other email transmission), which signature shall be binding on the party whose name is contained therein. Any party providing an electronic signature agrees to promptly execute and deliver to the other parties an original signed Agreement upon request. 3. Exhibit B to the Agreement, titled "Administrative Services Only Agreement", Schedule of Financial Charges is hereby deleted in its entirety and replaced with Amended Schedule of Financial Charges, effective January 1, 2021, attached as Exhibit A to this Amendment: Counterparts and Electronic Signatures. This Agreement may be executed in any number of counterparts, each of which so executed shall be deemed to be an original, and such counterparts shall together constitute but one and the sarne Agreement. The parties shall be entitled to sign and transmit an electronic signature of this Agreement (whether by facsimile, PDF or other email transmission), which signature shall be binding on the party whose name is contained therein. Any 8/20/2024 9:24 AM p. 427 City of Miami Solicitation RFP 1896386 All other terms, covenants and conditions of the original Agreement issued thereto shall remain in full force and effect, except to the extent herein amended. IN WITNESS WHEREOF, the parties have executed this Addendum to the Agreement. ATTEST: By: Print Name: Deborah Coolidge, CPA Title: Finance Officer (Corporate Seal) ATTEST: Todd B. Hannon; ity'G"lerk APPROVED AS TO LEGAL FORM AND CORRECTNESS: VictoriaMondez Matter ID:=1195 City Attorney D.J.G. "CIGNA" Connecticut Health and Life Insurance Company a Connecticut profit corporation 1,t By: Print Name: Victoria A. Sirica Title: Operations Senior Manager (Authorized Corporate Officer) "City" CITY OF MIAMI, a orida municipal corporation Arth I Noriega V, City Manager APPROVED AS TO INS REQUIRE M] NTS: 0 Ann -Marie Sharpe Risk Mand'gement Director I;ANCE 8/20/2024 9:24 AM p. 428 WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement Schedule of Financial Charges Certain fees and charges identified in this Schedule of Financial Charges will be billed to Employer monthly in accordance with CHLIC's then standard billing practices. However, CHLIC is authorized to pay all fees and charges from the Bank Account unless otherwise specified in this Agreement_ Medical Medical Vision Medical Medical es' ip; Network Point of Service Open Access (POSOA) with PHS Plus Medical Management (All Plans) Comprehensive with PHS Medical Management (All Plans) Cigna Vision (All Plans) s'r Network POSOA Access Fee (All Plans) Comprehensive Care Coordination Fee (All Plans) a. $16.73/employee/month $17.06/employee/month $0.3 5/employee/month $19.53/employee/month $5.73/employee/month Dependent Care Flexible Spending Account (DFSA) Administration For DFSA Products: $5.90/employee/month Health Care Flexible Spending Account (FSA) Administration For FSA Products: $5.90/employee/month 06/02/2021 3 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 w 0 Client Name: City of Miami Administrative Services Only Agreement Amounts paid by CHLIC with its own funds on behalf of Employer or the Plan with respect to charges for which Employer or the Plan is obligated to pay under this Agreement including Plan Benefits, Bank Account Payments (including fixed per person payments and pay -for -performance payments to Participating Providers), governmental taxes or assessments will be billed to Employer and CHLIC is authorized to pay all such amounts from the Bank Account. Cigna Pharmacy Product Administration Fee, only if applicable, is separate from the Medical Administration Charge shown above, but included ._ ... _.., . on same billing line as the Medical Administration Charge for billing purposes only. f�.ANEI HE „� � r �,�, , y � �, y narrnacy �fru�tc.'�rzt�:-guarantee�trie tollo�i�.g charges for Covered Diu s di `ensed b �. Gigna,l ome Delivery Phai mac ,, ,sub ect_to the, rovisions. n t� e section titled ; BM Pre ' n '" , <, Brand Drug Claims: For all Cigna Home Delivery Pharmacy Brand Drug Claims, the Employer's guaranteed average annual discount will be AWP minus 25.00%. Generic Drug Claims: For all Cigna Home Delivery Pharmacy Generic Drug Claims, the Employer's guaranteed average annual discount will be AWP minus an average discount of 81.75%. Dispensing Fees for Drug Claims: For all Cigna Home Delivery Pharmacy Brand Drug Claims and Generic Drug Claims the Employer's guaranteed average annual Dispensing Fee will be $0.00. Brand Drug Claims: For all Retail Pharmacy Brand Drug Claims, the Employer's guaranteed average annual discount will be AWP minus 18.25%. Generic Drug Claims: For all Retail Pharmacy Generic Drug Claims, the Employer's guaranteed average annual discount will be AWP minus an average discount of 79.25%. 06/02/2021 4 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 co w Client Name: City of Miami Administrative Services Only Agreement Dispensing Fees for Both Brand Drug Claims and Generic Drug Claims: For all Retail Pharmacy Brand Drug Claims and Generic Drug Claims, the Employer's guaranteed average annual Dispensing Fee will be $0.95. -:aay:supp. Brand Drug Claims: For all Retail Pharmacy Brand Drug Claims, the Employer's guaranteed average annual discount will be AWP minus 25.00%. Generic Drug Claims: For all Retail Pharmacy Generic Drug Claims, the Employer's guaranteed average annual discount will be AWP minus an average discount of 81.75%. Dispensing Fees for Both Brand Drug Claims and Generic Drug Claims: For all Retail Pharmacy Brand Drug Claims and Generic Drug Claims, the Employer's guaranteed average annual Dispensing Fee will be $0.00. CHLIC shall guarantee an aggregate annual average discount of 17.00% off AWP for covered Specialty Drug prescriptions dispensed by Retail Pharmacies and Cigna Home Delivery Pharmacy. CHLIC's performance will be measured based on analysis of Plan -specific utilization for the contract year. eLOCII.Ih : AU IIARANTF"ES Pricing Guarantee Calculation. The following calculation will be performed on an aggregated basis for all paid Claims for Covered Drugs processed during the applicable contract year in order to reconcile against the average annual ingredient cost discount guarantees set forth above: 1 — [(the total ingredient cost charged to the Employer prior to application of the Plan's Member cost -share requirements)/ (the total AWP) for all Covered Drugs] For the purposes of the pricing guarantee calculation, and notwithstanding anything herein to the contrary, the total ingredient cost shall also include the ingredient cost for a Covered Drug for which a Member pays 100% in the foul' of cost -share. The application of brand and generic pricing may be subject to certain "dispensed as written" ("DAW") protocols and Employer defined plan design and coverage policies for 06/02/2021 5 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement adjudication and Member Copayment purposes. For example, DAW 5 (House Generic) claims will be considered a Generic Drug claim for pricing purposes. Pricing Guarantee Exclusions. The following Claims or products shall be excluded from the calculation of any pricing guarantee set forth in this Agreement: - Specialty Drugs, unless otherwise noted in the Schedule of Financial Charges. - Workers' Compensation Claims. - Non-standard facility Claims (Indian Tribal, Veterans Administration, or Dep. of Defense facilities). - Limited distribution drugs. - Subrogation Claims. - Repackaged products. - Products filled through Pharmacies not participating in the network accessed by Employer under this Agreement (including a contracted pharmacy that does not participate in a sub -network or preferred network tier). - Over-the-counter (OTC) products. - Secondary Payer Claims. - Direct Member Reimbursement Claims. - Compound Drugs. - Claim reversals. - Products identified as prescriptions covered under the federal 340B drug pricing program. - Claims for Covered Drugs paid at the Retail Pharmacy' s U&C Charge shall be included in the calculation of any Retail Pharmacy pricing guarantee set forth in this Agreement. Provided, however, that Claims for Covered Drugs at a U&C Charge shall not be included in the calculation of any Dispensing Fee guarantee, as no separate Dispensing Fee is charged for such Claims � . _ u .. ..m......� . �. RA1 CHLIC will report on the guaranteed amounts within one -hundred eighty (180) days following the end of each contract year. Upon reconciliation, CHLIC's performance with respect to each ingredient cost discount or Dispensing Fee guarantee offered under this Agreement will be individually measured and then reconciled in the aggregate across all ingredient cost discount or Dispensing Fee guarantees. • The amount paid by CHLIC to the Retail Pharmacy for Claims for Covered Drugs may or may not be equal to the amount charged to Employer and/or Member, and CHLIC will absorb or retain any difference. • For a specific Claim for a Covered Drug dispensed by a Retail Pharmacy or Cigna Home Delivery Pharmacy, and after application of any 06/02/2021 6 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 CIient Name: City of Miami Administrative Services Only Agreement Plan cost -share requirements, CHLIC shall charge the Employer the lowest of the following amounts: (1) The Prescription Drug Charge; or (2) The pharmacy's submitted U&C Charge, if any. • For a specific Claim for a Covered Drug dispensed by a Retail Pharmacy or Cigna Home Delivery Pharmacy, CHLIC shall charge the Member in accordance with the terms of the Pharmacy Benefit. For example, for a Covered Drug subject to a fixed dollar copayment requirement, CHLIC shall charge the Member the lowest of the following amounts: The fixed dollar copayment for the Covered Drug, if any; The Prescription Drug Charge; and The pharmacy's submitted U&C Charge, if any. • Home Delivery Pharmacy Dispensing Fees and Dispensing Fee Guarantees are inclusive of shipping and handling. If carrier rates (i.e., U.S. mail and/or applicable commercial courier services) increase during the term of this Agreement, the Home Delivery Pharmacy Dispensing Fee and Home Delivery Pharmacy Dispensing Fee Guarantee will be increased to reflect such increase(s). • Unless specifically noted herein, the discounts to Employer for Covered Drugs set forth in this Agreement are not guaranteed to result in an average aggregate discount off the aggregate AWP of all such Covered Drugs. • Any pricing guarantees, including any ingredient cost discount or Dispensing Fee guarantee, set forth in this Agreement shall be rendered null and void in the event Employer terminates CHLIC's administration of the Pharmacy Benefit prior to completion of the then -current Plan Year. CHLIC's fees, Rebates (if any), discounts or guarantees (if any) are, among other conditions communicated in this Agreement or otherwise in writing to Employer, contingent on, and assume, adoption by Employer of a specific Formulary, Retail Pharmacy network, and Plan design features (e.g. cost -share structure, utilization/cost management programs). • Notwithstanding any other provision of this Agreement, CHLIC may, effective upon written notice to Employer, adjust any or all of the fees, Rebates (if any), discounts or guarantees (if any) in this Agreement to the extent reasonably necessary to preserve the economic value of this Agreement to CHLIC as it existed immediately prior to any of the following events or changes: (a) there are any significant changes in the composition of the CHLIC pharmacy network utilized by Employer hereunder or in such pharmacy network's contract compensation rates, or the structure of the pharmacy stores/chains/vendors that are contracted with CHLIC, including but not limited to disruption in the 06/02/2021 7 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement retail pharmacy delivery model, or bankruptcy of a chain pharmacy; or (b) there is a change in government laws or regulations which has a significant impact on pharmacy claim costs; or (c) any material manufacturer -rebate contracts with, or for the benefit of, CHLIC are terminated or modified in whole or in part; or (d) there is any legal action or law that materially affects, or could materially affect the manner in which CHLIC's rebate program is administered or an existing law is interpreted so as to materially affect or potentially have a material effect, on CHLIC's administration of the Plan; (e) a major change in market conditions affecting the phairuaceutical or pharmacy benefit management market, a drug shortage in the market, an issue involving the safety of the drug supply, an unexpected introduction of a new drug (e.g. authorized generic), or similar market event occurs; (f) the Pharmacy Benefit enrollment decreases by equal to or greater than 15% from the enrollment on which CHLIC's financial offer is based; or (g) there is material change in the Plan that is initiated by Employer (and which CHLIC agrees to administer) such as a change in Formulary selection or network, or Employer fails to disclose a material feature of the Plan or the Plan's Pharmacy Benefit. V1A1VTA CTTJRER PA 'ME1VT Sf I] Subject to the caveats below, CHLIC will remit to Employer the following portion of Rebates and Manufacturer Administrative Fees that CHLIC collects with respect to utilization of Covered Drugs under the Plan's Pharmacy Benefit: For All Products: The greater of: 100.00% of Rebates and Manufacturer Administrative Fees on such utilization dispensed in the full calendar year immediately preceding CHLIC's remittance, or the sum of $188.82 multiplied by the number of Retail Pharmacy Brand Claims dispensed in 30-day* supplies plus $469.73 multiplied by the number of Retail Pharmacy Brand Claims dispensed in 90-day** supplies plus $1,218.66 multiplied by the number of Cigna Home Delivery Pharmacy Brand Claims processed in such full calendar year. Caveats: (1) Upon termination of this Agreement, CHLIC may use Rebates otherwise payable to Employer to offset payable Bank Account Payments or other payable fees or charges identified in this Agreement. CHLIC may also use Rebate attributable to claims for which CHLIC has the financial responsibility under any applicable stop loss policy issued to Employer for purposes of paying or offsetting any stop loss reimbursement payments owed by CHLIC or its affiliates to Employer or otherwise to reconcile stop loss reimbursements. (2) Should Employer terminate this Agreement before completion of the then -current Plan Year, no Rebates shall be due with respect to that Plan Year, and any Rebate minimum or fixed dollar guarantees shall be null and void, as payments of Rebates is conditioned on CHLIC exclusively administering the Pharmacy Benefits for the entire Plan Year. 06/02/2021 8 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 w 01 Client Name: City of Miami Administrative Services Only Agreement (3) For percentage -based sharing arrangements, payout amount may differ slightly from the stated percentage when payout occurs before manufacturers' final reconciliations and payments are made to CHLIC. For the purposes of clarity, CHLIC shall reconcile its performance with respect to any Rebate payment guarantees, including, without limitation, any minimum or fixed dollar guarantees, in the aggregate. Moreover, any amount directly or indirectly provided by a manufacturer or other third party that is allocated to reduce and/or wholly or partially satisfy a Member's cost -sharing obligation for a Covered Drug shall not be considered a "Rebate" for the purposes of Rebate payments to Employer but may be included when reconciling CHLIC' s performance against any Rebate minimum guarantee set forth in this Agreement. (4) For percentage -based sharing arrangements, the percentage share payment of Rebates shall not include the payment of any Rebates received, if any, for Run -Out Claims, 340b Claims, Medical Specialty Claims, Direct Member Reimbursement Claims, Reversed Claims, and Compound Claims. (5) CHLIC or its agent contracts with drug manufacturers on CHLIC's own behalf, and not as agent of the Employer or the Plan. (6) The Rebate payment commitments, including any minimum or fixed dollar guarantees, if any, set forth in this Schedule of Financial Charges are, among any other conditions communicated in this Agreement or otherwise in writing to Employer, contingent on the availability of Rebates to CHLIC and Employer's Pharmacy Benefit applying a 90-day supply limit for Specialty Drugs. For example, in the event that Employer has adopted, or adopts, a 30-day supply limit for Specialty Drugs, CHLIC shall revise the stated Rebate minimum or fixed dollar guarantees, if any, to the extent necessary to reflect CHLIC's revised estimate of Rebates it may collect on Specialty Drugs utilized under the Pharmacy Benefit. Timing of Rebate Pay -Out: Remittance will be provided within ninety (90) days after the close of each applicable calendar quarter for the portion of such calendar quarter that coincides with the Plan Year. .,,.. G:. The Rebate Guarantee payment obligations set forth in this Schedule of Financial Charges shall exclude the following types of claims and/or products: - Claims paid pursuant to a Dispense as Written (DAW) 5 code. - Direct Member Reimbursement Claims. -Repackaged products. - Pharmaceutical supplies. - Biosimilar Claims. - Multi-source Brand Drugs. -Limited distribution drugs. - Vaccines. 06/02/2021 9 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 w rn Client Name: City of Miami Administrative Services Only Agreement -Compound Drugs. -Claim reversals. -Products identified as prescriptions covered under the federal 340B drug pricing program. Employer shall be solely responsible for ensuring that any pharmacy affiliated with or operated by Employer or its affiliate, such as an in-house pharmacy, systematically identifies 340E prescriptions on Claim transactions administered by CHLIC. If such pharmacy fails to systematically identify 340B prescriptions on Claim transactions submitted to CHLIC, then CHLIC may withhold all Rebates, or modify any minimum or fixed dollar Rebate guarantee, otherwise attributable to utilization at such pharmacy. -Run-Out Claims. `: rr .:j. [t '*r^ ,,:. .�i rt' *7 "s",� ,"',. ,•;r• „r: fOVI I� '?„\��a ''!R^ �x y i�ry � ✓� III iuy ,, �a &$:r�/�• ;; • . � .w ;u. • �\\S. ^l +Y'*--c�"�.SP.. 4�7 t � �+.,�1�.}ab:.;;. �� 5 .�q"u°i�I I �.� �':' ��w ^G.i.., �/ � l NII�V'I Notwithstanding anything to the contrary vaccines by CHLIC under the Cigna Vaccine Claims will adjudicate at the Claims, the U&C Charge shall be the administration and dispensing fees, in in this Agreement or otherwise, the following terms and conditions shall apply to the administration of Pharmacy Program. lower of the U&C Charge or the amounts shown in the Vaccine Pricing Schedule below. For Vaccine retail price charged by an in -network participating retail pharmacy for the particular vaccine, including a cash transaction on the date the vaccine is dispensed as reported to CHLIC by the in -network participating a Covered Drug which is avaccine. "Pass Through Pricing" means the actual ingredient cost and dispensing Claim when the Vaccine Claim is adjudicated by an in -network participating pharmacy, as set forth in pharmacy remittances related to the Vaccine Claim. Notwithstanding anything to the contrary in this Claims shall be excluded from the calculation, measurement, and payment of any and all financial to rebate guarantees, ingredient cost guarantees, and dispensing fee guarantees set forth in this Agreement. pharmacy. "Vaccine Claim" means a claim for fee amount paid by CHLIC for the Vaccine the specific in -network participating Agreement or otherwise, all Vaccine guarantees, including but not limited Vaccine Pricing Schedule Retail Pharmacy INFLUENZA Retail Pharmacy Member Submitted Vaccine Claims ALL OTHER VACCINES Vaccine Administration Fee Pass -Through Pricing (Capped at $15 per in -network Vaccine Claim) Pass -Through Pricing (capped at $20 per in -network Vaccine Claim) Submitted amount 06/02/2021 10 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement Ingredient Cost Retail Pharmacy Ingredient Cost as set forth in this Agreement Retail Pharmacy Ingredient Cost as set forth in this Agreement Submitted amount Dispensing Fee Retail Pharmacy Dispensing Fee as set forth in this Agreement Retail Pharmacy Dispensing Fee as set forth in this Agreement Submitted amount '• �' N '. a3 1', ',hill Idly" N ':+rid% I„ 4 + as a: � F „ .y � , .. s:; SF_ f.,r.., I'I: S'm ';" ,q,^"4 . ■??�•' A OY.. Y, ippppgg �IYI� z 5'.., �.vt ,.S.k k:;"3' "�'•' y4 ,�:"ttcc< ,, ir+ �v:u ,iilE=' A �ll. ' .., ....rodu,... ;.:.! Charge Cigna Home Delivery Pharmacy (a CHLIC affiliated company(ies)) Specialty drugs Plan's medical "Cigna Home its affiliates, Delivery Pharmacy service arrangements Home Delivery its pharmacy Agreement without regard entities like payments received or other charges This provision dispensed by Cigna Home Delivery benefit. Delivery Pharmacy" means a duly where prescriptions are filled and delivered may maintain product purchase .:. Pharmacy and administered under the licensed pharmacy operated by CHLIC or via the mail service. Cigna Home discount arrangements and/or fee -for- and wholesale distributors. Cigna on its own account in support of to services provided outside of this arrangements and may be entered into of the formularies that CHLIC offers to plans. Discounts and fee -for -service are not part of the administrative fees CHLIC's services hereunder. of the A cement. . The drug's charge under a national specialty drug discount schedule that generates a 12.5% annual average aggregate discount off AWP across specialty drug claims dispensed at Cigna Home Delivery Pharmacy to CHLIC's self -funded and insured group -client book of business. with pharmaceutical manufacturers Pharmacy contract for these arrangements operations. These arrangements relate and other pharmacy benefit management to whether a specific drug is on one Employer that sponsor group health by Cigna Home Delivery Pharmacy paid to CHLIC in connection with shall survive termination or expiration � � �.. # 3" e r IIpIIIIIII! Ii ,' I7 +'J�"' uun 'tw,,.�- .,.,e. , r4Ilip Tim, , o Network POSOA, Comprehensive and Vision Run -Out Period of twelve (12) months No Additional Cost Pharmacy Run -Out Period of three (3) months for all pharmacy claims No Additional Cost 06/02/2021 11 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement CHLIC administers the programs listed below to contain costs with respect to charges for health care service/supplies that are covered by the Plan (the "Cost -Containment Programs"),In administering these Cost -Containment Programs, CHLIC may contract with vendors to perfoiiu various Cost -Containment Program related services. CHLIC's charge for administering a Cost -Containment Program is the percentage indicated in the table below of the: 1) "gross savings" (i.e., the difference between the charge the provider made and the allowable amount resulting from the Cost -Containment Program); 2) "net savings" (i.e., the gross savings less the applicable vendor charge); or 3) "gross recovery" (i.e., the amount recovered as a result of the Cost -Containment Program) as applicable. CHLIC will make a per claim charge that includes both CHLIC' s applicable Cost Containment Program charge, as shown in the table below, and the applicable vendor charge. CHLIC will pay the vendor its charge. For charges for covered services received from a non -Participating Provider (including emergency/urgent care services that are covered at the in - network benefit level), CHLIC may apply discounts available under agreements with third parties or through negotiation of the non -Participating Provider's charges whether on a claim -by -claim basis or in advance of services being rendered. The programs for obtaining these discounts are identified in Section A of the table below as Non -Participating Provider Cost -Containment Programs. Applying these discounts may result in higher payments than if the maximum reimbursable charge is applied. Whereas application of the maximum reimbursable charge may result in the patient being balance billed for the entire imreimbursed amount, applying these discounts avoids balance billing and may substantially reduce the patient's out-of-pocket cost. CHLIC's per claim charge for administering the Non -Participating Provider Cost -Containment Programs in Section A of the table below plus any per claim vendor charges associated with the Non -Participating Provider Cost -Containment Programs in Section A of the table shall not exceed $30,000.00 per claim. Vendor charges for the Non -Participating Provider Cost -Containment Programs in Section A of the table generally range from 7-11% of gross savings. Specific rates charged by vendors for the programs in Section A of the table are available upon request, subject to execution of a mutually agreed upon non -disclosure agreement to protect the proprietary vendor infoinjation from unauthorized use/disclosure. If no discount is available or negotiated, reimbursement will be based upon: 06/02/2021 12 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement (i) If charges are not subject to CHLIC's benefit enhancement policy — the plan's maximum reimbursable charge (in which case the patient may be balance billed by the provider if the provider's charge exceeds the plan's maximum reimbursable charge); or (ii) If charges are subject to CHLIC's benefit enhancement policy — depending upon the Employer's election: a. the amount of provider's billed charge not exceeding the greater of a CHLIC deteiinined percentage of the Medicare allowable amount (the 80th percentile of the reasonable and customary charge if there is no Medicare allowable charge) or the amount required by state or federal, law (in the case of emergency room services) for charges subject to CHLIC's benefit enhancement policy (patient may be balance billed by the provider if the provider's charge exceeds such amount), or b. the provider's billed charge. The administration of charges for covered services from non -Participating Providers described above is consistent with the claim administration practices with respect to CHLIC's own health care insurance business where applicable. A. Non -Participating Provider Cost -Containment Programs 1. Network Savings Program 29% of net savings 2. Supplemental Network 29% of net savings 3. Medical Bill Review — (Pre -payment Cost Containment for Non -contracted claims): Inpatient Hospital Bill Review • Professional Fee Negotiation 29% of net savings • Line Item Analysis Re -pricing 29% of net savings Outpatient Hospital BM Review • Professional Fee Negotiation 29% of net savings • Line Item Analysis Re -pricing 29% of net savings Physician/Professional Bill Review • Professional Fee Negotiation 29% of net savings • Line Item Analysis Re -pricing 29% of net savings 06/02/2021 13 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 0 Client Name: City of Miami Administrative Services Only Agreement B. Other Cost -Containment Programs 1. Medical Bill Review — (Pre or Post -payment Cost Containment for Non -contracted and Contracted claims): • Bill Audit 29% of the gross savings/gross recovery achieved plus hospital fees or expenses passed through Diagnosis Related Grouping (DRG) Validation/Audits and Recovery. An overpayment audit and recovery program in which CHLIC or its vendors review paid claim data to identify overpayments based on inaccurate DRG coding. 29% of gross savings/gross recovery plus any fees or expenses passed through by the hospital or regulatory agency Medical Implant Device Audits 29% of the gross savings/gross recovery 29% of the gross recovery 2. COB Vendor Recoveries [Exclusive of pharmacy programs where claims are adjudicated at time prescription is received.] 3. Secondary Vendor Recovery Program 29% of the gross recovery 4. Provider Credit Balance Recovery Program 29% of the gross recovery 5. High Cost Specialty Pharmaceutical Audits (this service is only provided with respect to Medical coverage) 29% of the gross recovery 6. Eligibility Overpayment Recovery Vendor Services. Identification and recovery of funds in situations where the overpayment is due to the late receipt of Member termination information. (This service is only provided with respect to Medical coverage). 29% of the gross recovery 7. Class Action Recoveries 35% of the gross _recovery 06/02/2021 14 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement 8. Subrogation/Conditional Claim Payment. Identification, investigation and recovery of claim payments involving other party liability or where another entity is responsible for payment (including by way of example but not by limitation automobile insurance, homeowner insurance, commercial property insurance, worker's compensation). (This service is only provided with respect to Medical coverage.) 5% of the gross recovery plus litigation costs if counsel is retained and an appearance is filed on behalf of CHLIC or Employer in any litigation, or a lawsuit is filed on their behalf; 29% of the gross recovery if no counsel is retained and in all other instances, including cases where state law requires that employee benefit plans be named as party defendants or involuntary plaintiffs. 1 ✓� of ���` ,� a '�, >$ j, ®_{V5,4 j^i A.�,,w]., ,a if Iuy� II,I�,G'p i E '�.,� . rti � ��'".���I VII `'4E� `4Z:5� ',. mY,�"� ; u =�. Fd ` �I g1 @ vlra �+ wu .,> .,'... a a�,. c.. " CHLIC administers the following programs to contain costs with respect to charges for health care service/supplies that are covered by the Plan. In administering these programs, CHLIC contracts with vendors to perform program related services. CHLIC's charge for administering these programs is the percentage (indicated below) of the "recovery" (i.e. the amount recovered) as applicable. 1. Pharmacy Vendor Recoveries. CHLIC performs periodic audits of contracted pharmacies in order to determine the accuracy of payments to the pharmacy(ies). CHLIC's recovery vendor collects and remits to CHLIC all overpayments to pharmacy(ies), and CHLIC remits to Employer's Bank Account the balance collected from the recovery vendor, less the recovery fee set forth herein. 30% of recovery 2. Class Action Recoveries. CHLIC identifies, monitors and may (but is not required to) participate, on behalf of Employer, in class action lawsuits or similar legal proceedings against pharmaceutical manufacturers, including, without limitation, lawsuits alleging legal or equitable claims like fraud, anti-trust violations, or unfair trade practices by a manufacturer. As part of this authority, CHLIC may participate in a settlement, exclude 35% of recovery 06/02/2021 15 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement Employer from a settlement and/or otherwise represent Employer's interests outside the settlement. CHLIC collects and retains as a recovery fee set forth herein of any recovery (net •. la,:.rM. ..._.4..:". 11. . .. .. 9QI.;,::. .C""'� rsu..—..ru..,,.,. . fp a Ste*: Embarc Benefit To provide financial protection from the high cost, CHLIC has contracted with an $0.99 per Member/per affiliate, Protection eviCore ("eviCore" refers to eviCore healthcare MSI, LLC d/b/a/ eviCore healthcare and certain of its affiliates), to arrange for the provision of the following gene therapy drugs for month. Members when both drugs are covered by the Plan administered by CHLIC, and medically If, across eviCore's entire necessary (as determined by CHLIC) to treat the conditions indicated: Embarc Benefit Protection book of business (Cigna i. Luxturna® to treat inherited form of progressive blindness ii. Zolgensma® to treat children under 2 years old with spinal muscular dystrophy and non -Cigna clients), eviCore's cost for the two (Luxturna is the registered trademark of Spark Therapeutics, Inc. and Zolgensma is the (2) drugs provided in a registered trademark of AveXis, Inc.) given calendar year is lower than a As a result of this network contracting arrangement, eviCore is in most cases the exclusive, in -network Participating Provider of these drugs. eviCore arranges for the provision of these predetermined percentage of the PMPM charges drugs through its network of specialty pharmacies (including its affiliate, Accredo), and received, eviCore will certain facilities authorized to administer the gene therapies by the drug manufacturers. refund the difference pro eviCore will reimburse these specialty pharmacies and facilities at negotiated reimbursement rata, after having fully rates. This network solution is called Embarc Benefit Protection. recovered the outstanding balance created by any For arranging for the provision of these drugs, eviCore will be reimbursed by CHLIC on a Prior year deficits. The fixed Per Member Per Month (PMPM) basis. eviCore's PMPM fee (which is subject to refund, in any, will be change) will be charged to the Bank Account one month in arrears. (e.g., eviCore's charges determined on an eviCore for January will be made in February.) These Bank Account Payments will appear in Embarc benefit Protection Employer's monthly reporting. Embarc Benefit Protection does not provide financial book -of -business basis. protection from the cost of administering the two drugs. These costs are small in comparison The refund will be to the drug costs. provided by March 31 st of the following year. When covered under the Plan and determined by CHLIC to be medically necessary for the treatment of the specified conditions, Members will not incur any out-of-pocket costs for the Assuring Transparency: two drugs and the Plan will not be required to reimburse any expenses for the two drugs with After the refund is made 06/02/2021 16 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement two exceptions: Exceptions: 1. For Members born before the date that Embarc Benefit Protection is effective for the Plan and receiving Zolgensma,® the Plan's in -network reimbursement and the Member's in -network cost -sharing apply to either (as applicable): • eviCore's fee -for -service charge for Zolgensma® when provided through Accredo: Average Wholesale Price (AWP) minus 15.8% AWP (based on Medispan) = $2,550,000, or • the reimbursement rate of the participating facility or specialty pharmacy. 2. Members with an HSA must have met the applicable minimum deductible required for a high deductible health plan. eviCore's Embarc Benefit Protection and PMPM charge do not apply to a plan that: i. does not cover either or both drugs; ii. covers both drugs under its pharmacy benefits which are not administered by CHLIC, or iii. does not utilize a Cigna participating provider network. Upon Employer's request on or after the Effective Date, CHLIC shall provide to Employer an updated drug list, if applicable. CHLIC may revise charges/fees by giving Employer at least thirty (30) days' prior written notice. for a particular calendar year, eviCore will, upon request, provide Embarc Benefit Protection book - of -business information for that calendar year. 06/02/2021 17 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement .>� MI t � !J ii� „� ¢,es& _�,xnai z 7 i:. g.r �. ..,y,. ,� �: ;'^N wy :. a�g 11 �� '.ate. �... �"�r9x .....:. .. _ , .�' __ ��'?�' ��t�1C��3�����+�......... " �`� ma .pa" :xr:,�:,.. � � ����,.��,�,„ CHLIC arranges for third parties to provide care management ement services to: (i) contain the cost of specified health care services/items overall with respect to all plans insured and/or administered by CHLIC, and/or (ii) improve adherence to evidence based guidelines designed to promote patient safety and efficient patient care. Specific vendor fees and care management program services are available upon request. In addition to such third parties, CHLIC has arranged for an affiliate, eviCore, to provide the following care management/cost-containment programs (programs and charges identified below are not applicable to Participants who have elected PHS or Basic Low Medical Management (see Administrative Charges section above)) • Pre -certification of coverage of radiation therapy services. $842.79 per episode of care (EOC) • Pre -certification of coverage of diagnostic cardiology(IfEmployer$0.19 g gn services has elected Basic Standard Medical Management (see Administration Charges section above) this program and charge is not applicable to that membership). PMPM • Effective February 1, 2021, network management and care coordination of coverage of home health, durable medical equipment and home infusion services. $0.30 PMPM • Pre -certification of coverage of medical oncology services.816.00 per episode of care (EOC) • Pre -certification of coverage of musculoskeletal therapy services (If Employer has elected Basic Standard Medical Management (see Administration Charges section above) this program and charge is not applicable to that membership). $0.37 PMPM • Services related to the coverage of high tech radiology which may include pre -Fee certification. In certain instances, the Plan will pay eviCore a fee on a per member/per month basis for pre -certification, arranging care, and other services that eviCore may render. Such reimbursement will be in addition to the amount that the Plan pays to reimburse the provider through which eviCore arranged for the provision of the service or supply, reimbursement method and rates may vary by market and are available upon request 06/02/2021 18 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement which will be based on eviCore's contracted rate with that provider. In such instances, Plan Benefits and member cost -share will be determined based on the rate that eviCore contracted to pay the provider for the provision of the service or supply. (If Employer has elected Basic Standard Medical Management (see Administration Charges section above) this program and a charge is not applicable to that membership). eviCore may also charge for services related to the provision of high tech radiology as described below in "Other Vendors and Health Care Services Providers." • Effective February 1, 2021, pre -certification of coverage of sleep management services $0-10 PMPM (If Employer has elected Basic Standard Medical Management (see Administration Charges section above) this program and charge is not applicable to that membership) CHLIC may revise charges/fees by giving Employer at least sixty (60) days' prior written When a Member elects an External Review (as that term is defined in the Patient Protection and Affordable Care Act (PPACA)) of a benefit deteiuiination by an independent third party, the cost of a specific third party review is dependent on the nature and complexity of the issue on appeal. Third party review charges will be commensurate with the level of expertise necessary and the time required to complete the review. $500-$1,500 Review /� % �,ME, N• Y�\� _�,;.. ,. I li/�' �,�F, ,� ,t r,Y� ir` MN'�i^.: r'/r .'r;F�'. : �i n� A xe ,rC ,, �Er 5rs� 71.E I:�111, IIII 1,?,r,• ,,;.." :tea Num41 r - 1 r ICI, II ,I �zyy,_ "� oh V 41 is, 1 I�r, " a�t.��.i�n���I�d ln d .r .vN....-. i �4 s�„.AY u 1�1rr dy, >. ,,. ,... { � . 'wa�i1 �(, i- r E"?... ! , �, lul wi•;, , m., I,s Charges for vision care services will be paid as claims and will appear in Employer's m ,. ..i''V All Vision Products standard Bank Account activity data reports. Such payments will be at CHLIC's applicable charges then in effect, which may be amended from time to time. The applicable charges madeby innetwork vision care providers will be made available upon request. '�{�,i1,v-x-w fl �� ,r,,rn ..moll n .. � h. �. i 1 1 ^„ -,�. a A :�,,„ �,.��., F, �.' e ,:;,s 101,41 e' y'.� CC f y°, 4i,,,1 � a ww..,,... a� ,:) _... -s „e ��ni��"�if�N��':���.�5��. _.s���.".E"ud ll:rll0� CHLIC contracts directly or indirectly with other managed care entities and third party network vendors for access to their provider networks and discounts. These third parties charge either a network access fee, which is included in CHLIC's monthly charges, or a percentage of the savings realized on a claim by claim basis as a result of the application of their discounts. Charges based on percentage of savings may be paid from the Bank Account. Additional details regarding specific charges will be provided upon request. All Medical Products 06/02/2021 19 98E9686 dd2i uo!lepo!Iog WH iZ:6 VZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement 1121 The fixed per person per period and/or fee -for -service charges that CHLIC has directly or indirectly negotiated with Participating Providers for in -network health care services and/or supplies will be charged to the Bank Account and will be used in calculating any applicable Member cost -sharing. In addition, perfounance-based payments to Participating Providers will be charged to the Bank Account. Such payments will be at the payment rates then in effect, which may be amended from time to time. For certain types of specialty care, including, but not limited to, home health care, durable medical equipment, sleep management, high tech radiology, chiropractic care, physical medicine (such as physical and occupational therapy), speech therapy, orthotics and prosthetics, implants, and hearing, in certain markets CHLIC may contract with various third parties and/or affiliated companies, including eviCore, ("Specialty Vendors") to arrange for the provision of care through their own networks of health care providers on a fee -for -service basis. In addition to arranging for care through their own networks of providers, these Specialty Vendors may also provide additional services, including utilization management services and case management services designed to (i) improve adherence to coverage guidelines; and (ii) contain overall healthcare costs to the Plan. Specialty Vendors are included within the definition of `Participating Provider" set forth in this Agreement and in any benefit booklet covering the Plan. When care is arranged through a Specialty Vendor's network of providers, the form of reimbursement to the Specialty Vendor will be through one of the following methods: • Fee -For -Service Payment: In certain instances, the Plan will pay the Specialty Vendor rather than the treating provider on a fee -for -service basis as a claim for Plan Benefits. The Specialty Vendors' fee -for -service charges may be higher than the amounts that the Specialty Vendor contracts to pay the provider for the provision of any particular service or supply, and some portion of the Specialty Vendor's charges may be attributable to the services that the Specialty Vendor provides in addition to those services or supplies provided by the Specialty Vendor's network of providers, including any utilization management services and case management services. In such instances, Plan Benefits and member cost -share will be determined based on the Specialty Vendor's charges according to Plan terms. All Products 06/02/2021 20 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement • Administration Capitation Payment: In certain instances, the Plan will pay the Specialty Vendor a fee on a per member/per month basis for arranging care and other services that the Specialty Vendor may render. Such reimbursement will be in addition to the amount that the Plan pays to reimburse the provider through which the Specialty Vendor arranged for the provision of the service or supply, which will be based on the Specialty Vendor's contracted rate with that provider. In such instances, Plan Benefits and member cost -share will be determined based on the rate that the Specialty Vendor contracted to pay the provider for the provision of the service or supply. • All -Inclusive Capitation Payment: In certain instances, the Plan will pay the Specialty Vendor a fee an a per member/per month basis that covers (i) the services that the Specialty Vendor may render, including arranging care, and (ii) the fees charged by the provider through which the Specialty Vendor arranged for the provision of the service or supply. In such instances, Plan Benefits and member cost -share will be determined based on the rate that the Specialty Vendor contracted to pay the provider for the provision of the service or supply. CHLIC's arrangements with Specialty Vendors are subject to change at any time, and upon request, additional information can be provided that identifies current Specialty Vendors, their area of specialty(ies), whether they are CHLIC affiliates, and the form of payment that they currently receive. Notwithstanding the terms of the Plan, CHLIC shall not administer Member cost -sharing with respect to charges made by Cricket Health, Inc. for its personalized, evidence -based approach to managing chronic kidney disease and end -stage renal disease for clinically eligible Members in CA and such cost -sharing expenses shall, instead, be reimbursed by the Plan (not applicable if Employer has opted out). All Products (excluding HSA Products) 'd, . llvi � }� k4k d�,4• y g �'Y p 11111 ✓'� ..,� � 1 d� Gi �'V7 I Q• p`l - " p, I art ' k 0041,4n �„ ' CHLIC Manufacturer and of Manufacturer third contracts with pharmaceutical manufacturers or other third parties for Rebates, Administrative Fees, and other remuneration on its own behalf and for its own benefit, or All Pharmacy Products not on behalf of Employer or the Plan Accordingly, unless otherwise specified in this Schedule Financial Charges, CHLIC retains all right, title and interest to any and all actual Rebates, Administrative Fees, and other remuneration received from manufacturers or other parties; neither Employer, its Members, nor Employer's Plan retains any beneficial 06/02/2021 21 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 COCO Client Name: City of Miami Administrative Services Only Agreement proprietary interest in any such remuneration, which shall be considered part of the general assets of CHLIC. As an example of the remuneration other than Rebates or Manufacturer Administrative Fees that CHLIC may earn, CHLIC may also directly or indirectly earn from pharmaceutical manufacturers remuneration in connection with value payments and/or services that CHLIC provides to Employer ("Value -Based Payments"). Notwithstanding anything in this Agreement to the contrary, any Value -Based Payments earned by CHLIC are separate and apart from any Rebates or Manufacturer Administrative Fees that CHLIC directly or indirectly earns from pharmaceutical manufacturers, and CHLIC may retain any Value -Based Payments it earns. As examples of the value payments and/or services that CHLIC may provide to Employer in connection with Value - Based Payments that CHLIC may earn, CHLIC may provide care management or related services to Employer and/or remit to Employer monetary credits if Members discontinue therapy on certain pharmaceutical products. Information regarding any services, and/or monetary credits or other financial value, for which Employer may be eligible with respect to specific pharmaceutical products or therapeutic classes/conditions, including the products for which monetary credits or other financial value may be available to Employer, the amount of that value, and other payment terms, is available upon request. Any value payments and/or services provided by CHLIC to Employer are subject to change or termination by CHLIC as the value program(s), if any, offered by CHLIC change(s) or terminate(s). Information on the projected aggregate amount of such Rebates with respect to the Plan Pharmacy Benefit will be provided upon request. This provision shall survive termination or expiration of the Agreement. CHLIC may directly or indirectly receive and retain payments under contracts with pharmaceutical All Medical Products manufacturers or third parties with respect to Members' utilization of the manufacturer's products covered under the Employer's Plan medical benefit. These payments may include rebates, service fees (e.g. administrative fees), or other remuneration. CHLIC directly or indirectly contracts with pharmaceutical manufacturers or other third parties or any remuneration on its own behalf and for its own benefit, and not on behalf of Employer or the Plan. Accordingly, CHLIC retains all right, title and interest to any and all such remuneration received from manufacturer; neither Employer, its Members, nor Employer's Plan retains any beneficial or proprietary interest in any such remuneration, which shall be considered part of the general assets of CHLIC. 06/02/2021 22 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement This provision shall survive termination or expiration of the Agreement. From time to time, CHLIC, directly or through its affiliates, arranges with third parties (e_g., service All Products vendors, provider network managers) to provide various services (e.g., cost -containment services or health care services) in connection with the Plan. CHLIC and its affiliates may receive payments from such third parties to help defray CHLIC's expenses associated with its implementation and/or ongoing administration of these arrangements or as a reimbursement for services or network access provided to such parties by CHLIC. CHLIC may also receive compensation from third -party vendors that Employer may retain based upon a referral from CHLIC or that Members may utilize following an introduction facilitated by CHLIC or an affiliate. CHLIC may also receive: • network administration fees from some providers participating in its provider network, • credits from banks on balances in accounts utilized to administer claims, • non -material incidental compensation/benefits from other source as a result of administering the Plan. 06/02/2021 Where applicable, the following California and PPACA fees/assessments/taxes attributable to the Cigna Health Care of California group service agreement that provides in -network coverage for Members in California: • Comparative Effectiveness Research Fee • Health Insurer Fee • California Managed Care Organization Tax 1. Preparation of SBC, translation notice. CHLIC will not be responsible for any changes that Employer makes to the SBC. 23 Network Products: • Network POS OA No charge 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 01 0 0 Client Name: City of Miami Administrative Services Only Agreement 2. Provide SBC, translation notices prepared by CHLIC to Employer electronically as well as any updates or material modifications. No charge 3. :: i Include in SBC a summary of benefits administered by carve -out vendor if Employer or carve -out vendor provides CHLIC with necessary carve -out benefit information at least twelve (12) weeks prior to the date the SBCs are to be delivered to Employer. ' '/a' $500 for each benefit option under the Plan for which carve -out vendor benefits are included i e in SBC P -. km�, �" � .. �° l 9 IIII,1�, Fn...+a ?>fi rylr a w 3 �, lit: : ,� a'.0 v ems;, r , y'r,;,. ii Ir i '. �...W ''.�;� IxkNf�,u';",i{ �. .;„ . '.'� f �r� �d�.. ��? ., ". � : � �� vM4 IJ i !7� � ( Vly f{ ��ry I{rs< ds yfl ��`��w e�� '� m4�}� � � «ram ��5�s"��'j,y` :a 111 ± I S dl� �._ � b, �Iii ti3 ..._ +. a. .. � � .. /�+�1 � „ . � � {{ �� � n...'�eSf���p.IV11 ,• .Fs .. �..... . .,.. ....,.., .•t, �,E ,._..�, rs ��h,-i. �rl zf. Pharmacy Utilization Management Program (Opioid medications and Specialty Drugs) In administering the Pharmacy Benefit, CHLIC shall apply limits, For All Products: Included in Pharmacy Administration Fee quantity prior authorization and/or step therapy requirements to certain Specialty Drugs, opioid medications, or other products identified for safety/clinical reasons. Clinical Program A targeted condition medication therapy management program in which CHLIC provides support for Members using specialty medications for certain chronic conditions and that are obtained or administered at retail pharmacies or outpatient, office or home health care settings. As part of the program, Members are counseled on their condition, medication side effects, and importance of adherence. For the sake of clarity, if a specialty pharmacy affiliate of CHLIC provides therapy management for specialty medications the pharmacy dispenses to Members, then it does so in its capacity as a specialty pharmacy and not on behalf of CHLIC; CHLIC does not exert direction or control over the pharmacists at any specialty pharmacy affiliate. Included at No Additional Cost Your Health First A proactive health education and improvement program for Members with a chronic condition. The program involves services that span across the Member's health needs. Behavioral coaching principles and evidence based medicine guidelines are utilized to optimize self -management skills For Network POSOA Products: Charges are processed through the Bank Account as fixed per person per period payments and foster sustained health improvements. The program targets a chronic population at high risk for near tetni and future high cost medical expenses. Members are identified as having a chronic condition through a variety of sources which may include: claims data, referrals, and self -identification. A variety of resources is provided to those with a chronic condition, including access to online tools, personalized support, and targeted 06/02/2021 24 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 01cn Client Name: City of Miami Administrative Services Only Agreement materials. The program includes the following components for those with a chronic condition: • Chronic condition -specific coaching • Pre- and post -discharge calls • Lifestyle management coaching: stress, weight management and tobacco cessation • Treatment decision support and coaching In order to continuously assess the effectiveness of the program and/or test new ideas to further engage Members around their health, a small sample -of Members may be placed in a comparison group which for a defined period of time receives alternative services or is suppressed from receiving proactive outreach, such as engagement letters and/or calls. This could affect a few Members targeted for outreach during this limited time period. Claim and CHLIC will administer an optional second level of claim appeals Included in Medical Appeals Administration Charge Virtual Health Cigna Health and Life Insurance Company ("CHLIC") will provide or arrange through a Cigna Center affiliate ("Cigna") a virtual health center for the City of Miami ("Employer"). Employer owns or leases a facility located at 4114 SW 2nd Avenue, Miami, FL 33130 (the "Facility") and desires to provide an onsite virtual health center at the Facility for the benefit of its employees (the "Virtual Health Center"). CHLIC and Employer are sometimes referred to herein individually as the "Party" or collectively as the "Parties." Employer shall provide a secured non -mobile trailer at the Facility to house the Virtual Health Center. Employer's project management team will ensure that the trailer is functional and compliant. Employer will obtain any needed permits and ensure Virtual Health Center is in accordance with all applicable federal, state and local laws and regulations, including but not limited to municipal Fire and Building Codes, American Disabilities Act and other statutes and regulations related to equal access and non-discrimination. Cigna will provide interactive audio visual communications via the Tyto Care platfoiin within Epic, 06/02/2021 25 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 01cn Client Name: City of Miami Administrative Services Only Agreement and will lease the peripheral equipment, the Tyto Clinic device (the "Device"), for patient examination on behalf of Employer. Employer shall be responsible for payment to Cigna for the cost of the leased Device. An estimate of the cost to lease the Device is included in the Operating Budget. Employer shall also be responsible for the costs of all maintenance, repairs, parts or other items necessary for the functioning of the Device. 1. Services. Commencing on May 26, 2021, or such other date as may be mutually agreed to in writing by the Parties ("Virtual Health Center Commencement Date") and continuing for the Term, Cigna will operate and staff a Virtual Health Center at the Facility and provide or arrange for the provision of the Virtual Health Center Services ("Services") described below, for the benefit of Participants (as defined herein). The Services shall be rendered by medical provider(s) who shall be provided for or arranged for by Cigna ("Virtual Provider") through telemedicine interactive audio-visual communication with Participants. A Cigna Registered Nurse Health Coach ("Cigna Personnel") shall provide assistance making the appointment with the Virtual Provider, entering patient data and summary into the medical record and otherwise assisting with the telemedicine visits by initiating the call, assisting with the equipment and connection, obtaining vitals and assistance with use of peripheral medical equipment. The scope of Virtual Provider's services shall include the services set forth in herein. Virtual Provider shall not be required to provide any services, including those identified in herein, if in the Virtual Provider's medical judgment the services should not be provided through telemedicine in accordance with the standard of care. Employer understands and acknowledges that the Services shall be provided through Virtual Provider. Employer understands and agrees that Cigna shall not be required to provide the Services unless and until the Cigna has the Virtual Provider in place and available to perform. Should this not occur by the Virtual Health Center Commencement Date, Employer understands and agrees that Cigna will provide the Health Coach Services set forth below. Once Cigna has in place the required contract amendments, the Services shall be provided through Virtual Provider. Cigna will adjust/prorate the Operating Budget set forth in herein and will not charge Employer for Virtual Provider expenses during the period Cigna is providing Coach Services only. 06/02/2021 26 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 01 cn W Client Name: City of Miami Administrative Services Only Agreement a. Health and Wellness Services. Through this telemedicine model with Virtual Provider, Cigna will provide acute and episodic care and wellness visits. Additionally, the Cigna Personnel, under the supervision of Virtual Provider as applicable, shall provide the following services: b. Immunization Services. Cigna Personnel shall provide, or arrange for the provision of, immunizations, as agreed upon by the Parties, including: Annual flu. vaccinations, Hepatitis A & B Series, Tetanus & Pertussis (Tdap), Tetanus (Td), Tuberculosis (TB PPD) (Test), Pneumovax, Measles, Mumps, and Rubella (MMR) (under age 26), Human Papilloma Virus (HPV) (under age 26), Shingrix (age 50 and old), Travel immunizations (as needed at Client's request). Pediatric vaccinations are excluded, except for annual flu vaccinations for Pediatric Participants age nine and older. c. Monitoring Chronic Conditions. Cigna Personnel shall verify that Participants with chronic medical conditions have appropriate community primary care provider relationships and collaborate with primary care provider and specialist, as needed; refer Participants with chronic conditions to appropriate Employer telephonic and online wellness programs; and encourage health lifestyle habits that address the chronic condition. d. Laboratory Services. Cigna Personnel shall conduct laboratory testing onsite at the Virtual Health Center including: CLIA-waived testing (rapid testing); and specimen collection (blood draw station, urine collection, and collection of other specimens ordered by Virtual Provider or by community providers for pick up by contracted lab vendor). Results will be delivered to ordering provider. e. Biometric Screening. Cigna Personnel shall provide scheduled screenings that may include but not limited to; Height, Weight, BMI, Body Composition, Blood Pressure, Total Cholesterol, HDL Cholesterol, LDL Cholesterol, Coronary Risk Ratio, Blood Glucose. f. Lifestyle Risk Assessment. Cigna Personnel shall conduct lifestyle risk assessments; facilitate a discussion of health improvement and preventive care 06/02/2021 27 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 01cn Client Name: City of Miami Administrative Services Only Agreement opportunities; provide referrals and coordinate additional care for Participants, as required; and encourage Participant engagement in Employer -sponsored wellness programs (if any) as appropriate. g. Phauuacy. Cigna and Cigna Personnel shall make available to Participants as needed limited selection of first dose medications to treat acute aliments, if Cigna can reach agreement with Virtual Provider and do so in accordance with applicable law; and written prescription and/or e-prescribing by Provider, as allowed by law. h. Primary Care. Basic primary care performed in support of Participants' individual primary care physicians (excludes pediatric physicals). 2. Virtual Provider Scope of Services. In addition to the below, any additional conditions amenable to virtual treatment shall be based on the judgment of the Virtual Provider physician. Provider shall not provide virtual treatment for these or any other conditions if the provider believes in the provider's reasonable medical judgment that treatment cannot be provided within the standard of care. Injury Care (minor) Collaborating with patient's PCP Minor acute pain/strains Obtaining appropriate Labs Upper respiratory infection Ensure Evidenced -Based care is being provided to patients Sinus infection Closing Gaps in Care Ear infection Chronic Referring to appropriate Telephonic/Online programs Acute Episodes Sore throat Conditions Referring to Centers of Excellence and Preferred specialists (high quality/low cost) when needed Conjunctivitis Lifestyle and Behavioral modification to address conditions Urinary tract infection Diagnostics/ Individual biometric 06/02/2021 28 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement Screenings screenings/body fat analysis and subsequent Diagnoses ePrescribing/ Temp Med Refills Basic vision screening Wellness Review Cholesterol measurement / diagnosis Vaccinations, including: Diabetes screening / diagnosis Preventive Health - Flu Shots Testing/basic checks (CLIA- waived, `rapid' tests, or specimen collection for higher -level lab tests outsourced to preferred laboratories) including: - Immunizations (e.g., Tetanus) - glucose Diabetes Education/ Management Lab Services Cholesterol Medication Adherence - Rapid strep Weight Management - Pregnancy test Personalized Smoking Cessation - Urine dipstick (UTI) Coaching Stress Management - Phlebotomy blood draw as required Other - Covid-19 Diagnostic Testing 3. Health Coach Services. The following health coaching and wellness promotion services ("Health Coach Services") will be provided by the Cigna Personnel for eligible Participants as follows: Nutrition a. Establish nutritional health goals collaboratively; 06/02/2021 29 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 01cn Client Name: City of Miami Administrative Services Only Agreement b. Collaboratively (Participant and Cigna Personnel) establish coaching for a duration and at a frequency based on the coaching plan; and c. Deliver topic -specific education and referrals, as needed. Physical Activity a. Establish coaching duration and frequency collaboratively between Participant and Cigna Personnel based on the coaching plan; and b. Deliver topic specific education and referrals, as needed. Wellness Education and Referrals For: a. Prevention; b. Women's issues (includes menopause, infertility); c. Children' s health issues (includes the importance of vaccines, healthy eating, exercise, etc.); d. Men's health; e. Sleep; f. Stress; g. Weight; h. Other health topics and concerns; and i. Collaboratively (Participant and Health Coach) establish coaching for a duration and at a frequency based on the coaching plan. High Blood Pressure: 06/02/2021 30 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 01cn Client Name: City of Miami Administrative Services Only Agreement a. Establish blood pressure reduction goals collaboratively (Participant, Physician and Health Coach); b. Collaboratively (Participant and Health Coach) establish coaching for a duration and at a frequency based on the coaching plan; c. Deliver condition -specific education and referrals, as needed; and d. Identify any Gaps in Care ("GIC") and educate and assist in closing the GICs. High Cholesterol a. Establish cholesterol reduction goals collaboratively (Participant, Physician and Health Coach); b. Collaboratively (Participant and Health Coach) establish coaching for a duration and at a frequency based on the coaching plan; c. Deliver condition -specific education and referrals, as needed; and d. Identify any GIC and educate and assist in closing the GICs. Maternity a. Education on and referrals to Health Pregnancy/Healthy Baby program (if purchased by Employer) or Healthy Babies; b. Education on the importance of prenatal care; c. Leverage clinical guidelines used in existing programs; and d. Coordinate with a lactation consultant. Benefits Navigation 06/02/2021 31 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 01 e, co Client Name: City of Miami Administrative Services Only Agreement a. Deliver basic information concerning benefit resources and tools to maximize benefits, including cost and quality tools, mycigna.com resources, etc.; b. Refer to Employer Human Resources contact for detailed plan questions, concerns, and issues requiring escalation; c. Education and referrals to plan clinical programs (internal and external); and d_ Assist employees with health care professional referrals, (e.g., primary care physician or specialist referrals in the Cigna network). Wellness Promotion. Cigna Personnel shall support onsite wellness promotion events and activities for Employer employee population, as agreed upon by the Parties (i.e. completing health risk assessments, group seminars, etc.). 4. Participants. Participants are individuals who are eligible to receive Clinical Services at the Virtual Health Center in accordance with this Agreement as determined by the Employer including: Employer's full-time and part-time employees; dependents of Employer employees age six (6) years and older; spouses of Employer employees; retirees of Employer under age 65 who are on Employer's health benefit plan; and former employees entitled to Clinical Services as Participants under the Consolidated Omnibus Budget Reconciliation Act (COBRA). 5. Health Center Days and Hours of Operation. The Virtual Health Center will operate forty (40) hours per week, Monday, Wednesday, and Friday from 7:30 a.m. until 4:30 p.m. and on Tuesday and Thursday from 9:00 a.m. until 6:00 p.m. ("Virtual Health Center Operating Hours"). The Parties may change Days and Hours of Operation from time to time, as mutually agreed in writing. Electronic communication is deemed acceptable for such written agreement. 6. Virtual Health Center Closure. The Virtual Health Center will be closed on inclement weather days as determined by Employer, and on Cigna recognized holidays, including: New Year's Day, Martin Luther King Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, day after Thanksgiving, and Christmas Day. The Virtual Health Center may 06/02/2021 32 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 01cn Client Name: City of Miami Administrative Services Only Agreement be closed during Cigna Personnel vacancies as further described herein. 7. Virtual Health Center Utilities and Services. Employer shall, at its sole expense, provide the following services and utilities necessary to the operation of the Virtual Health Center. a. Telephone Services. Employer shall furnish a telephone system, that includes hardware and phone and fax vendor services for provision of the telephone solution. b. High Speed Internet Access. Employer shall ensure there are High Speed Internet services available to the building and extended to the Virtual Health Center. A minimum of 20 Mbps Down / 20 Mbps Up bandwidth to enable the Cigna Personnel to access the data tracking documentation and reporting system throughout the worksite and any other expanded services that require bandwidth. If no internet service providers have services established to the building or if services are not adequate to support the Virtual Health Center due to stability issues, Employer shall: Be responsible for all costs associated with establishing service to the building and installation of the line, including but not limited to trenching, wiring, materials and labor charges; or — Provide connectivity to the Employer network and supply two (2) Public JP addresses. c. IT Resource for Internet Troubleshooting. Employer and Cigna shall identify IT resources to work collaboratively to: - Prior to engaging Employer, Cigna will exhaust all troubleshooting activities on Cigna system and vendor services; - Employer will assist in coordination with the internet service provider to resolve issues at the Virtual Health Center; - Acknowledge notice of the issue within one (1) hour; and 06/02/2021 33 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 0) 0 0 Client Name: City of Miami Administrative Services Only Agreement - Be available within a three (3) hour timeframe after acknowledgement, provided the timeframe is during normal business hours of the Employer. Employer shall not be responsible to support Cigna's network, hardware, and other user 1 T equipment. d. Utilities, Services and Supplies. Employer shall provide the following: — adequate heating, ventilation, and air conditioning to maintain conditions and temperatures appropriate for the operation of the Virtual Health Center during Virtual Health Center Operating Hours; - hot and cold running water; restroom facilities and supplies for use by Cigna Personnel and Participants; - electricity adequate for computer systems, lighting, normal office use and heating and air conditioning; - air conditioning adequate for computer systems within Location of IT wiring closet; - lighting, and replacement of standard lamps when necessary; - pest control and extermination services in accordance with LEED standards; - cleaning and janitorial services each day the Virtual Health Center is open that meet safety and exposure control requirements of Occupational Safety and Health Regulations, including those relating to slip/trip/falls, blood home pathogens and toxic and hazardous material. Such cleaning and waste removal must be adequate to minimize or eliminate risk to Cigna Personnel and Participants from germs, unsanitary conditions and blood borne pathogens. Employer agrees to require janitorial service to comply with Cigna specifications for cleaning; 06/02/2021 34 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement - adequate security services for the Virtual Health Center and Facility and common areas around the Facility, including fire and burglar alarm devices and guard protection. - smoke detectors and fire extinguishers in the Virtual Health Center and elsewhere in the Facility. Employer shall also provide for the period maintenance and annual inspection of the Facility fire alarm system; - adequate parking spaces as available for Cigna Personnel at no charge to Cigna or the Cigna Personnel; - service availability contingent on construction timeframe deliverable. Employer shall provide a detailed timeline on constructions activities and completion dates; and - telephone services. 8. Term. The initial term of this Agreement ("Initial Term") shall begin on the Virtual Center Commencement Date and shall continue for a period of thirty-six (36) months. After the Initial Term, Employer has the option to renew for three (3) additional subsequent twelve (12) month terms by providing Cigna with ninety (90) days' prior notice of intent to renew (each a "Renewal Tenn"). The Initial Term and any Renewal Terms shall constitute the "Term" of the Agreement. This subsection is subject to the termination rights set forth elsewhere in. this Agreement. Notwithstanding the above, the Initial Term shall not be longer than the term or extended term of Cigna's agreement with the Virtual Provider. 9. Termination. For Cause. Either Party may terminate this Agreement by written notice to the other Party if the other Party materially breaches this Agreement and does not cure such breach to reasonable satisfaction within sixty (60) calendar days after receiving a written notice of breach. Unless the breach has been cured, the termination is effective on the sixty-first (61 st) calendar day after the breach notice is received. 06/02/2021 35 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 0) Client Name: City of Miami Administrative Services Only Agreement 06/02/2021 For Convenience. This Agreement may also be terminated without cause by either Party, in its entirety or with respect to a specific Facility, at any time after the first twelve months of the Initial Term by providing ninety (90) days' written termination notice to the other party. Such termination is effective on the ninety-first (91st) calendar day after the notice is received by the other Party. When terminating the Agreement for convenience, Employer shall pay a "Severance Fee" to Cigna in an amount equal to the actual severance obligation owed by Cigna to Cigna Personnel as of the date such termination of this Agreement is effective. The Severance Fee will be reduced to the extent that Cigna can recoup costs by successfully redeploying Cigna Personnel to a similar position within Cigna. Employer shall remain liable for any Operating Expenses incurred prior to the date of termination. For Financial Instability. This Agreement may also be terminated if either Party becomes insolvent, by providing ten (10) days' notice to the other Party provided that such termination shall be deemed effective as of the date said notice is delivered. 10. Operational Expenses. Cigna will use the attached Operating Budget as the projected budget for Operational Expenses (Salaries and Benefits, Supplies, Other Direct Expenses, System Expenses) and Other Infrastructure Costs, estimated Implementation Costs and Management Fees related to the Virtual Health Center Services for the Initial Term. The Operating Budget may be modified based on any change in the Virtual Health Center Commencement Date, delay in providing a compliant Facility to house Virtual health Center, or modification of services requested by the Employer, as mutually agreed upon by the Employer and Cigna. Cigna shall use its best efforts to manage all Total Operational Expenses to those amounts listed in the Operating Budget. Employer acknowledges that said Operating Budget constitutes Cigna's good faith projection of anticipated operating costs and expenses for the Virtual Health Centers. Employer understands and acknowledges that the Operating Budget may change, based upon the volume of Participants seen at the Virtual Health Centers, charges by Virtual Provider, Cart maintenance and repairs, and other factors, such as a change in Cigna Personnel with respect to level of professional licensure or salary. Cigna agrees that prior to making any changes to the scope of services or delivery of care strategies that may materially impact the budget, Cigna will discuss such changes with the Employer and obtain prior approval. 11. Payment. Employer shall pay and reimburse Cigna for the following as listed in the 36 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement Operating Budget. In the event that Employer requests permanent additional clinical and/or administrative personnel to provide the Services at the Virtual Health Center or other services, the cost of which will exceed the estimates set forth in the Operating Budget, Employer shall pay to Cigna, in addition to all Management Fees and Operational Expenses, an amount equal to the additional expenses incurred in connection with the additional Services ("Additional Resource Charges"). In addition, Employer shall reimburse Cigna for all Virtual Provider -related charges, maintenance and repair costs, all which shall be paid by Cigna and passed through as expenses to Employer for Employer reimbursement. Employer shall also reimburse Cigna for any Additional Resource Charges incurred under this Scope of Services. Payments shall be sent to: Evernorth Direct Health, LLC, A Cigna Company, 25600 North Norterra Drive, Phoenix, AZ 85085. 12. Invoicing Procedures. On or before the 20th day of each month, Cigna will issue to Employer an invoice for Fees, Operational Expenses, Implementation Costs and Additional Resource Charges (collectively, "Virtual Health Center Fees") due and owing for Virtual Health Center Services perfotuied during the preceding month. Employer shall pay Cigna's affiliate within forty-five (45) days of receipt of an invoice for Virtual Health Center Fees_ Invoice charges for supplies shall reflect actual amounts billed to Cigna from the supply manufacturer/vendor and shall not be adjusted for any rebate Cigna may receive from an affiliated Group Purchasing Organization. 13. Renewal Terms. Sixty (60) days prior to the expiration of the Initial Term of the Agreement, Cigna shall present to Employer a proposed Operating Budget for the Virtual Health Center for any Renewal Term, and Employer and Cigna shall mutually agree on such Operating Budget. Thereafter during any Renewal Teixu of the Agreement, sixty (60) days prior to the expiration of the Renewal Term, Cigna shall present to Employer a proposed Operating Budget for the Virtual Health Center for the upcoming Renewal Term, and Employer and Cigna shall mutually agree on such Operating Budget. 14. Cigna Staffing. Cigna shall recruit, interview, engage, hire, supervise and discharge all Cigna Personnel needed to assist Virtual Provider with providing the Clinical Services. All employment related decisions, including but not limited to hiring, firing, and perfoiuiance management, shall be at the sole discretion of Cigna and not Employer. Such Cigna Personnel shall in all events, and for all purposes, be employees or subcontractors of Cigna 06/02/2021 37 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 0) Client Name: City of Miami Administrative Services Only Agreement 06/02/2021 and not Employer. Cigna shall comply with all federal, state and local laws regulations and requirements relating to such employees and subcontractors. Cigna, and not Employer, shall be fully responsible for the payment of all salaries, wages, payroll and other compensation, taxes, fees, workers compensation insurance and other charges or insurance levied or required by any federal, state, or local law, regulation or ordinance relating to the employment of the Cigna Personnel. Cigna, and not Employer, shall be solely responsible for determining salaries, bonuses, and other compensation of Cigna employees and subcontractors. 15. Use of Subcontractors. Cigna may use third party vendors contracted with Cigna, its Affiliates, for supplies and equipment without Employer' s prior written consent, e.g. pharmacy providers, temporary labor, and laboratory service providers. 16. Cigna Personnel Performance. In the event that Employer is dissatisfied with the performance of any Cigna Personnel, or asserts that any Cigna Personnel has engaged in misconduct as defined by Employer or has materially failed to perform the Services in accordance with the Agreement, Employer shall so advise Cigna immediately and provide in writing the facts necessary to validate the concern or complaint. Cigna shall promptly consult with Employer as to the nature of the conduct complained of and the severity of Employer's dissatisfaction, and shall endeavor to resolve such issues to the satisfaction of Employer provided such resolution is non-discriminatory and otherwise legal. Employer acknowledges and agrees that the policies and procedures of Cigna or its Affiliates as to the performance shall govern, including any confidentiality requirements contained therein. Employer agrees, where necessary, to cooperate with Cigna in conducting any investigation or inquiry, and in providing documentation and testimonial support in event of litigation concerning Cigna Personnel misconduct or failure to perform. 17. Independent Contractors. The Parties are independent contractors, and no Party is or shall represent itself as having, and nothing in this Agreement shall be construed as creating between the Parties, a relationship as employer -employee, partners, principal -agent, joint ventures, or any relationship other than that of independent parties. 18. Provision of Services at Virtual Health Center. Clinical Services may only be provided by Virtual Provider with the assistance of Cigna Personnel, or any other professional 38 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 0) 01 01 Client Name: City of Miami Administrative Services Only Agreement provided by or arranged for through Cigna. Employer employees and contractors shall not be allowed to provide Clinical Services or any other health care services at the Virtual Health Center even if they are licensed to do so. 19. No Co -Employment. All Cigna Personnel performing Services hereunder shall work under Cigna's supervision, provided, however, that the Cigna Personnel and Virtual Providers shall exercise independent professional judgment within the scope of their professions. Due to their status as contractor and not employee of Client, no Cigna Personnel shall be entitled to any employer fringe benefits. 20. Virtual Health Center Staffing. Cigna shall provide or arrange for the provision of one (1) full-time Registered Nurse who will assist with telemedicine visits with Virtual Provider and who will also act as a Health Coach ("Cigna Personnel"). Full -Time is defined as regularly working a forty (40) hour week. Employer acknowledges and agrees that, in addition to Cigna Holidays, as defined herein, Cigna Personnel shall be entitled to paid time off ("PTO") and Leave in accordance with applicable law and policies of Cigna or its Affiliates, or applicable contract between Cigna Personnel and Cigna. PTO and Leave shall include vacation days, personal days, sick days, military leave, family medical leave (FMLA), caregiver leave, disability leave, and other leave in accordance with applicable law or Cigna policy. The number of days of PTO is the same applicable to all employees of Cigna and its Affiliates but may vary based on the job level and number of years of employment with Cigna, and will be prorated for part-time work status. Cost of such PTO and Leave is included under the "Salary & Benefits" component listed in the Operating Budget. For any independent contractors that may be used, the number of days of PTO shall be defined in the contract between Cigna and applicable agency or individual. If Cigna Personnel is expected to take Paid Time Off or Leave or there is otherwise an inability to provide Services that is to be expected to be in excess of ten (10) business days ("Vacancy"), Cigna will inform Employer of such Vacancy, and will determine in consultation with Employer if the position will be temporarily staffed. In the event that Employer elects to have such position filled on a temporary basis, Employer shall so notify Cigna in writing. Cigna shall use best efforts to secure temporary labor to fill Vacancies 06/02/2021 39 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 0) Client Name: City of Miami Administrative Services Only Agreement within a reasonable amount of time. Employer shall be responsible for payment of temporary labor costs. Employer will remain responsible for the payment of the costs for the Cigna Personnel that has taken Paid Time Off or Leave. The health center will be closed and no onsite services will be provided if the Cigna Personnel is absent and there is no temporary or substitute labor. However, customers needing coaching will be directed to Cigna's telephonic coaching program, and customers needing medical services may utilize the Cigna Telehealth Connection services. Cigna shall not reduce the Compensation/Fees set forth in the Operating Budget for any absence of Cigna Personnel due to the following: PTO, sick time or short teen disability leave under the then current Cigna policies; closure of the Employer's work site within which the Cigna Personnel provides services under this Agreement, due to Employer or other reasons beyond Cigna's control such as inclement weather, pandemic, acts of nature, or actus of the public enemy; or short teiiu disability or caregiver leave for which the Cigna Personnel is paid. 21. Non -Solicitation. During the tern of this Agreement, and for a period of one (1) year after expiration or termination of this Agreement for any reason, Employer shall not directly or indirectly, alone or in concert with others, solicit or entice an employee or independent contractor engaged by Cigna to provide services under this Agreement, to leave the. employment or engagement of Cigna in order to provide substantially similar services as those provided in this Agreement, to or on behalf of Employer, or to otherwise work in competition with Cigna. Should there be a termination of this Agreement and Employer desires to have a Cigna Personnel work for Employer or another health center vendor or otherwise serve in a similar capacity to benefit Employer within one (1) year following termination of this Agreement, Employer agrees that it shall reimburse Cigna all severance costs Cigna has paid to any and all Cigna Personnel resulting from a termination of this Agreement. 22. Indemnification. Section 11, Indemnification, of the ASO agreement applies to the Amendment as revised herein. Operating Budget: 06/02/2021 40 98E9686 dd2i uo!lepo!Iog INVVZ:6 17Z0Z/OZ/2 Client Name: City of Miami Administrative Services Only Agreement Evernorth Direct Reath, LLC, A Cigna Company Cost Projection Prepared for: City of Miami (FL irutual Standalone Projection valid thru: 513112021 Estimate for -Mee Rill Years EVER 0 IIMISSIIMaal3SPERE Participants: -Eligible far Access LOCO 1,6130 1,000 Potential Visits 2,500 2,M0 2,500 Penetration Rate 30.0% 375% 4511% Prolected Preventive/Acute Care Visits 759 937 1,126 l-1E`s ,Coach -Registered Name Tong ICs Salaries & Benefits Supplies Provider Services Concierge Practice Fee Per visit cost Other Direct Expenses System Expenses tea f.:::.';141:51!0111W7.10r72:23EFEWE 1.1111 1M 1.00 1170 123.-000 120,000 11300 21,000 21,080 21000 20,000 20,00g 61,600 73,000 12,000 12,DX) 32,000. 32,000 IT-410C60406641**0011*Stinf41CNIMiaagifigNEGREMEINSM000g:HIMMENEERNII;27.4.6.0VOliMigOVERiligIN1290,100: itiffaStflidliM Cost& Management Fee 20,000 49,001 1;44990 32,026 2zaria 1/ pop 37,0.01:•ifot OfiltiowilillainTaiNEMEREGRaligiumegamanoco•gGSORNME4111111116111414130;000:MINE-ggnin4A;306911 25,000 10,026 26,drid 10,006 WelPnwvinnatceotertostadnute:iEmonnti11•106.1,7K lEcarilaterilmigatent0TenlPeateniV,VMMPV442igijIlac.41.el;11.091 ' .1,-....,lit,t,';$311.,ltffli;„.§1MITAffdlEMPRA17;HiFEVinOilS29;6(1671 Pktip-A3c01:0441retfZ(WO!**'ito:0011:F.010,1NA,MEMIMIRK-40(0011:Mialr11,1,1,111,11,1Wilim„orwavgamimiiiipaRe)ia;lokono,, 171171WslotX4mtti*ON@tgtPlaq.412t...0.1i. ..--.1tabreaMIMMIE326.4g2_..anigaimiiifilasw.;054-atiggslamszpolglo714e0l Assumptions 1) The facility is staffed as inthcated I1,e PIE seobors above 2) Full-time is noritidwert to 0e 4.11 flours par week and represented by /Me FTE, temp tabor is provided Panetration 15 modeled to increase at 7-516 per year bp to 13E196 4) Marketing For communications tolhose eagbla tor access to the jbe Es planned at /inefil in year one and $25013 the farming yews 5) Recrukrnent cost for _Zed is projected at *5 jin kennel klarkefing & any a:dermal recruaroent expense:a are peas taro, client not /Abed ortteee incurred_ 6) Does .rtni include the con cf Maity handout 7) Does cot include the cost ci lease 6) Assumes 50% of e5gffete participants receive a go atmt in the dello 0) External lab vendor milt stilank a claim- 15j Corporate rtotlioo of fileoffdoe taw and Mate telernanicine regale may rmed ka be mArievead_ MM.-scat charges tray oppry for compLance. 1113 The cost to coritra for practiRoner to deliver service vathin the faa may hie higher or lower than proiacted. actuat casks are passed thrtmgfit. 12) High Spam& must Ire caraible to the trading =el extended to demo, eattin vendor sernoe citelance re-ritnemertle. connectivity far letemetaDSE/Telephone secs could apply ,brie cannot use cliereVs existing serirce— providers. 06/02/2021 41 !wewup 92£9621•dd uo!lelPloS WH iZ:6 17ZOZ/OZ/8 0) rn CO Client Name: City of Miami Administrative Services Only Agreement U,ba+� .fl.di iml y S'Y Health Improvement Fund For clinical/wellness/behavioral programs offered by CHLIC that are purchased, CHLIC will establish a Health Improvement Fund in the amount of $200,000.00. This fund will be used to defray the cost of CHLIC designated and arranged health and wellness improvement programs (e.g. biometric screenings, flu shots) for Employees of Employer and to reward participation in these programs. The Health Improvement Fund is a one-time credit to be used from January 1, 2021- December 31, 2021. Unused funds cannot be rolled over and CHLIC must pre -approve use of the Health Improvement Fund. The Health Improvement Fund shall be extinguished upon teiuiination of this Agreement and any fund amount not used prior to termination of this Agreement shall only be available to Employer for the purpose of funding the cost of those reimbursable services provided prior to such termination. 06/02/2021 42 98E9686 dd2i uogepo!Iog City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement CIGNA IIEALTIICARE OF ARIZONA - CIGNA MEDICAL GROUP (CMG) REPRESENTATIVE RATES FOR ROUTINELY PERFORMED MEDICAL SERVICES EFFECTIVE JANUARY 1, 2020 (Applicable to Network and Network POS Products) All Departments Adult Medicine Pediatrics Ophthalmology Podiatry Ra.diolog Radiology General Surgery Optometry ASC (Ambulatory surgical center) / Endoscopy Suite ASC Endoscopy Suite 99213 99396 99392 66984 11721 71046 77067 & 77063 47562 92014 Grouper 2 Grouper 8 OFFICE VISIT,EST EXP PROB FOC WELL EXAM, EST, 40-64 YEARS WELL EXAM, EST, 1-4 YEARS REMOVE CATARACT, INSERT LENS - Professional Fee only, at a facility DEBRIDEMENT NAIL SIX OR MORE CHEST X-RAY, PA & LAT SCREENING MAMMOGRAPHY DIGITAL LAPAROSCOPY;CHOLECYSTECTOMY- Professional Fee only, at a facility EYE EXAM & TREATMENT $95.41 $1.49.26 $124.36 $1,015.00 $57.93 $43.54 $278.56 $1,012.30 $158.56 $469,00 $1,104.00 * Medicare does not assign (or may not yet have assigned) relative value units (RVUs) for certain service codes. Codes not valued by Medicare are referred to as "gap codes." For example, Medicare does not assign values for wellness service codes (99381-99397). CMG refers to The Essential RBRVS (Annual) guide to obtain relative values for such gap codes for billing purposes. Typically, Cigna pays CMG for gap codes not valued by Medicare either at the discounted fee schedule referenced above or, for new codes not yet valued by Medicare, at the same rate it pays its other participating providers. The Urgent Care case rate excluding radiology and laboratory services is $135. CMG pharmacy rates: Brand Name: 30-day supply: AWP— 10.56% + $2.75 dispensing fee 90-day supply: AWP —17.91% + $1.50 dispensing fee Generic*: 30-day supply: AWP — 35% + $2.75 dispensing fee 90-day supply: AWP - 21% + $1.50 dispensing fee * If MAC pricing is available for generic medication, rate is MAC + dispensing fee 06/02/2021 43 8/20/2024 9:24 AM p. 469 WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement Appendix A — Pharmacy Benefit Management Services 1' F1TMGF1 Definitions Any capitalized term not defined below shall have the meaning given to such tear. in the Agreement. Any capitalized term utilized in the Schedule of Financial Charges or Exhibit B shall have the meaning given to such term in the Agreement, including the meanings set forth below. • "Actuarially Estimated" shall mean that the discount(s) listed in the Schedule of Financial Charges are estimated, but not guaranteed, to result in a particular average discount for Covered Drugs administered by CHLIC under this Agreement. Actuarially estimated discounts are calculated based on evaluation of an expected distribution of drug utilization across CHLIC's aggregate group client book of business. As measured in the aggregate for Employer's Pharmacy Benefit, Employer's average discount results may vary based on the Plan -specific factors such as drug mix utilization. "Authorized Generic" shall mean a pharmaceutical product sold, licensed, or marketed under a new drug application (NDA) approved by • the Food and Drug Administration (FDA) under section 505(c) of the Federal Food, Drug and Cosmetic Act (FFDCA) that is marketed, sold or distributed under a different labeler code, product code, trade name, trademark, or packaging (other than repackaging the listed drug for use in institutions) than the innovator brand name drug. • "Average Wholesale Price" or "AWP" shall mean the average wholesale price of a Covered Drug as established and reported by Medi- Span. The applied AWP of a Covered Drug shall be the AWP for the actual eleven (11) digit National Drug Code ("NDC"), Covered Drug specific, quantity appropriate actual package size (or the manufacturer -packaged quantity closest to the dispensed size), submitted by a Retail Pharmacy, Home Delivery Pharmacy, or Specialty Phannacy at the time that the Covered Drug is adjudicated. Notwithstanding any other provision in this Agreement, in the event of any major change in market conditions affecting the pharmaceutical or pharmacy benefit management market, including, for example, any change in the markup, methodologies, processes or algorithms underlying the published AWP(s), CHLIC may adjust any or all of the Rebates, charges, rates, discounts, guarantees and/or fees in connection with CHLIC's administration of the Pharmacy Benefit hereunder, including any that are based on AWP, as it reasonably deems necessary to preserve the economic value or benefit of this Agreement to CHLIC as it existed immediately prior to such change. Additionally, and notwithstanding any other provision in this Agreement, CHLIC may replace AWP as its pharmaceutical pricing benchmark with an alternative benchmark and/or may replace Medi-Span, or other such publication, as its source for the AWP or alternative benchmark with a different pricing source, provided that CHLIC adjusts any or all such AWP-based charges or such alternative benchmark -based charges as it reasonably deems necessary to preserve the economic value or benefit of this Agreement to CHLIC as it existed immediately prior to such replacement or immediately prior to the event(s) giving rise to such replacement, as the 06/02/2021 44 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement • case may be. "Biosimilar" shall mean a biological product that is licensed by the FDA as a biosimilar pursuant to Section 351(k) of the Public Health Service Act, 42 U.S.C. 262(k), based upon a showing that it is highly similar to a single FDA -licensed biological product, known as a reference product, and has no clinically meaningful differences compared to the reference product in teiuis of safety, purity, and potency. A biosimilar biological product may be licensed by the FDA as biosimilar or interchangeable, and in either case such biological product is a Biosimilar for the purposes of this Agreement. • "Brand Drug" shall mean a pharmaceutical product, including a Covered Drug that is a prescription drug, including over-the-counter drugs dispensed pursuant to a prescription, medicine, agent, substance, device, supply or other therapeutic product that is not a Generic Drug. Except if and where the language expressly states otherwise, a Brand Drug does not include a Specialty Brand Drug for ingredient cost discount purposes. • "Business Decision Team" shall mean a committee comprised of voting and non -voting representatives across various Cigna business units such as clinical, medical and business leadership that is duly authorized by Cigna to make decisions regarding coverage treatment of pharmaceutical products based on clinical findings provided by the P&T Committee, including, but not limited to, decisions regarding tier placement and application of utilization management to pharmaceutical products. • "Cigna Home Delivery Pharmacy" shall mean a duly licensed pharmacy operated by CHLIC or its affiliates, where prescriptions are filled and delivered via the mail service, which may include, for example, Accredo Health Group, Inc., ESI Mail Pharmacy Service, Inc., Express Scripts Pharmacy Inc., Tel -Drug of Pennsylvania LLC and Tel -Drug, Inc. • "Claim," for purposes of this Appendix A, is a claim or request for coverage under the Pharmacy Benefit. • "Compound Drug" shall mean a medication that (a) is comprised of two or more gaseous, solid, semi -solid, or liquid ingredients (other than water or flavoring added to any preparation) that are weighed or measured at a pharmacy and then prepared according to the prescriber's order and the pharmacist's art; (b) contains at least one FDA -approved federal legend drug as an active ingredient; (c) is not otherwise generally available in its compound form; and (d) is not a compound preparation administered by infusion or injection. • "Covered Drugs" shall mean prescription drugs, including over-the-counter drugs dispensed pursuant to a prescription, biologics, medicines, agents, substances, devices, supplies, and other therapeutic products that are prescribed for Members and are covered under the Pharmacy Benefit and shall include all associated standard services usually and customarily rendered by a pharmacy or provider in the normal course of business, including dispensing, administration, counseling and product consultation. 06/02/2021 45 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement • "Dispensing Fee" means an amount paid to a pharmacy for providing professional services necessary to dispense a Covered Drug to a Member. • "FDA" shall mean the U.S. Food and Drug Administration. • "Fointulary" shall mean the list of FDA -approved prescription drugs and supplies developed and managed by CHLIC across its self - funded and insured group book of business and that is selected and adopted by Employer. The drugs and supplies included on the Formulary will be modified by CHLIC from time to time as a result of factors including, but not limited to, economic and clinical factors like clinical appropriateness, manufacturer Rebate arrangements and patent expirations. Any changes CHLIC makes to the Formulary are hereby adopted by Employer. • "Generic Drug" means a pharmaceutical product, including a Covered Drug, whether identified by its chemical, proprietary, or non- proprietary name, that is accepted by the FDA as therapeutically equivalent and interchangeable with drugs having an identical amount of the same active ingredient(s), and which is identified as such in CHLIC's master drug file using indicators from First Databank, Medi- Span, or other nationally recognized source as used by CHLIC across its book of business on the basis of a proprietary algorithm, a summary of which may be made available for review by Employer or, subject to CHLIC's consent, its auditor upon request in accordance with the tennis set forth in this Appendix A. Employer and, as applicable, its auditor shall sign a confidentiality agreement acceptable to CHLIC relating specifically to such summary. The reference to a drug by its chemical name does not necessarily mean that the product is recognized as a generic for adjudication, pricing or copay purposes. Except if and where the language expressly states otherwise, a Generic Drug does not include a Specialty Generic Drug for ingredient cost discount purposes. For pricing purposes, a Generic Drug includes a Covered Drug that is otherwise identified as therapeutically equivalent and interchangeable with drugs having an identical amount of the same active ingredient(s) and is within its exclusivity period or other period of limited competition; provided that, notwithstanding the foregoing, a Generic Drug excludes an Authorized Generic identified as a brand name drug by the aforementioned proprietary algorithm used by CHLIC. For pricing purposes, a Generic Drug also excludes a Biosimilar. • "Maximum Allowable Charge" shall mean the maximum unit price for a Covered Drug included on the applicable MAC List as set forth on such MAC List. • "MAC List" shall mean a then -current list maintained by CHLIC of prescription drugs, devices, supplies and over-the-counter drugs identified as readily available as a Generic Drug or generally equivalent to a Brand Drug (in which case it may also be on a MAC List) and that, in each case, are deemed to require or are otherwise capable of pricing management due to the number of manufacturers, utilization and/or pricing volatility. "Manufacturer Administrative Fees" shall mean administrative fees paid by pharmaceutical manufacturers to CHLIC or its affiliate or 06/02/2021 46 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement subcontractor directly in connection with administering, invoicing, allocating and collecting Rebates. • "Pharmacy Benefits" shall mean amounts payable for covered pharmacy benefit services and products under the terms of the Plan; Pharmacy Benefits shall be considered Plan Benefits for purposes of this Agreement. • "P&T Committee" shall mean a committee comprised of clinicians that represent a range of clinical specialties. The committee regularly reviews pharmaceutical products, new pharmaceutical products, for safety and efficacy, the findings of which clinical reviews inform coverage status decisions made by the Business Decision Team. The P&T Committee's review may be based on consideration of, without limitation, FDA -approved labeling, standard medical reference compendia, or scientific studies published in peer -reviewed English -language bio-medical journals. • "PBM Proprietary Infounation" shall mean information relating to CHLIC's pharmacy benefit management products and services, including, without limitation, CHLIC's reporting and web -based applications, eligibility and adjudication systems and coding methodologies, system formats and databanks, clinical or formulary management operations or programs, information and agreements relating to Rebates and other financial information, prescription drug evaluation criteria and coverage policies, drug pricing information, including MAC List and Specialty Drug pricing, paid Claims information integrated into CHLIC's adjudication systems, and pharmaceutical manufacturer, vendor or pharmacy network agreements. • "Prescription Drug Charge" shall mean the amount that, prior to application of the Plan's cost -share requirement(s), Employer is obligated to pay for a Covered Drug dispensed at a Retail Pharmacy or Cigna Home Delivery Pharmacy, including any ingredient cost, applicable Dispensing Fee, service fee, and tax. The ingredient cost charged to Employer may be expressed as, for example, a discount off of AWP or other benchmark price, or a MAC. • "Rebate" shall mean retrospective formulary rebates received by CHLIC pursuant to the terms of a formulary rebate contract negotiated independently and directly attributable to or arising from the utilization by Members of certain Covered Drugs manufactured, sold, marketed, or distributed by a manufacturer. However, "Rebates" shall exclude: (i) pricing adjustments, payments and credits made in the ordinary course by any manufacturer on account of product returns, delivery errors or shipping damage or losses arising from drugs and other products purchased from such manufacturer by or on behalf of CHLIC (ii) pricing discounts paid or credited by a manufacturer to pharmacies affiliated with CHLIC for prescription drugs and other products purchased from such manufacturer; (iii) any fees or other compensation paid by any manufacturer in consideration of any services, products, activities or programs performed, provided or implemented by CHLIC or any of its affiliates for such manufacturer; (iv) Manufacturer Administrative Fees; (v) Value -Based Payments; (vi) any rebates or other amounts that are allocated to reduce and/or partially or wholly satisfy a Member's cost -sharing obligation for a Covered Drug; and (vii) rebates or other 06/O2/2021 47 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 CIient Name: City of Miami Administrative Services Only Agreement amounts paid to CHLIC for prescription drugs that are administered or otherwise provided to Members in providers' offices, home health care settings, or outpatient clinics. • "Retail Pharmacy" shall mean any licensed retail pharmacy with which CHLIC has contracted directly or indirectly with a third party, to provide Covered Drugs to Members, and is not a mail order pharmacy. A mail order pharmacy is a pharmacy that primarily fills and delivers pharmaceutical products via the mail service. The term "Retail", when immediately preceding the term "Brand Drug Claim", "Generic Drug Claim", "Specialty Drug Claim", "Specialty Brand Drug Claim", or "Specialty Generic Drug Claim" means that the resulting term (e.g., "Retail Brand Drug Claim") refers to such claim as dispensed by a Retail Pharmacy. • "Specialty Drug" shall mean a pharmaceutical product, including a Covered Drug, considered by CHLIC to be a Specialty Drug based on consideration of the following factors: (i) whether the pharmaceutical product is prescribed and used for the treatment of a complex, chronic or rare condition; (ii) whether the pharmaceutical product has a high acquisition cost; and, (iii) whether the pharmaceutical product is subject to limited or restricted distribution, requires special handling and/or requires enhanced patient education, provider coordination or clinical oversight. A Specialty Drug may not possess all or most of the foregoing characteristics, and the presence of any one such characteristic does not guarantee that a pharmaceutical product will be considered a Specialty Drug. The term "Specialty," when immediately preceding the terms "Generic Drug" or "Brand Drug", means that the resulting term (e.g. "Specialty Generic Drug") refers to a Generic Drug or Brand Drug that is considered a Specialty Drug, respectively. • "Specialty Pharmacy" shall mean a duly licensed pharmacy designated by or operated by CHLIC or its affiliates that primarily dispenses Specialty Drugs or provides services related thereto; provided, however, that when the Cigna Home Delivery Pharmacy dispenses a Specialty Drug, it shall be considered a Specialty Pharmacy hereunder. • "U&C Charge" shall mean the price the applicable Retail Pharmacy would charge a regular cash -paying customer for a Covered Drug (and any services related to the dispensing thereof) on the day on which the Covered Drug is dispensed. , M C"Y BENEFIT 1. Retail Pharmacy Network. (a) General. CHLIC shall maintain a Retail Pharmacy network. Retail Pharmacies included in the network shall provide Covered Drugs to which the Retail Pharmacies have access to Members during their normal business hours. A list of the Retail Pharmacies included in the network, as updated from time to time, shall be made available to Members online. CHLIC maintains multiple networks and/or sub -networks and may periodically consolidate networks and/or migrate clients, including Employer, between networks and sub -networks. CHLIC shall require each Retail Pharmacy included in the network to meet its requirements for participation in the Retail Pharmacy network, which include, but are not limited to, satisfaction of licensing and insurance 06/02/2021 48 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 01 Client Name: City of Miami Administrative Services Only Agreement requirements. (b) Retail Pharmacy Audits and Overpayments. CHLIC shall perform desktop and on -site audits of each Retail Pharmacy to ensure that each Retail Pharmacy is complying with the terms of its contract with CHLIC. In the event that CHLIC discovers that an overpayment has been made to a Retail Pharmacy, CHLIC shall take reasonable steps to recover the overpayment pursuant to the terms of this Agreement. (c) Independent Contractors. The Retail Pharmacies are independent contractors, and as such CHLIC does not direct or exercise any control over the pharmacists at Retail Pharmacies or the professional judgement exercised by any pharmacies in the dispensing or filling of prescriptions or performing other pharmaceutical services_ Neither CHLIC nor any CHLIC affiliate shall have any liability to Employer, any Member or any other person or entity for any act or omission of any Retail Pharmacy or it agents or employees. (d) Collection of Cost Sharing. CHLIC shall require Retail Pharmacies to collect all applicable Plan cost -shares from Members. 2. Cigna Home Delivery Pharmacy. (a) General. Members may submit new or refill prescription orders for fulfillment through Cigna Home Delivery Pharmacy or such other mail service pharmacy that CHLIC in its sole discretion may select from time to time. Such orders may be placed via mail, telephone, or electronic means. Subject to Applicable Law, Employer shall permit communication with Members regarding the availability and use of the Cigna Home Delivery Pharmacy potential cost savings associated therewith, and the provision of supporting services (e.g. phauuacist consultation) in connection with any prescription dispensed by the Cigna Home Delivery Pharmacy. Cigna Home Delivery Pharmacy shall deliver all drags to Members in accordance with its standard procedures. For the purposes of clarity, CHLIC does not exert direction or control over the pharmacists at Cigna Home Delivery Pharmacy in filling prescriptions or performing other pharmaceutical services_ (b) Cost Sharing. Members are responsible for the payment of the applicable cost sharing to Cigna Home Delivery Pharmacy for each prescription or prescription refill. Employer acknowledges that Cigna Home Delivery Pharmacy may suspend services to a Member who is in default of any cost -sharing obligations, in accordance with Cigna Home Delivery Pharmacy's standard credit policy. If payment of such cost -sharing has not been received from the Member within one hundred twenty (120) days of dispensing of the product, the Plan will be billed for the outstanding amount following the one hundred twenty (120) day collection period. 06/02/2021 49 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement (c) Affiliation with CHLIC. Accredo Health Group, Inc., ESI Mail Pharmacy Service, Inc., Express Scripts Pharmacy Inc., Tel -Drug of Pennsylvania LLC and Tel -Drug, Inc. are licensed pharmacy affiliates of CHLIC that fill and deliver Covered Drugs via the mail service. 3. Claims Processing. (a) General. CHLIC, in accordance with Section 2 of the Agreement, shall perform claims processing services for Covered Drugs dispensed by Retail Pharmacies or Cigna Home Delivery Pharmacy. In -network Claims shall be submitted via paper or electronically. Members using out -of -network covered services are required to submit a paper claim form. A separate charge shall apply for the submission of any paper claim form, whether in network or out -of -network. CHLIC is not required to provide coordination of benefits (COB) services for Claims for drugs dispensed, and electronically processed, at a pharmacy; Claims may be processed without consideration of a Member's coverage under another plan. Drug Utilization Review. CHLIC shall perform a concurrent Drug Utilization Review ("DUR") analysis of each prescription submitted for processing. Such DUR Analysis may include, for example: (1) prescribed dosage within a safe range; (2) drug -to - drug interaction; (3) drug -to -allergy interaction; (4) age -to -drug interaction; (5) duplicate therapy; (6) quantity limitations; and (7) days' supply. DUR processes shall not override the prescriber's, the pharmacist's or other health care provider's professional judgment. (b) 4. Utilization Management Program. CHLIC shall, in accordance with Section 2 of the Agreement, administer the Pharmacy Benefit utilization management program(s) identified in this Agreement. Employer acknowledges that CHLIC's coverage policies and claims administration procedures, which are utilized across CHLIC's self -funded and insured book -of -business to adjudicate claims and administer appeals, may change periodically. As an example of the coverage criteria that may apply to a pharmaceutical product, a Member may have to try one or more preferred pharmaceutical products, or demonstrate why trying the preferred pharmaceutical product(s) would be clinically inappropriate, in order to obtain coverage under the Plan for a given pharmaceutical product Employer further authorizes CHLIC to allow coverage for a use that otherwise would be excluded in the event of co -morbidities, complications and other factors not expressly addressed by the coverage policies utilized by CHLIC in reviewing Claims for coverage. CHLIC may rely wholly upon information about the Member and the prescriber's diagnosis of the Member's condition. CHLIC shall not substitute its judgment for the judgment of the prescribing physician, nor shall it determine medical necessity or make other medical determinations other than for coverage purposes. 5. Rebate Management. CHLIC shall pay Employer amounts equal to the Rebate amounts specified in the Schedule of Financial Charges. 06/02/2021 50 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement 6. Drug -Related Services. (a) Specialty Drugs. CHLIC shall process Claims regarding Specialty Drugs subject to the following provisions: (1) The Specialty Pharmacy shall fill prescriptions for Specialty Drugs based on the professional judgment of the dispensing pharmacist, accepted pharmacy practices and product guidelines. (2) A list of Specialty Drugs available via the Specialty Pharmacy and the pricing for those Specialty Drugs shall be made available as in effect on the Effective Date, as set forth in Appendix B. After the Effective Date, Employer may request that CHLIC provide it with an updated list of Specialty Drugs available via the Specialty Pharmacy and the pricing with respect thereto_ (3) To the extent acting in the capacity as a mail order pharmacy, the Specialty Pharmacy shall ship Specialty Drugs to Members in accordance with its standard procedures. (4) Members are responsible for the payment of the applicable cost sharing to the Specialty Pharmacy for each prescription or prescription refill. Employer acknowledges that the Specialty Pharmacy may suspend services to a Member who is in default of any cost -sharing obligations, in accordance with the Specialty Pharmacy's standard credit policy. If payment has not been received from the Member within one hundred twenty (120) days of dispensing, the Plan will be billed following the one hundred twenty (120) day collection period. For the purposes of clarity, CHLIC does not exert direction or control over the pharmacists at the Specialty Pharmacy in filling prescriptions or performing other pharmaceutical services. (b) Compound Drugs. CHLIC shall process prescribed Compound Drugs to the extent covered under the Plan. CHLIC shall treat as Covered Drugs only those components of a Compound Drug that would otherwise be treated as Covered Drugs were they not part of a Compound Drug. (5) 7. Member Communications and Services. (a) Member Communication. CHLIC shall provide to Members an ID card and instructions to access Member materials online, including the Formulary, the Retail Pharmacy directory, Cigna Home Delivery Pharmacy information, and an out -of -network Claim reimbursement form. 06/02/2021 51 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement (b) Rx Savings Messenger. CHLIC may send personalized mailings to Members regarding the Generic Drugs and preferred Brand Drugs and savings available from Cigna Home Delivery Pharmacy. (c) Call Center. CHLIC shall maintain toll -free customer service lines twenty-four (24) hours per day, seven (7) days per week for the purpose of responding to inquiries from Members regarding Retail Pharmacy, Cigna Home Delivery Pharmacy or Claims issues. 8. Formulary Management; Clinical Programs; Other Services. CHLIC shall provide Formulary management services, which shall include implementing Formulary placement decisions and determinations to apply utilization management requirements made by CHLIC's Business Decision Team. The Business Decision Team makes Formulary determinations based on consideration of clinical and economic factors. Clinical factors may include, but are not limited to, the CHLIC P&T Committee's evaluation of the place in therapy, relative safety or relative efficacy of the drug, as well as whether certain supply limits or other utilization management requirements should apply. Economic factors may include, but are not limited to, the drug's acquisition cost including, but not limited to, assessments on the cost effectiveness of the drug and available Rebates. Employer acknowledges that the Formulary, utilization management requirements, and coverage policies used by CHLIC to perfoiuu coverage reviews, including any changes made thereto, are adopted by Employer. When considering a drug for Formulary placement or other coverage conditions, CHLIC's Business Decision Team reviews clinical and economic factors regarding enrollees as a general population across its relevant book -of -business. CHLIC may also provide the clinical, safety and/or trend programs, or other programs and services to Employer, some of which may require payment of additional fees by Employer. If additional fees are required for such a program or service, CHLIC shall include the fee in the Schedule of Financial Charges or otherwise communicate the same in writing to by Employer. 1. Implementation of Agreement. (a) Project Plan. Employer and CHLIC shall develop an agreed upon implementation project plan with respect to the Agreement prior to the Effective Date or prior to the implementation with respect to any new Pharmacy Benefit under this Agreement following the Effective Date. (b) Initial Data and Commencement of Pharmacy Benefit Management Services. Prior to the Effective Date, Employer shall provide CHLIC with all data and/or documentation necessary for CHLIC to provide the services specified in this Agreement. Such data and/or documentation shall include, but is not necessarily limited to, claims history and Member prior authorization history. Assuming all data specified in the preceding sentence is received sufficiently in advance of the Effective Date, CHLIC shall 06/02/2021 52 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement commence providing services under this Agreement as of the Effective Date. 2. Timely Provision of Data by Employer. Employer acknowledges that CHLIC shall not be held responsible for, and shall be released from, fulfilling any obligation or performing any service under this Agreement if Employer or its designee does not provide accurate information in a timely manner. 3. Reporting. CHLIC shall make available to Employer CHLIC's standard reporting applications, subject to Applicable Law and Exhibit D, including, without limitation, HIPAA and state privacy laws. 4. Claims Data. (a) Retention. CHLIC shall retain data with respect to Claims for at least seven (7) years from the date the prescription is filled. Following the close of such retention period, CHLIC shall retain and dispose of such Claims data pursuant to its then -current standard policies and procedures, Applicable Law and the Business Associate Agreement described in the Agreement. (b) Disclosure to Vendor. Upon Employer's written request and subject to execution of a non -disclosure agreement acceptable to CHLIC, CHLIC shall provide prescription Claims data in its standard format to a vendor contracted with Employer and otherwise acceptable to CHLIC solely for the purposes of such vendor's support of Plan administration functions. Employer agrees that its vendors may not utilize Claims data for any other purpose, including, without limitation, developing products and services, analyzing the Claims data against market benchmarks or CHLIC competitors or adding to a normative database (even if de - identified and/or blinded as to Member and PBM/carrier) for the Employer's or vendor's commercial use. Employer shall be responsible for any use or disclosure of Claims data, or any services provided, by the vendor. Notwithstanding the foregoing, all audits of any pricing guarantees, Rebate -sharing obligations or Claims processing accuracy shall be conducted in accordance with the terms in this Agreement specifically relating to such audits. De -Identified Data. During and after the term of this Agreement, CHLIC may use Claims, drug, and medical data that has been de -identified in accordance with HIPAA for research, provider evaluation, database maintenance, and other commercial purposes. This provision shall survive termination or expiration of the Agreement. 5. Claims Processing Audits. Employer may, in accordance with the requirements set forth in Section 6 of the Agreement and at no additional charge while this Agreement is in effect, audit CHLIC's payment of Plan Benefits subject to the conditions set forth in Section 6 of the Agreement. (c) 06/02/202I 53 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 00 w 0 Client Name: City of Miami Administrative Services Only Agreement 6. Rebate Audits. Employer may, to the extent specified below, in accordance with the following requirements, and at no additional charge while this Agreement is in effect, audit CHLIC's Rebate payments. Any Rebate audit shall occur following CHLIC's issuance of the annual financial reconciliation to Employer and no new Rebate audit shall be initiated until such time that each party agrees that any prior audit is closed. In order to balance the need to adequately support the audit process for all CHLIC clients, with an efficient allocation of resources, Employers who desire to audit one or more components of the pharmacy arrangement must do so through a single annual audit. Rebate audits are subject to the following conditions: (a) Employer shall designate with CHLIC's consent, such consent not to be unreasonably withheld, an independent, third party auditor to conduct the audit (the "Auditor"). (b) The Auditor may audit records directly related to CHLIC's performance of its obligations hereunder regarding Rebates once in each 12-month period upon the following conditions: (1) Employer shall provide at least forty-five (45) days written notice to CHLIC; (2) the Auditor (including each auditor conducting the audit) shall be agreeable to Employer and CHLIC; (3) a mutually agreed upon nondisclosure/nonuse contract shall be executed by Employer, the Auditor and CHLIC; (4) the records to be audited shall be no more than two years old as of the date of the audit; (5) the scope of records to be audited shall be as mutually agreed upon by the Auditor and CHLIC as those which are necessary to determine compliance with the Rebate -sharing obligations under this Agreement; (6) the audit shall be conducted at a mutually acceptable time during regular business hours at CHLIC's office where such records are located; (7) records shall not be removed or photocopied without CHLIC's express written consent; (8) for the sole purpose of confirming compliance with the audit Confidentiality Agreement, Auditor will first submit in draft to CHLIC, prior to submission to Employer, its Rebate audit report so that CHLIC may confirm that no terms of the applicable agreements with manufacturers, which are confidential, are disclosed in the audit report; (9) the Auditor shall provide its final audit report to CHLIC and Employer at the same time; and (10) the Auditor may disclose the aggregate amount of Rebates due Employer but no other details of CHLIC's manufacturer contracts of which the Auditor is apprised, if any. This provision shall survive termination or expiration of the Agreement. 7. Financial Guarantee Reconciliation Audits. (a) Employer may, to the extent specified below and at no additional charge, audit such information that is related to CHLIC's pricing guarantees to determine whether CHLIC has met its contractual obligations hereunder once every Plan year following CHLIC's issuance of the annual reconciliation to Employer. No new audits shall be initiated until such time that all parties have agreed that any prior audit is closed. In order to balance the need to adequately support the audit process for all CHLIC clients, with an efficient allocation of resources, Employers who choose to audit one or more components of the pharmacy arrangement must do 06/02/2021 54 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 op w Client Name: City of Miami Administrative Services Only Agreement (b) so through a single annual audit. Any such audit shall be subject to the following conditions: (1) the audit may take place while this Agreement is in effect or within one (1) year after the termination or expiration of this Agreement; (2) such audit may cover up to two prior contract years to the extent such prior contract years have not previously been audited; (3) Employer shall provide CHLIC with forty-five (45) days' advance written request for the audit; (4) Employer and CHLIC shall agree on a mutually acceptable, independent, third party auditor to conduct the audit (the "Auditor"), and the individuals(s) employed or contracted to perform the audit shall not have a conflict of interest that could reasonably diminish their impartiality; (5) Employer shall be responsible for its Auditor's costs, and CHLIC will be responsible for its costs in connection with the audit; (6) the audit shall be conducted in accordance with the terms hereof and a Pharmacy Financial Guarantee Audit Agreement, a sample of which is attached hereto as Exhibit C2, which shall be signed by CHLIC, Employer, and the Auditor prior to the start of such audit; (7) any adjustments resulting from the audit will be based upon the actual Claims reviewed and not upon statistical projections or extrapolations, as the Auditor will be furnished with 100% of the paid Claims processed during the applicable contract period for purposes of the audit; (8) the Auditor shall provide the audit report to the Employer and CHLIC simultaneously; (9) CHLIC will respond to any audit report issued by the Auditor within thirty (30) days of the issuance of same; and (10) CHLIC will reconcile mutually agreed upon amounts due to Employer within a reasonable period of time following mutual agreement regarding any amount due to the Employer. This provision shall survive termination or expiration of the Agreement. Mtn'. 1. Funding and Payment of Claims. With respect to Pharmacy Benefits, (1) CHLIC may withdraw funds from the Bank Account for the purposes specified in Section 3 of the Agreement five times per month, and (2) any recovered overpayments shall be credited to Employer via a line item on its invoice, less the fee set forth on the Schedule of Financial Charges. 2. Retroactive Member Changes and Terminations. Notwithstanding anything in the Agreement to the contrary, Employer shall remain responsible for all charges and Bank Account Payments incurred or charged through the date CHLIC processed Employer's notice of a retroactive change or termination of a Member's enrollment in the Plan. Notwithstanding anything to the contrary in Section 4.c. of the Agreement, with respect to Phannacy Benefits, CHLIC generally will implement eligibility updates received from Employer that adhere to CHLIC's standard electronic format as soon as reasonably practicable following receipt of such updates. 06/02/2021 55 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 00 w Client Name: City of Miami Administrative Services Only Agreement CHLIC offers pharmacy benefit management services for consideration by Employer and other entities. The general parameters of such services and the supporting systems have been developed by CHLIC as part of CHLIC's administration of its general business as a pharmacy benefit manager for entities that sponsor group health plans. The Parties have negotiated the terms of this Agreement in an arm's-length fashion. Except to the extent CHLIC conducts the final level of internal appeal as set forth in Section 2.c of the Agreement, the Parties assert that neither Party intends that CHLIC shall be a fiduciary with respect to Pharmacy Benefits for either ERISA (if applicable) or state law purposes, and neither Party shall name CHLIC or any of its affiliates as a "plan fiduciary" with respect to its management of Pharmacy Benefits. Employer acknowledges and agrees that CHLIC (i) does not have discretionary authority or control respecting management of the Pharmacy Benefits, and (ii) does not exercise any authority or control respecting management or disposition of the assets relating to Pharmacy Benefits or of Employer. Rather, Employer retains all such authority and control. The Parties agree that, upon reasonable notice, CHLIC shall have the right to terminate its Pharmacy Benefit services under this Agreement to any Plan and/or Members located in a state that requires a pharmacy benefit manager to be a fiduciary to Employer, the Plan or a Member. This provision shall survive termination or expiration of the Agreement. A:�1V�s dC: 1. General. CHLIC contracts with its PBM affiliate for the provision of phaiivacy benefit services and financial arrangements. As such, CHLIC or its PBM affiliate, directly or indirectly contract on their own accounts with Retail Pharmacies and Cigna Home Delivery Pharmacy to dispense covered pharmaceutical products to Employer's Members, and not on behalf of, or for the benefit of, Employer or the Plan; accordingly, any discounts or other remuneration CHLIC or its PBM affiliate earns under an arrangement with a Retail Pharmacy or Cigna Hoene Delivery Pharmacy are obtained for, and inure to, the sole and exclusive benefit of CHLIC or its PBM affiliate, and not the Employer or the Plan. Amounts paid by CHLIC or its PBM affiliate or by the PBM affiliate for Retail Phaiinacy or Cigna Home Delivery Pharmacy for Brand Drag, Generic Drug, or Specialty Drug Claims may or may not be equal to the amount charged to Employer and/or Member. If the amount paid by Employer and/or Member does not equal the amount paid by CHLIC to its PBM affiliate or by the PBM affiliate to a particular pharmacy, CHLIC and its PBM affiliate will absorb or retain such difference. CHLIC may directly or indirectly contract for Rebates, Manufacturer Administrative Fees, and other remuneration on its own behalf and for its own benefit, and not on behalf of Employer or the Plan. As an example of other remuneration other than Rebates or Manufacturer Administrative Fees that CHLIC may earn, CHLIC may also directly or indirectly from pharmaceutical manufacturers remuneration in connection with value payments and/or services that CHLIC provides to Employer ("Value -Based Payments"). Notwithstanding anything in this Agreement to the contrary, any Value -Based Payments earned by CHLIC are separate and apart from any Rebates or Manufacturer Administrative Fees that CHLIC directly or indirectly earns from pharmaceutical manufacturers, and CHLIC may retain any Value -Based Payments it earns. As examples of the value payments and/or services that CHLIC may provide to Employer in connection with Value -Based Payments that CHLIC may earn, CHLIC may provide care management or other services to Employer 06/02/2021 56 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 00 00 W Client Name: City of Miami Administrative Services Only Agreement and/or remit to Employer monetary credits if Members discontinue therapy on certain pharmaceutical products. Information regarding any services, and/or monetary credits or other financial value, for which Employer may be eligible with respect to specific pharmaceutical products or therapeutic classes/conditions, including the products for which monetary credits or other financial value may be available to Employer, the amount of that value, and other payment terms, is available upon request. Any value payments and/or services provided by CHLIC to Employer are subject to change or termination by CHLIC as the value program(s), if any, offered by CHLIC change(s) or terminate(s). Accordingly, CHLIC retains all right, title and interest to any and all actual Rebates, Manufacturer Administrative Fees, Value -Based Payments, and other remuneration directly or indirectly received from manufacturers. CHLIC may provide Employer amounts equal to all or some portion of the Rebate and Manufacturer Administrative Fee amounts, or other financial value generated in connection with any value program(s), allocated to Employer, if any, and as specified on the Schedule of Financial Charges, from CHLIC's general assets (neither Employer, its Members, nor Employer's Plan retains any beneficial or proprietary interest in CHLIC's general assets). Rebate and Manufacturer Administrative Fee amounts received vary based on factors including, without limitation, Employer -specific utilization, the volume of utilization as well as Formulary position applicable to the drug or supplies, and adherence to various fouuulary management controls, benefit design requirements, and Claims volume. Employer acknowledges and agrees that neither it, its Members nor its Plan will have a right to interest on, or the time value of, any Claim payments charged by CHLIC to Employer or any Rebate, Manufacturer Administrative Fee or other payments received by CHLIC during the collection period of moneys payable under this section, if any, and that CHLIC shall retain any such remuneration. For purposes of this provision, the term CHLIC shall also include and mean CHLIC's PBM affiliate, Express Scripts, Inc. 2. Affiliates. Cigna Home Delivery Pharmacy may maintain product purchase discount arrangements and/or fee -for -service arrangements with pharmaceutical manufacturers and wholesale distributors in its capacity as a mail service and/or specialty pharmacy. Cigna Home Delivery Pharmacy may contract for these arrangements on its own account in support of its pharmacy operations, and not on behalf of, or for the benefit of, Employer or the Plan. Accordingly, Cigna Home Delivery Pharmacy retains the sole and exclusive benefit of any difference between its acquisition cost for a pharmaceutical product and the amount charged to Employer under this Agreement. Further these arrangements relate to services provided outside of this Agreement and other pharmacy benefit management arrangements and may be entered into without regard to whether a specific drug is on one of the formularies that CHLIC offers to entities that sponsor group health plans. Discounts and fee -for -service payments received by Cigna Home Delivery Pharmacy are not part of the pharmacy benefit management formulary rebates or associated administrative fees or charges paid to CHLIC in connection with CHLIC's pharmacy benefit management formulary rebate programs. This provision shall survive termination or expiration of the Agreement. 06/02/2021 57 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 0000 Client Name: City of Miami Administrative Services Only Agreement BEx�A.1GENT.O13.:.GATiNS R1'!1)?1AQ. c . ,.,.., Upon notice of termination of this Agreement, the following provisions shall apply with respect to Pharmacy Benefits: a) Employer shall notify Members at least thirty (30) days prior to the termination of the Agreement becoming effective of any transition to a successor pharmacy benefit manager. b) If mutually agreed upon by CHLIC and Employer, CHLIC shall provide services following termination of the Agreement at CHLIC's then -prevailing rate. Such services, if any, shall be determined by mutual agreement of CHLIC and Employer in advance of the termination of the Agreement becoming effective. c) Upon request by Employer and subject to execution of a nondisclosure agreement acceptable to CHLIC, CHLIC shall transition Claims files and/or history to the pharmacy benefit manager or other third party specified by Employer and otherwise acceptable to CHLIC. Any disclosure of Claims files and/or history shall be limited to the information the successor pharmacy benefit manager or other third party needs to implement or administer Employer's pharmacy benefits. CHLIC shall not be required to directly or indirectly release, and Employer shall not release, PBM Proprietary Information to any such third party. d) Upon termination of the Agreement for any reason, the Parties shall handle Confidential Information, PBM Proprietary lnfoin.iation and Protected Health Infoiniation (as defined in the Business Associate Agreement attached as Exhibit D) pursuant to the teens of the Agreement. e) In the event that CHLIC terminates the Agreement pursuant to Section 1.v of the Agreement, CHLIC shall have no further obligation following the date of such termination to pay Employer any Rebates, or any other amount that may otherwise be payable by CHLIC to Employer. This provision shall survive termination or expiration of the Agreement. n ., �p■��,t^,,�y�,+a.,, .. N 4 F !I�vT�j y�-y,� T i G E "�. 3ew�o 14�. �EZk L 3 ��-y. 1..+ � �T W. NT,4 d 1kCO� J.:f !L E3 f :"�. 'di v�„'^.S,l r,' .�..' f" 1. General. Employer acknowledges and agrees that CHLIC's PBM Proprietary Information constitutes competitively sensitive trade secrets, and that its misuse or mis-disclosure could result in material financial and legal loss or liability to CHLIC, its affiliates and their respective subcontractors. CHLIC shall not be required to disclose PBM Proprietary Information to Employer except to the extent necessary for Employer to exercise any audit rights expressly provided hereunder or perform other Plan administration functions. If CHLIC discloses PBM Proprietary Information to Employer, or, if CHLIC consents, to the Employer's vendor or designee, CHLIC may require Employer, or its vendor or designee, to execute a non -disclosure agreement specifically relating to the requested PBM Proprietary Information. Employer agrees .that it and its vendors may not utilize PBM Proprietary Information for any purpose other than performing 06/02/2021 58 98E9686 dd2i uo!lepo!Iog WH iZ:6 17ZOZ/OZ/8 Client Name: City of Miami Administrative Services Only Agreement Plan administration functions, including, without limitation, developing products and services, de -identifying, blinding or analyzing the PBM Proprietary Information against market benchmarks or CHLIC competitors or adding to a normative database for the Employer's, or vendor's or designee's, commercial use. For the purposes of clarity, infoi,nation shall not cease to qualify as PBM Proprietary Information if Employer or its vendor or designee de -identifies and/or blinds the PBM Proprietary Information such that the information cannot be faced or identified to a Member or CHLIC, its affiliates or their respective subcontractors. Employer shall be solely responsible for any disclosure of PBM Proprietary Infouuation by CHLIC to Employer or its vendor or designee, or any subsequent use or disclosure by Employer or its vendor or designee, or services provided by the same. Notwithstanding anything herein to the contrary, in no event will CHLIC be required to disclose to Employer, or its vendor or designee, information related to, or including, its phaiuiacy network agreements, vendor agreements or pharmaceutical manufacturer agreements. 2. Compelled Disclosures. If at any time Employer, or its vendor or designee, is required by law, court order or other valid legal process to disclose any Confidential Infoiniation, it will promptly notify CHLIC prior to any such compelled disclosure and, upon request, cooperate with CHLIC in seeking a protective order or other available relief to contest or limit the scope of such compelled disclosure. 3. Return or Destruction of Information. At any time upon CHLIC's request or upon expiration or termination of this Appendix A or the Agreement, whichever occurs first, Employer will, at CHLIC's option, promptly deliver, or, as the case may be, compel its vendor or designee to deliver, to CHLIC all PBM Proprietary Information or other Confidential Information (or such portion thereof as requested) and not retain any copies in whole or in part of such PBM Proprietary Information or other Confidential Information, or securely destroy or dispose, or, as the case may be, compel its vendor or designee to destroy or dispose, of those portions of documents and other materials in any foitn, including electronic form, prepared by or received by the Employer or its vendor or designee, that contain or reflect such PBM Proprietary Information or other Confidential Information. Employer, or its vendor or designee, shall certify such return and destruction, as the case may be, to CHLIC. 06/02/2021 59 98E9686 dd2i uo!lepo!Iog City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Appendix B - Cigna Home Delivery Pharmacy Specialty Drug List THIS SPECIALTY DRUG LIST IS CONFIDENTIAL, PROPRIETARY INFORMATION OF CHLIC. IT IS PROVIDED SOLELY FOR EMPLOYER'S PLAN ADMINISTRATION PURPOSES. RE -DISCLOSURE IS STRICTLY PROHIBITED EXCEPT AS OTHERWISE PROVIDED BY APPLICABLE LAW. CHLIC RESERVES ALL LEGAL RIGHTS AND REMEDIES TO ENFORCE THESE PROHIBITIONS ON USE AND DISCLOSURE. The Specialty Drug List shall be provided separately to Employer, and is hereby incorporated into the Agreement by reference, inclusive of any changes made subsequent to CHLIC's initial issuance of the Specialty Drug List to Employer to the pharmaceutical products included on the Specialty Drug List or the discounts pertaining to such pharmaceutical. products. Upon Employer's request on or after the Effective Date, CHLIC shall provide to Employer an updated Specialty Drug List. Currently Marketed Specialty Drugs on this Specialty Drug List. The discounts in this Specialty Drug List are the discounts that will be adjudicated in CHLIC's claim processing system for the drug indicated when dispensed by Cigna Horne Delivery Pharmacy, subject to all of the following. • Any or all of the discounts in this Specialty Drug List may be adjusted by CHLIC to the extent reasonably necessary to preserve the economic value of this Agreement as it existed immediately prior to the occurrence of any of the following events: a major change in market conditions affecting the pharmaceutical or pharmacy benefit management market, a drug shortage in the market, an issue involving the safety of the drug supply, or similar market situation. • The discounts in this Specialty Drug List are based on the terms and design of the Pharmacy Benefit that Employer has adopted and disclosed to CHLIC. Accordingly, if Employer fails to disclose to CHLIC, for example, that it uses or intends to use a consumer -driven health plan, a major cost - sharing program, or a utilization management program promoting generic or OTC drugs over brand drugs, CHLIC may adjust the discounts as it reasonably deems necessary to preserve the economic value or benefit of this Agreement as CHLIC anticipated based on the terms and design of the Pharmacy Benefit previously disclosed to CHLIC and prior to CHLIC's discovery of the Pharmacy Benefit design feature that materially impacts CHLIC's discounts in this Specialty Drug List. ▪ The discounts in this Specialty Drug List shall not apply to Compound Drug claims, Claims that process at U&C, direct member reimbursement (DMR) Claims, and drugs adjudicated under the medical benefit. • Any or all of the discounts in this Specialty Drug List may be adjusted by CHLIC to the extent reasonably necessary to preserve the economic value of this Agreement as it existed immediately prior to the occurrence of any of the following events: (a) there are any significant changes in the composition of CHLIC's pharmacy network or in CHLIC's pharmacy network contract compensation rates, or the structure of the pharmacy stores/chains/vendors that are contracted with CHLIC, including but not limited to disruption in the retail pharmacy delivery model, or bankruptcy of a chain pharmacy; or (b) there is a change in government laws or regulations which has a significant impact on pharmacy claim costs; or (c) any material manufacturer -rebate contracts with or for the benefit of CHLIC are terminated or modified in whole or in part; or (d) there is any legal action or Law that materially affects or could materially affect the manner in which CHLIC's rebate program is administered or an existing Law is interpreted so as to materially affect or potentially 06/02/2021 60 8/20/2024 9:24 AM p. 486 • City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement have a material effect on CHLIC's administration of the Pharmacy Benefit; or (e) there is a material change in the Plan or the Plan's Pharmacy Benefit that is initiated by Employer which impacts CHLIC's costs. New -to -Market Specialty Products. Specialty Drug Claims, excluding limited distribution drugs, that are for new -to -market drugs will have a minimum market -introduction guaranteed discount of 11.45% off the drug's A WP. 06/02/2021 61 8/20/2024 9:24 AM p. 487 City of Miami Solicitation RFP 1896386 SECRETARY'S CERTIFICATE CIGNA HEALTH AND LIFE INSURANCE COMPANY The undersigned, a duly elected Assistant Secretary of Cigna Health and Life Insurance Company (the "Company"), does hereby represent and certify that the following resolutions were adopted by the Board of Directors of the Company via written unanimous consent effective December 19, 2018 and that such resolutions remain in full force and effect as of the date hereof, not having been amended, modified or rescinded since the date of their adoption, Signature Authority RESOLVED, that any person holding the underwriter business title for Cigna Corporation and/or its subsidiaries and affiliates of Contractual Agreement Unit Manager or Operations Senior Manager is hereby authorized to enter into customer agreements, act as a registrar on insurance policies issued by the Company, and to sign such agreements and policies for and on behalf of the Company. FURTHER RESOLVED, that the foregoing resolution supersedes the resolution adopted by the Board effective as of November 11, 2005 with respect to the subject matter therein. The undersigned further certifies that the following individuals hold the business title indicated next to their respective name and are authorized to enter into customer agreements, act as a registrar on. insurance policies issued by the Company, and to sign such agreements and policies for and on behalf of the Company: Andrea M. Balestriere Operations Senior Manager Victoria A. Sirica Operations Senior Manager WITNESSS WHEREOF, 1 hereunto set my hand and set the seal of the Company this 27th day of November, 2019. ; 3 �.� ,)1). ) 1 t S'usan M. Metrow Assistant Secretary 8/20/2024 9:24 AM p. 488 City of Miami Solicitation RFP 1896386 ,tEMENT and Between The City of Miami, Florida tuati Contrwetigut Health and Life Insurance Company This Professional Services Agreement ("Agreement") is entered into this 18th. day of December, 2013 by and between the City of Miami, a municipal corporation of the State of Florida, whose address is 444 S.W. 2Td Avenue, 10th Floor; Miami, Florida 33130 ("City"), and Connecticut Health and Life Insurance Company (Cigna), ("PROVIDER") a Connecticut domiciled life and. health insurance company licensed to do business in Florida whose principal address is 900 • Cottage Grove Road, Bloomfield, CT 06002. RECITALS: WHEREAS, the City of Miami issued. a Request for Proposal No. 369325 on July 12, 2013 (the "REP" attached hereto, incorporated hereby, and made a part of as Exhibit A) for the provision of administrative services to City's Group Benefit Health Plan, ("Services" as more fully set forth in the Administrative Services Only Agreement between the City and Provider together with its associated schedules and exhibits. and attached hereto as Exhibit B (the "Administrative Services Only Agreement")) for the Risk Management Department, Provider's proposal ("Proposal.'', attached hereto, incorporated hereby, and made part of hereof -as Exhibit C), the Insurance Requirements (attached hereto ass Exhibit D), Provi.der's compensation ("Schedule of Financial Charges" as specifically set forth and attached hereto as Exhibit E), Provider's Corporate Resolution (attached hereto as Exhibit F), and Provider's Stop Loss Insurance Policy for the issuance of Stop Loss Insurance coverage ("Stop Loss Insurance Policy" attached hereto as Exhibit G), in response thereto, has been selected as the most qualified proposal for the provision of the Services. WHEREAS, the Evaluation Committee appointed by the City Manager determined that the Proposal submitted by the Provider was responsive to the REP requirements and recommended that the City Manager negotiate with the Provider.; and WHEREAS, the City wishes to engage the Services of Provider, and Provider wishes to perform the Services for the City; and WHEREAS, the City and the Provider desire to enter into this Agreement under the terms and - -condition. set forth heroin. WHEREAS, the City desires that the -Provider issue a Stop Loss:Insurance policy to the City that will be subject solely to the terms and cond:it'on set forth in such policy for the initial year and to applicable law, and that will be renegotiated:. w th, Provider annually. NOW, THEREFORE, E, in consideration off. -the rm.! and promises herein contained, Provider ctnd the City agree aS follows: 8/20,/2024 9:24 AM p. 489 City of Miami Solicitation RFP 1896386 TERMS: A. Recitals and incorporations; definitions: The recitals are true and correct and are hereby incorporated into and made a part of this Agreement. The City's RFP and related addendums are hereby incorporated into and made a part of this Agreement and attached hereto as Exhibit "A". The Administrative Services Only Agreement is hereby incorporated into and made a part of this Agreement as attached Exhibit "B", The Provider's Response to the RFP dated, August 8, 2013, is hereby incorporated into and made a part of this Agreement as attached Exhibit "C". The Provider's Compensation is hereby incorporated into and made a part of this Agreement as attached Exhibit "D" Schedule of Financial Charges. The insurance requirements are hereby incorporated into and made a part of this Agreement as attached Exhibit "E". The Provider's Certificate of Insurance evidencing compliance with the City's insurance requirements is also hereby incorporated into and made a part of this Agreement as Exhibit "E". The order of precedence whenever there is conflicting or inconsistent language between documents is as follows: (1) Provider's Professional Services Agreement ("PSA") with the attached exhibits B, C and D (2) Addenda/Addendum to the Request for Proposals; (3) Request for Proposals; and Provider's response to the Request for Proposals. 2. Term: The initial terra of this Agreement shall commence on the January 1, 2014 and shall continue in effect for a term of five (5) years ending on December 31, 2018, 3. Option to extend: The City, acting administratively through its City Manager, and subject to the termination provisions hereof, shall have two (2) option(s) to extend the term hereof for a period of three (3) years each, subject to availability, allocation and appropriation of funds and satisfactory performance by the Provider in the opinion of the City Manager. The City shall exercise its right to extend the term hereof by giving Provider at least thirty (30) days written notice prior to the expiration of the previous term. City Commission approval shall not be required as long as the total extended term does not exceed a total extended term of six (6) years. The total term of the Agreement cannot exceed eleven (11) years inclusive of these two Options to Extend. 4. Scope of services: A. Provider agrees to provide the Services as specifically described, and under the special te.uus and conditions set forth in Exhibit "B" Services, hereto, which by this reference is incorporated into and made a part of this Agreement. B. Provider represents to the City that: (i) it possesses and will maintain all qualifications, licenses as required by applicable laws and regulations, and expertise required for -the performance of the Services, including but not limited to 8/20/2024 9:24 AM p. 490 City of Miami Solicitation RFP 1896386 full qualification to do business in Florida; (ii) it is not delinquent in the payment of any sums due the City, including payment of permits,. fees; occupational licenses, etc., nor in the performance of any obligations to the City, (iii) all personnel assigned to perform the Services are and shall be, at all times during the term hereof, fully qualified, properly licensed if so required by applicable law, and trained to perform the tasks assigned to each; (iv) the Services will be performed in the manner described in Exhibit "B"; and (v) each person executing this Agreement on behalf of Provider has been duly authorized to so execute the same and fully bind Provider as a party to this Agreement. C. Provider shall at all times provide fully qualified, properly licensed if so required by applicable law, competent and physically capable employees to perform the Services under this Agreement. City may require Provider to remove any employee the City deems careless, incompetent, insubordinate, or otherwise objectionable and whose continued services under this Agreement is not in the best interest of the City. 5. Compensation: A. The amount of compensation payable by the City to the Provider shall be pursuant to the rates and schedules described in Exhibit "D" Schedule of Financial Charges, hereto, which by this reference is incorporated into and made a part of this Agreement. 13. Payment of charges that are not paid as Bank Account Payments (as defined in the Administrative Services Only Agreement) shall be made in arrears within thirty (30) days after receipt of Provider's invoice for Services performed, which shall be accompanied by sufficient supporting documentation and contain sufficient detail, to allow a proper audit of expenditures, should the City require one to be performed. Invoices shall be sufficiently detailed so as to comply with the "Florida Prompt Payment Act", §218.70. - 218.79, Florida Statutes, and other applicable laws. No advance payments shall be made at any time provided that City shall at all times comply with its obligations to fully fund the bank account in accordance with Exhibit B. C. Provider agrees and understands that (i) any and all subcontractors providing Services related to this Agreement shall be paid through Provider and not paid directly by the City and (ii) any and all liabilities regarding payment to or use of subcontractors for any of the Services related to this Agreement shall be borne solely by Provider. D. With respect to the Stop Loss Insurance Coverage, the severability of the insurance coverage from the Administrative Services Only (ASO) and terms and conditions is recognized by both parties. It is mutually agreed:that the Provider will issue a Stop Lass Insurance Policy to City on mutually agreed upon terms and conditions for 2014 plan year which will be governed solely by applicable law and the provisions of such Stop Loss Insurance policy and shall not be subject to the terms of this 8/20/2024 9:24 AM p. 491 City of Miami Solicitation RFP 1896386 Professional Services Agreement. It is mutually agreed that the Parties will negotiate ternis and conditions for Stop Loss Insurance annually each year following 2013.and will be subject to underwriting approval. Furthermore, given the severability of the Stop Loss Insurance Coverage which includes the payment of an annual insurance premium, a purchase order will be formally approved and issued for the payment of the Stop Loss Insurance premiumsby the Director of Procurement. 6. Ownership of documents: Provider understands and agrees that any information, document, report or any other material whatsoever which is given by the City to Provider, its employees, or any subcontractor, or which is otherwise obtained or prepared by Provider pursuant to or under the terms of this Agreement, is and shall at all times remain the property of the City. Provider agrees not to use any such information, document, report or material for any other purpose whatsoever without the written consent of the City Manager, which may be withheld or conditioned by the City Manager in his sole discretion. Provider is permitted to make and to maintain duplicate copies of the files, records, documents, etc. if Provider determines copies of such records are necessary subsequent to the termination of this Agreement; however, in no way shall the confidentiality as permitted by applicable law be breached. The City shall maintain and retain ownership of any and all documents which result upon the completion of the work and Services under this Agreement. Pra:vider acknowledges that nothing herein shall impair any ownership interest the City of Miami has'with respect to eligibility, claim and other Plan -related information ("Plan Information") provided, however, that: (i) The City of Miami shall make available to Provider and Provider may possess and use all such Plan Information as Provider may reasonably require for purposes of administering the Plan and that Provider may maintain such information in accordance with its record retention policy; (ii) City's ownership shall not extend to any of Provider's business records, including, without limitation to the extent such business records incorporate Plan Information recorded for or otherwise integrated into Provider's data processing systems in the ordinary course of business; (iii) Subject to compliance with Chapter 119, Florida Statutes, The Public Records Act, as amended, the City of Miami acknowledges that Plan Information reflecting the reimbursement rates or other terms under Provider's agreements with Provider's participating providers/arrangers of health care services/supplies is the proprietary information of Provider and shall be used solely for the purpose of administering the Plan or as otherwise required by law and that such proprietary information shall not be released to any third party without Provider's written consent and subject to a non -disclosure agreement from the third party that is satisfactory to Provider, and 8/20/2024 9:24 AM p. 492 City of Miami Solicitation RFP 1896386 (iv) Such ownership shall not be interpreted .to require Provider to divulge to the City of Miami any Plan Information or other information that Provider reasonably believes it cannot divulge to the City of Miami due to applicable state and/or federal privacy laws and /or regulations. 7.. Audit and inspection rights and records retention: A. Subject to the Claim Audit provision of the Administrative Services Only Agreement and Provider's confidentiality procedures and guidelines, Provider agrees to provide access to the City or to any of its duly authorized representatives, to any books, documents, papers, and records of Provider which are directly pertinent to this Agreement, for the purpose of audit, examination, excerpts, and transcripts subject to the claim audit provisions contained herein. The City may, at reasonable times, subject to claim audit provisions and for a period of up to three (3) years following the date of final payment by the City to Provider under this Agreement, audit and inspect, or cause to be audited and inspected, those books, documents, papers, and records of Provider which are related to Provider's claims administration services under this Agreement. Provider agrees to maintain any and all such books,. documents, papers, and records at its principal place of business for a period of three (3) years after final payment is made under this Agreement and all other pending matters are closed. Provider's failure to adhere to, or refuse to comply with, this condition shall result in the immediate cancellation of this Agreement by the City. In regard to Administrative Services Only (ASO Services), claims audits are permitted in accordance with and subject to the following terms: (i) Upon 45 days advance written request, documents relating only to claims administration services shall be made available to the City of Miami for its audit or inspection. (ii) The City of Miami will designate with Cigna's consent, an independent, and a third party auditor to conduct the audit. (iii) The City of Miami and Cigna will agree upon the date for the audit during regular business hours at Cigna's office(s). (iv) The City of Miami may review payment documents relating to a random, statistically valid sample of 225 paid claims. (v) The scope of the audit may include types of claims prone to overpayments provided that types of claims prone to underpayments are equally included and will exclude electronic analysis. (vi) Any.claiin adjustments will be based upon the actual claims reviewed and not on statistical projections or extrapolations: (vii) Audits are to be completed pursuant to the terms of Cigna's Claim Audit Agreement executed by all parties. (viii) No audit shall review claims paid more than two years before the date of the audit. 8/20/2024 9:24 AM p. 493 City of Miami Solicitation RFP 1896386 To the extent required by and in accordance with the provisions of applicable law, including, without limitation Section 18-101 and 18-102 of the Code of the City of Miami,. Florida, as same may be amended or supplemented, from time to time, (1) the City may, at reasonable times during the term hereof, inspect the Provider's facilities and perform such tests, as the City deems reasonably necessary, to determine whether the goods or services required to be provided by Provider under this Agreement conform to the terms hereof and/or the terms of the Administrative Services Agreement, if applicable; and (2) Provider shall make available to the City all reasonable facilities and assistance to facilitate the performance of tests or inspections by City representatives. All tests, inspections and audits shall be subject to, and made in accordance with the provisions of Section 18-101 and 18-102, as amended, of the Code of the City of Miami, Florida as same may be amended or supplemented from time to time. 8. Award of atreement: Provider represents and warrants to the City that it has not employed or retained any person or company employed by the City to solicit or secure this Agreement and that it has not offered to pay, paid, or agreed to pay any person any fee, commission, percentage, brokerage fee, or gift of any kind contingent upon or in connection with, the award of this Agreement. 9. Public records: A. Provider understands that the public shall have access, at all reasonable times, to all documents and information pertaining to City Agreements, subject to the provisions of Chapter 119, Florida Statutes, as amended, the Public Records Act, and agrees to allow access: by the City and the public to all documents to the extent subject to disclosure under applicable laws. Provider's failure or refusal. to comply with the provisions of this section shall result in the immediate termination of this Agreement by the City; provided that City remains liable for its obligations to fund claims and pay all other amounts required to be paid pursuant to the Administrative Services Only Agreement that are incurred or accrue as of or prior to the effective date of the termination or during any applicable Run -Out period (claims for Plan Benefits relating to health care services and products that are incurred prior to termination of this Agreement; termination of a Plan benefit option or eligible Members, as applicable) but not for any amounts incurred or accruing after the effective date of termination that is not the result of a run --out period. The Run -Out period is the specified period of time after a claim has been incurred and following a plan termination in which the claim can continue to be adjudicated and processed. Pursuant to the attached ASO Agreement, the Run -Out period for medical claims shall not exceed twelve (12) months and the run -out period for pharmacy claims shall not exceed three (3) months. No new claim expenses may be incurred during the Run -Out period. B. To the extent required by § 119.0701 Fla> Stat. (as same may -be amended or supplemented, from time to time). Provider must comply with the Florida public records laws, specifically the Provider must: 8/20/2024 9:24 AM p. 494 City of Miami Solicitation RFP 1896386 (a) Keep and maintain public records that ordinarily and necessarily would be required • by the public agency in order to perform the service. - (b) Provide the public with access to public records on the same terms and conditions that the public agency would provide the records and at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. (c) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosedexcept as authorized by law. (d) Meet all requirements for retaining public records and transfer, at no cost, to the public agency all public records in possession of the contractor upon termination of the contract and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the public agency in a format that is compatible with the information technology systems of the public agency. C. Should Provider determine to dispute any public access provision required by Florida Statutes, then Provider shall do so at its own expense and at no cost to the City. Should Provider determine to dispute any public access provision required by Florida Statutes, then Provider shall do so at its own expense and at no cost to the City. 10. Compliance with federal, state and local laws: Provider understands that agreements with local governments are subject to certain laws and regulations., including laws pertaining to public records, conflict of interest, record keeping, etc. City and Provider agree to comply with and observe all such applicable federal, state and local laws, rules, regulations, codes and ordinances, as they may be amended from time to time. Provider further agrees to include in all of Provider's agreements with subcontractors for any Services related to this Agreement this provision requiring subcontractors to comply with and - observe all applicable federal, state, and local laws rules, regulations, codes and ordinances, as. they may be amended from time to time. 11. Indemnification: Provider shall indemnify, defend and hold harmless the City and its officials, employees, and its designated third -party administrator for claims {collectively referred to as "Indemnitees") and each of them from and against all loss,- costs, penalties, fines, damages, claims, expenses (including attorney's fees) or liabilities (collectively referred to as "Liabilities") by reason of any - injury to or death of any person or damage to or destruction or loss of any property arising out of, resulting from, or in connection with (i) the negligent performance or non-performance of the - - Services contemplated by this Agreernent•(whether active or passive) of Provider or its employees or_subcontractors(collectively referred to as "Provider") which -is directly caused, in whole or in part, by any act, omission, default or negligence (whether active or passive or in strict liability) of the Indemnities, or any of them, or (ii) the failure of the Provider to comply • 8/20/2024 9:24 AM p. 495 City of Miami Solicitation RFP 1896386 materially with any of the requirements herein, or the failure of the Provider to conform to statutes, ordinances, or other regulations orrequirements of any governmental authority, local, federal or state, in connection with the performance of this Agreement. Provider expressly agrees to indemnify, defend and hold harmless the Indemnitees, from and. against all liabilities which may be asserted by an employee or former employee of Provider, orany of its subcontractors, as provided above, for which the Provider's liability to such employee or former employee would otherwise be limited to payments under state Workers' Compensation or similar laws. Provider further agrees to indemnify, defend and hold harmless the Indemnitees form and against (i) any and all liabilities imposed on account of the violation of any law, ordinance, order, rule, regulation, condition, or requirement, related directly to Provider's negligent performance under this Agreement, compliance with which is left by this Agreement to Provider, and (ii) any and all claims, and/or suits for labor and materials furnished by Provider or utilized in the performance of this Agreement or otherwise. Provider's obligations to indemnify, defend and hold harmless the Indemnitees shall survive the termination of this Agreement. Provider understands and agrees that any and all liabilities regarding the use of any subcontractor for Services related to this Agreement shall be borne solely by Provider throughout the duration of this Agreement and that this provision shall survive the termination or expiration of this Agreement, as applicable. Nothing contained herein intended nor shall be construed to waive the City's rights and immunities under Florida Statute 768.28 as amended from time to time. 12. Default: If Provider fails to comply materially with any term or condition of this Agreement, or fails to perform in any material way any of its obligations hereunder, and fails to cure such failure after reasonable notice from the City, then Provider shall be in default. Provider understands and agrees that termination of this Agreement under this section shall not release Provider from any obligation accruing prior to the effective date of termination. Termination by City pursuant to this section shall not relieve City of any obligation to fund and pay claims or to pay any amounts required to be paid under this Agreement. Provider agrees that the City of Miami may terminate for default. However, the City pursuant to its self -insured group benefit plan remains liable to Provider for its obligations to fund claims and pay all other amounts required to be paid pursuant to the Administrative Services Only Agreement that are incurred or accrue as of the effective date of the termination or the period during which Provider is processing Run -Out Claims (as defined in the Administrative Services Only Agreement) pursuant to the terms of the . Administrative Services Only Agreement (the "Run -Out "Period). but not those which are incurred or accrue after of the effective• date of the termination 8/20/2024 9:24 AM p. 496 City of Miami Solicitation RFP 1896386 13. Resolution of agreement disputes: Provider understands and agrees that all disputes between Provider and the City based upon an alleged violation of the terms of this Agreement by the City shall be submitted to the City Manager for his/her resolution, prior to Provider being entitled to seek judicial relief in connection therewith. In the event that the amount of compensation hereunder exceeds Twenty - Five Thousand Dollars and No/Cents ($25,000), the City Manager's decision shall be approved or disapproved by the City Commission. Provider shall not be entitled to seek judicial relief unless: (i) it has first received City Manager's written decision, approved by the City Commission if the amount of compensation hereunder exceeds Twenty -Five Thousand Dollars and No/Cents ($25,000), or (ii) a period of sixty (60) days has expired, after submitting to the City Manager a reasonably detailed statement of the dispute, accompanied by reasonable supporting documentation ninety (90) days if City Manager's decision is subject to City Commission approval); or (iii) City has waived compliance with the procedure set forth in this section by written instruments, signed by the City Manager. 14. Termination; obligations upon termination: A. The City, acting by and through its City Manager, shall have the right to terminate this Agreement, in its sole discretion, for convenience, without cause, at any time, by giving written notice to Provider at least sixty (60) calendar days prior to the effective date of such.termination. In such event, the City remains liable to Provider for its obligations to fund claims and pay all other amounts required to be paid pursuant to the Administrative Services Only Agreement that are incurred or accrue as of the effective date of the termination or any Run -Out Period but not those which arise or accrue after the effective date of termination. In no event shall the City be liable to Provider for any additional compensation and expenses incurred, other than that provided herein, and in no event shall the City be liable for any consequential or incidental damages. The Provider shall have no recourse or remedy against the City for a termination under this subsection except that City remains liable to Provider for its obligations to fund claims and pay all other amounts required to be paid pursuant to the Administrative Services Only Agreement that are incurred or accrue as of the effective date of the termination or any applicable Run -Out Period. B. The City Manager shall have the right to terminate this Agreement, without notice or liability to Provider, upon the occurrence of an event of a material default hereunder. In such event, the City shall not be obligated to pay any amounts to Provider for Services rendered by Provider after the date of termination, but the parties shall remain responsible for any payments that have become due and owing as of the effective date of termination. In no event shall the City be liable to Provider for any additional compensation and expenses incurred, other than that .provided herein; and in no event shall the City be liable for any consequential or incidental damages. C. This Agreement may be terminated, in whole or in part, at any time by mutual written consent of the parties hereto. In such event, the City shall. not be obligated to pay any 8/20/2024 9:24 AM p. 497 City of Miami Solicitation RFP 1896386 amounts to Provider for Services rendered by Provider after the date of termination, but the parties shall remain responsible for any payments that have become due and owing as of•the effective date of termination. In no event shall the City be liable to Provider for any • additional compensation and expenses incurred, other than that provided herein, and in no event shall the City be liable for any consequential or incidental damages. D. This Agreement may be terminated, in whole or in part, by either party if there has been a material default or breach on the part of the other party in any of its representations, warranties, covenants, or obligations contained in this Agreement and such default or breach is not cured within ninety (90) days following written notice from the non - breaching party. In such event, the City shall not be obligated to pay any amounts to Provider for Services rendered by Provider after the date of termination, but the parties shall remain responsible for any payments that have become due and owing as of the effective date of termination. In no event shall the City be liable to Provider for any additional compensation and expenses incurred, other than that provided herein, and in no event shall the City he liable for any consequential or incidental damages. E. Provider shall have right to terminate this agreement and the Administrative Services Agreement upon the occurrence of the following (capitalized terms in this section 14.0 that are not defined in this Agreement shall have the meaning assigned to such terms in the Administrative Services Only Agreement): 1. The date which is at least sixty (60) days from the date that Provider provides written notice to City of termination of this Agreement; 2. The effective date of any Applicable Law or governmental action which prohibits performance of the activities required by this Agreement; 3. Three (3) business days after the date upon which City fails to fund the Bank Account as required by the Administrative Services Only Agreement or fails to pay Provider any charges identified in the Administrative Services Only Agreement when due provided Provider notifies City of its election to terminate; 4. Any other date mutually agreed upon by the Parties. 5. Notwithstanding the foregoing, all provisions in this Agreement and the Administrative Services Only Agreement reasonably related to Provider's administration of the Plan's Pharmacy Benefit (as such term is defined in the Schedule of Financial Charges) (the "Pharmacy Benefit Provisions"), shall continue in effect for no less than thirty-six (36) months commencing on the Effective Date, except that, if any of the following dates occurs, the Pharmacy Benefit Provisions will cease being in effect as of such date: 8/20/2024 9:24 AM p. 498 City of Miami Solicitation RFP 1896386 a) The -effective date of 'any Applicable Law or governmental action which prohibits performance of.the activities.in connection with the Pharmacy Benefit required by this Agreement; b) Three (3) business days after the date upon which City fails to fund the Bank Account as required by this Agreement for claims under the Pharmacy Benefit or fails to pay Provider any charges in connection with the Pharmacy Benefit identified in this Agreement when due, provided Provider notifies City of its election to terminate the Pharmacy Benefit Provisions; or c) The date that is sixty (60) days after notice by one Party ("non - defaulting party") of the material breach by the other Party (the "defaulting party") of a material obligation of the defaulting party related to the Pharmacy Benefit (other than failure to fund the Bank Account or failure to pay any charges when due pursuant to Section C.5.b above) that is not cured to the reasonable satisfaction of the non -defaulting party within a reasonable time following the initial notice of breach. d) Term and Termination with respect to Pharmacy Benefit Administration services shall be as set forth in the. Administrative Services Only Agreement. Insurance: A. Provider shall, at all times during the term hereof, maintain such insurance coverage(s) as may be required by the City. The insurance coverage(s) required as of the Effective Date of this Agreement are attached hereto as Exhibit "F" and incorporated herein by this reference. The City REP number and title of the RFP must appear on each certificate of insurance. The Provider shall add the City of Miami as an additional named insured to its commercial general liability and auto policies on a blanket basis and as a named certificate holder on all policies. Provider shall provide the City's Risk Management Administrator with a copy of the additional insured endorsement evidencing compliance with the requirement of naming the City as an additional insured. Upon request by the City's Risk Management Administrator, the Provider shall provide a true and certified copy of its full insurance policy. The provider shall correct any certificate of insurance as requested by the City's Risk Management Administrator. All such insurance, including renewals, shall be subject to the approval of the City for adequacy of protection and evidence of such coverage(s) and shall be furnished to the City Risk Management Administrator on Certificates of Insurance indicating such insurance to be in force and effect and providing that it will not be canceled, modified, or changed during the perfoiu.iance of the Services under this .Agreement without adequate notice prior to any amendment to the City Risk Management Administrator. Completed certificates of insurance shall be filed with the City prior to the performance of Services hereunder, provided, 8/20/2024 9:24 AM p. 499 City of Miami Solicitation RFP 1896386 however, that Provider shall at any time upon request file duplicate. copies of the policies of such insurance with the City. • B. If, in the reasonable judgment of the City, prevailing conditions in the insurance marketplace warrant the provision by Provider of additional Five Million Dollars ($5,000,000.) of professional liability insurance coverage,. the City reserves the right to require the provision by Provider of up to such additional amount of professional liability coverage, and shall afford written notice of such change in requirements thirty (30) days prior to the date on which the requirements shall take effect. Should the Provider fail or refuse to satisfy the requirement of additional coverage within thirty (30) days following the City's written notice, this Agreement shall be considered terminated on the date the required change in policy coverage would otherwise take effect. C. Provider understands and agrees that any and all liabilities regarding the use of any of Provider's employees or any of Provider's subcontractors for Services related to this Agreement shall be borne solely by Provider throughout the term of this Agreement and that this provision shall survive the termination of this Agreement. Provider further understands and agrees that insurance for each employee of Provider and each subcontractor providing Services related to this Agreement shall be maintained in good standing and approved by the City's Risk Management Administrator throughout the duration of this Agreement. D. Provider shall be responsible for assuring that the certificates of insurance required under. this Agreement remain in full force and effect for the duration of this Agreernent, including any extensions hereof. If such certificates of insurance are scheduled to expire during the term of this Agreement and any extension hereof, Provider shall be responsible for submitting new or renewed certificates of insurance to the City's Risk Management Administrator at a minimum of ten (10) calendar days in advance of such expiration. In the event that expired certificates are not replaced, with new or renewed certificates which cover the term of this Agreement and any extension thereof: (i) the. City shall suspend this Agreement until such time as the new or renewed certificate(s) are received in acceptable form by the City's Risk Management Administrator; or (ii) the City may, at its sole discretion, terminate the Agreement for cause and seek re -procurement damages from Provider in conjunction with the violation of the terms and conditions of this Agreement. F. Compliance with the foregoing requirements shall not relieve Provider of its liabilities and obligations under this Agreement. 8/20/2024 9:24 AM p. 500 City of Miami Solicitation RFP 1896386 16. Nondiscrimination: Provider represents to the City that Provider does not and will not engage in discriminatory practices and that there shall be no discrimination in connection with Provider's performance under this Agreement on account of race, color, sex, religion, age, handicap, marital status or national origin.. Provider further covenants that no otherwise qualified individual shall, solely by reason of his/her race, color, sex, religion, age, handicap, marital status or national origin, be excluded from participation in, be denied services, or be subject to discrimination under any provision of this Agreement. 17. Assignment: Provider agrees not to assign the contract in whole, however while Provider serves as the sole provider of services requested in this proposal, a number of the services under our contracts are performed by affiliates of Provider or by subcontracted vendors without prior written approval for such subcontractors. Every such service will be supervised by Provider, which will be wholly responsible and liable for the services set forth in the contract. 18. Notices: All notices or other communications required under this Agreement shall be in writing and shall be given by hand -delivery or by registered or certified U.S. Mail, return receipt requested, addressed to the other party at the address indicated herein or to such other address as a party may designate by notice given as herein provided. Notice shall be deemed given on the day on which personally delivered; or, if by mail, on the fifth day after being posted or the date of actual receipt, whichever is earlier. TO PROVIDER: TO THE CITY: Yesenia Sanchez Connecticut General Life Insurance 1751 Sawgrass Corporate Parkway Sunrise, Florida 33323 Johnny Martinez, P.E. City Manager 444 SW 2"d Avenue, 10th Floor Miami, FL 3 313 0- 1910 8/20/2024 9:24 AM p. 501 City of Miami Solicitation RFP 1896386 19. Miscellaneous provisions: .A. This Agreement shall be construed and enforced according to the laws of the State of Florida. Venue in any proceedings between the parties shall be in Miami -Dade County, Florida. Each party shall bear its own attorney's fees. Each party waives any defense, whether asserted by motion or pleading, that the aforementioned courts are an improper or inconvenient venue. Moreover, the parties consent to the personal jurisdiction of the aforementioned courts and irrevocably waive any objections to said jurisdiction. The parties irrevocably waive any rights to a jury trial. B. Title and paragraph headings are for convenient reference and are not a part of this Agreement. C. No waiver or breach of any provision of this Agreement shall constitute a waiver of any subsequent breach of the same or any other provision hereof, and no waiver shall be effective unless made in writing. D. Should any provision, paragraph, sentence, word or phrase contained in this Agreement be determined by a court of competent jurisdiction to be invalid, illegal or otherwise unenforceable under the laws of the State of Florida or the City of Miami, such provision, paragraph, sentence, word or phrase shall be deemed modified to the extent necessary in order to conform with such laws, or if not modifiable, then the same shall be deemed severable, and in either event, the remaining terms and provisions of this Agreement shall remain unmodified and in full force and effect or limitation of its use. Provider shall comply with all applicable laws, rules and regulations in the performance of this Agreement, including but not limited to licensure, and certifications required by law for professional service providers. This Agreement constitutes the sole and entire agreement between the parties hereto. No modification or amendment hereto shall be valid unless in writing and executed by properly authorized representatives of the parties hereto. Except as otherwise set forth in Section 2 above, the City Manager shall have the sole authority to extend, to amend or to modify this Agreement on behalf of the City. 20.uccessarsac1 assigns: This Agreement shall be binding upon the parties hereto, their heirs, executors, legal representatives, successors, or assigns. 21. Independent contractors: Provider has been procured and is being engaged to provide Services to the City as an independent contractor, and not as an agent or employee of the City. Accordingly, neither Provider, nor its employees, nor any subcontractor hired by Provider to provide any Services 8/20/2024 9:24 AM p. 502 City of Miami Solicitation RFP 1896386 under this Agreement shall attain; nor be entitled to, any rights or benefits under the Civil Service or Pension Ordinances of the City, nor any rights generally afforded classified or unclassified employees. Provider further understands that Florida Workers' Compensation benefits available to employees of the City are not available to Provider, its employees, or any subcontractor hired by Provider to provide any Services hereunder, and Provider agrees to provide or to require subcontractor(s) to provide, as applicable, workers' compensation insurance for any employee or agent of Provider rendering Services to the City under this Agreement. Provider further understands and agrees that Provider's or subcontractors' use or entry upon City properties shall not in any way change its or their status as an independent contractor. 22. Contingency clause: Funding for this Agreement is contingent on the availability of funds and continued authorization for program activities and the Agreement is subject to or termination due to lack of funds, reduction of funds, failure to allocate or appropriate finds, and/or change in applicable laws or regulations, upon thirty (30) days written notice. Notwithstanding the foregoing, in the event that sufficient funds are not available by the City to pay all amounts required in accordance with this Agreement, Provider shall have the immediate right to cease to process claims for plan benefits including Run -Out Claims (as defined in the Administrative Services Only Agreement) and shall have the right to terminate this Agreement and the Administrative Services Only Agreement in accordance with the terms thereof. 23. Force majeure: A "Force Majeure Event" shall mean an act of God, act of governmental body or military authority, fire, explosion, power failure, flood, storm, hurricane, sink hole, other natural disasters, epidemic, riot or civil disturbance, war or terrorism, sabotage, insurrection, blockade, or embargo. In the event that either party is delayed in the performance of any act or obligation pursuant to or required by the Agreement by reason of a Force Majeure Event, the time for required completion of such act or obligation shall be extended by the number of days equal to the total number of days, if any, that such party is actually delayed by such Force Majeure Event. The party seeking delay in performance shall give notice to the other party specifying the anticipated duration of the delay, and if such delay shall extend beyond the duration specified in such notice, additional notice shall be repeated no less than monthly so long as such delay due to a Force Majeure Event continues. Any party seeking delay in performance due to a Force Majeure Event shall use its best efforts to rectify any condition causing such delay and shall cooperate with the other party to overcome any delay that has resulted. Nothing herein shall relieve the City of its obligations to fund and pay claims and charges in accordance with this Agreement. 24. City not liable for delays: Provider hereby understands and agrees that in no event shall the City be liable for, or responsible to Provider or any subcontractor, or to any other person, firm, or entity for or on account of, any stoppages or delay(s) in work herein provided for, or any damages whatsoever related thereto, because of any injunction or other legal or equitable proceedings or on 8/20/2024 9:24 AM p. 503 City of Miami Solicitation RFP 1896386 account of any delays) for any cause over which the City has no control. Nothing herein shall relieve the City of its obligations to fund and pay claims .and charges in accordance with this Agreement. - 25. Use of name: Provider understands and agrees that the City is not engaged in research for advertising, sales promotion, or other publicity purposes. Provider is allowed, within the limited scope of normal and customary marketing and promotion of its work, to use the general results of this project and the name of the City. The Provider and the City each agrees to protect any confidential and/or proprietary information provided by or on behalf of the other party and will not release information of a specific nature without prior written consent of the City Manager or the City Commission. 26. No conflict of interest: Pursuant to City of Miami Code Section 2-611, as amended ("City Code"), regarding conflicts of interest, Provider hereby certifies to City that individual member of Provider, no employee, and no subcontractor under this Agreement nor any immediate family,member of any of the same is also a member of any board, commission, or agency of the City. Provider hereby represents and warrants to the City that throughout the term of this Agreement, Provider, its employees and its subcontractors will abide by this prohibition of the City Code, 27. No third -party beneficiary: No persons other than the Provider and the City (and their successors and assigns) shall have any rights whatsoever under this Agreement. 28. Survival: All obligations (including but not limited to indemnity and obligations to defend and hold harmless) and rights of any party arising during or attributable to the period prior to expiration or earlier termination of this Agreement shall survive such expiration or earlier termination. 29. Truth -in -negotiation certification, representation and warranty: Provider hereby certifies, represents and warrants to City that on the date of Provider's execution of this Agreement and so long as this Agreement shall remain in full force and effect, the wage rates and other factual unit costs supporting the compensation to Provider under this Agreement - are and will continue to be accurate, complete, and current. Provider understands, agrees and acknowledges that the City shall adjust the amount of the compensation and any additions thereto to exclude any significant sums by which the City determines the contract price of compensation hereunder was increased due to inaccurate, incomplete, or non -current wage rates ,and other factual unit costs. All such contract adjustments shall be made within one (1) year of the end of this Agreement, whether naturally expiring or earlier terminated pursuant to the provisions hereof 8/20/2024 9:24 AM p. 504 City of Miami Solicitation RFP 1896386 30. Counterparts: This Agreement may be executed in three or more counterparts; each of which shall constitute an - original but all of which, when taken together, shall constitute one and the same agreement. 31. Entire agreement: This instrument and its attachments constitute the sole and only agreement of the parties relating to the subject matter hereof and correctly set forth the rights, duties, and obligations of each to the other as of its date. Any prior agreements, promises, negotiations, or representations not expressly set forth in this Agreement are of no force or effect. 8/20/2024 9:24 AM p. 505 City of Miami Solicitation RFP 1896386 IN WITNESS WIIEREOF, the parties hereto have caused this instrument to be executed by their respective officials thereunto duly authorized, this the day and year above written,. ATTEST: Todd Ilannon, City Clerk ATTEST: This 18th day of December, 2013 "City" CITY OF MIAMI, a municipal corporation By: y Martin-z, P.E., City Manager "Provider" Connecticut General Life Insurance Company Name: Victoria A. Sirica Its Account Management Lead Duly Authorized �1.PPROV ,D PTO L ,GAL FORM APP VE AS TO INSURANCE ANDC. R EC '. S: - RI�1RE ENTS: Victoria Mei City Attor �vin El1i •Risk Mana ment Director 8/20/2024 9:24 AM p. 506 City of Miami Solicitation RFP 1896386 EXIIII3IT 13 SERVICES (ADMINISTRATIVE SERVICES ONLY AGREEMENT TOGETHER WITH ITS EXHIBITS AND SCHEDULES) 8/20/2024 9:24 AM p. 507 City of-Mfarni won RF!?.-4..89. Administrative Services Only Agreement By and Between City of Miami "Employer" And Cigna Health and Life Insurance Company "CHLIC" Effective Date: January 1, 2014 TITIS AGREEMENT AND ITS TERMS ARE PROPRIETARY AND CANNOT BE DISCLOSED WITHOUT THE PERMISSION OF EACH OF TIIE PARTIES 8/20/2024 9:24 AM p. 508 Solicitation FP 48 Table of Contents Definitions 3 Section 1. Term and Termination of Agreement 4 Section 2. Claim Administration and Additional Services 4 Section 3. Funding and Payment of Claims 5 Section 4. Charges 6 Section 5. Enrollment and Determination of Eligibility 6 Section 6. Claim Audits and Confidentiality 6 Section 7. Plan Benefit Liability 7 Section 8. Modification of Plan and Charges 8 • Section 9. Modification of Agreement 8 Section 10. Laws Governing Contract 8 Section 11. Information in CHLIC's Processing Systems 9 Section 12. Resolution of Disputes 9 Section 13. Third Party Beneficiaries 9 Section 14. Waivers 9 Section 15. Headings 10 Section 16. Severability 10 Section 17. Force Majeure 10 Section 18. Assignment and Subcontracting 10 Section 19. Notices 10 Section 20. identifying Information and Internet Usage 10 • SIGNATURES 11 Schedule of Financial Charges 12 Exhibit A - Plan Document 23 Exhibit B — Services 24 ;Exhibit C Claim Audit Agreement (Sample) 35 Exhibit D -- Privacy Addendum 38 Exhibit F -- California Transfer Addendum to ASO Agreement 48 Schedule of Financial Charges 51 8/20/2024 9:24 AM p. 509 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement THIS AGREEMENT, effective January 1, 2014 (the "Effective Date") is by and between City of Miami ("Employer") and Cigna Health and Life insurance Company ("CHLIC"). RECITALS: WHEREAS, Employer, as Plan sponsor, has adopted the benefit described in Exhibit A, as may be amended, ("Plan") for certain of its employees/members and their eligible dependents (collectively "Members"); and • WHEREAS, Employer has requested CHLIC to furnish certain administration services in connection with the Plan 3202272. NOW, THEREFORE, in consideration of the mutual promises and covenants contained herein, it is hereby agreed as follows: Definitions Agreement this entire document including the Schedule of Financial Charges and all Exhibits. Applicable Law — means the state, federal and international laws and regulations that apply. Applicable Law includes but is not limited to the Employee Retirement Income Security Act of 1974, as amended and the rules and regulations thereunder ("ERISA"), the Health Insurance Portability and Accountability Act of 1996, as amended and the rules and regulations thereunder ("HIPAA"), the Foreign Corrupt Practices Act ("FCPA") and any other anti -bribery or anti -corruption laws in the countries where the Parties conduct business. Bank Atconnt -- a benefit plan account with a bank designated by CHLIC; established and maintained by Employer in its or a nominee's name. ERISA — the Employee Retirement Income Security Act of 1974, as amended and related regulations. Extra -Contractual Benefits — Payments which Employer has instructed CHLIC to make for health care services and/or products that CHLIC has determined are not covered under the Plan. Member -_. a person eligible for and enrolled in the Plan as an employee or dependent. Participant/Participating Members — Member(s) who is (are) participating in a specific program and/or product available to Members under the Plan. Participating Providers --- providers of health care services and/or products, who/which contract directly or indirectly with CHLIC to provide services and/or products to Members. Plan Benefits -- Amounts payable for covered health care services and products under the terms of the P Eata. Party/Parties -- refers to Employer and CHLIC, each a "Party" and collectively, the "Parties". Plan Year — the twelve (12) month period, beginning on the Effective Date and, thereafter, each subsequent twelve (12) month period. Rtin-Out Claims -- claims for Plan Benefits relating to health care services and products that are incurred prior to termination of this Agreement; termination of a Flan benefit option or eligible Members, as applicable. 12/26/2013 3 8/20/2024 9:24 AM p. 510 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Section 1. Term and Termination of Agreement This Agreement is effective on the Effective Date and shall remain in effect until the earliest of the following dates: i. The date which is at least sixty (60) days from the date that either Party provides written notice to the other Party of termination of this Agreement; ii. The effective date of any Applicable Law or governmental action which prohibits performance of the activities required by this Agreement; iii. The date upon which Employer fails to fund the Bank Account as required by this Agreement or fails to pay CHLIC any charges identified in this Agreement when due provided CHLIC notifies Employer of its election to terminate; iv. Any other date mutually agreed upon by the Parties. v. Notwithstanding the foregoing, all provisions in this Agreement reasonably related to CHLIC's administration of the Plan's Pharmacy Benefit (as such term is defined in the Schedule of Financial Charges) (the "Pharmacy Benefit Provisions"), shall continue in effect for no less than thirty-six (36) months commencing on the Effective Date, except that, if any of the following dates occurs, the Pharmacy Benefit Provisions will cease being in effect as of such date: a, The 'effective date of any Applicable Law or governmental action which prohibits performance of the activities in connection with the Pharmacy Benefit required by this Agreement; b. Tlie date upon which Employer fails to fund the Bank Account as required by this Agreement for claims under. the Pharmacy Benefit or fails to pay CHLIC any charges in connection with the Pharmacy Benefit identified in this Agreement when due, provided CHLIC notifies Employer of its election to terminate the Pharmacy Benefit Provisions; or c. The date that is sixty (60) days after notice by one Party ("non -defaulting party") of the material breach by the other Party (the "defaulting party") of a material obligation of the defaulting party related to the Pharmacy Benefit (other than failure to fund the Bank Account or failure to pay any charges when due pursuant to Section I.v.b above) that is not cured to the reasonable satisfaction of the non -defaulting party within a reasonable time following the initial notice of breach.. During such thirty-six (36) month period (or shorter period, as applicable under (a), (b) or (c) above), CIILIC will continue to be the exclusive provider of Pharmacy Benefit administration services for the Plan's Pharmacy Benefit. In the event that Employer purports to terminate such arrangement or enters into an agreement with another pharmacy benefit manager ("PBM") or other third party to provide any or all pharmacy benefit management services for Employer's benefit plan prior to the end of such thirty-six (36) month period, then, within thirty (30) days of CHLIC's written request, Employer shall pay CHLIC the amount of $2.25 per the average monthly number of Members who were enrolled in the Plan's Pharmacy Benefit from the beginning the thirty- six (36) month period to the effective date of such purported termination or other agreement multiplied by the nurnber of months remaining until the end of the thirty-six (36) month period. Section 20 Claim Administration and Additional Services a. While this: Agreement is in effect, CHLIC shall, consistent with, the claim. administration policies and procedures then applicable to its own health care insurance business (I) receive and review claims for Plart . Benefits; (ii) determine the Plan Benefits, if any, payable for such claims; (iii) disburse payments trf Plane 12./26/2013 4 8/20/2024 9:24 AM p. 511 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Benefits to claimants; and (iv) provide in the manner and within the time limits required by Applicable Law, notification to claimants of (a) the coverage determination or .(b) any anticipated delay in making a coverage determination beyond the time required by Applicable Law. b. Following (i) termination of this Agreement, except pursuant to Section 1 (iii); (ii) termination of Plan benefit option or (iii) termination of eligible Members, if the required fees have been paid in full, if any, CHLIC shall process Run -Out Claims for the applicable Run -Out Period (See Schedule of Financial Charges for applicable fees and Run -Out Period). At the termination of any applicable Run -Out Period, CHLIC shall cease processing Run -Out Claims and, subject to the requirements of Section 6.b, make all relevant records in its possession relating to such claims reasonably available to Employer or Employer's designee. CHLIC is not required to provide proprietary information to Employer or any other party. c. Employer hereby delegates to CHLIC the authority, responsibility and discretion to determine coverage under the Plan based on the eligibility and enrollment information provided to CHLIC by Employer. Employer also hereby delegates to CHLIC the authority, responsibility and discretion to (i) make factual determinations and to interpret the provisions of the Plan to make coverage determinations on claims for Plan Benefits, (ii) conduct a full and fair review of each claim which has been denied as required by ERISA, (iii) decide level one mandatory appeals of "Urgent Care Claims" "Concurrent", "Pre -service" and "Post -service" claims (as those terms are defined under ERISA) and notify the Member or the Member's authorized representative of its decision. Employer will ensure that all summary plan description materials provided to Members reflect this delegation. d. In addition to . the basic claim administrative duties described above, CHLIC shall also perform the Plan -related administrative duties agreed upon by the Parties and specified in Exhibit B. Section 3. Funding and Payment of Claims a. Employer shall establish a Bank Account, and maintain in the Bank Account an amount sufficient at all times to fund checks written on it for the following (collectively "Bank Account Payments"): (i) Plan Benefits; (ii) those charges and fees identified in the Schedule of Financial Charges as payable through the Bank Account and (iii) any sales oruse taxes, or any similar benefit- or Plan -related charge or assessment however denoininated, which may be imposed. by any governmental authority. Bank Account Payments may include without limitation: (i) capitated (Le. fixed per Member) payments :to Participating Providers; (ii) amounts owed to CPILIC; and-(iii) amounts paid to CHLIC's affiliates and/or subcontractors for, among other things, network access or in- and out -of network health care services/products provided to .Members. CHLIC may credit the Bank Account with payments due Employer under a stop loss policy issued by CHLIC or an affiliate. b. CHLIC, as agent for the Employer, shall make Bank Account Payments from the Bank Account, in the amount CHLIC reasonably determines to be proper under the Plan and/or under this Agreement. e. In .the event that sufficient funds are not available in the Bank Account to pay all Bank Account Payments when due, CHLIC shall cease to process claims for Plan Benefits including Run -Out Claims. d. CHLIC will promptly adjust any underpayment of Plan Benefits by drawing additional funds due the claimant from the Bank Account, In the event CHLIC overpays a claim for Plan Benefits or pays Plan Benefits to the wrong party, it shall take all reasonable steps to recover the overpayment; however, C.FILIC shall not be required to initiate court, mediation, arbitration or other administrative proceedings to recover any overpayment. CHLIC shall not be responsible for reimbursing any unrecovered payments of Plan Benefits unless made as a result of its gross negligence or intentional wrongdoing. e. Following termination of this Agreement, Employer shall remain liable for payment of all due Bank .Account Payments and for.all reimbursements due :Members under the Plan. Employer shall promptly reittiburse € 2/26/201.3 5 8/20/2024 9:24 AM p. 512 City of Miami Solicitation RFP 1896386 Client Nate: City of Miami Administrative Services Only Agreement Benefits to claimants; and (iv) provide in the manner and within the time limits required by Applicable Latin, notification to claimants of (a) the coverage determination or (b) any anticipated delay in making a coverage determination beyond the time required by Applicable Law. b. Following (i) termination of this Agreement, except pursuant to Section 1 (iii); (ii) termination of Plan benefit option or (iii) termination of eligible Members, if the required fees have been paid in full, :if any, CHLIC shall process Run -Out Claims for the applicable Run -Out Period (See Schedule of Financial Charges for applicable fees and Run -Out Period). At the termination of any applicable Run - Out Period, CHLIC shall cease processing Run -Out Claims and, subject to the requirements of Section 6.b, make all relevant records in its possession relating to such claims reasonably available to Employer or Employer's designee. CHLIC.is not required to provideproprietary information to Employer or any other party. c. Employer hereby delegates to CHLIC the authority, responsibility and discretion to determine coverage under the Plan based on the eligibility and enrollment information provided to CHLIC by Employer. Employer also hereby delegates to CHLIC the authority, responsibility and discretion to (i) make factual determinations and to interpret the provisions of the Plan to make coverage determinations on claims for Plan Benefits, (ii) conduct a full and fair review of each claim which has been denied as required by ERISA, (iii) decide level one mandatory appeals of "Urgent Care Claims" "Concurrent", "Pre -service" and "Post -service" claims (as those terms are defined under ERISA) and notify the Member or the Member's authorized representative of its decision. Employer will ensure that all summary plan description materials provided to Members reflect this delegation. d. I:t , addition to the basic claim - administrative duties described above, CHLIC shall also perform the Plan -related administrative duties agreed upon by the Parties and specified in Exhibit.B. Section Funding and Payment of Claims a. Employer shall establish a Bank Account, and maintain in the Bank Account an amount sufficient at all times toehind cheeks written on it for the following. (collectively "Bank Account Payments"): (i) Plan Benefits; (ii) tlmse charges and fees identified in the Schedule of Financial Charges as payable through the Bank Account and (iii) any sales. or use taxes, or any similar benefit- or Plan -related charge or assessment however denominated, which may be imposed by any governmental authority. Bank Account Payments may include without limitation: (i) capitated (i.e. fixed per Member) payments to Participating Providers; (ii) amounts owed to CHLIC; and (iii) amounts paid to CIILIC's affiliates and/or subcontractors for, among other things;.: network access or in-- and out -of network health care services/products provided to Members. CHLIC'may credit the Bank Account with payments due Employer under a stop loss policy issued by CHLIC-or an aflil late. b. CIILIC, as agent for the Employer, shall make Bank Account Payments from the Bank Account, in the amount CHLIC reasonably determines to be proper under the Plan and/or under this Agreement. c. In the event that sufficient funds are not available in the Bank Account to pay all Bank Account Payments when due, CHLIC shall cease to process claims for Plan Benefits including Run -Out Claims. d. CHLIC will promptly adjust any underpayment of Plan Benefits by drawing additional funds due the claimant from the Bank Account. In the event CHLIC overpays a claim for Plan Benefits or pays Plan Benefits to the wrong party, it shall take all .reasonable steps to recover the overpayment; however, CHLIC shall -not be required to initiate court, mediation, arbitration or other administrative proceedings to recover any overpayment. CELL IC shall not be responsible for reimbursing any unrecovered payments of Plan Benefits unless made as a result of its gross negligence or intentional wrongdoing. e. Following termination of this Agreement, Employer shall remain liable for payment of all due Bank Account Payments and for all reimbursements due Members Under the Plan. Employer shall promptly reimburse 12/26/2013 8/20/2024 9:24 AM p. 513 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement CHLIC 'for any Bank Account Payments paid by CHLIC with its own funds and ono such payment by CHLIC shall: be construed as an 'assumption of any of Employes liability. . • This Section 3 shall survive termination of this Agreement. Section 4A Charges , a Charges. CHLIC shall provide to Employer a monthly statement of all charges Employer is obligated to pay under this Agreement that are not paid as Bank Account Payments. Payment of all billed charges shall:be due on the first day of the, month, as indicated on the monthly statement. Payments received after the last day of the month In which they are due, shall be subject to late payment charges, from the due date .at a rate calculated as follows: the one (1) year Treasury constant'maturities rate for the first week ending hi January • plus five percent-(5%). For -purposes of calculating late payment charges, payments received will be applied. first to the oldest outstanding amount due. CHLIC may reasonably revise the methodology for calculating late payment. eha.rges upon thirty (30) days' advance written.notice:to Employer. b. Member Changes Additions and Terminations. If a Member's effective date is on or before the fifteenth (15th) day of the month, full charges applicable to that Member shall be. due for that Member for that month. If eovera.ge does not start or ceases on or before the fifteenth, (15th) day of the .month for a Member, no charges shall be due for that Member for that month. e. Retroactive Member Changes and Terminations. Employer shall remain responsible for all charges and Bank Account Payments incurred or charged through the date CHLIC processed Employer's notice of a retroactive change or termination of Membership, However; if the Change or termination would result in a reduction in charges, CHLIC shall credit to Employer the reduction in charges charged for the shorter of (a) the sixty (60) day period preceding the date CHLIC processes the notice, or .(b) the period from the date of the change or termination to the date CHLIC processes the notice. This Section. 4 shall survive termination of this Agreement. Section S. Enrollment and Determination of Eligibility a. Eli:g,ibility Determinations. and. Information. Employer is responsible for administering Plan enrollment. -In determining any-person's right to benefits under-the.Plan, CHLIC shall rely upon enrollment and eligibility information provided -by. the Employer. Such information shall identify the effective date of eligibility.:, and' the ,termination .date- of eligibility and shall be provided promptly to CHLIC in a format- and with such other information as reasonably may be required by CHLIC.for the proper administration of the Plan. - b. Release of Liability. Notwithstanding any inconsistent provision of this Agreement to the contrary, 'if Employer, fails to provide CHLIC with accurate enrollment and eligibility information, benefit design requirements, or other agreed -upon information itr CHL1C's standard tirneframe and format, CHLIC shall have no liability- under. this Agreement for. any act or .omission by CHLIC, -or its employees, affiliates: subcontractors, agents or representatives,.direetly or. indirectly caused by snob failure. c. Reconciliation of Eligibility and Inforrtiation and'T3elatilt Terminations, CHLIC will periodically share potential discrepancies in eligibility information with Employer. Employer will review and reconcile any discrepancies within thirty (30) days of receipt, If Employer fails to timely do so, CHLIC may terminate coverage for any Meinber not listed as eligible in 1w;mploycr9s submitted eligibility information. Section 6a Claim Audits and Confidentiality r a, Clan - .Audit: Employer May,. in accordancoWith ibe foltowing regti rernent and at'nt7 additional charge while • this Agreement is iii effect, audit CHLIC"s jrayinedt: of Plan Benefits: 12/26/2013 6 8/20/2024 9:24 AM p. 514 City of Miami Solicitation RFP 1896386 Client came: City of Miami Administrative Services Only Agreement a.. ym.....d.taw •& mom•,. Employer sh. llprovide-CHLIC forty-five (45) .days advance written request for audit from the later of (i) • receipt by CHLIC of the audit scope letter or (ii) the fully executed Claim Audit Agreement attached hereto as Exhibit C. Employer will designate with CHLIC's consent, such consent not to be unreasonably withheld, an independent, third party auditor to conduit the audit (the "Auditor). In addition, Employer and CHLIC will agree upon the date for the audit during regular business hours at CI-ILIC's offiee(s). Employer shall be responsible for its Auditor's costs, Except as otherwise agreed to by the parties in writing prior to the commencement of the audit, the audit shall be conducted in accordance with the terms of.CHLIC'-s:Claim Audit Agreement attached hereto as Exhibit C, which is hereby agreed to by Employer and which shall be signed by the Auditor prior to the start of the audit. ii. if Employer has five thousand (5,000) or more employees who are Members, Employer may conduct one such audit every Plan Year (but not within six (6) months of a prior audit); otherwise, Employer may 'conduct one such audit every. two (2) Plan Years (but not within eighteen (1 S) months of a prior audit). • iii, Auditor will review payment documents relating to a random, statistically valid sample of two -hundred twenty-five (225) claims paid during the two. prior Plan years and not previously audited (the "Audit")'• subject to any contrary terms in Participating Provider agreements. With respect to the Audit, the scope may include types of claims prone to overpayments provided the types of claims prone to underpayments are equally included and will exclude electronic analysis. Any claim adjustments will be based upon the actual claims reviewed and not upon statistical projections or extrapolations. Confiirlexrtiality, i. Subject to'... he requirements of Applicable Law, the terms of this Agreement and the Privacy Ad.dendurn in Exhibit;tD,- a signed Business :Associate agreernent between Employer and. its designee, and a signed Confidentiality Agreement by -applicable designee, CIS IC shall release copies of confidential claims and- Pl.an Benefit payment information in CHLIC's claims system ("Confidential information") and may release copies . of proprietary information relating to the Plan in CIILIC's claims system ("Proprietary Irrfarmati'tfu") to the Employer and/or .its designees. Employer agrees that Employer and its designees will keep Confidential Information and Proprietary Information confidential and will use Confidential Information and Proprietary Information solely for the purpose of administering the Plan or as otherwise • required by law. Employer is solely responsible for the consequences of any use, misuse, or disclosure of • Confidential Information provided by CHLIC pursuant to this -paragraph b.. • ii. CPILIC will maintain the confidentiality .of all Protected lleal'th Infermat on in its possession in accordance with the Privacy Addendum in Exhibit D and any applicable state privacy laws, including,' without limitation, 201 CMR 17.00; Massachusetts Standards for the Protection of Personal Information. of Residents of the Commonwealth. c. •Upon termination of this Agreement and subject to the provisions of Section 6:b above, CHLIC shall inake information available to the extent administratively feasible if the •Part.ies agree upon the charge to be paid by .Employer. The, obligations set forth in this Section 6 (b), shall survive termination o f this; Agreement. Section 7. Plan Benefit Liability a. Employer Liability for .Plan Benefits. Employer 'is responsible for all. Plan- Benefits including any Plan Benefits paid as a result of any legal action. Employer is responsible for reifnburs.ing CHLIC, its directors, - officers and employees for any reasonable expense incurred (including reasonable attorneys' fees) by them the defense. of any. action or proeeeding .involving a claim. for Plan. Benefits,(".IILIC shall reasonably cooperate with Employer in its defense of such actions. 12/26/2013 7 8/20/2024 9:24 AM p. 515 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement If Employer directs CHLIC•-in writing. to pay a claim for Extra-Contraetuai Benefits, Employer is responsible -- for funding the payment and such payrnents shall not be considered in .determining reimbursements or • payments under,. stop .loss {. insurance or in- determining any I risk -sharing or performance guarantee . reimbursements. Employer shall reimburse CHLIC for any liability or .expenses (including reasonable attorneys' fees) CHLIC may incur in connection with making such payments. Employer Liability for Plan Related Expenses. Employer shall reimburse CHLIC for any amounts CHLIC may be . required to pay (i) as state premium tax or any similar Plan -related .tax, charge, surcharge or assessment, or (ii) under any unclaimed or abandoned property, or escheat law, with respect to Plan Benefits and any penalties and/or interest thereon. The r•eirribur>em.ent obligations set forth in this Section 7 shall survive termination of this Agreement. Section$. Modification of Plan and Charges . a, CHLIC shall have the right to revise the charges identified in this Agreement (i) on each anniversary of this Agreement, (ii) at any time by giving Employer at least sixty (60) days' prior written notice, but not.Ynore • frequently than once .in a six (6) month period; (iii) upon any. modification or amendment of the benefits under .the Plan, (iv) upon any variation of fifteen percent (15%) or more in the number of Members used by CHLIC to calculate -its charges under this Agreement, and/or (v) upon any change in law or regulation that - materially impacts CI LIC's liabilities and/or responsibilities under this Agreement. :Bmployer.shall provide CHLIC written notice of any modification or amendment to the Plan sufficiently •in • .a{vance. of any such change. as to allow CHLIC to implement the modification or amendment. Employer and i ;l-1LIC shall agree upon the. manner and tinning of the implementation subject to CPILIC's system and operational capabilities. SeeOon 9. Modification of Agreement This Agreement constitutes the entire contract between the Parties regarding the sribjeet matter herein. Except, as 'Otherwise provided herein; the provisions of this Agreement shall control in the event of a conflict with the terms of any other agreements, No modification or amendment hereto shall be valid unless in writing and signed by an aittlrorized person of each of the Parties, except that modification of charges pursuant to Section 8 above m.ay be • made by written notice. to Employer;by CHLIC. If Employer pays such revised charges or fails to object to such • . revision inwriting within fifteen. (15) days of receipt, this Agreement shall be deemed modified to reflect- the • charges as communicated, by CHLIC. Section 'Id. Laws Governing Contract ... a. This Agreement shall be construed in accordance with the laws of the State of Connecticut without regard to conflict of law rules, and both Parties consent to the venue and jurisdiction of its courts. The' Parties shall perform their obligations under this Agreement itr conforrrra.nce with all Applicable Laws and regulatory requirements. .1212612013 8 8/20/2024 9:24 AM p. 516 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement ..Section 11 Information in CHLIC's Processing Systems CHI.;IC may retain and use all Plan -related claim and Plan Benefit Payment information recorded for or otherwise `integrated into CHLIC's b .ismess records including claim processing systems daring the ordinary coarse of business (provided, however, that claim or payment information will be available to Employer pursuant to Section 6). CIILIC will retain claim and payment information as required by Applicable Law. Section 12. Resolution of Disputes Any dispute between the Parties arising -from or relating to the performance or interpretation of this •Agreement ("Controversy") shall be resolved exclusively pursuant to the following mandatory dispute resolution procedures: . a. Any- Controversy shall first be referred to an executive level employee of each Party who shall meet rand confer with his/her counterpart to atternpt to resolve the dispute ("Executive Review") as.. follows: The disputing Party shall give the other Party written notice of the Controversy and request Executive Review. Within twenty (20) days of such written request, •the receiving Party shall respond to the other in writing. The notice and the response shall each include a summary .of and support for the Parry's. position. Within thirty (30) days of the request for Executive Review, an employee of each Party, with full authority to resolve the dispute, shall meet and attempt to resolve the dispute, b. If the Controversy has not been resolved within thirty-five- (35) calendar days of the request -of-Executive . Review under Section 12.a, above, the Parties agree to mediate the Controversy in accordance with the Ottrican Health Lawyers Association Alternative Dispute Resolution Service Rules of Procedure for . • .Nediation ("Mediation"). The mediation shall be conducted • in Hartford, Connecticut. Each Party shall • .-41.surne its. own costs. and attorneys' fees. The mediator's compensation and expenses and any administrative fees or costsassoc'sate.d with the mediation proceeding shall be borne equally by the Parties. c. 1iPthe Controversy has not been resolved by Executive Review or Mediation, the Controversy shall be settled *elusively 1usively by bidding arbitration. The arbitration shall be conducted in the same location as noted in Section 1-2.b. above; in accordance with the .American Health Lawyers Association Alternative Dispute Resolution Service Rules of Procedure for Arbitration. The arbitration shall be binding on the Parties to this Agreement and on any respective affiliates which joined in the arbitration. The arbitrator's decision shall be final; 'conclusive. and binding, and no action at law or in equity may be instituted by either Party other than -to enforce the arbitrator's award. Judgment -on the award rendered by the arbitrator may be -entered in any -Court - '; having jurisdiction thereof: Each Party shall •assume its •own costs- and attorneys' fees. The arbitrator's compensation and expenses and any administrative fees or costs associated With the arbitration proceeding shall be borne equally by the Parties. This Section. 12 shal.l.surv.ive termination of this Agreement. - - Section 13. Third -Party Beneficiaries Phis Agreement is solely for the benefit of Employer and CHLIC. It shall not be construed to create any legal- . relationship hetwe€n-CILICand any other party.. Section 14. Waivers No. course of dealing or failure -of either Parry to strictly enforce any term, right or condition of this Agreement shall be construed. as a waiver of such.term, right or condition. Waiver by either Party of any default shall trot be deemed a waiver of any other default. I2/2.6/20L3 8/20/2024 9:24 AM p. 517 City of Miami Solicitation RFP 1896386 Client Name: City of Miami . Administrative Services Only Agreement Section 15. Headings • - . • Article, ,section, or paragraph headings -contained in this Agreement are Tor reference purposes only and shall not • -affect the meaning or interpretation of this Agreement. . Section 16. Severability If any provision or any part of a provision of this Agreement is held invalid or unenforceable, such invalidity or unenforceability shall not invalidate or render unenforceable any other portion of this Agreement. Section47. Force Majeure CHLIC shall not be liable for any failure to meet any of the obligations required under this Agreement where such failure to perform is due to any contingency beyond the reasonable control of CHLIC, their employees, officers, or directors: Such contingencies include, but arenot limited' to, acts or omissions of any person or entity not employed or reasonably controlled by CHLIC, their employees, officers, or directors, acts of God, fires; wars, accidents, labor disputes or shortages, and governmental laws, ordinances, rules or regulations. Section 18. Assignment and Subcontracting Neither Party may assign any right, interest, or obligation hereunder without the express written consent of the other Party; provided, however that CHLIC may assign any right, interest, or responsibility under this Agreement to its affiliates and/or subcontract specific obligations under this Agreement provided that CI-IL.I.0 shall not be relieved of its obligations under this Agreement when doing so. Section :1.9. Notices . Exc pt as otherwise provided, all notices or other communications hereunder shall be in writing and shall be deemed ;to have been duly made when (a) delivered in person, (b) delivered to an agent, such as an overnight or similardelivery service, (c) delivered electronically, or.(d) deposited in the United States mail, postage prepaid, and addressed as follows: To CHLIC: Cigna Health and Life Insurance Company 401 Chestnut Street - Chattanooga, TN 3 7402 - Attention Jenny Wilson, Underwriting Director • To Employer: City of Miami 444 SW 2nd Ave, 9th Floor Department of Risk Management Miami, FL 33130 Attention: CalViri El1Ys The address to which notices or communications may be given by either Party may. be changed by written notice - given by one Party to the other pursuant to this Section. Section 20., identifying information and Internet Usage; Except, as necessary in the performance of their duties' under this Agreement, neither Party may use the other's name, logo, service marks, trademarks or other identifying information or to establish a link to the other's World Wide Web site without its prior written approval. 1 2/26/2 013 10 8/20/2024 9:24 AM p. 518 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Signature page intentionally deleted as -this ASCU Agreement is part of the Professional Service Agreement, . 12/26/2013 l 1. 8/20/2024 9:24 AM p. 519 Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services ©rely Agreement Schedule of Financial Charges Certain fees and charges identified in this Schedule of Financial Charges will be billed to Employer monthly in accordance with CHLIC's then standard billing practices. However, CHLIC is authorized to pay all fees and charges from the Bank Account unless otherwise specified in this Agreement. Medical Medical Vision Network Point of Service Open Access (POSOA) with PHS Plus Medical Management $18.53/employee/month Comprehensive with PHS Medical Management • Network POSOA Access Fee $18.85/employee/month $0.32/empldyee/month $18.40/employee/month - Medical • Comprehensive Care Coordination Fee $5.40!employee/month Behavioral Health $2,56/Member/month An Administrative Charge for Mental Health/Substance Abuse Services, including lifestyle management programs and a cognitive behavioral modification program, a Complex Psychiatric Case Management program, and a Narcotics Therapy Management program, will be processed through the Bank Account for members residing in North Carolina with a Network Product. * Dependent Care Flexible Spending Account (DFSA) Administration $5.90/employee/month 12/25/2O13 12 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement = Health Care Flexible Spending Account (FSA) Administration $5.90/employee!month .:*' 6 E€� �.. _ . .. -. :E.'.. c - !. {lPl' 1, `b = € :R.¢ 6 Eg ((; ??€€ �EI��`i..,'�SfttfE���i.#F:F (IE d8 `�a6 �p9 € '? - #?3.Si gF�' i £. A ¢ 1 ] . i a E � ? ar fit tq � �Ez" 4a-�` Y .a 1: a€� 3�!° #'E.> �" dpL3jjp?�j P 1 .� .s .R �k �§'..°�°... y��y$ y9@�@[ 9( °_°. x i- � P tl� ! '. tf'-8.'.8?. ,.:-Ni�?d9 a n b. � RIF�..' �'. ¢ �_ 3- a8 @ , a - E p i:..�9.£f:Ei za,�:. figg 4,p6.�: 1� � ai .I ��6E�� i IS 6f Ay { d ;'.' R�: >c . pp� psC�(�Y�j§p�}( {�I a :,.,.' 11§fgp t 9PR�"ErB '.��� .t. @ j §fs� ddFB��'_.�@et E g3 B30 ?'9'��=�}�, j 1.j$,. .P€B -�E�6? 6�m,. b. t ,g`? a 9'— _&E8 y. ap �€(g.: �z._a�--.- K ��.., s.> - -tla �� a . ��- §� 9��p,�. �-n9ggy EPIC'€E�4E �dF� ,s''_?s,,. it a @33 N�! v& t� ,; EE Definitions 0 • "Average Wholesale Price" or "AWP" is the Average Wholesale Price for a given pharmaceutical product in effect on the dispense date for the actual package size dispensed as published by Medi-Spain or other alternative publication or benchmark reasonably designated by CHLIC. "Brand Drug Claim" is a claim for a pharmaceutical product that is adjudicated as a brand drug as indicated on the claim record generated by the I claim processing system used by CHLIC. For application of discounts and dispensing fees, a "Brand Drug Claim" includes a claim for a generic drug within its exclusivity period or other period of limited competition, as CHLIC reasonably determines under its standard policies. "Generic Drug Claim" is a claim for a pharmaceutical product that is adjudicated as a generic drug as indicated on the claim record generated by the claim processing system used by CHLIC. • For application of discounts and dispensing fees, a "Generic Drug Claim" excludes a claim for a generic drug within its exclusivity period or other period of limited competition, as CHLIC reasonably determines under its standard policies. ® "Mail Service Pharmacy" or "Cigna Tel -Drug" or "Cigna Horne Delivery Pharmacy' is a pharmacy that is owned or operated by CHLIC or an j affiliated company(ies) (currently, Tel -Drug, Inc. and Tel -Drug of Pennsylvania, LLC), which dispenses drugs covered under the Plan's Pharmacy Benefit by mail, and is not a Retail Pharmacy. "Pharmacy Benefit" means the terms of the Plan that govern coverage and care/utilization management of drugs and related supplies dispensed to Members and charged to the Plan by the Mail Service Pharmacy or Retail Pharmacies through CHLIC's pharmacy claim processing system. "Rebates" or "Manufacturer Formulary Payments" means amounts that CHLIC collects under contracts with drug manufacturers that arebased on utilization of certain of the manufacturers' brand drugs under the Plan's Pharmacy Benefit and the drug's status on the Cigna drug formulary. 1 ® "Retail Pharmacy" is a pharmacy that is entitled to payment under the Plan for drugs it dispenses that are covered under the Plan's Pharmacy Benefit, and is not a Mail Service. Pharmacy. "Specialty Drug Claim" is a claim for a pharmaceutical product that is reasonably determined by CHLIC to be a specialty drug in accordance with industry practice. Specialty drugs generally are (i) injected or infused and derived from living cells, or are oral non -protein compoturds (e.g., oral chemotherapy drugs);,(ii) target the underlying condition, which is usually one of a relatively rare, chronic and costly nature; and/or (iii) require restricted a[[ ccess and/or close monitoring. ..� i vn.I 6 $� �'?' ¢¢@@ [[i§ c4[.D.O� .@ L! j' h @¢$& p d P Ea i3� �7�9I�§ 8�_ 9 .6� Pb:@E'8 ,. . {E .11. '.'. �§ 3 �r :i 6 1 F 'e b t € : ,t , t ? .y( jj S (I$E r >: Jill dq so � l....! iE��� � PI Jill ast. $ d. °a . 1, d I/ fl•1 B$ P y pp .... f'...:-: €' ®®� y q Sg %rtyy' P i p 1 S ] ? [ . 111 l- �i._ f .- EP. 'XI .. F§ . 3 . ,z [ iII ��xd* f .£: s � S..i, �@E@ ' 7j} I I3 PE 4�'d#. : . tliq}yB § @ : p¢ -I frE P-"@^ag �a I at, ! e 'Gg'b �k'Ek i.3'?.tin?-,i19 Y SE£d d gyFj 3 A I i$ 3$}.a4 �y Q9p6 x q, j9i £l .;r.Pi£,i.€@azP6t , 9 9�9d �Ep m.@I i 11` ? 51 € 9.ed[9¢tl..Y.e ..,u %,S,s__,a. P,...,. • Cigna Pharmacy Product Administration Fee: Included in Medical Administration Charge 12/26/2013 13 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement dill!" gg 88 @@ Ppp8 33 P.9� �Sp} €t {pyppgqpp� 3gg 41 if £Y $�C pp d ° ? � i @H {f �)jjEE j;7}(j9§§[�' ° 77 e EE@ MIS a0 lQ t EY f YfY�EB 1: �3�� 9 � A'$ A E 3',9 I, I B �' �pE < 10. E4fa A B�' '. 9 .(-8 j , ." d �:6$ p¢ iyYpNy I giY� $ $ @ ' E ` ni r �: �Cg� �ii E.� d gg L' P"�e. 3—sie. @ 2p § BR P t� g�¢w -pE' i 5:. v qes 97 ( W 0 6 9y q4 t 3 {1 1 } 3s 3 t d { P 8 $��ga :. ipi?$�L'`.i.53pegj�(�(�y7y7{ mom � Ydi. a3 i 3 € jjj t R §gi . q5 3: ij t is min �j �1 €4g°,e ��fg€p6�°Pj(� [� €q@ij s °$ NOWARM €°F Sf€�; 3t� ;� $?#37: F N '§€FE€iE EEE CIP 3 drug Dispensed by Mail ServicePharmacy:- CHUG will. charge ;Employex the fa'I10 g for clots ,covered mtde Si r aoy Benefit and i .ensed,b 'the I Tail; Service Pl armaeeY:,. Brand Drug Claims: AWP minus an average discount of 26.0% plus an average dispensing fee of $0.00. Generic Drug Claims: The drug's charge on a CHLIC generic Maximum Allowable Charge schedule that generates an annual average aggregate discount across Generic Drug Claims dispensed at Cigna Home Delivery Pharmacy to CHLIC group -client book of business of AWP minus $0.0% plus an average dispensing fee across such Generic Drug Claims of not more than $0.00. Specialty Brand Drug Claims: The drug's charge under a.national discount schedule that generates a 13.7% annual average aggregate discount off AWP for Specialty Drug Claims dispensed at Cigna Home Delivery Pharmacy across CHLIC 's group -client book of business (including Specialty Drug Claims dispensed by Mail Service Pharmacy, whether covered under group -clients' Cigna Pharmacy Benefit or Cigna medical benefit). Drags Dispensed by Retail Pharmacies CHLIC will charge Employerthe folio vrng,fordrugs covered undertfte°'Plan"s Pharitiacy Benefit and dispensed, by a:Reetail Pharmacy-tc the Plan Members, subi.ect to tho "Drug 'Ch rge • Additroital Pro iisio s7ec ton: Retail Brand Drug Claims: The Iesser of (i) AWP minus an average discount of 16.50% plus an average dispensing fee of $1.00; or (ii) the Retail Pharmacy's usual and customary charge. Retail Generic Drug Claims (other than those to which the above brand discount applies): The lesser of: (i) the drug's charge on a CHLIC generic Maximum Allowable Charge schedule that generates an annual average aggregate discount. across Generic Drug Claims dispensed. at Retail:Phormacies to CHLIC group -client book of business of AWP minus 76.5% (Plan -specific results may vary based on drug mix), plus an average dispensing fee across such Generic Drug Claims of no more than $ .00; or (ii) the Retail Pharmacy's usual and customary charge. Retail Specialty Brand Drug Claims: The lesser of (i) AWP minus an annual average aggregate discount of 13.5%, plus an average dispensing fee of no more than $1.40; or (ii) the Retail Pharmacy's usual and customary charge. 12/26/2013 14 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement a• rq i` �� a , s � a®" r ,' € u t° € is ' ;3. 3 3 a a �; 3i!��€ t? I: gj q .: , o, ; I,�. „it�a�-E �f I �j{ia� c-, E� �€� is if�i , €;@9dW91oi[).a.395¢wa?a,aa3 ,�;' „!E �. ! -,ii l .7�.;>� L' s3, �4a,10�4€,..Ids ▪ Cigna Home Delivery Pharmacy's discounts ate applied to the manufacturer average wholesale price (AWP) for the dispensed size (or to the AWP for the manufacturer -packaged quantity closest to the dispensed size, if there is no AWP for the dispensed size), Cigna Home Delivery Pharmacy will be reimbursed through the Bank Account for the price (discounted as per this Schedule) for replacement prescriptions shipped by Cigna Home Delivery Pharmacy which are reported as lost or damaged despite Cigna Home Delivery Pharmacy's . shipment to the Participant's correct name and address. ▪ The amount paid to the Retail Pharmacy for Brand, Generic, or Specialty Drug CIaims may or may not be equal to the amount charged to Employer, and CHLIC will absorb or retain any difference. • An excess achieved in any Plan -specific discount floor or dispensing fee cap offered under this Agreement will be used to offset a shortfall in any other Plans: -specific discount floor or dispensing fee cap offered under this Agreement. Industry Changes to or Replacement of Average Wholesale Price (AWP). Notwithstanding any other provision in this Agreement, including in this 'Exhibit, in the event- of any major change in market conditions affecting the pharmaceutical or pharmacy benefit management market, including, for example, -any change in the markup, methodologies, processes or algorithms underlying the published AWP(s), CHLIC may adjust any or all -ef the charges, rates, discounts, guarantees and/or fees in connection with- CHLIC's administration of the Plan's Pharmacy Benefit hereunder,,including any that are based -on. AWP, as it reasonably deems necessary to preserve the economic value or benefit of this Agreement as it existed immediately prior to such change. Additionally, and notwithstanding any other provision in this Agreement, including in this Exhibit, CHLIC may replace AWP as its pharmaceutical pricing benchmark with an alternative benchmark and/or may replace Medi-Span, or other such . publication as its source for the AV"P or alternative benchmark with a different pricing source, provided that CHLIC adjusts any or all such AWP- Based Charges or such alternative benchmark -based charges as it reasonably deems necessary to preserve the economic value or benefit of this Agreement. as it existed immediately prior to such replacement or immediately prior to the event(s) giving rise to such replacement, as the case may be. 12/26/2013 . 15 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement PONII BOB ElrBB BE 110 �?eT Subject to the caveats below, CHLIC will remit to Employer the following portion of Rebates that CHLIC collects with respect to utilization under the Plan's Pharmacy Benefit: The greater of 100% of Rebates, or the sum of $31.23 multiplied by the number of Retail Pharmacy Brand Drug Claims plus $104.26 multiplied by the number of Mail Service Pharmacy Brand Drug Claims. Caveats: (1) Upon termination of this Agreement, CHLIC may apply Rebates otherwise payable to offset Bank Account or other deficits of charges identified in this Agreement. (2) Should Employer terminate this Agreement before completion of the then -current Plan Year, no Rebates shall be due with respect to that Plan Year. (3) All applicable caveats communicated in writing by CHLIC in connection with its proposal made in connection. with this Agreement. (4) For percentage -based sharing arrangements, payout amount may differ slightly from the stated percentage when payout occurs before manufacturers' final reconciliations and payments are made to CHLIC. 0 (5) Rebates are not paid out on Run -Out Claims. (6) CHLIC:or its agent contracts with drug manufacturers on CHLIC's own behalf, and not as agent of the Employer or the Plan. Timing of Rebate Pay -Out Remittance will be provided within ninety (90) days after the close of each applicable calendar quarterly for the portion of Such calendar . uarter1y that coincides$ with the Plan. Year. Till or Ir Ia14,' IT Oit Employer's third party auditor may audit records . directly related to CHLIC's performance of its obligations hereunder . regarding sharing of A manufacturer formulary payments (a/k/a "rebates") once in each twelve-month period upon the following conditions: Employer shall provide at least forty-five (45) days written; notice to CHLIC; the auditor (including its individual auditors conducting the audit) shall be agreeable to Employer and CHLIC; a mutually;agreed .upon non-disclosure./non-use contract shall be executed by Employer, the auditor and CHLIC; the records to be audited shall be.ao more. than two years old as of the date of the audit; the scope of records to be audited shall be as mutually agreed upon by Employer's third pa ty auditor and CH'LIC as those which are necessary to determine compliance with the rebate -sharing obligations under this Agreement; the audit shall be conducted at a mutually acceptable time during regular business hours at CHLIC's office where such records are located; records shall not be removed or photocopied without CHLIC's express written consent; the auditor shall provide its audit report to CHLIC and Employer at the same time; and the auditor may disclose the aggregate araount of manufacturer formulary payments due Employer but no other details of CHLIC's manufacturer contracts of which the auditor is apprised; if any. 12/26/2013 RE g 11111 BBE 16 `°E BBEBBBBBEEM 3 98£9686 dd2i uoi}e}io!Iog N Client Marne: City of Miami Administrative Services Only Agreement ° ! ji?i?1 �>�! fij( i{ fyli 6 o9 a 1 : ? E !€ y i 8 ! .i ,Ilf rat tf fi(I li. 'I ,i i�iil i u [z� -i �� ! ° r t�>< $ r i. a� li € }7€€ i iE '°° i Y € } � � i Il, d i? i t . . C l II r�Esx 5 f€ i , i �, ; i li : , a i i i , �',� - , : ?E b £ °F �_ -ifl # Y } " II `°cif Yy i s p?p'i{ g li q; is i €I � iir: ��', is 1,1,, p lliik�i(iPx. riit,li,.,. la. i,.a:.... i ...i. i Network POSOA, Comprehensive and Vision Care Run -Out Period of twelve (12) months No Additional Cost Pharmacy Run -Out Period of three (3) months for all pharmacy claims No Additional Cost sj : a fi ii (t, jI pi j iihl�IE .3%ali4f l€ z Y.:.s 9 iS> �;3 89 1 I �I .� z f { R # I , @ 1 :5: ?� 111 ;- 1 I !( "; ! ' l II I i � ` , i�i 9}i i � 1 e °iil iE le i s'i¢ li � t �, @i j= g�jgip . B 6...£:.'..$ ; ,; f -.d.E.? f id .a 8. 8 n=m.a m� ^a- 9 11 m r ' i o-C �.. � [i p, - 8' ti' -: : it.Y � _ �r< I ie � �� s }I' i �j 'I° �ja�� ' 1 �aY F 4a, . f(1 5 'lam- i.r13 l l ; ie} �4 9 rJii�� ,.� dl,� �p� °n�;�= t�_I= I #°iarl(IPI,t�dePi E si ;I,gli, jis a;, o.�grl€i 661€ %s'•L i ii ,,, d,R,!1 �� . _? r .� t;.;}ds€I ? =1°IEiFI i. Subrogation/Conditional Claim Payment. Identification, investigation and recovery of claim payments involving other party liability or where another entity is responsible for payment (including by way of example but not by limitation automobile insurance, homeowner insurance, commercial property insurance, worker's compensation). (This service is only provided with respect to Medical coverage). 5% of recovery plus litigation costs if Counsel is retained and an appearance is filed on behalf of CHLIC or Employer in any litigation, or a lawsuit is filed on their behalf; 29% of recovery if no Counsel isretained and in all other instances, including cases where state law requires that employee benefit plans be named as party defendants or involunta ilaintiffs. 12/26/2013 17 98£9686 dd2i uo!}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement ?i'.1 �i CE {?p ? =3: :-7Ii: 6 :.? 4 : I; '.� A, I.:g 7@@E :'� 9i 1� 3. � 1. ? E e 4 �a pp ($�, ! I}'g 9 �53iE9�i9Bd9 3 i¢ lF CHLIC, �'9� IT §yp}${j§ �31 —.¢�.}?8_ a Cigna pjj 3 EI:=. company, s :I : 33 ttyg 4� j ad-ninisters the „ 9 following gg9p ea P'jB programs @yEgNM to contain Z costs •• with respect e to charges tIf ��.: for _ _. health �_m..,,,4.:.:` q care service/supplies @E .. ➢E i� 5 ..lilt that ¢i9r 8 gE( �y} S�It€�':i� are covered by the Plan. In administering these programs, CHLIC contracts with vendors to perform program related services. Specific vendor fees are available upon request. CHLIC's charge for administering these programs is the percentage (indicated below) of either (1) the "net savings" (i.e. the difference between the charge that the provider would have made absent the program savings and the charge made as a result of the program savings, less the applicable vendor fee which generally ranges from 7-11% of the program savings) or (2) the "gross savings" (i.e. the difference between the charge that the provider would have made absent the program savings and the charge made as a result of the program savings; CHLIC pays the applicable vendor fee) or (3) the "recovery" (i.e. the amount recovered) as applicable. For covered services received from non -Participating Providers, CHLIC may apply discounts available under agreements with third parties or through negotiation of the billed charges. These programs are identified below as the Network Savings Program, Supplemental Network & Medical Bill Review (pre -payment). This is consistent with the claim administration practices applicable to CHLIC's own health care insurance business when these prograrns are implemented. CHLIC charges the percentage shown for administering these programs. Applying these discounts may result in higher payments than if the maximum reimbursable charge is applied. Whereas application of the maximum reimbursable charge may result in the patient being balance billed for the entire unreimbursed amount, applying these discounts avoids balance billing and substantially reduces the patient's out -of pocket cost. MEDICAL AND PHARMACY COST CONTAINMENT 1. Network Savings Program 29% of net savings 2. Supplemental Network 29% ofnet savings 3. Medical Bill Review — (Pre -payment Cost Containment for Non -contracted claims): Inpatient Hospital Bill Review a Line Item Analysis Lesser of 5% of hospital bill or the savings achieved Professional Fee Negotiation 29% of net savings Outpatient Hospital Bill Review . 0 Professional Fee Negotiation 29% of net savings e Line Item Analysis Re -pricing 29% of net savings Physician/Professional Bill Review e Professional Fee Negotiation 29% of net savings Line Item Analysis Re -pricing 29% of net savings 12/26/2013 is 98£9686 dd2i uoi}e}io!Iog N Client Name: City of Miami Administrative Services Only Agreement A 1 { 4. Medical Bill Review (Pre or Post -payment Cost Containment for Non -contracted and - Contracted claims): ® Bill Audit 29% of the savingsirecovery achieved plus hospital fees or expenses passed through Diagnosis Related Grouping (DRG) Validation/Audits and Recovery. An overpayment audit and recovery program in which CHLIC or its vendors review paid claim data to identify overpayments based on inaccurate DRG coding. 29% of recovery plus any fees or expenses passed through by the hospital or regulatory agency Inpatient Admission Retrospective Review 29% of recovery Medical Implant Device Audits 29% of recovery, 5. COB Vendor Recoveries [Exclusive of pharmacy programs where claims are adjudicated at time prescription is received.] 29% of recovery 6. Secondary Vendor Recovery Program 29% of recovery 7. Provider Credit Balance Recovery Program 29% of recovery (' 1 8. High Cost Specialty Pharmaceutical Audits 29°10 of recovery 9. Pharmacy Vendor Recoveries 30% of recovery 10. Class Action Recoveries 35% of recovery :` � i� €€tt �a, i_�iI !l liir �l 16 s s fit,; d � ��,, .�t 3 '. '.'-i Q .'3fF�° �,�p a evts s .o ai seveee . s,as ' E 9 � �i !"�`.�'� � 8 a 1 9 f � o , p t E - �� .�.!€ ° 1 6! 31 �I[ ,�� �I ' I, % ((... „ „ -� . Is r. t a � a � i;. 3 " M i ]::. , $ F �_ = Ei R sx1 �' AtI.'$", 9:dg d I'll" ,, ,�t; ' lI l d air ge ,� � _�1 a( ?� � is9��a:a6 t�rei,,�3 1 CHLIC arranges for third parties to provide care management services to: (i) contain the cost of specified health care services/items overall with respect to all plans insured and/or administered by CHLIC; and/or (il) improve adherence to evidence based guidelines designed to promote patient safety and efficient patient care. Specific vendor fees and care management program services are available upon request. 12/26/2013 I9 98£9686 dd2i uo!}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement 12/26/2013 .Id L1 L i ,al 11! III IE 411 8j9 9 8 %it 1 t llitM Eligibility Overpayment Recovery Vendor Services. Identification and recovery of funds in 29% of recovery situations where the overpayment is due to the late receipt of Member termination information. (This service is only provided with respect to Medical coverage). 4111 1111 il !Jo III I 3I it aP, 141(ii1 When a Member elects an External Review (as that term is defined in ERISA) of a benefit determination by an independent third party, the cost of a specific third party review is 1 dependent on the nature and complexity of the issue on appeal. In highly complex, non -routine cases or cases related to new technology or experimental -investigational treatment, as part of the internal appeal process a panel of reviewers may be necessary. Third party review charges will be commensurate with the number of reviewers (usually only one is used), as well as their level of ex ,ertise and time required to complete the review. IS 14 , P 1 as Pi iL➢ Capitation or fee -for -service charges for vision care services will be paid as claims and will appear in Employer's standard Bank Account activity data reports. Such payments will be at CHLIC's applicable capitation or fee -for -service charges then in effect, which may be amended from time to time. Some Vision services are provided by CHLIC and/or designated vendors. The applicable rates to Employer for this product and identity of the provider of vision services will be made available upon request. CHLIC contracts directly or indirectly with other managed care entities and third party network vendors for access to their provider networks and discounts. These third parties charge either a network access fee, which is included in CHLIC's monthly charges, or a percentage of the savings realized on a claim by claim basis as a result of the application of their discounts. Charges based on percentage of savings are paid from the Bank Account._Additional details regarding specific charges will be provided upon re+uest. firent 1' l 111 • f!1a 77113116 91 Capitation and fee -for -service charges for various vendors and other providers/arrangers of health care services and/or supplies will be paid as claims for Plan Benefits. Such payments will be at CHLIC's applicable capitation or fee -for -service charges then in effect, which may be amended from time to time. Additional details regarding charges and the identity of the vendor or provider of health care services will be made available upon request. 20 $300-$4,000 Review 119 �i In 11i!'�11 All Vision Products 11 All Medical Products 9 1_t6E E E 1E. YI27 r 1!I11t 111 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement plii s.??_.x i t8°g'➢j a E §. gg � 11 i'a �aEa4gp° ¢yjj)}I .1q11gi(¢ j#P " €. €t€ �3 3bi (3tE;.-��i.8 0�$P [I4 § I£ £ 77 e hi (§n�ip}� ( 1i?� "�6 g E £ - 9 �.._S98di tl � 2 .3 �':."..yp �,_ 3 �' ,3 tg ° ��g� I �a _- 6: iii1 ''-i' � 9`�� ,s � € € i .$ € .E u$i a 1 .> @ §a is ax,.ax. � " x ,} g S E. o - x.. -- P }a's§§ls ;I§� �7�6 • 4' : st SSY 3PIE i ;� j 3 r E F b.b �( i€ =EsE Unless indicated it may receive Information request. otherwise in the Schedule of Financial Charges, CHLIC retains all payments from manufacturers of pharmaceutical products covered under the Plan. on the amount of such payments with respect to the Plan will be provided upon All Pharmacy Products From (e.g., provide CHLIC heb time service and defray various to time, CHLIC, directly or through its affiliates, contracts with third party parties vendors, provider network managers) for referring them to Employer or to services (e.g., cost -containment initiatives) in connection with the Plan. its affiliates may receive payments from such third parties for such referrals or to lementing the services rovided to the Plan. expenses associated with imi1'Iii*1 . All Products :� . s 13: � iLl; � '9 ggE �gg �3a, fir t?"S'?x rill s � F ' s § .� t i ill E E E€ f � r E a � .,� , b ¢ ib 1 11i �t°.{E i€ E L 3`� , . 1 .t E � ✓ ix� as<s" §§ t txtisz.eeen p EE ::.�° . r .r r, ¢r� � i� : ���� `� I - '1 @ 9 $ '0 �°$ ��! [dhE�d'E�3 CHLIC shall obligations; Protection of the Summary plans including. requirements provide under. and Affordable ?� of the following section: 2715 Care Benefits ("SBC), ( and FSA services to. assist Employer in. meeting its co piianee of the :Public, Health. Service Act as- addedi by the Patient. Act and applicable regulations with respect to the provision translation notice and. doss Applicable to all inedtcal } glossary. Pp which axe considered "group; health plans`:` subject to the SBC 1. Preparation Employer of SBC, makes translation to the SBC. notice. CHLIC will not be responsible for any changes that No charge 2. Provide any updates SBC, translation or material notices modifications. prepared by CHLIC to Employer electronically as well as No charge } 3. r Include in carve -out weeks prior SBC vendor to the a summary provide CHLIC date the SBCs of benefits administered by carve -out vendor if Employer or with necessary carve -out benefit information at least 12 are to be delivered to Employer. $500 option for vendor included for each benefit under the Plan which carve -out benefits are in SBC FN j Sf� , C t E�9i� i Ep i%�. .t tF E�1 Ili t ls` �, P EE � �,E, d � 7 3(1 1 -g9 ` @Hi E isU 1 7 y (X f 1 i $ 9 ' 81 �,� � - ''� � 9 P P 91 LEt agp8 1 @ 9 �p�h p��8 ' 7 _ L a �� .p � 1 r �t.1 i �.It Y EY E § i i.i ° ( vaeaxe: HOD (l ; xn its ii r:P'a, i a €,x, z� . ,-� r:t t•g 8 _ k ( �'@ ,"� : � , j § ilsY� i r1 = _ 1. Y�°�`(5 E t ;h�� 1 E p y ffi 4 r l �> . 7.a 1 }$ t �3 3 E° g g£ A itg4"4 669g P }LIa.:. i �Ef E `EE{EL F i<ddd �d Itidi93 d�§$}yy� }{.ylffe: � P Y,Ptl "@ed'���P<92�j3+ Ha e �4n eir Description Charge HIPAA Certificates Individual IPAA certificates for Members who have active coverage. $0.15/employee/month Included in Medical Administration Charge 12/26/2013 21 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement Pharmacy Clinical Program .. Cigna TheraCare® Program - a targeted condition drug therapy management program that targets individuals using specialty medications for certain chronic conditions and helps them better understand their condition, medication side effects and importance of adherence. Included at No. Additional Cost Your Health First . A proactive health education and improvement program for those with a chronic condition. The program involves services that span across the Member's health needs. Behavioral coaching principles and evidence based medicine guidelines are utilized to optimize self -management For Network POSOA Products: $5.25/employee/month Included in Medical Access Fee skills and foster sustained health improvements. The program targets a chronic population at high risk for near term and future high cost medical expenses. Members are identified as having a chronic condition through a variety of sources which may include: claims data, referrals, and self -identification. A variety of resources is provided to those with a chronic condition, including access to online tools, personalized support, and targeted materials. The program includes the following components for those with a chronic condition: a Chronic Condition -specific coaching ® Pre- and post -discharge calls • Lifestyle management coaching: stress, weight management and tobacco cessation • Treatment decision support and coaching In order to continuously assess the effectiveness of our programs and/or test new ideas to further engage your employees around their health, a small sample of Members may be placed in a comparison group which for a defined period of time receives alternative services or is suppressed from receiving proactive, outreach, such as engagement letters and/or calls. This could affect a few Members targeted for outreach during this limited time period. Medical Conversion Privilege Converting Employee Resides in FL: Comprehensive, Base PlanJMajor Medical & PPO Plans $20,000/conversion policy Client Fund Wellness Fund COLIC will establish a Wellness/Health Improvement Fund in the amount of $200,000.00 to be used at the City's discretion for wellness services_ Wellness/Health Improvement Funds are to be used from 1/1/2014-12/31/2014. Unused funds cannot be rolled over. 12/26/2013 22 98£9686 dd2i uoi}e}io!Iog City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Exhibit A - Plan Document A "Plan Booklet" that describes the Plan Benefits and Members' rights an.d responsibilities under the Plan will be provided by Employer to CHLIC for its use in administering the Plan including denials and appeals of denials of claims for Plan Benefits. If Employer has not provided CHLIC with a copy of its finalized Plan Booklet by the time this Agreement is effective, CHLIC will administer the Plan. in accordance with (i) the terms of coverage described in the Plan Booklet draft provided by CHLIC to Employer and, (ii) the medical management and claims administration policies and procedures and/or practices then applicable to its own health insurance business. CHLIC will continue to administer the Plan in this manner until CHLIC receives the finalized Plan Booklet and follows CHLIC's preparation and review process. After that time CHLIC will use the finalized Plan Booklet to administer the Plan. 12/26/2013 23 8/20/2024 9:24 AM p. 531 N Client Name: City of Miami Administrative Services Only Agreement A Exhibit B ® Services !iI ill g@@ g@@C @ 55 lP '6- E ! E jj 7 :. �:¢ }!S-: y � E .x3 i � j,,j[„$v fj (f{, dd A :-@ 6..i 3a€a a � -- �. . i?1„. :� , E S ,c.. > _ l.., i (. ... pg(( E yy ail ..� � ( t {d f€ °.� 91 i @f .�j;$j E� f .. j ,j�g�'q�jr iFi iH9 zap Pj A�dY i9k3& & 33'§.a «§°§'§ � ., r i $$.' E S:4 ��'s , y g §� ¢§,s xsa� Y.8�:@a9 s0'I4.9iii - a' s�x E4 � 9'@.'Ej 8g q3 '�9 t39� i3 !E jI]P. 1 i?, -• ••-• • '�E E-n,.snn «Q�� [j}{j {�§ yM §I 19 1111i18'@�. < •n ^S, a 9�- }�Yd-LthT , WN @ j; d �m �..:'i 9 x S } 1. a-: 7. ., , �. --'t'-Agg 8 g{ t &.'i 6" ,- i € :I Es ' �� "g£q# :. k:. s s i €y .E/ ,E e" ';;„•..ar.:nr.. _ - ... j' g {{§ € .. ,. 'y' G € Es E.. Y, y�g # �.Ndet gg8 €�x j(p, .{{(€5(¢ 68 �@EBB t -.A - € _ qg M%" �. T°Y .. C. rr �d��s j¢q,. 5.9�n,. w cMe�id?? $E •. 1 iiV 8. an e a E€FEE Products .excludingHealth Savings Account 1. Furnishing CHLIC's unclaimed apply CHLIC's standard Bank Account activity data reports to Employer administration of the Plan does not include performing obligations, property laws. It is Employer's responsibility to determine the extent to the Plan and to comply with such laws. as and when agreed upon. if any, under state escheat or to which these laws may All Products 2. Report Revenue to Employer the claim payment information required in connection with Code. Section 6041of the Internal All Products 3. If Employer 2807-t and surcharge forth required Employer In addition, Employer by by any has elected, pursuant to section 63 of the New York Health Care of the Public Health Law) ("the Act"), to pay the assessment on covered has consented to the conditions set forth in section 63, CHLIC shall file and assessment on covered lives on behalf of Employer through the Bank in section 63. Such obligation shall end immediately upon Employer's failure by CHLIC to fulfill this obligation, the failure to comply with any pursuant to the Act or the failure of Employer to properly fund the Bank where permitted and agreed to by CHLIC, CHLIC will file applicable and/or the Plan any assessment, surcharge, tax or other similar charge you or the Plan based on covered lives and/or paid claims or otherwise in accordance other applicable state and/or federal laws and regulations and your bank such payments made by CHLIC. Reform Act of 1996 (section lives set forth in section 63 such forms and pay such Account to the extent set to provide any information requirement imposed upon Account. forms and pay on behalf of which is required to be made with and as required account will be charged for All Products { { 7 { b � jj i £$ 4s [[[! (??? E�Iti�3��i��4 @ jk p .$ xs E Ejt fg 'ft j{ £. s?? i£p £ ]({[ 3df g y§ E {E i �.. m - 9 $$ s€ gd Y PtlPH ill gg • C $. .�.�. 3 g a p§ §_..& �f T$ {1`j fff §� F� IFj ii44 ,7§ (?[ .§ 7§i'�pl 9aj 1 p @�T.�gp�i68��v d4' 690 351 6 '684°e 6 `p py 9 B C3 E � 9y 3 vi. � 3s� j3$$ g$}( P.3 "f Y��r E rd (@Ep Ip @g t f9 P.D A ) P P day<,< 5p pg _ Q :i�� L. � � ; p $ � ffi8'?^0 �'. i { s 4E E i� 9y { @$ �§�(8g$�93�j§{9�9�}e$y�� i :i3 - 9888 r9.� � :':'�z i9i: t }i�@$� ° (p 60.0P _ ci 11 > ..�&I���f� �'�. E§{(fig ,�y i '. s �.f:... t$,g'-a I yy `9. _, E,; rP�i S1L� q,� ° a... 5y5$ to } g3pg� ?. Yi .�}s#i'd zqg. 'iY�. £ SS 3 jy qp [ i F$ i_8. Y a }} pp "d9LtlA. �! gip 4p6 I� 8°B{�d PB.A �S ,IE � FJi F� € j� j f?.f §Sid§, € € 4jj9,y�99999EFEEEEE[( t 7 k 01148 B" �f� si < d3 9 d 9`£f t °°31..§. €€ 4€i �i� Ey€E EIbEgFEE[IEEE Products excluding Health Savings Account 1. Calculate benefits, check and/or electronic payments disbursed from Employer's Bank Account. Bank Account payments will appear in Employer's standard Bank Account activity data reports. All Products 2. Prepare and make available CHLIC's standard claim forms. All Products 3, Investigate claims, as necessary, by CHLIC's Special Investigations Unit. All Products 4. Discuss claims, when appropriate, with providers of health services. All Products t2126./2013 cn w 0 3. 98£9686 dd2i uofe Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement 5. Perform, based on CHLJC's book of business internal audits of plan benefit payments on a random sample basis. All Products 6. Claim control procedures reported annually in Statement on Standards for Attestation Engagements (SSAE) No. 16 Report (SAS70 successor report). All Products (excluding Vision) 7. Respond to Insurance Department complaints. All Products S. Dedicated toll -free telephone line for Member and Provider calls to CHLIC Service Centers. All Products 9. Member Explanation of Benefit ("EOB") statements including, when applicable, notice of denied claims, denial reason(s) and appeal rights. All Products 10. Verify enrollment and eligibility using Member information submitted by Employer and/or its authorized agent. All Products Medical Only 1. 1. CHLIC's standard enrollment forms are prepared and delivered to Employer for distribution to individuals eligible to enroll in the Plan. All Medical Products 2. I CHLIC's standard ID card with toll -free telephone number are prepared and mailed directly to Members. All Medical Products 3. Administration of subrogation/conditional Claim Payment (terms described in Exhibit E). All Medical Products Pharmacy Only :.:. 1. CHLIC's standard ID cards with toll -free telephone number are prepared and mailed directly to Members. All Pharmacy Products 2. Pharmacy claims are adjudicated typically on-line at time of service without access to information on other coverage, and therefore coordination of benefits (COB) for pharmacy claims does not occur. Claims for Plan Benefits will be paid regardless of coverage under another plan. All Pharmacy Products 3. CHLIC's standard drug utilization review services. All Pharmacy Products 4: CHLIC may receive and retain payments under contracts with drug manufacturers with respect to utilization covered under the EmpIoyer's medical benefit for the manufacturer's specialty drugs, which are drugs that typically are injected or infused and derived from living cells; target an underlying rare, chronic or costly condition; and/or require restricted access and/or close monitoring. If CHLIC enters into any such contracts, it does so on its own behalf, and not as agent of the Employer or the Plan. All Pharmacy Products Health Care; Flexible Spending account and: Dependent Care Flexible Spending. Account Only -0 12/26/2013 cn w w 0 3 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement 1. Providing generic enrollment forms and reimbursement request forms to Employer for use in connection with Health Care Flexible Spending Account ("FSA") andlor Dependent Care Flexible Spending Account ("DFSA") under which eligible employees (collectively "FSA Members") may elect to reduce their salary on a pre-tax basis up to the IRS maximum contribution allowed for deposit into a FSA and/or DFSA. FSA and DFSA Products 2. At the end of each reimbursement period of the Plan Year, CHLIC shall issue payments to the extent that funds remain in each FSA Member's account, for the amount that is determined by it to be proper under the Plan. At the end of the final reimbursement period of the Plan Year, CHLIC shall issue payments for any amount then due for those expenses that are determined by it to be proper under the Plan. FSA and DFSA Products 3. Allowable expenses for reimbursement under a DFSA include all allowable expenses incurred for the care of dependents pursuant to I.R.C. Sections 125 and 129. DFSA Product 4. Allowable expenses for reimbursement under a FSA include all allowable health -related expenses, pursuant to I.R.C. Sections 125 and 213 except where reimbursement under a FSA is prohibited. FSA Product 5. FSA Member accounts will remain open after conclusion of the Plan Year until March 3lstt (the "Run Out Period"), so that FSA Members can submit any remaining expenses incurred but not paid out during the Plan Year. Separate account balances will be maintained as per FSA Member's election for the new Plan. Year. FSA and DFSA Products 6. Reimbursement requests of terminating FSA Members will continue to be processed for 30 days following termination of Membership for any expenses incurred prior to the Membership termination date. In the case of a DFSA, reimbursement will be up to the balance in the DFSA and in the case of a FSA, reimbursement will be to the originally selected goal amount, minus prior reimbursements, regardless of whether this amount has been funded. FSA and DFSA Products 7. For FSA payments that are not made with a Debit Card but are a result of Automatic Claim Forwarding of medical or dental claims from a medical or dental plan administered by CHLIC or Direct Submit Request For Reimbursement, an explanation of payment will ba mailed to the FSA Member at their home address or, if elected, provided electronically. An explanation of payment is not issued for FSA payments that are issued to a pharmacy at the point of service as a result of Automatic Claim Forwarding from the employee's pharmacy PIan. FSA Product 8. For DFSA payments made as a result of a Direct Submit Request For Reimbursement, an explanation of payment will be mailed to the DFSA Member at their home address or, if elected, provided electronically. DFSA Product 9. An 800 number directly linked to CI LIC's Member Services will be available for FSA Members' questions and status inquiries. This 800 number will be listed in the instructions on the reimbursement request form as well as having access to account information via Internet. FSA and DFSA Products -0 12/26/2013 cn w 0 3 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement 10. The Employer will identify through eligibility submission, FSA Members who elect to have medical and pharmacy claims processed but unpaid by CHLIC automatically submitted ("rolled over") to their FSA. Such rollover claims will be processed without additional submissions by the Participant and CHLIC shall be entitled to rely on the Employer's submission of the Participant's _rollover election that the submitted expenses were properly incurred, not reimbursable from any other source and are eligible for payment under the regulations governing flexible spending accounts. FSA Product 11. When CHLIC takes over a FSA administration mid -Plan Year, CHLIC will provide administration services from the date CIILIC receives the FSA Plan information for claims incurred anytime during the Plan year. FSA and DFSA Product �� , qq ' �i5 d i 1€ :� Ali �$ ' .dBa� �F t: E 8 �i' € t t H� @ "{ s ". g{}} II`r[ �°i(" t 81� �; u•bx dET$s . q �5° i is ! r 8 t 3 ! i£ S 1 _:,: a :_i� Hil{3 9y I } #: �i�?�i a naf )FtF �nrtfff fEfff ¢ YEg !§ e'gyp 1, I '- g@'.:,Y l { p 8 9Y6 Y ..-. .-; E $,... .:. . ... . £ n t >a a 1 �i i�i �� 9 6�' �� :..i ; ..''.> r k% <:.�{ ' � ° :.,:.. s @ ill F E g I 8r ��PEk _$p 6tL ' sifs: 4 3,_._ ? ep6 8 8 g E ," <:, a_ j m� ��799€ 'i $d F` ?€i i > 3 , � IA Products excluding Health Savings Account Prepare Member benefit booklet drafts to Employer. All Products jEf" (}yy ;g@(]{j� �w4ii�s�r� $ i�: � , �99 fp p9gg HJI!1 B� F @°@yaa€s ir< 3 °=t $y g§ $E3 q} = e 11 (t pg 1� It 3 31 1 { ) € : 6 r � - d E.S§� ill �a,:. ae4r, �,r �. :'F ..:!y*� :fin L [ 11 A g g g j g� i 'P '�:4 @ e:.€-'.. i i �: i '" .: @ � i $d � ������ �: i€ N # i. - @. .r.r`P sg�=s_-. r. 3 tAe9' r �< F :per ,-�-.�..� , p$ti :g. f. § @,�„r § @ 3e F���: ...�. t 1 '#? } ,p Y { $3 � ) @F@�� 6$E��a�@�s �€9��' (o (. gE E: s€Y §� ihi4r�€$99@ii:EEa[i({z ae.{ a9a9o� Via,, (qp PF�E�Eg�Q€QI . g,€. E's 13i= 1. 5500 Schedule C reporting. All Products 2. 5500 Schedule A or Annual Reconciliation Disclosure reporting (when applicable) All Products 3. CHLIC's standard Underwriting services: a) benefit design analysis-b) projected cost analysis. All Products ° 's § E �rLLL�f€,I�iKSG�= pp$$jj q§EE p( €P8 6E6 E j HE :i A i i51, 9 ?. & € g( F € tt.a.>%:.�-s isf4}{¢§( £Y4, 1 S6, i b $ zd�Is; '90 FB 8 8 r , S 1§ tt��H %' € 1 @E E"{9} 9 E' 7 g @ d((p ��� E $ ��,� S�i,,, 3 I` ? .� 3 @ g r€F e $r{r, L�� �§..i�f�Y ? }, 6it�� €=' p tdkn s s..br� ' p ¢ ;j $x �Si �i 99� °ris. .�!.,. if: i` '>,i. 3 £ 3 k ° e�tn-5 @a f cg t E €"E,r'�5 i=FS. d ! p � t i I- II �,� fiI ' 9 [i a ff. � i $ af' LA-Ili 1r [� Bgd s 4 ., �{�4433,�' 4{g 9$;$:@ 98° I 98 4 E$B(° 94� �. i'£�$:' e•3 a'a$ y SEE Products excluding Health Savings Account Handling of requests from Members for access to, amendment and accounting and requests for restrictions and alternative communications as required re lations, as set out in this Ay eement and its Exhibits of protected health information, under federal HIPAA law and All Products t�t €¢; dp( (((p$° P E gg EE°§ E €6°¢{:€¢ ({r.E 'gt.,bg p Ep ![ gp[{{ �1E , pp pE 4 pE bpp$$ 1 F py E j ! 33 ii 8d} d , 1 9 = v ± {K' � f s jj s £ E q¢ x -- A B z yp ( j`�< E !..1 # y @ _ } B i IA { {7 hi 0 !' ?•,�i9 : (`�`3t .a _3, �'3� b. ��.,1 i� i.. E.a A § { � g` 3d q I jE F E er t ' E k hi 1.1- J ! r �'.... . }E� fi. �` •. = d # �I.:f 3 ( ?�E i i != .. §£ s y(e �id'� �, 0 yQ tl 1 E9' ' Y �, �'P j£ $ >-F � Sp )3 b -P 3 � °'?3 ! �6 �:g 5Y3i3 p �¢.€ E 7;iq ;F1 ( 3 iii 333 8 Sg� gi,:,<[[[j�� q',,, . <.. ,5i., ed8. .e°A %,Y�p'r'.F' };: IE osa3 % 1. Maximum reimbursable charge determinations of non -Participating Provider charges for covered services. All Medical Products (with out -of -network benefits) 2. CHLIC's standard cost containment controls: Application of non -duplication and coordination of benefits rules and coordination with Medicare. All Medical Products 3. Delivery of information, as necessary, regarding standard application of non -duplication or coordination of benefits. All Medical Products 4. Review of medical bills in accordance with CHLIC's then current Medical Bill Review program. All Medical Products 12/26/2013 cn cn 0 3 98£9686 dd2i uo!le Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement 5. Network Savings Program, a national vendor network that provides discounted rates when a Member accesses care through a Network Savings Program contracted provider. All Medical Products 6. Annual reporting of CHLIC's standard cost containment results upon Employer's request. All Medical Products 7. Pharmacy Vendor Recoveries. All Pharmacy Products j... 9 ggg ii a, 88:4 8 �.9 8 (, F a' @ gpy "Ill P Lot tP.:l„f 4t8. Q@@E {� B @ 'Pj e it 8 , daa.P �` B y ' � P�,j ttPE�nP¢:a7FP€�.��;?£F y € $qqqg 111 ryg . �§{@g§( j{p ..'_3p}s 8 a!i ad d .d���@P8i'3?73��n. (f F dg tF .. 3 6({@gtl§.,[�y �Iog99@� @1.08} @ ����rn � ����31/rNLI£§:�sd� iij �tj! } jj prP x 3p }i Ez'3 jj j: t y s rg� rx.x>x� r } .r� 4 xa-ee p B °ar xa :P � b. s..,.%� .0 9 _ j g $ '1 E I_ '.,b#, �'qi.�� � j g� v cF r gP@[£p�8 ���� �Y'3� ix'._ -: �>i, ,�.. � a a@p�. ;i � $P^ `}, �$ ��a ? j 3 a£ £ y(� Ff.br*- #6g`��gr a€$p,4 ri . 6s-8¢s�. PPg^ ��€ ? P i � ■ 1. Summary reports of medical and pharmacy cost and utilization experience site, CignaAccess.com. are available through Cigna's web All Medical Products and Pharmacy 2_ CHLIC's standard pharmacy utilization reports. Pharmacy Product Only 3. Claim Reporting: CHLIC will provide its standard reports and information CHIC will not provide information on incurred -but -not reported claims, coverage, case management information or information on a Member's Stop Loss Reporting is an optional service provided at an additional through another entity other than CHIC. CHLIC will provide its carrier and Employer have executed CHLIC's standard Hold Harmless/Confidentiality based projected prognosis fee to Employers standard reporting upon paid claim data only. claims, pre -certifications of or course of treatment. who have stop loss only after the stop loss Agreement. - All Medical Products . CHLIC's standard management and statistical reports for Employer. FSA and DFSA Products 5. CHLIC's standard Individual Summary Statements for applicable Participants. FSA and DFSA Products g$ i (°" @ 1 ER - ( � �, I ( .�H.i ii°! $q PPd C 1¥ , E Reimbursement @8¢ it€.v,§.;.la#a? z ptoyer t �'� t` gt� P t llB 1: 3 g tE �gg@ �ia �.. tU directs CHLIC Account � �'.������,�S�f '�I�` 4 in administering benefit ::? ¥= }$;p t S to F f::. comply ! £ fi gg i 6 x the r , with # g 3 i q % } gg €€gg I P4 EE et E P 3 p . 1,: t. iia "rd! ' .� Health Care Flexible COBRA as follows: Spending t rt x... i r�..:. Acco x . ° .- F!'�- _. rxrt Ep y }PpE${ FF� i€ andfor 4{' Health I. 8�. ¢7 i�ia� ii .�.$ c '&a ytp 9 6 0 Bf�' d t g�j€o-! p d-€i:.�� �'. : - Y� =t� i3 "�Y3i39 i;;i§§4I"is!€, ;$) y q f S ;3Yii4'E'I�i�Ei'3Yi`�n�flii a'.e9 : 3 ! s q ... ...... �. ,yy}� yFFF „ }n9 g iY�P�L 1. Each FSA Member who experiences a qualifying event and elects continuation of account coverage in accordance with COBRA will be maintained until the earlier of the end of the Plan Year, the exhaustion of the FSA balance or other termination of the FSA. FSA Product 2. FSA Members electing continuation of FSA coverage under COBRA will continue contributions at a rate not to exceed 102% of the applicable premium. The Employer may require after-tax contributions, or may allow the continuant to elect a lump -sum salary reduction in the amount required in contributions for the remainder of the coverage period. FSA Product 12/26/20 i 3 cn w rn 0 3. 98£9686 dd2i uoi}e}io!Iog WV 17Z:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement 3. ' FSA Members who continue under COBRA and whose contributions have Reimbursement Requests for themselves and any eligible dependents, for date of the qualifying event but prior to the end of the coverage period. earlier of the end of the Plan Year or the termination of the NSA, includin_ been made as required may submit expenses incurred before or after the Requests may be submitted until the any applicable Run -Out Period. FSA Product , {$t §i§ r§p{ §.... '(' jj i�( p yy . 11 3 a f3s?% e 6 i • a' p �8� �99��p8�qq i- : � �.1 ! tip ° .t Y tl xx E x xar e r $, € ° E° ' �g F •a� a e E t 5 B 9 b j{€y�c �p¢jp 116111111111111 ad eB. �BI®.rf ®- : E ea,—� g 1 g F tl 9 £ ESS' 4 Egg6 Ill I A B B 9tlr�ge€� s E y¢ E Bgg66p�q{�� jjjj 6 $ ��dl"e�f�f44F�FY€is All Medical ;# y} � @°I� b ge k 4I s PB,p 8 { d }j§ or. b33H�Yiii9E$t'�?'.E�.. Products j p EgE¢E° 4 6B€6� t 7 F f 4 €3($€ yy.¢¢ $oR z y L H�i3 @ ¢¢§ § 1.�_E ,�Y+ :.,g .. qq z ,�z [p p pg - tl }[ o-.6 °,E {; �( �97 Fye �$ `y }� ;€ y _8 �8 6 &i i d : �8 0i 61111111111@. �i§ . 19 Sb d gg d 1� = c _ i4i3, t 7 4$ } X _ + P -_: 1 - jj- 5g �$ d 80�tlQi$N��'�% ���¢i �{ j f8l8 a s '.. 3 mR%31 y, 3i6r {$y " £ 6 ¢g}} 3gg3 g {{ � kda➢. i����� CHIC contracts with three (3) independent review organizations that meet the Patient Protection and Affordable Care Act (PPACA) external review requirements. Members may appeal eligible claims to an external independent review organization which is selected by CHLIC on a random basis. If Employer has chosen not to participate in this program, the Employer may be responsible for making other arrangements to meet the Patient(Protection and Affordable Care Act (PPACA) external review re uirements. ¢999 {E3E ¢9 (( i9 10 E[s 4 � 6€ { 3pg ?� 4 IT' I 8 �` 9 CHLIC following g: j 18 C 8¢ �'ad6 Y t � �� i 3b " ii _ � I ii �g3;;E!E'� �: E. Eit�Fa§.=�?�91 provides core 3i ��[# (il § }p integrated services. 9iYi I ! .. ° I � {�# �a€..R �°'-�fa��iEtiir��k�� Egs € Ri tt 1111111 medical €.. si 7E ¢ 9 i `' 7 Izi•,au� s<, e: }:, } € Y 2E9� [ ,,. „g� bpi ' ' management that includes g t me - $' Its g gp g 01 : 6i€i .Rfl��Bt�P��9f-�. (depending �-ii �� g of -���.4Y upon '_. � as Sid ?: the €ermsof �� 3��� the � -{". -�€_f.��iG Plan) - _ $g {{ iP`.? - ,@, the ( .LauC,�.��}`:399t . if Tip ,i'IIl1Pl?�8.�3 iii € '`tt' 66 @4'€y ({ Eg jE6p I i t EE��;s� �;�. •:j �?}3.pp3°�13 . ( � a"(gg°E pPp �g 3 8 61 ! I i°e�.I p 3 - S. F i �€�_�• 1. Pre -Admission Certification and Continued Stay Review (PACICSR) services to certify coverage of acute and sub -acute inpatient admissions/stays or provides guidance to appropriate alternative settings. Administered in accordance with CHLIC's then applicable medical management and claims administration policies, practices and procedures. All Medical Products 2. Case Management and Retrospective Review of Inpatient Care, a service designed to provide assistance to a Member who is at risk of developing medical complexities or for whom a health incident has precipitated a need for rehabilitation or additional health care support. All Medical Products 3. Assisting providers with resources and tools to enable them to develop long term treatment plans in the management of chronic or catastrophic cases_ All Medical Products 4' The Cigna HealthCare Healthy Babies® Program is a one-time educational mailing which provides Participants with prenatal care education and resources to help them better manage their pregnancy. All Medical Products �. HealthCare Cost and Quality tools on myCigna.com AlI Medical Products 6. A panel of physicians and other clinicians to assess the safety and effectiveness of new and emerging medical technologies. The panel meets monthly to review and a date coverage policies. All Medical Products 7. Cigna HealthCare's 24-Hour Health Information Lines is a service that provides 24 hour toll free access to registered nurses, who provide answers to healthcare questions, recommends appropriate settings for care, makes referrals to telehealth services when appropriate, and assists Participants in locating physicians. It also includes access to an extensive audio library on a wide range of medical topics. All Medical Products 12/26/2013 cn w 0 3. WV 17Z:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement - S. Cigna LifeSOURCE Transplant Network® contracts with over six -hundred fifty (650) transplant programs at more than one -hundred fifty (150) independent transplant facilities and provides access to solid organ and bone marrow/stem cell transplantation while improving cost containnient and reducing financial risk. All Medical Products 9. A health education program that delivers mailings to Members with certain conditions. All Medical Products Except Comprehensive and Indemnity 10. If behavioral health services are provided/arranged by Cigna Behavioral Health (CBH), CBH provides Network POSOA Products utilization review and case management for both inpatient and outpatient, in -network behavioral health Only services. (Non CA/NC Members Only) 11. Implementing clinical quality measurements, managing data, tracking and validating performance and initiating continuous quality improvement. All Medical Products Except Comprehensive and Indemnity 12. Transition of care services to allow Members with defined conditions to continue treatment with non- All Medical Products Participating Providers after enrollment for continued uninterrupted care for a limited time. Except Comprehensive and Indemnity Focused utilization management of outpatient procedures and identification of appropriate alternatives. For Network POSOA 13. Administered in accordance with CHLIC' s then applicable medical management and claims administration policies, practices and procedures. All Medical Products with PHS Plus E 9 9 � !1@si€;t@ ppf, 6 4 ° €€€I �` �{{ ` :k °€ $° °} B # } ti � �"•gay. dr 1` Y - 6.£ Fi ..a {, .E R°% k IE $€$€q6 j9' F' €': €6 C' i,@pErjSgggs e,99i ,§`ill ,g:lE!EId�R; ihl!. "° €'R` F8 �( p jj i�d EE €E 6(� $..i y'E �:. •ss 0 Ei E. F fxd x <.x� '€ E .<< S 6 ,w $ 9 �I §j}¢{9 E ' pp ,'j4 gS fr P.48@.di.t' L 71 �r 6i d'. §.d' ?. 36 1ld � � � } 5 { E ( 3 $ 16 i 3' i Ci � c' +.idi r y4�3j §3 L 9'.79@iiin ? ! @z .d .4 � d a� a -e. § g Af@_ �. g 1 H € rx 3'... �: @.�. pp .'4u3.:F °g$6�`6$€$'; �'t Et ,gd{§@& @ 3 pE�^ g �(¢ y{ 7}�{ €* E p c.�.r'�.i s`s . � Rt66E�$� ill' . tf. ?� i^i; d48€i'vO8 (Eb€€E€F@i 14 CHLIC, and/or its affiliates shall .. 1. Provide or arrange access to the applicable network of Participating Providers to furnish health care All Medical Products services/products to Members at negotiated rates and rnethods of reimbursement (e.g. fee -for service, capitation, per diem charges, incentive bonuses, ease -.rates, withholds etc.). The amount and type of negotiated reimbursement may vary depending upon the type of plan. For example, a hospital may accept less for patients enrolled in certain types of plans than others; 2. Credential and re -credential Participating Providers in accordance with CHLIC's credentialing requirements All Medical Products and ensure that third -party network vendors credential/re-credential Participating Providers in accordance with CIILIC's requirements; 3. Monitor Participating Provider compliance with protocols and procedures for quality, Participant satisfaction, and grievance resolution; All Medical Products 4. Facilitate the identification of Participating Providers by Members; and All Medical Products 5. Dedicated toll -free telephone line for Member and Provider calls to CHLIC Service Centers. All Medical Products -0 12/26/2013 cn w 0, 0 3. CD 0 s s T co rn w co Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement l 11 1 IkE 11 i� x�iaBedE I-�I', [041 IT It T R ls�t �B 0111111 1.1 C I-MIC has contracted with an affiliate., Cigna Behavioral Health ("CBH"), to provide or arrange for the These services are included provision of managed in -network behavioral health services, CBH is a Participating Provider, and is reimbursed primarily on a monthly fixed fee basis. This fixed fee for CBH services will be paid as claims and will appear in Employer's monthly reporting and on financial documents as capitation. Such payments will be at the relevant monthly rates then in effect. The monthly rates paid to CBH vary depending on geographic location of Members and on benefit design, and may be subject to change. The rates will be made available upon request. The fixed fee also includes lifestyle management programs, a cognitive behavioral modification program, a Complex Psychiatric Case Management program, and a Narcotics Therapy Management program. Behavioral claims from a client specific network are not included in the behavioral monthly fixed fee and will be paid from the Bank Account. In some states, payment for .behavioral health services must be paid on a fee - for -service basis. In these states, fee -for -service payments for behavioral health services and the CBH administrative fee (including the Iifestyle management programs, a cognitive behavioral modification program a Complex Psychiatric Case Management program and a Narcotics Therapy Management program) will be paid from the Bank Account as claims and will appear in Employer's monthly reporting. 12/26/2013 cn w in the following products: Network POSOA 0 v 3 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name. City of Miami Administrative Services Only Agreement qq--'g$il 1tIRr4 is 31 ("}}'€s i i di i 3 i i? r3P j3{ a Pi E, i§{q §E§�I}'�3I }H I aZ 1. �=.S.f P�� 3333 33� 3, 9 8 fEl., t.d� [EPd'. BA�I,Z ill, .11.}}d l,11 ?s r EE (..:�"t 45 §d{ jE,. 8333�.3e � 9 3?},} 8 #. S( 3� I ¢€�3>��3d�'sHh.. HEEE ��tlz:e 94:<,i}i�i� 'i...3... -� §?K. E,- :r § : § Milt j F i ^'.i '�' 1. .. BF �. '� Irr ?. < i�. F `�9PZ`8 .'7 �k`: s i... (( q gg gg . -I ES=..f.' '€�. II H p g $.4s F<_ Yz�'"CF�t. F. . ..€ '�E 9.iS'=,s.Y.= :i� iaf4.4 ':8 ...�.J .. .«. , sa'ib , �a .:. �.,.€ r a,..._.. i-'7a .0 9� § (y { s. �iSi i.'�...,r�,. , ... " -.-]'tl:-' £ g B'� :�I f d .3,.... `: } 4 E Ig:e9 •€H �e 3I a3< 3FEF Ili q' [3 I °P yp € g�g7 89y{ 3�33dd ....3,. ill d. Y��i', i3. :6°€:€.IPi. $ s {��}:�;9j§!�;I�,,§ } The Cigna HealthCare of Arizona, Inc. staff model ("Cigna Medical Group") is a Participating Provider located in metropolitan Phoenix, Arizona. Plan Participants may at some time receive treatment from a Cigna Medical Group ("CMG") facility or provider even if they do not reside in Arizona (as when traveling). Participants utilizing the IPA network will access certain specialty and/or ancillary services (including laboratory and urgent care services) through the CMG system. Lab services are not provided by CMG for Participants in PPO or EPO plans. . Except as provided below, for services provided to Participants, CMG is paid at the rates in effect at the time of service (as may be revised from time to tinge). Representative rates for routinely performed services are attached. A complete copy of the rates is available on request under a mutually agreed nondisclosure agreement (NDA). If the Plan requires Participants to select a primary care physician (PCP), Phoenix area Participants who do not select a PCP during open enrollment are assigned to a CMG PCP. CMG is paid a monthly primary care capitation amount for those Phoenix area Participants who select or are assigned to a CMG PCP. Charges will appear in Employer's standard Bank Account activity data reports at the rates in effect at the time of payment. Primary care capitation charges are age/sex adjusted and may be revisedfrom time to time. A primary care capitation rate grid and a list of the services included in the capitation are available upon request under a mutually agreed NDA. Primary care services rendered to Participants in Open Access Plans that do not provide for PCP assignment are paid at the rates then in effect, as described above. All Medical Products 2/26/20I en 0 0 v 3 98£9686 dd2i uoi}e}io!Iog City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement CIGNA HEALTHCARE OF ARIZONA - CIGNA MEDICAL GROUP (CMG) REPRESENTATIVE RA.'TES FOR ROUTINELY PERFORMED MEDICAL SERVICES EFFECTIVE JULY 1, 2013 (Applicable to all Network and Network. POS Products) CPT Service Code Service Description Rates 45330 Sigmoidoscopy, flexible; Diagnostic (combined rate, includes facility $416.17 fee $328) Diagnostic Colonoscopy (combined rate, includes facility fee $469) Chest XRay,Pa&Lat 45378 71020 74000 Abdomen X-Ray (Kub) 7705'7 Mammogram, Screening (Bilateral) 80053 Comprehensive Metabolic Panel Risk 80061 Cardiac R� .,....._..s....... ...... . .. ....... 82565 Creatinine; Blood 82947 Glucose, Serum 84075 " Phosphatase, Alkaline, Blood 84443 Tsh, Assay • 84450 Sgot (Ast) Transaminase 845241 ' Bun (Urea Nitrogen)Assay 85025 CBC and Differential 87086 Culture, Urine, Colony Ct 88164 Cytopathology, Slides 88305 Surg Path, Gross and Micro 92014 Eye Exam & Treatment 92567 Tympanometiy . 93000 Electrocardiogram, Complete 94 760 Oxnnetry Single Determination 95115 Allergy Injection, Single 951117 Allergy. Injection, Multiple 99211 Office Visit, Est Min (Md Or Non-Md) 99212 Office Visit, Est Prob Focused 99213 Office Visit, Est Exp Prob Foe 99214 V✓ Office Visit, Est Detailed 99231 Subsequent Hospital Care 99242 Office Consult, Exp Prob Focused, 30 Minutes 99395 Well Exarn, Est, 18-39 Years 99396 Well Exam, Est, 40-64 Years $'780 45 $44.05 $35.63 $11403 $.21.95 $27.83 $10.64 $8.15 $10.74 $34,89 $10,74 $8.19 $13.33 $16.78 $21.94 $147 76 $158.56 $22.65 $28.81 $3.58 $1405 $17.19 $27.86 $56.82 S95.41 $142.95 $55.48 $13362 $136.59 $149.26 12/26/20 1 3 8/20/2024 9:24 AM p. 541 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement kw MN arearrisece.Weinrn.s..smixeriaminilli.mi ThO U:rgent•Gare.case rate excluding radiology and laboratory.services is $115.' The CMG CareToday (CMG low acuity clinics) visit rate is $59. Lab tests -performed at the CMG CareToday facilities • - are $10 per service. A complete list of rates for CMG CareToday services is available on request. ASC (Ambulatory surgical center) grouper rates: Group 1 - $328 Group 2 - $469 Group 3 - $1.159 Group 4 - $1451 Group 5 - $1454 Group 6 - $1025 Group '7 - $171.7 Group 8-$1I04.- Group 9 - $1432 Unlisted - $469 CMG pharmacy rates: Brand Name: AWP— 10.56% + $2.'75 dispensing fee Generic: AWP 35% + $2.75 dispensing fee Plan charges a.re' i`educed • by any applicable copayment, coinsurance and/or deductible for service. Services not identified by CPT code or codes without established RVUs are reimbursed at the 50th Percentile -of"the Arizona Regional Medicode Schedule. 12/26/20l 3 8/20/2024 9:24 AM p. 542 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Exhibit C — Claim Audit Agreement (Sample) A. WHEREAS, Cigna Health and Life Insurance Company ("CHLIC") desires to cooperate with requests by (" Employer") to permit an audit for the purposes set forth below; and B. WHEREAS, ("Auditor") has been retained by Employer for the purpose of performing an audit ("Audit") of claims administered by CHLIC. C. WHEREAS, the Auditor and the Employer recognize CHLIC's legitimate interests in maintaining the - confidentiality of its claim information, protecting its business reputation, avoiding unnecessary disruption of its claim administration, and protecting itself from legal liability; NOW THEREFORE, IN CONSIDERATION of the premises and the mutual promises contained herein, CHLIC, the Employer and the Auditor hereby agree as follows: 1. Audit Specifications The Auditor will specify to CHLIC in writing at least forty-five (45) days prior to the commencement of the Audit the following "Audit Specifications": a, the name, title and professional qualifications of individual Auditors; b. the Claim Office locations, if any, to be audited; • c. the Audit .objectives; d.•the scope of the Audit (time period, lines of coverage and number of claims); e. .the process by which claims will be selected for audit; . f. the records/information required by the Auditor for purposes of the Audit; and g• the length of time contemplated as necessary to complete the Audit. Review of Specifications CLILIC will have the right to review the Audit Specifications and to require any changes in, or conditions on, the Audit Specifications which may be necessary to protect CHLIC's legal and business interests identified in paragraph C above. 3. Access to Information CI-ILIC will make the records/information called for in the Audit Specifications available to the Auditor at a mutually acceptable time and place. 4. Audit Report The .Auditor will provide CHLIC with a true copy of the Audit's findings, as well as the Audit Report, if any, that is submitted to the Employer. Such copies will be provided to CHLIC at the same time that the Audit findings and the Audit Report are submitted to the Employer. 5. Comment on Audit Report CHLIC reserves the right to provide the Auditor and the Employer with its comments on the findings and, if applicable, the Audit Report. 12/26/2.0 1.3 8/20/2024 9:24 AM p. 543 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement - -6. Confidentiality The Auditor understands that CHLIC is permitting the Auditor to review the claim records/information solely for purposes of the Audit. Accordingly, the Auditor will ensure that alrinforrnation pertaining to individual -claimants will be kept confidential in accordance with all applicable laws and/or regulations, Without limiting the generality of the foregoing, the Auditor specifically agrees to adhere to the following conditions: a, The Auditor shall not make photocopies or remove any of the claim records/information without the express written consent of CHLIC; The Auditor agrees that its Audit Report or any other summary prepared in connection with the Audit shall contain no individually identifiable information, 7. Restricted Use of the Audit Information With respect to persons other than the Employer, the Auditor will hold and treat information obtained from CHLIC during the Audit with the same degree and standard of confidentiality owed by the Auditor to its clients in accordance with all applicable legal and professional standards. The Auditor shall not, without the express written consent of CHLIC executed by an officer of CHLIC, disclose in any manner whatsoever, the results, conclusions, reports or information of whatever nature which it acquires or prepares in connection with the Audit to any party other than the Employer except as required by applicable law, The Employer and Auditor agree to indemnify and to hold harmless CHLIC for any and all claims, costs, expenses and damages which may result from any breaches of the Auditor's obligations under paragraphs 6 and 7 of this Agreement or from CHLIC's provision of information to the .Auditor, The Employer authorizes CHLIC to provide to the designated Auditor the necessary information to perform the audit in a manner consistent with all Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), Privacy Standards and in compliance with the signed Business Associate Agreement ("BAA"). 8. Termination CHLIC may terminate this agreement with prior written notice. The obligations set forth in Sections 4 through 7 shall survive termination of this agreement. 12/26/2013 8/20/2024 9:24 AM p. 544 City of Miami Solicitation RFP 1896386 • Client Name: City of Miami Administrative Services Only Agreement Cigna Health and Life Insurance Company By: TO BE SIGNED AT TIME OF AUDIT Duly Authorized Print Name: Title: Date: Employer: By: TO BE SIGNED AT TIME OF AUDIT Duly Authorized Print Name: Tit1.e: Date: Auditor: By: TO BE SIGNED AT TIME OF AUDIT Duly Authorized Print Name: Title: Date: 12/26/2013 8/20/2024 9:24 AM p. 545 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Exhibit 11-- Privacy Addendum ("Business Associate Agreement") @. GENERAL PROVISIONS Section 1. Effect. As of the Effective Date, the terms and provisions of this Addendum are incorporated inand shall supersede any conflicting or inconsistent terms and provisions of (as applicable) the Administrative Services Only Agreement and/or Flexible Spending Account or Reimbursement Accounts Administrative Services Agreement to which this Addendum is attached, including all exhibits or other attachments to; and all documents incorporated by reference in, any such applicable agreements (individually and collectively any such applicable agreements are referred to as the "Agreement"). This Addendum sets out terms and provisions relating to the use and disclosure of Protected Health Information ("PHI") without written authorization from the Individual. Section 2. Amendment to Comply with Law. CHLIC, Employer (also referred to as "Plan Sponsor") and the group health plan that is the subject of the Agreement (also referred to as the "Plan") agree to amend this Addendum to the extent necessary to allow either the Plan or CHLIC to comply with applicable laws and regulations including, but not limited to, the Health Insurance Portability and Accountability Act of 1996 and its implementing Administrative Simplification regulations (45 C,p..R. Parts 142, 160, 162 and 164) ("HIPAA"), also known as the HIPAA Standards for Electronic Transactions, the HIPAA Security Standards, and the HIPAA Privacy Rule; the Health .Information Technology for Economic and Clinical Health Act, which was included in the Arnerican Recovery and Reinvestment Act of 2009 (P.L. 111-5 ("ARRA")) and its implementing regulations and guidance ("HITECII"). Section 3. Relationship. of Parties. The parties intend that CHLIC is an independent contractor and not an agent of the Plan. II. PERMITTED USES AND DISCLOSURES BY CIILIC Section 1. Disclosures Generally. Except as otherwise provided in this Addendum, CHLIC may use or disclose PHI to perform functions, activities, or services for, or on behalf of, the Plan as specified in the Agreement, provided that such use or disclosure would not violate the HIPAA Privacy & Security Rules if done by the Plan. Section 2. To Carry Out Plan Obligations. To the extent CHLIC is to carry out one or more of the Pla.n's obligations under Subpart E of 45 CFR Part 164, CHLIC agrees to comply with the requirements of Subpart E that apply to the Plan in the performance of such obligations. Section 3. Management and Administration. (A) CHLIC may use PHI for the proper management and administration of CHLIC or to carry out the legal responsibilities of CHL,,IC, (B) CHLIC may disclose PHI for the proper management and administration of CHLIC, - provided that disclosures are: (a) required by law or (b) CHLIC obtains reasonable 12/26/2013 8/20/2024 9:24 AM p. 546 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement (C) assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed .only as required by law or for the purpose for which it is disclosed to the person, and the person notifies CHLIC of any instances of which it is aware in which the confidentiality of the information has been breached. Except as otherwise .limited in this Addendum, CHLIC may use PHI to provide Data Aggregation services relating to the healthcare operations of the Plan or to de -identify PHI. Once information is de -identified, this Addendum shall not apply. Section 4. Required By Law. CHLIC may use or disclose PHI as required by law. III. OTHER OBLIGATIONS AND ACTIVITIES OF CHLIC Section I. Receiving Remuneration in Exchange for PHI Prohibited. CHLIC shall not directly or indirectly receive remuneration in exchange for any PHI of an Individual, unless an authorization. is obtained from the Individual, in accordance with 45 C.F.R. §164,508, that specifies whether PHI can be exchanged for remuneration by the entity receiving PHI of that individual, unless otherwise permitted under the HIPAA Privacy Rule. 'Section 2. Lim�tj d Data Set or Minimum Necessary Standard and Determination. CHLIC shall, to the extent practicable, limit its use, disclosure, or request of Individuals' PHI to the minimum necessary amount of Individuals' PHI to accomplish the intended purpose of such use, disclosure, or request and to perform its obligations under the underlying Agreement and this Addendum. CHLIC •shall determine what constitutes the minimum necessary to accomplish the intended purpose of such disclosure. CHLIC's obligations under this Section 3 shall be subject to modification to comply with future guidance to be issued by.the Secretary. Section 3. Security Standards. CHLIC shall use appropriate safeguards and comply with Subpart C of 45 CFR Part 164 with respect to Electronic PHI to prevent use or disclosure of PHI other than as provided for by the Agreement. Section 4. Protection of Electronic PHI. With respect to Electronic PHI, CHLIC shall: (A) Implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity,. and availability of the Electronic PHI that CHLIC creates, receives, maintains, or transmits on behalf of the Plan as required by the Security Standards; (B) Ensure that any agent, including a subcontractor, to whom CHLIC provides Electronic PHI - agrees to irnplernent reasonable and appropriate safeguards to protect such information; and, (C) Report to the Plan any Security Incident of which it becomes aware. Section 5.. Reporting of Violations. CHLIC shall report to the Plan any.use or disclosure of PHI not provided for by this Addendum of which it becomes aware. CHLIC agrees to mitigate, to the extent practicable, any harmful effect from a use or disclosure of PHI in violation of this Addendum of which it is aware. 12/26/2013 8/20/2024 9:24 AM p. 547 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Section- 6. .Security Breach Notification. CHLIC will notify the Plan of a Breach (including privacy _related .incidents that might, upon further investigation, be deemed to be a Breach) without unreasonable .delay and, in any event, -within ten business days after CHLIC's discovery of sarne. This notification will include, to the extent known: i. the names of the individuals whose PHI was involved in the Breach; ii. the circumstances surrounding the Breach; iii. the date of the Breach and the date of its discovery; iv. the information Breached; v. any steps the impacted individuals should take to protect themselves; vi. the steps CHLIC is taking to investigate the Breach, mitigate losses, and protect against future Breaches; and, vii. a contact person who can provide additional information about the Breach. For purposes of discovery and reporting of Breaches, CHLIC is not the agent of the Plan or the Employer (as "agent" is defined under common law). CHLIC will investigate Breaches, assess their .impact under applicable state and federal law, including HITECH, and make a recommendation to the Plan as to whether notification is required pursuant to 45 C.F.R, §§164.404.408 and/or applicable state breach notification laws. With the Plan's prior approval, CHLIC will issue notices to such individuals, state and federal agencies - including the Department of Health and Human Services, and/or the media as the Plan is required to notify pursuant to, and in accordance with the requirements of applicable law (including 45 C.F.R. §§164.404-408). CFILIC will pay the costs of issuing notices required by law and other remediation and mitigation which, in CHLIC's discretion, are appropriate and necessary to address the Breach. CHLIC will not be required to issue notifications that are not mandated by applicable law. CHLIC shall provide the Plan with information necessary for the Plan to fulfill its obligation to report Breaches affecting fewer than 500 Individuals to the Secretary as required by C.P.R. § 164.408(c). Section 7. Disclosures to and Agreements by Third Parties. 1n accordance with 45 CFR §164.502(e)(1)(ii) and 164.308(b)(2), CHLIC agrees to ensure that any subcontractors that create, receive, maintain, or transmit PHI on behalf of CI-ILIC agree to the same restrictions, conditions, and requirements that apply to CHLIC with respect to such information. Section 8. Access to PHI. CI-ILIC shall provide an Individual with access to such .Individual's PRI contained in a Designated Record Set in response to such individual's request in the manner and time required in 45 C.F.R. §164.524. Section 9. Availability of PHI. for Amendment. CHLIC shall respond to a request by an :Individual forarnendthent to such Individual's PHI contained in a Designated Record Set in the manner and time required in 45 C.F.R. § 164.526, except that the Plan shall handle any requests for amendment of PHI originated by the Plan; :Plan Sponsor or the Plan's other business associates, such as enrollment information. 12/26/2013 8/20/2024 9:24 AM p. 548 City of Miami Client Name: City of Miami Administrative Services Only Agreement Solicitation RFP 1896386 Section 10. Right to Confidential Communications- and to Request Restriction of Disclosures of PHI. • CHLIC shall comply with, and shall. assist the Plan in. complying with, responding to Individuals' requests for confidential- communications or to restrict the uses and disclosures of their PHI under 45 C•F.R. § 164.522. This shall include _complying with requests to restrict the disclosure of certain PHI with which the Plan is required to agree, in accordance with 45 C.F.R. §164.522. Section 11. Accounting of PHI Disclosures. CHLIC shall provide an accounting of disclosures of PHI to an Individual who requests such accounting in the manner and time required in 45 C.F.R. §164.528. Section 12. Processes and Procedures. In carrying out its duties set forth in Article II, Sections 8 -- 11, above, CHLIC will implement the Standard Business Associate Processes and Procedures (the "Processes and Procedures") attached hereto for requests from Individuals, including the requirement that requests be made in writing, the creation of forms for use by Individuals in making such requests, and the setting of time periods for the Plan to forward to CHLIC any such requests made directly to the Plan or Plan Sponsor. In addition, CHLIC will implement the Processes and Procedures relating to disclosure of PHI to Plan Sponsor or designated third parties. Section 13. Availability of Books and Records. CHLIC hereby agrees to make its internal practices, books and records relating to the use and disclosure of PHI received from, or created or received by CHLIC on behalf of the Plan, available to the Secretary for purposes of determining the Plan's compliance with the Privacy Rule. IV. TERMINATION OF AGREEMENT WITH CHLIC Section 1. Termination Upon Breach of Provisions Applicable to PHI. Any other provision of the Agreement notwithstanding, the Agreement may be terminated by the Plan upon prior written notice to CHLIC in the event that CHLIC materially breaches any obligation of this Addendum and fails to cure the breach within such reasonable time as the Plan may provide for in such notice; provided that in the event that termination of the Agreement is .not feasible, in the Plan's sole discretion, the Plan shall have the -right to report the breach to .the Secretary. • - If CHLIC knows of a pattern of activity or practice of the Plan that constitutes a material breach or violation of the Plan's duties and obligations under this Addendum, CHLIC shall provide a reasonable period of time, as agreed upon by the parties, for the Plan to cure the material breach or violation. Provided, however, that, if the :Plan does not cure the material breach or violation within such agreed upon time period, CHLIC may terminate the A.greement at the end of such period. Section 2, Use of PHI upon Termination. The parties hereto agree that it is not feasible for CHM to return or destroy PHI at termination of the Agreement; therefore, the protections of this Addendum for PIII shall survive termination of the Agreement, and CHLIC shall limit any further .uses and disclosures of such PHI to the purpose or purposes which make the return or destruction of such PI -II infeasible. t2/26/2013 8/20/2024 9:24 AM p. 549 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement V. OBLIGATION OF THE PLAN The Plarnwill not request CHLIC to use or disclose PFlI in any manner that would not be permissible under HIPAA or FIITECH if done by the Plan. VI. DEFINITIONS FOR USE IN THIS ADDENDUM Definitions. Certain capitalized terms used in this Addendum shall have the meanings ascribed to them by HIPAA and HITECH including their respective implementing regulations and guidance. If the meaning of any term defined herein is changed by regulatory or legislative amendment, then this Addendum will be modified automatically to correspond to the amended definition. All capitalized terms used herein that are not otherwise defined have the meanings described in HIPAA and HITECH. A reference in this Addendum to a section in the HIPAA Privacy Rule, HIPAA Security Rule, or HITECH means the section then in effect, as amended. "Breach" means the unauthorized acquisition, access, use, or disclosure of Unsecured PHI which compromises the security or privacy of such information, except where an unauthorized person to whom such information is disclosed would not reasonably have been able to retain such information. A Breach does not include any unintentional acquisition, access, or use of PHI by an employee or individual acting under the authority of CHLIC if such acquisition, access, or use was made in good faith and within the course and scope of the employment or other professional relationship of such employee or individual with CHLIC; any inadvertent disclosure from an individual who is otherwise authorized to access PHI at a facility operated by CHLIC to another similarly situated individual at the same facility; and such information is not further acquired, accessed, used, or disclosed without authorization by any person. "Business Associate" means CHLIC. "Covered Entity" means Plan. "Designated Record Set" shall have the same meaning as the term "designated record set" as set forth in the Privacy Rule, limited to the enrollment, payment, claims adjudication, and case or medical• management record systems maintained by CHLIC for the Plan, or used, in whole or in part, by CHLIC or the Plan to make decisions about Individuals. "Effective Date" shall mean the earliest date by which the Plan is required to have executed a Business Associate Agreement with CHLIC pursuant to the requirements of applicable law. "Electronic Iectronic Protected Health Information"shall mean PIII that is transmitted by or maintained in electronic media as that tern is defined in 45 C.F.R. §160.103. "Limited Data Set" shall have the same meaning as the term "limited data set" as set forth in as defined in 45 C.F.R. §164.514(e)(2). "Protected Health Information" or "PHI" shall have the sate meaning as set forth at C.F.R. §`160.103. "Secretary" shall mean the Secretary of the United States Department of Flealth and Human Services. 12/26/2013 8/20/2024 9:24 AM p. 550 Client Name: City of Miami Administrative Services Only Agreement City of Miami Solicitation RFP 1896386 "Security Incident" shall have the same meaning as the term "security incident" as set: forth in 45 C.F.R.. § 164.304. "Unsecured Protected health Information" shall mean PHI that is not rendered unusable, unreadable, or indecipherable to unauthorized individuals through the use of a technology or methodology specified by the Secretary in the guidance issued under Section 13402(h)(2) of ARRA. 12/26/2013 8/20/2024 9:24 AM p. 551 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement , Cigna Health avid Life Insurance Company Standard Business Associate Processes and Procedures These Standard Business Associate Processes and Pr•oeedures apply to each self -funded group health plan ("Plan") of an entity ("Plan Sponsor") that has. entered or will enter into an Administrative Services Only Agreement, Flexible Spending Account or Reimbursement Accounts Administrative Services Agreement and/or Continuation Coverage Services Agreement (collectively, as applicable, the "Administrative Services Agreement") with Cigna Health and Life Insurance Company ("CHLIC"). The Plan and CHLIC are parties to a Business Associate Agreement/Privacy Addendum. Unless otherwise defined, capitalized terms have the meaning provided therein, or if not defined in such agreement, as defined in 45 C.F.R. parts 142, 160, 162 and 164 ("HIPAA"), also known as the HIPAA Standards for Electronic Transactions, the I-IIPAA Security Standards, and the HIPAA Privacy Rule and/or the Health Information Technology for Economic and Clinical Health Act, which was included in the American Recovery and Reinvestment Act of 2009 (P.L. 111-5 ("ARRA")). Section 1. Access to PIII. When an Individual requests access to PHI contained in a Designated Record Set and such request is made directly to the Plan or Plan Sponsor, the Plan shall forward the request to CHLIC within five (5) business days of such receipt. Upon receipt of such request from the Plan, or upon receipt of such a request directly from an Individual, CHLIC shall make such PHI available directly to the Individual within the time and manner required in 45 C.F.R. § 164.52,4. The Plan delegates to CHLIC the duty to determine, on behalf of the Plan, whether to deny access to PHI requested by an Individual and the duty to provide any required notices and review in accordance with the HIPAA Privacy Rule. Section 2. Availability of PHI for Amendment, (a) When an Individual requests amendment to PHI contained in a Designated Record Set, and such request is made directly to the Plan or Plan Sponsor, within five (5) business days of such receipt, the Plan shall forward such request to CHLIC for handling, except that the Plan shall retain and handle all such requests to the extent that they pertain to Individually Identifiable Health Information. (such as enrollment information) originated by the Plan, Plan Sponsor, or the Plan's other business associates. CHLIC shall respond to such forwarded requests as well as to any such requests that it receives directly from Individuals as required by 45 C.F.R. §164.526, except that CI-ILIC shall forward to the Plan for handling any requests for amendment of PHI originated by the Plan, Plan Sponsor, or the Plan's other business associates. (b) With respect to those requests handled by CHLIC tinder subparagraph (a) above, the Plan delegates to CHLIC the duty to determine, on behalf of the Plan, whether to deny a request for amendment of PHI and the duty to provide any required notices and review as well as, in the case of its determination to grant such a request, the duty to make any amendments in accordance with the terms of the Privacy Rule. In all other instances, the Plan retains all responsibility for handling such requests, including any denials, in accordance with the HIPAA Privacy Rule. (c) Whenever CHLIC is notified by the Plan that the Plan has agreed to make an amendment pursuant to a request that it handles under subparagraph (a) above, CHLIC shall incorporate any such amendments in accordance with 45 C.F.R. § 164.526. Section 3. - .Accounting of Disclosures. When an Individual requests an accounting of disclosures of PT -II held by CHLIC directly to the Plan or Plan Sponsor, the Plan shall within five (5) business days of such • receipt forward the request to CHLIC to handle. CHLIC shall handle such requests, and any such 12/2,6/2013 8/20/2024 9:24 AM p. 552 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement requests for an accounting of disclosures received directly from Individuals, in the time and manner as. required in 45 C.F.R. § 164.528. Section • 4. Requests for Confidential Communications or to Restrict Disclosure of PM. CHLIC shall handle Individuals' requests made to it for privacy protection for PHI in CHLIC's possession pursuant to the .requirements of 45 C.F.R. § 164.522. The Plan shall forward to CHLIC to handle any such requests the Plan receives from Individuals that affect PHI held by CHLIC. Section 5. General Provisions Regarding Requests. CHLIC may require that requests pursuant to Sections 1 through 4 above be made in writing and may create forms for use by Individuals in making such requests. When responding to an Individual's request as provided above, CI-ILIC may inform the Individual that there may be other "protected health information" created or maintained by the Plan and/or the Plan's other business associates and not included in the CHLIC's response. CHLIC shall not be responsible for performing any duties described in the Business Associate Agreement with respect to any such other "protected health information." In carrying out its duties set forth herein, CHLIC may establish such additional procedures and processes for requests from Individuals as permitted by the Privacy Rule. Section 6. Disclosure of PHI to the Plan Sponsor. To the extent that the fulfillment of CHLIC's - obligations under the Administrative Services Agreement requires CHLIC to disclose or provide access to PHI to Plan Sponsor or any person under the control of Plan Sponsor (including third parties), CHLIC shall make such disclosure of or provide such access to PHI only as follows: . (i) CHUG:. disclose Summary Health Information to any employee or other person under the control of Plan Sponsor (including third parties) upon the Plan Sponsor's written request for the purpose of obtaining premium bids for the provision of health insurance or HMO coverage for the - Plan or modifying, amending or terminating the Plan; and (ii) If the Plan.. elects to provide PHI to the. Plan Sponsor, CHLIC shall disclose or make available PHI, other than Summary Health Information, at the written direction of the Plan to only those employees or other persons that Plan Sponsor represents are identified in the Plan documents and under the control of Plan Sponsor solely for the purpose of carrying out the Plan administration functions that Plan Sponsor performs for the Plan. Where requested by CHLIC, such employees or other persons (including third parties) will be identified by the Plan in writing (by name, title, or other appropriate designation) to CHLIC as a condition of disclosure of PHI pursuant to this Section 6(ii). The Plan may modify such list from time to time by written notice to CHLIC. Section 7, Disclosures of PHI to Third Parties. Upon the Plan's written request, CHLIC will provide PHI to certain designated third parties who assist in administering the Plan and who are authorized by the Plan to receive suchinformation solely for thepurpose of assisting in carrying out Plan administration functions ("Designated Third Parties"). Such parties may include, but are not limited to, third -party administrators, consulta.nts, brokers, auditors, successor administrators or insurers, and stop -:loss carriers-. As a condition to providing PHI to a Designated Third Party, CHLIC may require that the Plan have a business associate agreement (within the meaning of the Privacy Rule) with such Designated Third Party.: 12/26/2013 8/20/2024 9:24 AM p. 553 City of Miami Client Name: City of Miami Administrative Services Only Agreement Solicitation RFP 1896386 Exhibit E — Conditional Clair .n/S►ubrogation Recovery Services I. Plans Without CHLIC Stop Loss Coverage If Employer has not purchased individual or aggregate stop loss coverage from CHLIC or an affiliate with respect to its self -funded employee welfare benefit plan: A. All conditional claim payment and/or subrogation recoveries under the Plan will be .handled by • the entity checked below; Employer An independent recovery vendor whose name and address follow: CHLIC and its subcontractor(s) lB. If Employer has designated CHLIC and its subcontractors to act as its recovery agent in paragraph I.A, above, then: i. Employer hereby confers upon CE LIC and its subcontractors' discretionary authority to reduce recovery amounts by as much as fifty percent (50%) of the total amount of benefits paid on Employer's behalf, and to enter into binding settlement agreements for such amounts. • ii. In the event a settlement offer represents a reduction greater than the percentage identified above, CHLIC and its subcontractors should seek settlement advice from: N ame: 'Title: Address: Telephone: iii. All amounts reimbursed to Employer's Bank Account shall be refunded at the gross amount. CHLIC's and it subcontractors' subrogation administration fee on cases where CHLIC and its subcontractors' have retained counsel and in cases where no counsel has been retained by CHLIC and its subcontractors are both reflected in the. Schedule of Financial Charges. C. Except where agreed to by CHLIC and Employer, CHLIC and its subcontractors shall have no duty or obligation to represent Employer in any litigation or court proceeding involving any matter which is the subject of this Agreement, but shall make available to Employer and/or Employer's counsel such information relevant to such action or proceeding as CHLIC and its subcontractors may have as a result of its handling of any matter under this Agreement. T). In the event Employer purchases individual or aggregate stop loss coverage from CFILIC or an affiliate with respect to its self. -funded employee welfare benefit plan at any time during the life of this Agreement, the provisions of paragraph IL, below, shall control. 12/26/2013 8/20/2024 9:24 AM p. 554 City of Miami Solicitation RFP 1896386 Client Name: City of Miami 'Administrative Services Only Agreement II. ; Plans with CIEILIC Stop Loss Coverage If Employer has purchased individual or aggregate stop loss coverage from CHLIC or an affiliate with respect to its self funded employee: welfare benefit plan: A. CIILIC and its subcontractors shall have the right and responsibility to manage all conditional claim payment and/or subrogation recoveries under the Plan. CHLIC and its subcontractors shall reimburse to the Plan the recovery minus relevant individual and aggregate stop loss payments made by CHLIC. B. All amounts reimbursed to Employer's Bank Account shall be refunded at the gross amount. CHLIIC's and its subcontractors' subrogation administration fee on cases where CHLIC and its subcontractors' have retained counsel and in cases where no counsel has been retained by CHLIC and its subcontractors, are both reflected in the Schedule of Financial Charges. C. CHLIC and its subcontractors shall have no duty or obligation to represent Employer in any litigation or court proceeding involving any matter which is the subject of this Agreement but shall make available to Employer and/or Employer's counsel such information relevant to such action or proceeding as CHLIC and its subcontractors may have as a result of its handling of any matter under this Agreement. Notwithstanding the foregoing, CHLIC and its subcontractors reserve to itself the right to retain counsel to represent CHLIC's own interests in any subrogation and/or conditional claim recovery action under the Plan. 12/26/2013 8/20/2024 9:24 AM p. 555 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement Exhibit F •-- California Transfer Addendum to ASO Agreement The following provisions are applicable to that portion of the Plan .that covers California Members under a managed care coverage option utilizing a provider network established by Cigna HealthCare of California, Inc, or its affiliates ("CHC"), and the Agreement is hereby modified accordingly. These provisions are added for the purpose of ensuring compliance with California regulatory requirements which are applicable when the provider network includes capitated providers. I . California. Banking Arrangements a. In addition to the Bank Account(s) required to be established under Section. 3, a separate Citibank, N.A., program account (the "CHC Program Account") will be established by CHC for the purpose of finding all in -network benefits. b. Employer shall, through a bank of its choice, periodically fund the CHC Program Account as described in the CHC Group Service Agreement ("GSA"). 2. California Contracting Requirements a. CHC shall issue to Employer a GSA. In -network services under the Plan for California Members shall be provided by CHC pursuant to this GSA. 3, Funding a. In addition to any other charges payable by Employer to CHLIC for the performance of services under this Agreement, Employer shall pay to CLILIC any amounts funded by Employer through the CHC Program Account which CHC is required to return to Employer pursuant to the Return of Payments provision of the GSA. In recognition of its obligation to fund benefits under this Administrative Services Agreement, Employer authorizes and directs CHC to pay over any such amounts directly to CHLIC. Such amounts shall be held by CHLIC to be paid to CHC in the event CHC seeks to recover from Employer any prior years' Losses under the Loss Recovery provision of the GSA. In the event that the GSA terminates at a time when CHLIC is still holding amounts paid by CHC under the Return of Payments provision, such amounts shall be considered additional compensation owed to CHLIC for services provided pursuant to this Administrative Services Agreement. b. From the amounts paid to CHLIC pursuant to the preceding subsection, CHLIC shall pay to CHC any amounts which Employer may be required to pay to CHC under the "Loss Recovery" provision of the GSA. 4. Stop Loss Coverage a. All amounts funded by Employer through the CHC Program Account shall be considered as benefit payments under the Plan for purposes of any stop loss policy issued to the Employer by a Cigna company with respect to the Plan, including amounts in excess of the Maximum Premium amount reflected in the GSA. 12/26/2013 8/20/2024 9:24 AM p. 556 City of Miami Cxii rat Narne: City of Miami Adrmirrf trot vO- SW" iCe5 On y A1,3 reer ru rbt Solicitation RFP 1896386 PROVIDER'S ' RESPONtNSE TO RFP LAC'`,1I0L )ER "roreV Cio7iRe-�b 8/20/2024 9:24 AM p. 557 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement EXHIBIT D SCHEDULE OF FINANCIAL CHARGES 12/26/20 E 33 8/20/2024 9:24 AM p. 558 Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement Schedule of Financial Charges Certain fees and charges identified in this Schedule of Financial Charges will be billed to Employer monthly in accordance with CHL IC's then standard billing practices. However, CHLIC is authorized to pay all fees and charges from the Bank Account unless otherwise specified in this Agreement. {ys- gg i P➢3dd g�34 $ { Pg {{gg: ti$g:,.� e.3g.g6, i�r. ..N€'(b„?73,.3I.I,i iEe§. , q ,. ) E9 Ei {E . 7: ; € {9 L e}f3�I::, 9 r i ° . ff a .:. P @I § I I�..IEr,t 33 1 fig' y ei ?9 �f{ t.{8it�s €. '§":3 �€ @@ . 's . "i € g$ SS Y [ j(i : �8p t{'�i Y' g'. j�{� "�z�"uiiL jigg t. 3t 3iP f �jo� 8 E $( il�.B.tlz3I3 a:E E,B��- i Bq$ r 16+p#@, [ 13 j4nF,.r;@@.{{a 3.E°. .E61j'E.. . ii ar s i � 81.! �.s6. .1..y� �.,d e9.tl$4.•..'${YitriL3P 1. s EEr"?' £ ;# �: d SS'"4: d ..... ' ? :� . l [,F 1 .s§ , r p i ,J i 1E:�:��mi7�l�,iE°£E" ?'xa{<s. jj" ., F,jq , <ar E r.i{3f3 df E•E ; j y"�j. 3 ,{ 3 €� �(i i #. p,,. (}$ i._ i .v ,g� . i '..f 'Fl ? - l i ] xC" .'l':.2r"x"•.' :.:� r t . =F £#aPit.i3Sr �`'�f{�17j�3i' d;�3{ yj y91{9p s fl 8ddr� y�y qy iE 4�I gyE :,3 .:3 . F`€'. - � z>i. ? >:zsS I t rzx �. n•S€.� -i p� E°� �' �:..� E e:i{� ,!:.� ,g ,:. 7 #: � F ..c :-j4$(Pp- P6Elix4 .t !�!°i...... �' y ���?�f$ Pi P� �0 x,} '.d' ��iliI' . E _� , sS,L =:i. tayS�3.. gg 9§ &d6 E 3§�¢ {��,E{,,yg i eCS�3k:P6SU€!f��S.�LL°�;d,HF.E,E Charge § i .. k. 6 j€,( Y E [p{ . ......°89 a'Esc#i6ptl€6@ : t3 a }sa 3. . ¢ @pg'� �.s d§8 8E° d i "(R " 3 § F, g@d�E@��� { (@ €�6p[p5"3'�� CRi d�FIB!E@� Product Description Medical • Network Point of Service Open Access (POSOA) with PHS Plus Medical Management $18.53/employee/month Medical Comprehensive with PHS Medical Management $18.85/employeeimonth Vision • Vision Care $a.32lemployeetmonth @.3Eis a E yj E �'}Ei���.jg�tat�%��3 8 ',gPg1;? j6jE qq)j[[)3 t 44�� 9i"Pi1z �$$f 1:4 3 qq @@�k =.i1 [ 'kk°BEa y i piS @p .� idlj$yp@@g?? 4 d@Eltlifi§E d >F $ �) iP 6g � 'E - 9 € �(jjE j{#j @@?@{':i!SSSi {� "f (b :. <�F§ §$' � j{ i s`! :'...' .d� � j ¢ $$ [s f�$ £�:s�� II � ,E. '`. '.. ... 4[$ �.,. Iy. Et`' . '� j...: '.t{F '. E,1 Em x . l } g 9 (( S E 6 6� € 8 g @ptl g .E P : EraEs �� r' yy I � .4 tqj¢ ? . B ysls! S t t fa8 - ' '". iiirm j[`. r £,.B' �. E.. ip a5 ..'.. F' ''..6.'P �i ¢ E. [ i p p tl>�tl tl.Fy38dtlt6Eb' 3 $ T 6�9p' x a'6E 7 4d �€ 7j$$' @pg-p { Y d 3d 9$} - $ t! .§ 9S:dS[ 4°.R i i @ s e aP § d @9t8iitdlf�{3sYis@Y!ti 6 6 fEi s] S� P k9 g? i":: •tI C':: -- � t €jJJjiy 9t }}' e ' B , a .. f ER £ :-(i � 't �!0. !' m � '>E {: j . j_]p 3 j j a v ,t@ z([: y y;{s .?y@3 . { ?.F $s # iSf. -3 99-:d 38��8 P �e.:'� F4 3? 6° gV4iYz''. ".��5€S3ile �i�4i��4� � t�.8a'8i�P.�€86 ' :3.... III ,� pk ¢{(@ B.dC � � '' '� � gy [g A .s. 3 Y.I"S j7 � ' '. �. Product Description Charge Medical • Network POSOA Access Fee $18.40/employeefmonth Medical • Comprehensive Care Coordination Fee $5.40/employeeImonth` Behavioral Health- An Administrative Charge management programs Psychiatric Case Management be processed through the Network Product. and for Mental Health/Substance Abuse Services, including lifestyle a cognitive behavioral modification program, a Complex program, and a Narcotics Therapy Management program, will Bank Account for members residing in North Carolina with a $2.56/Member/wont '•i "'3�= "3'3 • f{133 ���sas 3'•i'r i i 3t . H • i'.••i 3I j?j 3•' a7773 P § .. 98 . }(( @$ C�E 9 �@PP�{@ ° 6 E I EEx[ [E p{#' 33ss�}_,.}i� ''3}.3 3.°..... 3 [p 6€(t {,�`p{Y:; € jj rzn }'' tFi Y i '¢£ �t � EE ?€€iq{ a h £ £ fF � :. . F3� '. P.:` .t3 E E�6< x FEPF��sP.1n. °€,I f, 'E i.€ - }°{ra- l.. E - d9`d9 �� ,-P i t»':9.3i t i �tk':¢ th . { ¢ie9i'-. N':9B'£RBt9:oegp?°S ' '. -ie' x{ t9e -° E t:°£•i£3.• o { 9 '�¢� �7 & G g �• ¢¢•'� i � 3. .ii'ai iq 8 g a Pd ES@.q ', f£ $°Wj ,•.)' : E • •} � t d)E ?�@$@€ �xE iY E.3{3 f i�i �3 9 l j$ a dyd�4ro'r§9P ae£x j {i �E{ C 6 � °ta E ',;{ r $r x@ �rSS c. j fjFI l: ;4_ar;� �a:a§Ld9�:..§ .v£ i k3 f E i -r r 1Y;;I " d' p@ �Ifl : n@n @n e En $E, �� j 9 a E.R.. F I. `W i i € �DbY'-pt fir@..:. m$ :r'.qCij�[ . S a f Ff. ii : si .. n. ri 4 Is' ; r: Oil . �. . s d48 ES 9 x Product Charge Dependent Care Flexible Spending Account (DFSA) Administration I S5.90/employee/month I • Health Care Flexible Spending Account (FSA) Administration $5.90/em.ployee/month 12/26/2013 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement !' Definitions "Average Wholesale Price" or "AWP" is the Average Wholesale Price for a given pharmaceutical product in effect on the dispense date for the actual package size dispensed as published by Medi-Span or other alternative publication or benchmark reasonably designated by CPIL,IC. • "Brand Drug Claim" is a claim for a pharmaceutical product that is adjudicated as a brand drug as indicated on the claim record generated by the claim processing system used by CHLIC. For application of discounts and dispensing fees, a "Brand Drug Claim" includes a claim for a generic drug within its exclusivity period or other period of limited competition, as CHLIC reasonably determines under its standard policies. • "Generic Drug Claim" is a claim for a pharmaceutical product that is adjudicated as a generic drug as indicated on the claim record generated by theclaimprocessing system used by CHLIC. For application of discounts and dispensing fees, a "Generic Drug Claim" excludes a claim for a generic drug within its exclusivity period or other period of limited competition, as CHLIC reasonably determines under its standard policies. s "Mail Service Pharmacy" or "Cigna Tel -Drug" or "Cigna Home Delivery Pharmacy" is a pharmacy that is owned or operated by CHLIC or an affiliated company(ies) (currently, Tel -Drug, Inc. and Tel -Drug of Pennsylvania, LLC), which dispenses drugs covered under the Plan's Pharmacy Benefit by mail, and is not a Retail Pharmacy. • "Pharmacy Benefit" means the teinis of the Plan that govern coverage and care/utilization management of drugs and related supplies dispensed to Members and charged to the Plan by the Mail Service Pharmacy or Retail Pharmacies through CHLIC's pharmacy claim processing system. • "Rel afes5" er_ "Manufacturer Formulary Payments" means amounts that CHLIC collects under contracts with drug manufacturers that are based on utilizai oh of certain of the manufacturers' brand. drugs under the Plan's Pharmacy Benefit and the drug's status on the Cigna drug formulary. • "Retail Pharmacy" is a pharmacy that is entitled to payment under the Plan for drugs it dispenses that are covered under the Plan's Pharmacy Benefit; and is not a Mail Service Pharmacy. "Specialty Drug Claim" is a claim for a pharmaceutical product that is reasonably determined by CHLIC to be a specialty drug in accordance with industry practice. Specialty drugs generally are (i) injected or infused and derived from living cells, or are oral non -protein compounds (e.g., oral chemotherapy drugs); (ii) target the underlying condition, which is usually one of a relatively rare, chronic and costly nature; and/or (ill) require restricted access and/or close monitoring. 11 era 511 !l:I� 3 p 10 t! `s} IfE[ hip r Cigna Pharmacy Product Administration Fee: Included in Medical Administration Charge 9k11.6 1111 rii 111 1111 `i'1li1 i2 26/2oI3 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name. City of Miami Aciministrative Services Only Agreement B{{ E IF I 6 lT 2 s??�RR� i`33 e g ?p , % ;dE q ( 3 y cT €4�?i# i Mill � �i �� l�i� 1� � L. 4 ��f �8I . w d ,,x� ae c Ada, Leif 1 I E @ E,d dt Eeee etB g 9 l ` ' € Lid 7 a& t � 6 �, e° � s 3 b' 7 an 8 a113 �� � @ Ed ! �.E:: s i ��?. � >o �Rn IDS 5-� s - :,E ;a 4' _ s ,v ,! Mtgig }- sE 3-SPH §@B.§` , � y rs , gi g . ,�,.. q . t: x : Tr:' a e 4' p g ': : 8 ° 1 3 u �k�i ia¢iiti� 99 6° € •y� '.z. 9°I �iPII`I .jj: ur€ tf'i' 6 ! 8 6€ <-;; i . { ji{sU • ' pp jj q yy ?} gg {f & t { .a g ; a {( lr<,€ �.�.L�>7�.r�H €Ht�tt. t# ? } ,.., Drug isp s d by Mail Se -vicePharmacyr C, IC dispensed b the Mad S"erviee Pharmacy: -..'._.. . - q,� wilt charge Erployer the fo.11owni for' 6Ia s; covered u die - the ?i406: Ph rrr acy Benefit .and Brand Drug Claims: AWP minus an average discount of 26.0% plus an average dispensing fee of $0.00. Generic Drag Claims: The drug's charge on a CHLIC generic Maximum Allowable Charge schedule that generates an annual average aggregate discount across Generic Drug Claims dispensed at Cigna Home Delivery Pharmacy to CHLIC group -client book of business of AWP minus 80.0% plus an average dispensing fee across such Generic Drug Claims of not more than $0.00. Specialty Brand Drug Claims: The drug's charge under a national discount schedule that generates a 13.7% annual average aggregate discount off AWP for Specialty Drug Claims dispensed at Cigna Home Delivery Pharmacy across CHLIC 's group -client book of business (including Specialty Drug Claims dispensed by Mail Service Pharmacy, whether covered under group -clients' Cigna Pharmacy Benefit or Cigna medical benefit). D s euse0., 4y Retail Pharmacies CHLIC will charge Empt zyer the foil aw ig_ for ru . covered a the; ii's Phan*cYy• Benefit efit and: d dIS sed :by a;R tO Pha maey to the, Plan Members, subj eet to the "Drug Ch ges - M ditiOna1 Pro ions . eccttc d " Retail Brand Drug Claims: The lesser of (i) Retail Pharmacy's usual and customary charge. Retail Generic Drug Claims (other than those generic Maximum Allowable. Charge schedule Retail Pharmacies to CHLIC group -client book average dispensing fee across such Generic Drug Retail Specialty Brand Drug Claims: The dispensing. fee of no more than $1.40; or (ii) the AWP minus an average discount to which the above brand discount that generates an annual average of business of AWP minus 76.5% Claims of no more than $1.00; lesser of (i) AWP minus an annual of 16.50% plus an average dispensing fee of $1.00; or (ii) the applies): The lesser of: (i) the drug's charge on a CHLIC aggregate discount across Generic Drug Claims dispensed at (Plan -specific results may vary based on drug mix), plus an or (ii) the Retail Pharmacy's usual and customary- charge_ average aggregate discount of 13.5%, plus an average charge. Retail Pharmacy's usual and customary 12126/2013 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement ,E�11£��5 � t�s ���� �di���.i'i� �� � i!f'� "ta�rr� p� a� � t� € E�€ 1 [ .9E ,1�:.� �- - � r� i€� ii ,�i r �a4€ E s� � E ih 3 as i EE �� Cigna Home Delivery Pharmacy's discounts are applied to the manufacturer average wholesale price (AWP) for the dispensed size (or to the AWP for the manufacturer -packaged quantity closest to the dispensed size, if there is no AWP for the dispensed size). Cigna Horne Delivery Pharmacy will be reimbursed through the Bank Account for the price (discounted as per this Schedule) for replacement prescriptions shipped by Cigna Home Delivery Phaiinacy which are reported as lost or damaged despite Cigna Home Delivery Phaiinacy's shipment to the Participant's correct name and address. The amount paid to the Retail Pharmacy for Brand, Generic, or Specialty Drug Claims may or may not be equal to the amount charged. to Employer, and CHLIC will absorb or retain any difference. An excess achieved in any Plan -specific discount floor or dispensing fee cap offered under this Agreement will be used to offset a shortfall in any other Plan -specific discount floor or dispensing fee cap offered under this Agreement. industry Changes to or Replacement of Average Wholesale Price (AWP). Notwithstanding any other provision in this Agreement, including in this Exhibit, in the event of any major change in market conditions affecting the pharmaceutical or pharmacy benefit management market; including, for example, any change in the markup; methodologies, processes or algorithms underlying the published AWP(s), MAC may adjust any or all of the charges, rates, discounts, guarantees and/or fees in connection with CHLIC's administration of the Plan's Pharmacy Benefit hereunder, including any that are based on AWP, as it reasonably deems necessary to preserve the economic value or benefit of this Agreement as it existed immediately prior to such change. Additionally, and notwithstanding any other provision in this Agreement, including in this Exhibit, CHLIC may replace AWP as its pharmaceutical pricing benchmark with an alternative benchmark and/or may replace Medi-Span, or other such publication as its source for the AWP or alternative benchmark with a different pricing source, provided that CHLIC adjusts any or all:such AWP- Based Charges or such alternative benchmark -based charges as it reasonably deems necessary to preserve the economic value or benefit of this Agreement as it existed immediately prior to such replacement or immediately prior to the event(s) giving rise to_ such replacement, . as the case may be. ? 2 26/2013 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement 1 L i MIT 1111; E Subject to the caveats below, CHLIC will remit to Employer the following portion of Rebates that CHLIC collects with respect to utilization under the Plan's Pharmacy Benefit: The greater of 100% of Rebates, or the sum of $31.23 multiplied by the number of Retail Pharmacy Brand Drug Claims plus $104.26 multiplied by the number of Mail Service Pharmacy Brand Drug Claims. Caveats: (1) Upon termination of this Agreement, CI-ILIC may apply Rebates otherwise payable to offset Bank Account or other deficits of charges identified in this Agreement. (2) Should Employer terminate this Agreement before completion of the then -current Plan Year, no Rebates shall be due with respect to that Plan Year. (3) All applicable caveats communicated in writing by CHLIC in connection with its proposal made in connection with this Agreement. (4) For percentage -based sharing arrangements, payout amount may differ slightly from the stated percentage when payout occurs before manufacturers' final reconciliations and payments are made to CHLIC. (5) Rebates are not paid out on Run -Out Claims. (6) CHLIC or its agent contracts with drug manufacturers on CHLIC's own behalf, and not as agent of the Employer or the Plan. Timing of Rebate Pay -Out: Remittance will be provided within ninety (90) days after the close of each applicable calendar quarterly for the portion of such calendar quarterly that coincides with the Plan Year. It 11 a 4 Bii 1111 9,aSBtfl898a Il 14111111111. ;it 8. 8k E �1f�fl i 43I 8 i 8�i1j�: Employer's third party auditor may audit records directly related to CHLIC's performance of its obligations hereunder regarding sharing of manufacturer formulary payments (a/k/a "rebates") once in each twelve-month period upon the following conditions: Employer shall provide at least forty-five (45) days written notice to CHLIC; the auditor (including its individual auditors conducting the audit) shall be agreeable to Employer and CHLIC; a mutually agreed upon non-disclosure/non-use contract shall be executed by Employer, the auditor and CHLIC; the records to be audited shall be no more than two years old as of the date of the audit; the scope of records to be audited shall be as mutually agreed upon by Employer's third party auditor and CHLIC as those which are necessary to determine compliance with the rebate -sharing obligations under this Agreement; the audit shall be conducted at a mutually acceptable time during regular business hours at CHLIC's office where such records are located; records shall not be removed or photocopied without CHLIC's express written consent; the auditor shall provide its audit report to CHLIC and Employer at the same time; and the auditor may disclose the aggregate amount of manufacturer formulary payments due Employer but no other details of CHLIC's manufacturer contracts of which the auditor is apprised, if any. 12/26/2013 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement j[b �??' €it 1: Network Comprehensive Vision s$$jq� }£jj F E€ 1il �f Care 7j�3�iF Y it}x� ,iti p{}{d(,"' i $h 3")§["3�99y a@"6 lj F£§# P @� I Pi .3 d POSOA, and ` `• £ - .',�.F' P i$r"§71 .�?P €la � E� I! Y ` 9 ..i i. �Fx ;.§ i Run -Out ??? 4..x... ,0 § [P6p.$6p9E{ f 6" B I� €i� Ex .E� aAI, I@.l� Period of twelve . .' � i ` _ ( (12) months ig: ". m Ese �' rir^ i � '. - ' IACf 3f m :. 8 .. .} �2 ..-,C 0 s8 .. !!!6liI i£..1 € k 1 .:•dl� ill1i66. i E i 6e }� ¥sss Y 8 x -..�3eyp F� `E� 1'#. ':y p 8 3 9Ci9 f9 I ae @8 evv[cge9§'ey�§tle £" P S p8ge8 � 3f3y 3i 9 1...��: �1� t€sdlii 111� % €€. No Additional Cost Pharmacy Run -Out Period of three (3) months for all pharmacy claims No Additional Cost ----gggg B �!! 9 �. x y 99 8 5p$}"- '6 (} i!3 & i III CE -i8i ? B{{{6 f {?! 9 3 .. ,� . i' i _ �Y� to € g �?§§ b �`'s [ , 381 i( # ( (j? jS #33 4 p i 3 Sf ! §g h.8 ii x ci @Ej { p 3 ; y[{j} YF "' J tg}?b > r�<:=. _ . Pi. g E P E ( , .airs p jr 6 ! e'i S sa yE g. 'aCs.3 Y[ x k ,}._P q� ( . �..} �R. IP - i z j t ''v 9� s E i 'ta' ?asa? £ A 4 $ j$ r F �x a. ss- 3 S d E .. y te'': i11 }.��:it i; t -4E�¢f¢i ° LY.y IY 3ajt i3�� Sey.{ppNii$ g`ti E• 3 u43;�p3jy�$�t '3't � s [> I`f 6 9Pg$i}{q($i@f B11103 II I 3 96 i 888 � € §84 ��a dddllll pill g11.1�� : ;€ Subrogation/Conditional Claim Payment. Identification, investigation and recovery of claim 5% of recovery plus payments involving other party liability or where another entity is responsible for payment litigation costs if Counsel (including by way of example but not by limitation automobile insurance, homeowner is retained and an insurance, commercial property insurance, worker's compensation). (This service is only appearance is Med on provided with respect to Medical coverage). behalf of CIILIC or Employer in any litigation, or a lawsuit is filed on their behalf; 29% of recovery if no Counsel is retained and in all other instances, including cases where state law requires that employee benefit plans be named as party defendants or involuntary plaintiffs. • i 2126/20? 3 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement P' Q 1"" F{�]¢18:g6p! 'FY�pgb �$��13999'�p{9g1��(I �1{ d8� re0(1 � e' � {jt { d�� � e7ptl a ' 3d Y� r .�.{ � p[ � � � >3'� �i$[ � ��� °� °�'ri�� i � }f {g 8�1 9a re f6 e $ .. .F r r� A�i (y}iYi" EF�{{���{�[ 8 { d 0 " € {� K f�E E jjj y§}F 14 i fi,i ?3, �6 6 1 £s 3 �da? s ( i! {`91 8 11h El Y. 6€� ' 3 1 H €�€ j( 6tiPe 1 €6; t 6. . ,gHp ? i gg .�13 € -6 I _ 9p3� yd A$i .ls�s i g �N�i j('EpB 16 dg E E� ! d€l(6`6 i § o 6 G ., 9 E ,h t' tI6'=€S [ eEe . i(.�' g �x. &tl� P�.:. 5 g9€ ° 6ffii� s $ tl8 4 €�€�� tl .9�. e f ¢ i AE$ . 13 $ �... :�� f : '� p8 - ' 9 .�F6i y� ([ E P 3q :iP @ yY e� t ei_- }lll� k p �£ s 8f F [ ° e £ 6 - 9 = �BtlR t Y1s 3$ R '£ ��2.}���° ib S,l 3j[�E 538� '3�8p8 yY:yggg"1. 3 3j �4'8 1 A @g ?e>9@$A•t9� �. # ; }} 7 [7$1[3p:B 6 d },fir .gi93'8$ CHLIC, a Cigna company, administers the following programs to contain costs with respect to charges for health care service/supplies that are covered by the Plan. In administering these programs, CHLIC contracts with vendors to perform program related services. Specific vendor fees are available upon request. CHLIC's charge for administering these programs is the percentage (indicated below) of either (1) the "net savings" (i.e. the difference between the charge that the provider would have made absent the program savings and the charge made as a result of the program savings, less the applicable vendor fee which generally ranges from 7-11% of the program savings) or (2) the "gross savings" (Le. the difference between the charge that the provider would have made absent the program savings and the charge made as a result of the program savings; CHLIC pays the applicable vendor fee) or (3) the "recovery" (i.e. the amount recovered) as applicable. For covered services received from non -Participating Providers, CHLIC may apply discounts available under agreements with third parties or through negotiation of the billed charges. These programs are identified below as the Network Savings Program, Supplemental Network & Medical Bill Review (pre -payment). This is consistent with the claim administration practices applicable to CHLICs own health care insurance business when these programs are implemented.. CHLIC charges the percentage shown for administering these programs. Applying these discounts may result in higher payments than if the maximum reimbursable charge is applied. Whereas application of the maximum reimbursable charge may result in the patient being balance billed for the entire unreimbursed amount, applying these discounts avoids balance billing and substantially reduces the patient's out -of pocket cost. MEDICAL AND PHARMACY COST CONTAINMENT 1. ( Network Savings Program 29% of net savings 2. Supplemental Network 29% of net savings 3. Medical Bill Review -- (Pre -payment Cost Containment for Non -contracted claims): Inpatient Hospital Bill Review 9 Line Item Analysis Lesser of 5% of hospital bill or the savings achieved Professional Fee Negotiation 29% of net savings Outpatient Hospital Bill Review Professional Fee Negotiation 29% of net savings Line Item Analysis Re -pricing 29% of net savings Physician/Professional Bill Review • Professional Fee Negotiation 29% of net savings .. Line Item Analysis Re -pricing 29% of net savings i2/26/20 i3 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client flame: City of Miami Administrative Services Only Agreement 4. Medical Bill Review — (Pre or Post -payment Cost Containment for Non -contracted and Contracted claims): • Bill Audit 29% of the savings/recovery achieved plus hospital fees or expenses passed through Diagnosis Related Grouping (DRG) Validation/Audits and Recovery. An overpayment audit and recovery program in which CHLIC or its vendors review paid claim data to identify overpayments based on inaccurate DRG coding. 29% of recovery plus any fees or expenses passed through by the hospital or regulatory agency Inpatient Admission Retrospective Review 29% of recovery Medical Implant Device Audits 29% of recovery 5. COB Vendor Recoveries [Exclusive of pharmacy programs where claims are adjudicated at time prescription is received.] 29% of recovery 6. Secondary Vendor Recovery Program 29% of recovery 7. Provider Credit Balance Recovery Program 29% of recovery 8. High Cost Specialty Pharmaceutical Audits 29% of recovery 9. Pharmacy Vendor Recoveries 30% of recovery 10. Class Action Recoveries 35% of recovery i 6 : �� :a # pp'( l:: S < ER {{{ 4 �€ €,� : � 4: �F . E 4 7 ° e �, 4r� s ,L¢ �i - �F .1 ,� — � 1" . # '. ` i4 g ' € f € Huh -' � I, :i. r-- ,�� .�; �$� � � i6$ ��F�, ,B - .fin p$ g rg gg a vx�s uan —nxx, p 3:_--�..e k 7 �: e€ g ¢. P :. - ` ii p ?:. - E�: - 8 . s �fl � d��d� , � }�i >�d .,� I>�t�i�: >� . I� � � �-. I Ea -Tail .�'� : � � ,t I t:�� $ } € i f".r.¢r .4',�. 3 . o.. gg �1 €} �S p ?' -n ¢ .I 6 ¢d: #: sh};i., §€,1 :x zi i iuLg�0, j . :s € .,# j§'�Ssi'y?s s€x ii€I�{��Ri;'. a��°€5��.�,.i��3�. � �€�r ,?t.�� i ta?z¢t $d; strl.tt?t€€..€[.,(,t,a.� CHLIC arranges (i) contain insured (ii) improve for third parties to provide care management services to: the cost of specified health care services/items overall with respect to all plans r and/or administered by CHLIC, and/or adherence to evidence based guidelines designed to promote patient safety and -patient care. Specific vendor fees and care management program services are available upon request. ,jxx bli i �naaB j f¢ r�� t (�q 39 .. t � !�� � � l l' �, � �€ gyp�p�4 ?gi7;Si.d9.,.4.bESlfikz 9' <y. &, i � � .. _.�� — j jj�}}jj yp pt yy ,L gefficient �: ', ��i g�l� pp �# = S ea..,�. I F����?. k i?g gg c,I,S � Pa�� 7 E¢Ea ,�a ssa as aay.asa, a.s. {.a, &� p g a, . .,�.t Pi ? PP ? ?,? is 5, t, s¢¢t¢r, sa�g.e a°¢ae q r.ec c<a,p...sax �x:u� ... . �,,,r � v � p jj - g € �,g -flT =?�F; �' a $ i:. s . 2 x € T�Z � � �-. : ti :. S`.z� � { � � � � f � -`i? `iql� $iZ�i�� 7F��@'$'� 6�f[;�? p��?P;�jItP,�:+s' 8e ; : ,, :fin ggg _g ,qp $,;p7,�a, g{pb .1 @{ a i #,� p q g �S �F �..7 ¢ii3N� NM d@� , E� sil 12./26i2013 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement Eligibility Overpayment Recovery Vendor Services. Identification and recovery of funds in situations where the overpayment is due to the late receipt of Member termination information. (This service is onl provided with respect to Medical covera:e). 29% of recovery d 9 �i�.i3 el' 4 l °- @g Ili P' i;� }j'-� a -F.F' � �. n?{ ' s i�i1 3I)) �. 5� P19 s ' Ei }idg! f'pP Ill§ lilt/ @1 ,ei gypr. g9j 1}} I 6Pp� � 6�y§ r�il �i3 aeP:fa °€> i{SieCt$SI i�° ? Pp{ p �^ FE§{� ' t)'. s£e{ j i?i[i g g [ ( @ 9 i 4 1 3} 3E E EE4 j 8 xb&� S q� �xF �tF j aQ x R `�. t@DER :}� 1 s „s € €6<::.€a ..8 f ed�r i9• I �. E 89A a € Pd> P a 5 a j3 $ -a.. i".F yy' I e .'.. i L term of appeal. -investigational only .. r Sf ...� is defined a one I 9 g g °3 .. Q� ; f 7 g g°1 qq., g• ¢� pF �@ & 8.9• t u t at� ., #i 1��° in ERISA) of a benefit specific third party review In highly complex, non -routine treatment, as part of Third party review charges is used), as well as their level . y € ' ii is the will {j v $€t1 51 d 3 6.3� id6d.�..��•.S.�ass S300-$4,000 F 4 i(('� gE S z 11 Q �9gyy yyyyyjg 9 96 .,•.'? Y`1 f 4s4a9 eY;,- z; `�.� ,.,;g,,; 3 aa3 Review When a Member elects an External Review (as that determination by an independent third party, the cost dependent on the nature and complexity of the issue on cases or cases related to new technology or experimental internal appeal process a panel of reviewers may be necessary. be commensurate with the number of reviewers (usually of expertise and time required to com fete the review. r"'' 9E6P',, �� Rr.Y ' EB{ y i @ �C2 if �6�� - `� ° � r s� �e j S 88tY d F 8 $ 9 6 14 'f �'g 4Pa9 ASi FBEk charges or Vision request. .. 3 g. 4 k Bank fee -for services for this sam.'— �a:{{ 3 for vision Account -service are product : ° 1tl96 .k.t44 care services activity data charges then provided by and identity $� r reports. CHLIC `.,. 6 will in effect, of the °3'{F 'yy.:i [ be paid Such payments which and/or designated provider `{°i e•%gF { t' '0� _"d r^. § =tAC P j as claims and will be may be amended vendors. of vision services g _ 8 �a.�:d will at �` Alt �; pp € 1A8 p E i$ rE i ...� Vision Products F t 3g y9 y y " 9s 3 d49g4 Pxd43 i [ #'q �;�g P'3it S dgid86�i�i Capitation or fee -for -service appear in Employer's standard CHLIC's applicable capitation from time to time. Some The applicable rates to Employer will be made available upon P jggp g'd�d'.�. it Mill PII�P.� < gg E }q 3 s( ( i 6 �.��11111 ,PP�Pt€ : r rIPE 8 : $ OiPiP g �Pda � I I ;f;� d P��; .` jl i�41 ��� �. ►�� �������'. <<, a { > ! xsEsxsxflas is �,;:.. - 8g�' qP g _ t8 g I t-: e€ d� 6'� 6 a fE@ �_� € P- d'. E.< a € p # €p +y 's 4 3 3ia d�j€at P - tits �@ y9?@�? °�. 6 t9x'a e �t�? a �i� 8 �.,� ��l�� CHLIC contracts directly or indirectly with other managed care entities and third party network vendors for access to their provider networks and discounts. These third parties charge either a network access fee, which is included in CHLIC's monthly charges, or a percentage of the. savings realized on a claim by claim basis as a result of the application of their discounts. Charges based on percentage of savings are paid from the Bank Account__Additional details regarding specific charges will be rovided u on request] All Medical Products i}jaapap' d9 i e i99 8 o- ' i• 8g6 {7� Pe gpp((gg�� 11! �i`: S,P II $s (7q 1p' _ < �� E i � .ia ��� �� ,B. } it i 4111 ] 11 :°S 8 8 - !- 4 a, t @C [>;F $ # .r {' _> r® $ 6 sg yy 9'd�$ i_t � rn�. .� ® a £- 5 gg }}s MOM i(ppiiS { ggip pgH i yg �p�g,gpgt •�.� dt Eli : ��d� tM 111118, 6 3i84 11 .. l ; 3@{ �{ g� i {q}yt f Rii1' 1 1 PiMinj . ,. p: r> > a,n ,-x Mil3 .g 3 Rio Mil nifi iU PE. ¢ g p ,d� d De 4 � xr ,w w' .: ,',..tpeg; t.i Y h' t3 y � €H�F4 ti'� -3�€aiYFO -'3, ...,gtltp�:t{ g�<, --.;:E1EEE_W Iii`�i ,> y ya 4 3p--,5-{(' - : f ygge 8 3'I4' .§§ :Y#1"y3�:d ' � ��ii ,ll { 89€Ei 4-,39.3i !13 E9E 110, 1 1F [3p 1� aR4&B�f4 6 & P�B.�:� Capitation Capitation health be amended or and fee -for -service charges for various vendors and other providers/arrangers of care services and/or supplies will be paid as claims for Plan Benefits. Such payments will at CHLIC's applicable capitation or fee -for -service charges then in effect, which may be from time to time. Additional details regarding charges and the identity of the vendor provider of health care services will be made available u on request. All Products SSii 34i tt a f i_3 ��j .Es 4. }} {§ 1 .i -§PP9s pp ¢¢ . P9@ # i� }. 3 ��� e pf}�' 9? p99ip{p , lb e t bb: >j€ I, 6"d 3 § i @E� ' <:.��. eiP .�[si.:33. 3 985 f �@ d t. ,ii9� ?F Ai }@@pj+,� p 0' P.iS..d3 'c�.. r iiiiiiCI.9 3 ! s9.. '.� i¢ { ( >,.. l S§ . § § 1.. � 8 , €4 A�.eae x F 7 ? P' �E� aE`f$ �- {, iF� a� - [ x$ E �E�@@ E� ,ar aa3€� u„ax .nx>x ,n j ?gpj , i{ A [ 13 @.{E?t9 � � .§ :. S^:$ [[ 3 n.>�Sx, $3 ,� °id , F g F F3. 9'-f : t @ "t$p9��@¢t •� d d . '� s F € 2 s888 �i' 5 @° 1-�ar e.� fl't,}is.r3Pc.I: {! E 7 y £ # p> 3 3 7j $8@@9 RPM �d !3' ai``_6gt p 39j}, djd9 Hill � i V,&8 ill Ev i�&€ @'€%€�� y@1 33} I Q�6PEi 3 ref l�fa �e?333Et I , qi qq,� ;t 1d'p �� b3��.� F 'i, r eS . p 9 4 • ., 3 12/26/2013 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement Unless indicated otherwise in the Schedule of Financial Charges, CHLIC retains all payments it may receive from manufacturers of pharmaceutical products covered under the Plan. Information on the arnount of such payments with respect to the Plan will be provided upon request. Ali Pharmacy Products From time to time, CHLIC, directly or through its affiliates, contracts with third party parties (e.g., service vendors, provider network managers) for referring them to Employer or to provide various services (e.g., cost -containment initiatives) in connection with the Plan. CHLIC and its affiliates may receive payments from such third parties for such referrals or to help defray expensesassociatedagssociated with implementin the services provided to the Plan. All Products pp1F �� 8 i9(� � � i 8#P8[ )) ¢y } ¢jj yyy 9r9 {{ f d E :'- 7 . - yy55pp 9 f 16E il4flg E r g p[7j } F FF?f?�#§i}(?��[[ i$llii(s }};} �t1 F?3i �ll�dtb S pppp pp99,pp9999'9p9p Pp t 93�tl8ad B �� , a �' a��k;i 9 {a? q § $ €§i. FggS1"�@$9p#F _i{ #i fi43� ��9g4 1+57 [ j;rtS�F@�Fg, 13 i{E,Fi F M ...... ..... ... .� M� ¢%t i Y P&� a 3§ } S i���. •gg$ F9 y� q 9 5g'2[ g` Ai p p8 &'i $ { s . . py gy{ t .i s 4Y 3.�.� l ypp9� p( 9 vi" t 8.of8���E #gti ��� B��jEi39�' 3 : IB �' Mr €k.p€& � h Fil9 `3Fi9F€ 'j �� y � F CHLIC shall provide the following services to assist Employer in meeting obligations under section 2715 of the Public Health Service Act as. added.' Protection and Affordable Care, Act and applicable,,: regulations with respect of the Surnmary of Benefits('SBC),translation notice and loss y Applicable plans including BRA and. PS.A. which are considered 'group health plans" subject requir'erclents.. - -'- its compliance by the Patient to the. provision to all medical' to. the SBC I. Preparation of SBC, translation notice. CHLIC will not be responsible for Employer makes to the SBC. -any changes that No charge 2. Provide SBC, translation notices prepared by CHLIC to Employer electronically any updates or material modifications. as well as No charge 3. Include in SBC a summary of benefits administered by carve -out vendor if Employer or $500 for each benefit option under the Plan for which carve -out vendor benefits are included SBC carve -out vendor provide CHLIC with necessary carve -out benefit information weeks prior to the date the SBCs are to be delivered to Employer. at least 12 § 4� ?l�B>i. 41111 ;3 � g1g 6 ! i _£ £' 1 ` d it @� tg d "�€ht}gSIS`' IS �}{j sg �1Jc�d4d y ii �9�� r V0� �a 1 } l 6 E I1 9 :8 g.1 ! 8 II la i k ,C11 ?11 �E M , Oil i 68}r ' 8 iiHIgPI} ill pd' i B IF 73 3`; t CI pppp �3q SBIN ii s' 6 tl 8 P 3; I 11� Ilil„ E ( _ § s �... .D t� =1! ' d) dp i� , i; �f 13a��O 6g 9IL.n :3 .s�°E . € I�€ f - n�neggq _ . eee �8� i B CEP S qiii '-t. F°Ai s t,r w : �e r � . ; ;t i ( C� € r j�W'g�4y§§i ¢c SApE, tinj ? ? i3 sdi3SFF�bbE:ti?s`ESE'�:FE 3 Service Description : Charge HIP .AA Certificates Individual HIPAA certificates for Members who leave active coverage. $O.15/employee/"month Included in Medical Administration Charge Pharmacy Clinical Program Cigna TheraCare® Program — a targeted condition drag therapy management program that targets individuals using specialty medications for certain chronic conditions and helps them better understand their condition, medication side effects and importance of adherence. Included at No Additional Cost 12/26/2013 98£9686 dd2i uoi}e}io!Iog Wd bZ:6 17Z0Z/OZ/8 Client Name: City of Miami Administrative Services Only Agreement Your Health First A proactive health education and improvement program for those with a chronic condition. The program involves services that span across the Member's health needs. Behavioral coaching principles and evidence based medicine ;guidelines, are utilized to optimize self -management skills and foster sustained health improvements_ The program targets a chronic population at high risk for near term and future high cost medical expenses. Members are identified as having a chronic condition through a variety of sources which may include: claims data, referrals, and self -identification. A variety of resources is provided to those with a chronic condition, including access to online tools, personalized support, and targeted materials. The program includes the following components for those with a chronic condition: • Chronic Condition -specific coaching ® Pre- and post -discharge calls • Lifestyle management coaching: stress, weight management and tobacco cessation • Treatment decision support and coaching In order to continuously assess the effectiveness of our programs and/or test new ideas to further engage your employees around their health, a small sample of Members may be placed in a comparison group which for a defined period of time receives alternative services or is suppressed from receiving proactive outreach, such as engagement letters and/or calls. This could affect a few Members targeted for outreach during this limited time period. For Network POROA Products: $5.25/employee/month included in Medical Access Fee Medical Conversion Privilege Converting Employee Resides in FL: Comprehensive, Base Plan/Major Medical & PPO Plans $20,000/conversion. policy Client Fund Wellness Fund € CHLIC will establish a Wellness/Health Improvement Fund in the amount of $200,000.00 to be used at the City's discretion for wellness services. Wellness/Health Improvement Funds are to be used from 1/1/2014-12/31/2014. Unused funds cannot be rolled over. 12/26/2013 cn rn 98£9686 dd2i uoi}e}io!Iog City of Miami Client Name: City of Miami Administrative Services Only Agreement Solicitation RFP 1896386 EXHIBIT E INSURANCE REQIJIREME:NTS I. Commercial General Liability A. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence $1,000,000 General Aggregate Limit $ 2,000,000 Personal and Adv. Injury $ 1,000,000 Products/Completed Operations $ 1,000,000 B. Endorsements Required City of Miami included as an Additional Insured IL Business Automobile Liability A. Limits of Liability Bodily Injury and Property Damage Liability Combined Single Limit Owned/Scheduled Autos Including Hired, Borrowed or Non -Owned Autos Any One Accident $ 1,000,000 B. Endorsements Required City of Miami included as an Additional Insured IIL Worker's Compensation Limits of Liability Statutory -State of Florida Waiver of Subrogation IV. Employer's Liability A. Limits of Liability $100,000 for bodily injury caused by an accident, each accident $100,000 for bodily injury caused by disease, each employee $500,000 for bodily injury caused by. disease, policy limit 12/26/2013 8/20/2024 9:24 AM p. 570 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Administrative Services Only Agreement V. Professional Liability/Errors and Omissions Coverage Combined Single Limit Each Claim $1,000,000 General Aggregate Limit $5,000,000 Deductible- not to exceed 10% The above policies shall provide the City of Miami with written notice of cancellation or material change from the insurer not less than (30) days prior to any such cancellation or material change. Companies authorized to do business in the State of Florida, with the following qualifications, shall issue all insurance policies required above: The company must be rated no less than "A" as to management, and no less than "Class V" as to Financial Strength, by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Cldwick, New Jersey, or its equivalent. All policies and /or certificates of insurance are subject to review and verification by Risk Management prior to insurance approval. ] 2/2 6/2013 8/20/2024 9:24 AM p. 571 City of Miami Solicitation RFP 1896386 +II 'b`' CERTIFICATE OF LIABILITY INSURANCE 01/1712013Dmvv1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement $ . PRODUCER MARSH USA Ina. 1717 Arch Street PhIladelphie, PA 19103 Atin: Health care.A000untsCSSw ersh.com/FAX: 212 946.1307 1006077C{1NA CA5-13.14 O N AOT�. NAME: (ate No,ExtI;..., Nal; _,Lag. EMAIL $DDReses ' 1NSURErt1S) AFFORDING CCVERAi E NAIL # INsuRnR A: ACE American Insurance Company 22667 INSURED CIGNA CORPORATION 900 COTTAGE GROVE ROAD BBLOOMFIELD,CT 06002 INSURERS: N/A • NIA INsuRg 0: Indemnity Ins Co Of North America 43576 INSURER D: INSURER 4 s INSURER F: COVERAGES CERTIFICATE NUMBER: CLE-003605667-23 REVISION NUMBER: 23 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVVITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OP ANY CONTRACT OR' OTHER DOCUMENT WTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDMONS OF SUCH POLICIES, LIMITS SHQWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN L7R TYPE OF INSURANCE ADDL WS1 EMIR W'JD POLICY NUMBER POLICY EH IMMIDDIYVYY1 PC ICY P.%P.. (MM�<94iYYY41 LIMITS A GENERALLIABILiW COMMERCIAL GENERAL LIABILITY X OCCUR J 00027018105 ro,\ 07/01/2013 c 07101/2014 EACHOCCURRENCE $ 1,000,400 X OA E'to RE-00,D PRE ISESrEa oeeurre $ 1000,060 CLAIMS -MADE MED EXP (Any one pear* $ 6,000 r PERSONAL 8, ACV INJURY S 1,000,000 GENERAL AGaRE3ATE s 3,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: PRODUCTS »COMPIOPACO $ 1,000,000 I POLICY , 5p r LOC $ A AUTOMOBILE LIABILITY ANY AUTO AAL OS NED HIRED AUTOS SCHESDULED L T09 NCH -OWNED I$AH08718967 i ` 1 1 1 r• ` ' fu, ,i,r. iii:::��� f C 07101/2014 �ww✓�� $OMUINgD 81NOl.E LIMIT (a ae�l °nil $ 1,040,000 X BODILY INJURY Tor mason) $ BODILY INJURY (Pereccldsnl) $ (Per dent) AMA4E $ $ UMBRELLA LIAn OCCUR F_XCESs LIAR CLAIMS -MADE EACH OCCURRENCE $ AOGRECATE $ DEP RETENTION# $ 0 A A A WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE� W:ri EoilVOi61=REXCLUDED? {mandatory m NH) DESCRIPTION OFer OPERATIONS Pi INLR047317590(ACS) SCFC473170.05 (1NI) th'RC47317587 (GA & MA) WI R{%47817575 {WV) 07/01/2013 07101/2013 07A1112013 •0rll01/2014 07111112013 07101/2014 07101/2014 0710112014 X WCSTATU- I OTH- ` IQRYUMITS ER E.L. EACH ACCIDENT $ 1,000,001) I N El e,L. DISEASE - EA EMPLOYEE $ 1,000,0-66 below EL. DISEASE - POUCY LIMIT $ 1, 000 A EXCESS WORK ER8 COMpEI4SKTIQN WCUC47317617 (OH Only) • 07/0112013 0710112014 UMIT SIR $1,000,000 $1,000,600 DESCRIPTION OP OPERATIONS I LOCATIONS ( VEHICLES {Attach AGGRO 101, Addnlonai Remarks Sab mde, if more some Is required) RE; ACCOUNT # 3202272 CITY OF MIAMI IS INCLUDED AS ADDITIONAL INSURED {EXCEPT FOR WORKERS' COMPENSATION) WHERE REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION CITYOFAMIAMI CIO DEPARTMENT OF PURCHASING 444 SW 2ND AVE. 611-1 FLOOR MIMIr F.L 03130 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL Be DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE or Marsh USA Inc. Manashl MukherJee 01.,Q:•44,itsio.411* ACORD 25 (2010/05) 8/20/2024 9:24 AM c#31985-2010 ACORDCORPORATION.. Al rights reserved, The ACORD name and logo are registered marks of ACORD p. 572- City of Miami Client Warne: City of Miami Administrative Services Only Agreement Solicitation RFP 1896386 EXHIBIT F CORPORATE RESOLUTIONS AND EVIDENCE OF QUALIFICATION TO DO BUSINESS IN FLORIDA" (To be provided upon document execution) 12/26/2013 8/20/2024 9:24 AM p. 573 City of Miami Solicitation RFP 1896386 SECRETARY CERTIFICATE CONNECTICUT GENERAL LIFE INSURANCE COMPANY The undersigned, a duly elected Assistant Corporate Secretary of Connecticut General Life Insurance Company (the "Company"), does hereby represent and certify that the following resolution was adopted by the Board of Directors of the Company via unanimous consent dated November 15, 2005; and such resolution remains in full force and effect as of the date hereof, not having been amended, modified or rescinded since the date of their adoption: RESOLVED: That any person holding the underwriter business title for the Company of Regional Director, Contractual Agreement Unit Manager, Account Management Lead or Contractual Agreement Lead is hereby authorized to enter into customer agreements, act as a registrar on insurance policies issued by the Company, and to sign such agreements and policies for and on behalf of the Company, effective as of November 15, 2005. FURTHER RESOLVED: That the foregoing resolution supersedes the resolution adopted by the Board of Directors effective as of September 30, 2005 with respect to the same subject matter. The undersigned Assistant Corporate Secretary of the Company further certifies that Jessica Sheriff is a Contractual Agreement Unit Manager of the Company. 'IN WITNESSS WHEREOF, I hereunto set my hand and seal of said Connecticut General Life Insurance Company, Inc. this i t1'day of . d� �., , 2013. Anthony C. Padilla Assistant Corporate Secretary 8/20/2024 9:24 AM p. 574 City of Miami Solicitation RFP 1896386 Client Name: City of Miami Adrn inistrative. Services Only Agreement EXHIBIT G STOP LOSS INSURANCE POLICY PLACEHOLDER (See STOP LOSS AGREEMENT) 12 /26/2013 8/20/2024 9:24 AM p. 575 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna") Based on the application for this policy made by City of Miami (herein called the Policyholder) and based on the payment of the preinium when dne, Cigna agrees to reimburse the Policyholder for expenses covered and paid under the terms of this policy. This policy becomes effective at 12:01 a.m. at the Policyholder's address on the effective date shown in the Coverage information section. All matter printed or written by Cigna on the following pages forms a part of this policy as if recited over the signatures below. This policy is delivered in and is governed by the laws of the jurisdiction shownin the Coverage Information section. In witness thereof, Cigna has caused this policy to be executed at its home office in Bloomfield, Connecticut. ;sttrobliry Edward P. Potanka, Assistant Secretary CSL-CP 1 8/20/2024 9:24 AM p. 576 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna') Table of Contents DEFINITIONS 3 BENEFIT PROVISIONS 7 INDIVIDUAL STOP LOSS COVERAGE 7 AGGREGATE STOP LOSS COVERAGE 8 DUTIES OF THE POLICYHOLDER 9 EXCLUSIONS 11 OMISSION, CONCEALMENT OR MISREPRESENTATION OF FACT 12 SUBROGATION AND ACTS OF THIRD PARTIES 12 PRIVACY OF INFORMATION 13 PREMIUMS 14 RIGHT TO CHANGE TERMS OF COVERAGE 15 TERMINATION 16 GENERAL PROVISIONS 17 SCHEDULE OF INSURANCE 19 CSL-TOC 2 8/20/2024 9:24 AM p. 577 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna') Definitions Section Actual Attachment Point Actual Attachment Point means the amount of Actual Claim Payments above which aggregate stop loss benefits are payable. The Actual Attachment Point is deteuuined at the end of the Policy Year and is the greater of: (1) the sum of all Policy Months in the Policy Year of the number of Covered Persons enrolled during each Lagged Month in each product and plan design in the Benefit Plan multiplied by the Monthly Attachment Factors for that Policy Month; or (2) the sum of the Minimum Attachment Point for each Policy Month. For those policies with run -out coverage, in the year of termination the Actual Attachment Point is the sum of the product as calculated in accordance with the above paragraph plus the Run -out Period Attachment Point. Actual Claim Payment Actual Claim Payment means a payment made on behalf of the Policyholder for a Covered Person under the terms of the Benefit Plan. A payment is deemed to have been made as of the date the payment instrument is issued by the Claim Administrator. An Actual Claim Payment does not include a claim payment made in error on behalf of a Covered Person, Aggregate Individual Stop Loss Limit Aggregate Individual Stop Loss Limit means the limit that is used to determine benefits payable for Aggregate Stop Loss coverage. ASL Benefit Percentage Payable ASL Benefit Percentage Payable means the percentage of Covered Expenses payable to the Policyholder once the Actual Attachment Point has been reached. .Become Due Become Due is the earliest date upon which: (a) the Policyholder or the Claim Administrator has received due proof of loss for which a claim is made under the terms of the Benefit Plan, provided such loss is covered under this policy as a Covered Expense; and (b) an Actual Claim Payment has been made. .Benefit Plan or Plan Benefit Plan or Plan means the Policyholder's medical benefits and/or other health benefits applicable to either the Individual Stop Loss benefit and/or the Aggregate Stop Loss benefit as uniquely specified for each benefit in the Schedule of Insurance. Claim Administrator Claim Administrator means Cigna or an entity approved by Cigna to provide administrative services and to pay claims for the Policyholder's Benefit Plan. . CSL-DEF 3 8/20/2024 9:24 AM p. 578 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna") Corridor Factor Corridor means the risk retained by the Policyholder. It is expressed as a percentage of Expected Paid CIaims and is specified in the Schedule of Insurance. Covered Expenses Covered Expenses for a Policy Year are expenses made under the Benefit Plan that are reimbursable under this policy based on the criteria specified in the Schedule of Insurance. Covered Person Covered Person means a person who is enrolled for coverage and meets the eligibility requirements set forth in the Benefit Plano .Effective Date Effective Date means the date on which coverage begins under this agreement. Expected Paid Claims Expected Paid Claims means the projected claims at the time of the presale or renewal quote to be paid for all Covered Persons during the Policy Year. High Risk Individual High Risk Individual means a Covered Person whose claims under the Benefit Plan are expected to exceed the Individual Stop Loss Limit, For such person(s), a separate Individual Stop Loss Limit for High Risk Individuals is applicable, or such person may be excluded from coverage under this policy. Incurred Incurred means the date on which the supply is obtained or the service is rendered to a Covered Person under the Benefit Plan.. Individual Stop Loss Limit Individual Stop Loss Limit means the specific dollar amount of Covered Expenses paid by the Policyholder for each Covered Person during each Policy Year, as set forth in the Schedule of Insurance. If coverage is terminated during any Policy Year, the Individual Stop Loss Limit will be the same as if the coverage had remained in effect for the entire Policy Year. Individual Stop Loss Limit for High Risk Individuals Individual Stop Loss Limit for high Risk Individuals means the specific dollar amount of Covered Expenses paid by the Policyholder for each High Risk. Individual during each Policy Year, as set forth in the Schedule of Insurance. If coverage is terminated during any Policy Year, the Individual Stop Loss Limit for High. Risk Individuals will be the same as if the coverage had remained in effect for the entire Policy Year. ISL Benefit Percentage Payable ISL Benefit Percentage Payable means the percentage of Covered Expenses payable to the Policyholder once the Individual Stop Loss Limit has been. reached. Lagged Month Lagged Month is defined on the Schedule of Insurance as either the same as the current Policy Month or as the Policy Month one or more months prior to the corresponding Policy Month. In the event the Lagged Month refers to a month prior to the Effective Date of the policy, the Lagged Month is defined as the first Policy Month. CSL-DEF 4 8/20/2024 9:24 AM p. 579 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna') Minimum Attachment Exposure Minimum Attachment Exposure is the greater of the number of Covered Persons enrolled during the Minimum Attachment Lagged Month in each product and plan design in the Benefit Plan; or the original estimated number of Covered Persons at the time of underwriting. Minimum Attachment Lagged Month Minimum Attachment Lagged Month is defined on the Schedule of Insurance as either the same as the Policy Year's first Policy Month or one or more months prior to the Policy Year's first Policy Month. In the event the Minimum .Attachment Lagged Month refers to a month prior to the Effective Date of the policy, the Minimum Attachment Lagged Month is defined as the Policy Year's first Policy Month. Minimum Attachment Percentage The Minimum Attachment Percentage is used in computing the Minimum Attachment Point, and if applicable, the Minimum Run -out Period Attachment Point. This percentage is shown on Schedule of Insurance. Minimum Attachment Point The Minimum Attachment Point is either not applicable (in which case it is assumed to have a value of zero in any calculation), or for each Policy Month and for each product and plan design, it is equal to the Minimum Attachment Percentage multipliedby the Minimum Attachment Exposure multiplied by Monthly Attachment factors for the Policy Month. Minimum Run -out Period Attachment Point The Minimum Run. -out Attachment Point is the Minimum Attachment Percentage multiplied by the Minimum Attachment Exposure multiplied by the sum of the Terminal Attachment Factors for each month as shown on the Schedule of Insurance under Terminal Attachment Factors. Monthly Attachment Factor Monthly Attachment Factor is a factor assigned to this policy to be used to calculate the Actual Attachment Point and Minimum Attachment Point, as applicable. This factor is shown on the Schedule of Insurance. Policy Month Policy Month means a calendar month during a Policy Year. Policy Quarter Policy Quarter means a period of three consecutive calendar months during a Policy Year, with the first policy quarter beginning on the effective date of the policy. Policy Year Policy Year means the period beginning on the Effective Date of this policy (or most recent renewal date thereof) up to but not including the next renewal date or the date of termination, whichever period is shorter. The Policy Year is specified on the Schedule of Insurance and may differ by coverage as indicated on the Schedule of Insurance. Renewal Date Renewal Date is the day on which a new Policy Year begins as specified on the Schedule of Insurance. CSL-DEF 5 8/20/2024 9:24 AM p. 580 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna") Run -out Period Run -out Period is the length of time following the termination date of this policy during which claims that Become Due for a Covered Person under the Benefit Plan will accumulate toward stop loss coverage under this policy provided that they were incurred prior to the termination date of this policy. Run -out Period Attachment Point Run -out Period. Attachment Point is the greater of the Minimum Run -out Period Attachment Point or the sum of eachproduct in the Benefit Plan and each month (as shown on the Schedule of Insurance under Terminal Attachment Factors) of the Terminal Attachment Factor multiplied by the number of Covered Persons enrolled during the respective Lagged Month for that month. Terminal Attachment Factor Terminal A.ttachment Factor is a factor assigned to this policy to be used to calculate the Run -out Period Attachment Point and the Minimum Run -out Period Attachment Point, This factor is shown on the Schedule of Insurance. CSL-DBF 6 8/20/2024 9:24 AM p. 581 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna") Benefit Provisions Individual Stop Loss Coverage In consideration of payment of the Individual Stop Loss premium by the Policyholder, Cigna shall reimburse the Policyholder for the amount by which the total Covered Expenses for the Policy Year for a Covered Person exceed .the Individual Stop Loss Limit. The amount of reimbursement willbe calculated by multiplying the amount of Covered Expenses in excess of the Individual Stop Loss Limit times the ISL Benefit Percentage Payable, subject to Cigna's maximum liability specified on the Schedule of Insurance. Reimbursement for Covered Expenses will be made after an Actual Claim Payment is made. Cigna shall not be liable for any expenses that are incurred or become due outside the term of this policy. Other If Cignais not the Claim Administrator, payment for Covered Expenses will be made after receipt and acceptance by Cigna of such information and records as Cigna may reasonably require regarding the Actual Claim Payments. CSL-BP 7 8/20/2024 9:24 AM p. 582 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna') Aggregate Stop Loss Coverage In consideration of payment of the Aggregate Stop Loss premium by the Policyholder, Cigna shall reimburse the Policyholder. for Covered Expenses for the Policy Year that are in excess of the Actual Attachment Point. The amount of reimbursement will be calculated by multiplying the amount of Covered Expenses in excess of. the Actual Attachment Point times the ASL Benefit Percentage Payable, subject to Cigna's maximum Liability specified on the Schedule of Insurance. Covered Expenses paid by the Policyholder in excess of the Aggregate Individual Stop Loss Limit are excluded prior to determining if the Actual Attachment Point is reached. For the purpose of this calculation, amounts between the Aggregate Individual Stop Loss Limit and the Individual Stop Loss Limit for High Risk Individuals are also excluded. The above payments, reimbursements and credits made by Cigna to the Policyholder are subject to Cigna's maximum liability specified on the Schedule of Insurance. Cignashall not be liable for any expenses that are incurred or become due outside the term of this policy. Other If Cigna is not the Claim Administrator, payment for Covered Expenses will be made after receipt and acceptance by Cigna of such information and records as Cigna may reasonably require regarding the Actual Claim Payments. In the event Cigna is the Claim Administrator paying claims out of the Policyholder's bank account established for the purpose of paying claims and such bank account is still open and available to Cigna, any payments or reimbursements under this benefit will be executed by Cigna debiting or crediting the Policyholder's bank account. CSL-BP 8 8/20/2024 9:24 AM p. 583 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna") Duties of the Policyholder A. The Policyholder will submit to Cigna a complete copy of the Benefit Plan unless Cigna already has such copy in its possession; such Benefit Plan or its complete copy is incorporated herein by reference. B. Any changes to the Benefit Plan will be submitted to Cigna 60 days prior to their effective date. C. If Cigna is not the Claim Administrator, the parties agree that the Policyholder or the Claim Administrator approved by Cigna will have the following duties and obligations: 1. to investigate, audit, calculate and pay all claims in accordance with the provisions of the Benefit Plan and any applicable provider contracts. 2. to provide Cigna suchinformation and records as Cigna may reasonably require for: a. payment of any claim under this policy; and b. projection of future expected claims of the Benefit PIan. 3. to prepare and submit to Cigna on a monthly basis: a. a report of the Actual Claim Payments paid pursuant to the Benefit Plan for that month; b. a report of the total number of Covered Persons covered by the Benefit Plan for that month; and c. a report listing claimants with Covered Expenses during the Policy Year greater than 50% of the Individual Stop Loss Limit. The listing is to include cumulative paid claims and the respective ICD-9 codes. 4. for individual stop loss, the preparation and submission to Cigna on a monthly basis, within 15 clays of the previous month's end, of: a. a report showing Covered Expenses during the month for those Covered Persons for whom the total Covered Expenses for the stop loss Policy Year meet or exceed 50% of the Individual Stop Loss Limit; and b. a completed. Stop Loss Notification form (to be supplied) which must accompany the report for each Iisted Covered. Person. 5. for any and all Covered Persons whose Covered Expenses meet or exceed the Individual Stop Loss Limit during the Policy Year, the following information must be supplied for claim adjudicationunder this policy. This information must accompany a Stop Loss Notification form and must be presented to Cigna within 30 days of the end of the month in which the Covered Personexceeded the. Individual. Stop Loss Limit: a. copies of any and all documentation relating to outside bill reviews/negotiations for hospital bills greater than $15,000 and other provider bills greater than. $2,500; b. copies of any and all documentation relating to the Benefit Plan's subrogation interests, if applicable; c. detailed claimreports and check information if explanation of benefits (EOBs) are not available; d. itemized bills for any claims or charges over $5,000; e. an enrollment form or eligibility screen; and f coordination of benefits (COB) infoimation. CSL-DP 9 8/20/2024 9:24 AM p. 584 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna') D. The Policyholder will reimburse Cigna for any Actual Claim Payments subsequently repaid, refunded, rebated or owed to the Policyholder by any party. E. The Policyholder will furnish additional information or documentation as reasonably requested by Cigna. CSL-DP 10 8/20/2024 9:24 AM p. 585 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna") Exclusions Covered expenses under this policy do not include the following; 1. Actual Claim. Payments for which (a) there is other group insurance (including costs recoverable through the application of the coordination of benefits provision in the Benefit Plan); (b) third -party liability has been established; (c) there is coverage pursuant to any plan established by federal, state or local law (to the extent permitted); or (d) there is coverage under workers compensation insurance. 2. Expenses to the extent the Policyholder or Plan receives any payment(s), refund(s) or rebate(s), however denominated, or any reduction in charges including but not limited to reductions as a result of a PPO, EPO, or other managed care arrangement, claim reduction negotiation, or the application of any provider discount arrangement. 3. Expenses which Become Due after the date coverage under this policy ceases. 4. Administrative expenses of the Policyholder or Claim Administrator. 5. Extra contractual damages, expenses or reimbursements of any kind or nature. 6. Investigative or legal expenses including, but not limited to, attorneys' fees and court costs. 7. Expenses Incurred by a person not eligible under the terms of the Benefit Plan. 8. Expenses paid because of an amendment to the Benefit Plan which is not agreedto by Cigna. 9. Expenses for taxes, fees and surcharges that may be imposed on the Benefit Plan or Policyholder by federal, state or local governments. 10. Expenses Incurred as a result of war, whether declared or not, or acts of war or service in any military force of any country while such country is engaged in war, whether declared or not. 11. Expenses which are not considered Covered Expenses under the Benefit Plan. 12. Expenses for which the Policyholder, or Claim Administrator has failed to provide the required information set forth under the Duties of the Policyholder section. 13. With respect to individual stop loss, and with respect to aggregate stop loss if indicated on the Schedule, expenses resulting from capitation payments, if any (i.e. contractually determined periodic payments to certain providers based on the number of plan participants entitled to receive services from the provider, in return for which, such providers furnish certain agreed - upon services to eligible plan participants). 14. For liabilities which are non -pecuniary in nature (not having a monetary value). CSL-EX 11 8/20/2024 9:24 AM p.:586 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna ) Omission, Concealment or Misrepresentation of Fact The parties understand that Cigna has relied upon the completeness and accuracy of the underwriting information presented to Cigna in its decision to issue and/or renew this policy. Such information includes information volunteered by the Policyholder when requesting the quote, information provided in response to a request by Cigna, and any personal health statements filled out by persons covered under the Benefit Plan. If Cigna determines that any of the information has omitted, concealed or misrepresented any fact which Cigna determines to have had an effect on Cigna's assessment of the risk, Cigna reserves the right to re -underwrite the coverage, including but not limited to resetting the premium rates, resetting the individual stop limits, resetting or establishing coverage maximums, resetting monthly attachment factors, and minimum attachment factors; or Cigna may terminate this policy. Any such action by Cigna will be reasonable in relation to the nature of the omission, concealment, or misrepresentation,and may be retroactive to the beginning of the Policy Year. Subrogation and Acts of Third Parties Applicability Where allowed by law, this section will apply: 1. to Policyholders who receive payments for Covered Expenses under this policy; and 2. where Actual Claim Payments have bean made under the Benefit Plan to a Covered Person who has a lawful claim against, or who has received compensation, damages or other payment from another party or parties for expenses resulting inthe payment by Cigna of such Covered Expenses; and 3. to the Policy Year in which the corresponding payment was made. The expense of subrogation will be shared proportional according to the Benefit Plan. Policyholder Obligations To secure the rights of Cigna under this section, the Policyholder must: 1. pursue the rights of subrogation contained in the Benefit Plan; and 2. reimburse Cigna for Covered Expenses Incurred under this policy (but not more than the amount paid by the other party or parties) if payment from the other party or parties has been received by the Policyholder. The Policyholder must reimburse Cigna first, and in full, before retaining any benefit from the recovery; and 3. assign to Cigna the Policyholder's subrogation and/or reimbursement right contained in the Benefit Plan to the extent of Cigna's payments if requested by Cigna and Policyholder shall cooperate fully and do all things as necessary and required to enable Cigna to pursue the recovery right. CSL-OSP 12 8/20/2024 9:24 AM p: 587 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna') Privacy of Information In connection with the performance of its obligations under this policy, Cigna may disclose to and receive disclosure from the Policyholder or its Claim Administrator of information collected or received in connection with Covered Expenses reimbursable under this policy, provided the information is limited to that which is reasonable and necessary. Under no circumstances will Cigna provide the Policyholder with information on incurred, but not paid claims, projected claims, pre -certifications of coverage, case management notes, and course of treatment information or prognosis infoi oration. CSLOSP 13 8/20/2024 9:24 AM p. 588 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna') Premiums Premium Payments The initial premium shall be due and payable on the first day of the month of this policy, Subsequent premiums shall be due on the first day of each calendar month that this policy remains in effect. Premiums can be paid to Cigna's home office or to an authorized agent of Cigna. Each premium paid continues the policy in force until the date the next premium is due, except as set forth in the Grace Period section. The total monthly premium is the sum of the premium for all Covered Persons for all coverages as identified on the Schedule of Insurance. Grace Period A period of 31 days, without interest, is allowed for paying any premium other than the first premium payment. The policy will remain in force during the grace period, unless Cigna has been advised in writing that the policy is to cease prior to the end of the grace period. If any premium is not paid before the grace period ends, the policy will cease at the end of the grace period. When this policy ends the Policyholder will be liable for all premiums past due and unpaid, including a pro-rata premium for any time this policy remains in force during the grace period. Premium Refund Any error or correction of any premium paid must be reported to Cigna promptly. The premium will be adjusted retroactively to reflect the correct premium amount. If a correction will result in a decrease in premium, a refund will be given only for the two month period prior to Cigna's receipt of a correction request. CSL-PREM 14 8/20/2024 9:24 AM p. 589 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna') Right to Change Terms of Coverage Cigna reserves the right to change any of the terms shown on the Schedule of Insurance including but not limited to the Individual Stop Loss Limits, the Monthly Attachment Factors, the Terminal Attachment Factors, Minimum Attachment Factors and/or Premium Rates under the following circumstances: In the event the total number of Covered Persons at the beginning of the Policy Year or at any time during the Policy year differs more than 10% from the original estimated enrollment, such change to become effective on the first day of any month following the fluctuation, subject to advance written notice of at least 45 days. 2. In the event enrollment in any covered plan at the beginning of the Policy Year or at any time during the Policy year differs more than 10% from the original estimated enrollment, such change to become effective on the first day of any month following the fluctuation, subject to advance written notice of at least 45 days. 3. In the event of material changes in the Benefit Plan or changes in legislation or regulation, Cigna may revise the premium rates with the revision to become effective on the date such changes are effective. 4. In the event of the addition of a subsidiary, operation or class of Covered Persons not previously covered under the Benefit Plan and approved by Cigna, Cigna may revise the premium rates with the revision to become effective on the date such addition is effective. 5. In the event of the termination of a subsidiary, operation or class of Covered Persons covered. under this policy, Cigna may revise the premium rates with the revision to become effective on the date such termination is effective. 6. On any policy anniversary, subject to advance written notice of at least 45 days. 7. In the event of an omission, concealment or misrepresentation of material fact, as described in Omission, Concealment or Misrepresentation of Fact section, such change to become retroactively to the first day of the affected coverage period. If Cigna is not the Claim Administrator, Cigna also reserves the right to change any premium rates if Cigna determines that Actual Claim Payments are not being made in accordance with the provisions of the Benefit Plan. Such adjustment may be made retroactive to the beginning of the Policy Year, CSL-TERM 15 8/20/2024 9:24 AM p. 590 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna") Termination This policy will continue in effect from its effective date until terminated on the earliest of the following: 1. At the end of the grace period if the premium is not paid. 2. Upon mutual consent by the parties, on the date the parties agree to terminate. 3. On the premium due date following 45 days after the mailing of written notification of termination by Cigna or the Policyholder, 4. On the date of termination of the Benefit Plan. 5e If any state or other jurisdiction enacts a law which prohibits the continuance of this policy, or the existing law is interpreted to so prohibit the continuance of this policy, as reasonably determined by Cigna, the policy shall tetminate automatically as to such time or jurisdiction on the effective date of such law or interpretation. 6. Immediately upon written notice to the Policyholder of the discovery of the Policyholder's failure to comply with any material term of the policy. 7. Immediately upon written notice to the Policyholder if Cigna reasonably determines that the Policyholder has ceased or failed to sufficiently fund its account established to fund benefit payments under the Plan. This policy may also be terminated by Cigna as follows: R.etroactively to the Policy Effective Date or the latest Renewal Date as applicable, upon written notice to the Policyholder, if Cigna determines that any of the information has omitted, concealed or misrepresented any fact which Cigna determines to have hadaneffect on Cigna's assessment of the risk. 2. On the next premium due date, at Cigna's option, if Cigna determines that Actual. Claim Payrnents are not being made in accordance with the provisions of the Benefit Plan. 3. On the effective date of a change in the Benefit Plan which is not approved by Cigna. Cigna will give the Policyholder written notice within 45 days after receipt of a copy of such change. 4. On the effective date of any change in Claim Administrator which is not approved by Cigna. Cigna will give the Policyholder written notice within 45 days after receipt of notification of such change, All coverage ceases upon termination of this policy. The terminationof this policy does not excuse the Policyholder from forwarding to Cigna any and all premiums accrued through the date of termination. Cigna reserves the right not to provide Run -out coverage in the event of termination prior to the end of the Policy Year, CSL-TERM 16 8/20/2024 9:24 AM p: 591 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna') General Provisions Notice This policy provides benefits when the Policyholder's Benefit Plan incurs expenses in excess of the individual and/or aggregate limits as outlined in this policy. Since this policy insures the Policyholder and not the individuals covered by the Policyholder's Benefit Plan, this policy neither adds to nor subtracts from the terms of the underlying Benefit Plan. Additionally, this policy does not in any way affect the Policyholder's responsibility to comply with employment laws such as the Americans with Disabilities Act, the Age Discrimination in Employment Act, Title VII of the 1964 Civil Rights Act and other applicable state and federal laws. Parties to the Policy and Responsibility for Claims for Benefits by Covered Persons The parties to the policy are the Policyholder and Cigna. There are no third party beneficiaries and this policy does not create any rights or legal relation whatsoever between Cigna and a Covered Person under the Policyholder's Benefit Plan. Cigna's sole liability under this policy is to the Policyholder. The Policyholder shall retainthe exclusive obligation for any action, brought for benefits under the Policyholder's Benefit Plan however denominated, including any action purporting to be brought with respect to this policy. Policyholder agrees to assume the tender of any such action and to reimburse Cigna for reasonable costs, costs of whatever kind (including court costs and attorneys' fees) which Cigna .may incur to protect its and Policyholder's rights until Policyholder accepts tender. Provided that nothing herein shall alter Cigna's obligations contained in the parties' administrative services agreement, if any. Entire Contract The parties agree th.at this policy and any endorsement and amendment to the policy constitute the entire contract regarding the stop loss insurance between the parties. Any endorsement or amendment changing this policy must be in writing and must be signed by authorized officers of Cigna and the Policyholder respectively. No person may modify or waive any of the terms of this policy except by a written amendment signed by a duly authorized officer of Cigna. Enforceability In the event that one or more provisions in this policy shall, for any reason, be held to be invalid, illegal or unenforceable, the validity, legality or enforceability of the other provisions of this policy shall not be affected. Clerical Error Clerical error by the Policyholder or by Cigna will not continue terminated coverage. In the event of such clerical error, an appropriate adjustment will be made. Examination and Maintenance of Records If Cigna is not the Claim Administrator: 1. The Policyholder will furnish to Cigna such data as may be required for the administration of this policy. 2. The Policyholder's and the Claim Administrator's books and records pertaining to the policy will be available to Cigna for inspection during the usual business hours. Such books and records will be maintained for a period of not less than 6 years following termination of the policy. 3. Cigna will have the right at all reasonable times to inspect all records relating to Actual Claim Payments paid under the Benefit Plan whether maintained. by the Policyholder or the Claim Administrator. Cigna will treat as confidential all such records and information obtained. CSL-GP 17 8/20/2024 9:24 AM p. 592 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna'9 Dispute Resolution The Policyholder may not initiate any dispute resolution relating to a claim under this policy fewer than 60 calendar days or more than five years after due proof of such claim is furnished. to Cigna. Plan Changes Cigna reserves the right to approve a change in the Benefit PIan. The Policyholder must promptly furnish Cigna with a copy of each change in the Benefit Plan prior to its effective date. If such copy is not received, Cigna will only be liable for the reimbursement of Covered Expenses under this policy as if the plan was not changed. Subcontracting The work to be performed by Cigna under this policy may be performed wholly or in part through an authorized representative, subsidiary, affiliate, or parent of Cigna. Such subcontracting will not increase or diminish the rights or obligations of either party to this policy. Assignment No assignment of this policy by the Policyholder will be binding upon Cigna. Offset Cigna shall be entitled to offset payments due to the Policyholder under this policy against premiums due and unpaid by the Policyholder to Cigna. CSL-GP 18 8/20/2024 9:24 AM p.,,593 City of Miami Solicitation RFP 1896386 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna '9 Schedule of Insurance Coverage Information Policyholder: City of Miami Policy Number: 3202272 Effective Date: January 01, 2014 Issue Date: October 28, 2013 Next Renewal Date: January 01, 2015 State or other Jurisdiction of Issue: Florida Notices For the purpose of any notices required under this policy, such notices should be sent to the addresses shown below: Cigna Health and Life Insurance Company 900 Cottage Grove Road, Hartford, CT 06152 Attn: Stop Loss Unit For questions regarding coverage or to get help in resolving a complaint, the phone number is: 1-855- 246-1874 City of Miami 444 S.W. 2nd Avenue - 9th Floor Departxuent of Risk Management Miami, FL 33130 Attn: Calvin Ellis eellis@miamigov.com miamigov.com 305-416-1757 CSL-SCII 19 8/20/2024 9:24 AM p.594 City of Miami Solicitation RFP 18963;86 CIGNA HEALTH AND .LIFE INSURANCE COMPANY (Herein called "Cigna') Individual Stop Lass Policy Year: January 01, 2014 to December 31, 2014 Covered Expenses: Claims that are incurred between January 01, 1985 and December 31, 2014 and that Become Due between January 01, 2014 and December 31, 2014 Monthly Premium Rates: For each covered employee ISL Benefit Percentage Payable: Individual Stop Loss Limit: $61.42 100% $250,000.00 The following Covered Persons have been identified as High Risk Individuals and shall be subject to the Individual Stop Loss Limit as specified below: High Risk Individual Dorys Casanueva Relationship Amount SP $900,000.00 Benefit Plans Covered by Individual Stop Loss Coverage: Claim Administrator Product Cigna Comp Plan Cigna Mental Health/Substance Abuse Cigna Network POS Open Access Cigna Pharmacy Expense Cigna's maximum liability per individual: Will be the individual maximum, if any, as set forth in the Benefit Plan less the Individual Stop Loss Limit CSL-SCH 20 8/20/2024 9:24 AM p. 595 City of Miami Solicitation RFP 1896586 CIGNA HEALTH AND LIFE INSURANCE COMPANY (Herein called "Cigna") Aggregate Stop Loss Policy Year: January 01, 2014 to December 31, 0134 Covered Expenses:. Claims that are incurred between January 01, 1985 and December 31, 2014 and that Become Due between January 01, 2014 and December 31, 2014 For purposes of Aggregate Stop Loss, amounts attributable to claim base state surcharges and/or the New York Covered Lives Assessment, as applicable, shall not be considered to be an excluded expenses of the Policyholder or Claim Administrator an.d as such shall be considered Covered Expenses. Monthly Premium Rates: For each covered employee $3.32 ASL Benefit Percentage Payable: 100% Aggregate Individual Stop Loss Limit: $250,000.00 Benefit Plans Covered by Aggregate Stop Loss Coverage: Claire Administrator Product Cigna Comp Plan Cigna Mental Health/Substance Abuse Cigna Network POS Open .Access Cigna Pharmacy Expense Cigna's maximum liability for the Aggregate Stop Loss coverage: Unlimited for the Policy Year Corridor Factor: 120% Minimum Attachment Point: $46,566,776.00 Minimum Attachment Percentage: 100% Minimum. Attachment Lagged Month: Two Months prior to the Policy Year's first Policy Month Lagged Month: Two Months Prior Monthly Attachment Factor (for each Covered Person): CIaim Administrator Product Cigna Cigna Comp Plan Network POS Open Access $1,336.28 $1,336.28 Payment of premium is considered acceptance of this policy and the terms within. CSL-SCH 21 8/20/2024 9:24 AM p. 596 City of Miami Solicitation RFP 1896386 EXHIBIT D Total Health Insight Powered by Consultative Analyties City of Miami April 3, 2024 II .,ice —• we. Cigna healthcare Ceittipe124nat124**property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna Healthcare. PIP u1iplf1r! fiiICI@OrlailiNlilli IIIllllrrl{II 1Iflllffll IIll{Ilrrlrl1r11tI fhlf IIIIrIlfllrlll111111101 IIII111111 IIP II1tIIiI@ II11111fllllilfl11f1111{ r1 N111rl Iflll@RiIIIPIf it lJfllfl 11111f1fIPfl711 rfldfllPlflllflll{FI111 ,,_ 11141f111 tl1I11rCf111 PI1�� I I I11'N111I111I U �IiINRI o f ems. lrlllrllfl ll!@11IIf 1' MMMalli,MaerM■ HIII'r1111111r1`Illfnlf ■ •I I Ua■ ■mm IIl116 1.171 PIYI rl IIi1P1' _ , •.5,ul.a111111IfiIl111Yf171I �... I■■a{Put. {I PII'll Cllllll1111f1�11 , ma.arlllrr■ rlpl Illrrtl7lp< ... ■i MUUI.a.MM. IIIIr1111r1fl �. Af 1:::i:a:::m II11rlfrlfr@n@IfiQpH@ j mifllmimammmm IIr7117t1I Nra r11Alrra ll:allmf■ IIIII@@1njfAl - m{mmr!<Atmmm 11111I If1trl111T __ -- iiiiu.■.umm N rtilioelrt ■Maarm --n. ■ma11amI1a ltFlillrtrifl{I�If i'jLlt sea wrlrra p71I�r° 11I I i InIl1l1il 05�,�iY" City of Miami Agenda Insights 1. Total Health Insight Overview • Medical • Pharmacy 2. High Cost Claimants 3. Specialty Pharmacy 4. Cancer 5. Prevention 6. Virtual Care 7. Health Equity 8. Recommendations 9. Appendix Timeframes Current period reflects claims incurred between January 2023 and December 2023, paid through February 2024 Base period reflects claims incurred between January 2022 and December 2022, paid through February 2023 Norm represents Cigna Florida average for government and municipal employers 8�4 AM healthcare Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna Healthcare. 4licitation R I Multi -Year Trend Average Annual Trend, 2017-2023 3.7 0/0 City of Miami Solicitation RFP 1896386 $758 $695 $647 $697 $683 $558� $6a7 $586 582 $551 $866 $654 $593 2017 2018 2019 2020 2021 2022 2023 Compound Annual Growth Rate Total 3.7% Medical 2.4% Pharmacy 8.90/0 2020: -6% medical trend, roughly $1.2m in initial Covid-19 costs 2021: +12% medical trend impact from returning utilization pattern, Covid-19 costs increase approximately $2.2m 2022: Medical utilization normalizes, $2.5m decrease in Covid-19 costs 2023: 4 individual claimants exceed $700k each in total cost, hypoglycemic medications account for more than half of total pharmacy trend 8/20/2024 9:24 AM p. Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2023 Cigna Healthcare. 599 3 Total Health Insight Overtiew 4,151 Members; -0.1% Contract Size: 2.1 (Norm: 2.0) Total 12.5% t $866 PMPM $734 (Norm) Solicitation RFP 1896386 49% M / 51% F (Norm: 52% M / 48% F) Avg Age: 37.2 (Norm: 37.6) Medical 10.2%/0 t Pharmacy 20.4% T $654 PMPM $535 (Norm) $212 PMPM $199 (Norm) Insights Medical Plan Spend Current: $32.6 M Base: $29.6 M • Top 3 diagnostic groups accounted for41°I° of medical spend: • Neoplasms, Musculoskeletal, General Medical Pharmacy Plan Spend Current: $10,6 MI Base: $8.8 M • Top 3 therapeutic classes accounted for 48% of pharmacy spend: • Anti-Inflam Disease Modifiers, Hypoglycemics, Antivirals, HIV Specific Catastrophic Claimants (aver $100,000 cost per individual) Current: 56 Base: 42 Drivers of Trend Non -Catastrophic Medical 1.0% Non -Specialty Pharmacy 27.10/0 Non -Catastrophic Catastrophic Trend 12.5% Catastrophic Medical 34.00/0 Specialty Pharmacy 14.80/0 J Plan Spend PMPM � N ig O Hi r- r- -EA- O 0 N 0 *l N tfr il I I Non -Specialty Rx Specialty Rx • Base ■ Current Norm 8/20/2024 9:24 AM Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna Healthcare. ®:4i® VD p 6004 healthcare Medical Summary City of Miami What conditions contributed the most to trend? 8.6% Neoplasms 2.5°/_ Musculoskeletal 1.8% Neurological 1.5% Newborns 1.1% Skin -1.2571 BiIiary Tract/Liver Catastrophic claim spend accounted for 9.5% of the 10.2% Solicitation RFP 1896386 How much did we ask members of the plan to pay out of pocket? 6.0°!0 2.1% Base • Deductible/ Copay • Coinsurance 5.4% 1.9% 3.5% Current 8.1% 2.3% 5.8°fo Norm Lower cost share rate equates to roughly $600k in cost shifted medical cost trend to the City compared to other Florida municipalities Did members use the plan appropriately? 7531c 74°c 72° .. Physician Visit 51 °.;;. 48% 1 1 43% 1 82°eo 83% 81% Well Visit Clinical Compliance • Base ■Current Norm Employee well visit rate exceeds norm by over 11 percentage points Spouses incurred higher per capita costs than employees, 1% more across all claims and 3% excluding high cost claimants Unique individuals accessing MDLive for any type of care increased 56% from prior year ER utilization increased 2% overall, with steerable visits down 10%. Fewer steerable visits were incurred for employees related to injuries, ear/nose/throat and musculoskeletal health issues $2.9m in cost savings from case and utilization management programs during 2023 8/20/2024 9:24 AM Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna Healthcare. (Dianap 6015 CI healthcare City of Miami Solicitation RFP 1896386 Overall Rx. Trer Inflation Utilization 93) Drug Mix Pharmacy Summary cigna healthcare., DRIVERS OF PHARMACY TREND TREND CONTRIBUTION BY CLASS SPECIALTY VS. NON -SPECIALTY SPEND VINE OMEN 0 0 1' 20.4% OBSERVATIONS 250 members ( 5.6%) are on specialty medications driving $18,406,513 (45.6%) of the plan spend during the current period. Medications across medical and Rx benefits, account for 31.5% of total plan spend. Estimated $436k additional savings available through Essential Protection utilization management and SaveOnSP combined. 8/20/2 9.8% ® (1.8%): Antivirals, HIV ■ 0.2%: All Other ■ 1.1 %: Asthma Related ■ 11.1 % Hypoglycemics 9.8%: Anti-Inflam ACHIEVED SAVINGS ■ Count of Prescriptions . Plan Spend 86% 35% 53% KEY CONDITION MEDICATION ADHERENCE Plan Compliance 77% 75% Norm Compliance Hypertension Depression Cholesterol 77% 72% 74% 76% 22% of drug costs were managed through your plan's medical benefit p. 600 Population Health City of Miami Solicitation RFP 1896386 (Members with preventive care, minor health issues, etc.) (Maternity, many cancers, joint (Members with no claims, or replacements, trauma, etc.) episodes of care) (Spend greater than or equal to excl. catastrophic.) catastrophic threshold) (Diabetes, hypertension, COPD, 23°/o of the population 4% of spend 14% of the population 1O% of the population 1O3/4 of spend 0% of spend 52% of the population 51% of spend 1°/0 of the population 35°/° of spend Health Risk Highlights Top 5 Chronic Conditions Prevalence • Preventive care and annual physical utilization remained above norms for e m ployees and spouses • Dependents preventive care rates decreased 5 points and were below norms for2023 • Cancer screenings improved by 1-2 points in all areas • Mental health claimant prevalence decreased 4% overall, substance use issues rose by4 • Among pre -diabetic members, the top 3 co -morbid conditions are obesity, hypertension and depression 23a/o Obesity 19% 9% 1O% Hypertension Diabetes BASE CURR 7% Hyperlipidemia Asthma 8/20/2024 9:24 AM Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna Healthcare. VD p 6037 healthcare Catastrophic Summary City of Miami Solicitation RFP 1896386 Catastrophic claimants accounted for 1 % of the population and 35% of total costs, totaling over $14m in combined medical and pharmacy costs, $4m higher than 2022 Overview 56* individuals (42 in prior year) • 32 over age 50, 10 over age 65 • 32 employees, 12 spouses, 12 dependents • 5 were new enrollees on the plan (3 newborns) • 5 are no longer enrolled in the plan • 22 of the individuals also reached the catastrophic level in the prior policy year • 100% of medical spend was in - network *catastrophic level of $100,000 per individual $254K average cost per individual • Top individual incurred $920k in total cost • 22 individuals had over $100k in medication spend • Specialty medications accounted for 40% of total catastrophic costs • Top specialty drugs included Abraxane, Aloxi and Kadcyla (cancers), Stelara and Evrysdi • Cancer accounted for the highest percentage of costs and number of claimants, 14 individuals Conditions 91% have a chronic condition • 84% of those with a chronic condition had 2 or more • Hypertension, hyperlipidemia, diabetes and obesity were the most prevalent chronic medical conditions • 45% also have a co -morbid behavioral diagnosis • 17 see a Cigna Collaborative Care Physician • 86% medication adherence rate 8/20/2024 9:24 AM Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna Healthcare. crgna p 6048 hea��h�a�e Top 10 Catastrophic DetailofMiami M/F Age Relshp 1 F 50-59 EE 2 M 65+ SP 3 M 65+ EE 4 F 50-59 EE 5 M 50-59 EE 6 F 1-17 DEP 7 M 30-39 EE 8 M 60-64 EE 9 F 50-59 SP 10 F 60-64 EE ICD Major Neoplasms Neoplasms Neoplasms Neoplasms Skin Newboms Gastrointestinal Circulatory Neoplasms Neoplasms ICD Minor Leukemia C a re/Neoplas C a re/Neoplas C a re/Neoplas I nfections Morbidity Non Mat Stom/Int/Pan Hypertensive C a re/Neoplas C a re/Neoplas Solicitation RFP 1896386 Latest Cat Out of Date of in Clinical Medical Pharmacy Med Srx Pharm Srx Total ($) Net % Eligibility Base? Programs $857,660 $1,754 $59,499 $871 $919,783 0% 03/24 N $111,335 $7,013 $710,412 $0 $828,760 0% 03/24 Y $513,072 $6,188 $134,259 $100,464 $753,982 0% 02/24 N $214,064 $210 $511,047 $0 $725,322 0% 03/24 Y $624,207 $2,154 $1,784 $23,689 $651,833 0% 03/24 Y $594,202 $992 $16,532 $0 $611,727 0% 03/24 N $23,607 $3,171 $0 $355,513 $382,291 24% 03/24 Y $374,818 $951 $207 $0 $375,975 0% 10/23 N $26,313 $592 $338,708 $0 $365,613 0% 03/24 Y $343,239 $2,647 $0 $5,826 $351,712 0% 03/24 Y O NC,TRN,WI O NC,WI O NC,WI C 0 M,DIA,O NC,WC,WGT,WI COM,WI NIC WI C 0 M,EAP,WI WI 0 NC,WI CM/SPCM Programs (Case Mgmt) TCM-Transition Ca re Management C O M-Complex IN P-Inpatient N IC -Neonatal I ntensive Care 0 NC -Oncology RE H-Rehabilitation T RN -Transplant Acronym Key Chronic Coaching Programs AST -Asthma CAD -Coronary Heart Disease C H F-Chronic Heart Failure C PD-Chronic Obstructive Pulmonary Disorder D EP-Depression DIA-Diabetes Mellitus LBP-Low Back Pain 0 ST-Osteoa rthri tis PAD -Peripheral Artery D isease WGT-Weight Complications Additional Programs C CS-CancerC are Support Program EAP-Employee Assistance Program H PHB-Healthy Pregnancies H ealthy Babies LMP-Lifestyle ManagementPrograms 0 L-Online Programs T D S-Treatment Decision Support WC -Wellness Coaching WI -Well I nformed (Gaps I n Care) M I R-Medical Injectable 8/20/2024 9:24 AM Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna Healthcare. Cigna p 6059 Cancer Summary City of Miami Solicitation RFP 1896386 Cancer prevalence by age band Prevalence and cost by condition 24.0% 18.0% 12.0% 6.0% 0.0% Male Female <01 1-17 18-29 30-39 40-49 50-59 60-64 65+ 0.0% 0.0% 0.7% 1.6% 2.9% 6.1% 10.9% 23.1% 0.0% 0.3% 0.8% 1.9% 5.2% 6.6% 10.3% 12.4% • 31% of cancer patients also have a diagnosis of diabetes • Different than most groups, prostate cancer was the top cancer type by prevalence • Unique individuals with a prostate cancer screening increased 6% during the year Condition #of Prevalence Cancer Cost Total Plan Members Per Patient Spend Male Rep. 35 0.8% $35,578 $1,245,238 Neoplastic Disease 29 0.7% $24,480 $709,909 Dermatology 24 0.6% $1,994 $47,856 Breast 24 0.6% $93,576 $2,245,826 Thyroid 17 0.4% $3,445 $58,560 Gastrointestinal 10 0.2% $12,747 $127,471 Female Rep. 7 0.2% $29,959 $209,713 CNS 4 0.1% $7,169 $28,677 Hepatobiliary 3 0.1% $30,612 $91,835 Other 4 0.1% $190,980 $763,920 Total 146 3.5% $37,870 $5,529,005 Cancer screening rates 80% 60% 40% 20% 0% Current Norm Breast Cancer Cervical Cancer Colon Cancer 8/20/2024 9:24 AM Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna Healthcare. 71% 66% 65% 37% 60% 48% cigna 0 healthcare p. City of Miami Solicitation RFP 1896386 .air. claw Specialty Pharmacy Executive Summary Pharmacy and medical drug plan spend Account summary(PMPM basis) 100% 75% 50% 25% 0% r Base Current Norm Base Current Trend Norm Plan Spend Pharmacy Specialty Rx $96.88 $111.25 14.8% $93.55 Medical SRx HCP/Home Infusion Medical SRx Outpati ent/l n pat ent $13.08 $10.08 -22.9% $21.23 $38.71 $50.49 30.4% $15.35 Total Specialty Rx $148.67 $171.82 15.6% $130.13 Other Pharmacy $79.49 $101.07 27.1% $105.50 Pharmacy Specialty Rx - Percent of current plan spend Medical Specialty Rx-HCP / Home Infusion & OP/IP by condition 16.1% 47.9% 13.9% RA/Pso ri ad slCro h n's Antivirals, HIV Specific Cancer Spinal Muscular Atrophy Pulmonary Hypertension All Other Percent of current plan spend by condition 20.6% 10.6% 47.1% Cancer Cancer Anti emetic RA/Pso ri asi sfCro h n's Immune Related Neutropenia All Other 8/20/2O tg2 42(Mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 6011 City of Miami Solicitation RFP 1896386 Cig .air. na Specialty Pharmacy & Medical - Top Drug Spend Top drugs by spend Rank Plan Spend (PMPM) Members Claims Base Current Drug Name Condition Base Current Trend Norm Plan Spend Base Current Base Current 1 1 Stelara(SRx) RA/Psoriasis/Crohn's $13.74 $24.74 80.0% $6.55 $1,232,003 6 6 51 65 2 Abraxane Cancer $11.06 - $0.36 $550,771 - 1 25 10 3 Humira(Cf) RA/Psoriasis/Crohn's $4.34 $7.26 67.2% $9.39 $361,535 5 6 31 52 Pen(SRx) 17 4 Kadcy la Cancer $2.68 $6.80 154.0% $0.38 $338,708 1 1 4 10 3 5 Evrysdi(SRx) Spinal Muscular Atrophy $7.36 $6.70 -9.1% $0.40 $333,460 1 1 15 13 2 6 Biktarvy(SRx) Antivirals,HIVSpecific $8.45 $6.47 -23.4% $2.70 $322,227 12 10 112 85 8 7 Uptravi(SRx) Pulmonary Hypertension $4.98 $5.06 1.6% $0.49 $252,147 1 1 12 11 21 8 Aloxi CancerAntiemetic $2.31 $4.81 108.3% $0.03 $239,724 1 5 2 17 19 9 Rinvoq(SRx) RA/Psoriasis/Crohn's $2.48 $4.72 90.4% $1.64 $234,982 3 4 20 37 9 10 Keytruda Cancer $4.56 $4.12 -9.7% $2.19 $205,001 1 2 6 6 6 11 SkyriziPen(SRx) RA/Psoriasis/Crohn's $5.34 $4.02 -24.9% $3.50 $199,931 4 2 36 30 27 12 Kesimpta Pen(SRx)Multiple Sclerosis $1.81 $3.40 87.6% $0.51 $169,100 1 2 12 20 18 13 Norditropin Growth Hormone Deficiency $2.65 $2.98 12.6% $1.40 $148,418 2 2 15 18 Flexpro(SRx) 5 14 Neulasta Neutropenia $5.96 $2.46 -58.7% $0.70 $122,692 1 4 20 10 7 15 Entyvio RA/Psoriasis/Crohn's $5.19 $2.45 -52.8% $0.20 $121,856 3 1 18 6 All Other Specialty $76.82 $74.78 -2.6% $99.68 $3,724,342 206 224 1,035 1,148 Total $148.67 $171.82 15.6% $130.13 $8,556,898 234 250 1,389 1,553 • The top fifteen Specialty Pharmacy and Medical drugsaccountedfor56.5%($4,832,556) of the total Specialty plan spend($8,5 56,898) in thecurrent period. • The Specialty Top Drugsby Plan Spend(PMPM)are: Stelara ($24.74), Abraxane ($11.06), and Humira(Cf) Pen ($7.26). 8/20/QOpptg242mnects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 6082 City of Miami Pathwell Specialty — Solutions that work together to improve oncology outcomes Pathwell Specialty is a new national medical injection/infusion network and benefit that excludes high -cost providers and offers dedicated custo mer suppo rt. 0 Robust, high -performing Open Access Plus (OAP) -based national network of more than 28,000 local, affordable providers and pharmacies* 0 Dedicated care management team that guides members and providers to in -network providers 0 Optimized drug coverage management of affordable, clinically appropriate specialty medications II •.• Cigna healthcare Integrated strategy with benefit optimization that looks across pharmacy and medical benefits to maximize savings Comprehensive whole - person health approach that offers additional support through programs like: Caregiver Bridge, FoodsmartTM, Oncology Consult Service, and HelloFresh The new Cigna Pathwell Specialty®** Network has driven 15%+ reduction to medical specialty spend.*** *Number of providers as of February 2023. Subject to change. **Effective July 1, 2022, for Select clients and January 1, 2023, for National and Middle Market clients. ***Cigna Healthcare analysis 2022 based on commercial national book of business. Individual results and savings will vary and are not guaranteed. Savings vary by market, funding type and utilization and are subject to change. 8/20/2024 9:24 AM Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 02024 Cigna Healthcare City of Miami Oncology Consult Service is not just a second opinion Standard Second Opinion Experience: • Available for all cases, regardless of diagnostic and treatment complexity • Customer, or in some cases second opinion service initiates the process, which often happens after treatment has begun • Customer must coordinate with second opinion reviewer and their provider, including sharing of medical records • Length of review may delay treatment CIgncl *This is an average and not healthcare 8/20/2024 9:24 AI� u a ra n to ed The Cigna Healthcare Difference:* • Automatically initiated on customer's behalf as part of the prior authorization process prior to treatment • Targeted to those cases likely to benefit from a consultative review - $3,800 fee per completed consult forASO clients • Customer's provider and consulting physicians work together on customer's behalf, and consult service facilitates medical record exchange • No delays in treatment and most reviews complete in under a week • Consulting physicians are experts from National Cancer Institutes P.b1Y4 Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 02024 Cigna Healthcare City of Miami Solicitation RFP 1896386 .air. cing Patient Assurance Program - Performance Summary 343 customers 4 with $25 / script cost share s aved $23,644 Detail Base Current PAP Customer Total Savings $13,606 $23,644 Savings PM PM $0.27 $0.47 Average Per Script Savings $9 $9 PAP Script Count 1,471 2,620 % of Total Scripts 2.3% 4.0% ScriptsPerCustomer 6.9 7.6 Without PAP Cost Share Per Script $34 $34 With PAP Cost Share Per Script $25 $25 PAP Customer Count % of Total Population 213 6.5% 343 10.5% Cost share breakdown Without With PAP PAP Customer $89,169 $65,525 Manufacturer $0 $23,644 Client $1,814,305 $1,814,305 $23,644 saved on essential medications may drive better adherence and improved future health outcomes Top Customer Savings by Drug Drua Name Ozem pi c Mounjaro Farxi ga Other PAP Customer Customer Customers Scripts Spend Savings 126 797 $19,925 $8,275 113 619 $15,475 $7,522 42 294 $7,350 $1,885 • 100% of PAP customersfilled medicationsforother conditionsincluding Hypertension, Diabetesand Cholesterol • The total pharmacy cost of the 343 PAP customerswas $3,430,312, 32% of total pharmacyspendinthecurrentperiod • Total customer savi ngs of $23,644 was achi eyed on eligible drugswith cost 174 910 $22,750 $5,961 share greaterthan $25 per month Total 343 2,620 $65,500 $23,644 8/20/2O tg2 42(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 611;, City of Miami Solicitation RFP 1896386 asps! SaveOnSP: Specialty Copay Assistance - Opportunity SaveOnSP maximizes copay assistance from drug manufacturers for certain specialty medications by reducing customer cost share to $0 and sharing 75% of the maximized savings with the client within qualifying plans. Without SaveOnSP $19,805 With SaveOnSP $0 $341,219 0 0 $3,759,494 $3,438,080 Employer Spend Customer Spend M an ufacturer Copay Assistance Total drug spend: $3,779,299 Employer spend: $3,438,080 (including any SaveOnSP program passthroughs) Manufacturer copay assistance: $341,219 (Including customer cost share reductionto$0) Customer cost share: $0 Saves client $321,414 and eliminates $19,805 in cost share for 65 customers, Savings by Condition Current Condition Customers Scripts Plan Spend Plan Savings HIV 21 175 $623,435 $98,214 Arthritis Cancer All Other 19 174 $995,744 $97,451 5 17 $219,541 $37,647 22 187 $1,940,579 $107,907 Total 65 553 $3,779,299 $341,219 • Estimated plan savingsof$341,219or$6.85PMPM equatesto a reduction of total specialty pharmacy spend by 6.2% • 65 customers represents46% of specialty pharmacy utilizers, 2% of all pharmacy utilizers • Top impacteddrugsby plan savingsare Biktarvy, Stelara, Humira • M an ufacturer Copay Assistance isnet of program costs 8/20/ dAraects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 rg1Wdts claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p.612, City of Miami Solicitation RFP 1896386 '�- Pharmacy Drug Management - Essential cinw .�,„ Protection Opportunity Savings & Impact Current Drug List: Standard 2023 Managed Drug Class Current Estimated Savings $60,644 Savings(PMPM)" $1.22 Percent of Total Drug Cost 0.6% Estimated Member Impact Percent of Memberslmpacted" 57 1.3% Essential Opportunity $155,612 $94,968 $3.12 $1.90 1.5% 0.9% 241 5.4% * Per Cigna Book of Business, Specialty Drug Management represents an Additional $1.50 PMPM of cost savings and 1.25% of Additional member impact. 204 4.5% Opportunity by Therapeutic Class Therapeutic Class Neprilysin Inhibitors Hypoglycemics Lipid Lowering Asthma Related Acne Agents Kidney/Uri nary ACE/ARB Estrogenic/Androgenic/Progest Hyperglycemics Anticonvulsants Impacted Members 20 62 10 16 14 2 2 13 5 4 Estimated Say ings $28,812 $21,106 $10,849 $7,784 $5,259 $5,002 $3,526 $3,291 $1,877 $1,282 Opportunity Detail Program Element Current Essential Baseline PriorAuthorization Step Therapy Quantity Level Limit 0 0 • Program Description • Cigna's Essential protection package protectsclientsand customers against potentially harmful, i neffective and unnecessary drug treatmentsand rising drug costs. • Leverages i ntegrated medical/pharmacy data, clinical expertise and our connection to networkdoctorsto ensure safe prescribing and access to the most appropriate medications, helping clients and customersachieve their best health. • The Essential protection packageisoptimized bydrug listto ensure expected performance and actively administered throughoutthe yearto react to emerging market events. 8/20/202 tg24) mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 6137 City of Miami Solicitation RFP 1896386 .air. claw Preventive Care Summary Current period OV& preventive utilization 100.0% 75.0% 111. 50.0% 25.0% 0.0% rim PCP/SPC OV Annual Physical All Ages 74.2% 48.1% <18 80.1% 68.9% 18-39 61.5% 37.5% 40-49 74.3% 47.4% 50+ 83.9% 47.6% Well visit completion rates 80% 60% 40% 20% 0% Pediatric Adult Base 78.1% 45.5% Current 71.3% 43.7% Norm 69.9% 36.3% Preventive care utilization (all services) Well visit completion rates 80% 60% 40% 20% 0% Base • Current Norm • i 60% 45% 30% 15% 0% Employee Spouse Dependent Total Employee Spouse Dependent Total 58.9% 61.0% 56.9% 58.6% Base 46.7% 52.5% 55.9% 50.9% 57.8% 60.8% 51.9% 56.3% • Current 46.4% 48.3% 50.3% 48.1% 49.6% 58.8% 55.6% 53.1% Norm 35.3% 45.7% 53.6% 42.9% I rr 8/20/2O tg 2(Mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Bas? Period reflects clai s ipcaarred petty n Jar.2022 and Dec. 202,2 aic� throw h Fe. s0z3. Confdenttia unpublis e propery' o igna ealt care. o not duplicate or ist�bu e s and dis n ution limited solely to authorized personnel. ©2024 Cigna Healthcare. cfgna 6114$ healthcare p, Onsite Clinic Activity Appointment Counts YTD No Show 67 Other Canceled Completed Visits Total Appointments 30 714 811 Access Metrics No Show Rate City of Miami Solicitation RFP 1896386 YTD 8%° Same Day/Walk-in Rate 82% Schedule Utilization Provider Utilization 17% 15% Service Type (Top 8) Diagnostics Wellness Screenings Virtual Health Provider Visits Vaccinations Custom Coaching I Patient Outreach 1 8/20/2024 9:24 AM Dec YTD 23 461 24 422 4 107 3 97 4 91 3 58 0 2 0 1 Engagement Metrics Rolling 12 Encounters/Patient 2.2 Returning Patients MyChart Activation Telemed Adoption 44% 42%° 23% Patient Relationship Rolling 12 321 Employees Dependents Unknown Total Patients 6 53 380 Patient Type Rolling 12 Medical Patients Occupational Patients Coached Customers Total Customers 380 0 380 Patient Age Rolling 12 <20 1% 20-30 8% 30-40 24% 40-50 26% 50-60 22% 60+ 19% .:�5. c�gna 619 healthcare p. Virtual Care Summary Current Trend Total Visits 3,636 -13% Unique Users 965 -13°Io Users with Multiple Visits 507 -15% Total Behavioral Visits 2,157 -13% Member Utilization 23°Io -3To Cigna Medical Provider Virtual Visits by Specialty 17°/° 53°/° 15% 5% r L City of Miami Solicitation RFP 1896386 Virtual Care Visits by Provider rLn . Base vs Current to . Base ■ Current m T mun 000 1,0 1. �; 1 11 in r.CO Nr'ich ,- • G ,-I O M ,-I Total Cigna Medical Cigna MD Live MD Live PCP - MD Live PCP- MD Live MD Live Behavioral Urgent Care Wellness Routine Behavioral Dermatology • Family Medicine • Internal Medicine • Pediatrics ■ Endocrinology And Metabolism Nurse Practitioner All Other Demographics * 58°I° Employees * 62% Female Cigna Behavioral Virtual Visits by Condition 8% 9% 16% 27% 8/20/2024 9:24 AM Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna Healthcare. • Reactive Stress Disorders • Anxiety • Depression • Mental Disorder ADD/AD H D All Other Demographics * 49% Employees * 59% Female .'1i. .d cfgna 61p healthcare p. Health Equity City of Miami Solicitation RFP 1896386 Health inequities impact your workforce. Social determinants employee productivity and your costs. Health impacts 80%-90% of overall health outcomes are impacted by SDOH1 ® Workforce impacts 30% or more of African American/Black, Hispanic/Latino, LGBTQ+, and younger employees said they considered switching employers because of their health benefits2 of health (SDOH) affect health, Cost impact $135 billion Potential economic gain per year if racial disparities in health are eliminated, including $93 billion in excess medical care costs and $42 billion in untapped or unused productivity of your workforce3 • Race • Education • Ethnicity • Literacy • Sexual orientation • Gender identity/ expression • Culture • Age • Income level • Language • Cognitive, sensory, physical disabilities • Geographic location Embedding health equity into the core of our business • SDOH screenings through care management programs - and referrals when needs are identified • Specialized training for providers to identify and support those facing SDOH impacts - and help to resolve those barriers Creating data -driven solutions for equitable outcomes • MoreThanRxsM rural -focused care • 24/7 interpretation in 240 languages • Benefittranslation in over 200 languages (including Braille) Connecting into local communities • Find Help.com provides community resources such as transportation, food assistance, and other services • 90% of The Cigna Group Foundation grants focused on addressing SDOH City of Miami Social Determinants Index (SDI): Total Population 34% 27 Very High High Scarce Resources Limited Resources 22% 17% Medium Low Adequate Resources Vast Resources Top Domains driving Health Disparities: Food Access & Education 1. World Health Organization, Social determinants of health (who int) Accessed October 2023. 2. By Jenny Cordina, Megan Greenfield, Lindsay Purcell, and Jeris Stueland. " How employers can help advance health equity in the workplace" McKinsey & Company. December 3, 2021. https://www.mckinsey.com/industries/healthcare/ourinsights/income-alone-may-be-insufficient-how-employers-can-help-advance-health-equity-in-the- workplace. 3. W.K.. Kellogg Foundation, "The Business Case for Racial Equity: A Strategy for Growth." https://www.wkkf.org/news-and-media/article/2018/04/updated-study-outlines-potential-gains-to-u-s-economy-and-a- paagE 246k2r4cAfrAvth/. Accessed October 2023. Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna Healthcare. .%l0. cfgna healthcare p. Health Equity -Chronic editions CITY OF MIAMI Social Determinants Index (SDI): Total Population Very High Scarce Resources High Limited Resources Medium Adequate Resources Low Vast Resources 34% 22% 17% 61% Tap Domains driving Health Disparities: Food Access & Education Solicitation RFP 1896386 • Education factors include items such as high school and college education degree completion. Food Access measures the impact of distance to grocery stores and level of governmental assistance programs • Isolating diabetic members, individuals living in areas of high to very high SDI increase from 61% to 63% • Children living in Scarce resource areas are 5 points less compliant with annual pediatric visits than the group average How Do Results Vary by SDI Categories? (rolling 12 months) Annual Physicals (All) Employee Spouse Children Utilization per K 51% 54% 53% 45% 57% 55% 56% 57% 57% 54% 61% 55% 56% 54% 57% 60% Office Visits 4,375 4,658 4,857 5,730 ER Visits 415 345 359 331 Urgent Care Visits 499 592 650 680 8/20/2024 9:24 AM Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna Healthcare. Cigna p 612 Recommendations City of Miami Solicitation RFP 1896386 • Add Essential Utilization Management pharmacy program for 1/1/2025, expected savings are $95k • Add SaveOnSP: Specialty CopayAssistance pharmacy program for 1/1/2025, expected savings are $341k • Cigna Pathwell Specialty program upcoming for 1/1/2025, with Oncology Consult Service and Caregiver Bridge • New Well -Being Solution with Virgin Pulse upcoming for 2025 • Increase communication of new and existing behavioral health capabilities across membership, specifically dependents, and inclusive of EAP • Consider adding the Omada Complete (diabetes and hypertension support) program for 2025 8/20/2024 9:24 AM Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna Healthcare. eig+i+ n[ .. 61293 healthcare. City of Miami Solicitation RFP 1896386 Appendix cilna 8/20/ 4"t:24 AM p. Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2023 Cigna Healthcare. 6224 Key Metrics by Group City of Miami Solicitation RFP 1896386 Key metrics Actives Under65 Retirees Over65 Retirees Base Current Trend Base Current Trend Base Currenl Trend Members Average Number of Employees 1,867 1,878 0.6% 136 142 4.2% 208 200 -3.9% Average Number of Members 3,976 3,962 -0.3% 178 189 6.3% 252 240 -4.7% Cost Trend Plan Spend $35,944,227 $40,842,842 13.6% Plan Spend PMPM $753 $859 14.0% Performance Indicators Cat Claim ants i n Excess Per K Network Penetration Network Discounts Generi c Rx Utilization Rate Chronic Percent of Population Chronic Percent of Cost Health and Wellness Total Health Engagement -%of pop Health Maintenance Engagement Health ImprovementEngagement Preventive Care Utilization Health Assessment Penetration Gaps in Care Rule Compliance 10.1 13.6 35.5% 98.1% 98.6% 0.5% 68.1% 68.3% 0.2% 91.9% 92.3% 0.4% 49.2% 51.7% 2.5% 78.1% 81.6% 3.5% 47.3% 48.6% 1.3% 44.6% 45.4% 0.8% 6.6% 8.1% 1.5% 58.6% 56.5% -2.1 % 0.6% 0.4% -0.2% 82.1% 77.7% -4.4% $2,411,312 $2,286,906 -5.2% $1,130 $1,008 -10.8% 11.2 10.6 -5.9% 95.6% 98.8% 3.2% 71.5% 72.1% 0.6% 91.5% 92.7% 1.2% 79.1% 77.6% -1.5% 95.8% 96.2% 0.4% 51.0% 51.4% 0.4% 44.8% 44.2% -0.6% 15.5% 16.8% 1.3% 58.5% 52.4% -6.1 % 0.0% 0.0% 0.0% 87.2% 81.7% -5.5% $1,403,738 $1,490,136 6.2% $465 $518 11.3% 4.0 8.3 109.9% 94.9% 93.2% -1.7% 71.0% 56.9% -14.1% 91.1% 93.4% 2.3% 84.2% 87.8% 3.6% 91.4% 95.0% 3.6% 20.9% 26.0% 5.1% 17.9% 25.2% 7.3% 3.8% 4.1% 0.3% 34.5% 39.1% 4.6% 0.4% 0.0% -0.4% 100.0% 0.0%-100.0% Cigna 25 heath a,e p. 621 8/20/2024 9:24 AM Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna Healthcare. City of Miami Solicitation RFP 1896386 0, Executive Summary CI Yl Total Excluding Over 65 Retirees Medical & Rx Spend N. i��� 3:^••. $35 $167 $:, $492 12O0 14o0 $35 $2o' $9 $43 $187 $12 d0 1sao $1,boa PMPM Spend • Employer Paid - Medical • Member Paid - Medical Employer Paid - Pharmacy ■ Member Paid - Pharmacy Demographics & Financial Base Members Average Number of Employees Average Number of Members Av erage Employee Age Cost Trend Plan Spend - Medical Plan Spend - Pharmacy Total Plan Spend Medical Plan Spend PMPM Pharmacy Plan Spend PMPM Total Plan Spend PMPM Performance Indicators Cat Claimants in Excess Per K Cat Plan Spend PMPM(Med+Rx) Non -Cat Plan Spend PMPM(Med + Rx) Network Penetration Current Trend 2,003 2,020 0.8% 4,154 4,151 -0.1% 48.0 48.4 0.9% $29, 564, 880 $8, 790, 690 $38, 355, 571 $593.15 $176.37 $769.52 $32,557,201 10.1% $10,572,547 20.3% $43,129,749 12.4% $653.60 10.2% $212.32 20.4% $865.92 12.5% 10.1 13.5 33.4% $224.86 $294.61 31.0% $544.65 $571.31 4.9% 97.9% 98.6% 0.7% Norm $535.44 $199.05 $734.49 10.4 $198.50 $535.99 98.8% Medical & Rx Trend Total Plan Spend Current PMPM Total Employer Paid I Total Member Paid Medica Ss -nd PMP a' Employer Paid - Medical Pharmacy Spend PMPM Empl:; acy Trend $865.92 I 12.5% 17.9% $821.55 I 13.3% 21.0% Variance from Norm II $44.37 II $653.60 -0.2% 10.2% 10.8% 20.4% 21.5% 22.1% 25.6% 6.7% 9.0% Population Health & Pharmacy Base Current Trend Norm Population Health Measures Chronic Percent of Population Chronic Percent of Cost Total Health Engagement - % of Pop Preventive Care Utilization Well Visit Completions Health Assessment Completions Gaps in Care Rule Compliance Pharmacy Indicators Generic Dispensing Rate Generic Substitution Rate Specialty Plan Spend PMPM (Rx Only) Specialty Plan Spend PMPM (Med Only ) Non -Specialty Plan Spend PMPM (Rx only) Prescriptions PMPY(Retail adjusted) 50.4% 79.2% 47.5% 58.6% 50.9% 0.6% 82.4% 52.9% 82.4% 48.7% 56.3% 48.1 % 0.4% 83.1 % 91.8% 92.4% 97.3% 98.5% $96.88 $111.25 $51.80 $60.57 $79.49 $101.07 15.15 15.69 2.5% 3.2% 1.2% -2.3% -2.8% -0.2% 0.7% 0.5% 1.2% 14.8% 16.9% 27.1 % 3.5% 47.0% 78.7% 42.3% 53.1 % 42.9% 14.6% 80.9% 92.0% 98.3% $93.55 $36.58 $105.50 16.07 8/20/QOpptg22mtlects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 62k City of Miami Solicitation RFP 1896386 .$;. Executive Summary CI5rii Actives Medical & Rx Spend Noun $35 $615 $1(7-1 $35 $9 $492 $200 $dos $43 $187 56�0 $12 $800 PMPM Spend • Employer Paid - Medical • Member Paid - Medical Employer Paid - Pharmacy ■ Member Paid - Pharmacy Demographics & Financial Base Members Average Number of Employees Average Number of Members Av erage Employee Age Cost Trend Plan Spend - Medical Plan Spend - Pharmacy Total Plan Spend Medical Plan Spend PMPM Pharmacy Plan Spend PMPM Total Plan Spend PMPM Performance Indicators Cat Claimants in Excess Per K Cat Plan Spend PMPM(Med+Rx) Non -Cat Plan Spend PMPM(Med + Rx) Network Penetration Current Trend 1,867 1,878 0.6% 3,976 3,962 -0.3% 46.9 47.3 0.8% $27, 693, 349 $8, 250, 878 $35, 944, 227 $580.45 $172.94 $753.39 $30,893,605 11.6% $9,949,237 20.6% $40,842,842 13.6% $649.79 11.9% $209.27 21.0% $859.06 14.0% 10.1 13.6 35.5% $222.58 $297.45 33.6% $530.82 $561.60 5.8% 98.1% 98.6% 0.5% Norm $535.44 $199.05 $734.49 10.4 $198.50 $535.99 98.8% Medical & Rx Trend Total Plan Spend Current PMPM $859.06 Total Employer Paid I $815.58 Total Member Paid Trend Variance from Norm 14.0% 17.0% I 14.9% I 20.1% I $43.48 I 0.5% I 11.9% 12.7% Medica Ss -nd PMP a' Employer Paid - Medical Pharmacy Spend PMPM Empl:; acy -21.8% 21.4% 24.9% 5.1% Population Health & Pharmacy Base Current Trend Norm Population Health Measures Chronic Percent of Population Chronic Percent of Cost Total Health Engagement - % of Pop Preventive Care Utilization Well Visit Completions Health Assessment Completions Gaps in Care Rule Compliance Pharmacy Indicators Generic Dispensing Rate Generic Substitution Rate Specialty Plan Spend PMPM (Rx Only) Specialty Plan Spend PMPM (Med Only) Non -Specialty Plan Spend PMPM (Rx only) Prescriptions PMPY(Retail adjusted) 49.2% 78.1 % 47.3% 58.6% 51.5% 0.6% 82.1 % 51.7% 81.6% 48.6% 56.5% 48.5% 0.4% 77.7% 91.9% 92.3% 97.3% 98.5% $99.75 $114.21 $52.94 $62.95 $73.20 $95.06 14.15 14.67 2.5% 3.5% 1.3% -2.1 % -3.0% -0.2% -4.4% 0.5% 1.2% 14.5% 18.9% 29.9% 3.7% 47.0% 78.7% 42.3% 53.1 % 42.9% 14.6% 80.9% 92.0% 98.3% $93.55 $36.58 $105.50 16.07 8/20/2Opptg22mtlects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 622,7 City of Miami Solicitation RFP 1896386 .$;. Executive Summary CIgfl� Under 65 Retirees Medical & Rx Spend N. i��� $688 $492 $826 $43 $187 4:51 $234 $19 $46 $26E $12 $17 $too $400 $ebo stoo $i,boo sOoo PMPM Spend • Employer Paid - Medical • Member Paid - Medical Employer Paid - Pharmacy ■ Member Paid - Pharmacy Demographics & Financial Members Average Number of Employees Average Number of Members Av erage Employee Age Cost Trend Plan Spend - Medical Plan Spend - Pharmacy Total Plan Spend Medical Plan Spend PMPM Pharmacy Plan Spend PMPM Total Plan Spend PMPM Performance Indicators Cat Claimants in Excess Per K Cat Plan Spend PMPM(Med+Rx) Non -Cat Plan Spend PMPM(Med + Rx) Network Penetration Base Current Trend 136 178 62.8 142 189 62.9 4.2% 6.3% 0.3% Norm $1,871,500 $1,663,596 -11.1% $539,812 $623,310 15.5% $2,411,312 $2,286,906 -5.2% $876.99 $733.51 -16.4% $535.44 $252.96 $274.95 8.7% $199.05 $1,129.95 $1,008.46 -10.8% $734.49 11.2 10.6 -5.9% 10.4 $276.06 $234.53 -15.0% $198.50 $853.89 $773.92 -9.4% $535.99 95.6% 98.8% 3.2% 98.8% Medical & Rx Trend Total Plan Spend Total Employer Paid Total Member Paid Medica Ss -nd PMP Employer Paid - Medical Pharmacy Spend PMPM Empl:;, acy i Current PMPM $1,008.46 $945.45 Trend Variance from Norm -10.8% 37.3% I -10.8% I 39.3% -10.8% -16.4% -16.7% 10.3% Population Health & Pharmacy Base Current Trend Norm Population Health Measures Chronic Percent of Population Chronic Percent of Cost Total Health Engagement - % of Pop Preventive Care Utilization Well Visit Completions Health Assessment Completions Gaps in Care Rule Compliance Pharmacy Indicators Generic Dispensing Rate Generic Substitution Rate Specialty Plan Spend PMPM (Rx Only) Specialty Plan Spend PMPM (Med Only) Non -Specialty Plan Spend PMPM (Rx only) Prescriptions PMPY(Retail adjusted) 79.1 % 95.8% 51.0% 58.5% 38.2% 0.0% 87.2% 91.5% 97.3% $32.71 $26.12 $220.25 37.69 77.6% 96.2% 51.4% 52.4% 40.2% 0.0% 81.7% 92.7% 98.6% $48.62 $10.70 $226.33 36.98 -1.5% 0.4% 0.4% -6.1 % 2.0% 0.0% -5.5% 1.2% 1.3% 48.6% -59.0% 2.8% -1.9% 47.0% 78.7% 42.3% 53.1 % 42.9% 14.6% 80.9% 92.0% 98.3% $93.55 $36.58 $105.50 16.07 8/20/QOpptg22mtlects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 6248 City of Miami Solicitation RFP 1896386 0, Executive Summary CIYl Over 65 Retirees Medical & Rx Spend Noun 1?Du $1"1... 1 $43 $167 $17 14no Sdoo $300 PMPM Spend • Employer Paid - Medical • Member Paid - Medical Employer Paid - Pharmacy ■ Member Paid - Pharmacy Demographics & Financial Base Members Average Number of Employees Average Number of Members Av erage Employee Age Cost Trend Plan Spend - Medical Plan Spend - Pharmacy Total Plan Spend Medical Plan Spend PMPM Pharmacy Plan Spend PMPM Total Plan Spend PMPM Performance Indicators Cat Claimants in Excess Per K Cat Plan Spend PMPM(Med+Rx) Non -Cat Plan Spend PMPM(Med + Rx) Network Penetration Current Trend 208 200 -3.9% 252 240 -4.7% 74.2 74.5 0.5% $1,092,433 $1,294,115 18.5% $311,306 $196,021 -37.0% $1,403,738 $1,490,136 6.2% $361.02 $448.88 24.3% $104.08 $68.78 -33.9% $465.10 $517.66 11.3% 4.0 8.3 109.9% $55.01 $134.52 144.5% $410.08 $383.14 -6.6% 94.9% 93.2% -1.7% Norm $535.44 $199.05 $734.49 10.4 $198.50 $535.99 98.8% Medical & Rx Trend Total Plan Spend i Current PMPM $486.20 Total Employer Paid I $473.28 Total Member Paid Medica S+, Employer Paid - Medical Pharmacy Spend PMPM Trend Variance from Norm 16.5% -33.8% I18.1% -30.3% II $12.93 II 448.88 -22.6% 24.3% 26.3% -33.9% -76.7% -16.2% -11.2% EZI Population Health & Pharmacy Base Current Trend Norm Population Health Measures Chronic Percent of Population Chronic Percent of Cost Total Health Engagement - % of Pop Preventive Care Utilization Well Visit Completions Health Assessment Completions Gaps in Care Rule Compliance Pharmacy Indicators Generic Dispensing Rate Generic Substitution Rate Specialty Plan Spend PMPM (Rx Only) Specialty Plan Spend PMPM (Med Only) Non -Specialty Plan Spend PMPM (Rx only) Prescriptions PMPY(Retail adjusted) 84.2% 91.4% 20.9% 34.5% 26.2% 0.4% 100.0% 91.1% 98.5% $57.01 $45.13 $25.53 6.75 87.8% 95.0% 26.0% 39.1 % 27.9% 0.0% 0.0% 93.4% 99.4% $31.91 $67.30 $20.01 6.21 3.6% 3.6% 5.1% 4.6% 1.7% -0.4% -100.0% 2.3% 1.0% -44.0% 49.1 % -21.6% -7.996 47.0% 78.7% 42.3% 53.1 % 42.9% 14.6% 80.9% 92.0% 98.3% $93.55 $36.58 $105.50 16.07 8/20/2apptg22mtlects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 62¢g City of Miami Solicitation RFP 1896386 . =i Executive Summary CI5Yl Total with Over 65 Retirees Medical & Rx Spend N. i��� $492 $200 $400 :rs4 PMPM Spend • Employer Paid - Medical • Member Paid - Medical Employer Paid - Pharmacy ■ Member Paid - Pharmacy Demographics & Financial Members Average Number of Employees Average Number of Members Av erage Employee Age Cost Trend Plan Spend - Medical Plan Spend - Pharmacy Total Plan Spend Medical Plan Spend PMPM Pharmacy Plan Spend PMPM Total Plan Spend PMPM Performance Indicators Cat Claimants in Excess Per K Cat Plan Spend PMPM(Med+Rx) Non -Cat Plan Spend PMPM(Med + Rx) Network Penetration Base Current Trend 2,212 2,220 0.4% 4,406 4,391 -0.3% 50.4 50.7 0.6% $30, 657, 328 $9,101,996 $39, 759, 324 $579.86 $172.28 $752.14 $33, 851, 390 10.4% $10, 768, 568 18.3% $44, 619, 958 12.2% $642.40 10.8% $204.49 18.7% $846.89 12.6% 9.8 13.2 35.3% $215.16 $285.87 32.9% $536.98 $561.02 4.5% 97.4% 97.8% 0.4% Norm $535.44 $199.05 $734.49 10.4 $198.50 $535.99 98.8% Medical & Rx Trend Total Plan Spend Total Employer Paid Total Member Paid Medica Ss -nd PMP a' Employer Paid - Medical Pharmacy Spend PMPM Empl:; acy Current PMPM $837.97 $795.63 $42.34 $642.40 $608.31 $195.57 Trend 12.6% 13.4% -0.5% 10.8% 11.5% 18.9% 20.0% Variance from Norm 14.1% 17.2% -23.8% 20.0% 23.6% -1.7% 0.4% Population Health & Pharmacy Base Current Trend Norm Population Health Measures Chronic Percent of Population Chronic Percent of Cost Total Health Engagement - % of Pop Preventive Care Utilization Well Visit Completions Health Assessment Completions Gaps in Care Rule Compliance Pharmacy Indicators Generic Dispensing Rate Generic Substitution Rate Specialty Plan Spend PMPM (Rx Only) Specialty Plan Spend PMPM (Med Only ) Non -Specialty Plan Spend PMPM (Rx only) Prescriptions PMPY(Retail adjusted) 52.4% 79.7% 46.1 % 57.2% 49.5% 0.6% 82.4% 54.8% 82.8% 47.6% 55.3% 47.0% 0.4% 83.1 % 91.8% 92.4% 97.3% 98.5% $94.62 $106.93 $51.41 $60.94 $74.12 $93.31 14.68 15.17 2.4% 3.1% 1.5% -1.9% -2.5% -0.2% 0.7% 0.6% 1.2% 13.0% 18.5% 25.9% 3.4% 47.0% 78.7% 42.3% 53.1 % 42.9% 14.6% 80.9% 92.0% 98.3% $93.55 $36.58 $105.50 16.07 8/20/QOpptg22mtlects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 62§0 City of Miami Solicitation RFP 1896386 Behavioral Health Summary Key Metrics Total Membership Average Number of Employees Average Number of Members Behavioral Health Members Average Number of Claimants Mental Health Substance Use Disorder Catastrophic Claimants(>$100kin BH) Av erage Age Behav ioral Virtual visits ABA Claimants Happify Unique Users Happify Active Users iPrev ail Unique Users Total iPrev ail Activities Base Current Trend 2,003 2,020 0.8% 4,154 4,151 -0.1 % Behavioral Health Claimants 100% 75% 50% 25% 10% 10% 0% • ■ Percent of Total Membership 53% 52% Employ ee 15% 13% • Spouse % of Behav ioral Health Claimants Clinical & Member Interactions Engagement Types Customer Engagement Health Care Prov ider Engagement Access and Crisis Support Customer Advocacy Total Interactions Unique Members w/ clinical interaction Percent of Membersw/ clinical interaction 430 412 -4.1 % 425 406 -4.4% 11 15 38.1% 2 1 -50.0% 36.1 36.1 -0.0% 2,319 1,975 -14.8% 9 15 66.7% 12 7 -41.7% 8 5 -37.5% 7 0 -100.0% 39 0 -100.0% ■ Base ■ Current 98% 97% 33% 35% I I Dependents Member Network Utilization Base Current Trend 82 88 7.3% 266 219 -17.7% 332 378 13.9% 890 827 -7.1 % 1,570 1,512 -3.7% 469 492 4.9% 11.3% 11.9% 5.0% Top Conditions by Prevalence Reactive Stress Disorders Anxiety Depression ADD/ADHD Autism 2% 3% 8% 7% 27% 31% 29% 26°k 25% 22% 0 Base % Behavioral Health Members Curr%of Behavioral Health Members • 10% of the total membership had a claim with a behavioral health provider i nthe current period • Average age of employeeswith behavioral health claimswas 45.7 years • Virtual Care utilization with behavioral providers decreased by -14.8% i nthe current period. There were 0 MD Live behavioral visits, 25 Talkspace visits, and 0 Headspace Care visitsduri ng the current period • 11.9% of the total population hada behavioral healthinteraction during the current period Current Period reflects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 8/2(A.12,FV27J4rARfits claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna Healthcare. ci 31 p. 627 City of Miami Solicitation RFP 1896386 .,$0, Behavioral Health - Customer & Clinical Interactions cinQ Behavioral Interactions Summary Interaction Type Customer Engagement Health Care Prov ider Engagement Access and Crisis Support Customer Advocacy Total Interactions Unique Customers Engaged Description Outreaching and coaching customers to better manage their behavioral conditions Includescoaching and care managementforsubstance use disorders, eating disorders, autism, intensive care management, bipolar, lifestyle management programs Collaborating with healthcare providers to provide optimal care Includesinpatient and outpatient utilization management andcomplex psychiatric case management& narcoticstherapy management Offering behav ioral triage and after hours support to customers who reach out to of are transferred to behav ioral health Includes behavioral intake and assessment, emergentreferrals(seen in less than 6 hours), referral to a care manager, referral to an outpatient provider and coordinated appointment scheduling Fielding customer requests Includes benefit information and clarification, claimsstatusand adjustment requests, collaboration with CCC and other health providers Number of Interactions Customers Engaged 88 14 219 92 378 107 827 208 1,512 492 8/20/2O tg2 42(Mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 62§2 City of Miami Solicitation RFP 1896386 di'ria Member Cost Share Cost sharing per member - medical only $60 $45 $30 $15 $0 . I. Deductible/Copay Coinsurance Total Base $23 $12 $35 Current $23 $13 $35 Norm $31 $12 $43 Cost share as % of total plan spend - medical only 12% 9% 6% 3% 0% Deductible/Copay Coinsurance Total Base 3.9% 2.1% 6.0% Current 3.5% 1.9% 5.4% Norm 5.8% 2.3% 8.0% Account summary (PMPM basis) Base Current Trend Plan Costs Total Plan Spend -Medical $593.15 Cost Share - Medical $35.40 $653.60 10.2% $35.40 -0.0% Net Employer Paid -Medical $557.74 $618.20 10.8% • Medical cost share remained at$35.40 PMPM, andcomparesto a norm of $43.10 PMPM • Medical cost share as a percent of total plan spend decreased from 6.0%to 5.4%, and comparesto a norm of 8.1 % 8/20/2O tg2 42(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 62g3 City of Miami Solicitation RFP 1896386 Total Plan Spend by Condition g cin .illy,. Top conditions by plan spend 28.0% U¢ 21.0% 0 14.0% 7.0% 0.0% Base Current Norm Neoplasms Musculoskeletal Gen Med Diag Circulatory Gastrointestinal Neurological End/Nutr/Metab Renal/Urologic Int/Ext Injury Pregnancy All Other Top ICD conditions PMPM Claimants per 1k Spend per Claimant Trend ICD Category Base Current Contributio Norm Base Current Trend Base Current Trend n Neoplasms $78.37 $124.83 8.6% $73.54 182.5 191.3 4.8% $5,153 $7,831 52.0% Musculoskeletal $55.92 $69.70 2.6% $66.60 285.5 295.8 3.6% $2,350 $2,827 20.3% Gen Med Diag $55.07 $49.11 -1.1% $40.68 828.4 711.9 -14.1% $798 $828 3.8% Circulatory $46.41 $47.77 0.3% $42.17 214.5 223.8 4.3% $2,596 $2,561 -1.4% Gastrointestinal $48.79 $43.07 -1.1% $40.41 177.2 184.8 4.3% $3,304 $2,797 -15.4% Neurological $23.20 $32.94 1.8% $30.56 118.7 134.7 13.5% $2,346 $2,935 25.1% End/Nutr/Metab $27.00 $25.40 -0.3% $18.23 321.2 339.4 5.7% $1,009 $898 -11.0% Renal/Urologic $18.68 $22.04 0.6% $17.17 116.0 117.6 1.3% $1,932 $2,250 16.5% Int/Extlnjury $25.20 $21.51 -0.7% $20.84 84.0 85.5 1.8% $3,599 $3,018 -16.1% Pregnancy $25.28 $20.69 -0.9% $22.17 25.5 22.9 -10.3% $11,886 $10,851 -8.7% All Other $135.20 $141.13 1.1% $122.29 1449.6 1436.5 -0.9% $1,119 $1,179 5.3% Total $539.12 $598.18 11.0% $494.66 957.9 910.4 -5.0% $6,753 $7,885 16.8% 8/20/2O tg2 42(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 63g4 City of Miami Solicitation RFP 1896386 '``' Population Demographic Summary cing Percent ofmembership by age band 20% 15% 10% 5% 0% Base Current Norm - Demo Fact <1 1-17 18-29 30-39 40-49 50-59 60-64 Percent ofplan spend by age band 28% 21% 14% 7% 0% Base ■ Current Norm Al I u 65+ <1 1-17 18-29 30-39 40-49 50-59 60-64 65+ 4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0 Key metrics overview Base Current Trend Norm Percent of Pop. Age 40+ 47.5% 48.6% 1.1% 48.4% Average MemberAge 36.6 37.2 1.6% 37.6 Average EmployeeAge 48.0 48.4 0.9% 48.2 Percent of Population Male 48.7% 49.1% 0.4% 52.1% Percent of Population Female 51.3% 50.9% -0.4% 47.9% Average spend by age band Base Current Trend Norm All Members 40-49 $868 $845 -2.7% $733 50-59 $1,006 $1,197 18.9% $1,061 60-64 $1,322 $1,571 18.8% $1,306 65+ $1,606 $1,842 14.7% $998 Excluding Catastrophic 40-49 $621 $654 5.3% $570 50-59 $693 $746 7.7% $746 60-64 $900 $979 8.8% $887 r mnr_n N011fl AO/ Reno VJ� y.7VV yuctc -/ .V /0 yV.7V • Average memberageincreased from 36.6 yearsto 37.2 years, an increase of 1.6% • The percentage of membersin the 40+ age range i ncreased from 47.5% to 48.6%, and comparesto a norm of48.4% 8/20/2O tg2 42(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 631; City of Miami Solicitation RFP 1896386 Population Demographics by Relationship clog Percent of members by relationship 60% 45% 30% 15% 0% Base Current Norm 1 Employee Spouse Dependent Percent ofplan spend by relationship 60% 45% 30% 15% 0% Base ■ Current Norm 1 I I Employee Spouse Dependent Average spend by relationship Base Current Trend Norm Employee $921 $1,067 15.9% $824 Spouse $1,040 $1,076 3.5% $989 Dependent $437 $483 10.4% $401 Excluding Catastrophic Employee $691 $717 3.8% $606 Spouse $675 $736 9.0% $726 Dependent $315 $320 1.7% $300 • Em pl oyees represented 48.7%of the population and 60.0%of spend forthe current period, versusnormsof 50.7% and 57.9% • By relationshiptype, spousesincurred higher per member coststhan employees, $1,076 PMPMforthe current period • Excluding Catastrophic Claimants, spouses incurred higher perm ember costs compared to employees, $736 PM PM forthe current period 8/20/2Opptg2 42(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 632, City of Miami Solicitation RFP 1896386 Episode Treatment Group Summary ci ng 60% 45% 30% 15% 0% Distribution of members by category Distribution of cost by category 0. 100% 75% 50% 25% •• 0% 111 • 1 Chronic Maternity Major Minor Healthy NonUser Chronic Maternity Major Minor Healthy Base 50% 1% 15% 14% 12% 7% Base 79% 2% 13% 4% 1% Current 53% 1% 14% 14% 8% 11% Current 82% 1% 12% 4% 1% Norm 47% 1% 16% 17% 7% 12% Norm 79% 2% 14% 4% 1% Non -User Information Base Current Average Age 32.0 32.9 Demographic RiskScore 0.93 0.96 Gender Distribution % Male 66.9% 64.4% Male Average Age 32.8 33.6 Male Average Enrollment 9.3 10.0 % Female 33.1% 35.6% Female AverageAge 30.3 31.7 Female Average Enrollment 8.0 9.1 Distribution of diabetes medical cost by type Type 1 Diabetes 48.9% Type 2 Diabetes 41.9% PreglLabor 8.6% Other 0.6% 8/20/2Opptg22mtlects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 6337 City of Miami Solicitation RFP 1896386 Inpatient Summary cing Utilization metrics per 1,000 members 320 240 160 80 0 Admits Bed Days Base 48.9 225.6 Current 58.3 274.2 Norm 61.4 317.3 Average cost metrics $28,000 $21,000 $14,000 $7,000 $0 Base Current Norm 1 PerAdmit Per Bed Day $23,415 $5,073 $27,632 $5,876 $25,904 $5,012 Account summary (PMPM basis) Non -Catastrophic Inpatient Catastrophic Inpatient Total Inpatient All Other Servi ce Categories Total Plan Cost Trend Base Current TrendContribution $45.90 $56.20 22.4% 1.3% $57.19 $79.09 38.3% 2.8% $103.09 $135.29 31.2% 4.2% $666.43 $730.63 9.6% 8.3% $769.52 $865.92 12.5% • Non -catastrophic i npati entcostsi ncreased from $45.90 PMPM to $56.20 PMPM, contributing 1.3% of the overall 12.5% plan trend • Utilization increased from 48.9to 58.3 admitsperthousand andincreasedfrom 225.6 to 274.2 bed daysperthousand • Cost per admit increasedfrom $23,415 to $27,632andincreased for bed days from $5,073 to $5,876 8/20/2O tg2 42(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 6343 City of Miami Solicitation RFP 1896386 Inpatient - Major Diagnostic Category Summary clog Cost & utilization trends (excluding catastrophic) $PMPM Admits Per 1,000 Days Per 1,000 Cost Per Case Base Current Trend Base Current Trend Base Current Trend Base Current Trend Pregnancies $9.29 $7.82 -15.8% 9.9 8.2 -17.0% 29.1 21.7 -25.6% $11,300 $11,461 1.4% Musculoskeletal $2.47 $6.65 169.6% 1.4 3.4 133.5% 3.6 15.4 326.9% $20,480 $23,645 15.5% Circulatory $2.40 $6.17 157.5% 1.9 4.3 125.1% 3.9 15.7 306.5% $14,934 $17,081 14.4% Nervous $1.59 $5.92 271.0% 1.9 2.6 37.6% 20.5 13.7 -32.9% $9,937 $26,799 169.7% Metabolic $4.85 $5.76 18.8% 3.9 2.4 -37.5% 8.4 5.8 -31.4% $15,107 $28,686 89.9% Other $25.30 $23.88 -5.6% 19.7 18.3 -7.3% 63.1 64.1 1.6% $13,648 $15,540 13.9% Total Non -Cat Catastrophi c $45.90 $56.20 22.4% 38.8 39.3 1.3% 128.6 136.4 6.1% $13,329 $17,122 28.5% $57.19 $79.09 38.3% 10.1 19.0 88.2% 97.0 137.8 42.0% $62,076 $49,318 -20.6% Total $103.09 $135.29 31.2% 48.9 58.3 19.3% 225.6 274.2 21.5% $23,415 $27,632 18.0% • Pregnancieswasthe top category by plan cost in the current period. Pregnanciescost decreased from $9.29 PMPM to $7.82 PMPM, a decrease of 15.8% • Cost per case for the Pregnanciescategory increased from $11,300 to $11,461, an increase of 1.4% • Plan cost for non-catastrophicincreased from $45.90 PMPM to $56.20 PMPM, an increase of22.4% 8/20/2O tg2 42(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 63§g City of Miami Solicitation RFP 1896386 Inpatient Maternity clog Maternity admits utilization per 1,000 Newborn admits utilization per 1,000 8 6 4 2 0 Vaginal Cesarean Other Base 4.8 4.8 0.0 Current 4.1 4.1 0.0 Norm 5.4 3.2 0.8 3.32 2.49 1.66 0.83 0.00 Base ® Current Norm • Normal 2.2 2.6 3.3 Premature 1.0 0.5 0.7 Average payment per maternity admit Newborn admit average cost $20,000 $15,000 $10,000 $5,000 $0 Base Current Norm Vaginal Cesarean Other $8,007 $14,223 $0 $9,737 $13,185 $0 $10,711 $16,608 $16,150 $152,000 $114,000 $76,000 $38,000 $0 Base • Current Norm Full Term Comp. 2.6 2.4 2.9 Full Term Normal Premature Comp. $975 $74,542 $8,323 $1,335 $151,016 $15,712 $2,575 $86,900 $11,724 8/20/2O tg2 42(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 63&p City of Miami Solicitation RFP 1896386 '``' Top Outpatient Surgeries c Oct Outpatient surgical details Plan Spend PMPM Visits per 1k Trend Type of Surgery Base Current Contributio Norm Base Current Endoscopy $19.71 $21.05 3.24 $22.34 61.9 61.9 Cataract $4.50 $4.43 -0.2% $1.78 4.8 6.0 CardiacCath $4.08 $3.26 -1.9% $5.63 2.7 3.4 Upper GI $2.75 $2.71 -0.1% $3.77 9.6 9.2 Ovary Removal $5.21 $1.70 -8.3% $2.30 3.4 1.0 Hernia Repair $2.28 $1.50 -1.8% $1.65 2.2 1.0 Carpal Tunnel $1.08 $1.41 0.8% $0.79 2.4 1.5 Tonsils $0.49 $0.65 0.4% $1.34 1.0 1.2 Breast $0.07 $0.47 0.9% $0.29 0.2 0.7 Skin $0.82 $0.46 -0.8% $0.70 14.7 14.2 All Other $1.39 $0.57 -1.9% $1.38 1.7 1.7 Avg. Spend per Visit Average Ape Base Current $3,823 $4,080 $11,205 $8,826 $18,495 $11,602 $3,430 $3,557 $18,544 $21,124 $12,611 $18,732 $5,385 $11,740 $6,151 $6,515 $3,626 $7,874 $668 $388 $9,881 $4,090 Base Current 52.3 52.5 65.2 62.7 52.6 59.4 52.7 45.8 45.0 46.3 57.8 51.3 52.1 47.0 4.8 17.4 17.0 41.3 54.5 55.0 36.0 24.4 Total $42.38 $38.21 -9.8% $41.97 104.5 101.6 $4,867 $4,512 51.8 51.4 Endoscopy procedures per 1,000 60.0 45.0 30.0 15.0 0.0 Colonoscopy Bladder Uterus Joint Gall Bladder Base 40.4 10.6 5.5 3.9 1.4 Current 42.6 8.9 6.7 3.1 0.5 Norm 45.9 10.2 4.3 6.1 1.8 • The total cost of the surgeries, including facility and professional costs have been i ncl uded i n this exhi bit • Endoscopy was the top surgery by plan spend inthe current period. Endoscopy spend increased from $19.71 PMPMto $21.05 PMPM, an increase of 6.8% • Ovary Removal had the greatest impact on overall trend, contributing -8.3% 8/20M112i4P.(27x Mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 6341 City of Miami Solicitation RFP 1896386 -��- Outpatient - Emergency Room and Urgent Care Detail cina Facility outpatient utilization per 1,000 members 460 345 230 115 0 Base Current Norm 1 • ER Urgent Care 270.6 418.9 276.1 444.2 241.9 323.2 Facility outpatient cost per visit $3,000 $2,250 $1,500 $750 $0 Base Current Norm ER Urgent Care $2,825 $491 $2,810 $482 $2,765 $206 Account summary (PMPM basis) Trend Base Current Trend Contribution Emergency Room $63.70 $64.64 1.5% 0.1% Urgent Care $17.13 $17.86 4.3% 0.1% Total Outpatient Facility $204.03 $213.48 4.6% 1.2% Total Plan Cost $769.52 $865.92 12.5% 12.5% • Emergency room costsincreased from $63.70 PMPMto $64.64 PMPM, contributing0.1%ofthe overall 12.5%plantrend • Urgent Care was the largest category of utilization. Utilization perthousand increased from 418.9 to 444.2, and comparesto a norm of 323.2 • Emergency room wasthe largest average cost category. Cost pervisit decreased from $2,825 to $2,810, and comparesto a norm of $2,765 8/20/2O tg2 42(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 6342 City of Miami Solicitation RFP 1896386 Emergency Room/Urgent Care Opportunity ci ng Cost & utilization trends Visits Per 1000 Cost Per Visit PM PM Cost Share % Base Current Trend Base Current Trend Base Current Trend Current Emergency Room Non-Steerable 215.7 226.7 5% $3,233 $3,139 -3% $58 $59 2% 6.0% Steerable 54.9 49.4 -10% $1,222 $1,299 6% $6 $5 -4% 14.4% Urgent Care 418.9 444.2 6% $491 $482 -2% $17 $18 4% 6.4% Office Visits 3,992.4 3,977.4 -0% $157 $157 0% $52 $52 -0% 15.0% Convenience Care 14.0 14.5 4% $33 $27 -18% $0 $0 -15% 28.5% Virtual Care- Medical 46.5 76.4 64% $55 $59 7% $0 $1 82% 2.6% Total 4,742.3 4,788.5 1% $133 $135 1% Emergency Room Steerable Primary Opportunity for Urgent Care Plan Cost PMPM Total Visits Cost Per Visit Musculoskeletal $72,454 $1.45 52 $1,393.35 Ear,Nose,Throat $56,057 $1.13 43 $1,303.66 Respiratory $28,290 $0.57 17 $1,664.12 Infect/Parasit $25,511 $0.51 20 $1,275.56 Skin $19,295 $0.39 15 $1,286.30 Renal/Urologic $18,894 $0.38 15 $1,259.63 Eye $14,130 $0.28 15 $941.98 GenMed Diag $11,191 $0.22 11 $1,017.38 Int/Ext Injury $9,178 $0.18 7 $1,311.13 Other $11,238 $0.23 10 $1,123.85 Total $266,239 $5.34 205 $1,298.73 UC Average Cost Per Visit $384.83 Per Visit Redirect Savings $913.90 Opportunity Redirect Savings 10% Redirect to Urgent Care $18,735 25% Redirect to Urgent Care $46,837 "UC A veraae Cost per visit calculation for Steerable oDDorturrty exdudes outliers > $1.500 Urgent Care - nearest facility 0-5 miles 1 nn% • Current period urgent care cost pervisit was $482, comparedto emergency room steerable cost pervisit of $1,299 • In the current period, 205 emergency roomvisitswere steerable representing potential redirect savi ngsof up to $187,349 • Of the steerable emergency room visits, 100% had a contracted urgent care facility within 10miles • Steerable emergency room cost share percentageis14.4%, compared to urgent care at 6.4% 8/20/(1Q-%4it9?ai4dkMects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 p. 63 3 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 City of Miami Solicitation RFP 1896386 cina Office Visits Office visits per 1,000 members Average plan cost per office visit 8,000 $200 6,000 $150 4,000 $100 2,000 $50 0 $0 Primary Care Specialist Total Base 1,904.3 2,087.6 3,992.4 Base Current 1,866.5 2,110.6 3,977.4 Current Norm 2,003.5 2,019.3 4,023.0 Norm % of individuals continuously enrolled for at least 12 months who did not see a PCP/SPC 80% 60% 40% 20% 0% All <18 18-39 40-49 50+ f+ No OV 22% 16% 35% 22% 13% • % Employee 41% 0% 26% 77% 75% % Female 37% 49% 36% 33% 34% 1 1 Primary Care Specialist Total $130 $182 $157 $136 $176 $157 $132 $183 $158 • 81%of individualsages40 and above received care from a PCP and or Specialist in thecurrent period • 48% of individualsages40 and above received an annual physical inthe current period • Plan spend forSpecialistsin the current periodwas$31 PMPM compared to $21 PMPM for Primary Care Physicians • Specialist Evaluation & Managementcost remainedat$23 PMPM 8/20/2O tg2 42(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 64Q City of Miami Solicitation RFP 1896386 ci nCigna Health Matters - Engagement Index Summary 0 Total health engagement as a % of population Base Norm - 42% Current • Cigna'sHealth MattersEngagement Index providesgreaterinsight i nto engagement across all of the health andwellnessprogramsand servicesCigna offers • In the current period 49%of the total population hasengaged intwo or more Health Maintenance actionsorone or more Health Improvementactions. Thisisan increase of 2% from the base period of 47%. Thiscomparesto a norm of 42% • When engagement issplit i nto Health Maintenance and Health Improvement activities, 45% of the populationhascompleted2 or more Health Maintenance activities, and 8% of the population completed 1 or more Health Improvement activitiesduringthe currentperiod, com pared to 45% and 7% respectively in the base period • When the population issplitintosegmentsusing ETGmethodology, the Chronic III nesssegment had the greatest overall engagement at 66%forthe current period Engagement by behavior type and population segment Segment Chronic Illness Major Episode"/ Maternity Minor Episode"" Healthy""" Non User Total *Major Episode >$500 per episode **Minor Episode <$500 per episode Health Maintenance (HM) (2+) Base Current Norm 57% 60% 71% 54% 47% 60% 40% 39% 50% 16% 26% 44% 7% 5% 6% 45% 45% 40% Health Improvement (HI) (1+) Base Current Norm 13% 15% 14% 2% 3% 3% 0% 1% 1% 1% 0% 1% 1% 0% 0% 7% 8% 5% Total Engagement (2+ HM or 1+ HI) Base Current Norm 62% 66% 76% 55% 48% 61% 40% 40% 50% 17% 26% 44% 8% 5% 6% 47% 49% 42% 8/20/2O tg242(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 641 City of Miami Solicitation RFP 1896386 '``' Engagement Index - Top Activities c Oct Top engagement activities Health Maintenance 2% 2% 2% 20%� 28% 46% Preventive Care Dental Cleaning Gapsin Care Goal Set -Phone • EAP Interaction Other 26% Health Improvement 9% 1% 60% Gapsin Care Specialty Case Management Goal Set -Phone Treatment Decision Support • Pre/Post Admission Counseling • It is i mportant to understand the activitiesthat drive engagement. The graph aboveillustratesthe activitiesmost often com pleted for both Health Maintenance and Health Improvementforthose individuals meetingthe engagement criteria. • Top Health M ai ntenance activiliesforthose meeting the engagement criteria in the current period were, Preventive Care at 46%, Dental CI eaning at 28% and Gaps i n Care at 20% . Top Other activities nclude Onsite Lunch and Learn at 1% , Appsand Activities at 1% • Top Health I m provem ent activitiesfor those meeting the engagement criteria in the current periodwere, Gaps i n Care at 60% , Specialty Case Management at26%and Goal Set- Phone at 9%. 8/20/201".(2*AMects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 6446 City of Miami Solicitation RFP 1896386 Well Informed Gaps in Care - Summary cinQ Rule compliance summary Compliance by condition 100% 75% 50% 25% 0% Current Norm Non -Compliant Compliant 16.9% 83.1% 19.1% 80.9% Demographics - members with gaps 340 255 170 85 0 <01 01-17 18-29 30-39 40-49 50-59 60-64 65+ Male 0 167 231 125 184 305 158 91 Female 0 158 232 167 220 333 160 70 100% 75% 50% 25% 0% • Current * Norm Obesity HTN 99% 99% HPL Diabetes URI 87% 94% 84% 83% 85% 92% 83% 79% • 3,958 membersqualified fora gapin care evaluation, with 1,357 compliant and 2,601 non -compliant with evidence -based medicine guidelines • 83.1% of rulesevaluatedwere compliantwith evidence -based medicine guidelines, compared to a norm of 80.9% • The greatest number of memberswith gapswasfound in the 50-59age band, with 638 total members • The Diabetescategory hadthe greatest rate of multiplegaps(2 or more), 63% 8/20/2O242 1tMects Well Informed Gaps in Care program activity between Jan.2023 and Dec.2023 p. 6447 City of Miami Solicitation RFP 1896386 Cigna Health Matters - Your Health First claw Total health engagement as a percent of population 80% 60% 40% 20% 0% Base Current Norm Engagement as a percent of Engagement as a percent of total population identified population 47% 62% 49% 63% 42% 59% • Cigna'sHealth Mattersprioritizesforcoachesthe health risksthata customer should work on and predictsoptimaloutreachto customers(phone, or email/text) which guidesthem to the health programsthat custom ers prefer (online or live coaching). The Identified Population are outreached membersand self -identified customers. YHF focuses on individualsholistically -bringing together lifestyle, social, and behavioral supportforindividuals. • The overall population had an engagement rate of 49% inthe current period. The Identified population had an engagement rate of 63%in thecurrent period, an increase of2%from the base periodof62%.Thiscomparesto a norm of 59% • There were 1,364 membersengagedacrossYHF coaching services. The mode with the greatest engagementduri ng the current period was Preventive Care at 64% Identified and engaged by program Engagement by modality for identified population Sery ice Type Identified / Total Population Engaged / Identified Count of Individuals Curr% Norm% Curr% Norm% Chronic Condition Coaching 1,713 41.3% 42.6% 65.0% 58.5% Lifestyle Coaching 1,010 24.3% 24.7% 69.4% 68.6% Wellness Coaching 1,012 24.4% 22.8% 68.1% 68.9% Treatment Decision Support 156 3.8% 4.3% 73.7% 63.5% Case Management 52 1.3% 0.2% 82.7% 72.7% Employee Assistance Program 0 0.0% 0.0% 0.0% 100.0% Total Unique 2,159 52.0% 54.1% 63.2% 59.4% 80% 60% 40% 20% 0% Prev entive CareAlert with Action Telephonic Onsite All Other Base 67% 21% 9% 1% 2% Current 64% 25% 8% 2% 1% Norm 63% 18% 4% 3% 12% 8/20/2O tg2 2(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 64 City of Miami Solicitation RFP 1896386 .air. clog Chronic Conditions - Engagement Detail Current period detail Condition Asthma COPD Congestive Heart Failure Coronary Artery Disease Depression Diabetes Low Back Pal n Osteoarthritis Peripheral Arterial Disease Weight Complications Identified/ Total Population Count of Individuals 310 55 1.3% 83 2.0% 246 5.9% 465 11.2% 521 12.6% 388 183 4.4% 35 0.8% 450 10.8% Curr % 7.5% 9.3% Norm % 9.1% 2.1% 2.4% 8.5% 20.2% 14.8% 11.9% 8.0% 1.2% 14.7% Total Unique 1,713 41.3% Engaged / Identified Engaged / Identified Norms HM % 54.5% 56.4% E 55.4% 54.9% 60.2% 54.3% 61.3% 55.7% 40.0% 68.7% 42.6% 57.7% HI % 15.5% 20.0% 47.0% 30.9% 15.9% 35.7% 16.5% 25.7% 28.6% 16.0% Total Eng 61.9% 63.6% 74.7% 66.7% 67.5% 67.6% 67.0% 65.6% 48.6% 74.7% 18.0% 65.0% HM % 54.7% 46.7% 45.3% 49.9% 59.9% 52.4% 61.0% 54.7% 42.4% 67.9% HI oil 13.1% 17.5° 26.9° 20.9°° 9.9% 26.2%111 10.8% 13.9% 21.2% 11.0% otal Eng 59.5% 53.9% 57.0% 58.0% 62.7% 61.7% 64.2% 59.1% 50.4% 70.6% 54.3% 11.8% .58.5% Engagement by modality for chronic identified 80% 60% 40% 20% 0% Current Norm Preventive Alertwith Telephonic Digital Care Action 63% 25% 9% 1% 56% 18% 7% 16% All other 1% 5% • Chronic conditionsare a significant driver of medical cost and reduced productivity • In the current period, predictive models have identified41.3%ofthe population with a chronic condition, compared to 39.7%i n the base period • Of those identified, 65.0%were engagedin current period, compared to 60.9% in the base period and ishigherthanthe norm of58.5% • There were 1,113 membersengagedacrossthe chronic coaching service. The mode with the greatest engagement duringthe current periodwasPreventiveCare at 63% 8/20/2O tg2 2(Mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 64.M, City of Miami Solicitation RFP 1896386 .air. ci n YHF - Lifestyle, Wellness and Treatment Decision Support i Lifestyle Coaching Stress Tobacco Weight Identified/ Total Population Count of Curr % Norm % Indiv iduals 38 0.9% 2.1% 10 0.2% 1.2% 996 24.0% 33.8% Total Unique Wellness Coaching Healthy Eating Physical Activity Hypertension Hyperlipidemia Prevention Pre -Diabetes Mai ntaini ng a Healthy Lifestyle 1,010 24.3% 24.7% Identified/ Total Population Count of Individuals 42 1.0% 51 1.2% 388 171 4.1% 427 10.3% 293 7.1% 164 4.0% Total Unique Treatment Decision Support Benign Uterine Prostate/Breast Cancer Coronary ArteryDis. Low Back Pai n OsteoarthritisHip OsteoarthritisKnee 1,012 9.3% Curr % Norm % 2.4% 2.0% 14.6% 4.1% 6.0% 11.7% 1.0% 24.4% 22.8% Identified/ Total Population Count of Individuals 11 0.3% 0 0.0% 82 2.0% 24 0.6% 18 0.4% 46 1.1% Curr % Norm % 0.2% 0.0% 2.0% 0.5% 0.7% 1.4% Engaged / Identified Total Eng HM % 71.1% 70.0% 63.3% 63.2% H1/011111 23.7% 20.0% 19.1% 11LO% 73.7% II 70.0% 69.6% 69.4% Engaged / Identified HM % 76.2% 74.5% 54.1% 57.9% F 64.9% 65.2% F 76.2% 60.1% Total Unique 156 3.8% 4.3% HI 26.2% 25.5% 31.2% 33.3% .% 0.4% 2 ITotal Eng 83.3% 82.4% 67.5% 73.1% 69.3% 70.6% 77.4% 68.1% Engaaed / Identified HM %411 81.8% 0.0%19 62.2% 66.7% 72.2% 56.5% 64.1% rrHI 3 % 18.2% 0.0% 41.5% 29.2% 11.1% 28.3% 4.0% otal Eng 81.8% 0.0% 75.6% 70.8% 72.2% 63.0% 73.7% Engaged / Identified Norms HI 16.1% 16.1% 11.8% 11.9% HM % 85.1% 76.1% 66.7% 65.3% Total Eng 86.5% 78.9% 69.8% 68.6°/g Engaged / Identified Norms HM % 89.3% 93.8% 58.7% 66.2% 78.5% 66.8% 93.3% 64.7% HI 18.0% 16.7% 17.5% 28.7% 15.8% 10.6% 15.6% 14.6% [Total Eng 90.4% 94.5% 64.4% 75.0% 80.7% 69.3% 93.7% 68.9% Enaaaed / Identified Norms HM % 83.6% mi 53.9% 63.2% 56.3% 57.2% 57.8° 100.0% HI % 14.4% 0.0% 4.4% 20.0% 16.2% 16.1% . 19.6% Total Eng 84.4% 100.0% 61.6% 68.2% 61.1% 61.4% 63.5% 8/20/202 tg2 42(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 646 City of Miami Solicitation RFP 1896386 '``' Health Advocacy - Utilization Management cinq Inpatient utilization management summary Unique Members Events Savings($) % of Members Base Current Base Current Base Current Base Current Pre -Certification AdmissionsAvoided 20 13 22 14 $416,541 $268,015 0.48% 0.31% Inpatient Utilization Mgmt. Decertified Days 11 6 39 11 $144,807 $40,843 0.26% 0.14% Bed Day Intensity Mgmt 3 3 16 2 $22,144 $2,076 0.07% 0.07% ReadmissionsAvoided 2 0 $46,426 $0 0.00% 0.00% Total - Precert+ IP UM 32 21 79 27 $629,917 $310,934 0.77% 0.51% Outpatient utilization management Unique Members Requests Avoided Savings($) % of Members Base Current Base Current Base Current Base Current Base Current MRI 316 297 454 410 150 48 $164,250 $52,560 7.61% 7.15% PET 19 25 24 32 7 4 $21,483 $12,276 0.46% 0.60% CT 227 188 317 256 80 22 $79,200 $21,780 5.47% 4.53% DME 4 4 6 4 1 2 $3,501 $7,002 0.10% 0.10% Medicallnjectables 47 46 73 58 8 5 $24,840 $15,525 1.13% 1.11% Total Medical Cost Management(TMC) 207 200 $156,179 $91,663 4.98% 4.82% Other 143 123 238 176 114 93 $96,330 $78,585 3.44% 2.96% Total 796 750 1112 936 360 174 $545,783 $279,391 19.16% 18.07% 8/20/2O tg2 42(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 64gi City of Miami Solicitation RFP 1896386 Health Advocacy - Total Medical Cost Management cinq Total Medical Cost Management Management Program Description Radiation Therapy Through partnership with eviCore, Cigna customersreceive endto end Episode of Care managementfortargetedcancerdisease profiles, spanningfrom referral base (radiation oncologist) to treatment (therapy) to the final delivery of radiological dose. Cardiology Management Through a eviCore partnership, Cigna outpatient nuclear cardiology, cardiac cath and stress echo precertificationsare clinically reviewed to ensure compliancewith our best practice clinical guidelines. Sleep Therapy Cigna partnerswith evi Core to i m prove the overall quality and cost of sleep services through precertification requirements, movement of studiesfrom an outpatientto hom e setti ng (whi ch drives effi ciency without sacrifi cing efficacy), and end to end clinical management of obstructive sleepapnea. Physical Therapy Cigna ensuresappropriatecustomeraccessto outpatient physical therapy/occupational therapy (PT/OT) care by incorporating evidence -based clinical coverage standards; Medical Necessity Reviews(MNR)are conducted for both Participating and Non -Participating PT/OT practitioners. Chiropractic Sery ices Cigna ensu res appropri ate custom er accessto quality chiropractic care by i ncorporating evidence -based clinical coverage standards i n reviewsfor both Participatingand Non -Participating providers. Reviewsfocuson chiropractic care that dem onstrates i nconsi stencieswith recommended clinical evidence. M usculoskeletal/Pain Cigna works with evi Core healthcare to provide quality, cost-effective servicesto Management customers for sel ect inpatient and outpatient musculoskeletal and pain management services. This program helpseliminate excess uti I ization when services do not meet evidence -based guidelinesto help improve clinical outcomes. Genetic Testing Genetic counseling sessionsadministered priorto genetic testing help ensure tests are appropriate forthe customer and avoid potentially costly inappropriate testing. Total % of Medical Claims Savings Per Avoided/Events Avoidance/Event Total Sav ings 12 $3,800 $45,600 4 $1,145 $4,580 0 $0 $0 118 $124 $14,662 14 $62 $870 12 $1,852 $22,226 5 $745 $3,725 165 $556 $91,663 0.3% 8/20/2O tg2 42(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 p. 64§2 City of Miami Solicitation RFP 1896386 '``' Health Advocacy - Specialty Case Management cinq AIMIL Specialty case management summary Unique Members Interventions Closed Cases Savings($) % of Members Base Current Base Current Base Current Base Current Base Current Catastrophic 1 2 15 25 1 2 $0 $1,190 0.02% 0.05% Complex 113 85 652 425 204 109 $13,678 $3,842 2.72% 2.05% Maternity 6 4 47 26 6 4 $1,190 $2,884 0.14% 0.10% MedicallnjectableSteerage 4 1 39 16 5 1 $121,672 $0 0.10% 0.02% NICU 7 7 34 187 5 7 $42,653 $62,423 0.17% 0.17% Oncology 20 23 296 449 24 32 $27,900 $160,053 0.48% 0.55% Renal Case Management 1 3 7 20 1 3 $7,475 $22,425 0.02% 0.07% Transplant 6 9 151 129 0 9 $0 $2,056,416 0.14% 0.22% Total 152 130 1,241 1,277 246 167 $214,568 $2,309,233 3.66% 3.13% Case management referral source 9% 1% 16% 75% Other Predictive Model Inpatient Case Management Self -Referred • Specialty case management managed 130 individualsin the currentperiod, or 3.13% of the population compared with 152 or 3.66% i n the base period • 167 cases closed in the current period, generating $2,309,233in savings compared to 246 casesand $214,568i n the base period • Savingswere driven by the Transplant unit contributing$2,056,416 of $2,309,233 current periodsavings • Referralsinto specialty case management were driven primarily by Predictive Model contributing 16%of all referrals 8/20/2O tg2 2(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 6493 City of Miami Solicitation RFP 1896386 Specialty Pharmacy & Medical - Top Therapeutic Class Trend Cigna Therapeutic class trend driver analysis by plan spend Rank Base Current Therapeutic Class Condition 1 1 Ant i-Inflam Disease Modifiers RA/Psoriasis/Crohn's 2 2 Antineoplastics 3 3 Antiv irals, HIV Specific 6 4 Seborrhea/Psoriasis 8 5 Multiple/Lateral Sclerosis 5 6 Gene Therapy Agents 7 7 Vasodilators 10 8 Antiemetic 12 9 Immune Related 4 10 HematopoieticAgents All Other Specialty Cancer Antiv irals, HIV Specific RA/Psoriasis/Crohn's Multiple Sclerosis Spinal Muscular Atrophy Pulmonary Hy pertension Cancer Antiemetic I VI G/I m mune-related Other Blood Disorders Plan Spend PMPM Total Benefit Drug Spend Current Unique Utilizing PMPM Members Members Medical Current Trend $3.69 31 -13.9% $28.57 27 8.0% Base Current Trend Norm Pharmacy $33.04 $49.55 50.0% $30.08 $45.87 $25.62 $39.78 55.3% $30.64 $11.21 $18.70 $15.47 -17.3% $8.84 $15.47 $7.11 $7.39 3.9% $10.22 $7.39 $6.51 $7.11 9.1% $3.89 $4.57 $7.36 $6.70 -9.1% $0.40 $6.70 $7.00 $6.68 -4.5% $1.64 $6.68 $4.62 $6.41 38.6% $0.09 $3.80 $6.15 61.6% $1.97 $1.04 $12.38 $5.28 -57.4% $1.92 $2.29 $22.52 $21.31 -5.4% $40.44 $10.03 $148.67 $171.82 15.6% $130.13 $111.25 - 39 -2.5% - 5 -16.7% $2.53 6 20.0% - 1 - - 2 -33.3% $6.41 5 150.0% $5.10 17 41.7% $2.98 7 - $11.28 144 13.4% $60.57 250 6.8% • The top ten therapy classesaccounted for87.6% ($7,495,700) of the total specialty plan spend($8,556,898) i nthe current period. 8/20/2O tg2 42(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 65g4 City of Miami Solicitation RFP 1896386 .air. agaq Top Therapeutic Class Trend Therapeutic class trend driver analysis by plan spend Rank Base Current Therapeutic Class Condition 1 2 3 4 9 1 2 3 4 5 6 6 7 7 5 8 12 9 10 10 11 11 14 12 13 13 17 14 15 15 Anti-Inflam Disease Modifiers Psoriasis Diabetes HIV Cancer Asthma Seborrhea/Psoriasis Hy poglycemics Antiv irals, HIV Specific Antineoplastics Asthma Related Seborrhea/Psoriasis Vasodilators Gene Therapy Agents Lipid Lowering I nsulins Multiple/Lateral Sclerosis Pituitary Anticoagulants Migraine Contraceptives All Other Plan Spend PMPM Unique Utilizing Members Members Days Supply PMPM Inflation Pulmonary Hy pertension Spinal Muscular Atrophy Cholesterol Diabetes Multiple Sclerosis Growth Hormone Blood thinner Migraine Contraception Base Current Trend $28.53 $21.18 $18.70 $11.14 $5.94 $7.18 $7.07 $7.36 $4.48 $5.46 $5.07 $2.85 $3.22 $2.42 $2.67 $43.08 $45.90 $40.75 $15.47 $11.63 $7.84 $7.44 $6.74 $6.70 $5.83 $5.73 $4.57 $4.15 $3.66 $3.55 $2.64 $39.72 60.9% 92.4% -17.3% 4.3% 32.0% 3.6% - 4.6% - 9.1% 30.1% 4.9% - 9.8% 45.3% 13.7% 46.5% - 1.2% - 7.8% Norm Current $29.82 27 $33.37 465 $8.84 39 $18.95 65 $10.89 669 $10.38 15 $1.76 47 $0.40 1 $5.23 694 $6.98 69 $3.79 4 $2.98 8 $5.03 152 $4.42 59 $2.46 209 $53.76 3,146 Trend - 3.6% 28.1% - 2.5% 12.1% - 5.2% - 25.0% - 11.3% 0.0% 8.4% - 1.4% 0.0% - 42.9% - 3.8% 3.5% - 11.4% - 0.5% Trend Trend 40.2% 13.4% 30.3% 3.9% - 15.0% 5.2% 0.0% 5.3% - 4.0% 2.1% - 10.3% -3.8% 13.3% 5.9% - 13.3% 6.7% 8.8% 0.1% 10.5% 0.8% - 10.9% 7.0% - 23.8% -7.2% 6.4% 4.3% 8.5% 10.5% - 7.3% 1.2% 3.2% 3.6% Total $176.37 $212.32 20.4% $199.05 3,263 0.1% 5.1 % 4.4% • The top 15 therapy classesaccounted for 81.3% ($172.60) of total planspend PMPM$212.32 inthe current period 8/20/QOpptg242mnects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 65g5 City of Miami Solicitation RFP 1896386 .air. ci-na Top Drugs by Spend Top drugs by spend Rank Base Current Drug Name 1 1 Stelara (SRx) 4 2 Ozempic 26 3 Mounjaro 8 4 Humira(Cf) Pen (SRx) 3 5 Ev rysdi (SRx) 2 6 Biktarvy (SRx) 7 7 Uptravi(SRx) 15 8 Rinv oq (SRx) 6 9 Sky rizi Pen (SRx) 20 10 Kesimpta Pen (SRx) 14 11 Farxiga 13 12 Norditropin Flexpro (SRx) 22 13 Jardiance 9 14 Trulicity - 15 Brukinsa (SRx) 56 16 Dupixent Pen (SRx) 5 17 Promacta (SRx) - 18 Kisqali (SRx) - 19 Balv ersa (SRx) 34 20 Entresto Condition Psoriasis Diabetes DIABETES Arthritis Spinal Muscular Atrophy HIV Pulmonary Hy pertension Arthritis Seborrhea/Psoriasis Multiple Sclerosis Diabetes Growth Hormone Diabetes Diabetes Cancer Asthma White Cell Stimulant Cancer Cancer Heart Plan Spend PMPM Plan Spend Unique Members Scripts Base Current Trend Norm Current Base Current Base Current $13.74 $24.74 80.0% $6.55 $1,232,003 6 6 51 65 $6.50 $13.36 105.6% $9.62 $665,110 66 129 402 827 $1.38 $12.90 836.0% $6.21 $642,217 27 115 76 658 $4.34 $7.26 67.2% $9.39 $361,535 5 6 31 52 $7.36 $6.70 -9.1% $0.40 $333,460 1 1 15 13 $8.45 $6.47 -23.4% $2.70 $322,227 12 10 112 85 $4.98 $5.06 1.6% $0.49 $252,147 1 1 12 11 $2.48 $4.72 90.4% $1.64 $234,982 3 4 20 37 $5.34 $4.02 -24.9% $3.50 $199,931 4 2 36 30 $1.81 $3.40 87.6% $0.51 $169,100 1 2 12 20 $2.63 $3.40 29.0% $2.68 $169,058 35 43 256 324 $2.65 $2.98 12.6% $1.40 $148,418 2 2 15 18 $1.60 $2.70 68.7% $4.01 $134,319 27 41 151 253 $3.54 $2.55 -28.0% $4.56 $127,066 30 24 209 148 $0.00 $2.32 0.0% $0.21 $115,344 0 1 0 8 $0.63 $2.30 265.8% $2.39 $114,686 1 3 9 31 $6.12 $2.28 -62.7% $0.83 $113,699 2 1 9 3 $0.00 $2.05 0.0% $0.33 $102,300 0 1 0 6 $0.00 $2.02 0.0% $0.02 $100,464 0 1 0 4 $1.15 $1.97 70.6% $1.06 $98,041 13 20 98 158 • The top 20 drugsby plan spend PMPM accountedfor 53.3% ($113.18) of all plan spend PMPM ($212.32) i nthe current period 8/20/2Opptg242(mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 65k City of Miami Solicitation RFP 1896386 1143 High Cost Prescriptions High cost prescriptions ranking Rank Base Current Drug Name 1 1 2 2 3 3 4 8 5 6 7 8 9 9 10 11 12 13 13 14 10 15 11 16 17 17 18 19 16 20 Promacta (SRx) Ev ry sdi (SRx) Balversa (SRx) U ptrav i (SRx) Stelara (SRx) lenalidomide (SRx) Kisqali (SRx) Erleada (SRx) Brukinsa (SRx) Bosulif (SRx) Humira(Cf) Pen Psor-Uv-Add Hs (SRx) ev erolimus (SRx) Genotropin (SRx) Kesimpta Pen (SRx) Norditropin Flexpro (SRx) Aubagio (SRx) Cosentyx Sensoready (2 Pens) (SRx) Enbrel Sureclick (SRx) Humira(Cf) (SRx) Humira(Cf) Pen (SRx) Condition Cost per Plan Spend PMPM Script Unique Members Scripts Base Current Trend Norm Current Base Current Base Current White Cell Stimulant $6.12 $2.28 -62.7% $0.83 $37,900 2 1 9 3 Spinal Muscular $7.36 $6.70 -9.1% $0.40 $25,651 1 1 15 13 Atrophy Cancer $0.00 $2.02 0.0% $0.02 $25,116 0 1 0 4 Pulmonary $4.98 $5.06 1.6% $0.49 $22,922 1 1 12 11 Hypertension Psoriasis $13.74 $24.74 80.0% $6.55 $18,954 6 6 51 65 Cancer $0.00 $1.77 0.0% $0.63 $17,663 0 1 0 5 Cancer $0.00 $2.05 0.0% $0.33 $17,050 0 1 0 6 Cancer $0.00 $0.30 0.0% $0.62 $14,998 0 1 0 1 Cancer $0.00 $2.32 0.0% $0.21 $14,418 0 1 0 8 Cancer $3.17 $1.44 -54.5% $0.27 $14,348 1 1 12 5 Arthritis $0.00 $0.28 0.0% $0.03 $13,873 0 1 0 1 Cancer $0.00 $0.39 0.0% $0.11 $9,810 0 1 0 2 Growth Hormone $0.00 $1.13 0.0% $0.37 $9,365 0 1 0 6 Multiple Sclerosis $1.81 $3.40 87.6% $0.51 $8,455 1 2 12 20 Growth Hormone $2.65 $2.98 12.6% $1.40 $8,245 2 2 15 18 Multiple Sclerosis $2.06 $0.94 -54.1% $0.43 $7,834 1 1 12 6 Seborrhea/Psoriasis $0.00 $1.74 0.0% $0.48 $7,214 0 1 0 12 Arthritis $0.65 $0.87 33.5% $2.39 $7,201 2 1 5 6 Arthritis $0.00 $1.14 0.0% $1.20 $7,097 0 1 0 8 Arthritis $4.34 $7.26 67.2% $9.39 $6,953 5 6 31 52 • The top 20 high cost drugsaccountedfor 0.4% (252 scri pts) of the overall prescri ptionvol ume, and 32.4% ($68.82) of total plan spend PMPM i n th e current period 8/20/2O tg242(Mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 65§j City of Miami Solicitation RFP 1896386 Top Drugs by Volume clnct Top drugs by volume Cost per Rank Prescriptions Dispensed Unique Members Script Base Current Drug Name Condition Base Current Trend Base Current Current 1 1 atorvastatincalcium Cholesterol 2,565 2,685 4.7% 343 362 $27.87 3 2 losartan potassium Hypertension 1,644 1,842 12.0% 196 226 $8.59 2 3 am lodipinebesylate Hypertension 1,659 1,758 6.0% 228 236 $4.49 6 4 rosuvastatincalcium Cholesterol 1,419 1,728 21.8% 203 236 $30.53 4 5 metforminhcl Diabetes 1,510 1,593 5.5% 206 199 $4.96 5 6 lisinopril Hypertension 1,497 1,455 -2.8% 184 180 $4.61 8 7 levothyroxine sodium Thy roid 1,006 1,035 2.9% 115 111 $8.68 7 8 hydrochlorothiazide Hypertension 1,076 1,012 -5.9% 144 141 $2.55 12 9 metoprolol succinate Heart/Hypertension 860 971 12.9% 107 111 $1 1.54 9 10 omeprazole Ulcer/ Heartburn 948 930 -1.9% 184 180 $7.41 10 11 vitamind2 Vitamin D Supplement 908 919 1.2% 184 200 $2.14 27 12 Ozempic Diabetes 402 827 105.7% 66 129 $804.24 11 13 fluticasone propionate Itching / Inflammation 878 795 -9.5% 330 305 $13.30 13 14 ibuprofen Arthritis / Pain 757 742 -2.0% 533 533 $8.08 16 15 pantoprazole sodium Ulcer/ Heartburn 667 697 4.5% 146 131 $10.50 14 16 montelukastsodium Asthma 671 675 0.6% 125 121 $9.72 183 17 Mounjaro DIABETES 76 658 765.8% 27 115 $976.01 24 18 tadalafil (SRx) Pulmonary Hypertension 431 646 49.9% 88 117 $62.32 15 19 azithromycin Infection 669 619 -7.5% 479 463 $6.15 17 20 amoxicillin Infection 569 587 3.2% 452 462 $4.58 • The top 20 drugs by vol um e accounted for 34.1% (22,174) of all prescriptionsdispensed but only 15.0% ($10,572,547) of total plan spend inthe current period 8/20/2Opptg24) mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 6548 City of Miami Solicitation RFP 1896386 ci ''``'n Integrated Value of Well Informed & RationalMed for Cigna Well Informed and RationalMed for Cigna are gaps in care solutions which deliver alerts to providers and patients to improve health and safety while driving savings for our clients. Clinical Impact Opportunity Identified Gaps identified Providers outreached Customers outreached Success Rate Remaining opportunity Financial Impact 5,740 560 1,217 419 (7%) closures 5,321 gaps Total Savings $81,171 • Closing these gaps resulted in a savi ngsof $194 per success • An average of 5 gapswere identified for each of your outreached customers • The top five conditionsaddressed foryour population were: Diabetes, Cancer, Coronary Artery Disease, Hypertension, HIV nft MONITOR Claimsdata: Medical+ Laboratory+ Pharmacy ANALYZE Against evidence -based guidelines FIND Gaps, risks, omissions, errors, adverse events ALERT Gaps, risks, omissions, errors, adverse events IMPROVE Research, update/ arm aIartc 8/20/2Q2it9?2P Mects claims incurred between Jan. 2023 and Dec. 2023, paid through Feb. 2024 Base Period reflects claims incurred between Jan. 2022 and Dec. 2022, paid through Feb. 2023 p. 65§g City of Miami Demand grows for GLP-i drugs as view on obesity shifts Controlling costs and optimizing health outcomes requires utilization management and lifestyle change • Inappropriate use of medications containing GLP-1-agonists is creating shortages and access to care issues for customers managing diabetes. • Clients are facing increasing pressure to cover these highly effective medications, as obesity is now viewed as a chronic condition. High prevalence, high cost of GLP-1s, and potential need for lifelong therapy may led to dramatic increases in usage and cost: - Wegovy® costs" about $1,300/month - Zepboundm costs" about $1,000/month Obesity substantially raises an individual's risk of developing type 2 diabetes, coronary heart disease and hypertension2 42% of adults in the U.S. are obese.3 Cigna healthcare $1,861 higher annual medical costs than for people with healthy weight.3 5% weight loss can decrease the risk of chronic diseases related to cbesity.4 Introducing EncircleRxsM for Cigna The next evolution in benefit coverage of weight management medications EncircleRx for Cigna5 offers: • Enhanced management to ensure that appropriate customers have access • HigherBMI and documentation of weight -related co mo rbid ities • Required enrollment and ongoing engagement with a lifestyle modification program • Appropriate prescriber and pharmacy management with enhanced fraud, waste, and a buse activities focused on GLP-ls 1. Could Zepbound's Lower Cost Start a Weight Loss Drug Price War?' Nancy Schimelpfening. December 2023. htlps://www.healthline.com/health-news/zepbound-cost-lower. 2. Centers for Disease Control and Prevention Know Your Risk for Heart Disease https://www.cdc.gov/heartdisease/risk factors. htm Last reviewed: March 21, 2023. Accessed February 2024. 3. Centers for Disease Control Overweight and Obesity. Data and Statistics. https://www.cdc.gov/obesity/data/adulthtml. Last reviewed: May 17, 2022. Accessed February 2024. 4. Centers for Disease Control and Prevention. Healthy Weight, Nutrition, and Physical Activity. htlps://www.cdc.gov/healthyweight/losing_weight/index.html Last reviewed: June 15, 2023. Accessed February 2024. 5. Available 1/1/2025 for ASO clients through Proclaim. A PMPM client fee applies and includes aerformance guarantee. so 8/20/2024 9:24 AM p. 656 Confidential, unpublished property of Cigna Healthcare. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 02024 Cigna Healthcare City of Miami Solicitation RFP 1896386 Powered by Consultative AnalyticssM Together, all the way.' Copyright 2022 Cigna - Confidential and Privileged - Not for Distribution City of Miami Total Health Insight" April 19, 2022 • • Cigna. 8/20/2024 9:24 AM p. 657 City of Miami Solicitation RFP 1896386 Zry /•� _}•�_ AGENDA Cigna. 1. Total Health Insight Overview • Medical • Pharmacy • Covid-19 • Virtual Care 2. Large claim review 3. Specialty Pharmacy 4. Prevention 5. Recommendations 6. Appendix • Medical Utilization • Health Program Detail • Pharmacy Utilization T imeframes Current period reflects claims incurred between January 2021 and December 2021, paid through February 2022 Base period reflects claims incurred betw een January 2020 and December 2020, paid through February 2021 Norm represents Cigna's Florida average for municipal and government employers 2 8/20/2024 9:24 AM p. 658 City of Miami Solicitation RFP 1896386 1( TOTAL HEALTH INSIGHT OVERVIEW Cigna 4,105 Members; 2.0% 1 Contract Size: 2.1 48.5% M, 51.5% F Average Age: 36.3 MEDICAL 10.2% t $607 PMPM $526 (Norm) PHARMACY $151 PMPM 13.8% 1 $167 (Norm) TOTAL 10.9% t Medical: $29.9M • Cost Share: 5.9% (7.2% norm) • Top 3 Diagnostic Categories: • Neoplasms • Musculoskeletal • Infect/Parasit • 3 additional catastrophic claimants for the year (over $100,000 total cost per individual) • Highest cost claimant for the year exceeded $1.0m $758 PMPM $693 (Norm;; Non -Catastrophic Categories of Trend Non -Catastrophic Medical 14.4% atastrophic Medical .5% Trend 10.9% Non -Specialty Pharmacy 3.4% Specialty Pharmacy 24.2% Plan Spend (PM PM) Catastrophic OD CO ER ER CO Non -Specialty Rx ■Sale ■Cuwent •Ncrrrt Pharmacy: $7.4M • Cost Share: 6.5% (7.3% norm) • Top 3 Therapeutic Classes: • Anti-Inflam Disease Modifiers • Antivirals, HIV Specific • Hypoglycemics • Utilization Trend: 2% • Generic dispensing rate: 91% fV ib CO CO ER II Specialty Rx 3 CO FH 8/20/2024 9:24 AM p. 659 City of Miami Solicitation RFP 1896386 TOTAL HEALTH INSIGHT OVERVIEW Cigna DRIVERS OF PHARMACY TREND DRUG MIX HIGHLIGHTS TREND CONTRIBUTION BY CLASS a/[J Overall Rx. Tren t 13.8% Inflation t 2.5% NONE O O JAI Utilization t 2.1% Drug Mix t 9.2% SPECIALTY SITE OF CARE Specialty Pharmac $82 PCP & Home Infusion $12 Inpatient / Outpatient $32 of total plan spend, or $12.4M were associated with specialty medications • Generic dispensing increased to 91.5% up 0.9%, decreasing costs by -$456k • Formulary Compliance: 86.1% (increased 1.0%) • Pharmacy Ben. Specialty Drug Costs: -$4.1M (54.6% Pharmacy Ben. Spend) SAVINGS AND OPPORTUNITIES Achieved _ Savings Savings _ Opportunity Upcoming Patent $83 752 Expirations $879,278 81,418,234 • 1.9 % : Hematopoietic Agents • 2.1%: Hypoglycemics • 3.0 % : Seborrhea/Psoriasis • 3.1 %: All Other 3.7 % : Gene Therapy Agents EDICATION ADHEREN Plan Compliance Rate 72% 68% 71% 70% Norm Compliance Rate Hypertension it I Diabetes 77% 72% 74% Depression 76% Cholesterol 23% of drug costs were managed through your plan's medical benefit 8/20/2024 9:24 AM p. 660 City of Miami Solicitation RFP 1896386 0.4 r;1+1• . '�— Specialty Pharmacy Highlights Cigna Top Three Therapeutic Class Trend Drivers - Medical and Pharmacy Co mments • 62% of all specialty plan spend ($3.8M) is driven by the top three classes, • 26% of all specialty plan spend is driven by Antineoplastic drugs, • The Antineoplastics class is trending at 4.0% mainly driven by drug mix • Worthy to note is that 6 of the top 15 specialty drugs across both benefits are Antineoplastics, w ith Keytruda leading its class across both benefits • The Anti-Inflam Disease Modifiers class is trending at -4.5%, mainly driven by drug rrix • Worthy to note is that 4 of the top 15 specialty drugs across both benefits are Anti-Inflam Disease Modifiers, with Stelara being the leader across both benefits, Benefit Drug Spend Current Unique Utilizing Rank Plan Spend PMPM PMPM Members Members Base Current Therapeutic Class Condition Base Current Trend Norm Pharmacy Medical Current Trend 1 1 Antineoplastics Cancer $31.01 $32.25 4.0% $23.95 $9.04 $23.21 20 -23.1% 2 2 Anti-Inflam Disease Modifiers RA/Psoriasis/Crohn's $28.53 $27.24 -4.5% $26.78 $22.25 $4.99 30 7.1% 3 3 Antivirals, HIV Specific Antivirals, HIV Specific $16.26 $18.41 13.2% $8.58 $18.41 - 36 9.1% Key Stats and Top Five Therapeutic Class Trend Drivers - Pharmacy Co mments • Pharmacy plan spend of$4,051,158 w as incurred for specialty medications under the pharmacy benefit, • This spend spans across 104 customers. • 34% ($1,383,135) of specialty pharmacy plan spend under the pharmacy benefits is related to RA/FSoriasis/Crohn's, • Worthy to note • Cigna achieved savings of $837,865 through the application of discounts • 80% of total pharmacy plan spend w as distributed through the Cigna Specialty Pharmacy. • Through the AccredoTherapeutic Resource Center® (TRC) model; 571 clinical calls have been carried out spanning 57 'active' patients. 17% 8% 8% 22% RA/FSoriasis/Crohn's Antivirals, HIV Specific Cancer Spinal Muscular Atrophy Multiple Sclerosis All Other 5 8/20/2024 9:24 AM p. 661 City of Miami Solicitation RFP 1896386 Cigna TOTAL HEALTH INSIGHT — KEY MEDICAL AREAS UTILIZATION 12.7% trend due to higher medical utilization, excluding catastrophic claimants • Medical trend components: • Utilization: +12.7% • Service Mix: +0.6% • Unit Cost: -4.4% • Catastrophic: +1.2% • Covid-19 costs alone accounted for a 5.4% medical trend from prior year (+$1.4m) • Medical network penetration rate remained over 97%. Discount rate increased to 69% for the year • Cigna Care Designation physicians utilization rate at 41% of opportunity (remaining savings potential of over $400k locally from specialists only) CHRONIC RISK 48% of the population had a chronic condition during the year Obesity Hypertension Diabetes Hyperlipiderria Top Condition Preelence PREVENTION 9% of members had no services during 2021 • 74% of members had a physician 21% office visit during 2021 • Pre -diabetes prevalence of over 7% currently • 80% of diabetes spend was related to type 2 diagnoses • 9% overall increase in behavioral health issues, with substance use lower and mental health claimants higher • 59% of the population had at least one preventive service, 7 points higher than prior year • 49% of the total population had an annual physical, 5 points higher • Breast and cervical cancer screening results decreased slightly during 2021, colon cancer screening improved from 2020 but remained below norm 6 8/20/2024 9:24 AM p. 662 City of Miami Solicitation RFP 1896386 COVID-19 PANDEMIC CLAIM IMPACTS Cigna. SUMMARY 2020 2021 Utilization Members Tested Diagnosed Employees Spouses Dependents Average Age Admissions Total Bed Days Average Length of Stay 4,189 687 189 109 33 47 42 22 189 9 4,105 2,529 442 273 74 95 42 38 451 12 80% 60% 40% 20% 0% - 20% - 40% COST IM PACT 2020 2021 COVID-19 Spend Detail Total COVID Spend Testing Spend Treatment Spend Vaccination Spend Complications Spend COVID spend % of Total $1,103,561 $2,579,777 $92,344 $445,813 $167,146 $442,129 n/a $55,776 $844,071 $1,636,059 3.2% 6.9% UTILIZATION CHANGE — CUM ULATIVE YEAR TO DATE 2021 - Primary Care Office Visits - Specialist Office Visits Preventive VisiIs - Emergency Care (ER UC) Outpatient Surgeries - Behavioral Health -60% Jan-21 Feb-21 Mar-21 Apr 21 May-21 Jun-21 Jul-21 Aug-21 Sep-21 Oct--21 Nov-21 Dec-21 7 8/20/2024 9:24 AM p. 663 City of Miami Solicitation RFP 1896386 jr COVID-1 9 VACCINES Cigna. As COVID-19 Vaccinations become available to individuals across the US it is important to understand who is being vaccinated and at what stage of vaccination are those individuals (1st or 2nd dose for two shot vaccines or 1 dose for the single shot vaccines). The data displayed on this page and the following page will help to illustrate that information. Key Messages: • It is extremely important to understand that the COVID-19 vaccination data contained here is likely to be understated due to the involvement of public health agencies in the vaccine efforts. Cigna can only display information on individuals for whom claims have been submitted for the administration of the vaccine. • Three Vaccines are currently available: o Pfizer/BioNTech - 2 Doses, 21 days apart o Moderna - 2 Doses, 28 days apart o J&J/Jannsen -1 Dose • This percentage Is the percent of total members With at least one dose of the Covid•19 Vaccine. CITY OF MIAMI data as of 4/1/2022 COVID-19 VACCINATION STATUS Total Patients with a 1 Dose 1,615 (36.4%1 Initial Dose Only Complete Booster 82 1,533 701 VACCINATIONS BY MONTH Initial Dose Only • Complete • Booster ■111 May 2021 June 2021 Jut}, 2021 August 2021 September 2021 October 2021 November 2021 December 2021 January2022 February2022 March2022 RELATIONSHIP/AGE DISTRIBUTION 25.6._ 16-18 19-26 27-40 41.5C 51.65 6& All Cigna products and services are provided exclusively by or through operating subsidianes of Cigna Corporation. includrng Cigna health and Lire Insurance Company. The Cigna name, logo. and other Cigna marks are owned by Cigna Intellectual Property, Inc, a Copyright 2022 Cigna 52.7% <16 86 196 109 222 137 376 8 8/20/2024 9:24 AM p. 664 City of Miami Solicitation RFP 1896386 S( VIRTUAL CARE Cigna. 4,475 Total Visits; 8% 1,111 Unique Users; -15% 577 Users with Multiple Visits; -18% 27% Member Utilization Visits by Provider Acute Medical — MDLive/Amwell 148 Virtual Wellness Screenings Acute Medical — Cigna Providers 1,589 Behavioral lfirtual Visits 2,738 121 148 MD Live Visits by Provider 20 4,009 1 4,327 1 AmweII Cigna Provider ■ Base ■ Current Top Cigna Provider by Type (Current) INTERNAL MEDICINE FAMILY MEDICINE PEDIATRICS GASTROENTEROLOGY ENDOCRINOLOGY AND METABOLISM 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% Cigna Provider User Details User DemoaraDhics Employee Spouse Dependent % Male % Female Average Member Age End, Nutr, Met General Medical Circulatory Gastrointestinal Neurological Base Current 59.1% 58.3% 18.0% 19.0% 22.9% 22.7% 42.5% 41.5% 57.5% 58.5% 42.5 Current itions 45.1 Base 17.1% 20.9% 10.9% 13.7% 10.2% 8.6% 8.0% 8.6% 7.7% 7.1% 9 8/20/2024 9:24 AM p. 665 City of Miami Solicitation RFP 1896386 yY k1 11- 2019-2021 MEDICAL TREND Cigna MEDICAL SPEND - 3 YEAR VIEW 2019-2021 2.1% 2.6% 1.0% t Tota l Non -CAT t CAT $583 -5,5% $389 $194 $607 10.2% $409 $198 2019 DELAYED CARE -'21 VS. '20 2020 2021 MEDICAL TREND DRIVERS '21 vs. '20 Trend PMPM Contribution 6.5% $196 2.5% $198 1.2% $607 10.2% Delayed Care Non -emergency visits and elective procedures w hichw ere disrupted due to office closures and priority of care. Unavoidable Care 1. Key services w hich continued throughout the panderric. Catastrophic Medical Claimants >$100,000 Total Medical UNAVOIDABLE CARE -'21 VS. '20 Current Trend Current Trend Category PMPM Contribution Category PMPM Contribution Preventive Screenings $10.67 0.3% Maternity $23.20 0.8% Primary Care Office Visits - Standard $10.05 0.2% Newborn $4.70 -0.7 % Specialist Office Visits - Standard $24.95 0.6% Non-Steerable ER $39.85 0.2 % Urgent Care $14.67 0.5% Inpatient (Non -CAT) $44.43 0.7 % Cancer Screenings $18.30 0.6% Other Medical (Non -CAT) $83.42 1.3% Routine Diagnostic $27.59 0.8% Subtotal: Unavoidable Care $195.61 2.5% High Tech Imaging $0.54 -0.1% Steerable ER $3.60 0.0% Catastrophic $197.80 1.2% Outpatient (Non -CAT) $46.40 2.3% Professional (Non -CAT) $56.84 1.6% Subtotal: Delayed Care $213.60 6.5% 10 8/20/2024 9:24 AM p. 666 City of Miami Solicitation RFP 1896386 Cigna CATASTROPHIC SUMMARY Catastrophic individuals accounted for 1% of the population and 32% of the total spend ($11.4m combined medical and pharmacy costs) OVERVIEW individuals (41 in prior year) • 25 over age 50 • 28 employees, 11 spouses, 5 dependents • 4 were new enrollees during the year (includes 2 newborns) • 5 are no longer enrolled in the plan • 10 had a positive diagnosis for COVID-19 (within claim experience only) • • • • • "catastrophic level of $100,000 per individual COSTS average cost per individual Top individual incurred $1.0m in total cost Nearly 100% of medical spend was in -network 12 individuals had over $100k in medication spend Specialty medications accounted for roughly 32% of total catastrophic costs 18 individuals were catastrophic in the prior year CONDITIONS have a chronic condition • 83% of those with a chronic condition had 2 or more • Top chronic medical conditions were: Hypertension, Obesity, Diabetes and Hyperlipidemia • Behavioral health needs were roughly 4 times more prevalent compared to the overall population • Neoplasms was the highest diagnostic category by spend (17 individuals) ENGAGEMENT engagement rate • 33 impacted by inpatient management • 34 engaged with case management • 16 engaged with a health coach • 90% medication adherence rate 11 8/20/2024 9:24 AM p. 667 City of Miami Solicitation RFP 1896386 TOP CATASTROPHIC DETAIL Cigna. Latest Cat Out of Date of in Clinical M/F Pge Relshp ICD Major ICD Minor Medical Pharmacy Med Srx Pharm Srx Total (S) Net% Eligibility Base? Programs 1 F 40-49 EE Neoplasms Care/Neoplas $267,331 $9,064 $578,583 $146,742 $1,001,719 0% 03/22 Y DEP,ONC,VAC,WGT,VW 2 M 30-39 EE Musculoskeletal Fracture $639,158 $2,706 $0 $0 $641,864 0% 03/22 N CAT, EAP,INP,VW 3 F 1-17 DEP Musculoskeletal Back $247,178 $283 $0 $332,352 $579,812 1% 03/22 Y COM,VVI 4 M 18-29 EE Blood/Blood Org Anemia $420,158 $250 $0 $126,669 $547,078 0% 03/22 N TRN,VVI 5 M 40-49 EE Circulatory Other Heart $411,676 $4,713 $0 $53,134 $469,523 0% 03/22 Y COM,EAP,WI 6 M 65+ EE Neoplasms Care/Neoplas $187,954 $129 $237,336 $0 $425,419 0% 03/22 Y ONC,WI 7 F 40-49 EE Infect/Parasit Bacterial $420,468 $143 $0 $0 $420,611 1% 03/22 N COM,VVI 8 M <1 DEP Newboms Morbidity Non -Mat. $377,999 $0 $0 $0 $377,999 1% 03/22 N NIC 9 M 60-64 EE Infect/Parasit Viral Dis $361,546 $4,157 $0 $0 $365,703 0% 11/21 N COM,VVI 10 F 40-49 SP Neoplasms Female Breast $69,634 $227 $103,828 $145,219 $318,908 0% 03/22 Y ONC,VVI CM/SPCM Programs (Case Mgmt) TCM-Transition Care Management COM-Complex IN P-I npatient NIC-Neonatal Intensve Care ONC-Oncology REH-Rehabilitation TR N-Transplant Pcronym Key Chronic Coaching Programs AST -Asthma CAD -Coronary Heart Disease CHF-Chronic Heart Failure CPD-Chronic Obstructive Pulmonary Disorder DEP-Depresson DIA-Diabetes Mellitus LBP-Low Back Pain OST-Osteoarthritis PAD -Peripheral Artery Disease VVGT-VVeight Com plica<iors Pdditional Programs CCS-Cancer Care Support Program EAP-Employee Assistance Program HPHB-Healthy PregianciesHealthy Babes LMP-Lifestyle Management Progams OL-Online Programs TDS-Treatment Dedsbn Support WC -Wellness Coaching WI -Well Informed (Gaps In Care) MIR-Medical Injectable 12 8/20/2024 9:24 AM p. 668 City of Miami Solicitation RFP 1896386 Cancer Summary Cigna. Top cancer types by percent of cost Breast Male Rep. Female Rep Neoplastic Di Gastrointestinal 0% 5% 10% 15% 20% 25% 30% 35% 4D% 45% Prevalence and cost by condition Condition #of Prevalence Cancer Cost Total Plan Members Per Patient Spend Neoplastic Disease 24 0.6% $12,043 $289,022 Male Rep. 22 0.5% $28,474 $626,432 Breast 18 0.4% $77,313 $1,391,627 Thyroid 14 0.3% $3,175 $44,448 Female Rep. 10 0.2% $31,779 $317,793 Dermatology 10 0.2% $1,140 $11,396 Gastrointestinal 9 0.2% $29,265 $263,387 CNS 3 0.1% $14,040 $42,120 Rectum 2 0.0% $7,104 $14,208 Other 9 0.2% $30,737 $276,637 Total 111 2.7% $29,523 $3,277,072 • 111 individuals w th eligibility in the current period had a cancer episode, or 2.7% prevalence • Average cost per patient for these episodes w as $29,523 for a total of $3,277,072 • The primary cancer type was Neoplastic Disease w ith 0.6% prevalence and $289,022 in total plan spend 1 Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Cancer screening rates 80% 60% 40% 20% 0% ■ Current Norm 1 Breast Cancer Cervical Cancer Colon Cancer 71% 63% 66% 42% 60% 48% 13 8/20/2024 9:24 AM p. 669 City of Miami Solicitation RFP 1896386 Preventive Care Summary Cigna. Current period OV & preventive utilization 100.0% 75.0% 50.0% 25.0% 0.0% ■ Al I Ages • <18 ■ 18-39 40-49 50+ PCP/SPCOV 74.2% 80.1% 62.9% 76.5% 82.3% Annual Physical 48.5% 71.8% 39.3% 45.7% 46.1% Preventive care utilization (all services) 80% 60% 40% 20% 0% Base • Current Norm Employee Spouse Dependent Total 49.9% 50.9% 54.0% 51.5% 59.6% 60.2% 56.2% 58.5% 48.4% 59.4% 58.0% 53.4% Well visit completion rates 80% 60% 40% 20% 0% 1 F2diatric Adult Base 71.0% 38.7% • Current 73.4% 43.4% Norm 71.7% 36.8% Well visit completion rates 60% 45% 30% 15% 0% • Base ■ Current • Norm 11 Employee Spouse Dependent Total 39.5% 41.6% 52.8% 44.5% 45.4% 47.9% 53.0% 48.5% 35.3% 46.6% 55.2% 43.7% Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 14 8/20/2024 9:24 AM p. 670 City of Miami Solicitation RFP 1896386 Cigna Total Behavioral Health - Executive Summary Cigna Key Metrics Total Membership Average Numberof Employees Average Numberof Members Base 2,041 4,189 Current 1,989 4,105 Trend -2.6% -2.0% Behavioral Health Members Average NumberofClaimants Mental Health Substance Disorder Catastrophic Claimants(>$100kin BH) Average Age Behavioral Virtual visits ABA Claimants Happify Unique Users HappifyActive Urs iPrevail Unique Users Total i Prevail Activities 406 433 6.7% 398 430 7.9% 15 12 -19.8% 2 1 -50.0% 36.0 35.5 -1.5% 1,573 2,536 61.2% 9 9 0.0% 4 8 100.0% 3 6 100.0% 4 9 125.0% 23 27 17.4% Behavioral Health Claimants 100% 75% 50% 25% 0% 52% 54% 10%11% 14%13% Percent of Total Employee Spouse Membership % of Behavioral Health Claimants Clinical & Memberinteractions Engagement Types Customer Engagement Health Care Provider Engagement Access and Crisis Support Cu sto m e r Advoca cy Total Interactions Unique Membersw/ clinical interaction Percent ofMembersw/ clinical interaction Base 138 136 211 401 886 293 7.0% 34% 34% 1 Dependents • Base • Current 96% 97% Member Network Utilization Current Trend 143 3.6% 160 17.6% 275 30.3% 719 79.3% 1,297 46.4% 397 35.5% 9.7% 38.3% Top Conditions by Prevalence Reactive Stress Disorders: =� 2 % Anxiety Depression ADD/ADHD Autism I 2% 2% 25% 26% 24% 5% 5% 27% • Base % of Behavioral Members • Curr % of Behavioral Members 1 • 11 % of the total membership had a claim w ith a behavioral health provider in the current period • Average age of errployees w ith behavioral health claims w as 44.8 years • 96.9% of members used an in-netw ork behavioral health provider in the current period • Virtual Care utilization w ith behavioral providers increased by 61.2% in the current period • 9.7% of the total population was engaged w ith a clinician Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 15 8/20/2024 9:24 AM p. 671 City of Miami Solicitation RFP 1896386 -11-- RECOMMENDATIONS - PHARMACY Cigna OPPORTUNITY AREA Costs vary greatly for equivalent medications. The average ingredient cost per script for single source brand drugs was 10.1 times higher than for generic RECOMMENDATION Safety concerns for certain medications exist (i.e. anti - diabetics, blood thinners) Many medications have uses for multiple conditions By 2030, Specialty drugs are likely to represent 70%- 80% of total healthcare spend Specialty drug spend under the pharmacy benefit was $4, 051,158 and 54.6% of the total pharmacy spend. Specific to manufacturer copay assistance; customers view these programs favorably, as specialty drug affordability is a significant concern While manufactures regularly provide copay assistance to those in need, these programs can drive up plan costs for payers if left unmanaged Cigna's Essential protection package Protects clients and customers against potentially harmful, ineffective and unnecessary drug treatments and rising drug costs Drug Utilization Management ensures that certain medications are reviewed for safety and clinical appropriateness. SaveonSP Program WHY? Estimated cost reductions of$114k ($2.31 PMPM) Estimated 426 members impacted Leverages REAL-11ME data across medical/pharmacy, clinical expertise and our connection to network doctors to ensure safe prescribing and access to the most appropriate Medications Increases manufacturer copay assistance use for both plan sponsors and customers. The program works beyond plan copays and out-of-pocket requirements Leverages an exclusive partnership between SaveonSP and Cigna/Express Scripts Targets 95+ specialty drugs in several therapy classes Decreases customer responsibility for select specialty drugs to $0 Estimated savings of $477k ($10.83 PMPM) Applies only to specialty medications dispensed through Accredo Requires Exclusive Specialty Home Delivery (ESHD) and Best Start at Specialty (no retail fills) Program fee equal to 25% of realized savings Must begin on plan start or renewal date Copay/coinsurance benefit plans (not applicable to HSA qualified HDHP plans as Specialty drugs are not given a "preventive" designation 16 8/20/2024 9:24 AM p. 672 City of Miami Solicitation RFP 1896386 -11-- RECOMMENDATIONS - PHARMACY Cigna OPPORTUNITY AREA RECOMMENDATION 57.4% of all maintenance drugs are being filled for 90 day supplies at a Cigna 90 Now pharmacy Of the 916 customers filling 30 day prescriptions at Non-90 day retail pharmacies today, 97% are within 1.5 miles ofa 90day retail pharmacy Overall medication adherence for those customers using 90 day fills is 20.4% greater than those using 30 day fills Cigna 90 Now Mandatory WHY? The mandatory 90 Now program requires that members fill maintenance medications in a 90 day supply at one of the designated Cigna 90 day pharmacies or mail order (after up to 3 fills of 30 days and excluding specialty medications). Specialty medications are known to have adverse side - effects and/or high rates of physician change to dosage and form. Dispensing less than a 90-day supply per prescription for customers new to therapy allows for closer monitoring by Accredo specialists of customer drug tolerance and customer stabilization, and can decrease the potential for drug waste. CDS is intended to increase medication adherence by as much as 6%* for customers influenced by the program moving from a 30 day supply limit at specialty Clinical DaySupply Clinical Day Supply Program for Cigna (CDS) through Accredo leverages smart dispensing logic to ensure customers receive optimal drug supply, driving increased drug safety, cost savings and medication adherence Savings are driven both by lower network contracted rates and conversions to 90 Day maintenance prescriptions Potential savings for Cigna 90 Now Mandatory are $2.07 PMPM The Split Fill and Stabilization components of the program apply only to new specialty drug therapies. Members already taking specialty drugs may experience a reduction in day supply only if the medication is identified as being optimally prescribed at a 30 day limit. CDS is intended to increase medication adherence by as much as 6%* for customers influenced by the program moving from a 30 day supply limit at specialty 17 8/20/2024 9:24 AM p. 673 City of Miami Solicitation RFP 1896386 RECOMMENDATIONS - MEDICAL Cigna OPPORTUNITY AREA Plan design: • Remaining potential savings gains from Tier 1/Cigna Care Designation specialists Behavioral health: • 9% higher behavioral health claimant prevalence during the year, totally driven by mental health needs RECOMMENDATION Consider tiering physician benefit levels to add a differential for the usage of Tier 1/Cigna Care Designation providers Communicate availability of provider search and cost transparency tools on myCigna.com and mobile app. Consider offering educational materials at mobile clinic center related to Tier 1 specialists Continue encouraging members to seek behavioral health treatment through the modality that best meets their needs, including the multiple available digital therapy solutions and virtual options WHY? $400k in estimated remaining savings from usage of Tier 1 specialists locally (orthopedics - $140k, hematology - $108k) Addressing whole person health can help decrease overall healthcare spend 79% of participants saw improvement after engaging in personalized programing available through iPrevail and Happify* *Clinical trial through Prevail Health Solutions 18 8/20/2024 9:24 AM p. 674 City of Miami Solicitation RFP 1896386 Appendix Together, all the way: f�it,F Cigna: 19 8/20/2024 9:24 AM p. 675 City of Miami Solicitation RFP 1896386 )( Key Metrics by Group Cigna. Members Average Numberof Employees Average Numberof Members Actives Under65 Retirees Over65 Retirees Base Current Trend Base Current Trend Base Current Trend 1,892 1,847 3,994 3,921 -2.4 -1.8 % Cost Trend Plan Spend $31,416,859 $34,549,577 10.0% Plan Spend PMPM $656 $734 12.0% Performance Indicators CatClaimantsin Excess Per Percent of Population Age 40+ Network Penetration Network Discounts Generic Rx Utilization Rate Chronic Percent of Population Chronic Percent of Cost Health and Wellness Total Health Engagement - % of pop Health Maintenance Engagement Health ImprovementEngagement Preventive Care Utilization Health Assessment Penetration Gaps in Care Rule Compliance 9.0 43.7% 97.8% 64.0% 90.6% 43.9% 72.8% 41.3% 38.1 % 6.7% 51.5% 0.8% 79.7% 10.2 44.8% 97.3% 68.7% 91.6% 46.2% 73.9% 45.3% 41.5% 7.8% 58.3% 0.9% 82.0% 13.2% 1.1% -0.5 4.7% 1.0% 2.3% 1.1% 4.0% 3.4% 1.1% 6.8% 0.1% 2.3% 150 195 142 -5.4% 184 -5.8% $2,929,733 $2,775,273 -5.3% $1,249 $1,257 30.7 88.2% 97.1% 70.4% 90.2% 76.3% 94.3% 44.7% 35.3% 16.7% 52.7% 1.0% 80.8% 27.2 88.0% 98.3% 73.3% 90.2% 77.4% 94.1% 52.3% 45.7% 15.6% 63.6% 1.1% 83.6% 0.6% -11.5 % -0.2 1.2% 2.9% 0.0% 1.1% -0.2 7.6% 10.4% -1.1 10.9% 0.1% 2.8% 211 278 219 4.0% 266 -4.4% $3,805,102 $1,461,450 -61.6% $1,141 $459 -59.8% 14.4 94.3% 97.2% 71.5% 87.7% 88.3% 96.2% 19.9% 16.9% 5.3% 27.3% 0.0% 76.1% 7.5 93.2% 94.6% 78.3% 88.9% 86.2% 85.7% 20.4% 20.1% 3.6% 35.4% 0.4% 79.2% -47.7% -1.1% -2.6% 6.8% 1.2% -2.1 % -10.5% 0.5% 3.2% -1.7 % 8.1% 0.4% 3.1% Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 20 8/20/2024 9:24 AM p. 676 City of Miami Solicitation RFP 1896386 )( Executive Summary Cigna Excluding Over 65 Retirees Medical & Rx Spend Base Current Norm $519 $32 $123 $9 $571 $480 $36 $141 $19 $38 $155 $12 Sz1oo $400 $ 6h 0 $ 0o PMPM Spend • EmployerPaid -Medical • MemberPaid-Medical ■ EmployerPaid -Pharmacy ■ MemberPaid-Pharmacy Demographics& Financial Base Current Trend Members Average Numberof Employees Average Numberof Members Average Employee Age Demographic Factor Cost Trend Plan Spend -Medical Plan Spend -Pharmacy Total Plan Spend Medical Plan Spend PMPM Pharmacy Plan Spend PMPM Total PlanSpend PMPM Performance Indicators CatClaimantsin Exce%PerK Cat Plan Spend PMPM(Med+Rx) Non -Cat Plan Spend PMPM(Med + Rx) Network Penetration 2,041 1,989 -2.6% 4,189 4,105 -2.0% 46.9 47.6 1.3% 0.93 0.94 0.2% $27,697,016 $29,901,235 8.0% $6,649,647 $7,423,713 1 1.6% $34,346,663 $37,324,948 8.7% $551.00 $607.01 10.2% $132.46 $150.76 13.8% $683.45 $757.77 10.9% 9.8 10.7 9.5% $227.94 $242.60 6.4% $455.52 $515.16 13.1% 97.7% 97.4% -0.3% Norm 0.98 $525.61 $167.33 $692.93 10.4 $193.11 $499.82 98.1 % Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 Medical & Rx Trend 0 Total Plan Spend Total EmployerPaid Employer Paid - Medical PhaSpend PMPM Current PMPM $757.69 $711.95 $45.74 $150.69 Variance Trend from Norm F10.9 10.8% 10.0% 9.3 10.8% 13.8 % IIIIIIIIIIIIIIi Population Health & Pharmacy Base Current Trend Norm Population Health Measures Chronic Percent of Population Chronic Percent of Cost Total Health Engagement-%ofPop Preventive Care Utilization Well Visit Completions Health Assessment Completions Gaps i n Care Rule Compliance 45.5% 47.6% 2.1% 43.9% 74.7% 75.4% 0.7% 75.4% 41.6% 45.8% 4.2% 43.6% 51.5% 58.5% 7.0% 53.4% 44.5% 48.5% 4.0% 43.7% 0.9% 0.9% 0.0% 13.1% 79.8% 82.2% 2.4% 80.2% Pharmacylndicators Generic Dispensing Rate Generic Subditution Rate Specialty Plan Spend PMPM (Rx Only) Specialty Plan Spend PMPM (MedOnly) Non -Specialty Plan Spend PMPM (Rx only) PrescriptionsPMPY(Retail adjusted) 90.5% 91.5% 0.9% 90.4% 97.0% 97.1% 0.1% 97.6% $66.23 $82.27 24.2% $80.14 $45.08 $43.83 -2.8% $35.34 $66.23 $68.46 3.4% $87.18 13.21 14.11 6.8% 15.04 21 8/20/2024 9:24 AM p. 677 City of Miami Solicitation RFP 1896386 )( Executive Summary Cigna Actives Medical & Rx Spend Base Current Norm $552 $488 $31 $118 $9 $35 $137 $9 $38 $155 $12 000 Sdoo Woo Vino PMPM Spend • EmployerPaid -Medical • MemberPaid-Medical ■ EmployerPaid -Pharmacy ■ MemberPaid-Pharmacy Demographics& Financial Base Members Average Numberof Employees Average Numberof Members Average Employee Age Demographic Factor Cost Trend Plan Spend -Medical Plan Spend -Pharmacy Total Plan Spend Medical Plan Spend PMPM Pharmacy Plan Spend PMPM Total PlanSpend PMPM Performance Indicators CatClaimantsin Exce%PerK Cat Plan Spend PMPM(Med+Rx) Non -Cat Plan Spend PMPM(Med + Rx) Network Penetration Current Trend 1,892 1,847 3,994 3,921 45.8 46.4 0.90 0.90 $25,331,853 $27,648,408 $6,085,007 $6,901,169 $31,416,859 $34,549,577 $528.61 $587.60 $127.15 $146.72 $655.75 $734.32 9.0 10.2 $210.91 $230.29 $444.84 $504.03 97.8 % 97.3 % -2.4 % -1.8 % 1.4% 0.3 % 9.1 % 13.4% 10.0% 11.2% 15.4 % 12.0 % 13.2 % 9.2 % 13.3 % -0.5 % Norm 0.98 $525.61 $167.33 $692.93 10.4 $193.11 $499.82 98.1 % Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 Medical & Rx Trend 0 Total Plan Spend Total EmployerPaid Medic Employer Paid - Medical PharmacySpend PMPM Current PMPM $734.32 $689.56 $146.72 Trend F12.0 % 11.9% 12.5% 11.2% 11.0 % 15.4% Variance from Norm 6.0 % 7.3% -12.3 % Population Health & Pharmacy Base Current Trend Norm Population Health Measures Chronic Percent of Population Chronic Percent of Cost Total Health Engagement -%of Pop Preventive Care Utilization Well Visit Completions Health Assessnent Completions Gaps i n Care Rule Compliance 43.9% 46.2% 2.3% 43.9% 72.8% 73.9% 1.1% 75.4% 41.3% 45.3% 4.0% 43.6% 51.5% 58.3% 6.8% 53.4% 44.9% 48.6% 3.7% 43.7% 0.8% 0.9% 0.1% 13.1% 79.7% 82.0% 2.3% 80.2% Pharmacylndicators Generic Dispensing Rate Generic Subditution Rate Specialty Plan Spend PMPM (Rx Only) Specialty Plan Spend PMPM (MedOnly) Non -Specialty Plan Spend PMPM (Rx only) PrescriptionsPMPY(Retail adjusted) 90.6% 91.6% 1.0% 90.4% 97.0% 97.1% 0.0% 97.6% $67.85 $85.05 25.4% $80.14 $40.63 $43.62 7.4% $35.34 $59.30 $61.66 4.0% $87.18 12.16 13.13 8.0% 15.04 22 8/20/2024 9:24 AM p. 678 City of Miami Solicitation RFP 1896386 Executive Summary Cigna Under 65 Retirees Medical & Rx Spend Base Current Norm $961 $47 $219 $22 $97-1 $46 $216 $21 $488 $38 $155 $12 $ oo s boo PMPM Spend • Employer Paid -Medical • MemberPaid- Medical ■ Employer Paid -Pharmacy ■ Member Paid -Pharmacy Demographics& Financial Base Members Average Numberof Employees Average Numberof Members Average Employee Age Demographic Factor Cost Trend Plan Spend -Medical Plan Spend -Pharmacy Total Plan Spend Medical Plan Spend PMPM Pharmacy Plan Spend PMPM Total PlanSpend PMPM Current Trend 150 142 -5.4% 195 184 -5.8% 61.6 62.0 0.7% 1.58 1.60 1.2% $2,365,093 $2,252,729 -4.8% $564,641 $522,544 -7.5% $2,929,733 $2,775,273 -5.3% $1,008.57 $1,020.26 1.2% $240.78 $236.66 -1.7% $1,249.35 $1,256.92 0.6% Performance Indicators Cat ClaimantsinExcessPerK 30.7 27.2 -11.5% Cat Plan Spend PMPM(Med+Rx) $575.85 $504.90 -12.3% Non -Cat Plan Spend PMPM(Med + Rx) $673.50 $752.02 11.7% Network Penetration 97.1% 98.3% 1.2% Norm 0.98 $525.61 $167.33 $692.93 10.4 $193.11 $499.82 98.1 % Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 Medical & Rx Trend 0 Total Plan Spend Total Employer Paid Medic Employer Paid - Medical PharmacySpend PMPM Current PMPM $1,256.92 $1,190.27 $66.65 $1,020.26 $974.36 $236.66 Trend 0.6% 0.8% -1.7 % Variance from Norm 81.4% Population Health & Pharmacy Base Current Trend Norm Population Health Measures Chronic Percent of Population Chronic Percent of Cost Total Health Engagement -%of Pop Preventive Care Utilization Well Visit Completions Health Assessment Completions Gaps i n Care Rule Compliance 76.3% 77.4% 1.1% 43.9% 94.3% 94.1% -0.2% 75.4% 44.7% 52.3% 7.6% 43.6% 52.7% 63.6% 10.9% 53.4% 36.3% 45.7% 9.4% 43.7% 1.0% 1.1% 0.1% 13.1% 80.8% 83.6% 2.8% 80.2% Pharmacylndicators Generic Dispensing Rate Generic Subditution Rate Specialty Plan Spend PMPM (Rx Only) Specialty Plan Spend PMPM (MedOnly) Non -Specialty Plan Spend PMPM (Rx only) PrescriptionsPMPY(Retail adjusted) 90.2% 90.2% -0.1% 90.4% 97.1% 97.5% 0.4% 97.6% $33.17 $22.84 -31.1% $80.14 $136.07 $48.21 -64.6% $35.34 $207.61 $213.82 3.0% $87.18 34.60 34.84 0.7% 15.04 23 8/20/2024 9:24 AM p. 679 City of Miami Solicitation RFP 1896386 )( Executive Summary Cigna Over 65 Retirees Medical & Rx Spend PMPM Spend • EmployerPaid -Medical • MemberPaid-Medical ■ EmployerPaid -Pharmacy ■ MemberPaid-Pharmacy Demographics& Financial Base Members Average Numberof Employees Average Numberof Members Average Employee Age Demographic Factor Cost Trend Plan Spend -Medical Plan Spend -Pharmacy Total Plan Spend Medical Plan Spend PMPM Pharmacy Plan Spend PMPM Total PlanSpend PMPM Current Trend 211 219 4.0% 278 266 -4.4% 76.1 74.0 -2.7% 2.12 2.10 -1.1% $1,384,805 $2,420,297 $3,805,102 $415.11 $725.51 $1,140.62 $1,108,526 -20.0% $352,925 -85.4% $1,461,450 -61.6% $347.50 -16.3% $111.47 -84.6% $458.97 -59.8% Performance Indicators Cat ClaimantsinExcessPerK 14.4 7.5 -47.7% Cat Plan Spend PMPM(Med+Rx) $387.37 $117.52 -69.7% Non -Cat Plan Spend PMPM(Med + Rx) $753.25 $341.45 -54.7% Network Penetration 97.2% 94.6% -2.6% Norm 0.98 $525.61 $167.33 $692.93 10.4 $193.11 $499.82 98.1 % Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 Medical & Rx Trend 0 Total Plan Spend Total EmployerPaid 1 Employer Paid - Medical PharmacySpend PMPM Current PMPM $408.22 $389.85 $60.72 Trend F-64.2% -64.3% -62.1 I' -16.3% -17.2% -91.6% Variance from Norm -41.1% -39.3% -63.4% 33.9% 32.O% -63.7% Population Health & Pharmacy Base Current Trend Norm Population Health Measures Chronic Percent of Population Chronic Percent of Cost Total Health Engagement-%ofPop Preventive Care Utilization Well Visit Completions Health Assessment Completions Gaps i n Care Rule Compliance 88.3% 86.2% -2.1% 43.9% 96.2% 85.7% -10.5% 75.4% 19.9% 20.4% 0.5% 43.6% 27.3% 35.4% 8.1% 53.4% 19.1% 24.8% 5.7% 43.7% 0.0% 0.4% 0.4% 13.1% 76.1% 79.2% 3.1% 80.2% Pharmacylndicators Generic Dispensing Rate 87.7% 88.9% 1.3% 90.4% Generic Subditution Rate 95.6% 96.6% 1.0% 97.6% Specialty Plan Spend PM PM(Rx Only) $285.82 $72.35 -74.7% $80.14 Specialty Plan Spend PM PM (MedOnly) $50.94 $56.33 10.6% $35.34 Non -Specialty Plan Spend PMPM (Rx only) $439.69 $21.32 -95.2% $87.18 PrescriptionsPMPY(Retailadjusted) 64.73 6.32 -90.2% 15.04 24 8/20/2024 9:24 AM p. 680 City of Miami Solicitation RFP 1896386 )( Executive Summary Cigna Total Including Over 65 Rets Medical & Rx Spend Base Current Norm $$12 $31 $15u $11 $557 $35 $132 $9 $48B $38 $155 $12 S2ho $doo S>to 0 PMPM Spend • EmployerPaid -Medical • MemberPaid-Medical ■ EmployerPaid -Pharmacy ■ MemberPaid-Pharmacy Demographics& Financial Base Members Average Numberof Employees Average Numberof Members Average Employee Age Demographic Factor Cost Trend Plan Spend -Medical Plan Spend -Pharmacy Total Plan Spend Medical Plan Spend PMPM Pharmacy Plan Spend PMPM Total PlanSpend PMPM Performance Indicators CatClaimantsin Exce%PerK Cat Plan Spend PMPM(Med+Rx) Non -Cat Plan Spend PMPM(Med + Rx) Network Penetration Current Trend 2,252 2,208 -2.0% 4,467 4,371 -2.1 % 49.7 50.2 1.0% 1.01 1.01 -0.2% $29,081,821 $31,009,821 6.6% $9,069,944 $7,776,637 -14.3% $38,151,765 $38,786,458 1.7% $542.54 $591.22 9.0% $169.41 $148.38 -12.4 % $711.95 $739.59 3.9 % 10.1 10.5 4.5% $237.87 $234.99 -1.2% $474.07 $504.60 6.4% 97.6 % 96.9 % -0.7 % Norm 0.98 $525.61 $167.33 $692.93 10.4 $193.11 $499.82 98.1 % Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 Medical & Rx Trend 0 rTotal Plan Spend Total EmployerPaid Total Member Paid Employer Paid - Medical PharmacySpend PMPM Current PMPM $732.40 $688.66 $43.74 $591.22 $556.53 $141.19 Variance Trend from Norm F-2.9% 2.7% 5.1% 9.0% 8.70/0 -16.7 % 5.7 7.2 % -15.6 % Population Health & Pharmacy Base Current Trend Norm Population Health Measures Chronic Percent of Population Chronic Percent of Cost Total Health Engagement -%of Pop Preventive Care Utilization Well Visit Completions Health Assessment Completions Gaps i n Care Rule Compliance 48.1% 50.0% 1.9% 43.9% 76.9% 75.8% -1.1% 75.4% 40.2% 44.3% 4.1% 43.6% 50.0% 57.1% 7.1% 53.4% 42.9% 47.0% 4.1% 43.7% 0.8% 0.9% 0.1% 13.1% 79.7% 82.1% 2.4% 80.2% Pharmacylndicators Generic Dispensing Rate Generic Subditution Rate Specialty Plan Spend PMPM (Rx Only) Specialty Plan Spend PMPM (MedOnly) Non -Specialty Plan Spend PMPM (Rx only) PrescriptionsPMPY(Retail adjusted) 89.9% 91.4% 1.5% 90.4% 96.7% 97.1% 0.4% 97.6% $79.91 $81.67 2.2% $80.14 $45.44 $44.59 -1.9% $35.34 $89.50 $63.48 -29.1% $87.18 16.42 13.64 -17.0% 15.04 25 8/20/2024 9:24 AM p. 681 City of Miami Solicitation RFP 1896386 Population/Percentile Cost Profile Cigna What portion of the population drives your healthplan costs of $37.3 Million? Top 1% of claimants: 44 individuals • 31 % of total cost ,: $11.4 M illion Top 5% of claimants: • 223 individuals 55% of total cost • $20.4 M illion Top 10%ofclaimants: • 446 individuals 68% of total cost e. $25.4Million Top 20% of claimants: • 892 individuals 81 %of total cost • $30.0 Million of Total plan spend 100%J 80%- 60%- 40%_ 31% 20%_ 0% Total medical cost vs. %ofPopulation 55% 68% 81% Top 1% Top 5% Top 10% Top 20% ofPopulation Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 26 8/20/2024 9:24 AM p. 682 City of Miami Solicitation RFP 1896386 cMember Cost Share Cigna. Cost sharing per member - medical only $40 $30 $20 $10 $0 Base • Current • Norm Ceductible/Copay Coinsurance $20 $12 $23 $13 $27 $11 Total $32 $36 $38 Cost share as % of total plan spend - medical only 8% 6% 4% 2% 0% Ceductible/Copay Coinsurance Total Base 3.6% 2.2% 5.8% ■ Current 3.8% 2.1% 5.9% ■ Norm 5.2% 2.0% 7.2% Account summary (PMPM basis) Base Current Trend Plan Costs Total Ran Spend - Medical $551.00 Cost Share - Medical $31.78 $607.01 10.2% $35.89 12.9% Net Employer Paid - Medical $519.22 $571.12 10.0% • Medical cost share increased from $31.78 PMPM to $35.89 PMPM, and compares to a norm of $38.06 PMPM • Medical cost share as a percent of total plan spend increased from 5.8% to 5.9%, and compares to a norm of 7.2% Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 27 8/20/2024 9:24 AM p. 683 City of Miami Solicitation RFP 1896386 '114'('-'':= Total Plan Spend by Condition Cigna. Top conditions by plan spend otTotalSpend 24.0% 18.0% 12.0% 6.0% 0.0% Base • Current • Norm F Neoplasms Musculoskeletal Gen Med Diag Infect/Parasit Circulatory Gastrointestinal Neurological Pregnancy End/Nutr/Metab Int/Ext Injury All Other Top ICD conditions PMPM Claimants per 1 k Spend per Claimant Trend ICD Category Base Current Contribution Norm Base Current Trend Base Current Trend Neoplasms $80.85 $83.13 0.5% $66.29 148.0 180.5 22.0% $6,555 $5,526 -15.7% Musculoskeletal $46.05 $68.48 4.5% $70.61 255.0 288.9 13.3% $2,167 $2,844 31.2% Gen Med Diag $39.34 $53.75 2.9% $41.75 658.9 841.2 27.7% $716 $767 7.0% Infect/Parast $34.80 $48.13 2.7% $47.90 240.2 274.1 14.1% $1,739 $2,108 21.2% Circulatory $45.16 $43.11 -0.4% $38.88 197.7 214.9 8.7% $2,742 $2,408 -12.2% Gastrointestinal $36.46 $40.58 0.8% $38.50 152.3 168.1 10.4% $2,872 $2,897 0.8% Neurological $41.37 $24.16 -3.4% $26.26 121.3 119.6 -1.4% $4,094 $2,424 -40.8% Pregnancy $24.39 $23.51 -0.2% $19.55 21.7 23.6 8.8% $13,471 $11,937 -11.4% End/Nutr/Metab $19.83 $21.83 0.4% $17.99 276.9 318.6 15.1% $859 $822 -4.3% Int/Ext Injury $13.89 $19.69 1.2% $19.24 64.9 80.1 23.4% $2,567 $2,948 14.9% All Other $120.65 $128.55 1.6% $104.68 1116.0 1210.7 8.5% $1,297 $1,274 -1.8% Total $502.79 $554.91 10.4% $491.66 877.6 961.5 9.6% $6,875 $6,926 0.7 % Current Period reflects claims incurred betweenJ an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 28 8/20/2024 9:24 AM p. 684 City of Miami Solicitation RFP 1896386 7 Population Demographic Summary Cigna Percent of membership by age band 20% 15% 10% 5% 0% Base • Current • Norm - Derro Fact <1 i 1-17 18-29 30-39 40-49 50-59 60-64 Percent of membership by relationship 60% 45% 30% 15% 0% Base • Current • Norm Employee Spouse II 65+ Cependent 4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0 Key metrics overview Base Current Trend Norm Frcent of Fbp. Age 40+ 45.8% 46.7% 0.9% 48.3% Average Member Age 36.0 36.3 0.9% 37.5 Average Employee Age 46.9 47.6 1.3% 48.1 Frcent of Fbpulation Male 48.4% 48.5% 0.1% 52.3% Frcent of Fbpulation Female 51.6% 51.5% -0.1% 47.7% Average spend by age band Base Current Trend Norm All Members 40-49 $770 $952 23.6% $773 50-59 $910 $800 -12.0% $1,037 60-64 $1,141 $1,736 52.2% $1,218 65+ $1,876 $1,365 -27.2% $922 Excluding Catastrophic 40-49 $521 $588 13.0% $558 50-59 $651 $654 0.5% $715 60-64 $713 $864 21.1% $825 65+ $820 $963 17.6% $663 Average spend by relationship Base Current Trend Norm All Members Employee $798 $988 23.8% $808 Spouse $1,008 $871 -13.7% $962 Cependent $372 $391 5.1% $356 Excluding Catastrophic Employee $572 $653 14.2% $584 Spouse $569 $624 9.7% $695 Cependent $262 $300 14.4% $273 Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 29 8/20/2024 9:24 AM p. 685 City of Miami Solicitation RFP 1896386 lair. Episode Treatment Group Summary Cigna 60% 45% 30% 15% 0% Distribution of members by category Chronic Maternity Major Minor Base 45% 1% • Current 48% 1% ■ Norm 44% 1% 80% 60% 40% 20% NonUser Distribution of cost by category Chronic Maternity Major Minor Healthy 14% 17% 9% 14% Base 75% 2% 18% 4% 1% 15% 15% 13% 9% ■ Current 75% 3% 16% 4% 2% 16% 16% 13% 10% • Norm 75% 2% 15% 5% 2% Non -User Information Average Age Demographic Risk Score Gender Distribution % Male Male Average Age Male Average Enrollment % Female Female Average Age Female Average Enrollment Base Current 31.7 30.5 0.91 0.90 65.9% 61.9% 31.9 31.9 11.0 9.5 34.1% 38.1% 31.3 28.3 10.3 8.6 Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid througl Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 Distribution of diabetes medical cost by type Type 2 Diabetes 79.8% Type 1 Diabetes 8.9% Preg/Labor 10.5% Other 0.8% 30 8/20/2024 9:24 AM p. 686 City of Miami Solicitation RFP 1896386 Inpatient Summary Cigna. Utilization metrics per 1,000 members 400 300 200 100 0 1 Admits Bed Days Base 53.2 334.0 • Current 61.1 390.0 Norm 64.7 357.3 Average cost metrics $32,000 $24,000 $16,000 $8,000 $0 Pr Admit Per Bed Day Base $31,145 $4,964 ■ Current $30,167 $4,729 ■ Norm $26,880 $4,867 Account summary (PMPM basis) Non -Catastrophic Inpatient Catastrophic Inpatient Total Inpatient All Other Service Categories Total Plan Cost Trend Base Current Trend Contribution $54.99 $57.53 4.6% 0.4% $91.47 $96.29 5.3% 0.7% $146.46 $153.82 5.0 % 1.1% $537.00 $603.95 12.5% 9.8% $683.45 $757.77 10.9% • Non -catastrophic inpatient costs increased from $54.99 PMPM to $57.53 PMPM, contributing 0.4% of the overall 10.9% plan trend • Utilization increased from 53.2 to 61.1 adrrits per thousand and increased from 334.0 to 390.0 bed days per thousand • Cost per adrrit decreased from $31,145 to $30,167 and decreased for bed days from $4,964 to $4,729 Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 31 8/20/2024 9:24 AM p. 687 City of Miami Solicitation RFP 1896386 Inpatient - Major Diagnostic Category Summary Cigna. Cost& utilization trends (excluding catastrophic) $PMPM Admits Per 1,000 Days Per 1,000 Cost Per Case Base Current Trend Base Current Trend Base Current Trend Base Current Trend Respiratory $7.98 $12.04 50.8% 5.0 6.6 31.2% 22.2 43.4 95.3% $19,111 $21,968 14.9% P egnancies $5.50 $9.02 63.8% 6.9 10.7 54.8% 19.3 32.2 66.3% $9,541 $10,094 5.8% Metabolic $5.53 $5.07 -8.4% 3.3 3.7 9.3% 6.0 6.3 6.1% $19,853 $16,640 -16.2% Digestive $5.33 $3.93 -26.3% 3.1 1.9 -37.2% 13.8 11.0 -20.8% $20,601 $24,177 17.4% Circulatory $5.07 $3.53 -30.3% 2.9 3.2 10.5% 11.9 10.2 -14.3% $21,219 $13,380 -36.9% Other $25.58 $23.95 -6.4% 17.4 19.5 11.8% 88.8 103.5 16.6% $15,650 $14,681 -6.2% Total Non -Cat $54.99 $57.53 4.6% 38.7 45.6 17.8% 162.1 206.6 27.4% $16,178 $15,127 -6.5% Catastrophic $91.47 $96.29 5.3% 14.6 15.6 7.1% 171.9 183.4 6.7% $70,893 $74,112 4.5% Total $146.46 $153.82 5.0% 53.2 61.1 14.9% 334.0 390.0 16.8% $31,145 $30,167 -3.1% • Respiratory was the top category by plan cost in the current period. Respiratory cost increased from $7.98 PMPM to $12.04 PMPM, an increase of 50.8% • Cost per case for the Respiratory category increased from $19,111 to $21,968, an increase of 14.9% • Ran cost for non -catastrophic increased from $54.99 PMPM to $57.53 PMPM, an increase of 4.6% Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 32 8/20/2024 9:24 AM p. 688 City of Miami Solicitation RFP 1896386 Inpatient Maternity/Newborn Cigna. Maternity admits utilization per 1,000 8 6 4 2 0 L �1 Vaginal Cesarean Other Base 5.0 2.1 0.0 • Current 4.9 5.4 0.2 Norm 5.2 2.9 0.6 Average payment per maternity admit $20,000 $15,000 $10,000 $5,000 $0 Vaginal Cesarean Other Base $9,291 $13,207 $0 ■ Current $7,286 $12,572 $18,715 ■ Norm $10,018 $14,407 $13,970 Newborn admits utilization per 1,000 8 6 4 2 0 Full Term Normal Premature Comp. Base 3.6 1.2 2.4 • Current 1.7 1.0 4.4 • Norm 3.4 1.0 2.1 Newborn admit average cost $160,000 $120,000 $80,000 $40,000 $0 Base • Current • Norm Full Term Normal Premature Comp. $1,751 $159,712 $8,072 $1,323 $90,073 $8,959 $2,145 $61,689 $10,517 Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 33 8/20/2024 9:24 AM p. 689 City of Miami Solicitation RFP 1896386 Top Outpatient Surgeries Cigna. Outpatient surgical details Type of Surgery Endoscopy Cardiac Cath Upper GI Cataract Ovary Removal Skin Hernia Repair Carpal Tunnel Kidney Stones Breast All Other Plan Spend PMPM Visits per lk Avg. Spend per Visit Trend Base Current Contribution Norm Base Current $15.94 $23.41 21.7% $21.28 49.2 54.6 $6.29 $6.55 0.8% $4.65 4.3 2.9 $3.83 $3.19 -1.9% $3.54 10.7 11.2 $1.09 $3.04 5.7% $1.28 2.6 3.7 $2.63 $2.14 -1.4% $1.74 2.2 1.5 $0.09 $1.06 2.8% $0.60 4.3 12.9 $1.79 $0.98 -2.4% $2.01 1.4 0.7 $0.46 $0.43 -0.1% $0.49 1.9 1.5 $0.99 $0.39 -1.7% $0.81 1.0 0.5 $0.72 $0.36 -1.0% $0.45 1.2 0.7 $0.52 $0.09 -1.3% $1.01 1.4 0.2 Average Age Base Current Base Current $3,890 $5,147 52.9 51.8 $17,559 $26,889 53.4 46.7 $4,276 $3,416 42.7 45.8 $4,986 $9,992 60.2 63.8 $14,684 $17,581 38.7 37.3 $254 $988 60.8 56.0 $15,027 $16,158 39.5 66.0 $2,886 $3,526 51.2 54.8 $12,443 $9,558 50.7 48.0 $7,241 $5,985 36.8 35.7 $4,354 $4,208 35.0 17.0 Total $34.35 $41.64 21.2% $37.86 80.2 90.4 $5,139 $5,529 50.5 51.0 Endoscopy procedures per 1,000 60.0 45.0 30.0 15.0 00 Base • Current • Norm Colonoscopy 31.0 34.8 41.7 Bladder 8.6 8.3 10.2 Uterus 6.7 5.1 4.2 Gall Bladder Joint 1.2 1.7 3.4 2.9 2.1 6.5 • The total cost of the surgeries, including been included in this exhibit • Endoscopy w as the top surgery by plan Endoscopy spend increased from $15.94 increase of 46.9% facility and professional costs have spend in the current period. PMPM to $23.41 PMPM, an • Endoscopy had the greatest impact on overall trend, contributing 21.7% Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 34 8/20/2024 9:24 AM p. 690 City of Miami Solicitation RFP 1896386 ' Outpatient - Emergency Room and Urgent Care Detail Cigna. Facility outpatient utilization per 1,000 members ccount summary PMPM asis) 440 330 220 110 0 ER Urgent Care Base 220.8 334.0 • Current 229.2 387.6 • Norm 216.7 439.1 Facility outpatient cost per visit $2,600 $1,950 $1,300 $650 $0 Base • Current • Norm ER $2,501 $2,550 $2,514 Urgent Care $429 $463 $176 Trend Base Current Trend Contribution Emergency Room $46.03 $48.71 5.8% 0.4% Urgent Care $11.95 $14.96 25.1% 0.4% Total Outpatient Facility $142.98 $175.20 22.5% 4.7% Total Ran Cost $683.45 $757.77 10.9% 10.9% • Emergency room costs increased from $46.03 PMPM to $48.71 PMPM, contributing 0.4% of the overall 10.9% plan trend • Urgent Care w as the largest category of utilization. Utilization per thousand increased from 334.0 to 387.6, and compares to a norm of 439.1 • Emergency room was the largest average cost category. Cost per vis t increased from$2,501 to $2,550, and compares to a norm of $2,514 Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 35 8/20/2024 9:24 AM p. 691 City of Miami Solicitation RFP 1896386 Emergency Room/Urgent Care Opportunity Cigna. Cost& utilisation trends Visits Per 1000 Cost Per Visit PMPM Cost Share % Base Current Trend Base Current Trend Base Current Trend Current Emergency Room Non-Steerable 175.0 192.2 10% $2,889 $2,800 -3% $42 $45 6% 6.7% Steerable 45.8 37.0 -19% $1,021 $1,253 23% $4 $4 -1% 14.8% Urgent Care 334.0 387.6 16% $429 $463 8% $12 $15 25% 7.1% Office Visits 3,380.3 3,883.1 15% $157 $152 -3% $44 $49 11% 15.6% Convenience Care 14.6 10.5 -28% $42 $40 -5% $0 $0 -32% 21.1% Virtual Care -Medical 33.2 35.6 7% $55 $55 0% $0 $0 48% 15.5% Total 3,982.9 4,545.9 14% Emergency Room Steerable $102 $113 10% PrimaryOpportunity for Urgent Care Plan Cost PMPM Total Visits Cost Per Visit Musculosleletal $61,907 $1.26 42 $1,473.99 Ear,Nose,Throat $47,614 $0.97 35 $1,360.41 GenMedDiag $20,162 $0.41 15 $1,344.15 Eye $17,078 $0.35 17 $1,004.59 Int/Ext Injury $10,473 $0.21 9 $1,163.70 Skin $10,325 $0.21 10 $1,032.50 Infect/Parasit $6,357 $0.13 8 $794.57 Renal/Urologic $5,149 $0.10 7 $735.60 Gastrointestinal $3,761 $0.08 4 $940.18 Other $7,592 $0.15 5 $1,518.35 Total UC Average Cost Per Visit Pe r Visit Redirect Sav ings Opportunity RedirectSavings 10% Redirect to Urgent Care 25% Redirect to Urgent Care $190,419 $3.87 152 $1,252.75 $373.80 $878.96 *UC Average Cost pervisit calculation for steerable opportunity excludes outliers >$1,500 $13,360 $33,400 Urgent Care - nearest facility • 0-5 rriles 100% • Current period urgent care cost per visit w as $463, compared to emergency room steerable cost per vis t of $1,253 • In the current period, 152 emergency room vis is w ere steerable representing potential redirect savings of up to $133,602 • Of the steerable emergency room visits, 100% had a contracted urgent care facility w ithin 10 miles • Steerable emergency room cost share percentage is 14.8%, compared to urgent care at 7.1% Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 36 8/20/2024 9:24 AM p. 692 City of Miami Solicitation RFP 1896386 )( Office Visits Cigna Office visits per 1,000 members Average plan cost per office visit 8,000 6,000 4,000 2,000 0 Primary Care Specialist Total Base 1,595.2 1,785.2 3,380.3 • Current 1,814.6 2,067.7 3,883.1 • Norm 1,924.9 2,077.3 4,002.2 % of individuals continuously enrolled for at least 12 months who did not see a PCP/SPC 80% 60% 40% 20% 0% All <18 18-39 40-49 50+ ■ No OV 22% 16% 33% 21% 15% • % Employee 44% 0% 34% 75% 74% • % Female 40% 53% 38% 37% 35% $200 $150 $100 $50 $0 Base ■ Current Norm J1 P imary Care Specialist Total $129 $182 $157 $124 $176 $152 $126 $189 $158 • 80% of individuals ages 40 and above received care from a PCP and or Specialist in the current period • 46% of individuals ages 40 and above received an annual physical in the current period • Ran spend for Specialists in the current period w as $30 PMPM compared to $19 PMPM for Primary Care Physicians • Specialist Evaluation & Management cost increased from $18 PMPM to $22 PMPM, an increase of 21.0% Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 37 8/20/2024 9:24 AM p. 693 City of Miami Solicitation RFP 1896386 Cigna Care Designation - Utilization and Cost Statistics Cigna CCD visits for PCP and SCP 80% 60% 40% 20% 0% Base • Current Norm Lil CCD FCP CCD Opportunity PCP 41% 58% 40% 59% 33% 66% CCD SCP CCD Opportunity SCP 39% 59% 39% 59% 38% 56% Cigna Care Designation opportunity - nearest provider 100% 75% 50% 25% 0% or 0 to 10 rriles 11 to 20 rriles 21 to 30 rriles PCP ESOP CCD provider efficiency opportunity Market Client Episodes Total Non CCD Provider Episode Cost top markets Total CCD Provider Episode Cost Efficiency FL South Florida FL Orlando FL Tarrpa 2,725 197 35 $3, 676, 334 $62,981 $64,311 $2, 926, 203 $48,061 $55,264 $750,131 $14,920 $9,047 • 59% of plan spend for Cigna Care Designation primary and specialties utilization has the opportun ty for Cigna Care utilization • Cigna Care Designation represents applicable services w here a Cigna Care Designation provider was utilized. Cigna Care Designation opportunity represents applicable services w here a Cigna Care Designation provider w as not utilized, but one is available w ithin 30 rriles • Efficiency is derived using book of business experience w thin each market; average cost is then case mix and severity adjusted based on your members' actual experience • Efficiency opportunity is derived by taking the actual number of members w ho did not see a CCD provider and comparing their cost per episode to the cost for the same types of episodes delivered by CCD providers • Total efficiency opportunity represents the dollar impact if all of the episodes that were treated by non CCD providers moved to CCD providers Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 38 8/20/2024 9:24 AM p. 694 City of Miami Solicitation RFP 1896386 Top CCD Provider Opportunity Markets Cigna. Top opportunity markets detail Rank Market #1 FL South Florida CCD Cost Efficiency Specialty Description Cost Per Episode Orthopedics And Surgery $1,694 Hematology $5,429 Internal Medicine $725 General Surgery $6,601 Neurology $2,504 Non-CCD Cost Efficiency Client Cost Per Avg Episode Efficiency Episodes Episode Difference Opportunity 89 $3,181 $1,486 $132,284 14 $13,861 $8,432 $118,045 421 $986 $261 $109,933 47 $8,398 $1,797 $84,471 68 $3,670 $1,167 $79,352 639 $524,085 #2 FL Orlando Orthopedics And Surgery $1,648 General Surgery $5,576 Farrily Practice $183 Obstetrics And Gynecology $328 Urology $1,186 2 $5,529 1 $8,835 171 $194 11 $438 1 $1,503 186 $3,881 $7,762 $3,258 $3,258 $11 $1,828 $109 $1,203 $316 $316 $14,368 #3 FL Tampa Ophthalmology $1,529 Rheumatology $8,412 Urology $1,619 Obstetrics And Gynecology $2,724 Fdiatrics $273 6 $2,000 2 $9,504 6 $1,890 3 $3,228 6 $417 23 $471 $2,825 $1,092 $2,183 $271 $1,629 $504 $1,511 $144 $865 $9,013 Base Period refleds claims incurred between Jan. 2020 and Dec.2020, paid through Feb. 202 39 8/20/2024 9:24 AM p. 695 City of Miami Solicitation RFP 1896386 )( Cigna Health Matters - Engagement Index Summary Cigna Total health engagement as a % of population Base Norm-44% Current • Cigna's Health Matters Engagement Index provides greater insight into engagement across all of the health and wellness programs and services Cigna offers • In the current period 46% of the total population has engaged in tw o or more Health Maintenance actions or one or more Health Improvement actions. This is an increase of 4% from the base period of 42%. This compares to a norm of 44% • When engagement is split into Health Maintenance and Health Improvement activities, 42% of the population has completed 2 or more Health Maintenance activities, and 8% of the population completed 1 or more Health Improvement activities during the current period, compared to 38% and 7% respectively in the base period • When the population is split into segments using ETG methodology, the Chronic Illness segment had the greatest overall engagement at 61% for the current period Engagement by behavior type and population segment Segment Chronic Illness Major Episode* / Maternity Minor Episode** Healthy*** Non User Total *Major Episode >$500 perepisode **Minor Episode <$500 per episode *** Healthy-onlypreventiveclaims Health Maintenance (HM) (2+) Base Current Norm 48% 54% 70% 46% 44% 59% 39% 45% 62% 23% 24% 49% 7% 5% 7% Health Improvement(HI) (1+) Base Current Norm 15% 16% 15% 3% 3% 4% 0% 1% 1% 1% 1% 1% 0% 1% 0% 1111111otal Engagement (2+ HM or 1+ HI) Base Current 55% 61% 76% 47% 46% 61% 40% 46% 63% 23% 25% 49% 7% 6% 7% 38% 42% 41% 7% 8% 5% 42% 46% 44% Current Period reflects claims incurred betweenJ an. 2021 and Dec. 2021, paid throu1 Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 40 8/20/2024 9:24 AM p. 696 City of Miami Solicitation RFP 1896386 Ir Engagement Index - Top Activities Cigna. Top engagement activities Health Maintenance 53% ▪ Preventive Care ▪ Dental Cleaning ▪ Gaps in Care ▪ Goal Set - Phone ▪ EAP Interaction ▪ Other 34% Health Improvement ▪ Gaps in Care ▪ Specialty Case Management • Goal Set - Phone 55% ▪ Pre/Fbst Adrrission Counseling • Treatment Decision Support • It is important to understand the activities that drive engagement. The graph above Improvement for those individuals meeting the engagement criteria. • Top Health Maintenance activities for those meeting the engagement criteria in the 17% . Top Other activities include 24 HIL Interaction at 1% , Health Screening at 1% • Top Health Improvement activities for those meeting the engagement criteria in the Set - Phone at 7% . Top Other activities include Inpatient Case Management at 0% , illustrates the activities rrost often completed for both Health Maintenance and Health current period were, Preventive Care at 53% , Cental Cleaning at 25% and Gaps in Care at current period w ere, Gaps in Care at 55% , Specialty Case Management at 34% and Goal Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 41 8/20/2024 9:24 AM p. 697 City of Miami Solicitation RFP 1896386 )( Well Informed Gaps in Care - Summary Cigna. Rule compliance summary 100% 75% 50% 25% 0% ■ Current • Norm Non -Compliant Compliant 17.8% 82.2% 19.8% 80.2% Compliance by category 100% 75% 50% 25% 0% Achieve Approp. Approp. Med. Patient Targets Montor. Therapy Adhere. Safety ■ Current 85.0% 90.0% 75.2% 87.8% 96.6% ■ Norm 84.9% 87.8% 69.0% 88.7% 94.8% Current Period reflects Well Informed Gaps in Care program act Nity between Jan.2021 and Dec.2021 Compliance by condition 100% 75% 50% 25% 0% HTN L HPL Obesity Diabetes Asthma • Current 87% 92% 92% 84% 94% • Norm 85% 90% 92% 83% 94% . 3,913 members qualified fora gap in care evaluation, w ith 1,856 compliant and 2,057 non -compliant w ith evidence -based medicine guidelines • 82.2% of rules evaluated w ere compliant with evidence -based medicine guidelines, compared to a norm of 80.2% • The greatest number of members w ith gaps w as found in the 50-59 age band, w ith 625 total members • The Diabetes category had the greatest rate of multiple gaps (2 or more), 71 % 42 8/20/2024 9:24 AM p. 698 City of Miami Solicitation RFP 1896386 )(: Cigna Health Matters - Your Health First Cigna Total health engagement as a percent of population 60% 45% 30% 15% 0% Base Current Norm Engagement asa percent of Engagementasapercentof total population identifiedpopulation 42% 50% 46% 56% 44% 57% Identified and engaged by program Service Type Identified/Total Population Engaged / Identified Count of Individuals Chronic Condition Coaching 1,621 Lifestyle Coaching 878 WeIInessCoach ing 818 Treatment Decision Support 94 Case Management 48 Employee Assistance Program 0 Curr % Norm % Curr % Norm % 39.5% 21.4% 19.9% 2.3% 1.2% 0.0 % 29.4% 16.8% 15.6% 1.7 % 0.4 % 0.0 % 56.5 % 62.4% 64.8% 67.0 % 83.3% 0.0 % 56.5% 67.3% 66.7% 63.6% 78.6% 0.0 % Total Unique 1,942 47.3% 37.4% 56.0 % 57.2% • Cigna's Health Matters prioritizes for coaches the health risks that a customer should w orkon and predicts optimal outreach to customers (phone, or email/text) w hich guides them to the health programs that customers prefer (online or live coaching). The Identified Population are outreached members and self -identified customers. YHF focuses on individuals holistically - bringing together lifestyle, social, and behavioral support for individuals. • The overall population had an engagement rate of 46% in the current period. The Identified population had an engagement rate of 56% in the current period, an increase of 6% from the base period of 50%. This compares to a norm of 57% • There w ere 1,088 members engaged across YHF coaching services. The mode w ith the greatest engagement during the current period w as Preventive Care at 68% Engagement by modality for identified population 80% 60% 40% 20% 0% Preventive CareAlertwith Action Telephonic Digital All Other Base ■ Current • Norm 63% 22% 8% 1% 68% 20% 10% 1% 5% 1% 69% 12% 5% 11% 3% Current Period reflects claims incurred betweenJ an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 43 8/20/2024 9:24 AM p. 699 City of Miami Solicitation RFP 1896386 Chronic Conditions - Engagement Detail Cigna. Current period detail Identified /Total Population Engaged / Identified Condition Count of Curr % Norm % Individuals Asthma 273 6.6% 5.7% COED 61 1.5% 1.4% Congestive Heart Failure 84 2.0% 1.4% Coronary Artery Disease 210 5.1% 5.2% Cepression 462 11.3% 11.6% Diabetes 445 10.8% 8.7% Low Back Pain 408 9.9% 8.6% Osteoarthritis 174 4.2% 4.8% Fripheral Arterial Disease 43 1.0% 0.8% Weight Complications 403 9.8% 9.0% 1,621 39.5% 29.4% 48.3% 1 t 17.5% I 56.5% Total Unique HM 54.6% 55.7% 48.8% 46.2% 50.6% 45.2% f 52.0% 52.3% 46.5% f 53.8% Total 61.9% 70.5% 66.7% 63.8% 56.1 % 62.5% 57.6% 62.6% 65.1% 60.3% HI % 29.5% 39.3% 34.8% 35.3% 20.7% 37.2% 13 .2% 11 .7% 13 .0% 15 .4% Engaged / Identified Norms IHM% 6.6% 0.7% 39.0% 0 46.8% 54.5% 50.2% 55.9% 53.8% 38.8% 62.9% HI % 14.0% 19.1 % 28.2% 21.5% 10.0% 28.5% 10.3% 14.5% 22.8% 10.9% 51.7% 12.2% Total Eng! 61.2% 47.9% 51.7% 55.2% 57.8% 61.8% 59.6% 59.0% 48.5% 66.4% 56. Engagement by modality for chronic identified 80% 60% 40% 20% 0% • Current • Norm Preventive Care Alert w ith Telephonic Action Digital 67% 21% 10% 1% 61% 12% 8% 15% All other 1% 4% • Chronic conditions are a significant driver of medical cost and reduced productivity • In the current period, predictive models have identified 39.5% of the population w ith a chronic condition, compared to 38.5% in the base period • Of those identified, 56.5% w ere engaged in current period, compared to 51.8% in the base period and is higher than the norm of 56.5% • There w ere 916 members engaged across the chronic coaching service. The mode w iththe greatest engagement during the current period was Preventive Care at 67% Current Period reflects claims incurred betweenJ an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 44 8/20/2024 9:24 AM p. 700 City of Miami Solicitation RFP 1896386 YHF - Lifestyle, Wellness and Treatment Decision Support Cigna Lifestyle Coaching Individuals Stress 33 0.8% 1.5% Tobacco 17 0.4% 0.8% Weight 862 21.0% 20.8% Total Unique Wellness Coaching Identified /Total Population Count of Curr % Norm % 878 21.4% 16.8% Identified /Total Population Count of Curr % Norm % Individuals Healthy Eating 32 0.8% 1.6% Physical Activity 39 0.9% 1.5% Hypertension 372 9.1% 9.6% Hyperlipiderria 174 4.2% 2.7% Prevention 257 6.3% 4.3% Re -Diabetes 275 6.7% 6.2% Maintaining a Healthy Lifestyle 2 0.0% 0.4% Total Unique Treatment Decision Support 818 19.9% 15.6% Identified /Total Population Count of Curr % Norm % Individuals Benign Uterine 8 0.2% 0.1% Prostate/Breast Cancer 0 0.0% 0.0% Coronary ArteryDis. 58 1.4% 0.9% Low Back Pain 2 0.0% 0.1% Osteoarthritis Hip 0 0.0% 0.0% Osteoarthritis Knee 32 0.8% 0.6% Engaged / Identified 21.2% 17.6% 18.8% 18.7 Eng 78.8% 64.7% 62.2% 62.4% Engaged / Identified Norms HM % 86.3% 70.2% 64.1% 63.5% Total Big 88.2% 73.2% 67.6% 67.3% Engaged / Identified Engaged / Identified Norms HM % 78.1% 74.4% 50.0% 55.7% 63.0% 57.8% 100.0% 54.0 Total Unique 94 2.3% 1.7% HI % 37.5% 38.5% 33.9% 37.4% 24.1% 20.0% 0.0% i 24.9% Total En 84.4° 87.2° 64.2° 69.5 69.6 66.5% 100.0° HM % 90.5% 92.1 55.1 % 64.6% 77.3% 62.3% 90.4% 61.6 HI % 14.7% 13.7% 16.3% 30.9% 17.9% 10.8% 15.4% 15 24 Total Big 91.3% 92.6% 61.1% 74.3% 80.1 % 65.6% 91.0% 66.7% Engaged / Identified Engaged / Identified Norms 75.0% 0.0% 56.9% 50.0% 0.0% 50.0% 57.4% .0 0.0% 34.5% 0.0% 0.0% 15.6% 25.5% Total Eng 67.5% 0.0% 69.0% 50.0% 0.0 56.3°u 67.0 HM % 70.9% 100.0% 52.0% 58.6% 52.6% 54.2% 54.8% HI %' 17.3% 100.0% 32.7% 25.5% 15.8% 21.3% 26.7% r Total Big 75.0% 100.0% 63.7% 66.2% 55.3% 60.5% 63.6% Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 45 8/20/2024 9:24 AM p. 701 City of Miami Solicitation RFP 1896386 Coaching Engagement Summary - Telephonic Cigna. Telephonic coaching - identified and engaged by program Telephonic Identified Population Program Count of %of Norm % of Individuals Population pop Chronic Condition Coaching 860 20.9% 16.4% Lifestyle Coaching 558 13.6% 11.8% Wellness Coaching 663 16.1% 12.6% Treatment Decision Support 94 2.3% 1.7% Case Management 48 1.2% 0.4% Employee Assistance Program 0 0.0% 0.0% Telephonic Engaged/ Engaged/ Telephonic Telephonic Identified Identified Total Unique 1,112 Telephonic activity by type 60% 45% 30% 15% 0% 27.1 % 22.4 HI % 9.5% 10.0% 9.8% 7.4% 54.2% 0.0% 1 2.7% 8.2% • Current • Norm Chronic/Lifestyle/ SPCM 24/7 Nurseline Pre/Post All Other Wellness 46% 34% 11% 4% 5% 59% 20% 4% 1% 17% Total Eng % 10.5% 11.8% 11.8% 7.4% 54.2% 0.0% 9.50 59.7% HM % 52.3% 56.6% 57.4% 66.7% 0.0% 53.9% I I 22.2% a 64.0% 66.2% HI % 26.3% 24.6% 26.5% 25.5% 64.6% 0.0% Total Eng % 64.7% 69.4% 67.6% 67.0% 83.3% 0.0% Norm Eng % 65.2% 73.1 % 70.1 % 63.6% 78.6% 0.0% • In the current period, predictive models have identified 27.1% of the population for telephonic outreach compared to 28.9% in the base period. This compares to a norm of 22.4% • Telephonic engagement rate w as 9.5%, a 2% increase from the base period. Overall engagement rate w as 64.0%, a 5% increase from the base period , and lower than the norm of 66.2% • There w ere 106 members engaged telephonically across all the coaching services. The mode w ith the greatest engagement during the current period w as Chronic/LifestyleNVellness at 46% Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 46 8/20/2024 9:24 AM p. 702 City of Miami Solicitation RFP 1896386 Health Advocacy - Inpatient Utilization Management Cigna. Inpatient utilization management summary table Unique Members Events Savings($) %of Members Base Current Base Current Base Current Base Current Norm Pre -Certification Adrrissions Avoided 16 12 16 13 $393,878 $321,887 0.38% 0.29% 0.17% Inpatient Utilization Mgmt Decertified Days 14 14 54 49 $200,502 $181,937 0.33% 0.34% 0.00% Bed Day Intensity Mgmt 5 5 18 18 $24,220 $24,912 0.12% 0.12% 0.03% Readmissions Avoided 0 0 $0 $0 0.00% 0.00% 0.00% Total - Precert + IP UM 35 31 88 80 $618,600 $528,736 0.84% 0.76% 0.33% Clinical program management $24,912 5% $181,937 34% $321,887 61% • Admissions Avoided ▪ Cecertified Days • Bed Day Intensity Mgrrt • Inpatient pre -certification and utilization management generated $528,736 in savings and touched 31 individuals in the current period • Savings decreased from the base period result of $618,600 • 13 admissions were avoided, resulting in $321,887 savings • 49 days w ere decertified for $181,937 in savings and 18 days w ere stepped downfor$24,912 savings Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 47 8/20/2024 9:24 AM p. 703 City of Miami Solicitation RFP 1896386 Health Advocacy - Outpatient Utilization Management Cigna. Outpatient utilization management Unique Members Requests Avoided Sav ings($) %ofMembers Base Current Base Current Base Current Base Current Base Current Norm MRI 231 293 343 406 89 89 $97,455 $97,455 5.51% 7.14% 2.32% Ft 14 20 20 25 9 9 $27,621 $27,621 0.33% 0.49% 0.13% CT 158 207 224 294 46 73 $45,540 $72,270 3.77% 5.04% 1.60% DME 4 4 6 9 0 2 $0 $7,002 0.10% 0.10% 0.03% Medical Injectables 38 44 45 56 6 14 $18,630 $43,470 0.91% 1.07% 0.29% Total Medical Cost Managerrent (TMC) 261 264 * * $270,843 $229,147 6.23% 6.43% N/A Other 122 105 178 173 79 63 $67,184 $53,235 2.91% 2.56% 1.86% Total 730 795 816 963 229 250 $527,273 $530,200 17.43% 19.37% 6.82% Cost avoided by category $27,621 5% $43,470 8% $53,235 10% $72,270 14% $7,002 1% $97,455 Ro/ $229,147 44% • TMC • MRI • CT Other • Medical Injectables FtI DME • Outpatient pre -certification generated $530,200 savings and touched 795 individuals in the current period • Savings increased from the base period result of $527,273 • Total Medical Cost Management (TMC)s were the primary source of savings, $229,147 in savings * Health Advocacy- Total Medical Cost Managerrent (CP 084) details are available in the next slide. Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 48 8/20/2024 9:24 AM p. 704 City of Miami Solicitation RFP 1896386 i 4�yr -- fr Health Advocacy - Total Medical Cost Management Cigna. Total Medical Cost Management Management Program Savings Per Description Avoided/Events Avoidance/Event Total Savings Radiation Therapy Through partnership with eviCore, Cigna customers receive end to end Episode of Care management for targeted cancer disease profiles, spanning from referral base (radiation oncologist) to treatment (therapy) to the final delivery of radiological dose. Cardiology Management Through a eviCore partnership, Cigna outpatient nuclear cardiology, cardiac cath and stress echo precertifications are clinically reviewedto ensure compliance with our best practice clinical guidelines. Sleep Therapy Cigna partners w ith eviCore to improve the overall quality and cost of sleep services through precertification requirements, movement of studies (roman outpatient to home setting (w hich drives efficiency w ithout sacrificing efficacy), and end to end clinical management of obstructive sleep apnea. Physical Therapy Cigna ensures appropriate customer access to outpatient physical therapy/occupational therapy (PT/OT) care by incorporating evidence -based clinical coverage standards; Medical Necessity Review s (MNR) are conducted for both Participating and Non -Participating PT/OT practitioners. Chiropractic Services Cigna ensures appropriate customer access to quality chiropractic care by incorporating evidence -based clinical coverage standards in reviewsforboth Participating and Non -Participating providers. Review s focus on chiropractic care that demonstrates inconsistencies w ith recommended clinical evidence. Musculoskeletal/Pain Cigna w orks w ith ev iCore healthcare to provide quality, cost-effective services to Management customers for select inpatient and outpatient rrusculoskeletal and pain management services. This program helps elirrinate excess utilization w hen services do not meet evidence -based guidelines to help improve clinical outcomes. Genetic Testing Genetic counseling sessions adrrinistered prior to genetic testing help ensure tests are appropriate for the customer and avoid potentially costly inappropriate testing. Total 9 $3,800 $34,200 8 $1,145 $9,160 41 $1,890 $77,490 162 $124 $20,129 48 $64 $3,064 11 $6,887 $75,755 9 $1,039 $9,350 288 $796 $229,147 % of Medical Claims 0.8% Current Period reflects claims incurred betweenJ an. 2021 and Dec. 2021, paid throui Feb.2022 49 8/20/2024 9:24 AM p. 705 City of Miami Solicitation RFP 1896386 )( Health Advocacy - Specialty Case Management Cigna. Specialty case management summary Unique Members Interventions Closed Cases Sav ings($) % of Members Base Current Base Current Base Current Base Current Base Current Norm Catastrophic 1 1 36 50 1 1 $764 $0 0.02% 0.02% 0.01% Complex 53 118 621 671 64 152 $18,032 $7,820 1.27% 2.87% 0.48% Maternity 6 8 74 193 6 7 $60,868 $216,351 0.14% 0.19% 0.04% Medical Injectable Steerage 1 2 5 3 0 2 $0 $0 0.02% 0.05% 0.01% NICU 8 4 107 50 8 3 $102,772 $48,883 0.19% 0.10% 0.03% Oncology 16 21 365 249 19 25 $17,762 $22,250 0.38% 0.51% 0.21% Renal Case Management 2 3 19 31 2 3 $6,759 $14,234 0.05% 0.07% 0.01% Transplant 4 7 120 135 3 3 $460,852 $7,357 0.10% 0.17% 0.03% Total 87 158 1,347 1,382 103 196 $667,809 $316,895 2.08% 3.85% 0.82% Case management referral s ource 10% 14% Provider Predictive Model Inpatient Case Management • Specialty case management managed 158 individuals in the current period, or 3.85% of the population compared w ith 87 or 2.08% in the base period • 196 cases closed in the current period, generating $316,895 in savings compared to 103 cases and $667,809 in the base period • Savings w ere driven by the Matern ty unit contributing $216,351 of $316,895 current period savings Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 50 8/20/2024 9:24 AM p. 706 City of Miami Solicitation RFP 1896386 Behavioral Health - Customer & Clinical Interactions Cigna. Behavioral Interactions Summary Interaction Type Customer Engagement Health Care Provider Engagement Access and Crisis Support CustomerAdvocacy Total Interactions Unique Customers Engaged Description Outreaching and coaching customers to better manage their behavioral conditions - Includes coaching and care management for Substance use disorders Eating disorders Autism Children and families & young adults Intensive care management/Bipolar Lifestyle management programs Collaborating w ith healthcare providers to provide optimal care - Inpatient and outpatient utilization management - Complex psychiatric case management - Narcotics therapy management Offering behavioral triage and after hours support to customers w ho reach out to or are transferred to Behavioral health - Behavioral intake and assessment - Emergent referrals (seen in less than 6 hours) or referral to a care manager - Referral to an outpatient provider and coordinated appointment scheduling - Referral to an Employee Assistance Program Fielding customer requests - Benefit information and clarification - Claims status and adjustment requests - Collaboration w ith CAC and other health providers Number of Interactions Customers Engaged 143 21 160 48 275 95 719 174 1,297 397 Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 51 8/20/2024 9:24 AM p. 707 City of Miami Solicitation RFP 1896386 Onsite Health - Summary & Individual Sessions Cigna. Onsite Summary Total Unique Individual Members - Individual Sessions Base Current Individuals Individuals 335 138 Total Unique Group Members - Group Sessions 101 30 Total Unique Individuals Individual S es sion Activity Health Education - Total Unique Individuals 343 Base Individuals 309 138 Current Individuals 121 Health and Wellness Chronic Conditions Lifestyle Managerrent Health Coaching - Total Unique Individuals 793 1 54 15 260 0 110 8 Health and Wellness Chronic Conditions Lifestyle Managerrent Health Assistance -Total Unique Individuals 0 0 5 33 1 0 2 30 Biometric measurement Health Assessment Assistance Flu Shots Administered Total Unique Individuals Goals Set by Individuals Goal Category Goals Set 34 0 0 335 31 0 0 138 Goals Goals Goals %Progressed/ Open Progressed Met Met Healthy Eating Weight Improve Exercise All Other 2 1 1 0 0 0 0 0 0 0 0 0 2 1 1 0 100.0% 100.0% 100.0% 0.0% Total Goals 4 0 0 4 100.0% Coaching Sessions by Percent of Individuals 100% 75% 50% 25% 0% Base ■ Current 1 Coaching Session 53% 88% 2 Coach ing Sessions 3+Coach ingSessions 27% 20% 13% 0% • The total unique individuals engaged onsite was 138 in the current period versus 343 in the base period • Of the 138 in individual sessions, the highest engaged activity w as Health Education with 121 unique individuals engaged • There w ere a total of 4 new Goals Set in this period w ith a total of 0 Goals Open at the end of the period. There w ere 0 Goals Progressed and 4 Goals Met for a total of 100.0% of Goals Progressed/Met • Healthy Eating w as the category w ith the largest number of Goals Set w hile Healthy Eating had the highest percentage of Goals Progressed/Met • The depth of coaching engagement showsthat most engaged individuals had 1 Coaching Session, follow ed by individuals w ith 2 Coaching Sessions and with the few est individuals engaged in 3+ Coaching Sessions Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 52 8/20/2024 9:24 AM p. 708 City of Miami Solicitation RFP 1896386 Executive Summary - Pharmacy Cigna. Plan cost & trend $180 $135 $90 $45 $0 930 Base Current Norm Trend • Cost Share PMPM $9.38 $9.85 $12.19 5.0% • Paid Amount PMPM $123.08 $140.84 $155.13 14.4% Ran Spend PMPM $132.46 $150.69 $167.33 13.8% Trend impact 16.0% 12.0% 8.0% 4.0% 0.0% Overall Inflation Drug Mix Utilization 13.8% 2.5% 9.2% 2.1% Pharmacy performance Members Average Numberof Employees Average Numberof Members Average Utilizers Average MemberAge Base Current Trend Norm 2,038 1,989 4,184 4,106 70.5% 73.9% 36.0 36.3 Cost Trend Plan Spend $6,649,647 $7,423,713 Employer Paid $6,178,866 $6,938,416 MemberCost Share $470,781 $485,297 Drug Mix Generic Dispensing Rate Preferred Brand Non -Preferred Brand Generic Substitution Rate Formulary Brand Compliance Rate Utilization Total Prescriptions Retail Adjusted Scripts % Mail Order % Retail % Retail 90 Days Supply PMPM -2.4% -1.9 % 3.4% 0.9% 11.6% 12.3% 3.1% 37.5 90.5% 91.5% 0.9% 90.4% 7.8% 6.2% -1.6% 7.0% 1.7% 2.4% 0.7% 2.5% 97.0% 97.1% 0.1% 97.6% 85.2% 86.1% 1.0% 83.2% 39,483 41,666 5.5% 55,274 57,886 4.7% 17.5% 16.0% -1.6% 10.3% 56.2% 56.5% 0.3% 55.3% 26.2% 27.5% 1.3% 34.4% 29.21 29.82 2.1% 32.67 SpecialtyPharmacy Pharmacy Plan Spend PMPM $66.23 $82.23 24.2% $80.14 Medical Plan Spend PMPM $45.08 $43.83 -2.8% $35.34 Pharmacy Plan Spendas%of Total 50.0% 54.6% 4.6% 47.9% Specialty Utilizers 220 212 -3.6% Specialty ScriptsPMPY 0.17 0.15 -9.5% 0.18 Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 53 8/20/2024 9:24 AM p. 709 City of Miami Solicitation RFP 1896386 le Patient Assurance Program - Performance Cigna. Summary 144 customers with $25 / script cost share saved $10,273 Detail PAP Customer Total Savings Savings PMPM Average Per Script Savings PAP Script Count % of Total Scripts Scripts Per Customer Without PAP Cost Share Per Script With PAP Cost Share Per Script PAP Customer Count % of Total Fbpulation Current $10,273 $0.21 $10 1,047 1.8% 7.3 $35 $25 144 4.4% Cost share breakdown ■ Customer ■ Manufacturer ■ Client Without PAP With PAP $36,448 $26,175 $0 $10,273 $597,138 $597,138 $10,273 saved on essential medications may drive better adherence and improved future health outcomes Top Customer Savings by Drug Drug Name Trulicity Farxiga PAP Customer Customer Customers Scripts Spend Savings 30 174 $4,350 $1,970 25 182 $4,550 $1,810 Ozempic 29 124 $3,100 $1,414 Other 121 567 $14,175 $5,079 Total 144 1,047 $26,175 $10,273 Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 Comments • 100% of PAP customers filled medications for other conditions including Diabetes, Hypertension and Cholesterol • The total pharmacy cost of the 144 PAP customers w as $1,356,416, 18% of total pharmacy spend in the current period • Total customer savings of $10,273 w as achieved on eligible drugs w ith cost share greater than $25 per month 54 8/20/2024 9:24 AM p. 710 City of Miami Solicitation RFP 1896386 Specialty Pharmacy & Medical - Top Therapeutic Class Trend Cigna Therapeutic class trend driver analysis by plan spend Rank Base Current 1 1 2 2 3 3 4 4 5 5 9 6 20 7 6 8 7 9 8 10 Therapeutic Class Anti neopladics Anti-Inflam DiseaModifiers Antivirals, HIV Specific M ulti ple/Lateral Sclerosis Gene Therapy Agents Seborrhea/Psoriasis Hematopoietic Agents Vasodilators Bone Immune Related All OtherSpecialty Condition Cancer RA/Psoriasis/Crohn's Antivirals, HIV Specific Multiple Sclerosis Spinal Muscular Atrophy RA/Psoriasis/Crohn's OtherBlood Disorders Pulmonary Hypertension Osteoporosis IVIG/Immune-related Plan Spend PMPM Total Base $31.01 Current $32.25 Benefit Drug Spend Current Unique Utilizing PMPM Members Members Trend Norm Pharmacy 4.0% $23.95 $9.04 $28.53 $27.24 -4.5% $26.78 $22.25 $16.26 $18.41 13.2% $8.58 $18.41 $8.77 $8.21 -6.5% $4.33 $6.77 $7.15 $6.75 -5.7% $0.27 $6.75 $1.79 $5.83 226.3% $6.50 $5.83 $0.31 $5.27 1618.2% $1.30 $2.69 $3.56 $4.53 27.4% $0.93 $4.53 $2.46 $4.08 65.6% $0.69 $0.26 $2.39 $2.10 -12.0% $1.85 $1.42 $9.08 $11.40 25.6% $40.31 $4.30 $111.31 $126.06 13.3% $115.48 $82.23 Medical Current Trend $23.21 20 -23.1% $4.99 30 7.1% 36 9.1% $1.44 7 16.7% 1 5 150.0% $2.58 6 200.0% 2 100.0% $3.82 9 80.0% $0.68 14 - $7.10 106 -9.4% $43.83 212 3.6 % Comments • The top ten therapy classes accounted for 91.0% ($5,648,566) of the total specialty plan spend ($6,210,278) in the current period. Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 55 8/20/2024 9:24 AM p. 711 City of Miami Solicitation RFP 1896386 Specialty Pharmacy & Medical - Top Drug Spend Cigna Top drugs by spend Rank Base Current 1 1 3 2 18 3 7 4 52 5 11 6 14 7 8 8 48 9 4 10 11 12 16 13 13 14 49 15 Drug Name Stel a ra (S Rx) Bi Idarvy(SRx) Evrysd i (S Rx) Keytruda Perj eta Prolia Humira(Cf) Pen (S Rx) Ibrance(SRx) Verzenio(SRx) Remicade Ruxience Og i vri Triumeq(SRx) Mavenclad(SRx) T rem fya (SRx) All OtherSpecialty Condition RA/P so ri a si s/Cro h n's Antivirals, HIV Specific Spinal MuscularAtrophy Cancer Cancer Osteoporosis RA/Psoriasis/Crohn's Cancer Cancer RA/P so ri a si s/Cro h n's Cancer Cancer Antivirals, HIV Specific Multiple Sclerosis RA/ P so ri a si s/Cro h n's Plan Spend (PMPM) Base Current Trend Norm $11.82 $9.41 -20.4% $5.52 $6.30 $7.32 16.2% $2.53 $1.83 $6.75 269.0% $0.27 $4.24 $4.82 13.6% $1.11 $0.37 $4.77 1177.6% $1.14 $2.46 $3.82 55.0% $0.39 $2.31 $3.67 59.3% $6.49 $3.12 $3.22 3.2% $1.09 $0.50 $2.95 486.1% $0.48 $5.39 $2.88 -46.6% $0.57 $2.76 - - $2.75 - $2.07 $2.74 32.7% $0.85 $2.36 $2.73 15.7% $0.23 $0.47 $2.69 470.7% $1.18 $68.06 $65.82 -3.3% $93.63 Plan Spend $463,634 $360,456 $332,352 $237,336 $234,843 $187,964 $181,015 $158,588 $145,219 $141,808 $135,817 $135,635 $135,149 $134,670 $132,767 $3,242,673 Members Claims Base Current Base Current 4 5 40 32 10 14 94 102 1 1 4 14 3 1 4 3 1 1 1 7 5 7 18 26 5 4 20 30 1 1 13 12 1 1 2 11 8 6 50 27 1 - 7 1 8 4 6 33 41 1 1 2 2 1 2 3 22 189 180 851 888 Total $111.31 $126.06 13.3% $115.48 $6,210,278 220 212 1,135 1,232 Comments • The top fifteen Specialty Pharmacy and Medical drugs accounted for50.3% ($3,122,192) of the total Specialty plan spend ($6,210,278) in the current period. • The Specialty Top Drugs by Plan Spend(PMPM) are: Stelara ($9.41), Biktarvy ($7.32), and Evrysdi ($6.75). Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 56 8/20/2024 9:24 AM p. 712 City of Miami Solicitation RFP 1896386 Accredo Therapeutic Resource Centers® Cigna. Through the Accredo Therapeutic Resource Center® (TRC) model, we are able to leverage data across all benefits with advanced analytics and predictive modeling to identify those in most need of support. 15 Specialized areas of focus, including: 57 customers 571 calls RA & Inflammatory RA & Inflammatory Transplant Conditions HIV Active customers 25 14 11 6 With completed assessments 24/96% 9/64% 11/100% 5/83% With clinical calls 13 2 7 3 Therapy education Accredo helped educate 8 customers on the importance of therapies and also managed 2 & Adverse events adverse events. Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 57 8/20/2024 9:24 AM p. 713 City of Miami Solicitation RFP 1896386 Top Therapeutic Class Trend Cigna Therapeutic class trend driver analysis by plan spend Unique Utilizing Days Supply Rank Plan Spend PMPM Members Members PMPM Inflation Base Current Therapeutic Class Condition Base Current Trend Norm Current Trend Trend Trend 1 1 Anti-InflamDisease Modifiers Psoriasis $22.94 $22.48 -2.0% $26.79 21 5.0% 9.7% 4.3% 2 2 Antivirals, HIV Specific HIV $16.26 $18.41 13.2% $8.58 36 9.1% 8.1% 4.7% 3 3 Hypoglycemics Diabetes $11.98 $14.77 23.3% $19.25 296 -1.0% 3.1% 4.2% 4 4 Antineoplastics Cancer $8.78 $9.29 5.8% $15.31 61 -1.6% -1.8% 8.5% 5 5 MultipleiLateralSclerosis Multiple Sclerosis $8.11 $6.77 -16.6% $4.13 6 20.0% -32.2% 5.0% 17 6 Gene Therapy Agents Spinal Muscular $1.83 $6.75 269.0% $0.27 1 0.0% 256.7% -0.0% Atrophy 6 7 Insulins Diabetes $7.14 $6.00 -15.9% $7.20 69 1.5% -16.9% -0.9% 16 8 Seborrhea/Psoriasis Seborrhea/Psoriasis $1.87 $5.88 214.7% $6.64 20 5.3% 135.0% -45.9% 7 9 Asthma Related Asthma $4.41 $5.12 15.9% $8.51 609 3.0% -12.8% -0.5% 9 10 Vasodilators Pulmonary $3.64 $4.68 28.6% $1.06 40 5.3% 24.5% 3.0% Hypertension 8 11 Lipid Lowering Cholesterol $4.08 $3.87 -5.1% $4.10 619 5.3% 2.4% -0.1% 52 12 Hematopoietic Agents White CeII Stimulant $0.23 $2.69 1048.3% $0.38 3 200.0% 73.7% -18.2% 11 13 Contraceptives Contraception $2.63 $2.62 -0.4% $2.66 243 -4.3% -6.5% 1.2% 12 14 Anticoagulants Blood thinner $2.29 $2.54 11.1% $4.29 146 7.4% 3.6% 1.6% 10 15 ACE/ARB Hypertension $2.64 $2.46 -7.0% $1.92 610 -0.7% -2.8% -0.5% All Other $33.62 $36.37 8.2% $56.24 3,186 14.9% 5.3% 3.7% Total $132.46 $150.69 13.8% $167.33 3,287 11.3% 2.1% 2.5% Comments • The top 15 therapy classes accounted for 75.9% ($114.31) of total plan spend PMPM $150.69 in the current period Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 58 8/20/2024 9:24 AM p. 714 City of Miami Solicitation RFP 1896386 Top Drugs by Spend Cigna. Top drugs by spend Rank Base Current Drug Name 1 1 Stelara (SRx) 2 2 Bikiarvy(SR() 14 3 Evrysdi (SRx) 9 4 Humira(Cf)Pen(SRx) 4 5 Trulicity 3 6 Ibrance(SRx) 57 7 Verzenio (SRx) 11 8 Triumeq(SRx) 8 9 Mavenclad (SRx) 21 10 Ozempic 60 11 Tremfya (SRx) 12 Promacta (SRx) 7 13 Genvoya (SRx) 42 14 Bosulif(SRx) 15 15 Farxiga 10 16 EnbrelSureclick(SRx) 28 17 Humira Pen (SRx) 19 18 Skyrizi (2 Syringes) Kit (SR() 19 Uptravi (SRx) 12 20 Humalog Kwilqpen U-100 Condition Psoriasis HIV Spinal Muscular Atrophy Arthritis Diabetes Cancer Cancer HIV Multiple Sclerosis Diabetes Seborrhea/Psoriasis white Cell Stimulant HIV Cancer Diabetes Arthritis Arthritis Seborrhea/Psoriasis Pulmonary Hypertension Diabetes Plan Spend PMPM Plan Spend Unique Members Scripts Base Current Trend Norm Current Base Current Base Current $11.82 $9.41 -20.4% $5.52 $463,634 4 5 40 31 $6.30 $7.32 16.2% $2.53 $360,456 10 14 94 102 $1.83 $6.75 269.0% $0.27 $332,352 1 1 4 14 $2.31 $3.67 59.3% $6.49 $181,015 5 4 20 30 $2.85 $3.50 22.9% $4.08 $172,456 27 30 180 211 $3.12 $3.22 3.2% $1.09 $158,588 1 1 13 12 $0.50 $2.95 486.1% $0.48 $145,219 1 1 2 11 $2.07 $2.74 32.7% $0.85 $135,149 4 6 33 41 $2.36 $2.73 15.7% $0.23 $134,670 1 1 2 2 $1.29 $2.71 110.7% $4.17 $133,552 15 31 84 164 $0.47 $2.69 470.7% $1.18 $132,767 1 2 3 22 $0.00 $2.52 0.0% $0.20 $124,201 0 1 0 4 $2.42 $2.30 -4.9% $0.75 $113,174 4 3 36 32 $0.73 $2.29 212.1% $0.08 $112,637 1 1 3 9 $1.63 $2.23 37.2% $1.63 $109,854 17 25 161 213 $2.15 $1.96 -8.6% $2.85 $96,541 3 2 19 16 $1.04 $1.84 77.2% $1.74 $90,776 1 1 9 15 $1.31 $1.80 36.9% $2.02 $88,557 1 2 4 13 $0.00 $1.78 0.0% $0.18 $87,540 0 1 0 3 $1.90 $1.68 -11.6% $1.21 $82,722 30 25 192 154 Comments • The top 20 drugs by plan spend PMPM accounted for 43.9% ($66.09) of all plan spend PMPM ($150.69) in the current period Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 59 8/20/2024 9:24 AM p. 715 City of Miami Solicitation RFP 1896386 Top Drugs by Volume Cigna, Top drugs by volume Rank Base Current 1 843 3 4 2 5 8 10 6 12 7 11 14 9 13 16 15 26 18 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Drug Name atorvastatin calcium PfizerCovid-19 Vaccine (Eua) amlodipine besylate losartan potassium lisinopril metformin hcl rosuvastatin calcium vitamin d2 hydrochlorothiazide omeprazole levothyroxinesodium metoprololsuccinate ibuprofen montelulastsodium fluticasone propionate azithromycin pantoprazole sodium Moderna Covid-19Vaccine(Eua) Synthroid aspirin ec Condition Cholesterol Vaccine Hypertension Hypertension Hypertension Diabetes Cholesterol Vitamin DSupplement Hypertension Ulcer/ Heartburn Thyroid Heart/Hypertension Arthritis/Pain Asthma Itching / Inflammation Infection Ulcer/ Heartburn Vaccine Thyroid Pain Prescriptions Dispensed Base Current Trend 2,221 2,262 1.8% 2 1,616 80700.0% 1,536 1,538 0.1% 1,511 1,513 0.1% 1,563 1,474 -5.7% 1,428 1,365 -4.4% 942 1,166 23.8% 869 1,044 20.1% 1,124 995 -11.5% 840 863 2.7% 1,083 837 -22.7% 854 825 -3.4% 701 746 6.4% 891 650 -27.0% 703 637 -9.4% 466 565 21.2% 549 558 1.6% 0 510 0.0% 358 505 41.1% 454 445 -2.0% Unique Members Base Current Cost per Script Current 306 329 $15.29 2 963 $38.07 197 215 $7.25 186 190 $12.34 194 179 $6.94 205 193 $8.39 138 175 $20.69 173 214 $3.35 151 135 $4.77 195 191 $12.03 120 105 $12.15 100 94 $20.32 470 519 $10.25 154 130 $13.98 254 270 $16.58 373 447 $5.10 127 125 $17.19 0 283 $26.26 38 53 $24.93 73 78 $0.85 Comments • The top 20 drugs by volume accounted for34.7% (20,114) of all prescriptions dispensed but only 3.8% ($7,423,713) of total plan spend in the current period Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 60 8/20/2024 9:24 AM p. 716 City of Miami Solicitation RFP 1896386 le Integrated Value of Well Informed & RationalMed for Cigna Cigna. Well Informed and RationalMed for Cigna are gaps in care solutions which deliver alerts to providers and patients to improve health and safety while driving savings for our clients. Clinical Impact Opportunity Identified Gaps identified Providers outreached 5,655 595 Customers outreached 1,182 Success Rate Remaining opportunity Financial Impact 599 (11 %) closures 5,056 gaps Total Savings $105,053 Comments • aosing these gaps resulted in a savings of $175 per success • An average of 5 gaps w ere identified for each of your outreached customers • The top five conditions addressed for your population were: Diabetes, Cancer, Coronary Artery Disease, Blood thinner, Hypertension MONITOR Claims data: Medical + Laboratory + Pharmacy ANALYZE Against evidence -based guidelines FIND Gaps, risks, omissions, errors, adverse events ALERT Gaps, risks, omissions, errors, adverse events IM PROVE Research, update / add alerts Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 61 8/20/2024 9:24 AM p. 717 City of Miami Solicitation RFP 1896386 sad:. Pharmacy Utilization Management - Opportunity Analysis Cigna. g�n - Essential Protection Package Savings & impact Current Drug List : Standard Current UM Package : No UM (Baseline only) Proposed UM Package : Essential Protection Managed Drug Classes Current Package Estimated Savings $888,136 Savings (PMPM) $17.66 Percent of Total Drug Cost 11.7% Estimated Memberlmpact 846 Percent of Members Impacted 24.5% Additional Savings Opportunity $113,990 $2.31 1.5% 426 13.0% Opportunity by therapeutic class Therapeutic Class Impacted Estimated Members Savings Anticoagulants 31 $20,766 Migraine 41 $20,186 Lipid Lowering 36 $16,813 Anticonvulsants 7 $13,718 Insulins 2 $7,244 Glucocorticoids 4 $5,807 Impotency Related 59 $4,492 Estrogen is/Androgenic/Progest 12 $3,562 Acne Agents 70 $3,063 Antidotes 28 $2,709 Opportunity detail Program Bement Current Essential Prior Authorization Quantity Level Limit J J • Specialty Utilization Management Step Therapy oe Connnents * Cigna's Essential Protection package offers the recommended balance of Clinical Programs to protect clients and customers against potentially harrrful, ineffective and unnecessary drug treatments and rising drug costs • The UM savings opportunity is $113,990 , or $268 per impacted customer • Customer transition communications: All customers taking a medication subject to a new UM edit w ill receive a letter from Cigna in advance of the change. Customers w ill be encouraged to discuss the change w ith their physician, so the best course of action for the patient can be deterrrined Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 62 8/20/2024 9:24 AM p. 718 City of Miami Solicitation RFP 1896386 �tia'rs SaveOnSP: Specialty Copay Assistance - Opportunity Cigna. SaveOnSP maximizes copay assistance from drug manufacturers for certain specialty medications by reducing customer cost share to $0 and sharing 75% of the maximized savings with the client within qualifying plans. Without SaveOnSP $56, 747 $2,185, 372 • Employer Spend With SaveOnSP $0 • Customer Spend • Manufacturer Copay Assistance Total drug spend:$2,242,119 Employer spend: $1,708,422 (including any SaveOnSP program passthroughs) Manufacturer copayassistance:$533,697 (Including customer cost share reduction to $0) Customer cost share:$0 Saves client $476,950 and eliminates $56,747 in cost share for 37 customers. Savings by Condition Current Condition Customers Scripts Plan Spend Plan Savings Cancer 3 34 $432,695 $112,877 Multiple Sclerosis 4 24 $196,737 $107,539 FSoriasis 7 44 $513,956 $91,076 All Other 23 165 $1,098,731 $222,204 Total 37 267 $2,242,119 $533,697 Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 Comments • Estimated plan savings of $533,697 or $10.83 PMPM equates to a reduction of total specialty pharmacy spend by 13.2% • 37 customers represents 36% of specialty pharmacy utilizers, 1 % of all pharmacy utilizers • Top impacted drugs by plan savings are Aubagio, Stelara, Tremfya • Manufacturer Copay Assistance is net of program costs 63 8/20/2024 9:24 AM p. 719 City of Miami Solicitation RFP 1896386 r Maintenance Medication Program - Performance Analysis Cigna. Performance summary Cigna 90 Now Effective 01/01/2017: Voluntary Maintenance Medications Base Current Opportunity 30 Day Prescriptions Count 16,620 15,441 NA Percentage 44.6% 42.7% NA 90 Day Prescriptions Count 20,651 20,716 NA Percentage 55.4% 57.3% NA Savings Savings(PMPM) $192,012 $102,098 $3.90 $2.07 Percent of members with greater than 80% maintenance medication adherence 80.0% 60.0% 40.0% 20.0% 0 0% II Asthma Cholesterol Depression Diabetes Hypertension/ Total Cardiac 30 Day Rx 43.8% 55.1% 54.5% 48.0% 55.4% 56.5% 90 Day Rx 47.5% 78.8% 79.7% 74.5% 77.1% 76.9% Pharmacy utilization - maintenance prescriptions 13.5% (796 mbrs) 19.3% 38.1% 30 Day at Non-90 day retail ■ 90 Day at 90 day retail 30 Day at 90 day retail 90 Day at Home Delivery Connnents • Savings are driven both by low er netw orkcontracted rates and conversions to 90 Day maintenance prescriptions • 30 Day RX's decreased 7.1% and 90 Day RX's increased 0.3% • The $2.07 PMPM opportunity savings represents a 25% shift in utilization to 90 day. Adoption of Mandatory Cigna 90 Now estimated to yield additional PMPM savings of $3.25 • Of the 916 customers filling 30 day prescriptions at Non-90 day retail pharmacies today, 96.6% are w ithin 1.5 miles of a 90 day retail pharmacy • Overall medication adherence for those customers using 90 day fills is 20.4% greater than those using 30 day fills Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 64 8/20/2024 9:24 AM p. 720 City of Miami Solicitation RFP 1896386 :.+.. Clinical Day Supply for Cigna (CDS) - Opportunity r�� Cigna. Clinical Day Supply Program for Cigna (CDS) through Accredo leverages smart dispensing logic to ensure customers receive optimal drug supply, driving increased drug safety, cost savings and medication adherence. SPLIT FILL Dispensing less than day supply for First rno of new drugs 90 cr)30 30 DAY LIMITS 30 day supply limits regardless of new or existing therapy status -e CD 10 scripts could be optimized for 8 customers representing $75,618 of potential savings Opportunity impact go STABILIZATION 30 30 30 0 Dispensing 30 day 8 e supply for ffew months of newew drug therapy to establish stability on new therapy Split fill 30 day limits Stabilization Customers 0 1 8 Scripts 0 1 9 Day Supply Reduction 0 60 482 Therapeutic Class Blood Thinner •Arthritis • Multiple Sclerosis Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 COPAY PRORATION Day supply reductions are prorated to a cost share that fits the new supply amount Comments • Specialty medications are know n to have adverse side -effects and/or high rates of physician change to dosage and form Dispensing less than a 90-day supply per prescription for customers new to therapy allow s for closer monitoring by Accredo specialists of customer drug tolerance and customer stabilization, and can decrease the potential for drug w aste. • Savings opportunity is based on home delivery program eligible drugs. If members filled eligible drugs through retail, more savings potential may exist if they switchedto home delivery. • CDS is intended to increase medication adherence by as much as 6%* for customers influenced by the program moving from a 30 day supply lirrit at specialty. *Express Scripts (2019). Clinical Days Supply Evaluation. • The Split Fill and Stabilization components of the program apply only to new specialty drug therapies. Members already taking specialty drugs may experience a reduction in day supply only if the medication is identified as being optimally prescribed at a 30 day limit. 65 8/20/2024 9:24 AM p. 721 City of Miami Solicitation RFP 1896386 Generic and Biosimilar Pipeline Cigna. Upcoming generic and biosimilar opportunity Drug Name Condition Benefit Actual) Projected Generic Class Current Cost PMPM Type Launch Date Utilization (%ofTotal Cost) Stelara(SRx) RA/Psoriasis/Crohn's Rx 4Q 2023 0.0% $9.41 (6.2%) Humira(SRx) RA/Psoriasis/Crohn's Rx 1Q 2023 0.0% $1.84 (1.2%) Aubagio(SRx) Multiple Sclerosis Rx 1Q2023 0.0% $1.66 (1.1%) Gilenya(SRx) Multiple Sclerosis Rx 1Q2023 0.0% $1.12 (0.7%) Symbicort Asthma Related Rx 3Q 2023 75.7% $0.89 (0.6%) Vimpat Anticonvulsants Rx 2Q 2022 94.2% $0.85 (0.6%) Dexilant Antiulcer Rx 3Q 2022 96.1% $0.56 (0.4%) Vyvanse Stimulants Rx 3Q 2023 80.8% $0.52 (0.3%) Restasis Eye Rx 1Q 2022 83.8% $0.51 (0.3%) Victoza3-Pak Hypoglycemics Rx 3Q 2024 66.5% $0.42 (0.3%) Post Launch Post Launch Savings Savings Estimate Year 1 Estimate Year 3 $5.66 $7.15 $1.11 $1.40 $1.00 $1.26 $0.68 $0.85 $0.53 $0.67 $0.51 $0.64 $0.34 $0.43 $0.31 $0.40 $0.30 $0.39 $0.26 $0.32 Projected savings impact (PMPM) 20.0% 15.0% 10.0% 5.0% 0.0% Specialty (Rx) • Specialty (Med) • Non -Specialty 2022 $0.00 $0.00 $1.70 11 r 2023 2024 $8.44 $0.00 $2.96 $9.70 $0.00 $3.58 Comments • Over the next several years, several manufacturers w ill be releasing generic and biosimilar drugs that w ill help to reduce the cost for sorre of your current high -cost drugs. • As these new drugs enter the market, the savings w ill continue to grow as they gain additional market share and utilization. In addition, w e expect that other pharmaceutical manufacturers w ill also release similar lower cost drugs. • Anticipated savings w ill be $1.70 PMPM in 2022 and $13.28 PMPM in 2024 Current Period reflects claims incurred between an. 2021 and Dec. 2021, paid throui Feb.2022 Base Period refledsclaims incurred between Jan. 2020 and Dec.2020, paid through Feb. 2021 66 8/20/2024 9:24 AM p. 722 City of Miami Soli�jt op, Pr9}D264 EXHIBIT E Health and Wellness Center KPI Dashboard City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna p. 723 Miami City of Miami Soli�jt, Pr 83264 Summary Experience Utilization Engagement 95 308 16% Net Promoter Score (YTD) Operations Director Robin Chenoweth Years in Operation 2 Years 10 Months Health Center Staff 2 City of Miami 'd) Clinical Financial 90% 1.7 Visit Count Center Adoption Quality Composite Return on Investment (YTD) (Rolling 12) (YTD) (Rolling 12) Providers Care Team Linda Igbinoba, NP Nicole Aycart, RN City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2024 Cigna p. 722 Miami City of Miami Soli�jtpt Pr 83264 Experience 95 Net Promoter Score (YTD) Net Promoter Score Response (YTD) Previous Year Trend Previous Month Trend % vs April 2023 (YTD) 21 1 0 0 0 0 0 0 0 0 0 0 1 2 3 4 5 6 7 8 9 10 sit 4o 81 �{12Q2$,:t a City of Miami t 2 % vs March 2024 (YTD) Satisfaction Overall (YTD) Satisfied or Very Satisfied Satisfaction Detail (YTD) 100% 98% City of Miami Satisfaction Response YTD Positive Responses 98% Neutral Responses 2% Negative Responses 0% Total Responses 164 Total Surveys 22 100% Overall Visit Experience Provider Satisfaction Scheduling Satisfaction Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2024 Cigna p. 723 Miami City of Miami Soli�jtpt Pr 83264 Utilization Previous Year Trend Previous Month Trend 308 . 68, * 17aa Visit Count vs April 2023 vs March 2024 (YTD) (YTD) (Monthly) Visits by Month 75 • • Current Last Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec • 81 �{12Q2C:t a City of Miami Appointment Counts YTD No Show 9 Other Canceled 10 Completed Visits 308 Total Appointments 327 City of Miami Access Metrics YTD No Show Rate 3% Same Day/Walk-in Rate 83% Schedule Utilization 21% Provider Utilization 20% Service Type (Top 8) Apr YTD Diagnostics 54 226 Wellness 39 167 Provider Visits 20 75 Virtual Health 16 65 Screenings • 10 13 Vaccinations 1 0 5 Behavioral Health I 0 0 Client Support 1 0 0 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2024 Cigna p. 724 Miami City of Miami Soli�jtpt Pr 83264 Engagement 16% Center Adoption (Rolling 12) Center Adoption (Rolling 12) Previous Year Trend Previous Month Trend vs April 2023 (Rolling 12) 370 Unique Employees 2,259 Eligible Employees Updated 6/8/2021 vs March 2024 (Rolling 12) Engagement Metrics Rolling 12 Encounters/Patient 2.1 Returning Patients 42% MyChart Activation 43% Telemed Adoption 23% City of Miami Patient Relationship Rolling 12 Employees 370 Dependents 6 Unknown 64 Total Patients 440 Patient Type Rolling 12 Medical Patients Occupational Patients Coached Customers Total Customers 440 0 1 440 Patient Age Rolling 12 <20 1% 20-30 8% 30-40 24% 40-50 26% 50-60 24% 60+ 18% 81 �{2021*,:! a City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2024 Cigna p. 725 Miami City of Miami Soli�jtpt Pr 83264 Clinical cd, 90% Quality Composite (YTD) Quality Measures (YTD) BP Screening BP Follow -Up BP Control Tobacco Screening Tobacco Follow -Up Depression Screening Depression Follow -Up HbA1 c Testing N/A N/A N/A N/A N/A Previous Year Trend Previous Month Trend t 1 % % vs April 2023 vs March 2024 (YTD) (YTD) N/A N/A *N/A represents less than 10 qualifying encounters 90% Diagnosis Category YTD Preventive 29% Acute Illness 56% Disease Management 3% Multiple 12% City of Miami Gap Closures YTD Biometric Improvement 0 Immunization 0 Lab Testing 0 Screening 0 Visits 0 Referral Group (Top 8 YTD) Per 1000 Count Visits Specialty Physician 17 213 Primary Care 10 125 Lifestyle Management 9 113 Behavioral Health 7 88 Allied Health Professional • 1 13 Case Management i 0 0 Coaching i 0 0 Community Services i 0 0 81 �4 .2.021*,:igni a City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2024 Cigna p. 726 Miami City of Miami Soli�jtpt Pr883264 Financial 1.7 Return on Investment (Rolling 12) Savings Detail (Rolling 12) Replacement Coaching Sessions Generic Rx Savings Lab Vendor Services Provider Visits Rx Vendor Services Urgent Care / ER Visits Avoidance Acute PMPY Savings Coaching PMPY Savings Gap Closure Savings High Value Referrals Specialty Provider Visits Productivity Productivity Savings Total Savings Previous Year Trend .78, vs March 2023 (Rolling 12) Current Last Year $35 $35 $1,441 $670 $0 $0 $61,180 $25,590 $0 $0 $12,887 $15,688 $135,702 $71,298 $495 $495 $3,286 $3,638 $0 $0 $47,820 $22,920 $148,260 $78,930 411,105 219,264 *Due to a lag in financial reporting, all financial figures are as of the previous month. Previous Month Trend vs February 2024 (Rolling 12) ROI Inputs Rolling 12 Center Visits Coaching Sessions Generic Prescriptions Same Day Acute Visits Specialty Referral Rate 797 1 212 46 0% City of Miami Budget Variance Rolling 12 Budget $315K Expense $235K Variance $80K Utilization 74% Savings vs Expense Trend (Rolling 12) • Savings Expense Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 8•�12Q2:! City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2024 Cigna p. 727 Glossary �i Experience City of Miami Soli�jt, Pr983264 City of Miami Net Promoter Score Net Promoter Score Response Satisfaction Detail Satisfaction Overall Satisfaction Response 0 Utilization Measures the willingness of patients to recommend the center to co-workers The count of responses to the NPS survey question grouped by the actual value given by the patient between 0 and 10 Patient satisfaction grouped by the provider, appointment scheduling and overall experience with the center A measure of overall patient experience and satisfaction with the services provided to the customer Patient satisfaction grouped by response rating No Show Provider Utilization Same Day/Walk-in Rate Schedule Utilization Scheduled Visits Service Type Visit Walk-in Visits A Engagement An appointment where the patient does not arrive on or before the scheduled time or cancels within 24 hours of an appointment Percentage of available patient care time booked by patients for completed visits only Percentage of appointments scheduled on the same day including walk-in visits Percentage of available patient care time booked by patients including no show, late cancelled and completed appointments An appointment that was scheduled by the patient prior to arriving for their visit Groups of services performed by the clinical staff during a completed visit or group activity An encounter for a specific service including all in -person and telemedicine encounters (coded encounters) A visit where the patient did not schedule their visit prior to arriving Center Adoption Coached Customers Eligible Employees Medical Patients Occupational Patients Patient Portal Activation Returning Patient Telemed Adoption Total Customers Unique Employees Percentage of employees who utilized the center in a rolling 12 month period Unique customers with a custom coaching visit Total number of employees who have access to the center (client reported) Unique patients with a medical treatment service including in -person and telemedicine encounters Unique patients with a visit for occupational health services Percentage of patients who activated their Evernorth Direct Health patient portal account (excludes patients with only immunizations) Percentage of patients with two or more visits in a rolling 12-month period Percentage of patients who have had a telemedicine visit (excludes patients with only immunizations) Unique customers/patients provided any type of service at the center Count of employees with at least one visit in the last 12 months 9®/ 81 �4 2Q2116,1 0 City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2024 Cigna p. 730 Glossary Y) Clinical City of Miami Soli�jt, Pr983264 City of Miami Acute Illness Visits BP Control BP Follow -Up BP Screening Biometric Improvement Chronic Disease Visit Gap Depression Follow -Up Depression Screening Diagnosis Category Disease Management Visits HbA1c Testing Immunization Gap Closure Lab Testing Gap Closure Multiple Diagnosis Visits Preventive Visits Quality Composite Screening Gap Closure Tobacco Follow -Up Tobacco Screening Percentage of visits with a diagnosis indicating an episodic illness or condition requiring attention Percentage of patients with a hypertension diagnosis whose blood pressure with adequate blood pressure control Percentage of patients without diagnosed hypertension who experienced a high blood pressure reading with a documented follow-up plan Percentage of patients who were screened for high blood pressure during medical office visits Gaps closed from evidence -based improvement in chronic disease markers Closure of gaps related to provider visits for chronic disease Percentage of patients screening positive for depression with a documented follow-up plan Percentage of patients with an annual a PHQ2 or PHQ9 depression screen High level reason for an encounter based on ICD-10 diagnosis Percentage of visits with a diagnosis indicating ongoing management or treatment of chronic conditions Percentage of patients seen in the center with diabetes who had at least one hemoglobin Al c measurement during the calendar year Closure of gaps related to immunizations Closure of gaps related to evidence -based guidelines for monitoring of labs related to chronic disease Percentage of visits where more than one diagnostic category was addressed (e.g. preventive and disease management) Percentage of visits with a diagnoses indicating any type of preventive care, including screenings, immunizations, or annual physicals The consolidated compliance rate (weighted average) for applicable evidence based quality measures Closure of gaps related to evidence -based guidelines for cancer and other health condition screenings Percentage of patients identified as tobacco users who were provided with cessation counseling or intervention Percentage of patients screened for tobacco use during or prior to the measurement period 81 �{12Q21*,:t a City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2024 Cigna p. 731 Glossary d° Financial City of Miami Soli�jt, Pr983264 City of Miami Additional Inpatient Cost Savings Avoidance Savings Brand Drugs Replacement Budget Budget Utilization Budget Variance Center Visits Coaching PMPY Savings Coaching Session Replacement Coaching Sessions Expense Gap Closure Savings Generic Prescriptions High Value Referrals Lab Vendor Services Productivity Savings Provider Visit Replacement Replacement Savings Return on Investment Rx Vendor Services Same Day Acute Visits Specialty Provider Visit Avoidance Specialty Referral Rate Urgent Care / ER Visit Replacement o`Y 81�{242 :i a Cost avoidance associated with the reduction in inpatient utilization for patients of the center compared to non -users less the estimated inpatient portion of gaps and referral savings A projected reduction of network utilization and cost of care based on the quality of care provided at the center Value of replacing the utilization of brand drugs when a generic alternative was available Total YTD budgeted expense amount for the center A ratio of actual center expenses vs. the budgeted expense amount YTD The difference between the budgeted and actual expense amount YTD An encounter for a specific service including all in -person and telemedicine encounters (coded encounters) Cost avoidance associated with the projected reduction in total medical cost for members engaged in custom coaching compared to a matched control group of uncoached members. Value of replacing a custom coaching visit A personalized session with a coach for support and motivation to achieve evidence based goals Total YTD invoiced amount to the client for the expense of the center Cost avoidance associated with closing clinical gaps in care or improving clinical outcomes facilitated by a center provider A generic prescription written by the provider as an alternative to a higher priced brand drug Cost avoidance associated with referrals resulting in a visit with a high value network provider or Cigna program Value of replacing diagnostic tests performed by lab vendors Estimated savings associated with decreased absenteeism of employees engaged with their health attributed to center use, based on national productivity cost estimates Replacement of network provider visits valued and geographically adjusted based on codes used for billing outpatient procedures Direct cost savings attributed to replacing services provided at the center that would have otherwise occurred in the network A ratio of savings associated with a reduction in network utilization, outcomes and productivity vs the operational expense of the center Value of prescriptions written and filled at the center Walk-in or scheduled appointments on the same day where acute care was provided to the patient Cost avoidance from reducing specialty visits based on location -specific referral rates compared to national referral rates Percentage of visits in which a referral to a specialist was made Value of replacing same day acute visits that would likely have resulted in a visit to the emergency room (5%) or urgent care (95%) City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna p. 732 City of Miami Soli�jt op, Pr9}D264 Thank You City of Miami City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2024 Cigna p 1331 City of Miami DeceS tb° ? Health and Wellness Center KPI Dashboard City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2023 Cigna p. 734 Miami City of Miami Decdffitber2V2 Summary Experience Utilization Engagement 100 714 14% Net Promoter Score (YTD) Operations Director Robin Chenoweth Years in Operation 2 Years 6 Months Health Center Staff 1 Visit Count (YTD) Center Adoption.. Care Team Nicole Aycart, RN City of Miami City of Miami 'd) Clinical Financial 67% 1.6 Quality Composite Return on Investment (YTD) (Rolling 12) Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2023 Cigna p. 732 Miami City of Miami DeceS i t b P2 Experience 100 Net Promoter Score (YTD) Net Promoter Score Response (YTD) 0 0 0 0 0 0 0 0 Previous Year Trend Previous Month Trend 0 % vs December 2022 vs November 2023 (YTD) (YTD) 1 2 228 0 1 2 3 4 5 6 7 8 9 10 sit 4o 81 �{12Q2$,:t a City of Miami Satisfaction Overall (YTD) Satisfied or Very Satisfied Satisfaction Detail (YTD) City of Miami Satisfaction Response YTD Positive Responses 100% Neutral Responses 0% Negative Responses 0% Total Responses 1623 Total Surveys 231 100% 100% 99% Overall Visit Experience Provider Satisfaction Scheduling Satisfaction Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2023 Cigna p. 73E Miami City of Miami DeceS itber?P2 Utilization Previous Year Trend Previous Month Trend 714 .163, 4490. Visit Count (YTD) Visits by Month 153 vs December 2022 vs November 2023 (YTD) • Current Last Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec • 81 �{12Q2C:i a City of Miami (Monthly) Appointment Counts YTD No Show 67 Other Canceled 30 Completed Visits 714 Total Appointments 811 City of Miami Access Metrics YTD No Show Rate 8% Same Day/Walk-in Rate 82% Schedule Utilization 17% Provider Utilization 15% Service Type (Top 8) Dec YTD Diagnostics 23 461 Wellness 24 422 Screenings 4 107 Virtual Health 3 97 Provider Visits 4 91 Vaccinations 3 58 Custom Coaching I 0 2 Patient Outreach I 0 1 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2023 Cigna p. 734 Miami City of Miami DeceS itber?P2 Engagement 14% Center Adoption (Rolling 12) Center Adoption (Rolling 12) Previous Year Trend Previous Month Trend .117, t vs December 2022 vs November 2023 (Rolling 12) (Rolling 12) 321 Unique Employees 2,259 Eligible Employees Updated 6/8/2021 Engagement Metrics Rolling 12 Encounters/Patient 2.2 Returning Patients 44% MyChart Activation 42% Telemed Adoption 23% City of Miami Patient Relationship Rolling 12 Employees 321 Dependents 6 Unknown 53 Total Patients 380 Patient Type Rolling 12 Medical Patients Occupational Patients Coached Customers Total Customers 380 0 2 380 Patient Age Rolling 12 <20 1% 20-30 8% 30-40 24% 40-50 26% 50-60 22% 60+ 19% 81 �{2021*,:! a City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2023 Cigna p. 735 Miami City of Miami DeceS itber?P2 Clinical cd, 67% Quality Composite (YTD) Quality Measures (YTD) BP Screening BP Follow -Up BP Control Tobacco Screening Tobacco Follow -Up Depression Screening Depression Follow -Up HbA1 c Testing N/A N/A N/A N/A N/A Previous Year Trend Previous Month Trend 2 % vs December 2022 vs November 2023 (YTD) (YTD) N/A N/A *N/A represents less than 10 qualifying encounters 67% Diagnosis Category YTD Preventive 43% Acute Illness 44% Disease Management 6% Multiple 8% City of Miami Gap Closures YTD Lab Testing 5 Visits 1 Biometric Improvement 0 Immunization 0 Screening 0 Referral Group (Top 8 YTD) Specialty Physician Primary Care Allied Health Professional Behavioral Health Case Management Coaching Community Services Condition Management 1 Per 1000 Count Visits 8 41 3 15 1 5 0 0 0 0 0 0 0 0 0 0 81 �4 .2.0211",:igni a City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2023 Cigna p. 736 Miami City of Miami DeceS itbeI?P2 Financial 1.6 Return on Investment (Rolling 12) Savings Detail (Rolling 12) Replacement Coaching Sessions Generic Rx Savings Lab Vendor Services Provider Visits Rx Vendor Services Urgent Care / ER Visits Avoidance Acute PMPY Savings Coaching PMPY Savings Gap Closure Savings High Value Referrals Specialty Provider Visits Productivity Productivity Savings Total Savings Previous Year Trend 1000 vs November 2022 (Rolling 12) Current Last Year $70 $140 $1,176 $600 $0 $o $51,635 $16,827 $0 $0 $14,008 $13,447 $123,894 $53,095 $990 $1,980 $3,286 $4,138 $0 $0 $43,200 $16,140 $135,816 $59,020 374,074 165,386 *Due to a lag in financial reporting, all financial figures are as of the previous month. Previous Month Trend t 3 % vs October 2023 (Rolling 12) ROI Inputs Rolling 12 Center Visits Coaching Sessions Generic Prescriptions Same Day Acute Visits Specialty Referral Rate 720 2 169 50 0% City of Miami Budget Variance Rolling 12 Budget $306K Expense Variance Utilization $238K $68K 77% Savings vs Expense Trend (Rolling 12) • Savings Expense • Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov •••••i•• r• 8•�12Q2:! City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2023 Cigna p. 747 Glossary �i Experience City of Miami Decdffitber2V2 City of Miami Net Promoter Score Net Promoter Score Response Satisfaction Detail Satisfaction Overall Satisfaction Response 0 Utilization Measures the willingness of patients to recommend the center to co-workers The count of responses to the NPS survey question grouped by the actual value given by the patient between 0 and 10 Patient satisfaction grouped by the provider, appointment scheduling and overall experience with the center A measure of overall patient experience and satisfaction with the services provided to the customer Patient satisfaction grouped by response rating No Show Provider Utilization Same Day/Walk-in Rate Schedule Utilization Scheduled Visits Service Type Visit Walk-in Visits A Engagement An appointment where the patient does not arrive on or before the scheduled time or cancels within 24 hours of an appointment Percentage of available patient care time booked by patients for completed visits only Percentage of appointments scheduled on the same day including walk-in visits Percentage of available patient care time booked by patients including no show, late cancelled and completed appointments An appointment that was scheduled by the patient prior to arriving for their visit Groups of services performed by the clinical staff during a completed visit or group activity An encounter for a specific service including all in -person and telemedicine encounters (coded encounters) A visit where the patient did not schedule their visit prior to arriving Center Adoption Coached Customers Eligible Employees Medical Patients Occupational Patients Patient Portal Activation Returning Patient Telemed Adoption Total Customers Unique Employees Percentage of employees who utilized the center in a rolling 12 month period Unique customers with a custom coaching visit Total number of employees who have access to the center (client reported) Unique patients with a medical treatment service including in -person and telemedicine encounters Unique patients with a visit for occupational health services Percentage of patients who activated their Evernorth Direct Health patient portal account (excludes patients with only immunizations) Percentage of patients with two or more visits in a rolling 12-month period Percentage of patients who have had a telemedicine visit (excludes patients with only immunizations) Unique customers/patients provided any type of service at the center Count of employees with at least one visit in the last 12 months 9®/ 81 �4 2Q2116,1 0 City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2023 Cigna p. 748 Glossary Y) Clinical City of Miami Decdffitber2V2 City of Miami Acute Illness Visits BP Control BP Follow -Up BP Screening Biometric Improvement Chronic Disease Visit Gap Depression Follow -Up Depression Screening Diagnosis Category Disease Management Visits HbA1c Testing Immunization Gap Closure Lab Testing Gap Closure Multiple Diagnosis Visits Preventive Visits Quality Composite Screening Gap Closure Tobacco Follow -Up Tobacco Screening Percentage of visits with a diagnosis indicating an episodic illness or condition requiring attention Percentage of patients with a hypertension diagnosis whose blood pressure with adequate blood pressure control Percentage of patients without diagnosed hypertension who experienced a high blood pressure reading with a documented follow-up plan Percentage of patients who were screened for high blood pressure during medical office visits Gaps closed from evidence -based improvement in chronic disease markers Closure of gaps related to provider visits for chronic disease Percentage of patients screening positive for depression with a documented follow-up plan Percentage of patients with an annual a PHQ2 or PHQ9 depression screen High level reason for an encounter based on ICD-10 diagnosis Percentage of visits with a diagnosis indicating ongoing management or treatment of chronic conditions Percentage of patients seen in the center with diabetes who had at least one hemoglobin Al c measurement during the calendar year Closure of gaps related to immunizations Closure of gaps related to evidence -based guidelines for monitoring of labs related to chronic disease Percentage of visits where more than one diagnostic category was addressed (e.g. preventive and disease management) Percentage of visits with a diagnoses indicating any type of preventive care, including screenings, immunizations, or annual physicals The consolidated compliance rate (weighted average) for applicable evidence based quality measures Closure of gaps related to evidence -based guidelines for cancer and other health condition screenings Percentage of patients identified as tobacco users who were provided with cessation counseling or intervention Percentage of patients screened for tobacco use during or prior to the measurement period 81 �{12Q21*,:t a City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. 2023 Cigna p. 749 Glossary d° Financial City of Miami Decdffitber2V2 City of Miami Additional Inpatient Cost Savings Avoidance Savings Brand Drugs Replacement Budget Budget Utilization Budget Variance Center Visits Coaching PMPY Savings Coaching Session Replacement Coaching Sessions Expense Gap Closure Savings Generic Prescriptions High Value Referrals Lab Vendor Services Productivity Savings Provider Visit Replacement Replacement Savings Return on Investment Rx Vendor Services Same Day Acute Visits Specialty Provider Visit Avoidance Specialty Referral Rate Urgent Care / ER Visit Replacement o`Y .2.021*,:ign a Cost avoidance associated with the reduction in inpatient utilization for patients of the center compared to non -users less the estimated inpatient portion of gaps and referral savings A projected reduction of network utilization and cost of care based on the quality of care provided at the center Value of replacing the utilization of brand drugs when a generic alternative was available Total YTD budgeted expense amount for the center A ratio of actual center expenses vs. the budgeted expense amount YTD The difference between the budgeted and actual expense amount YTD An encounter for a specific service including all in -person and telemedicine encounters (coded encounters) Cost avoidance associated with the projected reduction in total medical cost for members engaged in custom coaching compared to a matched control group of uncoached members. Value of replacing a custom coaching visit A personalized session with a coach for support and motivation to achieve evidence based goals Total YTD invoiced amount to the client for the expense of the center Cost avoidance associated with closing clinical gaps in care or improving clinical outcomes facilitated by a center provider A generic prescription written by the provider as an alternative to a higher priced brand drug Cost avoidance associated with referrals resulting in a visit with a high value network provider or Cigna program Value of replacing diagnostic tests performed by lab vendors Estimated savings associated with decreased absenteeism of employees engaged with their health attributed to center use, based on national productivity cost estimates Replacement of network provider visits valued and geographically adjusted based on codes used for billing outpatient procedures Direct cost savings attributed to replacing services provided at the center that would have otherwise occurred in the network A ratio of savings associated with a reduction in network utilization, outcomes and productivity vs the operational expense of the center Value of prescriptions written and filled at the center Walk-in or scheduled appointments on the same day where acute care was provided to the patient Cost avoidance from reducing specialty visits based on location -specific referral rates compared to national referral rates Percentage of visits in which a referral to a specialist was made Value of replacing same day acute visits that would likely have resulted in a visit to the emergency room (5%) or urgent care (95%) City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2023 Cigna p./0 City of Miami Dece i itb°GI L Thank You City of Miami City of Miami Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2023 Cigna p. /41 City of Miami Solicitation RFP 1896386 EXHIBIT F PUBLISHED ADDENDA AND PREVIOUSLY UNANSWERED QUESTIONS FROM RFP NO. 1860386 - EMPLOYEE BENEFIT CONSULTING SERVICES 8/20/2024 9:24 AM p. 745 City of Miami Solicitation RFP 1896386 This Exhibit F contains all Addenda published pursuant to the previously issued RFP 1810386. Exhibits A — E, have been attached to the current re - solicited RFP as indicated below: • Exhibit A — Current City of Miami ("City") Benefits Consulting Agreement — originally contained in Addendum No. 2 as Item A to RFP 1810386 • Exhibit B — Current City Insurance Brokerage Agreement - originally contained in Addendum No. 2 as Item B to RFP 1810386 • Exhibit C — Current City Group Health Benefits Professional Services Agreement ("PSA"), with Administrative Services Only ("ASO") Agreement — originally contained in Addendum No. 4 as Item B to RFP 1810386 • Exhibit D — City 2022 and 2023 Total Health Insight Analysis ("THI") Reports — originally contained in Addendum No. 6 as Item B to RFP 1810386 • Exhibit E — December 2023 and April 2024 Health and Wellness Center Utilization Reports — originally contained in Addendum No. 6 to RFP 1810386 as Item C • Note: Addendum No. 1 to the previously issued RFP 1810386, Item B references the replacement of Attachment B, Reference Submittal Form, with Revised Attachment B, Reference Submittal Form. The current re -solicited RFP contains Attachment B, Reference Submittal Form, as it was replaced within Addendum No. 1 to RFP 1810386. 8/20/2024 9:24 AM p. 746 City of Miami Solicitation RFP 1896386 EitTitv f T mi ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 1 RFP 1810386 June 3, 2024 REQUEST FOR PROPOSALS ("RFP") FOR EMPLOYEE BENEFIT CONSULTING SERVICES The following changes, additions, clarifications, and deletions amend the RFP documents of the above captioned RFP and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. A. The deadline for the submission of Proposals has been changed to Tuesday, June 11, 2024, at 5:00 PM. B. Attachment B, Reference Submittal Form has been deleted in its entirety and replaced with Revised Attachment B, Reference Submittal Form and has been attached to the Document Section in BidSync. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFP AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME. �.�Y . (_�e���?i for Annie Perez, CPPO Chief Procurement Officer/Director AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Pablo R. Velez, Sr. Assistant City Attorney Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: DATE: SIGNATURE: 8/20/2024 9:24 AM p. 747 City of Miami Solicitation RFP 1896386 Titv ± T mi ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 2 RFP 1810386 June 11, 2024 REQUEST FOR PROPOSALS ("RFP") FOR EMPLOYEE BENEFIT CONSULTING SERVICES The following changes, additions, clarifications, and deletions amend the RFP documents of the above captioned RFP and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. A. The deadline for the submission of Proposals has been changed to Tuesday, June 18, 2024, at 5:00 PM. B. Contract No. RFP 678384, Employee Benefit Consulting Services, is hereby attached as Exhibit A to this Addendum and made available in the Documents Section of BidSync. C. City of Fort Lauderdale Contract No. 12536-525, Property and Casualty Insurance Brokerage and Consulting Services is hereby attached as Exhibit B to this Addendum and made available in the Documents Section of BidSync. D. The following are inquiries received from Prospective Proposers and the City's corresponding responses: Q1. Please provide the City's current benefits consulting contract. Al . Refer to item B above. Q2. Does the City want Proposers to submit their current financial statements? A2. No. Refer to Section 4, Submission Requirements. Q3. Are Proposers required to provide most favored pricing schemes? A3. Yes. Refer to Section 1.51, Most Favored Nations. Q4. Should Proposers submit pricing as one flat fee or does the City prefer that Proposers segment each service's cost? A4. Refer to Section 2.17, Compensation and Attachment E, Price Proposal. 8/20/2024 9:24 AM p. 748 City of Miami Solicitation RFP 1896386 Q5. Will the City allow the Successful Proposer to keep a copy of its work products generated during the course of the contract that will result from this RFP? A5. Yes. Q6. Please provide the City's current Insurance Brokerage Services contract. A6. Refer to Item C above. Q7. Upon award, would the City accept the Successful Proposer's Certificates of Insurance evidencing the required insurance coverages and endorsements, in lieu of the actual insurance policies? A7. Yes. Refer to Section 2.11, Insurance Requirements of the solicitation. ADDITIONAL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFP. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFP AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME. Annie Perez, CPPO Director/Chief Procurement Officer AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Pablo R. Velez, Sr. Assistant City Attorney Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: DATE: SIGNATURE: 8/20/2024 9:24 AM p. 749 City of Miami Solicitation RFP 1896386 EitTitv f T mi ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 3 RFP 1810386 June 18, 2024 REQUEST FOR PROPOSALS ("RFP") FOR EMPLOYEE BENEFIT CONSULTING SERVICES The following changes, additions, clarifications, and deletions amend the RFP documents of the above captioned RFP and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. The deadline for the submission of Proposals has been changed to Tuesday, June 25, 2024, at 5:00 PM. ADDITIONAL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFP NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFP. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFP AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME. AP:cj Annie 4. ( APerez, CPPO it' for Chief Procurement Officer/Director cc. Ann -Marie Sharpe, Director, Risk Management Department Pablo R. Velez, Sr. Assistant City Attorney Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: SIGNATURE: DATE: 8/20/2024 9:24 AM p. 750 City of Miami Solicitation RFP 1896386 Titv ± T mi ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 4 RFP 1810386 June 24, 2024 REQUEST FOR PROPOSALS ("RFP") FOR EMPLOYEE BENEFIT CONSULTING SERVICES The following changes, additions, clarifications, and deletions amend the RFP documents of the above captioned RFP and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. A. The deadline for the submission of Proposals has been changed to Tuesday, July 2, 2024, at 5:00 PM. B. The Group Benefit Health Plan, and Administrative Services Only Agreement ("ASO") pursuant to Contract No. 369325, is hereby attached as Exhibit C and can be found in the Documents section of BidSync. C. The following are inquiries received from Prospective Proposers and the City's corresponding responses: Q1. Please confirm whether the City would allow the Successful Proposer to advise that a cancelled or non -renewed insurance policy would be replaced with no coverage gap and a current Certificate of Insurance would be provided and not cancellation notice, since coverage will be replaced with no gap. Al . This is confirmed. Q2. Will the City accept a Certificate of Insurance that names the City as additional insured rather than an insurance policy with this endorsement? A2. Yes, as long as the Certificate of Insurance contains all required endorsements. Q3. Will the City allow the primary and non-contributory language to be removed in favor of the Commercial General Liability policy being primary? A3. No. 8/20/2024 9:24 AM p. 751 City of Miami Solicitation RFP 1896386 Q4. Does the City require that the Successful Proposer maintain insurance coverage for two (2) years after the termination/expiration of the contract? A4. Yes. Refer to Section 2.11, Insurance Requirements, of the solicitation. Q5. Please provide the current total compensation paid to the City's Benefits Consultant. A5. The current annual compensation paid to the City's Benefits Consultant is $184,482. Q6. Does the City's current Benefits Consultant receive any supplementary compensation or vendor overrides in addition to the fees and/or commissions being paid by the City? A6. Not to the knowledge of the City. Q7. Please provide a brief description of the City's current Wellness Programs. A7. The City's Wellness Programs include a combination of virtual wellness educational classes and instructor -led sessions such as: Zumba, Pilates, bootcamp, kickboxing, and spinning. Additionally, the City has an onsite clinic and a fully equipped gym for use by all City employees. Q8. Does the City want Proposers to submit their proposed price as a single flat fee for the provision of all services listed in Section 3, Specifications/Scope of Work, or to submit their proposed price segmented to display the cost for each individual service? A8. Refer to Section 2.17, Compensation and Attachment E, Price Proposal, Item A. Q9. Please provide the City's current ASO agreement and the pharmacy benefit management agreement (if separate). A9. Refer to Item B above. Q10. Section 3, Specifications/Scope of Work, subsection A.2.h) requires that the Successful Proposer "...attend City health and wellness meetings scheduled monthly, weekly or as needed by the City..." Will these meetings be held virtually or in person, and how frequently have they been held over the past twelve (12) months? A10. City health and wellness meetings are held virtually. They have been held monthly over the past twelve (12) months. ADDITIONAL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFP. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFP AND SHALL BE MADE A PART THEREOF. 8/20/2024 9:24 AM p. 752 City of Miami Solicitation RFP 1896386 ALL OTHER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME. Annie Perez, CPPO Director/Chief Procurement Officer AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Pablo R. Velez, Sr. Assistant City Attorney Yadissa A. Calderon, CPPB, NIGP-CPP, Assistant Director of Procurement This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: DATE: SIGNATURE: 8/20/2024 9:24 AM p. 753 City of Miami Solicitation RFP 1896386 Titv ± T mi ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 5 RFP 1810386 July 2, 2024 REQUEST FOR PROPOSALS ("RFP") FOR EMPLOYEE BENEFIT CONSULTING SERVICES The following changes, additions, clarifications, and deletions amend the RFP documents of the above captioned RFP and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. A. The deadline for the submission of Proposals has been changed to Tuesday, July 9, 2024, at 5:00 PM. B. The following are inquiries received from Prospective Proposers and the City's corresponding responses: Q1. Please confirm whether the City would accept that indemnification be limited to losses and damages as a result of the Successful Proposer's negligence and covered under the terms of the Successful Proposer's general liability insurance policy; any wrongful acts solely in rendering or failing to render professional services and covered under the Successful Proposer's professional liability insurance policy, or any claim alleging a security failure, privacy event or wrongful act and covered under the Successful Proposer's cyber liability insurance policy, assuming that misappropriation of trade secret or infringement of patent are exclusions of said cyber liability insurance policy. Al . This is confirmed. Q2. Is the City willing to accept a cap or limitation of one million dollars on liability and indemnification? A2. The City may be willing to negotiate a reasonable limitation of liability that protects the City's interests. Q3. Please confirm whether the City is willing to accept the following: The Successful Proposer shall retain sole and exclusive ownership of all right, title and interest in and to its intellectual property and derivatives thereof which no data or confidential information of the City was used to create, and which was developed entirely using the Successful Proposer's own resources. To the extent that the Successful Proposer's intellectual property is necessary for the City to use the services 8/20/2024 9:24 AM p. 754 City of Miami Solicitation RFP 1896386 provided, the Successful Proposer shall grant to the City a non-exclusive, royalty -free license to the Successful Proposer's intellectual property solely for the City's use of such services. A3. This is confirmed. ADDITIONAL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFQ NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFQ. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFP AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME. /a 4. ( hi fo r Annie Perez, CPPO Chief Procurement Officer/Director AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Pablo R. Velez, Sr. Assistant City Attorney Yadissa A. Calderon, CPPB, Assistant Director of Procurement This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: DATE: SIGNATURE: 8/20/2024 9:24 AM p. 755 City of Miami Solicitation RFP 1896386 Titv ± T mi ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 6 RFP 1810386 July 9, 2024 REQUEST FOR PROPOSALS ("RFP") FOR EMPLOYEE BENEFIT CONSULTING SERVICES The following changes, additions, clarifications, and deletions amend the RFP documents of the above captioned RFP and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. A. The deadline for the submission of Proposals has been changed to Tuesday, July 16, 2024, at 5:00 PM. B. The City of Miami's 2022 and 2023 Total Health Insight Analysis Reports are hereby attached as Exhibit D and can be found in the Documents section of BidSync. C. The City of Miami's December 2023 and April 2024 Health and Wellness Center Utilization Reports are hereby attached as Exhibit E and can be found in the Documents section of BidSync. D. Section 3, Specifications/Scope of Work, subsections A.1.c) and A.1.d) have been deleted in their entirety and replaced as follows: A.1.c) Conduct a bi-annual onsite claims audit of self -funded plans at administrator's facility as deemed necessary by the City, to include review and compliance with contractually established: (i) Performance Standards (ii) Payment Accuracy of Claims (iii) Coding Accuracy of Claims (iv) Plan Provisions Accuracy A.1.d) Conduct a bi-annual audit of the Pharmacy Benefits Management ("PBM") Agreement, for the review and compliance of all formulary rebates, to determine if the City receives guaranteed rebate amounts, in accordance with contractual obligations. E. The following are inquiries received from Prospective Proposers and the City's corresponding responses: Q1. Please provide the most recent 24 months of monthly medical and prescription claims. 8/20/2024 9:24 AM p. 756 City of Miami Solicitation RFP 1896386 Al . Refer to Item B above. Q2. Please provide a spend report listing the most recent top 25 prescription drugs purchased through the City's Group Health program. A2. Refer to Item B above. Q3. Please provide the clinic utilization report for the most recent twelve (12) months. A3. Refer to Item C above. Q4. Please provide a list of all in -force carriers by line of coverage. A4. The City only contracts with Cigna Health and Life Insurance Company ("CIGNA") for these services. Q5. When was the last solicitation completed for the in -force carrier? A5. The most recent solicitation, RFP 369325, Group Benefit Health Plan, was formally awarded November 21, 2013. Q6. Will terms negotiated during a previous solicitation process be honored during this process? A6. No. As this is a new solicitation, terms negotiated in previous solicitation processes will not be considered. Q7. Pursuant to Section 3. Specifications/Scope of Work, subsections A.1.c) and A.1.d), please confirm that it is the City's intent that medical claims and pharmacy benefit audits be conducted semi-annually.? A7. Refer to Item D above. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFP AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME. Annie Perez, CPPO Director/Chief Procurement Officer AP:cj 8/20/2024 9:24 AM p. 757 City of Miami Solicitation RFP 1896386 cc. Ann -Marie Sharpe, Director, Risk Management Department Pablo R. Velez, Sr. Assistant City Attorney Yadissa A. Calderon, CPPB, Assistant Director of Procurement This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: DATE: SIGNATURE: 8/20/2024 9:24 AM p. 758 City of Miami Solicitation RFP 1896386 Titv ± T mi ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 7 RFP 1810386 July 12, 2024 REQUEST FOR PROPOSALS ("RFP") FOR EMPLOYEE BENEFIT CONSULTING SERVICES The following changes, additions, clarifications, and deletions amend the RFP documents of the above captioned RFP and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. A. Section 4.1, Submission Requirements, subsection B.4.f) is hereby deleted in its entirety and replaced as follows: B.4.f) Provide a minimum of three (3) references on Attachment B, Reference Submittal form, of clients to whom services of a similar nature were provided, as described within Section 2.8, References. The City reserves the right to contact any reference as part of the qualification process. B. The following are inquiries received from Prospective Proposers and the City's corresponding responses: Q1. The RFP includes Attachment B, Reference Submittal Form for reference contact information as well as language in Section 4,1, Submission Requirements, subsection B.4.f) on page 53, that states that references must be on the letterhead of the client to whom services were provided. Can Proposers simply provide Attachment B, Reference Submittal Form containing all required client information rather than submitting references on clients' letterheads? Al . Yes. Refer to Item A above. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFP AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME. Annie Perez, CPPO Director/Chief Procurement Officer AP:cj 8/20/2024 9:24 AM p. 759 City of Miami Solicitation RFP 1896386 cc. Ann -Marie Sharpe, Director, Risk Management Department Pablo R. Velez, Sr. Assistant City Attorney Yadissa A. Calderon, CPPB, Assistant Director of Procurement This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: DATE: SIGNATURE: 8/20/2024 9:24 AM p. 760 City of Miami Solicitation RFP 1896386 EitTitv f T mi ANNIE PEREZ, CPPO Procurement Director ARTHUR NORIEGA V City Manager ADDENDUM NO. 8 RFP 1810386 July 16, 2024 REQUEST FOR PROPOSALS ("RFP") FOR EMPLOYEE BENEFIT CONSULTING SERVICES The following changes, additions, clarifications, and deletions amend the RFP documents of the above captioned RFP and shall become an integral part of the Contract Documents. Deletions of contract language will be specified herein. Bold words and/or figures shall be added. The remaining provisions are now in effect and remain unchanged. Please note the contents herein and affix it to the documents you have on hand. The deadline for the submission of Proposals has been changed to Tuesday, July 23, 2024, at 5:00 PM. ADDITIONAL INQUIRIES SUBMITTED IN ADVANCE OF THE DEADLINE LISTED IN THE RFP NOT ADDRESSED HEREIN WILL BE ADDRESSED IN A FUTURE ADDENDUM TO THE RFP. THIS ADDENDUM IS AN ESSENTIAL PORTION OF THE RFP AND SHALL BE MADE A PART THEREOF. ALL OTHER TERMS AND CONDITIONS OF THE RFP REMAIN THE SAME. yac .�Y . C.a. Q�Lbrli for Annie Perez, CPPO Director/Chief Procurement Officer AP:cj cc. Ann -Marie Sharpe, Director, Risk Management Department Pablo R. Velez, Sr. Assistant City Attorney Yadissa A. Calderon, CPPB, Assistant Director of Procurement This Addendum shall be signed by an authorized representative and dated by the Proposer and submitted as proof of receipt with the submission of the Proposal. NAME OF FIRM: SIGNATURE: DATE: 8/20/2024 9:24 AM p. 761 City of Miami Solicitation RFP 1896386 RFP 1860386 — EMPLOYEE BENEFIT CONSULTING SERVICES ADDITIONAL QUESTIONS Q1. Pursuant to Section 11 of the Sample Professional Services Agreement, titled "Default", are consequential and incidental damages required? Al. In the event of default by the Successful Proposer, consequential and incidental damages may be required, at the discretion of the City. Q2. Pursuant to Section 13 of the Sample Professional Services Agreement, titled "Termination: Obligations Upon Termination", Will the City agree to a mutual consequential and incidental damages provision? A2. No. 8/20/2024 9:24 AM p. 762 City of Miami Solicitation RFP 1896386 Question and Answers for Solicitation #RFP 1896386 - Employee Benefit Consulting Services Overall Solicitation Questions Question 1 Attachment A: Current City Benefits Consulting Agreement file will not open and is damaged. Please update the file. (Submitted: Aug 19, 20249:19:01 AM EDT) Question 2 Attachment B is the Risk Brokerage agreement for the City of Fort Lauderdale. Was this meant to be included? (Submitted: Aug 19, 2024 9:22:36 AM EDT) Question Deadline: Aug 28, 2024 5:00:00 PM EDT 8/20/2024 9:24 AM p. 763