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HomeMy WebLinkAboutCHC Wellness / Employee Health Services CHC WELLNESS, INC. 5440 N. CUMBERLAND AVE, SUITE 225 CHICAGO, IL 60656 SERVICES AGREEMENT EMPLOYER: CITY OF CARMEL A A STREET ADDRESS: ONE CIVIC SQUARE CITY: CARMEL STATE IN ZIP 46032 This agreement "Agreement is made as of October l st 201 1 (the "Effective Date between CHC Wellness Inc., an Illinois corporation "CHC and the City of Carmel, "CITY OF CARMEL for itself and on behalf of and for the benefit of the Plan Sponsor's health benefit plan(s) (individually and collectively "Client" or "CITY OF CARMEL (CHC and Client are also referred to individually as "Party" and together as "Parties INTRODUCTION: Client orders and CHC agrees to provide or arrange to provide healthcare "CHC Services as selected below, some of which are described in greater detail in Exhibit A: HRA Health Coaching (Outbound Calling) CHC Weight Management Program Full Venipuncture Health Coaching (Incentive Based) CHC Walking Program Health Coaching ®E- Learning Administer breath nicotine test for all non -users of tobacco (self identified) The Parties agree to be bound by the terms and conditions specified in this Agreement, the documents listed below, and by any amendments to same made in writing and signed by both parties hereto, each of which is part of this Agreement. Client acknowledges that the CHC Services are entirely voluntary and no employee of the Client shall be required to participate in the CHC Services. LIST OF DOCUMENTS: Schedule A General Terms and Conditions Schedule B Specific Terms and Obligations of Parties Exhibit A Health and Wellness Screening Overview Exhibit B HIPAA Business Associate Addendum for the CHC Wellness Services Agreement CLIENT HAS READ THIS AGREEMENT, AND EACH DOCUMENT LISTED ABOVE AND UNDERSTANDS THAT ALL SCHEDULES AND EXHIBITS ATTACHED HERETO APPLY FULLY TO ALL OTHER DOCUMENTS MADE A PART OF THIS AGREEMENT AND ACKNOWLEDGES THAT IT UNDERSTANDS AND IS BOUND BY THIS AGREEMENT. [SIGNATURE PAGE ATTACHED] 1 Schedule A— General r Terms and Conditions 1. THE SERVICES We offer services for wellness monitoring. The tests, services or products provided by CHC are not intended to diagnose, treat, or cure disease. We give 110 warranty that any of our services will prevent disease. All material is provided for educational purposes only and is not intended to be a substitute for a physician's consultation. Although CHC encourages increased self awareness and self -care, we strongly encourage the participants to consult and work with an experienced health -care practitioner. CHC does not engage in rendering medical advice or services. Individuals with health disorders, medical conditions, or any condition requiring medical supervision assume full responsibility for obtaining such professional medical assistance. A. Performance Standard CHC will perform the CHC Services in a proficient manner, and in conforming with applicable industry and professional standards, using personnel having a level of skill in the area commensurate with the requirements of the CHC Services to be performed. If CHC's employees are located on Client's property, they shall observe the reasonable security and safety policies of Client, provided that such policies are communicated to CHC sufficiently in advance from time to time. B. Accuracy of Client Information All CHC Services provided hereunder will be based upon information provided to CHC by Client. Upon receipt from CHC, whether electronically or otherwise, Client will promptly review all records and other reports prepared by CHC for validity and accuracy according to Client's records. 2. FEES; BILLING; TAXES A. Fees The Client shall pay CHC for the CHC Services indicated above. Client shall pay CHC for the CHC Services added in writing by Client after the date hereof at CRC's then prevailing prices for such services. The Client agrees to pay CHC a fee as described in Exhibit A for the CHC Services indicated above. If Client fails to pay any amount due hereunder, Client, on written demand, shall pay interest at the rate of 1.5% per month (or the maximum allowed by law if less) on such past due amount from the due date thereof until the payment date. Client shall reimburse CHC for any expenses incurred, including reasonable attorney fees, in collecting amounts due to CHC hereunder for the CHC Services or any other services added by Client in writing after the date hereof. B. Billing CHC will bill a flat rate as described in Exhibit A to City of Carmel for the CHC Services, as well as any additional charges specified therein. The participant will not be responsible for any cost for the CHC Services, unless they elect to receive voluntary "additional services in which case they will pay out of pocket for these tests. City of Carmel will not be responsible for any such additional charges. 3. DISCLAIMER OF WARRANTIES EXCEPT AS EXPRESSLY SET FORTH IN THIS AGREEMENT, OR REQUIRED BY LAW, CHC EXPRESSLY DISCLAIMS ANY WARRANTY, EITHER EXPRESS OR IMPLIED, INCLUDING ANY IMPLIED WARRANTIES OF MERCHANTABLIITY OR FITNESS FOR A PARTICULAR PURPOSE, NON INFRINGEMENT, NON INTERRUPTION OF USE, AND FREEDOM FROM PROGRAM ERRORS WITH RESPECT TO THE CHC SERVICES, THE CHC PRODUCTS, ANY CUSTOM PROGRAMS CREATED BY CHC OR ANY THIRD -PARTY SOFTWARE DELIVERD 7 BY CHC. CHC DOES NOT RECOMMEND SELF DIAGNOSIS OR SELF MEDICATION, AND NO INFORMATION PRESENTED BY CHC OR ITS ASSOCIATES SHOULD BE CONSTRUED OR INTERPRETED AS RECOMMENDING SELF DIAGNOSIS OR SELF MEDICATION. 4. INTELLECTUAL PROPERTY A. Ownership of Proprietary Rights All computer programs (other than pre packaged third -party software) tutorials and related documentation made available, directly or indirectly, by CHC to Client as part of the CHC Services (the "CHC Products are the exclusive property of CHC. All rights, title and interest in or to any copyright, trademark, service mark, trade secret, and other proprietary right relating to the CHC products and the related logos, product names, etc, are reserved. 5. HIPAA COMPLIANCE CHC and Client are required to meet the requirements of the Health Insurance Portability and Accountability Act of 1996, the Health Information Technology for Economic and Clinical Health Act, and the regulations promulgated there under, as they may be amended from time to time (collectively, "HIPAA CHC will only release a participant's information, results or any other component of their file received, created, or maintained by CHC to a third -party upon receipt of a valid authorization for such release from the participant. The Parties' obligations pursuant to HIPAA are more fully outlined in Exhibit B of this Agreement. 6. TERM AND TERMINATION A. Term. The term of this Agreement shall be for a period of one calendar year and shall, on the first day of each October thereafter, automatically renew for another calendar year unless otherwise agreed by the parties hereto. B. Termination. With respect to the CHC Services covered by this Agreement, Client or CHC may terminate this Agreement at any time upon 15 days prior written notice to the other Party. 7. MISCELLANEOUS A. Assignment. This Agreement shall not be assigned by Client without the prior written consent of CHC or by CHC without the prior written consent of Client. B. Inducement. Client has not been induced to enter into this Agreement by any representation or warranty not set forth in this Agreement. This Agreement contains the entire Agreement of the parties with respect to its subject matter. This Agreement shall not be modified except by a writing signed by CHC and Client. C. Non -Hire. During the term of this Agreement, Client shall not solicit the employment of any CHC employee who has been involved in furnishing services hereunder. D. Governing Law. The validity, enforceability, and interpretation of any provision of this Agreement shall be determined and governed by, and construed in accordance with, the laws of the State of Indiana without giving effect to its conflicts of law provisions. 3 Schedule B Specific Terms and Obligations of the Parties 1. PRICING AND PAYMENT CHC will bill City of Carmel for the CHC Services. CHC Services pricing information can be found in Exhibit A. The participant will not be responsible for any cost for the Health and Wellness Screening (each a "Wellness Solution described in Exhibit A. The only cost the participant may incur is if they choose to pay out of pocket for voluntary additional tests and /or services, including but not limited to Optional Tests, as described in Exhibit A. 2. SERVICES PROVIDED BY CHC I. Program Overview CHC will provide: A. Onsite wellness screenings at multiple City of Carmel locations. The screening will be comprehensive and provide awareness of risk factors for not only heart disease and diabetes, but also liver and kidney function, cancers, blood count readings and many others. Coupling this biometric data with a validated Health Risk Assessment (HRA) will provide a fuller picture of the participant's health. Breath nicotine tests will be administered to all participants who self report they do not use tobacco products. All marketing materials and sign up labor /technology will be supplied by CHC. Every participant's results are reviewed by a practicing physician, and those participants with any single factor or a combination of factors that give rise for a wellness concern are contacted by one of CHC's medical directors for further consultation. Sworn police officers and firefighters may chose to provide blood test results collected within the last 12 months by Public Safety Medical. The data gathered will be included in the aggregate CHC report in the same manner as the data from the onsite screening. B. Remote screening option as an alternative for taking part in one of the on -site screenings. C. Participants' results are available on -line, delivered in hard copy format through the mail, and sent directly to the participant's physician if the participant provides a signed authorization to disclose the results to his or her physician. Individual results can be trended to help track the participant's long term health year to year. Participants will also be provided with educational materials designed to inform them of what their results mean and to provide follow -up outlets designed to encourage them to take action based on their results. D. After screening follow up programs Follow up programs will be designed and made available based on the specific needs of City of Carmel, upon City of Carmel's written request. The level of intensity of these programs can be adjusted to fit seamlessly into the wellness culture. E. The de- identified aggregate results (in accordance with the HIPAA Privacy Rule) of the screening to evaluate the overall health of the population. Strategic consultation services to build and follow an action plan that best suits The City of Carmel, taking into account current plan design, needs and budgetary concerns. It should be noted, however, that despite being de- identified, such results or reports may contain elements of family medical history data and should not be used by Client for 4 underwriting, incentive programs, or any other purposes that may violate the Genetic Information Nondiscrimination Act of 2008 "GINA F. The resources to monitor the CHC Services and expertise to modify the CHC Services as CHC deems necessary. G. Tracking of points for the administration of employee incentive program. H. All services, procedures, materials, and communications provided by CHC will be ADA- compliant. II. The Health and Wellness Screening (Wellness Solutions) The Health and Wellness Screening includes the on -site biometric screening, blood pressure reading, and weight. The specific components of the Health and Wellness Screening are set forth under each respective "Wellness Solution as well as under "Health and Wellness Screening Overview in Exhibit A hereto. III. Health Risk Assessment (HRA) The validity of a tool is as important as the tool itself. Without a valid, proven HRA, the results coming from it mean nothing. For this reason, CHC has chosen to use the HRA developed and maintained by the University of Michigan's Health Management Resource Center (HMRC). The HRA is constantly evaluated and updated to be an accurate tool for reporting risk and cost. CHC has added some clinical questions to ensure accurate biometric ranges. This HRA can be taken in paper format or online. The HRA is available in English, Spanish and Polish. *NOTE: City of Carmel has the option of adding up to 5 additional questions to the HRA. This customization will allow City of Carmel to acquire any information that it deems valuable. Note, however, depending on the content of these questions and the participants' responses, City of Carmel may not be entitled to access the responses to these questions based on applicable federal and state medical privacy laws, including but not limited to the Employee Retirement Income Security Act "ERISA GINA, HIPAA, and any other applicable laws. Specifically, any information obtained by CHC pursuant to its performance of the CHC Services that is covered by the GINA rules and regulations (i.e., a participant's family medical history) will not be provided to the Client. CHC assumes that Client's intended uses of the CHC Services' results or reports are compliant with GINA, ERISA, HIPAA, and all other applicable health privacy laws, and CHC makes no representations as to whether Client's intended uses are compliant with such laws. Client should consult with its legal counsel regarding its intended uses of the CHC Services' results or reports, as well as its health plan documents, to avoid violating the aforementioned health privacy laws. IV. Remote Screening Option: A. The remote screening option provides an alternative screening option, in the event that a participant is unable to attend any of the onsite screenings. Remote screening participants will first register online and complete their HRA via CHC's secure website. Participants will then print out all the information needed for locating and visiting a local LabCorp facility. During a predetermined timeframe set by Client and CHC, the remote screening participants will visit their nearest LabCorp to have their blood drawn. The biometric data gathered by LabCorp will be combined with the participant's HRA data and transmitted electronically into CHC's system. The data gathered for remote screening participants will be included in the aggregate CHC report in the same manner as the data as on -site screening participants. Blood pressure readings will not be 5 taken at remote lab facilities. V. Post Screening: A. As soon as the screening results are processed, LabCorp will contact a CHC medical director if any participant has a test result that is dangerously out of normal range. Our medical director will then immediately contact that participant by telephone to discuss such test result(s). B. Any participant with a combination of results that are of concern to our reviewing physicians, but are not immediately dangerous, will receive a follow -up letter. C. Participants' results will be available for their viewing at www.chcw.com approximately 2 -3 days after the screening. Each participant's results will also be mailed to their home address, as provided to CHC on the CHC In -Take Form, approximately 2 weeks after the screening. Client will not have access to the individual participants' results. D. If the participant provides CHC with their personal physician's name and contact information and authorizes the disclosure of the results to such physician, a copy of the results will be sent directly to the physician free of charge. VI. CHC Walking Program (Purchased Separately): A. CHC will provide the following Assist in setting up and organizing the program Offer training for team setup and overall use Offer program tracking provided through the CHC Wellness web portal Provide fitness tips and goal setting flyers on a wide range of topics provided by CHC Provide participants online capabilities including: o Log steps via web browser o Ability to log and track steps, aerobic steps, calories burned and distance o Track progress daily, weekly and monthly o Track team progress against competing teams VII. CHC Weight Management Program (Purchased Separately): B. CHC will provide the following Assist in setting up and organizing the program Provide How -to documents to help get you started Set -up teams or have CHC Wellness randomly select teams for you On -site weigh -ins conducted by CHC Wellness Utilize online tracking and reporting to view real time contest updates Provide fitness tips and goal setting flyers Generate result graphs to include in marketing 6 Exhibit A Health and Wellness Screening Overview Chem Screen Profile: Glucose Sodium Potassium Chloride Urea Nitrogen Creatinine BUM /Creatinine Ratio Uric Acid Phosphorus Calcium Total Protein Albumin Calculated Globulin A/G Ratio Total Bilirubin Direct Bilirubin Alkaline Phosphatase GGT AST ALT LD Iron Carbon Dioxide Coronary Risk Assessment: Triglycerides Total Cholesterol HDL Cholesterol LDL Cholesterol Complete Blood Count: White Blood Cells Red Blood Cells Hemoglobin Hematocrit MCV MCH MCHC RDW Platelet Count Other Included Components: Blood Pressure Onsite participants will be weighed and Breath Nicotine Test as needed. have their blood pressure taken. Optional Tests TSH: Tests for Thyroid disorder $42 PSA: Early detection of prostate cancer for Men $39 Homocysteine: Test for risk of both Heart Disease and Alzheimer's Disease Risk $54 H. Pylori: Test detects the level of stomach bacteria, 1 -1. Pylori $41 Cardio C: A very sensitive test that measures inflammation xvithin the arteries $39 Hemoglobin Estimates the amount of glucose in an individual over the last 3 months $34 AIc• VAP: Analysis of cholesterol subclasses which increases heart disease detection by 40- $99 9fl% Blood Type: Determines your ABO blood type and Rh factor $25 Vitamin D: Test for Vitamin D deficiency $40 Testosterone: Measures the amount of male hormone androgen $42 B12 Folate: Tests B12 and Folate levels. Can cause depression, irritability, and other $42 svmnto ns Gluten Allergy: Determines gluten specific allergy $29 Colon Cancer Colon Cancer screening test to be completed in the privacy of the participants $10 Screeninn home *Optional tests are typically paid for by participant at the time of service. Client may cover at lower negotiated rate. 7 Exhibit B HIPAA BUSINESS ASSOCIATE ADDENDUM FOR THE CHC WELLNESS SERVICES AGREEMENT The Parties hereto wish to enter into this HIPAA Business Associate Addendum for the CHC Wellness Services Agreement (the Addendum and the Services Agreement collectively referred to herein as the "Agreement effective as of October 1 201 1 (the "Effective Date The Parties hereby agree to abide by the requirements of the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104 -191 (the "Act the privacy standards adopted by the U.S. Department of Health and Human Services (the "Department as they may be amended from time to time, 45 C.F.R. parts 160 and 164, subparts A and E (the "Privacy Rule the security standards adopted by the Department as they may be amended from time to time, 45 C.F.R. parts 160, 162, and 164, subpart C (the "Security Rule and the Privacy provisions (Subtitle D) of the Health Information Technology for Economic Clinical Health Act, Division A, Title XIII of Pub. L. 111 -5, and its implementing regulations (the "HITECH Act due to their status as a "Covered Entity" or a "Business Associate" under the Act. (The Act, the Privacy Rule, the Security Rule, and the HITECH Act are collectively referred to as "HIPAA" for the purposes of this Agreement.) The following are the terms and conditions pursuant to which protected health information "PHI that is provided by, or created or received by, CHC (the 'Business Associate from or on behalf of Client (the "Covered Entity"), will be handled between CHC and the Client during the term of the Agreement. 1. DEFINITIONS (a) Terms Used. Terms used, but not otherwise defined, in this Addendum shall have the same meaning as those terms in 45 CFR 160.103 and 164.501. 2. HIPAA OBLIGATIONS (b) Permitted Uses and Disclosures of Patient Information. Each Party shall comply with confidentiality, medical records and /or other applicable laws and regulations with regard to any and all information directly or indirectly accessed or used by the respective Parties and their personnel, including without limitation HIPAA. To the extent required by HIPAA, the Parties agree that: i. CHC shall use the minimum PHI necessary only as permitted by the Privacy Rule to perform its services under the Agreement or in performing other administrative services required or requested by Client as set forth in the Agreement between the Parties or as may be required by HIPAA. CHC may use and disclose PHI as is necessary for its proper management and administration of CHC's duties under the Agreement or to fulfill any legal responsibilities of CHC. ii. Nothing in this Section 2 shall limit or restrict any Party from de- identifying such data and information so that it is not individually identifiable health information or otherwise does not constitute PHI as defined under HIPAA. iii. With respect to PHI received by CHC under the Agreement, in furtherance of performing CHC services under the Agreement and for program development, CHC reserves the right to use such data and information for statistical evaluation and research, provided that the results of this statistical evaluation and research will only be disclosed in aggregate form and such disclosures will not identify Client or any individual, unless a valid prior authorization has been received. (c) Responsibilities of CHC. With regards to CHC's use and /or disclosure of Client's PHI, CHC hereby agrees to: i. Use and /or disclose PHI only as permitted or required by the Agreements or as otherwise permitted or required by applicable law. ii. Disclose to its subcontractors, agents or other third parties, and request from Client or Client's business associates, only the minimum PHI necessary to perform or fulfill a specific function required or permitted by the Agreement. iii. Use appropriate safeguards to prevent use or disclosure of PHI other than as provided in the Agreement. iv. Report to Client's Privacy Officer in writing any use and /or disclosure of unsecured PHI not provided for in the Agreements of which CHC becomes aware as soon as practicable following CHC's discovery of such unauthorized use and /or disclosure. v. Require any and all agents and subcontractors that receive or use, or have access to, PHI under the Agreement to agree, in writing, to adhere to the same restrictions and conditions on the use and /or disclosure of PHI that apply to CHC pursuant to the Agreement. vi. To the extent practicable, mitigate any harmful effect that is known to CHC of a use or disclosure of unsecured PHI by CHC, or any of its agents or subcontractors, in violation of the requirements of the Agreement. vii. Document any uses or disclosures of PHI and information related to such use or disclosure that would be required under the Privacy Rule for Client to respond to a request by an individual for an accounting of uses or disclosures of PHI. viii. If applicable, make available to Client the information required for Client to provide an accounting of the disclosures in accordance with 45 C.F.R. 164.528, in the time and manner reasonably designated by Client. ix. At the request of Client, provide access to PHI in a reasonable time and manner designated by Client, or, as directed by the Client, to an individual for purposes of accessing, inspecting or copying as further described and limited in accordance with 45 C.F.R. 164.524. x. At the request of Client or an individual, amend PHI that Client reasonably directs or agrees to in accordance with 45 C.F.R. §164.526 in a reasonable time and manner designated by Client. xi. Make its internal practices, books, and records relating to the use and disclosure of PHI received from, or created or received by CHC available to Client or to the Secretary of Health and Human Services, in the time and manner designated by Client or the Secretary, for purposes of determining Client's or CHC's compliance with HIPAA. xii. In addition to any other right to terminate the Agreement, this Agreement will terminate when all of the PHI provided by Client to CHC, or created or received by CHC on behalf of Client, is destroyed or returned to Client, or, upon mutual written agreement of the Parties that such return or destruction of PHI is infeasible, CHC will extend the protections of this Agreement to the PHI and limit further uses and disclosures to those purposes that make the return or destruction of the information infeasible, for so long as CHC maintains such PHI. In the event that CHC reasonably believes that returning or destroying PHI is infeasible, CHC will provide to Client written notification of the specific conditions that make return or destruction infeasible. (d) Responsibilities of Client. With regard to the use and /or disclosure of Client's PHI by CHC, Client hereby agree to: i. provide CHC with Client's Notice of Privacy Practices, as well as any changes to such notice if such changes affect the services provided by CHC under the Agreement, as soon as practicable after the distribution of such notice to participants; and ii. inform CHC of any changes in an individual's written authorization, to the extent that it knows of such changes and such changes affect CHC's permitted or required uses and disclosures, pursuant to 45 C.F.R. 164.506 and /or 164.508. (e) Termination for Failure to Comply. If either Party to this Agreement breaches a material term of this HIPAA Business Associate Addendum and has not cured such breach within a reasonable amount of time after receiving written notice from the non breaching Party, such cure period not to be less than ten (10) days, the non- breaching Party may immediately terminate the Agreement. 3. MISCELLANEOUS (a) Applicability. The provisions of this HIPAA Business Associate Addendum have been included based on the understanding of the Parties that they are required by HIPAA. To the extent that any relevant provision of HIPAA is amended or interpreted in a manner that changes the obligations of the Parties that are embodied in the terms of the Agreement, the Parties agree to negotiate in good faith appropriate amendments to the Agreement to give effect to such revised obligations. Notwithstanding the above, the terms of the Agreement will be construed in light of any interpretation and /or guidance on HIPAA issued from time to time by the U.S. Department of Health and Human Services, the Centers for Medicare and Medicaid of the Office of Civil Rights and any relevant court decisions. Any ambiguity in this Agreement will be resolved in favor of a meaning that permits the Parties to comply with HIPAA. (b) Notices. All notices records or reports required to be given to either party under this Agreement will be in writing and sent by traceable carrier to each party's address indicated below, or such other address as a party may indicate by at least ten (10) days' prior written notice to the other party. Notices will be effective upon receipt. CLIENT /COVERED ENTITY: City of Carmel One Civic Square Carmel, IN 46032 Attn: Barbara Lamb CHC /BUSINESS ASSOCIATE: Ron Malone 1 132 S. Rangeline Rd. 102 Carmel, IN 46032 (c) Term. This HIPAA Business Associate Addendum will continue in full force and effect for as long as the Services Agreement remains in full force and effect unless it is earlier terminated pursuant to Section 2(e). This HIPAA Business Associate Addendum will terminate upon the cancellation, termination, expiration or other conclusion of the Services Agreement. (d) Governing Law. This Agreement shall be governed by and interpreted in accordance with the laws of the State of Indiana. Jurisdiction and venue for any dispute relating to this Agreement shall rest exclusively with the state and federal courts of Indiana. [remainder of page left intentionally blank] ERK Billing Summary (Year 2 addendum Effective 10/1/2011) Client: CITY OF CARMEL Fundin Roster Billing through BAS for Best Practices Solution/Direct bill City of Carmel for Walking g Program and Weight Loss Challenge Billing: CHCW bills on a per participant per year basis for all solutions except the Premier Solution. For the Basic, Technology, Best Practice and Proactive Solutions, there is no cost for employees that do not participate in the wellness program. The Premier Solution utilizes a per employee pricing model because the EAP and DM resources will be available to all employees. not just those that take part in the wellness program. Standard travel expense costs (airfare, lodging, rental car. etc) will apply if applicable and can be added to the per participant price if the client group prefers. Basic Wellness Solution On -site biometric screening, Health Risk Appraisal(HRA), $95 per aggregate and participant reporting participant All Basic Wellness Screening Components, plus unlimited Technology Wellness Solution inbound Health Coaching, F.-learning tutorials and Incentive 5125 per Tracking participant Best Practice Wellness Solution Add Ad Hoc Incentive Capabilities, integration of both $170 Per (2012 Program) Incentive models. program branding. claims integration participant Optional Program Upgrades: Proactive Wellness Solution Add outbound Health Coaching for any participant with a 5195 per WellnessScore under 80, high risk Anxiety Depression participant I A fully integrated Health Management Model that includes a Premier Wellness Solution Disease Management (DM) Program Employee Assistance 5255 per i I Program (EAP) for every employee employee Please see the following page for detailed descriptions of each Wellness Solution DC roilli Basic I Technology Best Practices Proactive Premier i Included Services Solution I Solution Solution Solution Solution HRA (online and paper) 0 37 Test Venipuncture Screening 0 0 o Custom Marketing Materials 0 e Full Service Sign Up Participant Health Portals Company Health Portal 0 Over 500 E- Learning Courses Unlimited Inbound O 0 Telephonic Health Coaching Online Health Coaching Modules Online Participation -based Incentive Tracking o Health Standards O 0 0 0 Incentive Tracking Discounts to 4,000 gyms in the O e nationwide Globalfit network Ad Hoc Incentive Capabilities to Integration of the e 2 Incentive Models Program Branding e Claims Integration Reporting 0 o I Outbound Health Coach Calls to High Risk Participants Outbound Mental Health Calls to 0 High Anxiety Depression Fully Integrated Disease Management (DM) 0 Fully Integrated Employee Assistance I I 1 0 Program (EAP) I $95 per $125 p er $170 p er $195 per SOLUTION PRICING p $255 per 1 participant participant participant participant eligible Follow -Up Options E- learning Participant cnga,cment is atnumaticall) tracked x■ith the CI IC\V Incenti‘c l racking platl rm Included with our Technology Solution. every screening participant will have unlimited access for an entire year to interactive. online tutorials. Our library contains over 500 lessons. so there is something for everyone. Throughout the presentation of the materials, the program checks with the participant for comprehension. This will ensure that if the participant needs education on a subject (controlling cholesterol levels or diabetes for example) they not only get the information, but develop an understanding of the material. O Standard Health Coaching Participant en is automaticalh tracked with the ('I ICW Incentive Tracking platform Included with our Technology Solution. unlimited inbound access for an entire year, via the phone or internet, to a Health Coach for behavior modification, education, and referrals in the areas of: Nutrition management r Stress management Weight management o Pre /Post -natal care Fitness and exercise Smoking cessation Chronic condition management: (high o Complementary care: (chiropractic, yoga, cholesterol, high blood pressure, diabetes, etc.) acupuncture, massage) Unlimited access for an entire year to the wellness coaching portion of the website. This includes a proprietary Online Weight Management Program, Smoking Cessation Program and Walking Program as well as other educational information. Instant messaging with health coaches for privacy. Follow up surveys to determine level of engagement and behavior change including follow ups after 1 month. 6 months and 12 months to assess effectiveness. Free Educational Materials as determined by the Health Coach Discount memberships to 2000+ gyms in the nationwide Globalfit gym network LIME Integrated Support Programs o Walking Program Participant engagement is automaticallk tracked %Kith the CI ICW Incenti%e Tracking platform Cost: CIIC will bill City of Carmel $70 /participant. Replacement pedometers are included for up to 35% of 2012 participants. CHC will charge $40 each for any pedometers over the 35% limit. 12 months of unlimited use of the program. you can offer as many contests as you like.... While walking is cr purl of our everyday life, most people are unaware than simply increasing the distance they walk can have a big impact on their health. The CHC Wellness C'o17)Orate Walking Program will motivate employees to he more active. help build camaraderie and soliclifi) a healthy corporate culture that can lead to lower health care cost. Omron USB Pedometers for each participant How -to Documents to help get you started Set -up Teams or have CHC Wellness randomly select teams for you Utilize Online Tracking Reporting to view real time contest updates Download Weekly Fitness Tips and goal setting flyers Generate Result Graphs to include in marketing Employees will be able to Log Steps Anywhere through the CHC Wellness web portal 0 Weight Management Participant engagement is automatically tracked with the CI ICW Incentive Tracking platform Cost: O 8 week program, *$250 setup fee $28 per participant O 12 week program. *$350 setup fee $35 per participant O Online Only. $250 setup fee $10 per participant *Note: Onetime fee per program for each location or shift Help motivate your employees to shed those unwanted pounds! o How -to Documents to help get you started O Set -up teams or have CHC Wellness randomly select teams for you O Biweekly Onsite Weigh -ins conducted by CHC Wellness o Utilize Online Tracking and Reporting to view real time contest updates Download Weekly Fitness Tips and goal setting flyers O Generate Result Graphs to include in marketing I IN WITNESS WHEREOF, the Parties hereto have caused this Agreement as follows. CITY OF CARMEL, INDIANA CHC WELLNESS, INC. by and through its Board of Public Works and Safety By: By: ,d 4/ /'mes Brainard Presiding Officer Au orized Signature Date: ij C3,(,),Ift,.6 Pri ted Name y� M 0,4„6,i, G .CZ L Date: L A(2,6% Title Mary A Burkee, Member b FID /TIN: 5 -2 Li' 0 .1- 0 -CH Date: di/2c011 Lori Wat •n, Member Date: 1 I 1 Attest: /L_ di Diana Cordray, MC, Clerk- Treasurer Date: l /(p