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City Clerk Document No. City Council Meeting Date: April 28, 2022 AMENDMENT TO CITY OF CHANDLER AGREEMENT THIRD PARTY CLAIMS ADMINISTRATION – WORKERS COMPENSATION CITY OF CHANDLER AGREEMENT NO. HR9-953-4004 THIS AMENDMENT NO. 2 (Amendment No. 2) is made and entered into by and between the City of Chandler, an Arizona municipal corporation (City), and CorVel Enterprise Comp, Inc. (Contractor), (City and Contractor may individually be referred to as Party and collectively referred to as Parties) and made , 2022 (Effective Date). RECITALS WHEREAS, the Parties entered into an agreement for third-party claims administration services (Agreement); and WHEREAS, the term of the Agreement was July 1, 2019, through June 30, 2022, with the option of up to two two-year extensions; and WHEREAS, the Parties wish to exercise the first option through this Amendment to extend the Agreement for two years. AGREEMENT NOW THEREFORE, the Parties agree as follows: 1. The recitals are accurate and are incorporated and made a part of the Agreement by this reference. 2. Section 4, Price is amended to read as follows: The City will pay the Contractor the per unit cost set forth in Revised Exhibit B of the original Agreement, attached to and made a part of this Amendment No. 1. Total payments made to the Contractor during the term of this Amendment No. 1 will not exceed $80,000. 3. Section 5, Term is amended to read as follows: The Agreement is extended for a one-year period, July 1, 2022 through June 30, 2024. DocuSign Envelope ID: 947CFA34-B83D-466F-BCD5-500720782C72 4. All other terms and conditions of the Agreement remain unchanged and in full force and effect. If a conflict or ambiguity arises between this Amendment No. 1 and the Agreement, the terms and conditions in this Amendment No. 1 prevail and control. IN WITNESS WHEREOF, the Parties have entered into this Amendment on the Effective Date. FOR THE CITY FOR THE CONTRACTOR By: _________________________________________ By: _________________________________________ Its: Mayor Its: _________________________________________ APPROVED AS TO FORM: By: _________________________________________ City Attorney ATTEST: By: _________________________________________ City Clerk DocuSign Envelope ID: 947CFA34-B83D-466F-BCD5-500720782C72 CFO REVISED EXHIBIT B FEE SCHEDULE Workers' Compensation Claims Administration Description Pricing Life of Contract Flat Annual Fee Up to 42 Indemnity & 112 Medical Only Claims Annually $42,890.00 Per claim Fee after maximum number of claims: Medical-Only $135.00 Indemnity $647.00 Employer's Liability $647.00 ¹ Claim fee applies to AOS with the exception of premium states (CA, HI, AK, NY, TX and FL) ² CorVel Healthcare Corporation’s managed care services must be used for all claims administered by CorVel. Program Management Description Pricing Data Conversion - Per Data Source Waived Administration Fee - Per Annum ¹ Waived Implementation Fee - One Time Fee Waived CareMC Access - Per Annum ² First 5 Full Access Users Included Each User over 5 - Per User, Per Year $1,079.00 State Fund Oversight (OH, WA) 50% of standard fees, based on service level ¹ Includes Assistance with Self-Insured Data for State Reports, State Statistical Reporting & All State Filing Requirements ² Includes Executive Dashboard, Claim Details, Claims Summary Screen & Claims Reporting Account Management and Technical Support Description Pricing Account Management Staff Included Electronic Data Transmission - (Per Month, Based on Frequency) Monthly File $270.00 Weekly File $647.00 Daily File $2,158.00 Training – Onsite and Online Included Technical Support Included State EDI Files Included Monthly Reporting Included Ad hoc Report Programming - Per Hour $216.00 Communication Materials/Posters Pass through printing cost Annual Banking Fees One account included DocuSign Envelope ID: 947CFA34-B83D-466F-BCD5-500720782C72 Additional Account(s) - Per Account $1,079.00 Carrier TPA Oversight Fees ¹ Bill from Carrier to Client ¹ Fees charged by the carrier (Oversight fees, Tail Claim transfer / takeover fees, etc.) are the responsibility of the client and will be billed directly to the client by the carrier or by CorVel should CorVel be invoiced for such fees. Intake and Immediate Intervention Services Description Pricing Claim Intake (includes one FNOL distribution) - Per Intake Waived Incident Only Reporting - Per Incident $38.00 Advocacy 24/7 - Per Call Waived Telehealth Services Fee Schedule or U&C value by CPT code Allocated Expense Fees Legal Services Description Pricing Subrogation 25% of Recoveries Legal Bill Auditing ¹ 2.5% of gross legal charges reviewed Indexing and OFAC Compliance - Per Index $15.00 ¹ Fees will never exceed the savings generated Bill Review Services Description Pricing Bill Review: Includes Standard Fee Schedule and UCR - Per Bill ¹˒² $6.47 + Network Solutions Includes: ² 19% of Savings Clinical Review, Implant Analysis, Line Item Bill Review, Negotiations, PPO Network Access, Substantive Denials, Technical Evaluation Minimum Transaction Fee ² $0.00 State EDI, Scanning/OCR, Initial 1099 Provider Notification Letter Included ¹ Includes bill intake, document imaging, file upload, state EDI’s, and initial 1099 provider notification letters. ² Minimum transaction fee (MTF) per bill transaction. Applied per transaction if all other applicable fees do not meet the minimum transaction fee. Applies to all transactions, including but not limited to, Specialty Bills, Duplicate Bills and bills sent for Re-consideration or Re-evaluation. There is a maximum bill review transaction fee of $15,000.00. DocuSign Envelope ID: 947CFA34-B83D-466F-BCD5-500720782C72 Patient Management Description Pricing Telephonic Case Management, Field Case Management and Return to Work Coordinator - Per Hour All Other States ¹˒² $92.00 Vocational Rehabilitation - Per Hour $178.00 Specialty Services (Catastrophic, Life Care Plan, Medicare Conditional Payments, Medicare Set Asides, Bilingual) - Per Hour $235.00 Nurse Utilization Review - Per Review $162.00 Physician Utilization Review - Per Review $324.00 Care Advocate - Per Claim $50.00 PeerWell App Access - Per Claim (One-Time Fee) $500.00 ¹ Fee applies to all States with the exception of premium states (CA, HI, AK, and NY). ¹Statutory rates supersede if applicable. Prevailing IRS Mileage Rate applies. Each invoice for Case Management Services shall have an additional professional service fee of $39.00 billed to Customer. Pharmacy Solutions Description Pricing Retail Pharmacies Brand AWP -10% + $3.24 dispensing fee Generic AWP -30% + $3.24 dispensing fee Mail Order Brand AWP -14% + $1.62 dispensing fee Generic AWP -40% + $1.62 dispensing fee Clinical Modeling Integration of Pharmacy Data Included Dynamic Calculation/Display in CareMC Included Pharmacy Interventions Certified Pharmacy Technician Included Rx Nurse Included Nurse Management Case Management hourly rate Pharmacy Review - Per Review $405 Cognitive Behavioral Therapy - Per Hour $270 Medication Review - Per Hour $270 Specialty Network Services Description Pricing Medical Imaging Services Varies by State and Diagnostic Independent Medical Exam See 2022 IME/Peer Fee Schedule Physical and Occupational Therapy Varies by State DocuSign Envelope ID: 947CFA34-B83D-466F-BCD5-500720782C72 Durable Medical Equipment Varies by State and Equipment IME Peer Review - Per Hour See 2022 IME/Peer Fee Schedule Transportation Varies by State and Service Translation Varies by State and Service Level Medicare Agent Reporting Description Pricing Set up and engagement Included Monthly Maintenance Included Quarterly Reporting Included ▪ The above pricing per claim is based on handling of all claims that occur and are reported during the agreement period. If life of contract pricing is selected, claims will be handled until closed or until the end of the agreement period, whichever comes first. If life of claim pricing is selected, claims will be handled until closed. ▪ Rates on claims that occur outside of the United States are subject to alternative pricing to be discussed prior to start of the contract. ▪ Pricing is valid for first two years of this Renewal Term of the contract. At the end of the first year and each year thereafter, all fees outlined on the claims and managed care pricing sheet will be subject to an automatic increase of the greater of CPI or three and a half percent (3.5%). ▪ Any service not identified in this proposal will be provided at a later time. DocuSign Envelope ID: 947CFA34-B83D-466F-BCD5-500720782C72