HomeMy WebLinkAboutMagellan Healthcare Magellan
HEALTHCARE,'
March 22,2018
Pak Lin
Town of Los Altos Hills
26379 Fremont Rd
Los Altos Hills,CA 94022
Dear Pak:
Your Employee Assistance Program (EAP) provided by Magellan Healthcare affords easy-
access for your workforce to helpful services and expert resources that support individual and
overall organizational performance.
I am pleased to convey that your EAP contract will automatically renew for the period of
07/01/2018 to 06/30/2020 at the current rate of$2.20 per employee per month. Our records
currently show that you have a workforce population of 21.
Magellan continues to offer our program at competitive pricing due,in part,to efficiencies
realized in standard contracting. We appreciate your business and the opportunity to continue to
serve your employees,their families,and your organization as a whole.
Please contact me if you need additional resources to support solid workforce awareness of
the EAP,have questions about your program or would like to hear more about our additional
service capabilities.Thank you for the opportunity to provide you with our services.
Thank you,
Kyona Hamilton
Account Manager
314.387.5107
Frances Reed
From: Cox,Cyndy R. <CRCox@magellanhealth.com>
Sent: Tuesday,January 17,2017 11:42 AM
To: Frances Reed
Subject: RE EAP Account-Los Altos Hills
Hi Frances—so sorry about the lengthy delay. The Midwest was on lock down for the last few days with ice and I didn't have
access to be able to respond to you. Your current contract until 6/30/18 was automatically renewed and there is nothing to
sign since the rates and our services have not changed.
Please let me know if you need anything from me including ordering you communication materials/brochures for your
employees. Have a great day!
Cyndy Cox
Account Manager-EAP
Magellan Healthcare
14100 Magellan Plaza, St. Louis, MO 63043
0314-387-5824 I F 888-656-3852 I ECRCox@magehanhealth.com
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Tv 1k you.
From:Frances Reed [mailto:freed@losaltoshills.ca.gov]
Sent:Wednesday,January 11, 2017 3:29 PM
To:Cox,Cyndy R.<CRCox@magellanhealth.com>
Subject: RE:EAP Account- Los Altos Hills
Hello Cyndy,
Though we have not had any disruption in service,should we sign a new agreement,as our current letter seems to state it was
effective through June 2016?
I look forward to hearing from you.
Thank you,
Frances Reed
(650)941-7222
(650)947-2503 direct
Town of Los Altos Hills
1
PAGELLAN
BEHAVIORAL HEALID
June 27,2014
Town of Los Altos Hills
26379 Fremont Rd
Los Altos Hills,CA 94022
To Whom It May Concern:
This letter is to serve as an amendment of the current agreement for EAP services by and between Magellan
Behavioral Health, Inc. and/or Human Affairs International of California (collectively, as appropriate,
"Magellan") and TOWN OF LOS ALTOS HILLS ("Sponsor'), effective as of July 1, 2009 (the
"Agreement").
Effective July 1,2014:
1. Magellan Health Services of California, Inc.Employer Services is substituted for Human Affairs
International of California as a party to this Agreement and successor-in-interest to the rights and obligations
of Human Affairs International of California under this Agreement
2. This Agreement is renewed for an additional term of two (2)year(s) from July 1,2014 through June 30,
2016.
3. The number of Employees eligible for services is 21. Employees are located as follows:
0 United States (Non-California)&Puerto Rico
21 California
0 Canada
0 Other International(Non-Canada)
4. Addendum C Fee Schedule is deleted in its entirety and replaced with the new Addendum C E'ee
Schedule as attached.
5. Exhibit#1 Combined Evidence of Coverage and Disclosure Form is deleted in its entirety and replaced
with the new Combined Evidence of Coveraee and Disclosure Form, a sample of which is provided under
separate attachment as Exhibit#1.
All remaining terms and conditions of the Agreement shall remain unchanged and in effect.
If this letter reflects your understanding of the new terms of our agreement,please have this letter signed by
an authorized representative of Sponsor and returned to me for signature by Magellan.
Sincerely,
Kathy Park
Account Specialist
[Signature Page Follows]
AGREED TO AND ACCEPTED BY
MAGELLAN BEHAVIORAL HEALTII,INC.
(signature required only if Employees located outside California)
By:
Date:
MAGELLAN HEALTH SERVICES OF
CALIFORNIA,INC-EMPLOYER SERVICES
(signature required only if Employees located within California)
By:
Date:
TOWNOFLOS ALTOS/ HILLS A �.,/
By: d s/ s li.�'4 � /lc:. Sary:esst�J,r„4or
Date: s730A,1
2
DU C
PEEEE SCHEDULE
BASE FEES PEPM RATE
UNITED STATES:
X In-person EAI'Services-Choose session model $2.15
❑1-3 session 0 1-6 session
❑1-4 session 0 1-8 session
®1-5 session 0 1-10 session
Telephonic EAP Services
X Legal Consultation&Financial Consultation Services' ,05
Work/Life Services'
Nurse Advice line Services'
New Parent Support Services'
Employee Concern Line'
Other
INTERNATIONAL:
EAP Services-Insert session model
0 1- sessions
Telephonic EAP Services
WorkLife Referral Services'
Legal&Financial Referral Services'
Other Describe:
SUPPLEMENTAL PEES
United States - _--
Additional In-person Sessions $ 90.00 per In-person Session
Additional Service Hours $ 230.00 per provider hour
Mandatory Referralsa $1600.00 per case
CISM Cancellation Fee $ 250.00 per scheduled hour
International
Describe:
Describe:
Communication Materials
Brochures with 2 Wallet Cards $ 0.40 per unit—Estimate
Posters $ 1.60 per unit—Estimate
'Services may only be selected if EAP services are purchased.
Charge applies only if Sponsor selects the Telephonic EAP Service model and an Employee is referred for EAP
services under a'last chance agreement"or similar arrangement.
3
SERVICES AGREEMENT g
THIS SERVICES AGREEMENT(this"Agreement")is entered into as of this 151 day of f1
‘2901 (the"Effective Date")by and between MAGELLAN BEHAVIORAL HEALTH,INC.,and/or
VISTA BEHAVIORAL HEALTH PLANS,as indicated on the signature page below,on behalf of itself and its/their
Affiliates,(collectively,as appropriate,"Magellan")and
Too N OF Los A4--rn5 Ht-1S ("Sponsor"). As used herein,unless otherwise
indicated,capitalized terms shall have the meanings set forth in Article V.
RECITALS
WHEREAS,Sponsor has requested Magellan to provide certain employee assistance program services and
WHEREAS,Magellan agrees to provide such services in accordance with the terms and conditions of this
Agreement.
NOW,THEREFORE,in consideration of the mutual covenants and promises set forth herein and for other
good and valuable consideration,the receipt,adequacy and sufficiency of which are hereby acknowledged,Magellan
and Sponsor herebyagree as follows:
ARTICLE I
SERVICES;SERVICE FEES
1.1 Services. Magellan agrees hereby to provide the Services to Sponsor during the Term and
according to the terms and conditions of this Agreement as well as the"Fee Schedule and Conditions of Offer"
attached as Addendum C.
(a) For purposes of this Agreement,"Basic Services"means the following Services:
(1) Account Management. The Magellan Account Manager serves as the point of
contact and is responsible for answering questions about Magellan products,resolving service delivery issues,
facilitating consultation on behavioral health topics,and advising Sponsor how it can most effectively use the
Magellan EAP.
(2) Toll-Free Telephone Access. Magellan shall maintain a toll-free 1-800 or 1-888
telephone access line(the"Access Line")24 hours per day,7 days per week,to provide Participants access to
assessment,counseling,referral and emergency crisis intervention services.Magellan shall provide telephonic
services only or up to a designated number of face-to-face Sessions(as defined below)per Participant per problem
per year,based on the model selected by Sponsor designation on the"Fee Schedule and Conditions of Offer"
attached as Addendum C.
(3) Professional Services. Except as otherwise provided in this Agreement,all
direct clinical services provided through the Access Line shall be provided by EAP Clinicians. All face-to-face
clinical Sessions shall be conducted by Participating Providers who have at least a Master's level degree in the
appropriate field or such other training and practical experience that qualifies them to provide the applicable EAP
Services.
(4) Employee Communications. Magellan will provide to Sponsor for
dissemination to its Employees brochures,wallet cards,quarterly employee newsletters,posters and manuals.If
ERISA is applicable,Sponsor,or its designee,shall be deemed the Plan Administrator and Named Fiduciary under
ERISA with respect to other communications.
Magellan BCW°rel Health,Inc. 1 Rev.07/27/01
Growing Business Services Agreement
(5) Treatment Compliance Monitoring. To the extent that an Employee so elects
or if Sponsor makes a mandatory referral,then Magellan shall(1)monitor the compliance of the Employee with
respect to treatment recommendations received in connection with EAP Services and(2)provide regular telephonic
recovery support to the Employee with regard to chemical dependency treatment.
(6) Management Consultation. Magellan shall respond to inquiries by Sponsor's
managers and supervisors with consultation in dealing with troubled Employees whose problems are affecting job
performance.Consultations may include(a)coordinating Employee referrals to EAP Services,(b)discussing high-
risk situations which may lead to a threat of violence in the workplace,(c)facilitating the return of an Employee to
work,and(d)assessing and facilitating critical incident intervention. Magellan shall not disclose confidential
information relating to any Employee without the authorization of such Employee. Sponsor agrees to pay Magellan
based on the Fee Schedule and Conditions of Offer attached as Addendum C for management consultation services
performed by Magellan in excess of the number,if any,included in the Basic Services.
(7) Critical Incident Stress Debriefing. At Sponsor's request,Magellan shall
provide CISD(as defined below)services to Sponsor's management and Participants to counter emotional distress
caused by catastrophic or traumatic events.Sponsor agrees to pay Magellan based on the Fee Schedule and
Conditions of Offer attached as Addendum C(excluding hours spent by Magellan planning and coordinating such
CISD),plus expenses,for CISD services performed by Magellan hereunder in excess of the number,if any,included
in the Basic Services.
(8) Training and Orientations. Magellan shall provide training to Sponsor's
supervisors and employees to explain how they can make use of EAP Services.Additional training beyond the
number of hours set forth in the Fee Schedule and Conditions of Offer attached as Addendum C is available on a per
hour basis as indicated in the Fee Schedule. Sponsor agrees to pay Magellan based on the Fee Schedule and
Conditions of Offer attached as Addendum C for training services performed by Magellan in excess of the number,if
any,included in the Basic Services.
(9) Records and Reporting. Magellan shall maintain a record for each Participant
who contacts Magellan for EAP Services. Subject to the restrictions of Section 3.1,Magellan shall provide one or
more statistical reports of Participant utilization of EAP Services. Such reports shall reflect Sponsor-specific data
however,the reports will not include Participant-specific clinical information or other patient-identifiable
information.
(10) Run-Off Services. Sponsor acknowledges that,at the time of termination of this
Agreement,some Participants may be engaged in counseling. Accordingly,Sponsor shall allow Magellan to
continue to provide such EAP Services or to make other clinically acceptable arrangements for continued provision
of Services,provided,however that Sponsor shall not be responsible for payment for more than the maximum
number of Sessions specified in Fee Schedule and Conditions of Offer attached as Addendum C. Sponsor agrees to
pay Magellan additional Service Fees at the rate indicated in the Fee Schedule and Conditions of Offer attached as
Addendum C for each Session of EAP Services provided to a Participant pursuant to this section. The rights and
obligations set forth in this section shall survive the termination of this Agreement.
ro) For purposes of this Agreement,"Optional Services"means the following Services:
(1) MagellanAssist Coached Services. If Sponsor has selected MagellanAssist
Coached Services as indicated by the designation on the Fee Schedule and Conditions of Offer attached as
Addendum C,then Magellan shall provide Participants with access to Magellan's web-based multi-session program
of individual coaching and feedback assembled and monitored by a licensed clinician,utilizing the principles of
cognitive behavior therapy.
(2) Legal Consultation Services. If Sponsor has selected Legal Consultation
Services as indicated by the designation on the Fee Schedule and Conditions of Offer attached as Addendum C,then
Magellan Behavioral Health,Inc. 2 Rev.07/27/01
Growing Business Servlcas Agreement
Magellan shall provide Participants with access to attorneys who can assess and assist with the routine legal needs
of such Participants,except for legal needs relating to employment law. Participants engaging attorneys through this
process shall be entitled to one free initial consultation per problem,either by telephone or face-to-face at the option
of the Participant,and to a 25%reduction in the attorney's usual and customary fees for legal work beyond the initial
consultation.
(3) Wort(Life Resource and Referral Services. If Sponsor has selected Resource and
Referral Services as indicated by the designation on the Fee Schedule and Conditions of Offer attached as
Addendum C,then Magellan shall provide Participants referral and information services for child and elder care,
education and adoption assistance and other work/life services.
(4) Convenience Services. If Sponsor has selected Convenience Services as
indicated by the designation on the Fee Schedule and Conditions of Offer attached as Addendum C,then Magellan
shall provide Participants referral and information services for pet care,relocation and home repair/improvement.
(5) Nurse Line Services. If Sponsor has selected Nurse Line Services as indicated
by the designation on the Fee Schedule and Conditions of Offer attached as Addendum C,then Magellan shall
provide Participants access to registered nurses 24 hours a day,seven days a week,to respond to Participants'
general health concerns and to furnish health education and counseling on health decisions.Callers will have a
choice of talking to a nurse or being directed to an audio library of health information.
•
(6) Financial Consultation Services. If Sponsor has selected Financial Services as
indicated by the designation on the Fee Schedule and Conditions of Offer attached as Addendum C,then Magellan
shall provide Participants access to trained,degreed,financial professionals. Financial Services include consultation
on debt management,basic financial planning,insurance,retirement,savings and investments,vacations,family
issues and home issues.
1.2 Payments. As consideration for Magellan's agreement to perform the Services,Sponsor agrees to
pay Magellan Service Fees on a timely basis for performance of the Services including,without limitation,the Basic
Fees and all Supplemental Fees,as may be adjusted according to the provisions of this Agreement and in accordance
with the following terms and conditions:
(a) Magellan shall invoice Sponsor during the Term for Service Fees hereunder quarterly in
advance.To the extent that any Service Fees are incurred on a fee-for-service basis,Magellan will invoice Sponsor
for Supplemental Fees incurred at the next regular billing interval. After the Term,Magellan shall,at such times as
it deems appropriate in its discretion,invoice Sponsor for all Service Fees which remain due and payable under this
Agreement.
(b) Sponsor shall pay invoiced Service Fees to Magellan within thirty(30)days of Sponsor's
receipt of such invoice. All payments due to Magellan hereunder shall be addressed to:
Magellan Behavioral Health,Inc.
W4050 MBH
P.O.Box 7777
Philadelphia,PA 19175-4050
(c) Sponsor shall pay interest at the rate of one and one-half percent(1.5%)per month on all
payments due hereunder that are not received by Magellan within thirty (30)days of the date when due. In addition,
Sponsor shall reimburse Magellan for any costs Magellan incurs,including without limitation reasonable attorney
fees,with respect to the collection of any late payment of Service Fees.
(d) No later than ninety(90)days prior to the Contract Anniversary Date,Magellan shall
provide Sponsor with new rates for the Services under this Agreement to go into effect on such Contract Anniversary
Date.
Magellan Behavioral Health,Inc. 3 Rev.07/27/01
Growing Business Services Agreement
ARTICLE II
TERM;TERMINATION
2.1 Term. The term of this Agreement shall be for two years,extending from the Effective Date.
Thereafter,the Agreement shall be automatically renewed for successive one-year terms from the Contract
Anniversary Date unless terminated as provided in Section 2.2(a)of this Agreement or either party gives the other
written notice of nonrenewal not less than sixty(60)days prior to the expiration of the term of this Agreement or any
renewal thereof.
2.2 Termination.
(a) Either party may terminate this Agreement for cause,provided that,the complaining party
shall provide at least thirty(30)days' written notice to the breaching party specifying the nature and,so far as then
known,the extent of the breach and the action required to correct the breach. The breaching party shall be afforded
thirty(30)days(or such additional time as the complaining party may determine,as confirmed in writing,to be
reasonable)to cure the breach or,as determined by the complaining party,to achieve substantial cure if a complete
cure cannot be reasonably effectuated within the designated period. If the breach remains uncured at the expiration
of the designated period,this Agreement may be terminated by written notice given by the complaining party at any
time while the breach remains uncured thereafter.
(b) Notwithstanding Section 2.2(a),Magellan may terminate this Agreement due to Sponsor's
failure to comply with its payment obligations under Section 1.2 if payment is not received by Magellan within sixty
(60)days of Sponsor's receipt of invoice,and such termination shall be effective,unless previously cured,as of the
date fifteen(15)days from the date of written notice provided by Magellan to Sponsor. If Magellan receives such
payment in satisfaction of delinquent Service Fees more than fifteen(15)days after the issuance of its notice of
termination,Magellan may,in its sole discretion,either deny or accept Sponsor reinstatement.
ARTICLE III
GENERAL COVENANTS AND OBLIGATIONS
3.1 Confidentiality;Proprietary Rights;Records.
(a) Confidentiality of Participants will be protected in accordance with applicable state and
federal law.All client records will be held in a confidential manner and will be the property of Magellan.
(b) Sponsor expressly acknowledges that Magellan has developed manuals,procedures,
processes,publications,systems,management reports,knowledge,names,logos,trademarks,service marks and
information related to the Services which are proprietary in nature and which constitute trade secrets or other
intellectual property of Magellan(collectively,the"Proprietary Materials"). Sponsor agrees that the Proprietary
Materials shall remain the sole property of Magellan and that Sponsor will refrain from interfering with and/or
appropriating any of Magellan's proprietary rights therein.
3.2 Sponsor Cooperation. Sponsor agrees to cooperate with Magellan in Magellan's performance of
the Services by furnishing,among other things,timely reports and information in a form and manner specified by
Magellan,including the number of Employees covered under the Plan and such other information as may be
necessary for performance of Services.
3.3 Employee Count. As of the Effective Date,the Employee Count will be as set forth on Addendum
A. If at any time prior to or during the Term,the number of Employees increaws or decreases by more than fifteen
percent(15%)relative to the last reported Employee Count,Sponsor shall notify Magellan of such change,and the
basic fee(s)shall be adjusted in the next billing cycle to reflect the correct Employee Count. As appropriate,such
Magellan Behavioral Health,Inc. 4 Rev.07/27/01
Graving Business Services Agreement
adjustments may be made retroactively. If Sponsor's Employee Count decreases to less than ten(10)Employees in
any billing cycle,Sponsor will be billed for a minimum of ten(10)Employees.
3.4 Provision of Services.
(a) Generally. Magellan,in its sole discretion,shall provide the Services hereunder either
through its employees or the employees of an Affiliate of Magellan,or by retaining,directly or indirectly through an
Affiliate of Magellan,independent contractors to provide the Services.
(b) C molia c i h La . Magellan shall obtain and maintain,at its sole expense,all
licenses and permits necessary for it to perform the Services. Sponsor agrees to provide such information and
documents as may be necessary to assist Magellan in obtaining or maintaining such licenses or permits. Magellan
and Sponsor agree to comply with all applicable Legal Requirements.
(c) Insurance. Magellan agrees to obtain and maintain during the Term the following
insurance coverages: (a)comprehensive general liability in a minimum amount of three million dollars($3,000,000)
in the aggregate and one million dollars($1,000,000)per occurrence(in excess of deductible amounts)and(b)
professional liability insurance in a minimum amount of five million dollars($5,000,000)in the aggregate and per
occurrence(in excess oldeductible amounts).
(d) dial Terms in California. If Sponsor has Employees in California,as indicated on
Addendum A,special terms,set forth in Addendum B to this Agreement,apply in California in order to comply with the
Knox-Keene Health Care Service Plan Act of California. In the event of any conflict between the provisions in
Addendum B and the remainder of the Agreement,the provisions of Addendum B control with respect to Participants
located in the State of California.
ARTICLE IV
MISCELLANEOUS
4.1 Survival. In addition to those covenants and obligations,if any,specified elsewhere herein to
survive,the covenants and obligations contained in Sections 1.2 and 3.1 shall survive the termination of this
Agreement
4.2 Notices. All notices and other communications hereunder shall be in writing and shall be deemed
to have been duly given when(i)delivered personally or(ii)received by the addressee,if sent by telecopier(receipt
confirmed by telephone),Express Mail,Federal Express or other express delivery service(receipt requested)or by
registered or certified mail,return receipt requested,in each case to the other party at the following addresses and
telecopier numbers(or to such other address or telecopier number for a party as shall be specified by like notice;
provided that notices of a change of address or telecopier number shall be effective only upon receipt thereof):
To Magellan: Magellan Behavioral Health,Inc.
10150 South Centennial Parkway
Sandy,Utah 84070
Attention:Legal Department
telecopier: (801)256-7088
To Sponsor: the address set forth on Addendum A
4.3 Status of the Parties. Magellan and Sponsor agree that Magellan and all Providers are independent
contractors with respect to the Services performed under this Agreement and,except as otherwise specifically
provided in this Agreement,(a)no Provider is the agent of Magellan or Sponsor nor is any Provider authorized to act
on behalf of Magellan or Sponsor in any manner and(b)neither Magellan nor Sponsor is the agent of the other,nor
is either party authorized to act on behalf of the other in any manner.
Magellan Behavioral Health,Inc. 5 Rev.0727/07
Growing Business Services Agreement
4.4 Waiver. The failure of either party in any one or more instances to insist upon strict performance
of any of the terms and provisions of this Agreement,or to exercise any option conferred herein shall not be
construed as a waiver or relinquishment,to any extent,of the right to assert or rely upon any such terms,provisions
or options on any future occasion.
4.5 Governing_Law. This Agreement has been entered into between the parties in the State of Utah
and the laws of such state,without reference to its choice of law rules,shall govern its interpretation and
enforcement,except as such laws may be preempted by ERISA.
4.6 Severability. If any of the provisions of this Agreement shall be invalid or unenforceable by a
court with jurisdiction over the parties to this Agreement,such invalidity or unenforceability shall not invalidate or
render unenforceable the entire Agreement.
4.7 Authority. Each party hereto represents and warrants to the other that the person executing this
Agreement on behalf of such party has been duly authorized to execute and deliver this Agreement on behalf of said
party.
4.8 Entire Agreement:Modification. This Agreement represents the entire agreement between the
parties and supersedes any and all previously written or oral agreements or understandings. This Agreement may
only be changed in writing signed by Magellan and Sponsor.
4.9 Limited Liability and Warranties. Magellan warrants that it or its subcontractors will make every
effort to ensure the accuracy of the information or the appropriateness of any service or product provided to
Participants. Referrals given by Magellan to Participants for elder or child care,legal services or other community
services are not endorsements or recommendations for the referred programs or providers. The responsibility for
selecting and engaging such providers lies solely with the Participant. Vendors and other providers of elder or child
care,legal services,convenience services or other community services are not and shall not be deemed agents of
Magellan or Sponsor.
4.10 Exclusions.
(a) For purposes of this Agreement,the term'Participant"shall be deemed to exclude all
Participants(as otherwise defined)whose residence or place of employment with Sponsor is located outside of the
United States,Puerto Rico or Canada unless Sponsor has selected International Services as indicated by the
designation on the Fee Schedule and Conditions of Offer attached as Addendum C and notifies Magellan of the
location(s)of the Participants eligible for International Services.
(b) Coverage is not available to Sponsor's employees by employee choice under a cafeteria
plan.
(c) EAP services do not include any of the following:
(i) Gatekeeping to the behavioral component of Sponsors group health plan;
(ii) Evaluations required by any state or federal judicial officer to other
governmental official or agency mandating that a Participant undergo
counseling;
(iii) Performance evaluations or recommendations to be used in child custody
proceedings,child abuse proceedings,criminal proceedings,workers
compensation proceedings,or any legal actions of any kind;
(iv) Performance of professional assessments for fitness for duty determinations or
excuses for leaves of absence or time off;
(v) Treatment for any problem or condition that is not amenable to resolution in
brief counseling.
Magellan Behavioral Health,Inc. 6 Rev.07/27/01
Growing Business Services Agreement
ARTICLE V
DEFINITIONS
For the purposes of this Agreement,the following terms shall have the meanings specified or referred to below.
5.1 "Affiliate"means a legal entity related by common ownership,management or control.
5.2 "Agreement"means this Services Agreement,including the Fee Schedule and Conditions of Offer
attached as Addendum C and all other appendices,exhibits and schedules hereto,which are hereby incorporated
herein by this reference.
5.3 "CISD"or"Critical Incident Stress Debriefing"means response to and consultation in connection
with a sudden,unanticipated incident or circumstance that produces a high degree of distress in the affected
workplace of Sponsor or an immediate or delayed emotional reaction by Participants,including Employees,that
surpasses normal coping mechanisms.
5.4 "COBRA Continuee"means any natural person eligible to receive benefits under EAP by virtue of
electing to continue group health benefits under the Consolidation Omnibus Budget Reconciliation Actor 1985
(COBRA).
5.5 "Contract Anniversary Date"shall mean the date that is two years after the Effective Date and each
subsequent anniversary of such date.
5.6 "Contract Year"shall mean the contract period,commencing with the Effective Date or a Contract
Anniversary Date,as applicable,and ending twelve months later.
5.7 `pendent"means any natural person residing with an Employee on a non-commercial basis.
5.8 `BAP Clinician"means an employee of Magellan or of an Affiliate of Magellan who is a clinical
professional licensed or certified under applicable state law to provide treatment in the areas of mental health and
substance abuse.
5.9 "Effective Date"shall mean that date first set forth at the beginning of this Agreement,which shall
be no sooner than thirty(30)days following notice to Magellan of Sponsor's intent to enter this Agreement.
5.10 `Employee"means any natural person eligible to receive Services by virtue of being a current
employee or COBRA Continuee of Sponsor.
5.11 `Emplovec Assistance Program Services"or"EAP Services"means those Services described in
Section 1.1(a)to this Agreement.
5.12 "Employee Count"shall mean the number of Sponsor's Employees.
5.13 `ERISA"means the Employee Retirement Income Security Act of 1974,as amended.
5.14 "Fee Schedule"means that schedule of fees and charges attached to this Agreement as Addendum
C and describing the fees and charges payable to Magellan by Sponsor pursuant to this Agreement
5.15 "Legal Requirement"means any law,statute,ordinance,decree,requirement,order,treaty,
proclamation,convention,rule or regulation(or any amendment or administrative or judicial interpretation of any of
the foregoing)of any federal,state or local governmental authority of competent jurisdiction.
Magellan Behavioral Health,Inc. 7 Rev.0727101
Growing Business Services Agreement
5.16 "Named Fiduciary"means,if the EAP is governed by ERISA,Sponsor or such other party
identified by Sponsor in accordance with Section 402(a)of ERISA. In no case shall Magellan act as a Named
Fiduciary.
5.17 "Participant"means any Employee or Dependent;provided,that if Sponsor offers a Plan governed
by ERISA,"Participant"shall have the meaning set forth in Section 3(4)of ERISA.
5.18 "Participating Provider"means an individual practitioner,group of practitioners,facility or other
specialized provider of services which(i)maintains a practice or is an employee of Magellan or an Affiliate of
Magellan (ii)has been credentialed by Magellan or an Affiliate or designee of Magellan in accordance with
Magellan's credentialing policies and(iii)has been designated as"participating"by Magellan or an Affiliate of
Magellan to provide specified services to Participants.
5.19 'PEPM"means"per Employee per month."
5.20 'Plan Administrator"means Sponsor or such other party designated by Sponsor as,or otherwise
deemed to be,an administrator of the EAP for purposes of ERISA,if applicable,or any applicable state law of
similar nature. In no case shall Magellan act as or be deemed,by virtue of its performance of the Services or
otherwise for any reason,to be a Plan Administrator.
5.21 "Pronrietary Materials"shall have the meaning set forth in Section 3.1(6).
5.22 Service Fee means the Basic Fee and Supplemental Fees.
5.23 "Services"means the Basic Services and the Optional Services,described in Section 1.1(b),
selected by Sponsor by designation on the Fee Schedule and Conditions of Offer attached as Addendum C.
5.24 "Session"means each separate occasion,as determined by Magellan,when Magellan provides or
offers personal consultation or counseling as an EAP Service to a Participant,whether by telephone or in person,
provided that post-counseling evaluations and post-referral telephone follow-up calls shall not be deemed Sessions.
5.25 "Sponsor"means the undersigned party to this Agreement identified as such in the first paragraph
of this Agreement.
5.26 "Supplemental Fees"means all fees and charges,except for Basic Fees,due and payable by
Sponsor to Magellan for performance of Services at the rates listed on the Fee Schedule for such Services.
5.27 "Vista" means the wholly owned subsidiary of Magellan Health Services,Vista Behavioral Health
Plans,a California corporation. Vista Behavioral Health Plans provides EAP Services in California as a licensed
specialty health care services plan under the California Knox-Keene Health Care Service Plan Act of 1975,as
amended,and is subject to the regulatory oversight of the Department of Managed Health Care of the State of
California.
Magellan Behavioral Health,Inc. 8 Rev.07/27/01
Growing Business Semites Agreement
IN WITNESS WHEREOF,Magellan and Sponsor have executed this Agreement to be effective as of the Effective
Date.
MAGFI I AN: SPONSOR:
MAGELLAN BEHAVIORAL HEALTH,INC. 7OOM of 1.af ASTM Plus
(Only required if Sponsor has Employees located
outside state of California)
1
By: By: kName: Name: s M. .;,k
Title: Tide: CITY M4MA6EL
Date: Date:
Witness: Witness: _ - '
VISTA BEHAVIORAL HEALTH PLANS
(Only required if Sponsor has Employees located
in state of California)
By
Name:
Title: Flora Vivaldo
President
Date: `517k77�
Witness:
1 )
t. L: . .
Magellan Behavioral Health,Inc. 9 Rev.07127101
Growing Business Services Agreement
ADDENDUM A
Sponsor Information
Initial Employee Count as of Effective Date:
Number of Employees in the State of California -20
Number of Employees in states other than California 0 2
Total - 020
'Enter 0 or N/A if no Employees located in California.
'Enter 0 or N/A if no Employees located in other states.
Address for Notice to Sponsor pursuant to Section 4.2 of the Agreement
SARAN 3a nue* ADN.N Svas Doe
7o&u OF 1-os A✓fas fttu-S
}6374 FRENour 12 Mb
Dos 4'--ros rt <44 CA 99ofl
Attention: SARAH 0'0,0 .0-.
telecopier: ( 65o ) 941 316 0
•
•
Magellan Behavioral Health,Inc 10 Rev.07/27/01
Growing Business Services Agreement
ADDENDUM B
California Special Terms
If Sponsor has Employees in California,the following additional terms and conditions apply.
B-1.1 Definitions. In addition to the definitions set forth in Article V of the Agreement,the following terms and
conditions apply to Services in California.
(a) "Department"means the California Department of Managed Health Care,acting in its capacity
to administer or enforce Knox-Keene.
(b) "Director"means the Director of the Department of Managed Health Care of the State of
California.
(c) 'Disclosure Form"means a Combined Evidence of Coverage and Disclosure Form meeting the
requirements of Knox-Keene. The initial Disclosure Form for use in connection with provision of the EAP Services
hereunder is attachedhereto as Exhibit 1,and the terms thereof(as such may be amended and superseded by subsequent
Disclosure Forms)are hereby incorporated herein by this reference.
(d) "Knox-Keene"means the Knox-Keene Health Care Service Plan Act of 1975,as amended,
and regulations issued thereunder.
11-1.2 Provider Contracts. Magellan shall provide written notice to Sponsor within a reasonable time of
the occurrence of any termination of,breach by a Provider of,or inability of a Provider to perform its obligations under,
any contract between Vista or an Affiliate of Vista and such Provider,if,in the reasonable estimation of Vista,Sponsor
may be materially and adversely affected by such termination,breach or inability to perform. In the event of the
termination of such a contract,Vista shall be liable for any EAP Services rendered by the Provider to a Participant who
is under the care of such Provider at the time of such termination until such care is ultimately completed by the Provider,
unless Vista makes reasonable and clinically appropriate provision for the assumption,continuation and completion of
such care by another Provider. The rights and obligations set forth in this section shall survive the termination of this
Addendum or this Agreement.
B-13 Cancellation of Group Contract
(a) Upon the cancellation of,or failure to renew,this Agreement,Vista shall issue promptly to
Sponsor a notice of cancellation meeting the requirements of Knox-Keene. Upon receipt from Vista of any notice of
cancellation or termination,Sponsor shall promptly mail to Participants a legible,tie copy of such notice of
cancellation and inform Participants of the termination of this Agreement and the resultant cancellation of the eligibility
of Participants to receive Services under this Agreement effective as of the date of such termination of this Agreement
(subject to the provisions of Paragraph 1.1(a)(l0). Such notice to Participants shall be acceptable to Vista in form and
content,and Sponsor shall provide Vista proof of timely mailing of such notice.
(b) Upon the termination of this Agreement,and except for termination by Vista for cause due
to fraud or deception by Sponsor in connection with the Services or this Agreement(or Sponsor's knowingly permitting
such fraud or deception by another),Vista shall refund to Sponsor the portion of any Service Fees paid to Vista
applicable to the expected performance of EAP Services for any period following such termination,less any amounts
then due and owing from Sponsor to Vista pursuant to this Agreement.
Magellan Behavioral Health,Inc. 11 Rev.07/27/71
Growing Business Services Agreement
(c) If this Agreement is terminated due to the failure of Sponsor to make timely payment of
Service Fees relating to EAP Services,then this Agreement shall be reinstated,as though it had never been terminated,
upon the foil payment of such Service Fees by Sponsor to Vista prior to or on the first due date for the payment of
Service Fees under Section 1.2 following the due date with respect to which Sponsor was delinquent;provide,
however,that if Vista receives such payment in satisfaction of delinquent Service Fees more than fifteen(15)days after
the date of issuance of its notice of termination,then Vista may,in its sole discretion,either(1)deny such reinstatement
by refunding such payment within twenty(20)business days of its receipt thereof or(2)within twenty(20)business days
of its receipt thereof,issue to Sponsor a new group services agreement accompanied by written notice stating clearly
those respects in which the new agreement differs from this Agreement in benefits,coverage or otherwise.
B-1.4 Cancellation of Participant Benefits. In addition to any cancellation of benefits of a Participant
hereunder due to cancellation of this Agreement pursuant to Section 2.2 and Paragraph B-1.3 a Participant's coverage for
EAP Services may be terminated only by notice to Vista from Sponsor that such Participant is no longer eligible for such
benefits. If a Participant alleges that his or her enrollment or subscription has been wrongfully cancelled(or not
renewed),such Participant may request review of such cancellation(or failure to renew)by the Director.
B-1.5 Notices. With respect to any notice under this Agreement by Vista regarding a material matter,
Sponsor shall furnish notice to Participants by the earlier of its next regular communication to Participants or thirty
(30)days following receipt of notice.
B-1.6 Governing Law and Provisions. Vista and the provision of EAP Services hereunder are subject to
the requirements of Knox-Keene,and any provision required to be in this Agreement by any of the above shall bind
Vista and Sponsor whether or not provided herein.
B-1.7 Participant Grievance Procedures;Public Policy.
(a) Vista has established and maintains grievance policies and procedures in accordance with
Knox-Keene and shall provide its grievance procedures to Sponsor in connection with the Disclosure Form. Vista shall
also make them available to Participants upon request. Sponsor agrees to distribute the Disclosure Form to Participants
on a regular basis.
(b) Vista shall provide a toll-free telephone number for the filing of complaints by Participants.
(c) Vista shall afford Participants the opportunity to participate in Vista's formulation of public
policy pursuant to Knox-Keene.
13-1.8 Limitations,Exceptions and Exclusions. The EAP Services offered hereunder shall not include(a)
psychiatric services,(b)inpatient or outpatient treatment for physical illness,(c)direct treatment or services for mental
retardation or autism,(d)counseling services beyond the number of Sessions provided in Paragraph A-1.2,(e)services
by Providers not meeting the criteria set forth in this Agreement for Providers,(f)court-mandated counseling or
treatment paid for by Workers'Compensation,(g)psychological,psychiatric or neurological testing and(h)medications.
For purposes of this Addendum A only,the terms"Participant"and"Employee"shall be deemed to exclude all
Participants(as otherwise defined)whose residence or place of employment with Sponsor is located outside of the State
of California. In no case shall Vista reduce or decrease the EAP Services offered hereunder by Vista unless upon thirty
(30)days'notice to Sponsor.
Magellan Behavioral Health,Inc, 12 Rev.07/27/01
Growing Business Services Agreement
Employee Assistance Program
Call 24 hours a day, 7 days a week,for confidential help
with work,family, personal matters, legal or financial issues.
Combined Evidence of Coverage
and Disclosure Form
The purpose of this Combined Evidence of Coverage and Disclosure Form is to let you know the terms and
conditions of your EAP benefit. We encourage you to read this form completely and carefully. If you have any
special mental health care needs,you should read carefully the sections of this form that may apply to those needs. If
you would like additional information about your EAP benefit,please call us at the telephone number listed below.
This Combined Evidence of Coverage and Disclosure Form constitutes only a summary of your plan. The
EAP plan contract must be consulted to determine the exact terms and conditions of coverage. A copy of the
plan contract will be furnished upon request.
Vista Behavioral Health Plans
400 Oyster Point Boulevard,Suite 306
South San Francisco,California 94080
Telephone: (650)742-0890
Magellan Behavioral Health,Inc. 13 Rev.07/27/01
Growing Business Services Agreement
What is the Employee Assistance Program?
The Employee Assistance Program(EAP)is a confidential counseling and referral service that can help
you and your dependents successfully deal with life's challenges.The EAP provides:
• Face-to-face evaluations at an office convenient to your home or where you work All calls and
counseling sessions are confidential,except as specified by law(such as when a person's emotional
condition is a threat to him or herself or others,or if there is child or elder abuse).
• Easy access to services and crisis counseling 24 hours a day, seven days a week, via a toll-free
telephone number.
Employee assistance professionals will listen to your concerns with an open mind and help you identify
the cause of your problem. They will then work with you and our network of specialized providers to
develop a practical solution as quickly as possible.
We and your employer encourage you to read this form, share it with your family,and take full advantage
of this program. We are ready when you are.
It is your program
The EAP is an addition to your employee benefits. It is a program designed to offer a professional and
confidential source of help for personal concerns. This EAP, offered by Vista Behavioral Health Plans,
Inc. ("Vista"),an affiliate of Magellan Behavioral Health, Inc,is regulated by the California Department
of Managed Health Care as a specialized health plan.
Why does your employer offer an EAP?
Because your employer:
• cares about the personal health and well-being of employees and their dependents;
• wants you to maintain good job performance;
▪ wants to retain valued employees.
Who is eligible to use the EAP?
All employees and any natural persons residing with an employee on a non-commercial basis
are eligible to seek assistance through the EAP. Other related or non-related persons residing in the
home may be seen only with the employee as appropriate. If you have questions about eligibility,you
may call the EAP or ask your employer for clarification.
How do I start using the EAP?
To initiate EAP services call Vista's toll-free,24-hour telephone number listed on your Vista EAP
brochure or wallet card. You may choose to obtain EAP services either through telephone consultation
or through an in-person appointment. An appointment will be made promptly at a time and location
convenient to you. If you have an emergency medical condition that requires emergency treatment,you
should call"911"or the appropriate local telephone number for emergency services.
Magellan Behavioral Health,Inc. 14 Rev.07/27/01
Growing Business Services Agreement
•
What kinds of problems can the EAP help with?
The EAP offers assistance with a range of personal problems, including,but not limited to:
• Work-related issues
• Family problems
• Marital and relationship issues
• Alcohol and drug abuse,and co-dependency issues
■ Emotional problems
• Physical concerns
• Access to certain legal services
■ Access to dependent care referral services(if this option was selected by employer)
What services are actually provided through the EAP?
Through Vista's EAP you can access the services of licensed professional counselors, legal referral
services,other community resources and,if your employer has so selected,dependent care referral
services. (Dependent care referral services are an optional benefit.Please consult with the sponsoring
employer's benefits representative.)
You are eligible for up to the number of sessions indicated on the last page of this form per
problem per year with an employee assistance professional. Vista EAP services are provided through
a network of experienced professionals. These individuals are available to help you and/or your
dependents with almost any personal concern. They will help you identify and assess the problems you
may be facing,may offer referrals to other resources in the community,provide consultation and,if
clinically indicated,may provide counseling up to the number of remaining sessions that have been
prepaid by your employer. When clinical counseling is provided,your sessions will be performed by a
licensed professional counselor who has at least a master's level degree in a behavioral health field and
additional professional experience. Vista provides follow up to monitor the effectiveness of the
assistance you have received.
Who actually provides the assistance?
Vista contracts with independent professional counselors to provide EAP services.EAP access is
available to you 24 hours a day, seven days a week via a dedicated toll-free telephone number.
Vista maintains referral arrangements with selected community resources for services from which you or
your dependents may benefit. The Vista contracted counselors and other providers are paid for their
services on a fee-for-service basis.Vista does not use any financial incentives for the providers to reduce
or limit their services to you.
If Vista terminates its contract with the counselor you are seeing,but you wish to continue to see the
counselor to complete your EAP services,in most cases,you may do so, provided that the additional EAP
sessions are available and clinically appropriate. You may simply continue seeing the counselor,without
seeking Vista approval. However, if your counselor refuses to continue to see you on the same terms and
conditions(for example,at the fee Vista offers to pay for EAP sessions),Vista will contact you to
arrange for referral to another contracted counselor. Similarly,if Vista terminated your counselor
Magellan Behavioral Health,Inc. 15 Rev.07/27/01
Growing Business Services Agreement
because of fraud,criminal activity,incompetence or unprofessional conduct likely to be harmful to.
client safety or delivery of client care,Vista will contact you to arrange for referral to another contracted
counselor. If Vista offers you another contracted counselor but you choose to continue to see the
terminated counselor,you will be responsible for paying for the counselor's services.
Vista is part of the Vista Behavioral Health organization,the country's largest behavioral health,EAP
and human services organization, serving more than 64 million individuals across the United States and
Canada. The Vista Behavioral Health family of companies specialize in managed mental health and
substance abuse services as well as employee assistance/work-life programs,and serves over 3,000
clients representing health plans,government agencies,unions,and corporations,including more than 20
percent of all Fortune 500 companies.
Resource & Referral, legal, and other referral services
If you need assistance with routine legal problems(except employer-related issues or third-party
consultations),you may call the toll-free EAP number on your Vista EAP brochure or wallet card. A
Vista EAP representative will connect you with an attorney referral service. This service will provide
you with an initial consultation with an attorney without charge. If you decide to engage the attorney and
additional time is required beyond the initial session,he or she will provide a twenty-five percent(25%)
discount from the attorney's usual and customary fees.
If your employer selected our optional dependent care referral services,a call to the toll-free EAP
number indicated on your Vista EAP brochure or wallet card will also help you access elder and/or child
care.
Vista can also refer you to other community resources,as needed.
Is the EAP confidential?
The EAP is designed as a confidential program and Vista is committed to protecting your privacy. Your
confidentiality is protected by law,except in certain specific circumstances. In most cases EAP
counseling offices are located away from the worksite. The discussions you have with your counselor
will not be disclosed to anyone outside Vista without your written consent,except in the specific
instances required by law. You are encouraged to discuss the roles of confidentiality(and those
exceptions)directly with your EAP counselor. A copy of Vista's confidentiality policy is available upon
request.
What costs are involved?
The EAP is an employer-sponsored program.Your employer has prepaid the entire cost of the EAP
session(s)for which you are eligible,including any of the EAP services which Vista may provide in
person or over the phone. Through its contracts,Vista prohibits its contracted counselors from charging
you for services rendered under this program,regardless of whether or not payment is received from
Vista. The prepaid services provided through the EAP are often all that is required to address a personal
problem. However,if you are referred to(and elect)services outside the Vista EAP system,you will be
responsible for the cost of those services. You should check to see whether the costs of healthcare
services to which you are referred are partly or fully covered by your employee medical benefits plan.
Also,certain referral services(e.g., legal or dependent care referral services)may result in discounted
charges for services beyond the initial consultation. Please make sure you understand whether you are
responsible for any such charges.
Magellan Behavioral Health,Inc. 16 Rev.0727/01
Growing Business Services Agreement
Vista works hard to provide quality services, whether they are provided by contracted providers or
through referrals to other community resources. However,referrals given in connection with EAP
services are not endorsements or guarantees for the programs or providers to which you are referred.
You are encouraged to discuss any concerns about resources with your EAP counselor.
EAP limitations and exceptions
As an employee or eligible dependent,you are eligible to receive the number of EAP sessions prepaid
and sponsored by the employer each year. However,there are some limitations and exceptions. For
example,the Vista EAP does not provide:
• Psychiatric services
• Inpatient or outpatient treatment for physical illness
• Direct treatment or services for mental retardation or autism
• EAP counseling services beyond the number of employer-sponsored,prepaid sessions
• Services by providers who are not part of Vista's EAP network
• Court-mandated counseling or treatment paid for by workers'compensation
• Testing
• Prescription drugs
When does EAP coverage begin and end?
Persons are eligible to receive Vista's EAP services if they are active employees,covered retirees,ex-
employees if eligible for COBRA benefits,or dependents of such individuals. Your eligibility ends when
the employer's contract with Vista terminates or when you(or the person through whom you receive
benefits)separate from the employer.
During your term of employment(or that of the person through whom you receive benefits),your
coverage cannot be canceled,nor can you be denied renewed coverage because of your health status or
your requirements for service.
May I continue coverage after leaving employment?
You may be able to obtain EAP coverage,at your cost,following the end of employment,if federal law
requires the employer to offer it. Talk to the employer's benefits representative if you are interested. If
federal law requires continuation of EAP coverage,you will have 60 days to elect to continue EAP
coverage.
May I obtain a second opinion?
If you have questions about the counselor's assessment of your problem or the action plan developed with
the counselor or the counselor is unable to make an assessment,you may contact Vista to discuss the
assessment or action plan. You may also contact Vista to discuss questions regarding failure of your
problem to improve within an appropriate time period. After discussing the issues with a Vista care
manager, you may request a second opinion. If Vista determines a second opinion is clinically
appropriate and you have EAP sessions left,Vista will refer you to an appropriately qualified
professional who will provide a second opinion. In a case involving an imminent,serious health threat,
Vista will process your request on an expedited basis. If you would like additional information regarding
Magellan Behavioral Health,Inc. 17 Rev.07/27/01
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the availability of a second opinion,call Vista toll-free at the telephone number below or write to Vista
at 400 Oyster Point Boulevard, Suite 306,South San Francisco,California 94080.
Grievance procedure
Member satisfaction is an integral component and primary goal of Vista's EAP program. We strive to
ensure that the professionals to whom you are referred meet your needs.However,even in the best
system,grievances may occur.When they do,we make every effort to resolve them quickly.
If you are not satisfied with the services you are provided by the Vista EAP,please call a Vista EAP
representative at the toll-free number listed on your brochure or wallet card. You may verbally report
your complaint to the representative or may request that a complaint form be forwarded to you. If you
request a complaint form, you should complete it at your earliest convenience and forward the completed
form to Vista Behavioral Health Plans,Atm: Comment Coordinator,400 Oyster Point Boulevard, Suite
306,South San Francisca California 94080. If you need assistance completing the complaint form,
please call your Vista toll-free number.If possible, Vista will respond to your inquiry immediately.Vista
will offer you a resolution in writing,explaining the reasons for our resolution,within ten(10)business
days following our receipt of your complaint. If you are not satisfied with Vista's response at this point,
you may request consideration of your complaint through Vista's grievance procedure or you may file an
administrative appeal. If you pursue review through the grievance process,Vista will acknowledge
receipt of your grievance within twenty(20)days and notify you whom Vista may contact in connection
with your grievance. Whether you pursue a grievance or an appeal,Vista will offer you a resolution in
writing,explaining the reasons for our resolution,within thirty(30)days following receipt of your
request.
If your complaint or grievance is of an urgent nature,Vista will conduct an expedited review and provide
you with a written statement of Vista's resolution within three(3)business days of receipt of the
complaint or grievance.
The Department of Managed Health Care
The California Department of Managed Health Care is responsible for regulating health care service
plans. The Department has a toll-free telephone number(1.800-888-HMO.2219)to receive complaints
regarding health plans. The hearing and speech impaired may use the California Relay Service's toll-free
telephone numbers(1-800-735-2929(TTY)or 1-888-877-5378 (TTY))to contact the department. The
Department's Internet website(www.hmohelo.ca.¢ov)has complaint forms and instructions online. If
you have a grievance against your health plan,you should first telephone your plan at the toll-free
telephone number on your EAP brochure or wallet card and use the plan's grievance process before
contacting the Department. If you need help with a grievance involving an emergency,a grievance that
has not been satisfactorily resolved by your plan,or a grievance that has remained unresolved for more
than 30 days, you may call the Department for assistance. The plan's grievance process and the
Department's complaint review process are in addition to any other dispute resolution procedures that
may be available to you,and your failure to use these processes does not preclude your use of any other
remedy provided by law.You may file a grievance with the Department on the earlier of completion of
Vista's grievance process or thirty(30)days after initiation of Vista's grievance process.
Magellan Behavioral Health,Ina 18 Rev.0727/01
Growing Business Services Agreement
What can I do if I suspect fraud?
Vista has implemented an anti-fraud program in order to detect,deter,and fully investigate suspected
fraud on the part of its providers, affiliates,and/or staff To maximize protection against fraudulent
activity,an anti-fraud hotline is available to all Vista providers,affiliates and staff as well as employees
(and their household members)of organizations that contract with Vista for EAP services. If you suspect
Fraud related to submission of claims or other activities related to your EAP benefit,please contact the
Vista anti-fraud hotline at 1-800-443-5704.
Program renewal
Vista and the sponsoring employer may negotiate changes in the EAP program periodically,typically at
each anniversary of the contract. While the number or type of EAP sessions you receive may change in
such cases,it is unlikely that your eligibility for EAP services will be affected.
Public policy participation
If you are interested, you can have a voice in our public policy-making process. Call us with your ideas
at(800)424-6038 or write to Vista's Public Policy Committee. Our address is:
Vista Behavioral Health Plans
Attn: Public Policy Committee
400 Oyster Point Boulevard, Suite 306
South San Francisco, California 94080
Summary of Vista's EAP
In closing,here is a listing of the features and services we offer:
Features
• Up to c counseling sessions per problem per year, as clinically appropriate
• 24 hours/seven days per week availability in crisis
• Confidentiality
• Voluntary
• Available to employees and families
• Employer-sponsored and prepaid
• Designed to assist with all types of personal problems
Services
• Consultation
• Assessment
• Counseling
• Referral,if appropriate
• Follow up
Magellan Behavioral Health,Inc. 19 Rev.07!27/01
Growing Business Services Agreement
ADDENDUM C
FEE SCHEDULE AND CONDITIONS OF OFFER
BASIC FEES Fee PEPM
Basic Services
[Choose only one]
X Face to Face Employee Assistance Program
Model--Choose selected model below:
❑3-session ❑6-session
.gi 5-session ❑S-session
Or
Telephonic Only Services
Optional Services
J( MagellanAssist Coached Services 'a.o
)( Legal Consultation Services •43.
Work Life Resource and Referral
Services--Choose model below:
❑Basic g�
®Full
g Full,with Convenience Services
K Nurse Line Services •73
X Financial Consultation Services -019
SUPPLEMENTAL FEES
Additional Services
Additional Twinings $125 per clinician
hour
Additional Mandatory Referrals $700 per referral
Additional CISDs $200 per clinician
per hour
Additional Sessions $90.00 per Session
Run-Off Services ' $100.00 per Session
Additional Communications Materials
Postcard and refrigerator magnet $0.60 per unit
Additional Videos $14.00 per unit
Additional Wallet Cards $0.10 per unit
Additional Brochures $0.40 per unit
Additional Posters $1.60 per unit
Additional Newsletters $0.12 per unit
Magellan Behavioral Health,Inc. 20 Rau.07/27/01
Growing Business Services Agreement
SUPPLEMENTAL FEES(cont.)
International Services
Set-up Fee US$3000
Face-to-Face Counseling Services US$225 per one-
hour session
Termination Fees
Terminations effective in the I"contract quarter 25%of one month's
fee
Terminations effective in the 2°d contract quarter 15%of one month's
fee
8%of one month's
Terminations effective in the 3'a contract quarter fee
Travel costs to remote areas for training and CISDs will be reimbursed to Magellan by Sponsor at
Magellan's cost
CONDITIONS OF OFFER
P .tes are initially for 24 months. Thereafter rates are evergreen with an annual rate adjustment at
Sponsor's renewal.
• Renewal rates are on a community basis effective on the customer contract renewal date.
• Rate increases will be indicated 90 days in advance.
2. The Basic Fee for Basic Services(EAP)covers the following:
• Trainings: none included if less than 100 employees, 1 hour at 100 employees,plus 1
hour for each additional 200 employees
• CISDs: one hour if Sponsor has more than 250 employees
• Mandatory Referrals: Up to 2 mandatory referrals per year
• Access to MagellanAssist and EPOTEC
• Standard Magellan employee communications package,consisting of:
> Brochures @ 1.3 per employee
> Wallet Cards @ 1.3 per employee
> Quarterly Employee Newsletter @ 1 per employee per quarter
• Posters @ 1 per 150 employees
> Supervisor manual @ 1 per 20 employees
> Employee Videos @ 1 per 500 employees
• Supervisor Videos @ 1 per 500 employees
• One insert page for each ancillary product
• Distribution of above materials to one location
• One Sponsor-specific annual usage report if Sponsor has fewer than 250 Employees; if
Sponsor has 250 or more Employees,four quarterly Sponsor-specific usage report.
3. Magellan offers no performance guarantees and will report on service center overall performance
only.
4. Optional Services may be purchased only in conjunction with Basic Services(EAP).
Convenience Services may be purchased only when Full Dependent Care has been
purchased.
Magellan Behavioral Health.Inc. 21 Rev.07127/01
Growing Business Services Agreement
RESOLUTION No. 45-02
A RESOLUTION OF
THE CITY COUNCIL OF flit TOWN
OF LOS ALTOS HILLS AUTHORIZING EXECUTION OF AN
AGREEMENT WITH MAGELLAN BEHAVIORAL HEALTH,INC.
FOR EMPLOYEE ASSISTANCE PLAN SERVICES
WHEREAS, the City Council of the Town of Los Altos Hills has approved the
establishment of an Employee Assistance Plan for the benefit of its employees;
AND WHEREAS,Magellan Behavioral Health has offered an Employee Assistance
Plan with a full range of services at a competitive rate;
NOW THEREFORE, the City Council of the Town of Los Altos Hills does hereby
authorize the City Manager on behalf of the Town to execute the Agreement between the
Town and Los Altos Hills and Magellan Behavioral Health, Inc.
REGULARLY PASSED AND ADOPTED this 41h day of April, 2002.
BY: "�
ayor ftc Tan •
t'F.ST:
� =-
City Clerk