HomeMy WebLinkAboutCity Council Meeting - Council - Agenda - 05/19/1998 7
Cloty of Kent
ClotyCouncil Meeting
Agenda
CITY OF
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Mayor Jim White
Councilmembers
Leona Orr, President
Sandy Amodt Connie Epperly
Tom Brotherton Judy Woods
Tim Clark Rico Yingling
May 19, 1998
Office of the City Clerk
CITY OF 1O\1 r4T
SUMMARY AGENDA
KENT CITY COUNCIL MEETING
May 19, 1998
Council Chambers
V 7 : 0 0 p.m.
MAYOR: Jim White COUNCILMEMBERS: Leona Orr, President
Sandy Amodt Tom Brotherton Connie Epperly
Rico Yingling Tim Clark Judy Woods
CALL TO ORDER
FLAG SALUTE
ROLL CALL
1. PUBLIC COMMUNICATIONS
A. Drinking Driver Task Force Design Contest Recognition
Ceremony
B. Fire Department Officer Development Academy Presentation
C. Finance Department Award Presentation
D. Arson Alarm Award Presentation
2 . PUBLIC HEARINGS
None
3 . CONSENT CALENDAR
A. Approval of Minutes
B. Approval of Bills
C. LID 348, 64th Avenue S. Street Improvements, Final
Assessment Roll - Ordinance
D. Fire Inspection Agreement with King County -
Authorization
E. COPS Universal Grant Budget Amendment - Approval
F. Horseshoe Acres Annexation - Set Hearing Date
G. 108th Avenue Sewer Extension - Acceptance
H. W.S.D.O.T. Detour Agreement, 84th Avenue/Grady Way -
Authorization
I. King County Waste Reduction Agreement - Authorization
J. Declaration of Surplus Vehicles - Approval
K. Chamber of Commerce Freight Mobility Systems Proposal -
Authorization
L. Blue Cross of Washington and Alaska and Group Health
Contract Renewal for 1998 - Authorization to Sign
M. Rhododendron Estates Preliminary Plat - Set Meeting Date
N. Network Backbone Equipment Contract - Authorization
O. Canterbury Greens Townhomes Final Plat - Set Meeting
Date
P. Senior Center Carpet Replacement - Approval
Q. Council Absence (Yingling) - Approval
4 . OTHER BUSINESS
biene /1.
5. BIDS
A. Russell Road Ballfi�dComplex Improvements
6. CONTINUED COMMUNICATIONS
7. REPORTS
EXECUTIVE SESSION - Property Acquisition
8. ADJOURNMENT
NOTE: A copy of the full agenda packet is available for perusal in the City ClerKs Office and the Kent Library.
An explanation of the agenda format is given on the back of this page.
Any person requiring a disability accommodation should contact the City in advance for more information. For TDD relay service call
1-800-635-9993 or the City of Kent(253)854-6587.
PUBLIC COMMUNICATIONS
Citizens wishing to address the Council will, at this time,
make known the subject of interest, so all may be properly
heard.
A) Drinking Driver Task Force Design Contest Recognition
B) Fire Department Officer Development Academy Presentation
C) Finance Department Award Presentation
D) Arson Alarm Award Presentation
CONSENT CALENDAR
3 . City Council Action:
Councilmember OP& moves, Councilmember
seconds that Consent Calendar Items A through�p�
Discussion -Inn
Action_"/ n& (i&hV'F
3A. Approval of Minutes.
Approval of the minutes of the regular Council meeting of
May 5, 1998.
3B. Approval of Bills.
Approval of payment of the bills received through April 30 and
paid on April 30, 1998, after auditing by the Operations
Committee on May 5, 1998 .
Approval of checks issued for vouchers:
Date Check Numbers Amount
4/30/98 199208-199502 $ 340, 221. 07
4/30/98 199503-199932 2 , 086 , 875. 17
$2 , 427 , 096. 24
Approval of checks issued for payroll for April 16 through
April 30 and paid on May 5, 1998 :
Date Check Numbers Amount
5/5/98 Checks 227220-227555 $ 252 , 872. 52
5/5/98 Advices 57869-58397 738 , 920. 83
$ 991, 793 . 35
Council Agenda
Item No. 3 A-B
Kent, Washington
May 5, 1998
Regular meeting of the Kent City Council was called to order at
7: 00 p.m. by Mayor Pro Tem Orr. Present: Councilmembers Amodt,
Clark, Epperly, Woods and Yingling, Operations Director/Chief of
Staff McFall, Assistant City Attorney Brubaker, Police Chief
Crawford, Fire Chief Angelo, Planning Director Harris, Public
Works Director Wickstrom, Parks Director Hodgson, and Assistant
Finance Director Hillman. Councilmember Brotherton was excused
from the meeting. Approximately 25 people were in attendance.
PUBLIC Employee of the Month. Mayor Pro Tem Orr
COMMUNICATIONS announced that Officer Trisha King of the Police
Department has been chosen as Employee of the
Month for May. She noted that Officer King is
an instructor at the Kent Police Department
Training Center, teaches Police Ethics at the
Washington State Criminal Justice Training
Center, and has instructed for the International
Association of Chiefs of Police. She also
stated that Officer King serves on the committee
for the annual conference of the Association of
Field Training Officers and is a founding member
of the King County Peer Support Team which
responds to critical incidents throughout the
County, facilitating counseling sessions of
employees, police officers, fire fighters and
communications personnel involved in critical
incidents. Orr then presented Officer King with
the Employee of the Month plaque.
Police Chief Crawford stated that Officer King
is a driving force in the Department in how
situations are handled ethically. He said she
deserves this honor and expressed his pride in
her.
Letter Carriers Food Drive Day. Mayor Pro Tem
Orr read a proclamation explaining that the
National Association of Letter Carriers will
sponsor their Sixth Annual food drive and
declaring May 9 , 1998 , as Letter Carrier' s Food
Drive Day in the City of Kent. She urged all
citizens to aid those in need by participating
in the food drive. The proclamation was
presented to William Parmenter.
Mr. Parmenter thanked the Council for the
proclamation and encouraged all families to
place some form of food on, in or near their
mailbox on May 9th. He noted for Yingling that
they would like non-perishable food, as well as
articles for babies. He noted that all food
1
Kent City Council Minutes May 5, 1998
PUBLIC will go to Food Lifeline and the Kent Food
COMMUNICATIONS Banks. He said that over 65, 000, 000 pounds of
food was collected last year and the goal for
this year is 100, 000, 000 pounds.
Correctional officer Week. Mayor Pro Tem Orr
read a proclamation noting that the Kent
Corrections Facility is celebrating their
twelfth anniversary this month, and that the
City wishes to honor the valor, service and
dedication of its Corrections Officers, and
proclaiming the week of May 3-9, 1998, as
Correctional Officer Week in the City of Kent.
She presented the proclamation to the
Corrections officers.
CONSENT WOODS MOVED that Consent Calendar Items A
CALENDAR through G be approved. Clark seconded and the
motion carried.
MINUTES (CONSENT CALENDAR - ITEM 3A)
Approval of Minutes. APPROVAL of the minutes of
the regular Council meeting of April 21, 1998.
WATER (CONSENT CALENDAR - ITEM 3F)
Guiberson Reservoir. ACCEPT the Guiberson
Reservoir Sei -ic Upgrade project as complete
and release retainage to RDS Construction upon
standard releases from the State and release of
any liens, as recommended by the Public Works/
Planning Committee. The original contract
amount was $61, 359 . 00. The final construction
amount was $79, 673 . 85 . The contract exceeded
the bid amount due to additional costs incurred
in relocating a 6" storm line as well as cap-
sizing structural material. Adequate funds
exist within the project budget to cover this
overage.
STREETS (CONSENT CALENDAR - IT- . �C)
LID 340 S. 196th/200th Street Corridor Proiect.
ADOPTION of Resolution No. 1509 setting the
public hearing date for June 2nd to establish
the formation of LID 340 - S. 196th/200th Street
Corridor, as recommended by the Public Works/
Planning Committee.
(PUBLIC HEARINGS - ITEM 2A
LID 348, 64th Avenue South Street Improvements.
This date has been set for the public hearing on
2
Kent City Council Minutes May 5, 1998
STREETS the confirmation of the Final Assessment Roll
for LID 348 . Public Works Director Wickstrom
explained that this is the last stage of a long
process for improving 64th Avenue South from
Smith Street to 212th. He displayed a map out-
lining the boundaries of the LID and noted that
the final amount of the project is 11% less than
the original amount. He pointed out that the
City is a property owner and that funds are
budgeted. He explained the method of assessment
and noted that many property owners have been
waiting for this project as they desire another
access.
Wickstrom explained that an appraisal was done
on Assessment No. 6 in 1997 , which showed that
that property benefited to the amount of
$225, 000 and has an assessment of approximately
$96, 000, assuming that the property is develop-
able. He noted receipt of a letter from the
property owner saying that the property is not
benefited because it is not developable. He
explained that the property owner based his
information on an appraisal done by the City
when trying to acquire property for the road in
which it was noted that on the inventoried
wetlands, all but the north 30 feet seems to be
encumbered by wetlands making it undevelopable,
and the City had to base their acquisition costs
on that. Wickstrom noted that the property
owner provided another appraisal stating that
wetlands are not benefited from the improvements
to the project and they should therefore not be
assessed. He said that there has never been any
documented evidence that the property contains
wetlands and explained that when a property is
shown on the wetlands inventory maps, a more
detailed analysis is required. He then gave
examples of instances in which the more explicit
environmental analysis reveals substantially
less wetlands encumbrances than reflected by the
inventoried map.
Wickstrom noted that the property owner has
suggested that the lack of a curb cut is
evidence that the property is not benefited, and
said the City disagrees. He said the City also
disagrees with the property owner' s claim that
there is drainage impact to the property because
of the lagoon project. Wickstrom then explained
the method of payment.
3
Kent City Council Minutes May 5, 1998
STREETS Assistant City Attorney Brubaker explained that
in this hearing the Council acts as a Board of
Equalization and is adjudicating the rights of
specific individuals rather than policy matters
of regional or area-wide importance. He said
the Council sits in a quasi-judicial capacity,
as a neutral decision maker for this hearing,
and said that if any Councilmember has had any
ex parte contacts with any individuals who may
be protesting their assessment, it would appro-
priate make a disclosure of those contacts.
WOODS MOVED to make the letter of protest
regarding Assessment No. 6 and Wickstrom' s memos
of April 30 and May 5, 1998 , a part of the
public record. Clark seconded and the motion
carried.
Mayor Pro Tem Orr opened the public hearing.
There were no comments from the audience. At
7 : 33 p.m. , on the advice of the Assistant City
Attorney, the hearing was continued while the
Council went into Executive Session for approxi-
mately five minutes. The meeting reconvened at
7 : 43 p.m. ' There were no comments from the
audience and WOODS MOVED to close the public
hearing. The motion carried.
CLARK MOVED to establish the Final Assessment
Roll for LID 348 affecting the properties
identified and in the amounts presented for
this hearing; to allow additional documentary
evidence to be presented and introduced into the
record regarding Assessment No. 0006, specifi-
cally including additional wetland delineation
data; to allow for subsequent adjustment of the
Final Assessment amount for Assessment No. 0006,
based upon that additional evidence; and to
direct the City Attorney to prepare the neces-
sary ordinance, including the appropriate
findings and conclusions consistent with the
record, to establish the Final Assessment Roll
affecting the properties identified and in the
amounts presented for this hearing (as may be
subsequently adjusted for Assessment No. 0006)
in order to complete the LID 348 , 64th Avenue
South street improvements. Woods seconded and
the motion carried.
4
Kent City Council Minutes May 5, 1998
COMMUTER RAIL (OTHER BUSINESS - ITEM 4B)
Commuter Rail Parking Garage Funding, The City
Council has been presented with a number of
optional methods for funding the City' s share
of a parking garage to be constructed at the
downtown commuter rail station. The Council
Operations Committee has recommended the use of
LTGO (Councilmanic) bonds in an amount not to
exceed $4 , 000, 000 with subsequent principle and
interest payments to be made from undesignated
reserves in the Capital Improvement Fund.
McFall noted that this issue has been reviewed
by the Committee of the Whole and the
Operations Committee.
EPPERLY MOVED that the City' s portion of the
Downtown Sound Transit Commuter Rail Parking
Garage be funded with up to $4, 000, 000 of LTGO
(Councilmanic) bonds and that the Capital
Improvement Fund budget be amended to provide
for principle and interest payments on those
bonds to be paid from the funds which are
currently undesignated reserves in the CIP;
further, staff is directed to aggressively
pursue other funding sources including contri-
butions from METRO, Sound Transit contingency
funds, grants, and other funding sources which
could also include private partnerships for
potential retail uses on the ground floor; any
funds resulting from this effort will be
utilized to reduce the amount of the bonds sold
to fund this project or to cover the City's
costs in excess of $4, 000, 000. Amodt seconded.
Woods offered a friendly amendment to consider
the possibility of new revenue sources as well.
Epperly and Amodt agreed to the amendment. The
motion as amended then carried.
PUBLIC WORKS (BIDS - ITEM 5A)
Vactor Solids Facility S. 266th & 64th Avenue
S. The bid opening on this project was held on
April 29th with seven bids received. The low bid
was submitted by Archer Construction in the
amount of $339 , 545 .99 . The Engineer' s estimate
was $369 , 193 . 03 .
The Public Works Director recommends that the
contract be awarded to Archer Construction.
CLARK MOVED that the Vactor Solids Facility (S.
5
Kent City Council Minutes May 5, 1998
PUBLIC WORKS 226th & 64th Avenue South) contract be awarded
to Archer Construction for the bid amount of
$339 ,545.99. Yingling seconded and the motion
carried.
FRANCHISE (CONSENT CALENDAR - ITEM 3D)
Union Pacific Railroad/196th St. Our Crossing
Franchise. ADOPTION of Ordinance No. 3402 which
authorizes the operation of a railroad spur
crossing to Union Pacific Railroad, as recom-
mended by Council. This crossing is located on
196th Street in the vicinity just east of the
Green River.
DOWNTOWN (CONSENT CALENDAR - ITEM 3E)
STRATEGIC Downtown Strategic Action Plan Grant. ACCEPT
ACTION PLAN the Downtown Strategic Action Plan additional
grant of $10, 000 granted to the City from the
Washington State Department of Community and
Economic Development (DCTED) to complete Kent' s
proposed Downtown Strategic Action Plan and
direct staff to adjust the budget accordingly
and spend the monies for same, as recommended by
the Public Works/Planning Committee.
PLAT (OTHER BUSINESS - ITEM 4A)
Green Meadows Townhomes Final Plat FSU-97-4.
This date has been set to consider a final plat
application by Baima & Holmberg for the Green
Meadows Townhomes. The subdivision is 2 .85
acres in size and is located north of SE 256th
and east of 138th Place SE. This subdivision was
transferred to Kent by King County, who approved
the preliminary subdivision under Ordinance
#12219 on January 16, 1996.
CLARK MOVED to approve staff ' s recommendation of
approval with conditions of the Green Meadows
Townhomes Final Plat and to authorize the Mayor
to sign the final plat mylar. Woods seconded
and the motion carried.
COUNCIL (CONSENT CALENDAR - ITEM 3G)
Excused Absence, Councilmember Brotherton.
APPROVAL of an excused absence for Councilmember
Tom Brotherton who is unable to attend tonight' s
Council meeting.
6
Kent City Council Minutes May 5, 1998
FINANCE (CONSENT CALENDAR - ITEM 3B)
Approval of Bills. APPROVAL of payment of the
bills received through April 15 and paid on
April 15 after auditing by the Operations
Committee April 28 , 1998 .
Approval of checks issued for vouchers:
Date Check Numbers Amount
4/15/98 198501-198771 $ 822 , 447 . 93
4/15/98 198772-199207 1, 456 , 245 .23
$2 , 278, 693 . 16
Approval of checks issued for payroll for
April 1 through April 15 and paid on April 20,
1998 :
Date Check Numbers Amount
4/20/98 Checks 226898-227219 $ 247 , 776. 13
4/20/98 Advices 57338-57868 759 , 979 .89
$1, 0071574. 02
REPORTS Council President. Orr asked interested
Councilmembers to contact Ms. Banister regarding
the Suburban Cities dinner on May 13 .
Operations Committee. Woods announced that the
Committee now meets on the first and third
Tuesday of each month at. 3 : 30 p.m.
Public Safety Committee. Epperly noted that the
next meeting will be held on May 12th at
5 : 00 p.m.
Parks Committee. Woods noted that the meeting
time for this committee is now 4 : 30 p.m. on the
third Tuesday of each month, and that at the
next meeting they will discuss the possibility
of a parks bond issue on one of the fall
ballots.
EXECUTIVE At 7 : 55 p.m. , McFall announced an Executive
SESSION Session of approximately fifteen minutes.
The meeting reconvened at 8 : 20 p.m.
7
Kent City Council Minutes May 5, 1998
Property WOODS MOVED to authorize the Mayor to execute
Acquisition the necessary documents to purchase the property
located at and near 212th and Frager Road, known
as the LDS Property, pursuant to the terms
established in the existing Purchase and Sale
Agreement. Amodt seconded and the motion
carried.
ADJOURNMENT The meeting adjourned at 8 :22 p.m.
u.e�d--�eh�
Brenda Ja ber, CMC
City Cler
8
01
Kent City Council Meeting
Date May 19 , 1998
Category Consent Calendar
1. SUBJECT: LID 348, 64TH AVENUE S. STREET IMPROVEMENTS, FINAL
ASSESSMENT ROLL - ORDINANCE
2 . SUMMARY STATEMENT: As recommended by Council, adoption of
Ordinance No. 3qQ_3 establishing the final assessment roll for
LID 348 , 64th Avenue South Street Improvements.
3 . EXHIBITS: Ordinance
4. RECOMMENDED BY: Council
(Committee, Staff, Examiner, Commission, etc. )
5. UNBUDGETED FISCAL/PERSONNEL IMPACT: NO X YES
6 . EXPENDITURE REQUIRED: $
SOURCE OF FUNDS:
7 . CITY COUNCIL ACTION:
Councilmember moves, Councilmember seconds
DISCUSSION•
ACTION:
Council Agenda
Item No. 3C
05/14/98 17:27 FA% 206 447 9700 F P & S 1a 002/006
COPY RECEIVED
CITY OF KENT, WASHNGTON
ORDINANCE NO. Cent City Atwrney
AN ORDINANCE of the City of Kent, Washington, approving and
confirming the assessments and assessment roll of Local Improvement District
No.348 for THE construction of 64th Avenue South from approximately 200 feet
north of South 226th Street to South 216th Street; including miscellaneous
intersection improvements at the intersection of 64th Avenue South and West
Meeker Street and a water main line extension to complete water main loop on 64th
Avenue South and water and sewer stub extensions to unserviced property, as
provided by Ordinance No. 3347, and levying and assessing a part of the cost and
expense thereof against the several lots, tracts, parcels of land and other property as
shown on the assessment roll-
WHEREAS,the assessment roll levying the special assessments against the property located
in Local Improvement District No. 348 in the City of Kent, Washington(the "City', has been filed
with the City Clerk as provided by law:, and
WHEREAS, notice of the time and place of hearing thereon and making objections and
protests to the roll was published at and for the time and in the manner provided by law fixing the
time and place of hearing thereon for the 5th day of May, 1998,at the hour of 7:00 p.m.,local time,
in the Council Chambers in the City Hall,Kent, Washington, and further notice thereof was mailed
by the City Clerk to each property owner shown on the roll; and
WHEREAS, at the time and place fixed and designated in the notice the hearing was held,
all written protests received were considered and all persons appearing at the hearing who wished to
be heard were heard, and the City Council, sitting and acting as a Board of Equalization for the
purpose of considering the roll and the special benefits to be received by each lot,parcel and tract of
land shown upon such roll,including the increase and enhancement of the fair market value of each
such parcel of land by reason of the improvement, overruled all such protests; NOW,
TIEREFORE,
Uai14/98 17:L8 tAK 106 447 9700 F e x 6 ,oui J06
THE CITY COUNCIL OF THE CITY OF KMTT, WASHINGTON, DO ORDAIN as
follows:
Section 1. Roll Confirmation- The assessments and assessment roll of Local
ch has been created and established for the purpose of
Improvement District No. 348, whi
constructing 64th Avenue South from approximately 200 feet north of South 226th Street to
South 216th Street, including miscellaneous intersection improvements at the intersection of 64th
Avenue South and West Meeker Street and a water main line extension to complete water main
loop on 64th Avenue South and water and sewer stub ex easions to unserviced property, as
provided by Ordinance No. 3347, as the same now stand shall be and the same are approved and
confirmed in all things and respects in the total amount of$1,743,701.30.
Section 2 Parcel 6 Objection.
(a) By letter dated Mayl, 1998, the City Council received a document from Jennifer
D. Cobb, attorney at law, that was characterized as a "formal objection" to the proposed
assessment for K&W Holdings, Inc. (Assessment Parcel No. 6, Tax Lot No. 1122204-9059-08)
("Objection'j. This document asserted that the proposed City improvements did not provide a
special benefit to the subject property because (a) the improvements would not increase the
property's value and (b) there would be no access to the property from the proposed roadway
improvement.
(b) At the hearing, the uncontested evidence demonstrated that the Objection was
based on as inconclusive wetland designation of the Parcel. However• there was no wetland
survey or delineation to either confirm or deny the existence of wetland on the Parcel.
Additionally, the evidence showed that the City had written the owner requesting to enter the
O5/14/98 17:28 FAX 206 447 9700 F P & S (4004/006
property to conduct a wetland survey or delineation at City expense in order to verify the
existence or nonexistence of wetlands on the Parcel,but K&W had refused.
(c) The evidence demonstrates clearly that a number of similarly situated properties
that appeared to be encumbered by wetlands had recently been developed in the City. According
to the evidence, at the time of development application, such property had been subject to more
detailed surveys and mitigation measures that allowed the sites to be developed. Accordingly, in
the absence of convincing evidence to the contrary,the Parcel was properly assessed as if it were
fully developable.
(d) With respect to access, the evidence is persuasive that the Parcel abuts the
roadway that is the subject of this LID, and will be allowed driveway access at the time the
Parcel is developed. Consistent with Public Works Department policies, the City does not
construct driveway aprons onto undeveloped land as part of a street widening project. The
reason for these policies is that, historically, actual development proposals typically require
relocation of any existing driveway aprons.
(e)The evidence presented in the Objection is not persuasive, and insufficient to rebut the
presumption of correctness. Even if sufficient to overcome the presumption of correctness, the
uncontested evidence at the hearing supports the finding of special benefit to at least the amount
shown on the roll.
Section 3. Special Benefit. Each of the lots, traces, parcels of land and other property
shown upon the assessment roll is determined and declared to be specially benefited by this
improvement in at least the amount charged against the same, and the assessment appearing
against the same is in proportion to the several assessments appearing upon the roll. There is
05/14/98 17:28 FA1 206 447 9700 P P S -QJ' Jib
levied and assessed against each lot,tract or parcel of land and other property appearing upon the
roll the amount finally charged against the same thereon.
Section 4. Notice of Roll. The assessment roll as approved and confirmed shall be filed
With the Finance Division Director of the City for collection and the Finance Division Director is
authorized and directed to publish notice as required by law stating that the roll is in her hands
for collection and that payment of any assessment thereon or any portion of such assessment can
be made at any time within 30 days from the date of first publication of such notice without
penalty, interest or cost, and that thereafter the sum remaining unpaid may be paid in 15 equal
annual installments. The estimated interest rate is stated to be %per anaum, with the exact
interest rate to be fixed in the ordinance authorizing the issuance and sale of the local
improvement bonds for Local improvement District No. 348. The first installment of
assessments on the assessment roll shall become due and payable during the 30-day period
succeeding the date one year after the date of first publication by the Finance Division Director
of notice that the assessment roll is in her hands for collection and annually thereafter each
succeeding installment shall become due and payable in like manner. if the whole or any portion
of the assessment remains unpaid after the first 30-day period, interest upon the whole unpaid
sum shall be charged at the rate as determined above, and each year thereafter one of the
installments, together with interest due on the unpaid balance, shall be collected. Any
installment not paid prior to expiration of the 30-day period during which such installment is due
and payable shall thereupon become delinquent. Each delinquent installment shall be subject, at
the.time of delinquency,to a charge of 9% penalty levied on both principal and interest due upon
that installment, and all delinquent installments also shall be charged interest at the rate as
05/14/98 17:28 FAX 206 447 9700 F P & S 10006/006
lments shall be enforced in the
determined above. The collection of such delinquent instal
manner provided by law.
Section 5. Effective date. This ordinance shall take effect and be in force five (5) days
from and after its passage and five (5) days following its publication as required by law.
By
JIlv1 wHrM,Mayor
ATTEST:
BRENDA JACOBER,City Clerk
APPROVED AS TO FORM:
Special Counsel and Bond Counsel
for the City
Passed the day of May, 1998.
Approved the day of May, 1998.
Published the day of May, 1998
Kent City Council Meeting
Date May 19 . 1998
Category Consent Calendar
1. SUBJECT: FIRE INSPECTION AGREEMENT WITH KING COUNTY -
AUTHORIZATION
2 . SUMMARY STATEMENT: Authorize the Mayor to sign the Fire
Inspection Interlocal Agreement between the City of Kent and
King County for 1998 .
This agreement with King County covers the inspection of all
occupancies in Fire District No. 37 with the exception of
single-family residences and miscellaneous structures. This
agreement is in a series of continuing agreements that have
been signed for the last several years. This agreement
provides a tool used by the Fire Department to alleviate
serious fire hazards in the District's commercial buildings.
It is for the first inspection and one re-inspection only. Any
follow up work after the first re-inspection is the
responsibility of the King County Fire Marshal.
From a financial standpoint the County will reimburse the City
at the rate of $85 per hour for travel, research time, and
inspections performed on any permit application within the Fire
District' s jurisdictional boundary. This agreement has been
reviewed by the City Attorney' s Office.
3 . EXHIBITS: Interlocal agreement
4 . RECOMMENDED BY: Fire Chief Angelo and Public Safety Com. (3-0)
(Committee, Staff, Examiner, Commission, etc. )
5. UNBUDGETED FISCAL/PERSONNEL IMPACT: NO X YES
6. EXPENDITURE REQUIRED: $
SOURCE OF FUNDS:
7 . CITY COUNCIL ACTION:
Councilmember moves, Councilmember seconds
DISCUSSION•
ACTION:
Council Agenda
Item No. 3D
INTERLOCAL AGREEMENT
BETWEEN
KING COUNTY
AND
City of Kent
THIS AGREEMENT is made and entered into this day by and between King
County, a home rule charter County in the State of Washington (hereinafter referred to
as the "County") and City of Kent , a Washington municipal corporation (the "City").
WHEREAS, RCW 19.27.030 provides that on and after January 1, 1975, there
shall be in effect in all cities, towns, and counties of the state a state building code; and
WHEREAS, RCW 19.27.030 provides that a portion of the aforementioned code
shall consist of the Uniform Fire Code and the Uniform Fire Code Standards, published
by the International Conference of Building Officials and the Western Fire Chiefs
Association; and
WHEREAS, RCW 19.27.040 authorizes counties to amend any component of the
state building code as it applies within its jurisdiction in all such respects as shall not be
less then the minimum performance standards and objectives enumerated in RCW
19.27.020; and
WHEREAS, KCC 17.04.020 provides that the terms "fire chief" and "fire
department" as used in the Uniform Fire Code shall mean fire marshal and fire marshal's
office of King county, respectively; and
WHEREAS, Section 2.103(a) of the King County Modifications to the Uniform Fire
Code, as adopted by K.C. Ordinance 10608 provides the King County Fire Marshal's
Office shall have responsibility for inspections and the enforcement of the fire prevention
provisions of the code; and
WHEREAS, Section 2.103 (c) of the King County Modifications to the Uniform
Fire Code, as adopted by KC. Ordinance 10608 provides the King County Fire
Marshal's may by written contract, delegate to the chief of the fire districts and fire
departments authority for inspections and/or the enforcement of the fire prevention
provisions of the code within their respective jurisdictions.
WHEREAS, the City desires to provide by agreement for effective inspection
pursuant to the Uniform Fire Code within the jurisdictional boundaries of City of Kent
and effective administration and inspection of the Hazardous Materials
Inspections/Permit program.
1
WHEREAS, this Agreement is authorized by the Interlocal Agreement Act., RCW
39.34.
NOW, THEREFORE, in consideration of their mutual promises set forth herein,
the County and District/Department hereby agree as follows:
1. COUNTY OBLIGATIONS
1.1. General. The County agrees to continue: to assume the enforcement
powers for the Uniform Fire Code as provided for by King County Title 23; to be
responsible for the issuance of all required permits or certificates; to collect all required
permit fees; to reimburse the City in accordance with the terms of this Agreement for
additional insurance premium charges and for work performed as a result of the City's
participation in the activities described in this Agreement.
1.2. Ordinances. The County agrees that it shall notify the City upon the
adoption of any ordinance that affects or requires inspections to be made under the
Uniform Fire Code or in any way affects the duties of the City under the terms of this
Agreement.
1.3 Forms. If the County specifies or requires any forms or writen reports to
be used under the terms of this Agreement, the County agrees to provide such forms to
the City at the expense of the County.
1.4. Reimbursement For Work Performed. The County agrees to reimburse
the City at the rate of$85.00 per hour for travel and research time and inspections
performed on any permit applications within the City's jurisdictional boundaries pursuant
to this Agreement.
2. CITY OBLIGATIONS.
2.1 Permit Inspection of Occupancies. The City agrees to perform
Hazardous Materials Permit inspections within its jurisdictional boundary on behalf of the
County in accordance with the terms and provisions of the Uniform Fire Code of King
County, and the guidelines established by the King County Fire Marshal. In addition, the
City agrees to inspect occupancies, as defined in Section 301 of the Uniform Building
Code, other than single family dwellings and those occupancies classified as "U", on an
annual basis. The City further agrees to make one reinspection when required.
Additional reinspections or other actions required for code compliance may become the
responsibility of the King County Fire Marshals Office.
2.2. Identification of Required Permits. As part of its routine annual
maintenance inspection process, the City agrees to evaluate occupancies within its
jurisdiction to determine whether circumstances exist which require permits under the
Uniform Fire Code. When a circumstance requiring permit is identified, the City shall
2
provide the occupant with a permit application, verify which code provisions for the
permitted use or material being are met, initiate corrective action when needed, and
notify the Fire Marshal's Office of any expired or missing permits.
2.3 Notice Upon Inability to Inspect. If for any reason the City cannot meet
any of the above obligations, the City will promptly notify and seek additional assistance
from the King County Fire Marshal's Office.
3. LIABILITY INSURANCE.
3.1 Municipal or State Agency Provisions. If the contractor is a
Municipal Corporation or an agency of the State of Washington and is self-insured for
any of the above insurance requirements, a certificate of self-insurance shall be
attached hereto and be incorporated by reference and shall constitute compliance with
this section.
4. RECORDS AND DOCUMENTS.
All records compiled by the City under the provisions of this Agreement shall
constitute records of the County and shall be made available to the County upon
request.
All records and documents with respect to this Agreement shall be subject to
mutual inspection and review by both parties during the performance of this Agreement
and for seven (7) years after termination.
5. EMPLOYEE COMPENSATION AND CONTROL.
The County shall be responsible for the payment of all salaries, wages, other
benefits, and compensation to all county employees performing services under this
Agreement. Further, the County shall be solely responsible for control of personnel,
standards of performance, discipline, and all other aspects of performance of all county
employees performing services under this Agreement.
The City shall be responsible for the payment of all salaries, wages, other
benefits, and compensation to all City employees performing services under this
Agreement. Further, the City shall be solely responsible for control of personnel,
standards of performance, discipline and all other aspects of performance of all City
employees performing services under this agreement.
In providing services under this Agreement, the City is an independent contractor,
and neither the City nor it officers, agents or employees are employees of the County for
any purpose. The City shall be responsible for all federal and or/ state tax, industrial
insurance and Social Security liability that may result from the performance of and
3
compensation for these services and shall make no claim of career service or civil
service rights which may accrue to a County employee under state or local law.
6. NONDISCRIMINATION.
In performing any obligations in this Agreement, neither the City nor any parry
subcontracting under the authority of this Agreement shall discriminate on the basis of
race, color, sex, religion, nationality, creed, marital status, sexual orientation, age, or
presence of any sensory, mental, or physical handicap in the employment or application
for employment or in the administration or delivery of services or any other benefits
under this Agreement.
The City shall comply with all applicable requirements of Section 504 of the
Rehabilitation Act of. 1973 as amended and the Americans with Disabilities Act of 1990.
7. NO THIRD PARTY BENEFICIARY INTENDED
This Agreement is intended solely to provide assistance to the County and City
and is not intended to benefit any third party.
8. ADMINISTRATION
This Agreement shall be administered by the County Fire Marshal or his/her
designee, and the City Manager, or his/her designee.
9. DURATION.
This Agreement shall take effect on the 1st day of January, 1998 and shall
terminate one year thereafter on the 31st day of December, 1998 unless otherwise
terminated in accordance with Section 10 of this Agreement.
10. TERMINATION.
Either party may terminate this Agreement upon thirty (30) days written notice to
the other party. In addition the failure to comply with any of the provisions stated herein
shall constitute material breach and shall constitute cause for immediate termination.
Any termination of this Agreement shall not terminate thoizQ obligations of either party
that matured prior to such termination.
11 . INDEMNIFICATION.
11.1 The County shall indemnify and hold harmless the City and its officers,
agents and employees or any of them from any and all claims, actions, suits, liability,
loss, costs, expenses, and damages of any nature whatsoever, by reason or arising out
of any negligent action or omission of the County, its officers, agents, and employees, or
4
any of them, in performing obligations pursuant to this Agreement. In the event that any
suit based upon such a claim, action, loss, or damage is brought against the City, the
County shall defend the same at its sole cost and expense; provided that the City retains
the right to participate in said suit if any principal of governmental or public law is
involved; and if final judgment be rendered against the City and its officers, agents,
employees, or any of them, or jointly against the City and County and their respective
officers, agents, and employees, or any of them, the County shall satisfy the same.
11.2 The City shall indemnify and hold harmless the County and its officers,
agents and employees or any of them from and all claims, actions, suits, liability, loss,
costs, expenses, and damages of any nature whatsoever, by reason or arising out of
any negligent action or omission of the City, its officers, agents and employees, or any of
them in performing obligations pursuant to this Agreement. In the event that any suit
based upon such a claim, action, loss or damage is brought against the County, the City
shall defend the same at its sole cost and expense; provided, that the County retains the
right to participate in said suit if any principal of governmental or public law is involved;
and if final judgment be rendered against the County and of it officers, agents,
employees, or any of them, or jointly against the City and County and their respective
officers, agents and employees or any of them, the City shall satisfy the same.
11.3 The City and the County acknowledge and agree that if such claims, actions,
suits, liability, loss, costs, expenses and damages are caused by or result from the
concurrent negligence of the City, its agents, employees, and/or officers and the County,
its agents, employees, and/or officers, this section shall be valid and enforceable only to
the extent of the negligence of each party, its agents. employees and/or officers.
12. AMENDMENTS.
This Agreement is the complete expression of the terms hereto, and any oral
representation or understandings not incorporated herein excluded. Any modifications to
this Agreement shall be in writing and signed by both parties.
IN WITNESS WHEREOF the parties hereto have caused this Agreement to be
executed.
KING COUNTY CITY OF KENT
County Executive
Dated Dated
5
Approved as to form: Approved as to form:
Deputy Prosecuting Attorney
KING COUNTY FIRE PROT. DIST. #37
E.L. PURDY, CHAIRMAN/COMMISSIONER
TOM SAWYER, COMMISSIONER
PAT RIORDAN, COMMISSIONER
6
4/1
Kent City Council Meeting
Date May 19 . 1998
Category Consent Calendar
1. SUBJECT: COPS UNIVERSAL GRANT BUDGET AMENDMENT - APPROVAL
2 . SUMMARY STATEMENT: Approval of a budget amendment to the
1998 revenue budgets for the COPS Universal three-year grant
which funds two police officers, as recommended by the Public
Safety Committee. The amendment would decrease the COPS
revenue by $23 , 928 and increase the City share revenue
transferred in from the general fund by $23 ,928 . The maximum
amount of the COPS Universal grant is $150, 000 which has been
reimbursed as of this time. These funds may not be needed, but
the budget amendment is necessary for balancing the project
revenue and expenditures, and to maintain the project for the
three-year report period.
3 . EXHIBITS: Memorandum
4 . RECOMMENDED BY: Staff and Public Safety Committee (3-0) 5/12/98
(Committee, Staff, Examiner, Commission, etc. )
5. UNBUDGETED FISCAL/PERSONNEL IMPACT: NO YES X
6. EXPENDITURE REQUIRED: $23 ,928
SOURCE OF FUNDS: General Fund
7 . CITY COUNCIL ACTION:
Councilmember moves, Councilmember seconds
DISCUSSION•
ACTION•
Council Agenda
Item No. 3E
RENT POLICE DEPARTMENT
TO: Public Safety Committee
FROM: Mary Ann Kern, Administrative Services Support Manager
SUBJECT: Requested Budget Adjustment for COPS Universal Grant
DATE: April 17, 1998
-------------------------------------------------------------------
When the 1998 budget was projected, the revenue estimates to be
received from the Federal Government for the COPS Universal Grant
were projected based on actuals to date. This is a 3 year project
and the ma=imum revenue that can be received was $150,000. Since
the revenue budget carries forward to 1998, the maximum revenue
budget was already budgeted at $150, 000 which included 1996 and
1997 revenues .
An adjustment is needed for 1998 to move $23, 928 revenue budgeted
from the COPS Universal Revenue to the City Share of transferred in
revenue. There is a high probability that these funds will not
really be needed, but the budget is necessary for balancing
purposes and for the three year commitment and tracking require-
ments. The unused funds at the end of the reporting period would
be returned to the city general fund.
The line items affected would be:
Was Change New
N82-000-2231-311601 COPS U Revenue (23,928) 23,928 0
N82-000-2231-970001 Trsf In Gen (118,323) (23,928) (142,251)
001-T00-2231-5N82 Trsf Out COPS U 118,323 23,928 (142,251)
Thank you for your consideration of this request. I apologize for
missing this during the budget preparation process.
c:N82PUB98
r
Kent City Council Meeting
Date May 19 , 1998
Category Consent Calendar
1. SUBJECT: HORSESHOE ACRES ANNEXATION AN-98-1 - SET
HEARING DATE
2 . SUMMARY STATEMENT: Set June 16, 1998, for the public
meeting to accept the 10 percent petition for the annexation of
36 acres located between the Green River and the Burlington
Northern - Santa Fe Railroad and between S. 258th and the Green
River.
3 . EXHIBITS: None
4. RECOMMENDED BY: Staff
(Committee, Staff, Examiner, Commission, etc. )
5. UNBUDGETED FISCAL/PERSONNEL IMPACT: NO X YES
6. EXPENDITURE REQUIRED: $
SOURCE OF FUNDS•
7 . CITY COUNCIL ACTION:
Councilmember moves, Councilmember seconds
DISCUSSION•
ACTION•
Council Agenda
Item No. 3F
Kent City Council Meeting
Date May 19, 1998
Category Consent Calendar
1. SUBJECT: 108TH AVENUE SEWER EXTENSION - ACCEPTANCE
2 . SUMMARY STATEMENT: As recommended by the Public Works/
Planning Committee, authorization to accept as complete the
108th Avenue Sewer Extension project, and release of retainage
to VLS Construction, Inc upon standard releases from the State,
and release of any liens. The original contract amount was
$85, 120. 68. The final construction cost was $161,555.27.
After the completion of the 277th Corridor Earthworks project,
it was determined that an access road along the top of the
steep slopes would be desirable. This road construction along
with preparation of two surplus houses being made ready for
sale, constituted the overage. Adequate funds exist in the
project budget to cover this overage.
3 . EXHIBITS: Public Works/Planning minutes and Public Works
Director Memorandum
4 . RECOMMENDED BY: Public Works/Planning Committee
(Committee, Staff, Examiner, Commission, etc. )
5 . UNBUDGETED FISCAL/PERSONNEL IMPACT: NO X YES
6. EXPENDITURE REQUIRED: $
SOURCE OF FUNDS:
7 . CITY COUNCIL ACTION:
Councilmember moves, Councilmember seconds
DISCUSSION:
ACTION:
Council Agenda
Item No. 3G
PUBLIC WORKS/PLANNING COMMITTEE
May 4, 1998
PRESENT: Tim Clark Tom Brubaker
Rico Angling Don Wicicstrom
Leona Orr Jim Harris
108th Avenue SE Sanitary Sewer Extension
Wickstrom explained that this project is 90% over the original contract amount because
of additional work required after the project was started. He said that this sewer project
is in the area of the S. 277th &- 108th Ave S.E., immediately adjacent to our new
corridor project and involved connecting sewer to two houses to relocate for resale.
When this contract was released, it was decided by the Public Works Dept that
maintenance roads along the top of the banks to do maintenance work along the slopes
of the road would be required. Rather than going out for bid on this work, we got a price
from this VLS Construction, the contractor for the sewer project, to do the job and he
just added the cost to the 108th Sewer contract. We also had to do some cleaning up
on the houses and can hopefully put them on the market for sale.
Committee unanimously recommended to accept as complete the 108th Ave SE Sanitary
Sewer Extension project.
WSDOT Detour Agreement - 84th Ave/Grady Way
Wid-,=om explained that the State is doing roadwork along the valley freeway, they are
also installing signals at the various on/off ramps to coordinate traffic flow onto the
freeway. He said that this agreement with Kent would allow the State to detour traffic
onto some of our city streets.
Committee unanimously recommended authorization of the Mavor's signature on the
Dept of Transportation Detour Agreement for the SR 167 - 84th Ave to Gradv Wav
project.
King County Waste Reduction Agreement
Wickstrom said this is a grant we received to expand our recycling program into the
commercial business area. This grant ($33,187) offers education for commercial
businesses which includes mailing information packets and two scheduled recycling fairs
where businesses can discuss what they are doing about their recycling program.
I
DEPARTMENT OF PUBLIC WORKS
May 4, I 998
TO: Public WorksManning Committee
FROM: Don Wickstrom 0
RE: 108th Avenue SE Sanitary Sewer Extension
The contract for the 108th Ave SE Sanitary Sewer Extension was awarded to VLS
Construction, Inc. for the bid amount of $85,120.68. Their work was to install a
sanitary sewer to service the two houses the City intends to re-sell.
After the completion of the 1997 277th Corridor Earthworks project, it was determined
that an access road along the top of the steep slopes would be desirable. This would
provide maintenance access over the winter months and on a permanent basis. Because
VLS was still working in the vicinity, we asked them to add this work to their contract.
Further,we asked them to do various other miscellaneous tasks associated with getting
our two houses in shape for sale. Therefore, the project exceeded the bid amount due
to extra material required to build the access road and preparing our surplus houses for
sale. The final construction cost was $161,555.27 (90% over).
Adequate funds exist in the project budget to cover this overage.
MOTION: Accept as complete the 108th Ave SE Sanitary Sewer Extension project.
?1(
Kent City Council Meeting
Date May 19, 1998
Category Consent Calendar
1. SUBJECT: W.S.D.O.T. DETOUR AGREEMENT, 84TH AVENUE/GRADY
WAY - AUTHORIZATION
2. SUMMARY STATEMENT: As recommended by the Public Works/
Planning Committee, authorization for the Mayor to sign the
Washington State Dept. of Transportation Detour Agreement for
the SR167 - 84th Ave S. to Grady Way project. During the
State's construction of improvements along SR167, nine ramps
will be closed and several of the detours will cross the
jurisdictional boundaries of Kent, Renton and King County.
This agreement will allow the State use of our City streets as
part of their detour route.
3 . EXHIBITS: Public Works/Planning minutes and WSDOT Detour
Agreement
4. RECOMMENDED BY: Public Work/Planning Committee
(Committee, Staff, Examiner, Commission, etc. )
5 . UNBUDGETED FISCAL/PERSONNEL IMPACT: NO X YES
6. EXPENDITURE REQUIRED: $
SOURCE OF FUNDS:
7. CITY COUNCIL ACTION:
Councilmember moves, Councilmember seconds
DISCUSSION•
ACTION•
Council Agenda
Item No. 3H
PUBLIC WORKS/PLANNING COMMITTEE
May 4, 1998
PRESENT: Tim Clark Tom Brubaker
Rico Angling Don Wickstrom
Leona Orr Jim Harris
108th Avenue SE Sanitary Sewer Extension
Wickstrom explained that this project is 90% over the original contract amount because
of additional work.required after the project was started. He said that this sewer project
is in the area of the S. 277th & 108th Ave S.E., immediately adjacent to our new
corridor project and involved connecting sewer to two houses to relocate for resale.
When this contract was released, it was decided by the Public Works Dept that
maintenance roads along the top of the banks to do maintenance work along the slopes
of the road would be required. Rather than going out for bid on this work, we got a price
from this VLS Construction, the contractor for the sewer project, to do the job and he
just added the cost to the 108th Sewer contract. We also had to do some cleaning up
on the houses and can hopefully put them on the market for sale.
Committee unanimously recommended to accept as complete the 108th Ave SE Sanitary
Sewer Extension project.
(� WSDOT Detour Agreement - 84th Ave/Grady W
Wickstrom explained that the State is doing roadwork along the valley freeway; they are
also installing signals at the various on/off ramps to coordinate traffic flow onto the
freeway. He said that this agreement with Kent would allow the State to detour traffic
onto some of our citv streets.
Committee unanimously recommended authorization of the Mayor's signature on the
Dept of Transportation Detour Agreement for the SR 167 - 84th Ave to Grady Way
project.
King County Waste Reduction Agreement
Wickstrom said this is a grant we received to expand our recycling program into the
commercial business area. This grant ($33,187) offers education for commercial
businesses which includes mailing information packets and two scheduled recycling fairs
where businesses can discuss what they are doing about their recycling program.
1
DEPARTMENT OF PUBLIC WORKS
May 4, 1998
TO: Public Works/Planning Committee
FROM: Don Wickstrom �V�
RE: W.S.D.O.T. Detour Agreement
84th Avenue/Grady Way
The Wa State Dept of Transportation is planning construction or improvements along
SR 167 from 84th Avenue S to Grady Way. During the construction, nine ramps onto
SR 167 will be closed, however no two closures will occur at the same time. Each closure
will last approximately one night. Several of the detours will cross the jurisdictional
boundaries of the Cities of Renton and Kent and also King County.
This agreement allows the State the use of our City streets as part of their detour route.
MOTION: Authorize the Mayor to sign the Dept of Transportation Detour Agreement
for the SR 167 - 84th Ave S to Grady Way project.
Washington State
MPANk
Washington
of Transportation
Organization and Address
Local Agency City of Kent
Haul Road/Detour 220 - 4th Avenue South
Agreement 98032-5895
Agreement Number
HRD 1-0225 Section/Location
State Route Number Control Section Number SR 167, - 84th Ave. S to Grady Way
167 1765 Surveillance Control & Driver Information system (SC &DI)
Region Description of Roads or Streets
Northwest Region NB & SB on/off ramps closed - (one night each)
Intended Use(Haul Road or Detour Road) See attached plans for specific detour, closures and effected streets.
Detour
Vehicle Restrictions
NONE
THIS AGREEMENT, made and entered into this day of between the STATE OF
WASHINGTON, Department of Transportation, acting by and through the Secretary of Transportation, (hereinafter the'STATE")and the
above named organization, (hereinafter the"LOCAL AGENCY").
WHEREAS,the STATE is planning the construction or improvement of a section of state highway as shown above, and
WHEREAS, in the construction of the project it is planned to use, for the purpose noted above,those LOCAL AGENCY roads or
streets described above and as further detailed in red on the attached Exhibit'A", and
WHEREAS, it is anticipated that as a result of the use of these roads or streets, additional maintenance expense may be incurred by
the LOCAL AGENCY.
NOW THEREFORE, IT IS MUTUALLY AGREED AS FOLLOWS:
I IV
The LOCAL AGENCY hereby agrees to the STATE's use of the Upon completion of use of the roads or streets covered by this
roads or streets covered by this AGREEMENT subject to the AGREEMENT, a joint inspection shall be made by the parties to
conditions contained herein. determine the condition of said roads or streets. All maintenance
and/or repairs shall be based upon the conditions of these roads
II or streets at the time of this completion inspection,taking into
Immediately prior to the beginning of the STATE's use of the account the memorandum record made under Section ll.
above described roads or streets,the parties to this
AGREEMENT shall make a joint condition inspection and the
STATE shall prepare a memorandum record of the condition of V
said roads or streets. The memorandum record shall include a It is expressly understood that the STATE shall be responsible only
statement the extent and frequency of routine maintenance for that extra maintenance and repairs of the LOCAL AGENCY's
operations normally
normally carried out by the LOCAL AGENCY on said roads or streets and may include photographs showing condition roads or streets occasioned by the project use. In the event of a
of the existing roadway. dispute over the terms of this AGREEMENT and/or the extent of
maintenance or repair work required to be performed,the dispute
shall be submitted to the Secretary of Transportation for
III determination. In determining this responsibility the Secretary shall
The STATE agrees to reimburse the LOCAL AGENCY for the give consideration to the memorandum record provided for in
cost of additional routine maintenance and repairs, operations in Section Ii. The conclusions of the Secretary as to the extent and
excess of those enumerated in the record made under the amount of such maintenance shall be final and conclusive as to all
provisions of Section II, made necessary by the STATE's project parties to this AGREEMENT.
The reimbursement for such additional routine maintenance and
repairs shall be limited to the actual cost of such operations
supported by proper records. Such costs are to be exclusive of all
administrative and overhead costs and all charges for small tools. A
The LOCAL AGENCY agrees not to restrict below legal limits the
size,weight, or speed of vehicles using the roads or streets
covered by this AGREEMENT except as stated above under
DOT Form 224-074 EF Vehicle Restnctions.
Revised 1/98
VII
No liability shall attach to the STATE or the LOCAL AGENCY by
reason of entering into this AGREEMENT except as expressly
provided herein.
IN WITNESS WHEREOF,the parties hereto have executed this AGREEMENT as of the day and year first above written.
LOCAL AGENCY STATE OF WASHINGTON
DEPARTMENT OF TRANSPORTATION
By By
Title Title
Date
DOT Form 224-014 EF
Revised 1/98
Kent City Council Meeting
Date May 19. 1998
Category Consent Calendar
1. SUBJECT: KING COUNTY WASTE REDUCTION AGREEMENT -
AUTHORIZATION
2 . SUMMARY STATEMENT: As recommended by the Public Works/
Planning Committee, authorization for the Mayor to sign the
King County Waste Reduction & Recycling Agreement, direct staff
to accept the grant of $33 , 187 . 00, and establish a budget for
same.
3 . EXHIBITS: Public Works/Planning minutes, Public Works Director
memorandum, and Waste Reduction agreement
4. RECOMMENDED BY: Public Works/Planning Committee
(Committee, Staff, Examiner, Commission, etc. )
5. UNBUDGETED FISCAL/PERSONNEL IMPACT: NO X YES
6. EXPENDITURE REQUIRED: $
SOURCE OF FUNDS:
7 . CITY COUNCIL ACTION:
Councilmember moves, Councilmember seconds
DISCUSSION•
ACTION•
Council Agenda
Item No. 3I
PUBLIC WORKS/PLANNING COMMITTEE
May 4, 1998
PRESENT: Tim Clark Tom Brubaker
Rico Angling Don Wickstrom
Leona Orr Jim Harris
108th Avenue SE Sanitary Sewer Extension
Wickstrom explained that this project is 90% over the original contract amount because
of additional work required after the project was started. He said that this sewer project
is in the area of the S. 277th st 108th Ave S.E., immediately adjacent to our new
corridor project and involved connecting sewer to two houses to relocate for resale.
When this contract was released, it was decided by the Public Works Dept that
maintenance roads along the top of the banks to do maintenance work along the slopes
of the road would be required. Rather than going out for bid on this work, we got a price
from this VLS Construction, the contractor for the sewer project, to do the job and he
just added the cost to the 108th Sewer contract. We also had to do some cleaning up
on the houses and can hopefully put them on the market for sale.
Committee unanimously recommended to accept as complete the 108th Ave SE Sanitary
Sewer Extension project.
WSDOT Detour Agreement - 84th Ave/Grady Way
Wickstrom explained that the State is doing roadwork along the valley freeway; they are
also installing signals at the various on/off ramps to coordinate traffic flow onto the
freeway. He said that this agreement with Kent would allow the State to detour traffic
onto some of our citv streets.
Committee unanimously recommended authorization of the Mayor's signature on the
Dept of Transportation Detour Agreement for the SR 167 - 84th Ave to Grady Way
project.
King County Waste Reduction Agreement
Wickstrom said this is a grant we received to expand our recycling program into the
commercial business area. This grant ($33,187) offers education for commercial
businesses which includes mailing information packets and two scheduled recycling fairs
where businesses can discuss what they are doing about their recycling program.
1
Committee unanimously recommended authorizing the Mayor to sign the grant
agreement, direct staff to accept the grant and establish a budget for $33,187.00.
Wickstrom noted that we are trying to provide businesses with as much information as
possible. Relative to performance measures, commercial recycling is regulated by
WUTC. All we can do is facilitate the program. Wickstrom also noted, regarding
staffing for this program, Robyn Bartelt who handles all of the conservation programs,
manages the garbage and recycling contracts is the only staff person for the entire
recycling program.
Surplus Vehicles
Wickstrom referenced a list of vehicles that we are proposing to surplus at we! next
public auction. These vehicles have all met the point system. The Fleet Manager works
with the different departments and City Administration to establish a point system of
when vehicles reach certain age and can then be declared as surplus.
Committee unanimously recommended authorization to declare this equipment as
surplus and authorize the sale thereof at the next public auction.
Burlington Northern - Santa Fe Railroad Depot
Jim Harris stated that on March 2nd, the Committee received an over-view of some
downtown depot issues and that is, preserving the downtown depot. At this time he
wanted to have more explicit direction from the Committee. Harris presented copies of
the "Adoptive Reuse" study which was done in 1989 for the Planning Dept which
included four alternatives presented for use of the depot. Some of these alternatives were
based on the thought that the depot would be the Regional Transit Authority's depot,
however that is not going to happen now. Harris said we still have an opportunity to do
something with that depot. Our problem in 1989, '90 and '91 was in working with the
Railroad on how we might get our hands on the depot. Now that there is a Burlington
NorthernVSante Fe Railroad and there are more things happening in the valley with rail,
we may have a better chance to talk with them.
Linda Johnson, Downtown Partnership, stated the following. The last time we reviewed
the use of the railroad site, we were told that the Railroad is using it as a working depot.
We have been advised by consultants to go after ISTEA funds and possibly use the
pedestrian orientation money to restore that depot as an historic building. The
Partnership felt that even if it were not going to be used as the train station itself, the
parking lot area could possibly be used as the depot. Commercial use could then go back
into the train station. Harris suggested that the City work with the Downtown
Partnership. Yingling asked how the downtown would be linked with the new rail site.
Harris said if the RTA depot goes to the south end it could be linked to the downtown
DEPARTMENT OF PUBLIC WORKS
Mav 4, 1998
TO: Public Works/Planning Committee
FROM: Don Wickstrom V�
RE: IGng County Waste Reduction &-- Recycling Program - Agreement
As part of the IGng County Waste Reduction/Recycling Grant Program, we have received
a Grant Agreement from IGng County to promote 'waste reduction participation in
commercial programs for recyclable materials. The total budgeted funding under this
grant is $33,187.00
MOTION: Authorize the Mayor to sign the Grant Agreement, direct staff to accept
the grant and establish a budget for $33,187.00
CONTRACT AMENDMENT Page 1 of 2 Pages
Project Name Waste Reduction and Recycling Contract No. D25348D
Grant Program Date Entered 7/1"7
Agency/Contractor City of Kent Amendment No. 1
Date Entered
Address 220 Fourth Avenue South
Kent, WA 98032
AMENDMENT REQUESTED BY: AMENDMENT AFFECTS: ("X"applicable items)
Solid Waste Division x Scope of Services _ Method of Payment
Organization Time of Performance Reliance
Rodney G. Hansen, Manager x Compensation x Terms & Conditions
Name Results of Services
NECESsrrY It is necessary to change the Scope of Services since the City of Kent has been
FOR CHANGE allocated additional funds through the Solid Waste Division's current waste
reduction and recycling grant program.
AMEND PREAMBLE, Paragraph 3, Sentence 2
The City of Kent will be participating in Phase II, and potentially Phase III.
To READ The City of Kent will be participating in Phase II and Phase III.
AMEND Section MAJ., Sentence 2
The total amount of funds available from this grant shall not exceed $33,187.
IN WITNESS HEREOF, the parties hereto have caused this amendment to be executed and
instituted on the date first above written.
ACKNOWLEDGEMENT AND ACCEPTANCE
KING COUNTY, WASHINGTON Agency/Contractor
By By
Title County Executive Title
Date Date
:kb Wfomsa oonaad4pamaAdoc
CONTRACT AMENDMENT Page 2 of 2 Pages
Project Name Waste Reduction and Recycling Contract No. D2S348D
Grant Program Date Entered 71I S197
Agency/Contractor City of gent Amendment No. I
Date Entered
To READ The total amount of funds available from this grant shall not exceed $57,136.
AMEND Section II.B.1., Sentence 3
The City of Kent's budgeted grant funds are $33,187, which is the City's current
share of Phase II grant funds.
To READ The City of Kent's budgeted grant funds are $57,136. Of this amount, $50,447 is
Phase II monies and $6,689 is Phase III monies.
AMEND Section H.B.5.
The waste reduction and recycling grant program shall be administered by Lyne
Davis, Project Manager, or designee, specified by the King County Solid Waste
Division.
To READ The waste reduction and recycling grant program shall be administered by Lyne
Morris, Project Manager, or designee, specified by the King County Solid Waste
Division.
AMEND Exhibit A, Scope of Work and Budget
To READ Exhibit A, Revised Scope of Work and Budget
EXHIBIT A
Contract # D25348D
Revised Scope of Work and Budget
King County Waste Reduction and Recycling Grant Program
for the Suburban Cities
A. PROGRAM INFORMATION:
1. City Name: City of Kent
2. Program Manager: Robyn Bartelt
Conservation Specialist
City of Kent
220 Fourth Avenue South
Kent, WA 98032
TEL: 253 859-6573
FAX: 253 859-3559
3. Consultant: Paul Devine, Pacific Energy Institute
101 Yesler Way, Suite 606
Seattle, WA 98104
TEL: 206 628-0460
FAX: 206 628-0514
4. Program Budget: $57,136 = Total Contract Amount ($50,447 Phase II funds &
$6,689 Phase III funds)
$33,187 = Original Contract Amount (Phase II funds)
$33,187 = Original Contract Amount incorporated in this Revised
Scope of Work Budget
$23,949 = Supplemental funds added under this Contract
Amendment ($17,260 Phase II funds & $6,689 Phase III
funds)
$57,136 = Total Revised Scope of Work Budget
5. Program Summary: In the original Scope of Work, the City outlined plans for a
Business Recycling Program that involved consultations and the distribution of
materials and equipment. This Revised Scope of Work is comprehensive and includes
all of the components of the original Scope of Work. The Business Recycling
Program has been revised and expanded to include recycling fairs.
i
B. PROGRAM SCOPE OF WORK:
Task 1: Business Recycling Program
Subtask IA: Materials/Equipment Distribution and Consultations
Project Description:
The City of Kent will work through it's consultant, Pacific Energy Institute (PEI), to
promote waste reduction, participation in commercial collection programs for recyclable
materials, and the purchase of recycled products through the following program efforts
with City businesses:
• Distribute brochures on recycling service providers to businesses through direct
mailings and door-to-door delivery. These brochures have already been produced by
the City.
• Produce and distribute guides to buying recycled products in Kent and distribute them
through direct mailings and door-to-door delivery. The City will utilize information
previously developed by King County and/or other sources whenever possible.
• Distribute recycling bags that were previously purchased by the City with funds from
the 1992-1995 King County waste reduction and recycling (WR/R) grant program and
the Washington State Department of Ecology's grant programs.
• Purchase and distribute a variety of different recycling containers/bins.
• Conduct on-site waste consultations with commercial business owners and managers,
produce individual consultation reports, and provide follow-up assistance.
Deliverables:
• Approximately 3,000 guides to buying recycled products distributed to businesses
• Approximately 500 distributed recycling containers/bins
• 500 - 1,000 distributed recycling bags
• A minimum of 300 on-site consultations and follow-up services
Schedule:
• Print 3,000 guides to buying recycled products by October 31, 1997
• Distribute recycling bags/containers/bins on an ongoing basis
• Conduct on-site consultations and follow-up assistance on an ongoing basis
Project Goals and Objectives:
• Promote cost-effective handling of the business waste stream;
• Increase participation in recycling programs in the commercial sector from 25-30% to
45-50%; and
• Promote the purchase of recycled products to the business sector.
2
Program Evaluation:
The City will monitor the program by reporting the following:
• The number of brochures printed/distributed,
• The types and number(s) of recycling containers purchased/distributed;
• The number of recycling bags distributed;
• The names of businesses assisted and services provided;
• The number of businesses assisted; and
• The increase in City businesses participating in waste reduction, recycling, and
recycled product procurement activities for the duration of the grant program.
Subtask 1B: Recycling Fairs
Proiect Description:
The City of Kent will work through it's consultant, Pacific Energy Institute (PEI), to
promote participation in commercial recycling programs for recyclable materials by
hosting approximately two recycling fairs for Kent businesses. The fairs will bring together
City businesses to learn about topics such as: office recycling programs; hard to recycle
materials (such as florescent lights, shrink-wrap, and plastics); purchasing recycled
products; and other related topics. Business will be invited to attend the"lunch-time"
recycling fairs through a direct newsletter/mailing piece. The fairs will help bring together
the Kent business community to share recycling experiences, learn about new recycling
opportunities, and sign up for recycling services. The program will:
• Distribute two newsletters on recycling service providers and the recycling fairs to
City businesses. The first newsletter will provide businesses with information on
recycling services in Kent. The second will promote the recycling fairs. The City will
utilize information previously developed by King County and/or other sources
whenever possible.
• Host approximately two separate summer lunch-time fairs on recycling topics that will
help Kent businesses learn more about recycling and offer the opportunity to sign up
for recycling services. The City will work with the Kent Chamber of Commerce and
the Rotary Club to promote the fairs.
• Distribute reusable lunch bags and recycling bins to fair participants to increase
participation. These items were previously purchased by the City of Kent with funds
from the King County Solid Waste Division, the King County Health Department, and
the Washington State Department of Ecology's grant programs.
• Conduct recycling demonstrations for Kent businesses on recycling related topics.
Deliverables:
• Approximately 3,000 newsletters to Kent businesses
• Approximately two recycling fairs for Kent businesses
• Distribution of reusable lunch bags and recycling bins
3
Schedule:
• Print 3,000 newsletters by July 15, 1998
• Host approximately two recycling fairs for Kent businesses by September 1, 1998
Proiect Goals and Objectives:
• Promote cost-effective handling of the business waste stream;
• Increase participation in recycling programs in the commercial sector from 25-30% to
45-50%; and
• Promote the purchase of recycled products to the business sector.
Program Evaluation:
The City will monitor the program by reporting the following:
• The number of newsletters printed/distributed;
• The number of fairs hosted and their topics;
• The number of attendees at each fair;
• The number of reusable lunch bags and recycling bins distributed;
• The names of City businesses who signed up for recycling services (if available); and
• The increase in City businesses participating in recycling for the duration of the grant
program.
C. PROGRAM BUDGET: $57,136 (Please see attached)
4
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Kent City Council Meeting
Date May 19, 1998
Category Consent Calendar
1. SUBJECT: DECLARATION OF SURPLUS VEHICLES - APPROVAL
2 . SUMMARY STATEMENT: As recommended by the Public Works/
Planning Committee, authorization to declare certain Equipment
Rental vehicles as surplus and authorize the sale thereof at
the next public auction.
3 . EXHIBITS: Public Works/Planning minutes and Public Works
Director memorandum
4 . RECOMMENDED BY: Public Works/Planning Committee
(Committee, Staff, Examiner, Commission, etc. )
5. UNBUDGETED FISCAL/PERSONNEL IMPACT: NO X YES
6. EXPENDITURE REQUIRED: $
SOURCE OF FUNDS•
7 . CITY COUNCIL ACTION:
Councilmember moves, councilmember seconds
DISCUSSION•
ACTION•
Council Agenda
Item No. 3J
Committee unanimously recommended authorizing the Mayor to sign the grant
agreement, direct staff to accept the grant and establish a budget for $33,187.00.
Wickstrom noted that we are trying to provide businesses with as much information as
possible. Relative to performance measures, commercial recycling is regulated by
WUTC. All we can do is facilitate the program. Wickstrom also noted, regarding
staffing for this program, Robyn Bartelt who handles all of the conservation programs,
manages the garbage and recycling contracts is the only staff person for the entire
recycling program.
(� Surplus Vehicles
`> Wickstrom referenced a list of vehicles that we are proposing to surplus at the next
public auction. These vehicles have all met the point system. The Fleet Manager works
with the different departments and City Administration to establish a point system of
when vehicles reach certain age and can then be declared as surplus.
Committee unanimously recommended authorization to declare this equipment as
surplus and authorize the sale thereof at the next public auction.
Burlington Northern - Santa Fe Railroad Depot
Jim Harris stated that on March 2nd, the Committee received an over-view of some
downtown depot issues and that is, preserving the downtown depot. At this time he
wanted to have more explicit direction from the Committee. Harris presented copies of
the "Adoptive Reuse" study which was done in 1989 for the Planning Dept which
included four alternatives presented for use of the depot. Some of these alternatives were
based on the thought that the depot would be the Regional Transit Authority's depot,
however that is not going to happen now. Harris said we still have an opportunity to do
something with that depot. Our problem in 1989, '90 and '91 was in working with the
Railroad on how we might get our hands on the depot. Now that there is a Burlington
Northern/Sante Fe Railroad and there are more things happening in the valley with rail,
we may have a better chance to talk with them.
Linda Johnson, Downtown Partnership, stated the following. The last time we reviewed
the use of the railroad site, we were told that the Railroad is using it as a working depot.
We have been advised by consultants to go after ISTEA funds and possibly use the
pedestrian orientation money to restore that depot as an historic building. The
Partnership felt that even if it were not going to be used as the train station itself, the
parking lot area could possibly be used as the depot. Commercial use could then go back
into the train station. Harris suggested that the City work with the Downtown
Partnership. Yingling asked how the downtown would be linked with the new rail site.
Harris said if the RTA depot goes to the south end it could be linked to the downtown
2
area by bringing in retail and if the depot goes to the north end, there is still a proximity
to other uses.
Committee unanimously recommended that staff be directed to re-open dialog with the
Railroad and-work with Kent Downtown Partnership and RTA to find out what interests
are there and pursue any options we have for preserving the station.
Chamber of Commerce Freight Mobility Systems Alignment Proposal
Wickstrom said that we have been approached by the Chamber to be a co-sponsor for
this proposal in the amount of a $10,000 grant. This is a system wide approach to
freight mobility looking at all factors in trying , find low cost implementable ideas or
mechanisms that can move freight faster without and extensive amount of money. To
move freight faster in Kent would mean our buildings and warehouses would be efficient
and generate more revenue in terms of sales tax and etc. Wickstrom said he feels it's a
worthy investment; we do have money in the South King County Area Transportation
Improvement Board (SCATBD) which meets monthly. Rico Yingling noted that he is
co-chair on the SCATBD Committee looking at the business side of freight mobility
throughout the state. We are looking at how we can use improvement strategies for the
business side of the equation rather than infrastructure. Yingling said there are many
organizations dealing with freight mobility; State Agencies, Customs, Ports, Maritime
Industries, etc. If a system uses five different organizations to move freight and if each
one is working at 90% efficiency, the problem is when five are working together, handing
off the freight from one to the next, even at 90% efficiency the entire system only works
at 60% efficiency. If each one of those groups works to improve their efficiency just a
little, the entire system improves clot. Yingling said no one else in the system is working
on it from that directive and the idea is, within 18 months we have three to six very
concrete implementable ideas for improvement and we also have new performance
measures for our Puget Sound area.
Committee unanimously recommended that the City expend $10,000 to co-sponsor the
Kent Chamber Freight Mobility System Alignment Proposal and authorize the monies
to come out of the Green River Transportation Benefit District Project fund (R52).
As a point of clarification, Tom Brubaker stated that in the Public Works document we
used the word 'grant' but what the City is actually doing is co-sponsoring with the
Chamber of Commerce. There is a constitutional prohibition against the use of gift of
public funds and this is actually a quid-pro-quo arrangement; we are co-sponsors with the
Chamber and we will be receiving valuable benefit from this study. We are sharing in
the cost but it is not truly a grant.
Meeting adjourned: 4:18 p.m.
3
DEPARTMENT OF PUBLIC WORKS
May 4, 1998
TO: Public Works/Planning Committee
FROM: Don Wickstrom
RE: Surplus Vehicles - Authorization
Attached is a list of Equipment Rental vehicles which are no longer needed by the
City, As such, we are requesting that they be declared as surplus and sold at the next
public auction.
ACTION: Authorization to declare this equipment as surplus and authorize the
sale thereof at the next public auction.
Public Works Operations
IYIEMORAND UI
Phone: 359-3395 Fax: 359 3664
April 22, 1998
To: Don Wicxstrom, Publi Works Director
From: Steve Hennes eet Superintendent
Thru: Eddy Chu, Operations Manager
Subject: Surplus Vehicle Authorization Request
I am requesting authorization to surplus the following vehicles that have been replaced
with the 98 purchases and are no longer needed by Fleet Services. All of these vehicles
meet Fleet Services replacement point system except #1016 and #8703. Both of these
vehicles have had extremely hard use and need major repairs that would not be cost
effective to repair. All of the vehicles will be sold to the highest bidder at the next Public
Auction.
SERVICE VEHICLES
Unit# Yr. Serial# Mileaee Description
1004 * 82 282282 82,000 Dodge 1/2 Ton Pickup
1016 88 228847 69,000 Celebrity Sedan
5364 * 91 511834 128,000 GMC Cargo Van
6508 * 73 192725 71,000 Dodge Pumper Truck
8703 89 143324 77,500 Corsica Sedan
8726 * 81 516627 85,000 Dodge Aerial Bucket Lift
POLICE VEHICLES
Unit# Yr. Serial# Mileaee Description
3103 ** 93 175600 82,000 Ford Crown Vic Sedan
3130 ** 94 123374 87,000 Chev Caprice Sedan
3134 ** 94 124095 86,000 Chev Caprice Sedan
3138 ** 94 124169 82,000 Chev Caprice Sedan
3143 ** 91 134492 57,000 Chev Caprice Sedan
3150 ** 90 506932 53,000 Kawasaki Motorcycle
3153 ** 89 506332 39,000 Kawasaki Motorcycle
3154 ** 89 506385 54,000 Kawasaki Motorcycle
* Meets Service Vehicle Replacement Point System of 20.
** Meets Police Vehicle Replacement Point System of 11.
1 point per year, 1 point per 1 OK
cc: Dianne Sullivan
Bill Price
Frank Olson
Kent City Council Meeting
Date May 19 . 1998
Category Consent Calendar
1. SUBJECT: CHAMBER OF COMMERCE FREIGHT MOBILITY SYSTEMS
PROPOSAL - AUTHORIZATION
2 . SUMMARY STATEMENT: As recommended by the Public Works/
Planning Committee, authorization to co-sponsor $10, 000 for the
Chamber of Commerce Freight Mobility Systems Proposal.
The Chamber of Commerce has been pursuing the issue of freight
mobility on a system wide basis. The proposal involves esta-
blishing a 50 member state-wide stakeholder team to identify
low cost implementable system improvements. Their proposal has
received support from the business community as well as
affected governmental agencies. The total cost of this effort
is $160, 000. The monies would come from the Green River
Transportation Benefit District Project fund (R52) .
3 . EXHIBITS: Public Works/Planning minutes, Public Works Director
memorandum, and Freight Mobility Systems Proposal
4 . RECOMMENDED BY: Public Works/Planning Committee
(Committee, Staff, Examiner, Commission, etc. )
5. UNBUDGETED FISCAL/PERSONNEL IMPACT: NO X YES
6. EXPENDITURE REQUIRED: $
SOURCE OF FUNDS:
7 . CITY COUNCIL ACTION:
Councilmember moves, Councilmember seconds
DISCUSSION:
ACTION•
Council Agenda
Item No. 3K
area by bringing in retail and if the depot goes to the north end, there is still a proximity
to other uses.
Committee unanimously recommended that staff be directed to re-open dialog with the
Railroad and work with Kent Downtown Partnership and RTA to find out what interests
are there and pursue any options we have for preserving the station.
Chamber of Commerce Freight Mobility Systems Alignment Proposal
Wickstrom said that we have been approached by the Chamber to be a co-sponsor for
this proposal in the amount of a $10,000 grant. This is a system wide approach to
freight mobility looking at all factors in trying to find low cost implementable ideas or
mechanisms that can move freight faster without and extensive amount of money. To
move freight faster in Kent would mean our buildings and warehouses would be efficient
and generate more revenue in terms of sales tax and etc. Wickstrom said he feels it's a
worthy investment; we do have money in the South King County Area Transportation
Improvement Board (SCATBD) which meets monthly. Rico Yingling noted that he is
co-chair on the SCATBD Committee looking at the business side of freight mobility
throughout the state. We are looking at how we can use improvement strategies for the
business side of the equation rather than infrastructure. Yingling said there are many
organizations dealing with freight mobility; State Agencies, Customs, Ports, Maritime
Industries, etc If a system uses five different organizations to move freight and if each
one is working at 90% efficiency, the problem is when five are working together, handing
off the freight from one to the next, even at 90% efficiency the entire system only works
at 60% efficiency. If each one of those groups works to improve their efficiency just a
little, the entire system improves alot. Yingling said no one else in the system is working
on it from that directive and the idea is, within 18 months we have three to six very
concrete implementable ideas for improvement and we also have new performance
measures for our Puget Sound area.
Committee unanimously recommended that the City expend $10,000 to co-sponsor the
Dent Chamber Freight Mobility System Alignment Proposal and authorize the monies
to come out of the Green River Transportation Benefit District Project fund (R52).
As a point of clarification, Tom Brubaker stated that in the Public Works document we
used the word 'grant' but what the City is actually doing is co-sponsoring with the
Chamber of Commerce. There is a constitutional prohibition against the use of gift of
public funds and this is actually a quid-pro-quo arrangement; we are co-sponsors with the
Chamber and we will be receiving valuable benefit from this study. We are sharing in
the cost but it is not truly a grant.
Meeting adjourned: 4:18 p.m.
3
DEPARTMENT OF PUBLIC WORKS
Mav 4, 1998
TO: Public Works/Planning Committee
FROM: Don Wickstrom`lam
RE: Kent Chamber of Commerce Freight Mobility Systems
Alignment Proposal
For some time, the Chamber has been pursuing the issue of freight mobility. While they
recognize Capital Improvements are a necessary element thereof, their approach has been
to look at the issue on a system wide basis. Their proposal involves establishing a 50
member state-wide stakeholder team who, after some training, education and visioning,
will identify four to six key low cost implementable system improvements. Further,
their proposal includes the implementation of three to four of said system improvements.
This proposal has received much support from the business community as well as from
affected governmental agencies. The total cost of this effort is $160,000 for which the
Chamber seeks our co-sponsorship in the amount of a $10,000 grant.
The Public Works Department supports this effort and recommends that the City co-
sponsors same. Monies therefore could come from the Green River Transportation
Benefit District Project fund (R52) if Council so authorized.
MOTION: Recommend the City to co-sponsor the Kent's Chamber of Commerce
Freight Mobility System Alignment Proposal with a grant thereto in the
amount of$10,000 and, authorize the monies therefore to come out of the
Green River Transportation Benefit District Project fund (R52).
0
KENT CHAMBER
OF COMMERCE
April 23, 1998
Mayor Jim White
Director of Operations Brent McFall
City of Kent
220-40' Ave. S
Kent, WA 98032
Dear Jim and Brent:
The Kent Chamber of Commerce has assembled a team to improve the speed, consistency
and capacity of our state's freight mobility system by improving the system's business
practices. I've attached a project proposal for your review. We'd like your ideas about
our ideas, and we'd love to have you or board.
So far, we've achieved enthusiastic sponsorship from numerous private business groups
(including funding support from Fisher Properties President Mark Weed and Borden
Chemical Co.), the Governor's office, endorsement and funding from Port of Tacoma
Executive Andrea Riniker, a unanimous vote (with Executive Mic Dinsmore's help) to
endorse and fund by the Port of Seattle Commission, and strong interest from King
County Executive Ron Sims,House Speaker Clyde Ballard, House Transportation Chair
Karen Schmidt, and U.S. Senator Slade Gorton. We currently have commitments of over
$80,000 in cash and in-kind support towards our goal of$160,000.
Our King County contacts have indicated that they would be inclined to fund if there was
a commitment to partner with them by South King County cities, such as Kent, that will
receive the greatest benefit from an improved freight system. Drawing on their comments
and the obvious benefits to the City of Kent, we are writing to ask for a$10,000 grant
from the City of Kent for the project.
Please feel free to call me at 253-854-1770 or email at <bivanov@kentchamber.com> with
any questions or comments.
Best regards,
.
ara Ivanov
Executive Director
524 West Meeker Street • Suite tt 1 • P.O. Box 128 • Kent, Washington 98035.0128
(253) 854-1770 • Fax (253) 854-8567 • www.kentchamber.com • kentcocCkentchamber.cum
Freight Mobility Systems Team
Grant Contract Proposal
PROPOSAL.
Support is requested to develop and maintain a Freight Mobility Systems Team that
is charged with:
1. Establishing a 50-member statewide stakeholders team dedicated to continuous
improvement of the freight mobility system
2. Training the team in systems thinking, analysis and continuous improvement
methodology
3. Forming a common vision and comprehensive strategic work agenda
4. Developing profound knowledge of the existing system and make that knowledge
available to stakeholders
5. Developing solid performance measures for the system
6. Identifying system constraints
Deliverables include:
1. Executing a two-day retreat in 1998
2. Managing monthly team meetings
3. Recommending four to six key freight mobility system improvements available at no or
low cost
4. Implementing two to three system improvements
5. Developing a freight mobility systems team communications plan in conjunction with
the Governor's policy advisor on transportation issues
AlignmentWo �kinq Together Wa5hi- n9ton
Freight Mobility System
Working Together
Community Vision Book
y
Sharing Visions
Corn munity,Forum
(Defining Performance)
now,
n Findin Common
Celebrating Wins'. 9
Goals/Obstacles
Awards/Recognition
Learning_.Opportunities
Partnering on
Achieving Success , db
Key Goals
Learning Opportunities
Alignment Opportunities
Overcoming
Obstacles
Problem Solving
Background
For several years, freight mobility has been recognized as a serious problem for the State
of Washington. Current transportation congestion increases costs for businesses,
decreases the State's competitiveness and increasingly interferes with non-freight traffic.
Most efforts to address this problem are either region-wide capital infrastructure projects,
local infrastructure improvements, or localized review of transportation problems.
Several groups in the past year have focused on lobbying elected officials at the federal,
state, county and local level for new funding for transportation (highway and railroad
grade separation) improvements. This effort has succeeded in elevating interest in solving
the conflicts between freight movement and local communities, but it hasn't addressed
freight mobility as a region-wide system in need of improvement.
We've been asking: "We've outgrown our capacity. How can we find funds for capital
improvements?"
We need to ask:
1. "We will always have more capital improvement needs than we have money. What
additional approaches will enhance the value of our current and planned capital
improvements?"
2. "How can the system quickly and efficiently move containers (or bulk and break-bulk
materials, etc.) to distribution and production points in Washington State as well as to
other eastern locations in our nation?" Imagine the effect on our regional economy if
we can guarantee that"We will deliver containers in the Puget Sound region within 24
hours and to Chicago/St. Louis within 48 hours."
With this in mind we have created a vision and mission statement.
Vision
Our vision is to run such an efficient, high-value freight movement system from Asia
through the Washington State ports, that companies in Asia and the U.S. that have been
k ,nt out of international business by the cost of transportation will open entire new
markets. Improved competition with L. A. is not our goal. We plan to radically expand
the market.
Mission
Our mission is to:
Improve the throughput (movement of freight through the state) and intra-state
freight mobility systems, and to
Promote recognition that quality of the freight mobility system is defined by
consistency of delivery timing, adequate capacity of system, and low cost of
throughput and intra-state freight movement.
Examples: During Washington State's last legislative session's discussion of capital
infrastructure improvements we asked systems users, freight forwarders and truckers,
where the worst bottlenecks are to be found and we expected them to talk about
highways. But they didn't. They talked about problems in existing processes.
Here are three real-life examples of process problems in Puget Sound's freight mobility
system:
1. A large freight forwarding firm in Kent said that they can get the trucks to the docks,
but sometimes the stevedores take three hours to load them up and sometimes they
take three days. This part of the process is unpredictable and often slow.
2. Trucking companies said that the hours of service regulations on truckers are inflexible
and force them to run inefficiently and add costs.
3. Customs officials at the Canadian border do not inspect double-stacked railcars,
thereby pushing freight onto trucks that congest Bellingham highways, which causes
Bellingham officials to fight for more highway funds.
These kind of issues will not be resolved by building highway improvements. So, if we
focus solely on funding capital improvements, we're not solving the problem.
Recommendation:
We need to do four things.
1. Recognize that the ports, highways,railroads, users and governing authorities already
function as a whole system. But no organization is looking at it as a total"system"
nor at how parts of the system can be improved to make it function as a better system.
2. Ask for a commitment from all of the involved parties to identify and work on two or
three process areas where we can get the biggest bang for the buck in the next five
years. We must bring every potential stakeholder on board from the beginning.
Together, these constituencies (ports, railroads, shippers, trucking firms, unions/labor,
U.S. customs, manufacturers and distributors) will learn how to improve the system
and keep the system's energy focused on moving towards shared objectives.
3. Apply quality management principles to distribution system problem solving.
4. Gain leadership committed to improving the processes within the system. We need
federal, state,Puget Sound county leaders and leaders in Bellingham, Yakima and
Spokane,public officials and business people and labor leaders, to establish a
statewide continuous improvement team. This level of change requires high-level
leaders who are committed to the vision and strongly supportive of the team's efforts.
We ask that your staff work with us to identify system stakeholders and invite them to
participate in a permanent continuous-improvement team. This team will study and
recommend a variety of improvements for implementation within the system. We
recommend that the team is in place by summer 1998.
SCOPE OF WORK.
1. The Freight Mobility Planning Team began,in February 1997,to address systemic
improvements of the freight mobility system. To review their work,please see
attachment"Orientation for FMSAT." Members include:
A. Chair Jay Bakst, Automation Associates
B. Maher Abed,Public Works Administrator, City of Pacific
C. Kimberly Becklund,Program Development, City of Renton
D. Jess Browning,Director,UW Global Trade,Transportation &Logistics
E. Jack Cairnes, State Representative, 47"District
F. Rhonda Devito, Principal, Ideas International
G. Mark Edin, Owner, Express IT Transportation
H. Greg Elkerton,Project Mgr, Seattle Manufacturers Council
I. Fawn Franksen, Assoc. Property Mgr., Fisher Properties, Inc.
J. Dan Gatchet, Owner, West Coast Trucking
K Emory Gleason, Assoc., The Freeland Group
L. Margaret Hornbaker, Olympic Pipeline/Orion Group Assoc.
M. Barbara Ivanov, Executive Director, Kent Chamber of Commerce
N. Bruce Kendall, V.P., Economic Development Council of King County
O. Jim Keough, Mgr. Business Development, Sealand
P. Sue Kincaid, Mgr.,Worldwide Distributors, Inc.
Q. Jack Lattemann,Transit Planner III, METRO
R. Dan McQuesten, Air Cargo,Expeditors International of Washington
S. Patti Otley, Governmental Affairs,BNSF Railroad
T. Birgitte_Paulsen, Consultant,Port of Seattle
U. Ed Parks, Jr., Mgr. International Relations/Airfield, Port of Seattle
V. Steve Queen, Washington State Ferries
W. Mian Rice, Assoc. Planner Aviation,Port of Seattle
X. Susan Serres,Transportation Planner, WADOT
Y. Paul Takamine, Sr. Transportation Planner, King County Dept_ of Trans.
Z. Trina Torgelson, Mgr.Public Affairs, Seattle Chamber of Commerce
AA. Chris Vance, King County Council Member
BB. Liz Warman,Local Govt. Affairs Mgr., The Boeing Co.
CC. Eugene Wasserman, Exec. Director, Neighborhood Business Council
DD. Larry Weldon, WADOT Freight Mobility Administrator
EE. Julie Wilson, Materials Mgr., Insulate Windows
FF. Mike Wong, Supervising Trans. Planner, King County DOT
GG. Rico Yingling,Plant Mgr., Borden Chemical
2. The Freight Mobility Systems Team will develop a communications plan in conjunction
with the Governor's policy advisor on transportation issues. This plan will contain criteria
for selecting team members, public announcement(s) of team mission and members, and
ongoing communications to larger communities of interest
3. The Freight Mobility Systems Team will assemble 50 key stakeholders to form the
continuous improvement team. Dan Gatchet, owner of West Coast Trucking, has agreed
to serve as team chair. The stakeholders may include, but are not limited to,
representatives from:
A. AgLink
B. American Waterways Organization (AWO)
C. Association of Washington Cities
D. Association of Washington Counties
E. Corridor cities and counties (north-south and east-west corridors of
Whatcom, Snohomish, King, Pierce, Yakima and Spokane counties)
F. Corridor chambers of commerce
G. Seattle Tacoma Air Cargo Association
H. Cascadia"Cross Borders"project/Discovery Institute
I. County Road Board Association
J. Freight Mobility Roundtable staffed by the Seattle King County Economic
Development Council & the Puget Sound Regional Council
K Freight Mobility Advisory Committee (FMAC) to the state legislature
L. International Marketing Program for Agriculture &Trade (IMPACT) at
Washington State University
M. Legislation Transportation Committee (LTC)
N. Pacific Northwest Economic Region (PMWER)
O. Ports of Everett, Seattle and Tacoma
P. Puget Sound Steamship Operators Assn.
Q. Rail companies
R. Seattle Industrial Council
S. Stevedoring companies
T. Union leaders: Longshoreman (ports), Teamsters (trucking) and United
Transportation (rail)
U. Washington State Dept. of Transportation
V. U.S. Dept. of Transportation
W. University of Washington Global Trade,Transportation and Logistics
Dept.
X. U. S. Customs/FDA
Y. Washington Environmental Community
Z. Washington Public Ports Association
AA. Washington State Dept. of Community, Trade &Economic Development
BB. Washington State Good Roads Association
CC. Washington Trucking Association
DD. Representatives of manufacturing and distribution companies with
representation from geographic, industry, and transportation mode sectors
3. The FMS Team will hold a two-day retreat in 1998 for all team members to:
A. Gain knowledge of systems thinking. Training will be led by professional(s)
with expertise in systems analysis and continuous improvement.
B. Form a common vision, comprehensive strategic work agenda, and clarify
team working norms. Recommended facilitator is Steven Boyd of
MacDonald Boyd and Associates.
4. The FMS Team will meet monthly following the retreat to:
A. Develop profound knowledge of the exisung system and make that knowledge
available to all stakeholders.
B. Develop solid performance measures for the system.
C. Identify system constraints.
5. The FMS Team will recommend four to six key freight mobility system improvements
available at no or low cost by December, 1998.
6. The FMS Team will implement two to three sy, m improvements by April, 1999.
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ORIENTATION FOR FMSAT
TABLE OF CONTENTS
INTRODUCTION
FREIGHT MOBILITY WHAT IS IT?
FMSAT MISSION ST- ":.MENT
WHAT IS A SYSTEM: APPROACH
HOW 7"ES FMSAT D-- MR FROM OTHER FREIGHT MOBIILITY GROUPS?
WHAT IS THE CURRENT FREIGHT MOBILITY SYSTEM IN THE PUGET
SOUND REGION?
HOW DO WE DEVELOP IT
FLOW CHARTS
FMSAT GOALS
CURRENT ACTIVITIES
ACTIONS NEEDED
SYSTEMS APPROACH EXAMPLES
INTRODUCTION
The Freight Mobility Systems Approach Task Force (FMSAT)
began in February 1997 in response to a growing problem of
getting freight around and through the Puget Sound Area. A
meeting held with business members and government officials
showed conclusively that the need and interest of the
subject was timely.
A search of others addressing this problem showed two types
of groups . Some groups worked on infrastructure and funding
for transportation systems . Other groups addressed the
needs of small geographic areas or a specific task to be
accomplished (e.g. , grade separation in the FAST corridor)
These groups are all addressing real needs and are to be
encouraged. However, we discovered that there was no group
working on the transportation system of our entire area. We
formed a planning committee to evaluate the need and
feasibility of such a task force. Over the next few months,
the need for such a group was reinforced over and over in
discussions with a wide range of transportation, business,
and government leaders . The committee moved to plan how we
would attack the problem.
Our first deliverable was a vision statement followed by a
mission statement :
vision:
* To run an efficient, high-value freight movement system
from Asia through the Washington State ports that
companies in Asia and the U. S . that have been kept out
of international business by the cost of transportation
will open entirely new markets .
Mission Statement:
* To improve throughput and consistency of intra- and
inter-freight mobility by looking at it as a systems
and communications problem.
* To promote recognition that throughput and consistency
are the measures of quality for a freight mobility
system.
Our second step was to develop a set of system flow charts
of freight movement in and through the Puget Sound Area. We
identified five modes of transport : Shipping, Trucking,
Air, Train and Pipeline. Flow charts of movement with each
mode were created. A set of committees were then formed to
research each mode through interviews with people in the
field. The reports of each committee are included in this
orientation as are the minutes of our meetings .
This document covers our current state. The group is
continuing to move further into the determination of system
opportunities and implementation of some system aspects to
improve freight mobility.
A Systems Approach — What Is It?
The movement of goods, as with most everything else, is
accomplished not by one activity alone, but by one activity
following another. The effectiveness of each activity is
easy to understand. A truck moving from a ship dock to a
rail head can accomplish this in one hour, four hours or two
days . The system aspect of this is that after the container
is unloaded from a ship, the truck is not able to be there
at that time . The interval between the unloading of the
ship and the movement of the truck is that system time or
system handoff. The effect of system efficiency is highly
leveraged. If a handoff is handled with 95% efficiency, we
would be very happy. But a series of twelve steps at 95%
efficiency yields 56% overall efficiency. The good news is
that a 1% improvement in each transition has a similar
cumulative effect overall .
System Approach Supports Infrastructure Needs
We believe that an improvement in freight mobility is
available by understanding and improving the transportation
system. This is not, however, the complete solution. Just
as capital investment is not the complete solution. The
truth is that we have far more infrastructure needs than
money to pay for them and resources to build them. Our
issue is that there is a need for system improvement in
addition to infrastructure . Long term, a better
understanding of the freight system will improve our
allocation of capital dollars . But we must certainly move
forward on existing capital plans .
What Is The Current System
Bow Do We Develop?
* We have identified in the freight mobility system five
modes of transport: trains, ships, planes, trucks and
pipeline. We have also identified classes of freight
movement . These are variations of:
* Freight enters our system -
* (Freight transported through our system/freight starts
or ends in our system) -
* Freight leaves our system.
We created high level flow diagrams of each
combination/mode. A committee was created to learn more
about each mode . As more information is learned, the flow
diagrams are up dated. The flow charts are included next .
What Are Our Goals?
Initial Goals
The short term (6-18 months) goals of FMSAT are to :
* Increase the visibility of systems approach to
transportation.
* Raise our understanding of the existing freight
movement system in the Puget Sound region.
* Increase public education of the benefit of a systems
approach to transportation to transportation improve-
ment.
* Make sure that the public understands that this is not
a panacea, but an important piece of the puzzle .
* Lay the foundation to create an organization to pursue
the long term goals of FMSAT .
Long Term Goals (to be achieved through the organization)
* Develop a detailed understanding of regional freight
mobility system.
* Working with all stakeholders to identify specific
actions to be taken to improve the quality of our
regional freight mobility system.
* Put in motion teams to accomplish system improvement
tasks .
* Use the systems approach to create a framework for
future capital investment .
Current Activities
Goal: Increase the visibility of systems approach to
transportation.
* We have met with most King/Snohomish/Pierce counties'
government levels to inform them of FMSAT.
* We have met with many of the other freight mobility
groups to inform them of FMSAT and how we are working
with them to improve freight mobility.
* We have met with other transportation groups (SKTB
Board, etc. ) to raise the recognition of a systems
approach to freight mobility.
Goal: Raise our understanding of the existing freight
movement system in the Puget Sound region.
* We have committees researching the system flow of goods
for each identified mode. Reports of Pipeline,
shipping, Truck, Rail and Air are, or will be, included
in this paper.
Goal: Increase public education of the benefit of a systems
approach to transportation to transportation
improvement.
* We have met with some government groups and are working
with the State Department of Transportation. We are
laying the foundation for a stronger educational
effort .
Goal: Make sure that the public understands that this is
not a panacea, but an important piece of the puzzle.
* We have included realism in our message, but need to
do more with this and public education.
Goal: Lay the foundation to create an organization to
pursue the long term goals of FMSAT.
* We have reached out to government groups (staff and
elected officials) .
* We have reached out to business groups .
* We have reached out to labor groups .
* We have reached out to the staffs of the region' s
Ports .
* We have reached out to the academic community.
Current Actions
* Seeking a-. organizational host : We understand that
long term, our task force must either grow to encompass
a much broader set of stakeholders or come under the
umbrella of another organization with the proper drive,
stature and credibility. Our search for such a group,
individual or combination continues .
* Seek out stakeholders : Our search for representatives
from all stakeholder groups continues . This has been a
success as the task force continues to grow with
talented, committed people. This growth has been a
strain on our learning curve and we have launched an
educational process within the task force.
* Extending our outreach to elected port officials .
* Launching a facilitation effort to build more of an
understanding of the systems approach and what it
means .
Actions Needed
* Lay the groundwork for more public awareness of
importance of freight system to local economy.
* More ideas on future home for the task force.
* Development of an effort directed to Eastern Washington
on how Puget Sound freight mobility has a direct
bearing on their economic future .
Examples of Systems Approach to Freight Mobility
The following are examples that have come up to help explain
how a systems approach can improve freight mobility in ways
that may not be directly measurable .
1 . Double Stacked Trains at Blaine: Currently U.S . and
Canadian customs will not inspect trains with
containers two-high. This not only reduces the
efficiency of the trains, but forces more containers
to travel between Seattle and Vancouver, B.C. by truck.
This increases the number of trucks driving through
Bellingham (as an example) , increases traffic
congestion on the North 1-5 corridor and increases
wear and tear on the highways .
2 . Direct Train Link to Ports: Currently not all harbor
terminals have a rail link to the mainline yards of
railroads . Because of this, containers are unloaded
from a ship and placed on the ground in storage . At
the end of the day, a call is made to a trucking firm
to transport the containers . The next day, the truck
picks up the container and drives on a congested
arterial to the rail station. When and if the
containers could be loaded directly on the rail cars,
the container would not have to wait a day for the
truck to arrive, the traffic on this tight corridor
would be reduced and eventually, the train could be
built, in some cases, at the port which would elimin-
ate the need to stop at the mainline station at all .
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Kent City Council Meeting
Date May 19 . 1998
Category Consent Calendar
1. SUBJECT: BLUE CROSS OF WASHINGTON AND ALASKA AND GROUP
HEALTH CONTRACT RENEWAL FOR 1998 - AUTHORIZATION
TO SIGN
2 . SUMMARY STATEMENT: Authorization for the Mayor to sign
contracts with Blue Cross of Washington and Alaska and Group
Health Cooperative. The Blue Cross contract is an administra-
tive agreement whose sole function is to provide claims
administration services. The City purchases medical insurance
through Group Health Cooperative. Funding is provided through
the Health and Welfare Fund.
3 . EXHIBITS: Contracts
4 . RECOMMENDED BY: Operations Committee
(Committee, Staff, Examiner, Commission, etc. )
5. UNBUDGETED FISCAL/PERSONNEL IMPACT: NO X YES
6. EXPENDITURE REQUIRED: $
SOURCE OF FUNDS: Health and Welfare Fund
7 . CITY COUNCIL ACTION:
Councilmember moves, Councilmember seconds
DISCUSSION•
ACTION:
Council Agenda
Item No. 3L
t
BLUE CROSS OF WASHINGTON AND ALASKA
CONTRACT ADMINISTRATION AGREEMENT
This Agreement is effective this first day of January 1998, by and
between the CITY OF FENT (hereinafter referred to as the "Plan
Sponsor") , and BLUE CROSS OF WASHINGTON AND ALASKA (hereinafter referred
to as the "Contract Administrator") .
WHEREAS, the Plan Sponsor has established an employee benefit plan
(hereinafter referred to as the "Plan") which provides for payment of
certain welfare benefits to and for certain eligible individuals as
defined by the Plan Document, such individuals being hereinafter
referred to as "Participants, Dependents and Beneficiaries"; and,
WHEREAS, the Plan Sponsor has chosen to self-insure the benefit
program(s) provided under the Plan; and
WHEREAS, the Plan Sponsor desires to engage the services of the Contract
Administrator to provide administrative services for the Plan;
NOW THEREFORE, in consideration of the mutual covenants and conditions
as contained herein the parties hereto agree as follows:
SECTION I DUTIES AND RESPONSIBILITIES OF THE PLAN SPONSOR
1.01 The Plan Sponsor shall provide the Contract
Administrator with a copy of the Plan Document and any
other documents describing the benefit program(s) which
the Contract Administrator may rely upon in performing
its responsibilities under this Agreement.
1.02 The Plan Sponsor shall have final discretionary
authority to determine the benefit provisions and to
construe and interpret the terms of the Plan.
1.03 The Plan Sponsor shall have final discretionary
authority to determine eligibility for benefits and the
amount to be paid by the benefit program(s) .
1.04 Unless specifically delegated to the Contract
Administrator by this Agreement, the Plan Sponsor shall
be responsible for the proper administration of the Plan
including:
a. providing the Contract Administrator a complete and
accurate list of all individuals eligible for
benefits under the benefit program(s) upon which
the Contract Administrator shall be entitled to
rely until it receives documentation of any change
thereto;
7486T
1
b. notifying the Contract Administrator on a monthly
basis of changes in eligibility;
C. distributing to all eligible Participants,
Dependents and Beneficiaries all appropriate and
necessary materials and documents, including but
not limited to benefit program booklets, summary
plan descriptions, material modifications, the Plan
Document, amendments to the Plan Document,
identification cards, enrollment applications and
notice forms necessary for the operation of the
Plan;
d. providing the Contract Administrator with any
additional information necessary to perform its
functions under this Agreement as may be requested
by the Contract Administrator from time to time;
e. maintaining adequate funds from which the total
cost of all claims for each preceding [week/month]
will be paid to the Contract Administrator by wire
transfer. Funds must be provided within forty-
eight (48) hours of phone notification by the
Contract Administrator to a person designated by
the Plan Sponsor.
1.05 The Plan Sponsor shall be responsible for all taxes,
assessments and fees levied by any local, state or
federal authority in connection with the Contract
Administrator's duties pursuant to this Agreement.
1.06 The Plan Sponsor shall be responsible for the Plan's
continuing compliance with federal, state and local laws
and regulations, including but not limited to the
Internal Revenue Code, the Employee Retirement Income
Security Act of 1974 (ERISA) , and the Consolidated
Omnibus Budget Reconciliation Act of 1985 (COBRA) , and
the Health Insurance Portability and Accountability Act
of 1996 (HIPAA) . The Plan Sponsor, and not the Contract
Administrator, is the "plan administrator" for purposes
of 29 USC Section 1002 (16) (a) and 26 USC Section
4980B(g) (3) and the "plan sponsor" for purposes of 29
USC Section 1161, et seq. The Plan Sponsor shall be
responsible for determining whether it is subject to
COBRA and for notifying Participants, Dependents and
Beneficiaries of their COBRA rights both initially and
upon the occurrence of a qualifying event, for
calculating and collecting premiums for COBRA
continuation of coverage and for promptly notifying the
Contract Administrato7- when an individual is no longer
eligible for COBRA cc .=inuation of coverage.
7486T
2
1.07 The Plan Sponsor shall be responsible for defending any
legal action brought against the Plan, including a claim
for benefits by or on behalf of any individual or
entity, including but not limited to any Participant or
former Participant, Dependent, Beneficiary, any
fiduciary or other party. This responsibility includes
the selection and payment of counsel. The Plan Sponsor
shall not settle any legal action or claim without the
prior consent of the Contract Administrator if the
action or claim could result in the Contract
Administrator being liable, including for example, any
liability for contribution to or indemnification of the
Plan Sponsor or other third party either directly or
indirectly.
1.08 In the event the Contract Administrator does not have
adequate information to complete the Certificate of
Group Health Coverage as required by HIPAA, the Plan
Sponsor shall be responsible for completing the missing
information on the Certificate and forwarding it to the
Participant or Dependent upon their termination from the
Plan or upon request within 24 months of termination.
SECTION II DUTIES AND RESPONSIBILITIES OF THE CONTRACT
ADMINISTRATOR
2.01 The Contract Administrator agrees to perform the
following administrative services for the Plan Sponsor:
a. assist in the preparation and printing of the Plan
Document, benefit program booklets, identification
cards, and other materials necessary for the
operation of the Plan;
b. process all eligible claims incurred after the
effective date of this Agreement which are properly
submitted in accordance with the procedures set
forth in the Plan Document. Checks will be issued
on the contract Administrator's check stock, but
the responsibility for funding benefits is the Plan
Sponsor's and the Contract Administrator is not
acting as an insurer. The Contract Administrator
shall make reasonable efforts to determine that a
claim is covered under the terms of the benefit
program(s) , to apply the coordination of benefits
provisions, identify subrogation claims, and make
reasonable efforts to recover subrogated amounts
administratively, and prepare and distribute
benefit payments to Participants, Dependents and
Beneficiaries and/or service providers;
C. perform reasonable internal audits;
d. answer inquiries from the Plan Sponsor,
Participants, Dependents and Beneficiaries, and
service providers regarding the terms of the Plan,
7486T
3
although final authority for construing the terms
of the Plan's eligibility and benefit provisions is
the Plan Sponsor's;
e. prepare and provide to the Plan Sponsor monthly
reports of claims paid under the Plan in accordance
with Attachment C;
f. prepare and provide the Plan Sponsor with an annual
report of the operations of the Plan in accordance
with Attachment C;
g. provide information to the Plan Sponsor for
preparing Form 55001s; however, the Plan Sponsor
shall be solely responsible for insuring timely
filing of the Form 55001s;
h. coordinate with any stop-loss insurance carrier;
i. when "preferred provider" benefits are provided,
maintain a network of hospital and professional
providers; paid claims will reflect any negotiated
provider discounts;
j . perform utilization management services including,
preadmission review, admission review, length of
stay assignment, focused concurrent review,
discharge planning, individual case management and
retrospective review.
k. provide a Certificate of Group Health Coverage to
Participants and Dependents when their coverage
under this Plan terminates or upon their request
within 24 months of termination. In the event the
Contract Administrator does not have adequate
information to complete the Certificate, the Plan
Sponsor will be responsible for completing the
missing information on the Certificate and
forwarding it to the Participant or Dependent.
SECTION III LIMITS OF THE CONTRACT ADMINISTRATOR'S RESPONSIBILITY
3.01 It is recognized and understood by the Plan Sponsor that
the Contract Administrator is not an insurer and that
the Contract Administrator's sole function is to provide
claims administration services and the Contract
Administrator shall have no liability for the funding of
benefits.
3 .02 If during the course of an audit performed internally by
the Contract Administrator pursuant to Section 2.Ol,c.
or by the Plan Sponsor pursuant to Section VI of this
Agreement any error is discovered, the Contract
Administrator shall use reasonable efforts to recover
any loss resulting from such error.
7486T
4
3.03 The Contract Administrator is an independent contractor
with respect to the services being performed pursuant to
this Agreement and shall not for any purpose be deemed
an employee of the Plan Sponsor.
3.04 This Agreement is between the Contract Administrator and
the Plan Sponsor and does not create any legal
relationship between the Contract Administrator and any
Participant, Dependent, Beneficiary or any other
individual.
3 .05 It is recognized by the parties that errors may occur
and it is agreed that the Contract Administrator will
not be held liable for such errors unless they resulted
from its gross negligence or willful misconduct. The
Plan Sponsor agrees to defend, indemnify, and hold
harmless the Contract Administrator from all claims,
damages, liabilities, losses, and expenses arising out
of the Contract Administrator's performance of
administration services under the terms of this
Agreement, so long as they did not arise out of the
Contract Administrator's gross negligence or willful
misconduct.
SECTION IV FEES OF THE CONTRACT ADMINISTRATOR
4.01 By the first of each month, The Plan Sponsor shall pay
the Contract Administrator in accordance with the fee
schedule set forth in Attachment D which is incorporated
herein by reference.
4.02 Late Payments
a. If, for any reason whatsoever, the Plan Sponsor
fails to make a timely payment required under this
Agreement, the Contract Administrator may suspend
performance of services to the Plan Sponsor,
including processing and payment of claims, until
such time as the Plan Sponsor makes the required
payment, including interest as set forth in b.
below.
b. The Contract Administrator will charge interest to
the Plan Sponsor on all late payments, including
amounts paid to reinstate this Agreement after
termination pursuant to Section 9.05, at the
average annual prime rate posted by Seattle First
National Bank plus two (2) percent on the amount of
the late payments for the number of days late.
Interest will be in addition to any other amounts
payable under this Agreement.
7486T ,
5
C. In the event of late payment, the Contract
Administrator may terminate this Agreement pursuant
to Section 9.05. Acceptance of late payments by
the Contract Administrator shall not constitute a
waiver of its right to cancel this Agreement due to
delinquent or nonpayment of fees.
SECTION V OUT-OF-AREA PROGRAM
5.01 B1ueCard* Access Fees
Blue Cross/Blue Shield Plans outside of the Washington
and Alaska service area may charge Blue Cross of
Washington and Alaska a fee (referred to as an access
fee) for making their discounted rates and the resulting
savings available on claims incurred by Enrollees. The
access fee, if one is charged, is up to ten (10)
percent, but not to exceed $2, 000 for any claim, of the
discount the Plan has obtained from its providers. The
access fee may be charged only if that Plan's
arrangement with the provider prohibits billing
Enrollees for amounts in excess of the discounted rate.
However, providers may bill for deductibles,
coinsurance, amounts in excess of stated benefit
maximums, and charges for noncovered services. In the
event a participating provider discount cannot be passed
along to Enrollees, no discount or access fee will
apply.
*The BlueCard is a program name established by the Blue
Cross and Blue Shield Association.
When BCWA is charged an access fee, BCWA will pass the
charge along to the Group as a claims expense. If BCWA
receives an access fee credit, BCWA will give the Group
a claims expense credit. Access fees are considered a
claims expense because they represent claims dollars
BCWA is unable to, or in the case of a credit, avoid
paying.
Instances may occur in which BCWA does not pay a claim
(or pay only a small amount) because the amounts
eligible for payment were applied to the deductible
and/or coinsurance. If the Plan's arrangement with its
providers allows the discounted payment rate to apply
when the amount is fully or mostly a patient obligation,
BCWA will pay the Plan's access fee and pass it along to
the Group as a claims expense even though the Group paid
little or none of the claim.
7486T
6
SECTION VI AUDIT
6.01 Within thirty (30) days of written notice from the Plan
Sponsor, the Contract Administrator shall allow an
authorized agent of the Plan Sponsor to inspect or audit
all records and files maintained by the Contract
Administrator which are directly pertinent to the
administration of the Plan. Such documents shall be
made available at the administrative office of the
Contract Administrator during normal business hours.
The Plan Sponsor shall be liable for any and all fees
charged by the auditor. Any agent or auditor that has
access to the records and files maintained by the
Contract Administrator shall agree not to disclose any
proprietary or confidential information used in the
business of the Contract Administrator.
SECTION VII SUBROGATION
7.01 The Contract Administrator shall make reasonable efforts
to pursue subrogation claims administratively on behalf
of the Plan. However, the Contract Administrator shall
have no affirmative duty to pursue subrogation claims
beyond those specified in section 2.O1,b. The Plan
Sponsor shall have the sole discretion to bring any
legal claim or action to enforce the Plan's subrogation
provisions. The Contract Administrator will cooperate
with the Plan Sponsor in the event the Plan Sponsor
brings any legal action to enforce the subrogation
provisions of the Plan. Any costs and attorneys' fees
incurred in pursuing such subrogation claims shall be
the responsibility of the Plan Sponsor.
SECTION VIII TERM OF AGREEMENT
8 .01 The term of this Agreement shall be the period from
12:01 a.m. on January 1, 1998, to midnight on December
31, 1998 (hereinafter referred to as the "Agreement
Period") .
8.02 Except as stated otherwise in section 9.03 below, the
terms and conditions of this Agreement and the fee
schedule set forth in Attachment D are established for
the Agreement Period.
8.03 The Plan Sponsor acknowledges that the fee schedule set
forth in Attachment D and the services provided for in
this Agreement are based upon the terms of the Plan and
the enrollment as they exist on the effective date of
this Agreement. Any substantial change, whether
required by law or otherwise, in the terms and
provisions of the Plan or in enrollment may require that
the Contract Administrator incur additional expenses.
The parties agree that any substantial change, as
determined by the Contract Administrator, shall result
7486T
7
in the alteration of the fee schedule, even if the
alteration is during the Agreement Period. The phrase
"any substantial change" shall include, but not be
limited to:
a. a fluctuation of ten (10) percent or more in the
number of Participants, Dependents and
Beneficiaries as set forth on the census
information included in Attachment B which is
herein incorporated by reference and made a part of
this Agreement;
b. the addition of benefit program(s) or any change in
the terms of the Plan's eligibility rules, benefit
provisions or record keeping rules that would
increase administration costs by more than $2,000;
C. any change in claims administrative services,
benefits or eligibility required by law;
d. any change in administrative procedures from those
in force at the inception of this Agreement which
is agreed upon by the parties;
e. any additional services which the Contract
Administrator undertakes to perform at the request
of the Plan Sponsor which are not specified in this
Agreement such as the handling of mailings or
preparation of statistical reports and surveys not
specified in this Agreement.
SECTION IX TERMINATION
9.01 The Plan Sponsor may terminate this Agreement at any
time by giving the Contract Administrator thirty (30)
days written notice.
9.02 This Agreement will terminate on the last day of the
Agreement Period or the last day of any extension of the
Agreement Period granted by the Plan Administrator.
9.03 Either party may terminate this Agreement effective
immediately by giving written notice to the other if a
party becomes insolvent, makes a general assignment for
the benefit of creditors, files a voluntary petition of
bankruptcy, suffers or permits the appointment of a
receiver for its business or assets, or becomes subject
to any proceeding under any bankruptcy or insolvency
law, whether foreign or domestic. A party is insolvent
if it has ceased to pay its debts in the ordinary course
of business; cannot pay its debts as they become due; or
the sum of its debts is greater than the value of its
property at a fair valuation.
9.04 If loss of services is caused by, or either party is
unable to perform any of its obligations under this
7486T
8
Agreement, or to enjoy any of its benefits because of
natural disaster, action or decrees of governmental
bodies or communication failure not the fault of the
affected party, such loss or inability to perform shall
not be deemed a breach. The party who has been so
affected shall immediately give notice to the other
party and shall do everything possible to resume
performance. Upon receipt of such notice, all
obligations under this Agreement shall be immediately
suspended. If the period of nonperformance exceeds
thirty (30) days from the receipt of such notice, the
party whose performance has not been so affected may, as
its sole remedy, terminate this Agreement by written
notice to the other party effective immediately. In the
event of such termination, the Plan Sponsor shall remain
liable to the Contract Administrator for all payments
due, together with interest thereon as provided for in
Section 4.02.
9.05 The Contract Administrator may, in its sole discretion,
terminate this Agreement effective as of a missed
payment due date in the event that the Plan Sponsor
fails to make a timely payment required under this
Agreement.
9.06 In the event this Agreement is terminated prior to the
end of the Agreement Period, the Plan Sponsor shall
remain liable to the Contract Administrator for all
delinquent sums together with interest thereon as
provided for in section 4.02 above. Furthermore,
because the Contract Administrator will have incurred
fixed costs which, but for the termination, would have
been recouped over the course of the Agreement Period,
as liquidated damages, and not as a penalty, the Plan
Sponsor shall pay the Contract Administrator an amount
equal to two (2) months administration fee at the rate
set forth in Attachment D multiplied by the average
number of Participants, Dependents and Beneficiaries
covered by the Plan for the immediately preceding six
(6) month period or such shorter period if this
Agreement has not been in effect for a period of six (6)
months. The Plan Sponsor shall remain liable for claims
incurred during the Agreement Period but not paid during
the Agreement Period and for the claims run-out
processing fee set forth in subsection C of Attachment
D.
9.07 within one hundred twenty (120) days of termination by
either party, the Contract Administrator shall deliver
to the Plan Sponsor an interim accounting. within
fifteen (15) months of termination the Contract
Administrator shall deliver to the Plan Sponsor a
complete and final accounting of the status of the Plan.
7486T
9
At the expense of the Plan Sponsor, the Contract
Administrator shall make available a record of
deductibles and coinsurance levels for each Participant,
Dependent and Beneficiary and deliver this information
to the Plan Sponsor or its authorized agent.
9.08 For the twelve (12) month period following termination
of this Agreement, the Contract Administrator shall
continue to process eligible claims incurred prior to
termination at the claims run-out processing fee rate
set forth in Attachment D.
SECTION X DISCLOSURE
10.01 It is recognized and understood by the Plan Sponsor that
the Contract Administrator is subject to all laws and
regulations applicable to contract administrators and
health care service contractors.
10.02 It is recognized and understood by the Plan Sponsor that
the Contract Administrator is not acting as an insurer
and also is not providing stop-_oss insurance.
SECTION XI OTHER PROVISIONS
11.01 Choice of Law
The validity, interpretation, and performance of this
Agreement shall be controlled by and construed under the
laws of the State of Washington. unless federal law
applies. Any and all disputes :oncerning this Agreement
shall be resolved in King County Superior Court. The
party substantially prevailing shall be entitled to
recover its reasonable costs, including attorneys' fees.
11.02 Trademarks
The Contract Administrator reserves the right to, the
control of, and the use of the words "Blue Cross of
Washington and Alaska" and all symbols, trademarks and
service marks existing or hereafter established. The
Plan Sponsor shall not use such words, symbols,
trademarks or service marks in advertising, promotional
materials, materials supplied to Participants,
Dependents and Beneficiaries or otherwise without the
Contract Administrator' s prior written consent which
shall not be unreasonably withheld.
11.03 Independent Corporation
The Plan Sponsor hereby expressly acknowledges, on
behalf of itself and all of its eligible employees and
their eligible dependents, its understanding that this
Contract Administration Agreement constitutes an
Agreement solely between the Plan Sponsor and the
Contract Administrator, that the Contract Administrator
7486T
10
is an independent corporation operating under a license
with the Blue Cross and Blue Shield Association, an
association of independent Blue Cross and Blue Shield
Plans (the "Association") permitting the Contract
Administator to use the Blue Cross Service Mark in the
States of Washington and Alaska, and that the Contract
Administrator is not contracting as the agent of the
Association.
The Plan Sponsor further acknowledges and agrees that it
has not entered into this Contract Administration
Agreement based upon representations by any person other
than the Contract Administrator, and that no person,
entity or organization other than the Contract
Administrator shall be held accountable or liable to the
Plan Sponsor for any of the Contract Administrator's
obligations to the Plan Sponsor created under this
Contract Administration Agreement. This provision shall
not create any additional obligations whatsoever on the
Contract Administrator's part other than those
obligations created under other provisions of this
Contract Administration Agreement.
11.04 Notice
Except for the notice given pursuant to section 1.04,e. ,
any notice required or permitted to be given by this
Agreement shall be in writing and shall be deemed
delivered three (3) days after deposit in the United
States mail, postage fully prepaid, return receipt
requested, and addressed to the other party at the
address as shown below.
11.05 Integration
This Agreement, including any appendices or attachments
incorporated herein by reference, embodies the entire
Agreement and understanding of the parties and
supersedes all prior oral and written communications
between them. The terms hereof may be modified only by
a writing signed by both parties hereto.
11.06 Assignment
Neither party shall assign this Agreement or any of its
duties or responsibilities hereunder without the prior
written approval of the other.
SECTION XII ATTACHMENTS TO THE CONTRACT ADMINISTRATION AGREEMENT
12.01 The following attach to and become part of the body of
this Agreement and they are herein incorporated by
reference.
7486T
it
Attachment A - Plan Document No. 7486T
Program Number 13595
Program Number 13596
Program Number 13597
Program Number 17620
Program Number 17884
Attachment B - Census
Attachment C - Reporting
Attachment D - Fee Schedule
Attachment E - Right Of Conversion
7486T
12
The parties below have signed as duly authorized officers and have
hereby executed this Agreement. If this Agreement is not signed and
returned to the Contract Administrator within sixty (60) days of its
delivery to the Plan Sponsor or its agent, the Contract Administrator
will assume the Plan Sponsor's concurrence and the Plan Sponsor will be
bound by its terms.
IN WITNESS WHEREOF the parties hereto sign their names as duly
authorized officers and have executed this Agreement.
CITY OF KENT
BY: DATE:
Title
BY: DATE:
Title
Address:
BLUE CROSS OF WASHINGTON AND ALASKA
BY: / DATE: September 23, 1997
Title: Sr. Vice President, General Manager
Group Market Services
Address: P.O. Box 327
Seattle, WA 98111-0327
7486T ,
13
Attachment A
CITY OF KENT
(Plan Sponsor)
PLAN DOCUMENT
The employee benefit programs set forth in the Plan Document are
available to certain eligible individuals as defined within the benefits
programs. The entire Plan Document consists of the following: the Plan
Document face page, the attached benefit booklet for Program Number
13595, Program Number 13596, Program Number 13597, Program Number 17620,
Program Number 17884, The enrollment applications of eligible persons on
file with the City of Kent and all attachments, endorsements, and riders
included or issued hereafter. All benefits of this Plan Document are
subject to the terms and conditions stated herein and any endorsements
or riders included or issued thereafter. The City of Kent has the
discretionary authority to determine eligibility for benefits and to
construe the terms used in this Plan Document.
Blue Cross of Washington and Alaska has been selected by the City of
Kent to administer the benefits of this Plan Document. Blue Cross of
Washington and Alaska is not the Underwriter of this Plan Document. The
City of Kent is solely and totally responsible for: funding benefits
under the benefit programs; compliance with all applicable laws and
regulations affecting the benefit programs; and fiduciary liability for
the benefit programs. If, for any reason, the Contract Administration
Agreement between Blue Cross of Washington and Alaska and the City of
Kent terminates, Blue Cross of Washington and Alaska shall be relieved
of its administrative duties under this Plan Document, except as
otherwise provided in the Contract Administration Agreement.
This Plan Document attaches to and becomes a part of the Contract
Administration Agreement effective January 1, 1998.
CITY OF KENT
By: Date:
Title
By: Date:
Title
PLAN DOCUMENT EFFECTIVE DATE: January 1, 1998
PLAN DOCUMENT NUMBER: 7486T
7486T ,
14
Attachment B
Census Information
Administration Fees effective January 1, 1998 are based on the
following:
Number of Active and Retired Enrollees:
Employee Spouse Children
Medical/RX 658 440 709
Dental 694 458 767
Vision 696 458 767
Number of COBRA Enrollees:
Medical/RX 2 1 3
Dental 2 1 1
Vision/RX 2 1 1
Other Carriers Offered: Group Health Cooperative.
7486T
15
Attachment C
Reporting
The following reports will be provided to the Plan Sponsor within the
fees set forth in Attachment D:
Report Title Frequency
Weekly Claims Recap Weekly
Detail Claim Runs Monthly
Premium/Claims Report Monthly
Large Claims Analysis Yearly
7486T
16
Attachment D
Fees of the Contract Administrator
Pursuant to the Contract Administration Agreement, the Group shall pay
the Contract Administrator a fee, as set forth below, for administrative
services.
A. Administration Fees:
Composite
13595, -01, -99 $ 31.77
13596, -01, -99 $ 31.77
17620 $ 31.77
13597, -01 $ 5.53
17884 $ 1.74
B. Other Fees:
$1.75 per booklet
$ .75 per I.D. card
Prescription drug charge - $1.20 per claim
Conversion Contract Fee - $1,000 per conversion
C. Claims runout processing fee:
S'k of runout claims processed
7486T
17
0Grou�
Cooperative
of Puget Sound
GROUP MEDICAL COVERAGE
AGREEMENT
Group Health Cooperative of Puget Sound (also referred to as "GHC" or"the Cooperative") is a non-profit health
maintenance organization furnishing health care primarily on a prepayment basis. As a direct service provider, the
Cooperative is dedicated to providing to its Members quality health care, including preventive medical services.
This Agreement states the terms of enrollment,payment and coverage under which a Group may secure GHC health
benefits. The Schedule of Benefits lists the benefits to which those enrolled under this Agreement are entitled.
Words with special meaning are capitalized. They are defined in Section I.
MEMBERS ARE ENTITLED TO COVERED SERVICES ONLY AT GHC FACILITIES AND FROM GHC
PROVIDERS,UNLESS THE MEMBER HAS BEEN REFERRED BY A GHC PRIMARY CARE PROVIDER OR
HAS RECEIVED EMERGENCY SERVICES ACCORDING TO SECTION X.I. OF THE SCHEDULE OF
BENEFITS.
Female Members may see a participating General and Family Practitioner, Physician's Assistant, Gynecologist,
Certified Nurse Midwife, Doctor of Osteopathy, Obstetrician and Advanced Registered Nurse Practitioner who
provides women's health care services directly, without a Referral from their Primary Care Provider, for medically
appropriate maternity care, covered reproductive health services, preventive care and general examinations,
gynecological care, and medically appropriate follow-up visits for the above services. If your women's health care
provider diagnoses a condition that requires referral to other specialists or hospitalization, you or your chosen
provider must contact your Primary Care Provider for preauthorization and care coordination. Women's health care
services are covered as if your Primary Care Provider had been consulted, subject to any applicable Copayments
and/or Coinsurance as set forth in the Copayments and Allowances Schedule. For more information on women's
health care providers,contact Group Health Customer Service Center
Limited direct access to providers within GHC's defined network is also available for manipulative therapy as set
forth in Section X.B.
0036900-CO3046 ` 4
- GROUP HEALTH COOPERATIVE OF PUGET SOUND
By:�";�&&4,� —
Title: Vice President. Health Plans&Health Related Businesses
GROUP
City of Kent, #0369
By:
Title:
This Agreement will become effective January 1, 1998 and will continue
in effect until terminated as herein provided for.
PA-1133
0036900-CO3046 5
A ® A
GROUP HEALTH COOPERATIVE OF PUGET SOUND
CONTRACT REVISIONS
--ctive 1/1/98
CONTRACT
LANGUAGE/BENEFIT CHANGE EXPLANATION
Signature Page New Contract Officer Signature/Title
Richard Marks,Vice President,Health Plans
&Health Related Businesses
COBRA Section IV.has been revised in accordance
with the 1997 Federal COBRA regulations.
Diabetic Supplies Diabetic supplies,including insulin
syringes, lancets,urine-testing reagents,
external insulin pumps,diabetic monitoring
equipment and blood glucose monitoring
reagents are covered,subject to
the prescription drug copayment.
Enteral Therapy Outpatient elemental and over-the-counter
enteral formulas for malabsorption or
access problems is covered.Elemental
formulas for malabsorption problems are
covered at 80%.Over-the-counter enteral
products for access problems are excluded.
Equipment and supplies for the
administration of enteral therapy is covered.
Manipulative Therapy This is a clarification in the benefit.
Self-referrals for manipulative therapy of
the spine and extremities limited to one
evaluation and ten(10)spinal
manipulations only when provided by
GHC Providers are covered,subject to the
office visit copayment. Additional
exclusion language has been added.
Orthopedic Appliances This is a clarification in the benefit.
Arch supports including custom shoe
inserts and their fitting except for
therapeutic shoes and shoe inserts for
severe diabetic foot disease and
orthopedic shoes that are not attached to an
appliance are excluded.
Tobacco Cessation A clarification has been made to denote that
the Tobacco Cessation Program is covered
at 100%for the individual/group sessions.
Exclusions This is a clarification in the exclusions
section.Those parts of an examination and
0036900-CO3046 '` 2
I .�
associated reports and immunizations
required for employment,immigration,
license,travel,or insurance purposes that
are not deemed Medically Necessary by the
GHC for early detection of disease.
0036900-CO3046 3
440Health
0, Cooperative
at Puget Sound
GROUP MEDICAL COVERAGE
AGREEMENT
Group Health Cooperative of Puget Sound (also referred to as "GHC" or"the Cooperative") is a non-profit health
maintenance organization furnishing health care primarily on a prepayment basis. As a direct service provider, the
Cooperative is dedicated to providing to its Members quality health care, including preventive medical services.
This Agreement states the terms of enrollment,payment and coverage under which a Group may secure GHC health
benefits. The Schedule of Benefits lists the benefits to which those enrolled under this Agreement are entitled.
Words with special meaning are capitalized. They are defined in Section I.
MEMBERS ARE ENTITLED TO COVERED SERVICES ONLY AT GHC FACILITIES AND FROM GHC
PROVIDERS,UNLESS THE MEMBER HAS BEEN REFERRED BY A GHC PRIMARY CARE PROVIDER OR
HAS RECEIVED EMERGENCY SERVICES ACCORDING TO SECTION X.I. OF THE SCHEDULE OF
BENEFITS.
Female Members may see a participating General and Family Practitioner, Physician's Assistant, Gynecologist,
Certified Nurse Midwife, Doctor of Osteopathy, Obstetrician and Advanced Registered Nurse Practitioner who
provides women's health care services directly, without a Referral from their Primary Care Provider, for medically
appropriate maternity care, covered reproductive health services, preventive care and general examinations,
gynecological care, and medically appropriate follow-up visits for the above services. If your women's health care
provider diagnoses a condition that requires referral to other specialists or hospitalization, you or your chosen
provider must contact your Primary Care Provider for preauthorization and care coordination. Women's health care
services are covered as if your Primary Care Provider had been consulted, subject to any applicable Copayments
and/or Coinsurance as set forth in the Copayments and Allowances Schedule. For more information on women's
health care providers,contact Group Health Customer Service Center.
Limited direct access to providers within GHC's defined network is also available for manipulative therapy as set
forth in Section X.B.
0036900-CO3046
4
GROUP HEALTH COOPERATIVE OF PUGET SOUND
By:
Title: Vice President.u lrh Plans X Health Related Bucineccec
GROUP
City of Kent, #0369
By:
Title:
This Agreement will become effective January 1, 1998 and will continue
in effect until terminated as herein provided for.
PA-1133
5
0036900-CO3046
GROUP MEDICAL COVERAGE
AGREEMENT
Table of Contents
I. Definitions
II. Dues,Fees and Copayments
III. Termination
IV. Continuation Coverage,Conversion,and Transfer
V. Coordination of Benefits
VI. Subrogation
VII. Grievance Procedures
VIII. Miscellaneous Provisions
IX. Enrollment and Eligibility Schedule
X. Schedule of Benefits
XI. Exclusions and Limitations
XII. Claims
• Medicare Endorsements
• Copayments and Allowances Schedule
• Dues Schedule
• Service Area Map
0036900-003046 6
® I ►
Section I. Definitions
AGREEMENT: This Medical Coverage Agreement, including the Schedule of Benefits, Enrollment and
Eligibility Schedule, Dues Schedule, Copayments and Allowances Schedule, Service Area Map, and Medicare
endorsements.
ALLOWANCE: The maximum amount payable by GHC for certain Covered Services under this Agreement, as
set forth in the Copayments and Allowances Schedule.
COINSURANCE: An amount the Member is required to pay for Covered Services received under this Agreement,
which is a percentage of the Allowance for such services, as set forth in the Copayments and Allowances Schedule.
COPAYMENT: The specific dollar amount required to be paid by a Member for certain Covered Services under
this Agreement as set forth in the Copayments and Allowances Schedule.
COVERED SERVICES: The services and benefits to which a Member is entitled under this Agreement.
DEDUCTIBLE: A specific maximum amount paid by a Member for certain Covered Services before benefits are
payable under this Agreement. The applicable Deductible amounts are set forth in the Copayments and Allowances
Schedule.
DIRECTORY OF SERVICES: A fee-for-service schedule adopted by GHC,setting forth the fees for medical and
hospital services not covered by a GHC prepayment agreement.
EMERGENCY: The sudden,unexpected onset of a medical condition that in the reasonable judgment of a prudent
person is of such a nature that failure to render immediate care by a licensed medical provider would place the
Member's life in danger,or cause serious impairment to the Member's health.
FAMILY DEPENDENT: Any member of a Subscriber's family who meets all applicable eligibility requirements,
is enrolled hereunder,and for whom the dues prescribed in the Dues Schedule have been paid.
FAMILY UNIT: A Subscriber and all his/her Family Dependents.
GHC DESIGNATED FACILITY: A facility, not including a GHC Facility, which the GHC Board of Trustees
has specified to provide health care services to its Members. (See Service Area Map.) Designated Facilities may be
changed by GHC upon appropriate notice.
GHC FACILITY: A hospital or medical center owned and operated by Group Health Cooperative of Puget Sound.
(See Service Area Map.)
GHC MEDICARE PLAN: A plan of coverage for persons enrolled in Medicare Part A (hospital insurance) and
Part B(medical insurance),or Part B only.
GHC PRIMARY CARE PROVIDER: A provider who is employed by or contracted with GHC to provide
primary care services to Members and is selected by each Member to provide or arrange for the provision of all
non-emergent Covered Services,except for services set forth in this Agreement which a Member can access without
referral. Primary Care Providers must be capable of and licensed to provide the majority of primary health care
services required by each Member.
GHC PROVIDER: The Medical Staff,Clinic Associate Staff, and Allied Health Professionals employed by GHC,
and any other health care professional with whom GHC has contracted to provide health care services to persons
enrolled under this Agreement, and who at such time is providing services which have been authorized in advance
by GHC, including, but not limited to, podiatrists, nurses, physician assistants, social workers, optometrists,
0036900-003046 + 7
A h
psychologists, physical therapists and other professionals engaged in the delivery of healthcare services who are
licensed or certified to practice in accordance with Title 18 RCW.
GROUP: An employer, union, welfare trust, or association which has entered into a Group Medical Coverage
Agreement with GHC.
HOSPITAL CARE: Those Medically Necessary services generally provided by acute general hospitals for
admitted patients which a GHC Provider has prescribed, directed, or authorized. Hospital care does not include
convalescent or custodial care which can, in the opinion of the GHC Provider, be provided by a nursing home or
convalescent care center.
MEDICAL CONDITION:A medical condition is a disease,an illness or an injury.
MEDICALLY NECESSARY: Appropriate and necessary services, as determined by the GHC's Medical
Director, or his/her designee, according to generally accepted principles of good medical practice, which are
rendered to a Member for the diagnosis, care or treatment of an illness or injury. Services provided under this
Agreement must be medically necessary for benefits to be provided The cost of services and supplies which are
not medically necessary shall be the responsibility of the Member. Services and supplies must meet the following
requirements: (a) are not solely for the convenience of the patient, his/her family, or the provider of the services
or supplies; (b) are the most appropriate level of service or supply which can be safely provided to the patient, (c)
are for the diagnosis or treatment of an actual or existing illness or injury unless being provided under GHC's
schedule for preventive services; (d) are not for recreational life-enhancing relaxation or palliative therapy
(except for treatment of terminal conditions); (e) are not primarily for research and data accumulation; (j) are
appropriate and consistent with the diagnosis and which, in accordance with accepted medical standards in the
State of Washington, could not have been omitted without adversely affecting the patient's condition or the
quality of health services rendered; (g) as to inpatient care, could not have been provided in a physician's office,
the outpatient department of a hospital, or a non-residential facility without affecting the patient's condition or
quality of health services rendered, and(h) are not experimental or investigational. The length and type of the
treatment program and the frequency and modality of visits shall be determined by the GHC Medical Director, or
his/her designee..
MEDICARE: The federal health insurance program for the aged and disabled.
MEMBER: Any Subscriber or Family Dependent covered by this Agreement.
OPEN ENROLLMENT: An annual period, specified by the Group and GHC, during which an eligible person
may apply for coverage.
PRE-EXISTING CONDITION: A condition for which there has been diagnosis,treatment(including prescribed
drugs),or medical advice within the three(3)month period prior to the effective date of coverage,or a condition for
which symptoms existed within the three (3) month period prior to the date of coverage and for which a prudent
person would have ordinarily sought treatment.
REFERRAL: A written temporary referral agreement authorized in advance by a GHC Provider and approved by
GHC, which entitles a Member to receive Covered Services from a specified non-GHC health care provider.
Entitlement to such services shall not exceed the limits of the Referral and is subject to all terms and conditions of
the Referral and this Agreement.
SERVICE AREA: Clallam; Island, King, Kitsap, Lewis, Mason, Pierce, San Juan, Skagit, Snohomish, Thurston,
and Whatcom Counties,and any other areas designated by GHC. (See Service A!-ea Map.)
SKILLED HOME HEALTH CARE: Reasonable and necessary care for the treatment of an illness or injury
which requires the skill of a nurse or therapist, based on the complexity of the service and the condition of the
patient,and which is performed directly by an appropriately licensed professional provider.
8
0036900-003046
® A
STOP LOSS: The maximum amount of Copayments,and expenses incurred and paid,during the calendar year for
Covered Services received by the Subscriber and his/her Family Dependents within the same calendar year. The
Stop Loss amount is set forth in the Copayments and Allowances Schedule.
SUBSCRIBER: A person employed by or belonging to the Group who meets all applicable eligibility
requirements, is enrolled hereunder,and for whom the dues specified in the Dues Schedule have been paid.
URGENT CONDITION: The sudden, unexpected onset of a medical condition that is of sufficient severity to
require medical treatment within twenty-four(24)hours of its onset.
USUAL,CUSTOMARY,AND REASONABLE: A term used to define the level of benefits which are payable by
GHC when expenses are incurred from a non-GHC physician or provider. Expenses are considered Usual,
Customary, and Reasonable if (1) the charges are consistent with those normally charged by the provider or
organization for the same services or supplies; and(2)the charges are within the general range of charges made by
other providers in the same geographical area for the same service or supplies.
Section II Dues. Fees. and Co.Rayments
A. MONTHLY DUES PAYMENTS. The Group shall submit to GHC for each Member the monthly dues set
forth in the current Dues Schedule and a verification of enrollment,on or before the due date, subject to a grace
period of ten(10)days. Dues are subject to change by GHC upon thirty(30)days written notice.
In the event the group increases enrollment at least twenty-five percent (25%) or more through acquisition or
merger, GHC reserves the right to require re-rating of the group.
B. COPAYMENTS AND COINSURANCE.
1. Copayments. At the time of service, Members shall be required to pay Copayments as set forth in the
Copayments and Allowances Schedule. Failure to pay for services and/or Copayments at the time of
service may result in a billing fee. Failure to cancel a scheduled appointment at least 24 hours prior to the
appointment may result in a billing for the value of the service.
Payment of a Copayment does not exclude the possibility of an additional billing if the service is
determined to be a non-Covered Service.
Total out-of-pocket Copayment expenses incurred during the same calendar year shall not exceed the
aggregate maximum amount(Stop Loss) as set forth in the Copayments and Allowances Schedule. Those
Copayment categories which apply toward the aggregate maximum amount are set forth in the Copayments
and Allowances Schedule.
If Copayments have been billed, any applicable billing fees shall not be considered in calculating total
out-of-pocket expenses for Copayments made.
2. Coinsurance. Members shall be required to pay Coinsurance for certain Covered Services as set forth in
the Copayments and Allowances Schedule.
C. SUBSCRIBER'S LIABILITY. The Subscriber is liable for(1) payment to the Group of his/her contribution
toward the monthly dues, if any; (2)payment to the Cooperative of Copayments and/or Coinsurance amounts
for Covered Services provided to the Subscriber and his/her Family Dependents,as set forth in the Copayments
and Allowances Schedule; and (3) payment to the Cooperative of any fees charged for non-Covered Services
provided to the Subscriber and his/her Family Dependents.
0036900-003046 9
payment of an amount billed and any applicable billing fee must be received within thirty (30) days of the
.ling date.Amounts paid for billing fees do not apply toward the Stop Loss.
I' ,r:LF-PAYMENTS DURING A STRIKE, LOCK-OUT, OR OTHER LABOR DISPUTE. In the event of
,spension or termination of employee compensation due to a strike, lock-out, or other labor dispute, a
Subscriber may continue uninterrupted coverag%! under this Agreement through payment of monthly dues
directly to the Group. Coverage may be continued for the lesser of the term of the strike, lock-out, or other
labor dispute,or for six(6)months after the cessation of work.
If the Group Agreement is no longer available,the Subscriber shall have the opportunity to apply for individual
Group Conversion or, if applicable, continuation coverage (see Section IV.), or an Individual and Family
Medical Coverage Agreement at the duly approved rates.
THE GROUP IS RESPONSIBLE FOR IMMEDIATELY NOTIFYING EACH AFFECTED SUBSCRIBER OF
HIS/HER RIGHTS OF SELF-PAYMENT UNDER THIS PROVISION.
Section III. Termination
A. TERMINATION OF ENTIRE AGREEMENT. This Agreement may be terminated in the following
circumstances:
1. Termination on Notice. This is a guaranteed renewable contract and c_ c be terminated without the
mutual approval of each of the parties except as set forth below(subsection '.and 3.).
2. Nonpayment. Failure to make any monthly dues payment in accordance with Section II.A. shall result in
termination of this Agreement as of the due date.
3. Misrepresentation to Obtain Insurance. Group Health Cooperative may terminate this Agreement upon
written notice in the event of material misrepresentation, fraud, or omission of information in order to
obtain Group Coverage.
4. The Group may terminate this Agreement by giving thirty(30)days written notice to GHC.
B. TERMINATION OF SPECIFIC MEMBERS. This Agreement may be terminated as to a specific Member
for any of the following reasons:
1. Loss of Eligibility.If a Member no longer meets the eligibility requirements set forth in Section IX.B.,and
is not enrolled for continuation coverage as described in Section W.A.,coverage under this Agreement will
terminate at the end of the month during which loss of eligibility occurs, unless otherwise specified by the
Group as set forth in Section IX.Enrollment and Eligibility Schedule.
2. For Cause. Coverage of a Member may be terminated upon written notice for:
a. Material misrepresentation, fraud, or omission of information in order to obtain coverage. This
includes failure to answer fully and correctly all questions contained in the application forms. In such
event,the Cooperative may,within two(2)years from the date of the application, refuse to cover any
service for a condition(s) to which such question was relevant, or may nonrenew or cancel the
Member's coverage upon ten(10)working days written notice.
b. Permitting the use of a GHC identification card by another person, or using another person's
identification card to obtain care to which one is not entitled.
c. Failure to comply with the rules and regulations of the Cooperative.
d. Nonpayment of charges as set forth in Section II.C.
3. Nonpayment of dues for a specific Member by the Group.
0036900-CO3046 10
4. In no event will a Member be terminated solely on the basis of their physical or mental condition provided
they meet all other eligibility requirements set forth in this Agreement.
5. The Member may appeal the termination decision through GHC's grievance process as set forth in Section
VII.
C. PERSONS HOSPITALIZED ON THE DATE OF TERMINATION. A Member who is a registered bed
patient receiving Covered Services in a GHC Facility or GHC Designated Facility on the date of termination
shall continue to be eligible for Covered Services for the condition for which the Member was hospitalized,
until discharge from the facility. This continued coverage will also apply to a Member hospitalized in a
non-GHC Designated Facility as a result of an Emergency or Referral as set forth in Section XI.B.1.
D. SERVICES PROVIDED AFTER TERMINATION. Any services provided by GHC after the effective date
of termination(except those services covered under Section III.C.) shall be charged according to the Directory
of Services. The Subscriber shall be liable for payment of all such charges for services provided to the
Subscriber and all Family Dependents.
A certificate of creditable coverage will be issued automatically upon termination of coverage, and may also be
obtained upon request.
Section IV. Continuation Coverage, Conversion, and Transfer
A. CONTINUATION COVERAGE.
This subsection A. only applies to employer groups who must offer continuation coverage under the applicable
provisions of the Consolidated Omnibus Budget Reconciliation Act of 1985 ("COBRA"),as amended,and only
applies to grant continuation of coverage rights to the extent required by federal law.
To the extent required by federal law, if the Subscriber or Family Dependent loses eligibility under this Group
Agreement, group coverage may be continued under the circumstances described below. Except as set forth in
Section W.A.12.,below, this provision applies only to Subscribers and Family Dependents enrolled under this
Agreement prior to the date of eligibility for continuation coverage who would otherwise lose coverage as a
result of one of the qualifying events listed below in subsections(1.),(2.),and(3.).
1. Subscribers and Family Dependents are eligible for continuation coverage for a maximum period of up to
eighteen(18)months commencing at the date that:
• The Subscriber's employment is terminated(unless terminated for gross misconduct);or
• the Subscriber experiences a reduction in work hours resulting in loss of eligibility for group benefits.
2. Family Dependents are eligible for continuation coverage for a maximum period of up to thirty-six (36)
months commencing at the date that:
• The Subscriber is divorced or legally separated;
• the Subscriber dies;
• the Subscriber becomes entitled to Medicare;or
• a Dependent child ceases to qualify as a Family Dependent under Section IX.B.2.(b)or(c).
3. A COBRA eligible beneficiary who loses coverage due to the employee's termination of employment
(other than for misconduct)or reduction of hours,and who is disabled on or within the first sixty(60)days
of COBRA coverage, may extend his/her coverage and coverage for all of his or her COBRA eligible
family members from eighteen (18) months up to twenty-nine (29) months, so long as the disabled
beneficiary provides notice of his/her Social Security disability determination within sixty (60) days of
such determination and before the end of the eighteen (18) month coverage period. Social Security
0036900-CO3046 11
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Administration certification of total disability is required. The period of extended coverage provided under
this subsection shall terminate on the first day of the first month which begins more than thirty (30) days
after the date of the Social Security Administration's final determination that the qualified beneficiary is no
longer disabled. The disabled individual is required to notes the Group of his or her recovery within
thirty(30)days of Social Security's determination of recovery.
4. In the event the group has retirees,the Subscriber who is a retiree or the spouse or Dependent of a retiree,
may continue coverage hereunder if the Subscriber and /or Family Dependent would otherwise lose
coverage hereunder within one year of the date a proceeding under Title I 1 of the United States Code is
commenced with respect to the Group. Coverage under this Section IV.A.4., continues only upon payment
of applicable monthly charges to the Group at the time specified by the Group. Such Subscribers and
Family Dependents may be eligible to continue coverage until death or such earlier date provided under
COBRA. Medicare entitlement is not a terminating event for individuals continuing coverage under this
provision. The terms and conditions of this coverage are governed by COBRA.
5. If an individual enrolled for continuation coverage experiences a second qualifying event as set forth in
subsection (2.) above, continuation coverage may be extended for up to thirty-six (36)months, beginning
from the date of the first qualifying event.
6. In addition to the conditions set forth in Section III. Termination,continuation coverage may be terminated
prior to the prescribed period set forth in subsections(l.),(2.),(3.), (4.),and(5.)above if:
• there is a failure to make timely payment of any monthly dues required under this Agreement;
• the Member becomes covered under any other group health plan, unless such plan contains an
exclusion or limitation on coverage for any pre-existing condition which may apply to the Member;
• the Member becomes enrolled under Medicare;
• the employer ceases to maintain any group health plan for any of its employees;or
• the Member is no longer disabled as determined by the Social Security Administration.
7. In the event a child is bom to, or is placed with the covered Subscriber for adoption, during a period of
COBRA continuation coverage, such child will also be considered a qualified beneficiary Such children
may be added to coverage according to the same rules which apply to active employees.
S. Notice. The Group is responsible for assuring compliance with COBRA and that Members are given
timely notice of their continuation coverage option. The Group is also responsible for notifying GHC in a
timely fashion of the election to continue coverage and the applicable coverage period.
The Subscriber or Family Dependent must notify the Group,or plan administrator, if any,within sixty(60)
days following a divorce, legal separation, or when an enrolled dependent child no longer meets the
eligibility requirements set forth in Section D{.B.2., or within sixty(60) days following the date coverage
ends in accordance with the termination provisions under this Agreement,whichever is later.
9. Application. Written application for continuation coverage must be made within sixty (60) days of the
termination date of coverage, or the date that the Member receives specific notice of his/her right to
continuation coverage, whichever is later. For the purposes of this Agreement, "receives" means that
written notice was mailed by the Group to the Member's most recent address as recorded with the Group.
No lapse in coverage prior to continuation coverage is permitted, except as provided above. The
application shall be deemed by GHC to include all Family Dependents eligible for continuation coverage
unless specifically stated otherwise.A physical examination or statement of health is not required.
10. Monthly Dues. Monthly dues must be paid directly to the Group.The Group is responsible for submitting
such dues with its regular monthly dues payment to GHC.
0036900-003046 12
Payment of the initial dues payment, which includes the period from the election retroactive to the
qualifying event,and any regular dues payment that becomes due prior to the initial dues payment date,for
continuation coverage under COBRA is due forty-five (45)days after the date of the election. Subsequent
dues payments are due on a monthly basis. Dues for persons extending COBRA coverage from eighteen
(18) months to twenty-nine (29) months because of total disability may be charged at one hundred fifty
percent(150%)of the Group's dues rate that would otherwise apply to them.
11. Group Conversion. In addition to Group Conversion rights as set forth in Section IV.B.,the Subscriber or
Family Dependent enrolled for continuation coverage is entitled to convert to GHC's Group Conversion
Plan within a 180-day period prior to termination of continuation coverage, if his/her coverage under this
Agreement is terminated for any reason other than nonpayment or cause. See Section IV.B.2. GHC Group
Conversion Plan-Application.
12. Open Enrollment and Adding Dependents. To the extent required under COBRA, a qualified
beneficiary under COBRA may add Family Dependents during the Group's Open Enrollment period and
newly eligible persons according to the procedures specified in Section IX.A.
B. GHC GROUP CONVERSION PLAN.
1. Eligibility. Any Subscriber or Family Dependent is entitled to convert to GHC's Group Conversion Plan if
his/her coverage under this Agreement is terminated for any reason other than cause. (See Section III.B.2.)
Following termination of marriage or death of the Subscriber, all Family Dependents are entitled to make
such a conversion.
2. Application. Application for conversion must be made within thirty-one (31) days following termination
under this Agreement. Coverage under the GHC Group Conversion Plan is subject to all terms and
conditions of such plan, including dues payment. A physical examination or statement of health is not
required for enrollment in the Group Conversion Plan.
Section V. Coordination of Benefits
A. BENEFITS SUBJECT TO THIS PROVISION: As described in subsection H., benefits provided under this
Agreement do not duplicate other group coverage for medical care or treatment. If a Member is entitled to
receive benefits or services for medical care or treatment under another individual, group or governmental plan,
GHC may recover the reasonable cash value of services provided under this Agreement so that benefits and
services under all plans do not exceed one hundred percent(100%)of allowable expenses(except copayments,
coinsurances and deductibles)as set forth in this section.
B. PLAN: The definition of a"Plan"includes the following sources of benefits or services:
1. Group or blanket disability insurance policies and health care service contractor and health maintenance
organization group agreements, issued by insurers, health care service contractors and health maintenance
organizations;
2. Labor-management trusteed plans, labor organization plans, employer organization plans or employee
benefit organization plans;
3. Governmental programs;and
4. Coverage required or provided by any statute.The term "Plan"shall be construed separately with respect to
each policy, agreement or other arrangement for benefits or services, and separately with respect to the
respective portions of any such policy,agreement or other arrangement which do and which do not reserve
the right to take the benefits or services of other policies, agreements or other arrangements into
consideration in determining benefits.
0036900-CO3046 13
C. ALLOWABLE EXPENSE: "Allowable Expense" means any necessary, reasonable and customary items of
expense at least a portion of which is covered under at least one of the Plans covering the person for whom the
claim is made. When a Plan provides benefits in the form of services rather than cash payments,the reasonable
cash value of each service rendered shall be considered as both an Allowable Expense and a benefit paid.
D. CLAIM DETERMINATION PERIOD: "Claim Determination Period" means a period beginning with any
January 1 and ending with the next following December 31 except that the first Claim Determination Period
with respect to any person shall begin on the effective date of coverage under this Agreement with respect to
such person and end on the following December 31. In no event will a Claim Determination Period for any
person extend beyond the last day on which such a person is covered under this Agreement.
E. RIGHT TO RECEIVE AND RELEASE INFORMATION: For the purpose of determining the applicability
of and implementing this provision and any provision of similar purpose in any other Plan, the Cooperative
may,with such consent as may be necessary,release to or obtain from any other insurer,organization or person
any information,with respect to any person which the insurer considers necessary for such purpose. Any person
claiming benefits under this Agreement shall furnish to the Cooperative the information necessary for such
purpose.
F. FACILITY OF PAYMENT: Whenever coverage which should have been provided under this Agreement in
accordance with this provision has been provided or paid for under any other Plan, the Cooperative shall have
the right, exercisable alone and in its sole discretion,to pay over to any Plan making such other payments any
amounts it shall determine to be warranted in order to satisfy the intent of this provision, and amounts so paid
shall be considered to be coverage or benefits paid under this Agreement and, to the extent of such payments,
the Cooperative shall be fully discharged from liability under this Agreement.
G. RIGHT OF RECOVERY: Whenever benefits have been provided by the Cooperative with respect to
Allowable Expenses in total amount, at any time, in excess of the maximum amount of payment necessary at
that time to satisfy the intent of this provision, the Cooperative shall have the right to recover the reasonable
cash value of such benefits,to the extent of such excess,from one or more of the following,as the Cooperative
shall determine: any persons to or for or with respect to whom such benefits were provided, any other insurers,
any service plans or any other organization or other Plans.
H. EFFECT ON BENEFITS:
1. This provision shall apply in determining the benefits for a person covered under this Agreement for a
particular Claim Determination Period if, for the Allowable Expenses incurred as to such person during
such period,the sum of:
a. The reasonable cash value of the benefits that would be provided under the Agreement in the absence
of this provision,and
b. The benefits that would be payable under all other Plans in the absence therein or provisions of similar
purpose to this provision would exceed such Allowable Expenses.
2. As to any Claim Determination Period with respect to which this provision is applicable, the reasonable
cash value of the benefits provided under this Agreement in the absence of this provision for the Allowable
Expenses incurred as to such person during such Claim Determination Period shall be reduced to the extent
necessary so that the sum of the reasonable cash value of benefits and all benefits payable for such
Allowable Expenses under all other Plans,except as provided in subparagraph(3)of this Section,shall not
exceed the total of such Allowable Expenses. Benefits payable under another Plan include benefits that
would have been payable had a claim been duly made therefor. In determining liability under this
paragraph,the Plan is not required, and will not take into consideration, deductibles, copayments, or other
cost-sharing provisions.
3. If
0036900-003046 14
s A ►
a. another Plan which is involved in subparagraph (2) of this Section and which contains a provision
coordinating its benefits with those of this Agreement would, according to its rules, determine its
benefits after the benefits of this Plan have been determined;and
b. the rules set forth in subparagraph (4) of this Section would require this Agreement to determine its
benefits before such other Plan,then the benefits of such other Plan will be ignored for the purposes of
determining the benefits under this Agreement.
4. For the purposes of subparagraph (3) of this Section, the rules establishing the order of benefit
determination are:
a. The benefits of a Plan which covers the person on whose expenses a claim is based other than as a
dependent shall be determined before the benefits of a Plan which covers such person as a dependent.
b. In the case that a dependent is covered under both parents'medical Plan,the benefits of the Plan of the
parent whose birthday falls earlier in the year are determined before those of the Plan of a parent
whose birthday falls later in the year. This birthdate will refer only to the month and day, not the year
in which a person was bom. If both parents have the same birthday, the benefits of the Plan which
covered the parent longer are determined before those that covered the other parent for a shorter period
of time,except that in the case of a person for whom claim is made as a dependent child,
i. when the parents are separated or divorced and the parent with custody of the child has not
remarried,the benefits of a Plan which covers the child as a dependent of the parent with custody
of the child will be determined before the benefits of a Plan which covers the child as a dependent
of the parent without custody;and
ii. when the parents are divorced and the parent with custody of the child has remarried,the benefits
of a Plan which covers the child as a dependent of the parent with custody shall be determined
before the benefits of a Plan which covers that child as a dependent of the stepparent, and the
benefits of a Plan which covers that child as a dependent of the stepparent will be determined
before the benefits of a Plan which covers that child as a dependent of the parent without custody.
Notwithstanding items (i) and (ii) above, if there is a court decree which would otherwise establish
financial responsibility for the medical, dental or other health care expenses with respect to the child,
the benefits of a Plan which covers the child as a dependent of the parent with such financial
responsibility shall be determined before the benefits of any other Plan which cover the child as a
dependent child.
c. When rules(a)and(b)do not establish an order of benefit determination,the benefits of a Plan which
has covered the person on whose expenses claim is based for the longer period of time shall be
determined before the benefits of a Plan which has covered such person the shorter period of time,
provided that:
i. The benefits of a Plan covering the person on whose expenses claim is based as a laid off or
retired employee, or dependent of such person shall be determined after the benefits of any other
Plan covering such person as an employee, other than a laid off or retired employee,or dependent
of such person;and
ii. If either Plan does not have a provision regarding laid off or retired employees, which results in
each Plan determining its benefits after the other,then the provisions of(i)of this subsection shall
not apply.
d. If none of the above rules determines the order of benefits,the benefits of the Plan which covered an
employee or Subscriber for the longer period of time shall be determined before those of the Plan
which covered that person for the shorter time period.
0036900-CO3046 15
1k I k
5. When this provision operates to reduce the total amount of benefits otherwise to be provided to a person
covered under this Agreement during any Claim Determination Period, the reasonable cash value of each
benefit that would be provided in the absence of this provision shall be reduced proportionately, and such
reduced amount shall be charged against any applicable benefit limit of this Agreement.
Section VI. Subrogation
"Injured person" under this section means a Member covered by this Agreement who sustains compensable injury.
"GHC's medical expenses" means the expense incurred and the reasonable value of the services provided by the
Cooperative for the care or treatment of the injury sustained.
If the injured person was injured by an pct or omission of a third party giving rise to a claim of legal liability against
the third parry, GHC shall have the right to recover from the third parry GHC's medical expenses. This right is
commonly referred to as "subrogation."GHC shall be subrogated to and may enforce all rights of the injured person
to the extent of GHC's medical expenses. GHC's equitable and contractual rights of subrogation are limited(only as
required)by Washington law.
The injured person and his or her agents must cooperate fully with GHC in its efforts to collect GHC's medical
expenses. This cooperation shall include supplying GHC with information about any defendants and/or insurers
related to the injured person's claim.The injured person and his or her agents shall permit GHC,at GHC's option,to
associate with the injured patty or to intervene in any action filed against any third party.The injured person and his
or her agents shall do nothing to prejudice GHC's subrogation rights. The injured person shall not settle a claim
without protecting GHC's interest.
GHC shall be subrogated to and may enforce all rights of the injured person to the extent of its medical expense.
GHC's right of subrogation shall be limited to the excess of the amount required to fully compensate the injured
person for the loss sustained. Full compensation shall be measured on an objective, case-by-case basis, but is
subject to a presumption that a settlement which does not exhaust the third party's reachable assets is full
compensation to the injured person. If the Member fails to cooperate fully with GHC in recovery of medical
expenses as described above,the Member shall be responsible for reimbursing GHC for such medical expenses.
GHC shall not pay any attorney's fees or collection costs to attorneys representing the injured person where it has
retained its own legal counsel or acts on its own behalf to represent its interests and unless there is a written fee
agreement signed by GHC prior to any collection efforts. When reasonable collection costs have been incurred with
GHC's prior written agreement, to recover GHC's medical expenses, there shall be an equitable apportionment of
such collection costs between GHC and the injured person subject to a maximum responsibility of GHC equal to
one-third of the amount recovered on behalf of GHC.
Section VII Grievance Procedures
The Member Services Program is designed to help a Member resolve formal complaints and concerns about medical
and business service.GHC will record,research,and respond in a timely manner to a Member's concern.A concern
should initially be registered at the Member's area medical center. If not satisfied, the Member should then contact
the regional Member Services Department, which will arrange for review by appropriate Medical Staff,
management,and/or GHC consumers.A Member,or person responsible for the Member, shall have the opportunity
to appear before the grievance committee. If the Member is not satisfied with GHC's decision, the Member may
submit their concern to non-binding mediation. The mediation will be conducted by a mediator agreed upon by
both the Member and GHC.
For grievances following denial of claims for experimental/investigational procedures,see Section XI.A.
Section VIII Miscellaneous provisions
0036900-CO3046 16
A
A. DISSEMINATION OF INFORMATION. The Group is responsible for disseminating to Subscribers written
information concerning this Agreement which is provided by the Cooperative.
B. IDENTIFICATION CARDS. The Cooperative will furnish cards, for identification only, to all persons
enrolled under this Agreement.
C. ADMINISTRATION OF AGREEMENT. GHC may adopt reasonable policies and procedures to help in the
administration of this Agreement.
D. MODIFICATION OF AGREEMENT. Except as required by Washington state law,this Agreement may not
be modified without agreement between both parties..
E. Group Health Cooperative reserves the right to construe the provisions of this Medical Coverage Agreement,
and to determine any and all questions pertaining to benefit entitlement and coverage.
No oral statement of any person shall modify or otherwise affect the benefits, limitations,and exclusions of this
Agreement, convey or void any coverage, increase or reduce any benefits under this Agreement or be used in
the prosecution or defense of a claim under this Agreement.
F. INDEMNIFICATION. GHC agrees to indemnify and hold the Group harmless against all claims, damages,
losses, and expenses, including reasonable attorney's fees, arising out of GHC's failure to perform or negligent
performances of its express obligations under the Group Medical Coverage Agreement. GHC further agrees to
indemnify and hold the Group harmless against claims, damages, losses or expenses, including reasonable
attorney's fees, for injury or damage caused to any person which is the result of or is alleged to be the result of
the failure to provide or the negligent provision of medical services or supplies specified under this contract by
any health care provider who is employed by, is an agent of or who has a direct contractual relationship with
GHC.Provided,however,that the Group notifies GHC in writing promptly of any such claims,that it will assist
GHC (at GHC's expense) in the defense of same,and that GHC has the right to direct and arrange the defense
of the case.
The foregoing shall not in any way be construed as applying to any claim, demand or loss arising out of
negligent acts or omissions of the Group, its agents,officers or employees, or failure by the Group to carry out
any of its responsibilities under this Agreement.
G. The Medical Coverage Agreement is entered into and governed by the laws of Washington State, except as
otherwise pre-empted by ERISA and other Federal laws.
Group Health Cooperative of Puget Sound does not discriminate on the basis of physical or mental handicaps in
its employment practices and services.
Section IX Enrollment and Fligibilify Schedule
A. ENROLLMENT
1. Application for Enrollment. Application for enrollment shall be made on an application form furnished
and approved by GHC. No person shall be enrolled or dues accepted until this completed application has
been received and approved by GHC.The Group is responsible for submitting completed application forms
to GHC.
a. Newly Eligible Persons. Newly eligible Subscribers may make written application for enrollment to
the Group within thirty-one (31) days of eligibility. If the Subscriber wishes to enroll his/her eligible
Dependents,application must be made during this same thirty-one(31)day period.
0036900-003046 17
1.® I \
Written application for enrollment for a newly dependent person, other than a newborn or newborn
adopted child,must be made to the Group within thirty-one(31)days after the dependency occurs.
A Subscriber's newborn child shall be automatically enrolled when born:
i. at a GHC Facility or GHC Designated Facility;or
ii. at a non-GHC Facility due to an Emergency,provided that all the requirements of Section X.L. of
this Agreement are met, including notification of GHC by way of the GHC Notification Line
within twenty-four (24) hours following inpatient admission, or as soon thereafter as medically
possible.
GHC shall provide notice of such enrollment to the Subscriber and the Group. It is the Subscriber's
responsibility to complete and submit a revised application form to the Group. If the Subscriber does
not want the newborn child enrolled, he/she must notify GHC within sixty (60) days of the date of
birth.
If subsequent to enrollment it is discovered that the newborn child is not eligible or if the Group does
not initiate dues payments on or before sixty(60) days from the date of birth, GHC shall disenroll the
child retroactive to the effective date of coverage.
Children who are born in a non-GHC Facility on a nonemergency basis will not be automatically
enrolled. In the event there is a change in the monthly dues payment as a result of the addition of a
newborn child,the Subscriber must make written application for enrollment to the Group within sixty
(60)days following the date of birth.
In the event there is a change in the monthly dues payment as a result of the lition of an adoptive
child,including adopted newborns,the Subscriber must make written application. .,;: enrollment within
sixty(60)days from the day that the child is placed with the Subscriber for the purpose of adoption
and the Subscriber assumes financial responsibility for the medical expenses of the child.
b. If the spouse and/or eligible Family Dependents of a GHC Subscriber loses eligibility under a
comparable medical plan they may be added to the GHC Subscriber's plan. There must be no more than
a three (3) month lapse of coverage between plans, and application must be made prior to the
expiration of this three(3)month period.
c. Open Enrollment. A person not enrolled as a Subscriber or Family Dependent when newly eligible,
as described above,may make written application during the Group's Open Enrollment period.
2. Limitation on Enrollment. This Agreement will be open for application as set forth in Section IX.A.L
GHC may limit enrollment, establish quotas, or set priorities for acceptance of new applications if it
determines that its capacity, in relation to its total enrollment, is not adequate to provide services to
additional persons.
3. Effective Date of Enrollment.
a. Provided application is made as set forth in Section IX.A.I.a. (above),enrollment for a newly eligible
Subscriber and listed Dependents will begin on the date of hire.
Subscribers who return to work from a leave without pay status within ninety (90) days, shall be
eligible for enrollment on the first of the month following their date of return to work.
Enrollment for newly dependent persons,other than newborns and adopted children, will begin on the
first(1st)of the month following application.
0036900-003046 18
d A
Provided newborns are enrolled as specified in Section IX.A.La. (above), enrollment is effective from
the date of birth.
For adopted children, enrollment is effective from the date that the adopted child is placed with the
Subscriber for the purpose of adoption and the Subscriber has assumed financial responsibility for the
medical expenses of the child.
b. Persons Hospitalized on Effective Date. If a person, other than a newborn or adoptive child, is
confined in a hospital on the date enrollment would otherwise become effective, the effective date of
enrollment for the person(s)hospitalized will not begin until discharge from the facility.
4. Effective Date of Services and Benefits. Services provided to Enrollees,including newborns and adoptive
children, are subject to all terms and conditions of the Group Agreement including the requirement that all
services must be received at a GHC or GHC Designated Facility under the medical management of a GHC
Providerunless the Enrollee has been Referred by a GHC Provideror has received Emergency services
according to Section X.L.
B. ELIGIBILITY
In order to be accepted for enrollment and continuing coverage under the Group Agreement, individuals must
meet all applicable requirements set forth below.The Group is responsible for determining eligibility.
Subscribers and Family Dependents must reside in the GHC Service Area (as defined in Section I.)in order to
be eligible for enrollment under this Agreement, except for temporary residency outside the Service area for
purposes of attending school, court-ordered coverage for Dependents, or when approved in advance by GHC,
other unique family arrangements. All non-urgent/emergent care must be provided at GHC Facilities or GHC
Designated Facilities.
1. Subscribers.Bona fide employees and LEOFF II employees who are employed on a regularly scheduled
basis of not less than twenty(20)hours per week shall be eligible for enrollment.
Elected officials and council members shall be eligible for enrollment.
LEOFF I employees will not be covered under this plan.
2. Family Dependents.The Subscriber may enroll any of the following:
a. The Subscriber's legal spouse;
b. Unmarried dependent children who are under the age of twenty-one (21), provided they reside
regularly with the Subscriber or are chiefly dependent on the Subscriber for support and maintenance,
provided proof of suca dependency is furnished to GHC.
"Children" means the children of the Subscriber including adopted children, stepchildren, foster
children, children for whom the Subscriber has a qualified court order to provide coverage, and any
other children for whom the Subscriber is the legal guardian.
c. Enrollment may be extended past the limiting age for an unmarried person enrolled as a Family
Dependent on his/her twenty-first(21st)birthday if:
i. the Dependent is a full-time registered student at an accredited secondary school, college, or
university and under the age of twenty-three(23);or
ii. the Depende is totally incapable of self-sustaining employment because of a developmental
disability or -hysical handicap incurred prior to attainment of the limiting age as set forth in
0036900-003046 19
Section IX.B.2.b., or prior to attainment of the student limiting age as set forth in Section
IX.B.2.c., and is chiefly dependent upon the Subscriber for support and maintenance. Enrollment
for such a Dependent may be continued for the duration of the continuous total incapacity,
provided enrollment does not terminate for any other reason. Medical proof of incapacity and
proof of financial dependency must be furnished to the Cooperative upon request, but not more
frequently than annually after the two(2)year period following the Dependent's attainment of the
limiting age.
d. Dependents of LEOFF I employees are eligible for coverage under this contract.
e. Temporary Coverage for Ineligible Newborns. A child born to a covered Member which does not
otherwise qualify as an eligible dependent as set forth in this section will be entitled to the benefits set
forth in Section X.from Vi th through three(3)weeks of age. After three(3)weeks of age,no benefits
are available unless the newborn child qualifies as a Dependent and is enrolled under this Agreement.
All contract provisions, limitations, and exclusions will apply except Section IV. Continuation of
Coverage,Conversion, and Transfer.
In regard to temporary coverage, continuation of coverage benefits set forth in Section IV. will not
apply.
Ineligible Persons.GHC reserves the right to refuse enrollment to any person whose coverage under the Group
Agreement or any other Medical Coverage Agreement issued by Group Health Cooperative of Puget Sound has
been terminated for cause.
C. CONTINUATION OF ENROLLMENT
While on a group approved leave of absence, the Subscriber and listed Dependents will continue to receive
services and benefits under this Agreement for up to one hundred eighty(180) days,provided the employer or
Group continues to remit dues to GHC for the Subscriber and such Dependents.
While on a group approved leave of absence the Subscriber and listed Dependents can continue to be covered
under this Agreement, provided they remain eligible for coverage, such leave is in compliance with the
employer's established leave of absence policy consistently applied to all employees, the employer's leave
policy is in compliance with the Family and Medical Leave Act when applicable, and the employer or Group
continues to remit dues for the Subscriber and Dependents to the Cooperative.
D. PERSONS ENTITLED TO, OR ELIGIBLE TO PURCHASE MEDICARE. Except as defined by federal
regulations, all Members entitled to, or eligible to purchase Medicare must be enrolled in the GHC Medicare
Plan upon such entitlement or eligibility. A condition of coverage under the GHC Medicare Plan requires that a
Member be continuously fully qualified and enrolled fro the hospital (Part A)and medical (Part B)benefits, or
Part B only, available from the Social Security Administration, and sign any papers that may be required by
GHC or Medicare. Subscribers and covered dependents who are eligible for Medicare (as set forth below)
must, effective the date that Medicare would become the primary payor, enroll in Medicare Parts A & B, and
must participate in GHC's Medicare Plan. For purposes of this section, an individual shall be deemed eligible
for Medicare when he or she has the option to receive part A Medicare benefits, irrespective of whether the
individual elects to enroll in Part B coverage under the federal regulations. All applicable provisions of the
GHC Medicare Plan are fully set forth in the Medicare Endorsement(s)attached to this Agreement.
E. PERSONS AGE SIXTY-FIVE (65) OR OLDER WHO ARE NOT ENTITLED TO, OR ELIGIBLE TO
PURCHASE MEDICARE. Upon reaching age sixty-five (65), if not entitled to, or eligible to purchase
Medicare, Members may continue coverage under this Agreement upon payment of the applicable dues as set
forth in the Dues Schedule.
0036900-CO3046 20
s A
Section X. Schedule Of Benefits
Subject to all provisions of this Group Medical Coverage Agreement, including the Copayments and
Allowances Schedule, Members are entitled to receive the benefits and services that are Medically Necessary
for the treatment of a Medical Condition as determined by GHC's Medical Director or his/her designee, and
as described in this Schedule of Benefits.
A. HOSPITAL CARE
Hospital care is provided when approved by a GHC Provider, limited to the following services:
1. Room and board,including private room when prescribed,and general nursing services.
2. Hospital services(including use of operating room,anesthesia, oxygen,x-ray, laboratory,and radiotherapy
services).
3. As a cost-effective alternative in lieu of otherwise covered, Medically Necessary hospitalization or other
covered, Medically Necessary institutional care, alternative care arrangements may be covered.
Alternative care arrangements in lieu of covered hospital or other institutional care must be determined
appropriate and Medically Necessary based upon the patient's medical condition. Such determination of
medical appropriateness and necessity,and authorization of coverage must be made in advance by GHC.
For additional coverage,see Section X.E. Skilled Home Health Care Services and Section X.F.Hospice.
For Skilled Nursing benefits other than as set forth in this Section,see Section X.B.
4. Drugs and medications which are listed as covered in the GHC Drug Formulary(approved drug list).
5. Special duty nursing(when prescribed as Medically Necessary).
If a Member is hospitalized in a non-GHC Facility,GHC reserves the right to require transfer of the Member to
a GHC Facility, upon consultation with a GHC Provider. If the Member refuses to transfer to a GHC Facility,
all further costs incurred during the hospitalization are the responsibility of the Member.
B. MEDICAL AND SURGICAL CARE
Medical and surgical services are provided, limited to the following,when prescribed by a GHC Provider:
I. Surgical services.
2. Diagnostic x-ray,nuclear medicine,ultrasound,and laboratory services.
3. Family planning counseling services.
4. Hearing examinations to determine hearing loss.
5. Blood derivatives and the administration of blood and blood derivatives. The cost of blood is not covered.
6. Preventative services for health maintenance, including routine mammography screening, physical
examinations in accordance with criteria established by GHC for the detection of disease, and
immunizations and vaccinations which are listed as covered in the GHC Drug Formulary (approved drug
list). A fee may be charged for health education programs.
7. Radiation therapy services.
0036900-CO3046 21
8. The following services are covered by GHC wh:n performed by a GHC Provider or GHC oral surgeon:
reduction of a fracture or dislocation of the ja« : �icial bones; excision of tumors or non-dental cysts of
the jaw,cheeks, lips,tongue,gums,roof and fli of the mouth;and incision of salivary glands and ducts.
9. Nonexperimental implants,limited to the following:cardiac devices,artificial joints,and intraocular lenses.
Experimental artificial or mechanical hearts are excluded.
10. Respiratory therapy.
11. Dietary formula for the treatment of phenylketonuria (PKU) when determined Medically Necessary by
GHC's Medical Director, or his/her designee. Coverage for this formula is not subject to a Pre-existing
Conditions waiting period, if any.
Outpatient total parenteral nutritional therapy, when Medically Necessary and in accordance with medical
criteria as established by GHC, is covered including supplies necessary for its administration.
Outpatient elemental and over-the-counter enteral formulas for access problems or malabsorption are
covered as set forth in the Copayments and Allowances Schedule. Equipment and supplies for the
administration of enteral therapy is covered
Dietary formulas and special diets, except for treatment of phenylketonuria(PKU)and total parenteral and
enteral nutritional therapy as set forth above,are excluded.
12. Visits by GHC Providers(including consultations and second opinions by a GHC Provider)in the hospital
or office.
13. Diabetic supplies, including insulin syringes, lancets, urine-testing reagents, external insulin pumps,
diabetic monitoring equipment and blood glucose monitoring reagents are covered subject to the
prescription drug copayment,provided they are listed in the GHC drug formulary or listed as approved
GHC stock.
External insulin pumps and diabetic monitoring equipment are covered subject to the prescription drug
copayment.
14. Routine eye examinations and refractions are covered, limited to once every twelve (12) months, except
when Medically Necessary. Services for routine eye examinations must be received at a GHC Facility and
in accordance with GHC medical criteria in order to be covered.
Evaluations and surgical procedures to correct refractions which are not related to eye pathology are not
covered. Complications related to such surgery are also excluded.
Contact lens fittings and related examinations are not covered except as set forth below. Contact lens
examinations and fittings for eye pathology are provided in full. When dispensed through GHC Facilities,
one contact lens per diseased eye in lieu of an intraocular lens, including exam and fitting, is covered for
Members following cataract surgery performed by a GHC Provider, provided the Member has been
continuously covered by GHC since such surgery. Replacement of a covered contact lens will be provided
only when needed due to change in the Member's medical condition but may be replaced only one time
within any twelve(12)month period.
15. Maternity care,including care for complications of pregnancy and prenatal and postpartum visits.
Prenatal testing for the detection of congenital and heritable disorders when Medically Necessary as
determined by GHC's Medical Director,or his/her designee.
0036900-003046 22
Hospitalization and delivery services and voluntary (not medically indicated and non-therapeutic)
termination of pregnancy are not covered unless indicated in the next paragraph of this section.
Additional Maternity Care Services
Hospitalization and delivery, including home births for low risk pregnancies when approved in advance
and provided by a GHC Provider,is covered.
Voluntary (not medically indicated and nontherapeutic) or involuntary termination of pregnancy is
covered.
16. Transplants. When authorized as medically appropriate by GHC's Medical Director or his/he- designee,
and in accordance with criteria established by the Cooperative, for heart, heart-lung, single lung, double
lung, kidney, simultaneous pancreas/kidney, cornea, bone marrow, and liver transplants, limited to the
following:
• evaluation testing to determine recipient candidacy;
• transplantation, limited to costs for the surgery and hospitalization related to the transplant, and
medications;and
• follow-up services for specialty visits,re-hospitalization,and maintenance medications.
High dose chemotherapy and stem cell (obtained from the peripheral blood or marrow as medically
appropriate) support is covered when authorized as medically appropriate by GHC's Medical Director, or
his/her designee.
Transportation expenses,except as set forth under Section X.M. of this Agreement,and living expenses are
excluded.
Donor costs for a covered organ recipient are covered,limited to procurement center fees,travel costs for a
surgical team, excision fees, and matching tests. GHC shall exclude coverage for donor costs to the extent
that the donor costs are reimbursable by the organ donor's insurance.
Except for children who have been continuously enrolled at GHC since birth, coverage for all transplants
and any related services, items, and drugs shall be excluded until such time as the Member has been
continuously enrolled under this Agreement, or any pri GHC Medical Coverage Agreement, for twelve
(12) consecutive months without any lapse in coverage, unless the Member requires a transplant as the
result of a condition which had a sudden unexpected onset after the Member's effective date of coverage.
17. Self-referrals for manipulative therapy of the spine and extremities limited to one evaluation and ten (10)
spinal manipulations only when provided by GHC Provider,are covered up to a maximum of 10 visits per
calendar year,subject to the office visit Copayment.
The medical necessity for manipulative therapy must meet GHC protocol. Excluded are services not
included in GHC protocol, including, but not limited to,supportive care rendered primarily to maintain
the level of correction already achieved, care rendered primarily for the convenience of the Member, or
care rendered on a non-acute,asymptomatic basis.
18. Medical and surgical services and related hospital charges, including orthognathic (jaw) surgery for the
treatment of temporomandibular joint (TMJ) disorders, are covered as set forth in the Copayments and
Allowances Schedule when determined to be Medically Necessary and referred in advance by GHC. Such
disorders may exhibit themselves in the form of pain,infection,disease,difficulty in speaking,or difficulty
in chewing or swallowing food. TMJ appliances are covered as set forth under orthopedic appliances
(Section X.H.1.).
0036900-CO3046 23
Orthognathic(jaw)surgery, radiology services and TMJ specialist services, including fitting/adjustment of
splints, is subject to the benefit limit set forth in the Copayments and Allowances Schedule.
The following services including related hospitalizations,are excluded regardless of origin or cause:
• orthognathic(jaw)surgery in the absence of a TMJ diagnosis,
• treatment for cosmetic purposes,and
• all dental services(except as noted above),including orthodontic therapy.
19. When authorized as medically appropriate by GHC's Medical Director, or his/her designee, and in
accordance with criteria established by the Cooperative, treatment of growth disorders by growth
hormones.
Growth hormone treatment shall be excluded until such time as the Member has been continuously
enrolled under this Agreement or any prior GHC Medical Coverage Agreement for twelve(12)consecutive
months without any lapse in coverage.
20. Diabetic training and education.
21. Pre-existing conditions are covered in the same manner as any other illness.
22. Skilled Nursing Facility care in a GHC-approved skilled nursing facility up to a maximum of thirty (30)
days per condition when full-time skilled nursing care is necessary in the opinion of the attending GHC
Provider.
When prescribed by a GHC Provider,such care may include board and room; general nursing care; drugs,
biologicals, supplies, and equipment ordinarily provided or arranged by a skilled nursing facility; and
short-term physical therapy,occupational therapy,and restorative speech therapy.
Excluded from coverage are personal comfort items such as telephone and television; and rest cures,
custodial,domiciliary or convalescent care.
C. CHEMICAL DEPENDENCY TREATMENT
Subject to all terms and conditions of this Agreement, care is provided as set forth below at a GHC Facility,
GHC Designated Facility, or GHC-approved treatment facility, subject to the Benefit Period Allowance and
Lifetime Maximum Benefit as described below and as shown in the Copayments and Allowances Schedule.
1. Chemical Dependency Treatment Services.
a. All alcoholism and/or drug abuse treatment services must be: (1) provided at a facility as described
above and must be authorized in advance, except for acute chemical withdrawal as described in
Section X.C.2.b.; and (2) deemed Medically Necessary by GHC's ADAPT Director or his/her
designee. Chemical dependency treatment may include the following services received on an inpatient
or outpatient basis: diagnostic evaluation and education, organized individual and group counseling,
detoxification services,and prescription drugs and medicines.
b. Court-ordered treatment shall be provided only if determined to be Medically Necessary by GHC's
ADAPT Director or his/her designee.
2. Emergency Care.
a. Coverage for medical Emergencies incident to the abuse of alcohol and/or drugs is subject to the
Emergency care benefit as set forth in Section X.L.
0036900-CO3046 24
b. Coverage for acute chemical withdrawal is provided without prior approval. If a Member is
hospitalized in a non-GHC Designated Facility, coverage is subject to payment of the Deductible
shown in the Copayments and Allowances Schedule, and notification of GHC by way of the GHC
Notification Line within twenty-four(24)hours following inpatient admission,or as soon thereafter as
medically possible. Furthermore, if a Member is hospitalized in a non-GHC Designated Facility, GHC
reserves the right to require transfer of the Member to a GHC Facility upon consultation with a GHC
Provider. If the Member refuses transfer to a GHC Facility, all further costs incurred during the
hospitalization are the responsibility of the Member.
For the purpose of this section, "acute chemical withdrawal"means withdrawal of alcohol and/or drugs
from a person for whom consequences of abstinence are so severe as to require medical/nursing
assistance in a hospital setting, and which is needed immediately to prevent serious impairment to the
Member's health.
3. Benefit Period and Benefit Period Allowance.
a. Benefit Period. For the purpose of this section, "Benefit Period" shall mean a twenty-four (24)
consecutive calendar month period during which the Member is eligible to receive covered chemical
dependency treatment services as set forth in this section. The first Benefit Period shall begin on the
first day the Member receives covered chemical dependency services under this or any other group
insurance, health care service contractor, health maintenance organization, self-insured plan or any
combination thereof, hereinafter referred to as "group plans," and shall continue for twenty-four(24)
consecutive calendar months, provided that coverage under this Agreement remains in force. All
subsequent Benefit Periods thereafter will begin on the first day Covered Services are received after
expiration of the previous twenty-four(24)month Benefit Period.
b. Benefit Period Allowance. The maximum allowance available for any Benefit Period shall be the
total of all chemical dependency benefits provided and payments made for chemical dependency
treatment under any group plan(s), not to exceed the Benefit Period Allowance shown in the
Copayments and Allowances Schedule during the Member's Benefit Period.
4. Lifetime Maximum Benefit.
Chemical dependency services are not covered after the Member has reached his/her Lifetime Maximum
Benefit amount as shown in the Copayments and Allowances Schedule. All such benefits provided or
payments made by:
a. GHC under any GHC Group Medical Coverage Agreement,plus
b. all amounts paid on an individual's behalf under any carrier or plan maintained by the Group,
including self-insured plans,shall be applied toward this Lifetime Maximum Benefit amount.
Any Deductibles or Copayments which may be home by the Member under the terms of this Agreement shall
not be applied toward the Benefit Period Allowance or Lifetime Maximum Benefit.
In regard to this section, the Benefit Period(s), Benefit Period Allowance(s), and Lifetime Maximum Benefit
shall include only alcoholism treatment services received on or after January 1, 1987 and alcoholism and/or
drug abuse services received on or after January 1, 1988.
D. PLASTIC AND RECONSTRUCTIVE SERVICES are covered:
1. to correct a congenital disease or congenital anomaly as determined by a GHC Provider; or to correct a
Medical Condition following an injury or incidental to surgery covered by GHC which has produced a
major effect on the Member's appearance,provided:
• the Member has been continuously enrolled with GHC since the date of such injury or surgery;and
0036900-003046 25
, ® A
when in the opinion of a GHC Provider, such services can reasonably be expected to correct the
condition.
In the case of a congenital condition which affects appearance,an anomaly will be considered to exist if the
Member's appearance resulting from such condition is not within the range of normal human variation.
Complications of noncovercd surgical services arc excluded.
2. for reconstructive surgery and associated procedures following a mastectomy, regardless of when the
mastectomy was performed. Internal breast prostheses required incident to the surgery will be provided.
A Member will be covered for all stages of one reconstructive breast reduction on the nondiseased breast to
make it equivalent in size with the diseased breast after definitive reconstructive surgery on the diseased
breast has been performed.
3. for women who have not undergone breast reconstruction,external breast prostheses following mastectomy
and post-mastectomy bras limited to one external breast prosthesis per diseased breast every two years,and
two post-mastectomy bras every six (6) months, up to four (4) in any twelve (12) consecutive month
period. Coverage for post-mastectomy bras is subject to the Coinsurance as set forth in the Copayments
and Allowances Schedule.
E. HOME HEALTH CARE SERVICES, as set forth in this section, shall be provided by GHC Home Health
Services or by a GHC-authorized home health agency when Referred in advance by a GHC Provider for
Members who meet the following criteria:
1. The Member is unable to leave home due to his or her health problem or illness (unwillingness to travel
and/or arrange for transportation does not constitute inability to leave the home);
2. the Member requires intermittent Skilled Home Health Care services,as described below;and
3. a GHC Provider has determined that such services are Medically Necessary and are most appropriately
rendered in the Member's home.
Covered Services for home health care may include the following when prescribed by a GHC Provider and
when rendered pursuant to an approved home health care plan of treatment: nursing care, physical therapy,
occupational therapy, respiratory therapy, restorative speech therapy, and medical social worker and limited
home health aide services. Home health services are provided on an intermittent basis in the Member's home.
"Intermittent" means care that is to be rendered because of a medically predictable recurring need for Skilled
Home Health Care services.
Excluded are: custodial care and maintenance care, private duty or continuous nursing care in the Member's
home, housekeeping or meal services, care in any nursing home or convalescent facility, any care provided by
or for a member of the patient's family,and any other services rendered in the home which are not specifically
listed as covered under this Agreement.
F. HOSPICE
It is understood and agreed that the following fully sets forth the eligibility requirements and Covered Services
for a Member who elects to receive services through GHC's Hospice Program. Members who elect to receive
GHC Hospice Services do so in lieu of curative treatment for their terminal illness for the period that
they are in the GHC Hospice Program.
Hospice Program
0036900-003046 26
I
1. Eligibility.Hospice Services,as set forth below,shall be provided to Members for as long as the following
criteria are met:
a. A GHC Provider has determined that the Member's illness is terminal and life expectancy is six (6)
months or less;
b. the Member has chosen a palliative treatment focus (emphasizing comfort and supportive services
rather than treatment aimed at curing the Member's terminal illness);
c. the Member has elected in writing to receive hospice care through GHC's Hospice Program;
d. the Member has available a primary care person who will be responsible for the Member's home care;
and
e. a GHC Provider and GHC's Hospice Director determine that the Member's illness can be appropriately
managed in the home.
2. Hospice care shall be defined as a coordinated program of palliative and supportive care for dying persons
by an interdisciplinary team of professionals and volunteers centering primarily in the Member's home.
3. Covered Services. Hospice services may include the following as prescribed by a GHC Provider and
rendered pursuant to an approved hospice plan of treatment:
a. Home Services
i. Intermittent care by a hospice interdisciplinary team which may include services by a physician,
nurse, medical .vcial worker, physical therapist, speech therapist, occupational therapist,
respiratory therapist, and limited services by a Home Health Aide under the supervision of a
Registered Nurse.
ii. One period of continuous care service per Member in the Member's home when prescribed by a
GHC Provider, as set forth in this paragraph. A continuous care period is defined as "skilled
nursing care provided in the home during a period of crisis in order to maintain the terminally ill
patient at home." Continuous care may be provided for pain or symptom management by a
Registered Nurse, Licensed Practical Nurse, or Home Health Aide under the supervision of a
Registered Nurse. Continuous care is provided for four(4) or more hours per day for a period not
to exceed five (5) days, or a total of seventy-two (72) hours, whichever first occurs. Continuous
care is covered only when a GHC Provider determines that the Member would otherwise require
hospitalization in an acute care facility.
b. Inpatient Hospice Services shall rr provided in a facility designated by GHC's Hospice Program
when Medically Necessary and autnorized in advance by a GHC Provider and GHC's Hospice
Program. Inpatient hospice services shall be provided according to the provisions set forth in Section
X. of this Agreement.
4. Hospice Exclusions:All services not specifically listed as covered in this section including:
a. Financial or legal counseling services.
b. Housekeeping or meal services.
c. Custodial or maintenance care in the home or on an inpatient basis.
d. Services not specifically listed as covered by this Medical Coverage Agreement.
e. Any services provided by members of the patient's family.
f. All other exclusions listed in Section XI., Exclusions and Limitations of this Medical Coverage
Agreement,apply.
G. REHABILITATION SERVICES are covered as set forth in this section, limited to the following: physical
therapy; occupational therapy; and speech therapy to restore function following illness, injury, or surgery.
Services are subject to all terms,conditions,and limitations of this Agreement,including the following:
0036900-003046 27
1. All services must be provided at GHC or a GHC-approved rehabilitation facility and must be prescribed
and provided by a GHC-approved rehabilitation team that may include medical, nursing, physical therapy,
occupational therapy,massage therapy and speech therapy providers.
2. The Member must be referred for rehabilitation services in advance by a GHC Provider.
3. Services are limited to those necessary to restore or improve functional abilities when physical,
sensori-perceptual and/or communication impairment exists due to injury or illness. Such services are
provided only when GHC's Medical Director, or his/her designee, determines that significant, measurable
improvement to the Member's condition can be expected within a sixty(60)day period as a consequence of
intervention by covered therapy services described in paragraph one(1)above.
4. Coverage for inpatient and outpatient services is limited to the allowance set forth in the Copayments and
Allowances Schedule.
Services excluded under this benefit include the following: specialty rehabilitation programs not provided by
GHC; long-term rehabilitation programs; physical therapy, occupational therapy, and speech therapy services
when such services are available (whether application is made or not) through governmental programs;
programs offered by public school districts; therapy for degenerative or static conditions when the expected
outcome is primarily to maintain the Member's level of functioning(except for neurodevelopmental therapies);
recreational life-enhancing relaxation or palliative therapy; implementation of home maintenance programs;
programs for treatment of learning problems;any other treatment not considered Medically Necessary by GHC;
any services not specifically included as covered in this Section; and any services that are excluded under
Section XI.
Neurodevelopmental Therapies for Children Age Six (6) and Under. When determined to be Medically
Necessary by GHC's Medical Director, or his/her designee,physical therapy, occupational therapy, and speech
therapy services for the restoration and improvement of function for neurodevelopmentally disabled children
age six (6) and under shall be covered. Coverage includes maintenance of a covered Member in cases where
significant deterioration in the Member's condition would result without the services. Coverage for inpatient
and outpatient services is limited to the allowance set forth in the Copayments and Allowances Schedule.
Services excluded under this benefit include: specialty rehabilitation programs; long-term rehabilitation
programs;physical therapy, occupational therapy,and speech therapy services when such services are available
(whether application is made or not) through governmental programs; programs offered by public school
districts; except as set forth above,therapy for degenerative or static conditions when the expected outcome is
primarily to maintain the Member's level of functioning; implementation of home maintenance programs; any
treatment not considered Medically Necessary;any services not specifically included as covered in this Section;
and any services that are excluded under Section XI.
H. APPLIANCES,DEVICES AND SUPPLIES
1. Orthopedic Appliances. When Medically Necessary, orthopedic appliances, which are attached to an
impaired body segment for the purpose of protecting the segment or assisting in restoration or
improvement of its function, are covered. Medically Necessary repair, adjustment or replacement of an
orthopedic appliance is covered when authorized in advance by a GHC Provider. Covered Services are
subject to the Coinsurance set forth in the Copayments and Allowances Schedule. Excluded are arch
supports including custom shoe inserts and their fittings except for therapeutic shoe inserts for severe
diabetic foot disease; orthopedic shoes that are not attached to an appliance; or any orthopedic appliances
that are not listed as covered in GHC's Orthopedic Appliance Formulary.
2. Ostomy Supplies.Ostomy supplies necessary for the removal of bodily secretions or waste are covered.
0036900-CO3046 28
3. Oxygen and Oxygen Equipment. When medical criteria as established by GHC are met, and upon
Referral,oxygen and oxygen equipment for home use is covered.
4. Nasal CPAP Device. When Medically Necessary, the purchase of a nasal CPAP device, and the initial
purchase of associated supplies, is covered. The initial one-month rental of the device prior to purchase,
which is required to establish compliance, is also covered. Medically Necessary repair or replacemew of a
nasal CPAP device is covered when authorized in advance by a GHC Provider. Covered Services are
subject to the Coinsurance as set forth in the Copayments and Allowances Schedule. Coverage for
replacement of supplies is excluded.
Replacement or repair of appliances, devices and supplies that are due to loss, breakage from willful damage,
neglect or wrongful use,or due to personal preference are excluded.
I. TOBACCO CESSATION. When provided through GHC, services related to tobacco cessation are covered,
limited to:
1. participation in one individual or group program per calendar year;
2. educational materials;and
3. one course of nicotine replacement therapy per calendar year, provided the Member is actively
participating in the Group Health Free and Clear Program.
Covered Services are subject to the Allowances set forth in the Copayments and Allowances Schedule.
J. LEGEND (PRESCRIPTION) DRUGS AND MEDICINES FOR OUTPATIENT USE as prescribed by a
GHC Provider for conditions covered by this Agreement, including off-label use of FDA-approved drugs
(provided that such use is documented to be effective in one of the standard reference compendia; a majority of
well-designed clinical trials published in peer-reviewed medical literature document improved efficacy or
safety of the agent over standard therapies, or over placebo if no standard therapies exist; or by the federal
secretary of Health and Human Services).
All drugs, supplies, medicines, and devices must be obtained at a GHC pharmacy. The prescription drug
copayment as set forth in the Copayments and Allowances Schedule applies to each 30-day supply.
Copayments for single and multiple 30-day supplies of a given prescription are payable at the time of delivery.
"Standard reference compendia" means the American Hospital Formulary Service-Drug Information; the
American Medical Drug Evaluation; the United States Pharmacopoeia-Drug Information,or other authoritative
compendia as identified from time to time by the federal secretary of Health and Human Services. "Peer-
reviewed medical literature" means scientific studies printed in healthcare journals or other publications in
which original manuscripts are published only after having been critically reviewed for scientific accuracy,
validity,and reliability by unbiased independent experts. Peer-reviewed medical literature does not include in-
house publications of pharmaceutical manufacturing companies.
Excluded are: over-the-counter drugs, medicines, and devices not requiring a prescription under state law or
regulations; dietary formulas and special diets, except as set forth in Section X.B.; contraceptive drugs and
devices and their fitting unless otherwise noted in this section; medicines and injections for anticipated illness
while traveling; and any other drugs, medicines and injections not listed as covered in the GHC Drug
Formulary(approved drug list).
The Member will be charged for replacing lost or stolen drugs,medicines or devices.
K. MENTAL HEALTH CARE SERVICES
1. Outpatient Services.Mental health care services are provided on an outpatient basis at GHC in individual,
family, couple, and group therapy formats. Services provided place priority on restoring social and
0036900-003046 , 29
Milk I
occupational functioning,such as evaluation,crisis intervention,managed psychotherapy, intermittent care,
psychological testing, and consultation services. The length and type of the treatment program and the
frequency and modality of visits shall be determined by the Director of GHC's Mental Health Service, or
his/her designee.
Coverage for each Member is provided according to the Outpatient Mental Health Care Allowance set
forth in the Copayments and Allowances Schedule. Psychiatric medical services including medical
management and medications are covered as set forth in Sections X.B. and X.J. All individual, family,
couple, and group visits of one and one-half (1-1/2) hours or less are regarded as one full visit per
individual. A missed appointment will be considered a "visit" unless GHC's Mental Health Service is
notified at least twenty-four(24)hours in advance of a scheduled session.
2. Inpatient Services. Usual, Customary, and Reasonable charges for services described in this section,
including psychiatric Emergencies resulting in inpatient services, shall be covered to the maximum benefit
as set forth in the Copayments and Allowances Schedule. This benefit shall include coverage for acute
treatment and stabilization of psychiatric emergencies in GHC-approved hospitals. When medically
indicated, outpatient electro-convulsive therapy(ECT) is covered in lieu of inpatient services. Payment of
bills incurred at non-GHC facilities shall exclude any charges that would otherwise be excluded for
hospitalization within a GHC Facility.
When authorized in advance by the Director of GHC's Mental Health Service, or his/her designee, partial
hospitalization and outpatient electro-convulsive therapy programs are covered subject to the maximum
inpatient benefit limit described in the Copayments and Allowances Schedule. Every two (2) partial
hospitalization days or two (2) electro-convulsive therapy treatments are equivalent to one inpatient
hospital day. The total maximum annual benefit under this section shall not exceed the number of inpatient
days described in the Copayments and Allowances Schedule.
Subject to the maximum Inpatient Mental Health Care Allowance as set forth in the Copayments and
Allowances Schedule, services provided under involuntary commitment statutes shall be covered at
facilities approved by GHC. Services for any court-ordered treatment program beyond the seventy-two
(72)hours shall be covered only if determined to be Medically Necessary by the Director of GHC's Mental
Health Service, or his/her designee.
Coverage for voluntary/involuntary Emergency inpatient psychiatric services is subject to the Emergency
care benefit as set forth in Section X.L., including the twenty-four (24) hour notification and transfer
provisions. All other voluntary psychiatric care must be authorized in advance by the Director of GHC's
Mental Health Service,or his/her designee;the facility must be approved by the Cooperative.All voluntary
care not authorized in advance by GHC's Mental Health Service is not covered.
3. Exclusions and Limitations for Outpatient and Inpatient Mental Health Treatment Services. Covered
Services are limited to those considered to be Medically Necessary by the Director of GHC's Mental Health
Service, or his/her designee. Covered Services are limited to those provided for covered conditions for
which, in the opinion of the Director of GHC's Mental Health Service,or his/her designee, improvement or
stabilization can be expected.
Partial hospitalization programs and electro-convulsive therapy are covered only under subsection K.2.
(Inpatient Services).
Excluded are all forms of extensive psychotherapy; day treatment; custodial care; treatment of sexual
disorders; specialty programs for mental health therapy which are not provided by GHC; court-ordered
treatment which is not specifically described above; or any other services not specifically listed as covered
in this section.All other provisions,exclusions and limitations under this Agreement also apply.
L. EMERGENCY/URGENT CARE
0036900-CO3046 30
Emergency Care(See Section I.for a definition of Emergency):
1. At a GHC Facility or GHC Designated Facility. GHC will cover Emergency care for all Covered
Services as set forth in the Copayments and Allowances Schedule.
2. At a Non-GHC Designated Facility. Usual, Customary, and Reasonable charges for Emergency care for
Covered Services are covered subject to:
a. payment of the Emergency Care Deductible shown in the Copayments and Allowances Schedule;
and
b. notification of GHC by way of the GHC Notification Line within twenty-four (24) hours
following inpatient admission,or as soon thereafter as medically possible.
Outpatient medications prescribed by a non-GHC Provider are excluded.
3. Waiver of Emergency Care Copayment/Deductible.
a. Waiver for Multiple Injury Accident. If two or more members of the Family Unit require
Emergency care as a result of the same accident, only one Emergency Care Copayment/Deductible
will apply.
b. Emergencies Resulting in an Inpatient Admission. If the Member is admitted to a GHC or GHC
Designated Facility directly from the emergency room. the Emergency Care Copayment is waived.
However,the first day's Hospital Care Copayment, if any,will be charged.
4. Transfer and Follow-up Care.If a Membe• !s hospitalized in a non-GHC Facility,GHC reserves the right
to require transfer of the Member to a Gr.. Facility, upon consultation with a GHC Provider. If the
Member refuses to transfer to a GHC Facility, all further costs incurred during the hospitalization are the
responsibility of the Member.
Follow-up care which is a direct result of the Emergency must be obtained at GHC,unless a GHC Provider
has authorized such follow-up care in advance.
Urgent Care(See Section I.for a definition of Urgent Condition):
5. Urgent Care. Care for Urgent Conditions received inside the GHC Service Area is covered only at GHC
medical centers, GHC urgent care clinics, or network providers' offices. Urgent care received at any
hospital emergency depar,rnent is not covered unless authorized in advance by a GHC Provider.
M. AMBULANCE SERVICES are covered as set forth below, provided that the service is authorized in advance
by a GHC Provider or meets the definition of an Emergency.(See Section I.)
1. Emergency Transport to a GHC Facility,GHC Designated Facility,or non-GHC Designated Facility.
Each Emergency is covered as set forth in the Copayments and Allowances Schedule.
2. GHC-Initiated Transfers.GHC-initiated non-emergent transfers to or from a GHC Facility is covered.
Section K Exclusions and Limitations
A. EXCLUSIONS
1. Blood for transfusions.
2. Unless otherwise noted as covered in Sections X.B., X.D., X.H., and X.I., corrective appliances and
artificial aids including: eyeglasses; contact lenses, including services related to their fitting; prosthetic
devices; hearing aids and examinations in connection therewith; take-home dressings and supplies
0036900-CO3046 31
® I k
following hospitalization;or any other supplies,dressings,appliances,devices or services which are not for
the specific treatment of disease or injury,or not specifically listed as covered in Section X.
3. Cosmetic services, including treatment for complications of cosmetic surgery, except as provided in
Section X.D.
4. Convalescent or custodial care, including skilled nursing facility care,unless otherwise noted in Section X.
5. Durable medical equipment such as hospital beds, wheelchairs, and walk-aids, except while in the hospital
or as set forth in Section X.B.or X.H.
6. Services rendered as a result of work-incurred injuries, illnesses or conditions.
7. Those parts of an examination and associated reports and immunizations required for employment(unless
otherwise noted in Section X.B.), immigration, license, travel, or insurance purposes that are not deemed
Medically Necessary by GHC for early detection of disease.
8. Procedures,services,and supplies related to sex transformations.
9. Re:=ardless of origin or cause, diagnostic testing and medical treatment of sterility, infertility, and sexual
dys unction,unless otherwise noted in Section X.B.
10. Services of practitioners whose licensing category is not represented by GHC Medical Personnel, unless
otherwise noted in Section X.B.
11. Services directly related to obesity,except for nutritional counseling provided by GHC staff.
12. Any services to the extent benefits are available to the Member under the terms of any vehicle,
homeowner's,property or other insurance policy, except for individual or group health insurance,whether
the Member asserts a claim or not, pursuant to: (1) medical coverage, medical "no fault" coverage,
Personal Injury Protection coverage, or similar medical coverage contained in said policy; and/or (2)
uninsured motorist or underinsured motorist coverage contained in said policy. For the purpose of this
exclusion, benefits shall be deemed to be "available" to the Member if the Member is a named insured,
comes within the policy definition of insured, is a third-party donee beneficiary under the terms of the
policy,or otherwise has the right to receive benefits under the policy.
The Member and his or her agents must cooperate fully with GHC in its efforts to enforce this exclusion.
This cooperation shall include supplying GHC with information about any available insurance coverage.
The Member and his or her agents shall permit GHC at GHC's option,to associate with the Member or to
intervene in any action filed against any party related to the injury. The Member and his or her agents shall
do nothing to prejudice GHC's right to enforce this exclusion.
GHC shall not enforce this exclusion as to coverage available under uninsured motorist or underinsured
motorist coverage until the Member has been made whole,unless the Member fails to cooperate fully with
GHC as described above. In the event the Member fails to cooperate fully, the Member shall be
responsible for reimbursing GHC for such medical expenses.
GHC shall not pay any attorneys' fees or collection costs to attorneys representing the injured person where
it has retained its own legal counsel or acts on its own behalf to represent its interests and unless there is a
written fee agreement signed by GHC prior to any collection efforts.
13. Services or supplies not specifically listed as covered in the Schedule of Benefits.
14. Voluntary (not medically indicated and nontherapeutic) termination of pregnancy, unless otherwise noted
in Section X.B.
0036900-CO3046 32
® I \
15. The cost of services and supplies resulting from a Member's loss of or willful damage to covered
appliances, devices, supplies, and materials provided by GHC for the treatment of disease, injury, or
illness.
16. Routine circumcision, including newborn circumcision,which is not considered Medically Necessary.
17. Orthoptic(eye training)therapy.
18. Specialty treatment programs that are not provided by GHC including weight reduction,rehabilitation, and
"behavior modification programs."
19. Services required as a result of war,whether declared or not declared.
20. Nontherapeutic sterilization (unless otherwise noted in Section X.B.) and procedures and services to
reverse a therapeutic or nontherapeutic sterilization.
21. Dental care, surgery, services, and appliances, including: treatment of accidental injury to natural teeth,
reconstructive surgery to the jaw incident to denture wear, dental implants, periodontal surgery, and any
other dental services not specifically listed as covered in Section X. The Cooperative's Medical Director,
or his/her designee, will determine whether the care or treatment required is within the category of dental
care or service.
If a GHC Provider determines that an unrelated medical condition requires that a Member be hospitalized
for a dental procedure which is normally done in a dentist's office, GHC will cover associated hospital and
anesthesia costs at a GHC or GHC Designated Facility. GHC will not cover the dentist's or oral surgeon's
fees.
22. Drugs, medicines, and injections, except as set forth in Section X.J. Any exclusion of drugs, medicines,
and injections, including those not listed as covered in the GHC Drug Formulary(approved drug list),will
also exclude their administration.
23. Investigational or experimental treatment, including medical and surgical services, drugs, devices and
biological products, until formally approved by GHC for medical coverage. GHC's determination shall be
made in accordance with criteria for determining investigational status as established by GHC as generally
outlined below. Specific indications and methods of use shall be considered in GHC's review of evidence
provided by evaluations of national medical associations, consensus panels, and/or other technological
evaluations, including the scientific quality of such supporting evidence and rationale. Any investigational
or experimental treatment, including medical and surgical services, drugs, devices and biological products
not meeting GHC's determination pursuant to its criteria as outlined below are excluded.
a. Investigational or experimental drugs, devices and biological products until clinical trials have been
completed and approved by the U.S. Food and Drug Administration (FDA) as being safe and
efficacious for general marketing and permission has been granted by the FDA for commercial
distribution;
b. there is sufficient scientific evidence in published medical literature to permit conclusions concerning
the effect of the treatment on health outcomes;
c. there is conclusive evidence in published peer-reviewed medical literature that the treatment will result
in a demonstrable benefit for the particular injury, disease or condition in question, and that the
benefits are not outweighed by risks;
d. evidence that the new treatment is as safe and effective as all existing conventional treatment
alternatives;and
e. that treatment will satisfy(c)and(d)outside of a research setting.
0036900-003046 33
s A k
Appeals regarding denial of coverage must be submitted to your regional Member Services Department, or
to GHC's Contracts and Coverag• Department at 1730 Minor Avenue, Suite 19'0. Seattle,.WA 98101.
GHC will respond in writing witlui:twenty(20)working days of the receipt of a fL documented request.
24. Mental health care,except as specifically provided in Section X.K.
25. See coverage for pre-existing conditions under Section X.B.
B. LIMITATIONS
1. Conditions and Extent of Coverage. ALL SERVICES AND BENEFITS UNDER THIS
AGREEMENT MUST BE PROVIDED BY GHC MEDICAL PERSONNEL AT A GHC FACILITY
UNLESS:
a. The Member has received a Referral from a GHC physician.
b. The Member has received Emergency services according to Section X.L.
2. Recommended Treatment. The Cooperative's Medical Director or his/her designee will determine the
necessity,nature,and extent of treatment to be provided in each individual case and the judgment,made in
good faith,will be final.
Members have the right to participate in decisions regarding their health care. A Member may refuse
recommended treatment or diagnostic plan to the extent perm z`red by law. In such case, GHC shall have no
further obligation to provide the care in question.Members w!.0 seek other sources of care because of such
a disagreement do so with the full understanding that GHC has no obligation for the cost,or liability for the
outcome,of such care.
3. Major Disaster or Epidemic. In the event of a major disaster or epidemic, GHC M,-�k... Personnel will
provide Covered Services according to their best judgment,within the limitations of a%atlable facilities and
personnel. The Cooperative has no liabilityy for delay or failure to provide or arrange Covered Services to
the extent facilities or personnel are unavailable due to a major disaster or epidemic.
4. Unusual Circumstances. If the provision of Covered Services is delayed or rendered impossible due to
unusual circumstances such as complete or partial destruction of facilities, military action, civil disorder,
labor disputes,or similar causes, GHC shall provide or arrange for services that, in the reasonable opinion
of GHC's Medical Director, or his/her designee, are emergent or urgently needed. In regard to nonurgent
and routine services, GHC shall make a good faith effort to provide services through its then-available
facilities and personnel. GHC shall have the option to defer or reschedule services that are not urgent or
routine while its facilities and services are so affected.In no case shall the Cooperative have any liability or
obligation on account of delay or failure to provide or arrange such services.
Section XII. Claims
Members must submit claims for reimbursement of Covered Services to GHC within sixty(60)days of the service
date, or as soon thereafter as is reasonably possible. In no event, except in the absence of legal capacity, shall a
claim be accepted later than one (1)year from the service date. This section applies to Covered Services received
under Section X.L.and X.M.,or services for which the Member has received a Referral from a GHC physician.
0036900-003046 34
Medicare
Endorsement
For Persons Covered by Parts A and B of Medicare
THE PROVISIONS OF THE GROUP MEDICAL COVERAGE AGREEMENT SHALL REMAIN IN EFFECT
EXCEPT AS MODIFIED BY THE ADDITION OF THE PROVISIONS, EXCLUSIONS, AND LIMITATIONS
CONTAINED IN THIS MEDICARE ENDORSEMENT. IN NO EVENT SHALL THE BENEFITS UNDER THIS
ENDORSEMENT DUPLICATE THE BENEFITS UNDER THE GROUP MEDICAL COVERAGE
AGREEMENT. THE HIGHER LEVEL OF BENEFIT WILL APPLY. COVERAGE UNDER THIS GROUP
MEDICAL COVERAGE AGREEMENT IS INTEGRATED WITH THE MEDICAL AND HOSPITAL BENEFITS
ESTABLISHED BY TITLE 18 OF TIIE SOCIAL SECURITY ACT AS AMENDED, AND REFERRED TO AS
"MEDICARE." THE BENEFITS AND EXCLUSIONS DESCRIBED IN THIS ENDORSEMENT APPLY ONLY
TO MEMBERS WHO ARE COVERED UNDER BOTH PART A AND PART B OF MEDICARE.
Except as defined by Federal Regulations,all Members entitled to,or eligible to purchase Medicare must transfer to
the GHC Medicare Plan upon such entitlement or eligibility. A condition of enrollment under the GHC Medicare
Plan requires that a Member be continuously enrolled for the hospital (Part A) and medical (Part B) benefits
available from the Social Security Administration, and sign any papers that may be required by GHC or Medicare.
For additional information,the Member may refer to"The Medicare Handbook,"which can be obtained from your
local Social Security office.
NEITHER GHC NOR MEDICARE MAY PAY FOR SERVICES PROVIDED AT NON-GHC FACILITIES
UNLESS THE MEMBER HAS BEEN REFERRED BY GHC OR THE MEMBER HAS RECEIVED
EMERGENCY OR URGENTLY NEEDED SERVICES ACCORDING TO SECTION V.D. OF THIS MEDICARE
ENDORSEMENT OR THE MEMBER HAS RECEIVED NON-EMERGENT AND/OR NON-URGENTLY
NEEDED CARE AT FACILITIES OUTSIDE THE SERVICE AREA ASSET FORTH IN SECTION V.D.
Those enrolled under GHC's Medicare plan,as set forth in this Endorsement, all Copayments are waived except the
prescription drug Copayment.
This Endorsement does not constitute a Medicare supplemental contract.
Section I. DEFINITIONS
CUSTODIAL CARE: Care that is primarily for the purpose of meeting personal needs and could be provided by
persons without professional skills or training. Custodial Care includes help in walking, bathing, dressing, eating,
and taking medicine.
EMERGENCY SERVICES(Medicare defined): Inpatient or outpatient services that are rendered immediately by
an appropriate non-GHC provider because of an injury or sudden illness, and for which the time required to reach
GHC or a GHC Designated Facility would risk permanent damage to the Member's health.
HEALTH CARE FINANCING ADMINISTRATION (HCFA): The federal agency that administers the
Medicare program.
MEDICARE: The federal health insurance program for the aged and disab
MEDICARE GUIDELINES: Coverage rules and policies established by t . -lealth Care Financing Administration
(HCFA),a federal agency.
0036900-CO3046 35
MEDICARE HANDBOOK (Titled "The Medicare Handbook"): A pamphlet published by the Health Care
Financing Administration, which provides an easy-to-read explanation of Medicare benefits, and can be obtained
from your local Social Security office,or your Washington State Part B carrier's office.
OUT OF THE SERVICE AREA ALLOWANCE. The maximum amount payable by GHC for non-emergent
and/or non-urgently needed care received at facilities outside the Service Area This Allowance is set forth in the
Copayments and Allowances Schedule.
PERMANENT MOVE:An uninterrupted absence of more than ninety(90)days from GHC's Service Area.
REFERRAL: A written temporary referral agreement authorized in advance by a GHC physician and formally
approved in advance through GHC's Medicare medical coverage approval process,that entitles a Member to receive
Covered Services from a specified non-GHC health care provider. Entitlement to such services shall not exceed the
limits of the Referral and is subject to all terms and conditions of the Referral and this Agreement.
SERVICE AREA: The geographic area comprised of Island, King, Kitsap, Lewis, Pierce, San Juan, Skagit,
Snohomish,Thurston, and Whatcom Counties, and any other areas designated by GHC and approved by the Health
Care Financing Administration.(See Service Area Map.)
SKILLED NURSING FACILITY: A Medicare certified and licensed facility, as defined in Medicare regulations,
primarily engaged in providing skilled nursing care or rehabilitation and related services for which Medicare pays
benefits or qualifies to receive such approval.
URGENTLY NEEDED SERVICES (Medicare defined): Services needed in order to prevent a serious
deterioration of the Members health due to an unforeseen illness or injury while temporarily absent from GHC's
Service Area,and which cannot be delayed until-the Member returns to the Service Area.
USUAL,CUSTOMARY,AND REASONABLE: A term used to define the level of benefits which are payable by
GHC when expenses are incurred from a non-GHC physician or provider. Expenses are considered Usual,
Customary and Reasonable if (1) the charges are consistent with those normally charged by the provider or
organization for the same services or supplies; and(2)the charges are within the general range of charges made by
other providers in the same geographical area for the same services or supplies.
Section II TERMINATION
Enrollment under the GHC Medicare Plan for a specific Member,may be terminated in the circumstances set forth
below.
Until such time as a Member's termination of enrollment is effective, neither GHC nor Medicare shall pay for
services provided at non-GHC Facilities unless the Member has been Referred by GHC or the Member has received
Emergency or Urgently Needed Services according to Section V.D.of this Medicare Endorsement.
A. Termination of Specific Members.
1. Loss of Medicare Part B Entitlement.If the Health Care Financing Administration(HCFA)advises GHC
that a Member's entitlement to Medicare coverage no longer exists, or the Member voluntarily terminates
Medicare enrollment, enrollment under the GHC Medicare Plan shall terminate the first of the month as
specified by HCFA.
2. Change of Permanent Residence Outside GHC's Service Area. If a Member makes a Permanent Move
as set forth in Section 1. of this Medicare Endorsement, enrollment shall terminate the first day of the
month following the month in which GHC receives notification of such move.
3. For Cause.Enrollment may be terminated upon written notice for:
0036900-CO3046 36
a. Knowingly providing fraudulent information to obtain coverage. In such event, GHC may rescind or
cancel enrollment upon ten(10)working days'written notice.
b. Permitting the use of a GHC identification card by another person.
c. Failure to comply with the rules and regulations of GHC including disruptive, unruly, abusive or
uncooperative conduct.
Such termination shall be subject to review and approval by HCFA.
B. Persons Hospitalized on the Date of Termination. A Member who is a registered bed patient receiving
Covered Services in a GHC Facility or GHC Designated Facility on the date of termination shall continue
to receive covered inpatient services, until discharge from the facility. This continued coverage will also
apply to a Member hospitalized in a Medicare-certified non-GHC Designated Facility as a result of
Emergency or Urgently Needed Services or Referral as set forth in Section VI.B. of this Medicare
Endorsement.
C. Services Provided After Termination. An. services provided by GHC after the effective date of
termination (except those services covered under Section II.B. of this Medicare Endorsement) shall be
charged according to the Directory of Services. The Subscriber shall be liable for payment of all such
charges for services provided to the Subscriber and all Family Dependents.
Section rTI SUBROGATION
"Injured . i" under this section means a Member covered by this Agreement who sustains compensable injury.
"GHC's .al expense"means the expense incurred by GHC for the care or treatment of the injury sustained.
If the injured person was injured by an act or omission of a third party giving rise to a claim of legal liability against
the third party, GHC shall have the right to recover its cost of providing benefits to the injured person(subrogation)
from the third party as set forth in this Agreement and in compliance with Medicare regulations and guidelines.
GHC shall be subrogated to and may enforce all rights of the injured person to the extent of its medical expense.
After Medicare laws and regulations mandating recovery of Medicare payments have been satisfied, the
Cooperative's right of subrogation shall be limited to the excess of the amount required to fully compensate the
injured person for the loss sustained.Full compensation shall be measured on an objective,case-by-case basis,but is
subject to a presumption that a settlement which does not exhaust the third party's reachable assets is full
compensation to the injured person.
The injured person and his or her agents must cooperate fully with Gh in its efforts to collect GHC's medical
expenses. This cooperation shall include, but is not limited to, supplying GHC with information about any
defendants and/or insurers related to the injured person's claim. The injured person and his or her agents shall permit
GHC, at GHC's option,to associate with the injured party or to intervene in any action filed against any third party.
The injured person and his or her agents shall do nothing to prejudice GHC's subrogation rights. The injured person
shall not settle a claim without protecting GHC's interest.
GHC shall not pay any attorney's fees or collection costs to attorneys representing the injured person where it has
retained its own legal counsel or acts on its own behalf to represent its interests and unless there is a written fee
agreement signed by GHC prior to any collection efforts. When reasonable collection costs have been incurred,with
GHC's prior written agreement, to recover GHC's medical expenses, there shall be an equitable apportionment of
such collection costs between GHC and the injured person subject to a maximum responsibility of GHC equal to
one-third of the amount recovered on behalf of GHC.
This provision does not apply to occupationally incurred disease,sickness,and/or injury.
Section IV,A AND IFVAN F PROCEDURES
Y
A. Grievances.
0036900-003046 �` 37
If a member is dissatisfied with care or services received at a Medical or Dental Office or Hospital, or a
Member disputes amounts owed, eligibility or membership status, the Member may submit a written
grievance to GHC. GHC will conduct a formal review and provide a written response within 60 days of the
time all pertinent materials are received.
B. Expedited Requests for Care or Service.
If a member requests care or a service they believe is covered by Medicare and the Member believes and/or
his/her physician states that a delay in making a determination about coverage could jeopardize the
Member's health or ability to function, the Member may request an expedited decision. In most instances,
GHC will reach a decision within 72 hours. GHC's decision may be delayed an additional 10 working days
if it is in the Member's best interest to delay a decision or upon the Member's request. GHC's decision may
also be postponed in the event information for a non-GHC provider has not been received in a timely
manner. If GHC denies a Member's request for an expedited decision, the standard process to review
requests will be utilized If a Member disagrees with GHC's decision not to expedite his/her request, the
Member may file a grievance.
C Appeals.
Members have a right to appeal any decision in which GHC declines to provide, cover, or pay for services
that the Member believes are covered by Medicare. If GHC declines to provide or to cover a service, GHC
will provide the Member with a Notice of Non-coverage containing the reasons) for the denial and an
explanation of the Member's appeal rights.
Members who disagree with the decision may submit a written appeal to GHC. Members may request either
a Standard (60-day) appeal or an Expedited (72-hour) appeal if the Member believes (or the Member's
Physician states)that a delay in responding to the Member's appeal could seriously jeopardize his/her health
or ability to function.
Appeals will be reviewed by persons not involved in the initial decision. If GHC decides to uphold the
original adverse decision, either in whole or in part, the entire file will be forwarded by GHC to HCFA for
review.
1. Standard(60-day)Appeal.
A member may submit an appeal requesting a second review at any time GHC denies coverage for
services already provided or arranged by either GHC or a non-GHC provider or facility, or for future
services. Member must submit appeals in writing to GHC,or to any Social Security Office,or in the case
of a railroad retirement annuitant, a Railroad Retirement Board Office, within 60 days of receiving
notice of GHC's initial decision. After receiving all pertinent materials, GHC will conduct a formal
review of the appeal. GHC will nottfy the Member of its decision within 60 days of receipt. If GHC
upholds any part of the initial denial, the entire file will be forwarded by GHC to HCFA for review.
HCFA will make a reconsideration decision and advise the Member or its decision, the reasons for the
decision and the right to additional appeal rights.
2. Filing an Expedited(72-hour)Appeal(does not apply to denied claims for payment).
f a delay in receiving a decision could jeopardize the Member's health or ability to function, the
Member or his/her Physician may submit a request for an expedited appeal either orally or in writing to
GHC. In most cases, GHC will make a determination within 72 hours of GHC's receipt of a Member's
request If GHC determines it is in the Member's best interest, or upon Member request, GHC may
extend the review period of an additional 10 working days. GHC's decision may also be delayed in the
event medical information for a non-GHC provider has not been received If the Member disagrees with
GHC's decision not to expedite his/her appeal,the Member may file a grievance.
0036900-003046 38
Ek Ad h
D. Immediate Peer Review Organization ("PRO')Review.
A Member may request immediate Peer Review Organization ("PRO') review if GHC denies coverage of a
continued inpatient stay in a hospital on the basis of medical necessity. A Member may request immediate
PRO review by phone or in writing. If a Member request PRO review by noon of the first business day after
a Member has received a Notice of Noncoverage, the Member will not be fmancially responsible for the cost
of the continued hospitalization until the PRO determination. GHC will provide the Member written notice
of procedures by which to request a PRO review. If a Member requests a PRO review,the Member may not
pursue the Standard Appeal Procedure and/or the Expedited Appeal Procedure with respect to denial of the
same hospital stay.
E. Additional Appeal Rights.
If HCFA upholds GHC's initial determination and denies the appeal and if the amount in controversy is
greater than $100.00, the Member may request a hearing before an administrative law judge of the Social
Security Administration. The Member may request a hearing before an administrative law judge by writing
to GHC, HCFA, or a Social Security Office within 60 days after the date of notice of an adverse
reconsideration decision.
If the administrative law judge denies a Member's appeal, either the Member or GHC may request a review by
the Social Security Administration's Appeals CounciC
If a Member's appeal is denied by the Appeals Council and if the amount in controversy is greater than
$1,000.00,the Member or GHC may request a review by a Federal District Court.
An initial, revised, or reconsideration determination made by GHC, HCFA, an administrative law judge, or the
Appeals Council can be reopened(a) within twelve months, (b) within four years for just cause, or(c) at any time
for clerical correction or in the case of fraud
The Medicare Appeals Coordinator can be reached by calling (206) 287-2204, toll free at 1-(888)-901-4600(ask
for 287-2204), by fax at (206) 442-2071, or by writing to Group Health Cooperative of Puget Sound, do
Medicare Appeals Coordinator,P.O.Box 34750,Seattle WA 98124-1750.
Section V. SCHEDULE OF BENEFITS
All benefits and services listed in this Schedule of Benefits:
• are subject to all provisions of this Agreement and Medicare Endorsement;
• must be approved in advance by GHC except for Emergency and Urgently Needed Services as set forth in
Section V.D. of this Medicare Endorsement;and
• must meet Medicare guidelines and limitations unless otherwise specified.
The booklet, "The Medicare Handbook" provides additional information about Medicare benefits, and can be
obtained from your local Social Security office,or your Washington State Part B carrier's office.
A. Skilled Nursing Facility. Upon Referral and following a Medicare-certified three (3) day hospital stay, GHC
will cover up to one hundred (100) days of care in a Skilled Nursing Facility, in accordance with Medicare
Guidelines,when Medically Necessary,as determined by GHC's Medical Director,or his/her designee.
B. Hospice.
Members with Part A and Part B of Medicare who elect to receive Medicare-covered hospice services may
select any Medicare-certified hospice program. Members who elect to receive services from the GHC Hospice
Program are entitled to hospice services as provided under the Medicare Hospice Program. Members who elect
0036900-CO3046 39
to receive hospice services do so in lieu of curative treatment for their terminal illness for the period that
they are in the hospice program.To receive hospice services,the Member is required to sign the Hospice
Election Form.
Covered Services. In addition to the hospice services provided under the Group Medical Coverage Agreement,
the following hospice services shall be provided:
1. Home Services
Continuous care services per Member in the Member's home when prescribed by a:GHC physician, as set
forth in this paragraph. Continuous care is defined as "skilled nursing care provided in the home during a
period of crisis in order to maintain the terminally ill patient at home." Continuous care may be provided
for pain or symptom management by a Registered Nurse, Licensed Practical Nurse, or Home Health Aide
under the supervision of a Registered Nurse. Continuous care may be provided up to twenty-four (24)
hours per day during periods of crisis. Continuous care is covered only when a GHC physician determines
that the Member otherwise would require hospitalization in an acute care facility.
2. Inpatient Hospice Services for short-term care shall be provided through a Medicare-certified Hospice
Program when Medically Necessary, and authorized in advance by a GHC physician. Respite care is
covered for a maximum of five (5) consecutive days per occurrence in order to continue care for the
Member in the temporary absence of the Member's primary care-giver(s).
3. Other hospice services may include the following:
a. drugs and biologicals that are used primarily for the relief of pain and symptom management;
b. medical appliances and supplies primarily for the relief of pain and symptom management;
c. counseling services for the Member and his/her primary care-giver(s);and
d. bereavement counseling services for the family.
C. Mental Health Care,Alcoholism and Drug Abuse Treatment Services.
1. Outpatient mental health, alcoholism and substance abuse treatment services are covered for each
Member in accordance with Medicare Guidelines.
2. Inpatient mental health care services are covered in full up to a 190-day lifetime benefit when such
services are provided in a Medicare-certified mental health facility.
Inpatient alcoholism and drug abuse treatment services are covered in full when such services are
provided in a hospital-based treatment center.
3. Coverage for Medical Emergencies incident to alcoholism and drug abuse or for acute alcoholism or drug
abuse, including acute detoxification, is provided as set forth in Section V.D. of this Medicare
Endorsement.
D. Emergency/Urgently Needed Services. When an Emergency meets the Medicare definition for Emergency or
Urgently Needed Services as defined in Section I.of this Medicare Endorsement,services are covered.
Dl. Out Of The Service Area Non-Emergent and/or Non-Urgently Needed Care. Non-Emergent and/or non-
urgently needed care will be covered outside GHC's defined Service Area,but within the United States and its
territories, up to a maximum of$2,000.00 (GHC's Service Area is defined in Section I. of this Agreement).
Coverage under this benefit does NOT include coverage of prescription drugs.
Services, as noted in this section, are available to Members traveling outside GHC's defined Service Area,
except when traveling primarily for the purpose of seeking medical care. Any durable medical equipment or
prosthetic devices will be excluded unless authorized in advance by GHC.
0036900-CO3046 40
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The services received under this benefit are subject to all limitations set forth in this Agreement.
All Medicare non-covered expenses, including hospital inpatient deductibles and inpatient and outpatient
Coinsurances,are the responsibility of the Member.
E. Medicare Ambulance Benefit.Medically Necessary ambulance transportation to or from a hospital or Skilled
Nursing Facility is covered in full only if transportation by any other vehicle could endanger the patients health
and the ambulance,equipment,and personnel meet Medicare requirements.
F. Medical and Surgical Care. The following medical and surgical services are covered when prescribed by
GHC Medical Personnel,Medicare requirements are met:
1. Eye examinations and treatment for eye pathology.
Evaluations and surgical procedures to correct refractions which are not related to eye pathology are not
covered. Complications related to such surgery are also excluded.
2. One pair of eyeglasses or contact lenses, including examination and fitting, following cataract surgery, are
covered subject to UCR charges when required to replace the natural lens of the eye. Covered eyeglasses
and contact lenses must be dispensed through GHC Facilities. Replacements for Members following
insertion of an intraocular lens are set forth in Section F.13. below. Replacements in the absence of an
intraocular lens will be provided when needed due to change in the Members medical condition or when
deemed appropriate by a GHC physician.
3. Blood,blood derivatives,and their administration.
4. Maternity and pregnancy-related services, including visits before and after birth;involuntary termination of
pregnancy;and care for any other complication of pregnancy.
5. Organ transplants, limited to heart, kidney, cornea, bone marrow, and liver, when established criteria are
met.
6. Physician calls (including consultations and second opinions by a GHC physician) in the hospital, office,
home, Skilled Nursing Facility,nursing home,or convalescent center.
7. Restorative physical,occupational,and speech therapy following illness,injury,or surgery.
8. Immunizations and vaccinations that are listed as covered in the GHC Drug Formulary(approved drug list)
or approved by Medicare.
9. Services related to dysfunction of the jaw. When Referred by a GHC physician, evaluation and treatment
by a GHC-approved temporomandibular joint(TMJ)care provider.
All TMJ appliances,other than the occlusal splint and its fitting,are excluded.
Treatment of jaw dysfunction, including TMJ dysfunction,will NOT be provided when the dysfunction is
related to malocclusion or when TMJ services are needed due to dental work performed. All such services
and related hospitalization, including orthodontic therapy and orthognathic (jaw) surgery, are excluded
regardless of origin or cause.
(See Section X.B.17. of the Group Medical Coverage Agreement for Covered Services not meeting
Medicare guidelines).
10. Chiropractic care limited to spinal manipulations. Excluded are any other diagnostic or therapeutic
services,including x-rays,fumished by a chiropractor. Members who receive their primary care in portions
0036900-003046 41
� I �
of the GHC Service Area where GHC-designated licensed practitioners are available must utilize GHC's
designated providers in order to be covered.
11. Podiatric care. Services are covered when all Medicare criteria are met and when authorized in advance by
your Primary Care Provider. Excluded is treatment of flat feet or other misalignments of the feet; removal
of corns and calluses; and routine foot care such as hygienic care, except in the presence of a nonrelated
medical condition affecting the lower limbs. Members who receive their primary care in portions of the
GHC Service Area where GHC designated licensed practitioners are available must utilize GHC's
designated providers in order to be covered.
12. Home intravenous(IV)drug therapy services.
13. Routine eye examinations and refractions, limited to once every twenty-four (24) months, except when
Medically Necessary. Services fe- routine eye examinations must be received at a GHC Facility and in
accordance with GHC medical criteria in order to be covered and are not subject to Medicare requirements.
Lenses. One pair of standard glass single vision, lenticular, or nonbler.aed bifocal or trifocal lenses, or
contact lenses,will be covered subject to UCR charges once every twenty-four(24) months, and replaced
as specified below,when received at a GHC facility and in accordance with GHC medical criteria.
Frames. An Allowance of up to$100 per Member once every 24 months will be provided for frames.
Replacements. Lens replacement for any reason (including loss, breakage or change in prescription) will
be provided not more often than once every 24 months.
Replacement of frames will be provided subject to the frames Allowance set forth above not more often
than once every 24 months.
14. Hearing examinations to determine hearing loss. Hearing aids, including examinations and fitting,must be
received at a GHC Facility and are covered up to a maximum of$250 per Member once every 24 months.
G. Prosthetic Devices,such as cardiac devices,intraocular lenses,artificial joints,breast prostheses,artificial eyes,
and braces, are covered. Excluded are: orthopedic shoes unless they are part of leg braces; dental plates or other
dental devices;and experimental devices.
H. Medical/Surgical Supplies,such as casts,splints,post-surgical dressings,and ostomy s Aies,are covered.
I. Rental or Purchase of Durable Medical Equipment,such as oxygen and oxygen equipment,wheelchairs and
other walk-aids,and hospital beds,is coverea.
Section VI XCLUSIONS AND LIMITATIONS
A. Exclusions.
1. Investigational procedures, including medical and surgical services, drugs and devices until formally
approved by Medicare unless specifically provided herein (See Section XI.A.23. in the Group Medical
Coverage Agreement).
2. Supportive devices(shoe inserts)for the feet.
3. Services directly related to obesity except as provided by Medicare.
4. Services or supplies not specifically listed as covered by Medicare or GHC.
B. Limitations.
0036900-CO3046 42
, s A
Conditions and Extent of Coverage. EXCEPT AS PROVIDED IN SECTIONS V.F.10. AND V.F.I I., ALL
SERVICES AND BENEFITS UNDER THIS AGREEMENT MUST BE PROVIDED BY GHC MEDICAL
PERSONNEL AT A GHC OR GHC DESIGNATED FACILITY UNLESS:
1. the Member has received a Referral from GHC,or
2. the Member has received Emergency or Urgently Needed Services as defined in Section 1. and as set forth
in Section V.D.of this Medicare Endorsement.
Section VII. CLAIMS PROCEDURE
Claims for services or supplies and explanation of Medicare benefits for services or supplies from providers other
than Group Health Cooperative should be sent to: Medicare Claims, Group Health Cooperative of Puget Sound. If
you must receive Emergency or Urgently Needed Services from a non-GHC provider, be sure to show your GHC
I.D.card and your red,white,and blue Medicare card.
A. The Member must file claims for services rendered during the first nine (9) months of a calendar year by
December 31 of the following calendar year.
B. The Member must file claims for services rendered in the last three(3)months of a calendar year the same as if
the services had been furnished in the subsequent calendar year. The time limit on filing claims for services
furnished in the last three(3)months of the calendar year is December 31 of the second calendar year following
the calendar year in which the services were rendered.
See "The Medicare Handbook" for additional information regarding filing claims, which can be obtained from
your local Social Security office,or your Washington State Part B carrier's office,or call 1-800-772-1213.
GHC may obtain information which it deems necessary concerning the medical care and hospitalization for which
payment is requested.
0036900-CO3046 43
Medicare
Endorsement
For Persons Covered by Part B only of Medicare
THE PROVISIONS OF THE GROUP MEDICAL COVERAGE AGREEMENT SHALL REMAIN IN EFFECT
EXCEPT AS MODIFIED BY THE ADDITION OF THE PROVISIONS, EXCLUSIONS AND LIMITATIONS
CONTAINED IN THIS MEDICARE ENDORSEMENT. IN NO EVENT SHALL THE BENEFITS UNDER THIS
ENDORSEMENT DUPLICATE THE BENEFITS UNDER THE GROUP MEDICAL COVERAGE
AGREEMENT. THE HIGHER LEVEL OF BENEFIT WILL APPLY. COVERAGE UNDER THIS GROUP
MEDICAL COVERAGE AGREEMENT IS INTEGRATED WITH THE MEDICAL BENEFITS ESTABLISHED
BY TITLE 18 OF THE SOCIAL SECURITY ACT AS AMENDED, AND REFERRED TO AS "MEDICARE."
THE BENEFITS AND EXCLUSIONS DESCRIBED IN THIS ENDORSEMENT APPLY ONLY TO MEMBERS
WHO ARE COVERED UNDER PART B ONLY OF MEDICARE.
Except as defined by Federal Regulations,all Members entitled to, or eligible to purchase Medicare must transfer to
the GHC Medicare Plan upon such entitlement or eligibility. A condition of enrollment under the GHC Medicare
Plan requires that a Member be continuously enrolled for medical (Part B) benefits available from the Social
Security Administration,and sign any papers that may be required by GHC or Medicare. For additional information,
the Member may refer to "The Medicare Handbook," which can be obtained form your local Social Security
office.
NEITHER GHC NOR MEDICARE MAY PAY FOR SERVICES PROVIDED AT NON-GHC FACILITIES
UNLESS THE MEMBER HAS BEEN REFERRED BY GHC OR THE MEMBER HAS RECEIVED
EMERGENCY OR URGENTLY NEEDED SERVICES ACCORDING TO SECTION V.C. OF THIS MEDICARE
ENDORSEMENT OR THE MEMBER HAS RECEIVED NON-EMERGENT AND/OR NON-URGENTLY
NEEDED CAREAT FACILITIES OUTSIDE THE SERVICE AREA ASSET FORTH INSECTION V.C.
Those enrolled under GHC's Medicare plan,as set forth in this Endorsement,all Copayments are waived except the
prescription drug Copayment.
This Endorsement does not constitute a Medicare supplemental contract.
Section I DEFINITIONS
CUSTODIAL CARE: Care that is primarily for the purpose of meeting personal needs and could be provided by
persons without professional skills or training. Custodial Care includes help in walking, bathing, dressing, eating,
and taking medicine.
EMERGENCY SERVICES (Medicare defined): Medicare Part B services that are rendered immediately by an
appropriate non-GHC provider because of an injury or sudden illness,and for which the time required to reach GHC
or a GHC Designated Facility would risk permanent damage to the Member's health.
HEALTH CARE FINANCING ADMINISTRATION (HCFA): The federal agency that administers the
Medicare program.
MEDICARE:The federal health insurance program for the aged and disabled.
MEDICARE GUIDELINES:Coverage rules and policies established by the Health Care Financing Administration
(HCFA),a federal agency.
0036900-CO3046 44
MEDICARE HANDBOOK (Titled "The Medicare Handbook"): A pamphlet published by the Health Care
Financing Administration, which provides an easy-to-read explanation of Medicare benefits, and can be obtained
from your local Social Security office,or your Washington State Part B carrier's office.
OUT OF THE SERVICE AREA ALLOWANCE. The maximum amount payable by GHC for non-emergent
and/or non-urgently needed care received at facilities outside the Service Area. This Allowance is set forth in the
Copayments and Allowances Schedule.
PERMANENT MOVE: An uninterrupted absence of more than ninety(90)days from GHC's Service Area.
REFERRAL: A written temporary referral agreement authorized in advance by a GHC physician and formally
approved in advance through GHC's Medicare medical coverage approval process,that entitles a Member to receive
Covered Services from a specified non=GHC health care provider. Entitlement to such services shall not exceed the
limits of the Referral and is subject to all terms and conditions of the Referral and this Agreement.
SERVICE AREA: The geographic area comprised of Island, King, Kitsap, Lewis, Pierce, San Juan, Skagit,
Snohomish, Thurston,and Whatcom Counties,and any other areas designated by GHC and approved by the Health
Care Financing Administration.(See Service Area Map.)
SKILLED NURSING FACILITY. A Medicare-certified and licensed facility,as defined in Medicare regulations,
primarily engaged in providing skilled nursing care or rehabilitation and related services for which Medicare
pays benefits or qualifies to receive such approval.
URGENTLY NEEDED SERVICES (Medicare defined): Medicare Part B services needed in order to prevent a
serious deterioration of the Member's health due to an unforeseen illness or injury while temporarily absent from
GHC's Service Area,and which c,nnot be delayed until the Member re:ems to the Service Area.
USUAL,CUSTOMARY,AN- .SONABLE: A term used to define the level of benefits which are payable by
GHC when expenses are in from a non-GHC physician or provider. Expenses are considered Usual,
Customary and Reasonable he charges are consistent with those normally charged by the providcr or
organization for the same se r supplies; and(2)the charges are within the general range of charges made by
other providers in the same cga.phical area for the same services or supplies.
Section II. TERMINATIQN
Enrollment under the GHC Medicare Plan for a specific Member, may le terminated in the circumstances set forth
below.
Until such time as a Member'3 termination of enrollment is effective, neither GHC nor '.Medicare shall pay for
services provided at non-GHC Facilities unless the Member has been Referred by GHC or Member has received
Emergency or Urgently Needed Services according to Section V.C.of this Medicare Endorsement.
A. Termination of Specific Members.
1. Loss of Part B Medicare Entitlement.If the Health Care Financing Administration(HCFA)advises GHC
that a Member's entitlement to Medicare coverage no longer exists, or the Member voluntarily terminate
Medicare Part B enrollment, enrollment under the GHC Medicare Plan shall terminate the first of the
month as specified by HCFA.
2. Change of Permanent Residence Outside GHC's Service Area. a Member makes a Permanent Move
as set forth in Section I. of this Medicare Endorsement, enrollm--c shall terminate the first day of the
month following the month in which GHC receives notification of such move.
3. For Cause.Enrollment may be terminated upLn written notice for:
0036900-003046 45
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a. Knowingly providing fraudulent information to obtain coverage. In such event, GHC may rescind or
cancel enrollment upon ten(10)working days'written notice.
b. Permitting the use of a GHC identification card by another person.
c. Failure to comply with the rules and regulations of GHC including disruptive, unruly, abusive or
uncooperative conduct.
Such termination shall be subject to review and approval by HCFA.
Section III SUBROGATION
"Injured person" under this section means a Member covered by this Agreement who sustains compensable injury.
"GHC's medical expense"means the expense incurred by GHC for the care or treatment of the injury sustained.
If the injured person was injured by an act or omission of a third party giving rise to a claim of legal liability against
the third parry,GHC shall have the right to recover its cost of providing benefits to the injured person(subrogation)
from the third party as set forth in this Agreement and in compliance with Medicare regulations and guidelines.
GHC shall be subrogated to and may enforce all rights of the injured person to the extent of its medical expense.
After Medicare laws and regulations mandating recovery of Medicare payments have been satisfied, the
Cooperative's right of subrogation shall be limited to the excess of the amount required to fully compensate the
injured person for the loss sustained.Full compensation shall be measured on an objective,case-by-case basis,but is
subject to a presumption that a settlement which does not exhaust the third parry's reachable assets is full
compensation to the injured person.
The injured person and his or her agents nv cooperate fully with GHC in its efforts to collect GHC's medical
expenses. This cooperation shall include is not limited to, supplying GHC with information about any
defendants and/or insurers related to the in) �erson's claim.The injured person and his or her agents shall permit
GHC, at GHC's option,to associate with th .red party or to intervene in any action filed against any third party.
The injured person and his or her agents shay: so nothing to prejudice GHC's subrogation rights. The injured person
shall not settle a claim without protecting GHC's interest.
GHC shall not pay any attorney's fees or collection costs to attorneys representing the injured person where it has
retained its own legal counsel or acts on its own behalf to represent its interests and unless there is a written fee
agreement signed by GHC prior to any collectr;r. efforts. When reasonable collection costs have been incurred,with
GHC's prior written agreement, to recover GHC's medical expenses, there shall be an equitable apportionment of
such collection costs between GHC and the injured person subject to a maximum responsibility of GHC equal to
one-third of the amount recovered on behalf of GHC.
This provision does not apply to occupationally incurred disease, sickness,and/or injury.
Section IV 4 PML AND GRIEVANCE PROCEDURES
A. Grievances.
If a member is dissatisfied with care or services received at a Medical or Dental Office or Hospital, or a
Member disputes amounts owed, eligibility or membership status, the Member may submit a written
grievance to GHC. GHC will conduct a formal review and provide a written response within 60 days of the
time all pertinent materials are received.
B. Expedited Requests for Care or Service
If a member requests care or a service they believe is covered by Medicare and the Member believes and/or
his/her physician states that a delay in making a determination about coverage could jeopardize the
Member's health or ability to function, the Member may request an expedited decision. In most instances,
GHC will reach a decision within 72 hours. GHC's decision may be delayed an additional 10 working days
0036900-CO3046 46
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if it is in the Member's best interest to delay a decision or upon the Member's request. GHC's decision may
also be postponed in the event information for a non-GHC provider has not been received in a timely
manner. If GHC denies a Member's request for an expedited decision, the standard process to review
requests will be utilized. If a Member disagrees with GHC's decision not to expedite his/her request, the
Member may file a grievance.
C. Appeals.
Members have a right to appeal any decision in which GHC declines to provide, cover, or pay for services
that the Member believes are covered by Medicare. If GHC declines to provide or to cover a service, GHC
will provide the Member with a Notice of Non-coverage containing the reason(s)for the denial and an
explanation of the Member's appeal rights.
Members who disagree with the decision may submit a written appeal to GHC. Members may request either
a Standard (60-day) appeal or an Expedited (72-hour) appeal tf the Member believes (or the Member's
Physician states)that a delay in responding to the Member's appeal could seriously jeopardize his/her health
or ability to function.
Appeals will be reviewed by persons not involved in the initial decision. If GH( decides to uphold the
original adverse decision, either in whole or in part, the entire file will be forwarded by GHC to HCFA for
review.
1. Standard(60-day)Appeal.
A member may submit an appeal requesting a second review at any time GHC denies coverage for
services already provided or arranged by either GHC or a non-GHC provider or facility, or for future
services. Member must submit appeals in writing to GHC,or to any Social Security Office,or in the case
of a railroad retirement annuitant, a Railroad Retirement Board Office, within 60 days of receiving
notice of GHC's initial decision. After receiving all pertinent materials, GHC will conduct a formal
review of the appeal. GHC will nott& the Member of its decision within 60 days of receipt. If GHC
upholds any part of the initial denial, the entire file will be forwarded by GHC to HCF4 for review.
HCFA will make a reconsideration decision and advise the Member or its decision, the reasons for the
decision and the right to additional appeal rights.
2. Filing an Expedited(72-hour)Appeal(does not apply to denied claims for payment).
If a delay in receiving a decision could jeopardize the Member's health or ability to function, the
Member or his/her Physician may submit a request for an expedited appeal either orally or in writing to
GHC. In most cases, GHC will make a determination within 72 hours of GHC's receipt of a Member's
request. If GHC determines it is in the Member's best interest, or upon Member request, GHC may
extend the review period of an additional 10 working days. GHC's decision may also be delayed in the
event medical information for a non-GHC provider has not been received. If the Member disagrees with
GHC's decision not to expedite his/her appeal,the Member may file a grievance.
D. Immediate Peer Review Organization("PRO")Review.
A Member may request immediate Peer Review Organization ("PRO') review if GHC denies coverage of a
continued inpatient stay in a hospital on the basis of medical necessity. A Member may request immediate
PRO review by phone or in writing. If a Member request PRO review by noon of the first business day after
a Member has received a Notice of Noncoverage, the Member will not be fmancially responsible for the cost
of the continued hospitalization until the PRO determination. GHC will provide the Member written notice
of procedures by which to request a PRO review. If a Member requests a PRO review, the Member may not
pursue the Standard Appeal Procedure and/or the Expedited Appeal Procedure with respect to denial of the
same hospital stay.
0036900-CO3046 47
E. Additional Appeal Bights.
If HCFA upholds GHC's initial determination and denies the appeal and if the amount in controversy is
greater than $100.00, the Member may request a hearing before an administrative law judge of the Social
Security Administration. The Member may request a hearing before an administrative law judge by writing
to GHC, HCFA, or a Social Security Office within 60 days after the date of notice of an adverse
reconsideration decision.
If the administrative law judge denies a Member's appeal, either the Member or GHC may request a review by
the Social Security Administration's Appeals Council,
If a Member's appeal is denied by the Appeals Council and if the amount in controversy is greater than
S1,000.00,the Member or GHC may request a review by a Federal District Court
An initial, revised, or reconsideration determination made by GHC, HCFA, an administrative law judge, or the
Appeals Council can be reopened(a) within twelve months, (b) within four years for just cause, or(c)at any time
for clerical correction or in the case of fraud
The Medicare Appeals Coordinator can be reached by calling (206) 287-2204, toll free at 1-(888)-901-4600(ask
for 287-2204), by fax at (206) 442-2071, or by writing to Group Health Cooperative of Puget Sound, clo
Medicare Appeals Coordinator,P.O.Box 34750,Seattle WA 98124-1750.
Section V. SCHEDULE OF BENEFITS
All benefits and services listed in this Schedule of Benefits:
• are subject to all provisions of this Agreement and Medicare Endorsement;
• must be approved in advance by GHC except for Emergency and Urgently Needed Services as set forth in
Section V.C.of this Medicare Endorsement;and
• must meet Medicare guidelines and limitations unless otherwise specified.
The booklet, "The Medicare Handbook" provides additional information about Medicare benefits, and can be
obtained from your local Social Security office.
A. Hospice.
It is understood and agreed that the following fully sets forth Covered Services for a Member with Part B
Medicare only who elects to receive hospice services.Members who elect to receive hospice services do so in
lieu of curative treatment for their terminal illness for the period that they are in the hospice program.
To receive hospice services,the Member is required to sign the Hospice Election Form.
Covered Services.Hospice services may include the following as prescribed by a GHC physician and rendered
pursuant to an approved hospice plan of treatment:
1. Home Services
Continuous care services per Member in the Members home when prescribed by a GHC physician, as set
forth in this paragraph. Continuous care is defined as "skilled nursing care provided in the home during a
period of crisis in order to maintain the terminally ill patient at home." Continuous care may be provided
for pain or symptom management by a Registered Nurse, Licensed Practical Nurse, or Home Health Aide
under the supervision of a Registered Nurse. Continuous care may be provided up to twenty-four (24)
hours per day during periods of crisis. Continuous care is covered only when a GHC physician determines
that the Member otherwise would require hospitalization in an acute care facility.
0036900-CO3046 48
2. Inpatient Hospice Services for short-term care shall be provided in a facility designated by GHC's
Hospice Program when Medically Necessary and authorized in advance by a GHC physician and GHC's
Hospice Program. Respite care is covered for a maximum of five (5) consecutive days per occurrence in
order to continue care for the Member in the temporary absence of the Member's primary care-giver(s).
3. Other hospice services may include the following:
a. drugs and biologicals that are used primarily for the relief of pain and symptom management;
b. medical appliances and supplies primarily for the relief of pain and symptom management;
c. counseling services for the Member and his/her primary care-giver(s);and
d. bereavement counseling services for the family.
B. Outpatient Mental Health Cart; Alcoholism and Drug Abuse Treatment Services are covered for each
Member in accordance with Medicare Guidelines.
C. Outpatient Emergency/Urgently Needed Services. When an Emergency meets the Medicare definition for
Emergency or Urgently Needed Services as defined in Section 1. of this Medicare Endorsement, services are
covered in full.
Cl. Out Of The Service Area Non-Emergent and/or Non-Urgently Needed Care. Non-Emergent and/or non-
urgently needed care will be covered outside GHC's defined Service Area, up to a maximum of $2,000.00
(GHC's Service Area is defined in Section 1. of this Agreement). Coverage under this benefit does NOT
include coverage of prescription drugs.
Services, as noted in this section, are available to Members traveling outside GHC's defined Service Area,
except when traveling primarily for the purpose of seeking medical care. Any durable medical equipment or
prosthetic devices will be excluded unless authorized in advance by GHC.
The services received under this benefit are subject to all limitations set forth in this Agreement.
All Medicare non-covered expenses including Part B deductibles and coinsurances are the responsibility of the
Member.
D. Medicare Ambulance Benefit. Medically Necessary ambulance transportation t;; or from a hospital or Skilled
Nursing Facility is covered in full only if transportation by any other vehicle could endanger the patient's health
and the ambulance,equipment,and personnel meet Medicare requirements.
E. Medical and Surgical Care. The following medical and surgical services are covered when prescribed by
GHC Medical Personnel,Medicare requirements are met:
I. Eye examinations and treatment for eye pathology.
Evaluations and surgical procedures to correct refractions which are not related to eye pathology are not
covered. Complications related to such surgery are also excluded.
2. One pair of eyeglasses or contact lenses, including examination and fitting, following cataract surgery, are
covered subject to UCR charges when required to replace the natural lens of the eye. Covered eyeglasses
and contact lenses must be dispensed through GHC Facilities. Replacements for Members following
insertion of an intraocular lens are set forth in Section E13. below. Replacements in the absence of an
intraocular lens will be provided when needed due to change in the Member's medical condition or when
deemed appropriate by a GHC physician.
3. Blood,blood derivatives,and their administration.
0036900-CO3046 49
s A �
4. Maternity and pregnancy-related services,including visits before and after birth; involuntary termination of
pregnancy;and care for any other complication of pregnancy.
5. Organ transplants, limited to heart, kidney, cornea, bone marrow, and liver, when established criteria are
met.
6. Physician calls (including consultations and second opinions by a GHC physician) in the hospital, office,
home,Skilled Nursing Facility,nursing home,or convalescent center.
7. Restorative physical,occupational,and speech therapy following illness,injury, rr rgery.
8. Immunizations and vaccinations that are listed as covered in the GHC Drug Formulary(approved drug list)
or approved by Medicare.
9. Services related to dysfunction of the jaw. When Referred by a GHC physician, valuation and treatment
by a GHC-approved temporomandibular vnnt(TMJ)care provider.
All TMJ appliances,other than the occlusal splint and its fitting, are excluded.
Treatment of jaw dysfunction, including TMJ dysfunction, will NOT be provided when the dysfunction is
related to malocclusion or when TMJ services are needed due to dental work performed. All such services
and related hospitalization, including orthodontic therapy and orthognathic (jaw) surgery, are :;xcluded
regardless of origin or cause.
(See Section X.B.17. of the Group Medical Coverage Agreement for Covered Services not meeting
Medicare guidelines).
10. Chiropractic care limited to spinal manipulations. Excluded are any other diagnostic or therapeutic
services,including x-rays,furnished by a chiropractor. Members who receive their primary care in portions
of the GHC Service Area where GHC-designated I;:eased practitioners are available must utilize GHC's
designated providers in order to be coverr,.'.
11. Podiatric care. Services are covered when all Medicare criteria are met and when authorized in advance by
your Primary Care Provider. Excluded is treatment of flat feet o- other misalignments of the feet;removal
of toms and calluses; and routine foot care such as hygienic care, except in the presence of a nonrelated
medical condition affecting the lower limbs. Members who receive their primary care in portions of the
GHC Service Area where GHC designated licensed practitioners are available must utilize GHC's
designated providers in order to be covered.
12. Home intravenous(IV)drug therapy services.
13. Routine eye examinations and refractions, limited to once every twenty-four (24) months, except when
Medically Necessary. Services for routine eye examinations must be received at a GHC Facility and in
accordance with GHC medical criteria in order to be covered and are not subject to Medicare requirements.
Lenses. One pair of standard glass single vision, lenticular, or nonblended bifocal or trifocal lenses, or
contact lenses, will be covered subject to UCR charges once every twenty-four(24)months, and replaced
as specified below,when received at a GHC facility and in accordance with GHC medical criteria.
Frames. An Allowance of up to $100 per Member once every twenty-four (24) months will be provided
for frames.
Replacements. Lens replacement for any reason (including loss, breakage or change in prescription) will
be provided not more often than once every 24 months.
0036900-003046 50
Replacement of frames will be provided subject to the frames Allowance set forth above not more often
than once every 24 months.
14. Hearing examinations to determine hearing loss. Hearing aids, including examinations and fitting,must be
received at a GHC Facility and are covered up to a maximum of$250 per Member once every 24 months.
F. Prosthetic Devices,such as cardiac devices,intraocular lenses,artificial joints,breast prostheses,artificial eyes,
and braces,are covered.Excluded are: orthopedic shoes unless they are part of leg braces; dental plates or other
dental devices;and experimental devices.
G. Medical/Surgical Supplies,such as casts,splints,post-surgical dressings,and ostomy supplies,are covered.
H. Rental or Purchase of Durable Medical Equipment,such as oxygen and oxygen equipment, wheelchairs and
other walk-aids,and hospital beds, is covered.
L Skilled Nursing Facility. Upon Referral and following a Medicare-certified three(3)day hospital stay, GHC
will cover up to one hundred (100) days of care in a Medicare-certified Skilled Nursing Facility, in
accordance with Medicare Guidelines, when Medically Necessary, as determined by GHC's Medical
Director,or his/her designee.
Section VI EXCLUSIONS AND LIMITATIONS
A. Exclusions.
1. Investigational procedures, including medical and surgical services, drugs and devices until formally
approved by Medicare unless specifically provided herein (See Section XI.A.10. in the Group Medical
Coverage Agreement).
2. Supportive devices(shoe inserts)for the feet.
3. Services directly related to obesity except as provided by Medicare.
4. Services or supplies not specifically listed as covered by Medicare or GHC.
B. Limitations.
Conditions and Extent of Coverage. EXCEPT AS PROVIDED IN SECTIONS V.E.10. AND V.E.I 1., ALL
SERVICES AND BENEFITS UNDER THIS AGREEMENT MUST BE PROVIDED BY GHC MEDICAL
PERSONNEL AT A GHC OR GHC DESIGNATED FACILITY UNLESS:
1. the Member has received a Referral from GHC,or
2. the Member has received outpatient Emergency or Urgently Needed Services as defined in Section I. and
as set forth in Section V.C.of this Medicare Endorsement.
Section VII CLAIMS PROCEDURE
Claims for services or supplies and explanation of Medicare benefits for services or supplies from providers other
than Group Health Cooperative should be sent to: Medicare Claims, Group Health Cooperative of Puget Sound. If
you must receive Emergency or Urgently Needed Services from a non-GHC provider, be sure to show your GHC
I.D. card and your red,white,and blue Medicare card.
A. The Member must file claims for services rendered during the first nine (9) months of a calendar year by
December 31 of the following calendar year.
0036900-CO3046 51
B. The Member must file claims for services rendered in the last three(3)months of a calendar year the same as if
the services bad been furnished in the subsequent calendar year. The time limit on filing claims for services
furnished in the last three(3)months of the calendar year is December 31 of the second calendar year following
the calendar year in which the services were rendered.
See "The Medicare Handbook" for additional information regarding filing claims, which can be obtained from
your local Social Security office,or your Washington State Part B carrier's office.
GHC may obtain information which it deems necessary concerning the medical care and hospitalization for which
payment is requested.
0036900-CO3046 52
COPAVMENTS AM .ALLOWANCES SCHEDULE
The benefits described in this sche&i=are subject t.. xovisions, limitations and exclusions set forth in the Group
Medical Coverage Agreement.
STOP LOSS:
Total out-of-pocket Copayment expenses for the following Covered Services:
Limited to an aggregate maximum of$750 per Member and$1,500 per family per calendar year.
• Outpatient Services
• Emergency Care at a GHC or GHC Designated Facility
INPATIENT HOSPITAL.SERVICES:
HOSPITAL CARE: All inpatient medical and surgical hospital care services are subject to the stated Copayment.
• Chemical dependency treatment(see benefit limits under Chemical Dependency section of the Copayments and
Allowances Schedule)
• Rehabilitation Services. Inpatient physical, occupational and restorative speech therapy services combined,
including services for neurodevelopmentally disabled children age six (6) and under, plus associated hospital
services for the purpose of rehabilitation is covered up to 60 days per condition per calendar year.
• Pregnancy-related complications prior to delivery
• Other pregnancy-related services
No Copayment. Covered in full.
OUTPATIENT SERVICES; Diagnostic radiology and laboratory services and administration of injections
including covered immunizations and vaccinations are not subject to the outpatient Copayment. All other outpatient
medical and surgical services are subject to the stated Copayment.
• Medical and surgical care
• Office visits,including consultations
• Outpatient surgery
• Physical examinations,including well-child care and routine mammography screening
• Radiation therapy and chemotherapy
• Family planning counseling
• Audiological testing
• Routine eye exam/refraction;contact lens exams and fitting for eye pathology
• Chemical dependency treatment(see benefit limits under Chemical Dependency section of the Copayments and
Allowances Schedule)
• Prenatal and postpartum visits and prenatal testing
• Pregnancy-related services
• Outpatient physical, occupational and restorative speech therapy services combined, including services for
neurodevelopmentally disabled children age six (6) and under are covered up to 60 visits per condition per
calendar year
$5 Copayment per visit per Member.
0036900-003046 53
w A
CH MICAL•DEPENDENCY:
• Benefit Period Allowance
$5,000 maximum per Member per any 24 consecutive calendar month period
• Lifetime Maximum Benefit
$10,000 per Member
TOBACCO CESSATION:
• Individual/Group Sessions
Covered at 100%of the total charges.
• Nicotine replacement therapy
Covered subject to the Outpatient Prescription Drug Copayment for eacn . 0)day supply or less of a prescription or
refill when provided at GHC Facilities and prescribed by a GHC Provider. Copayment does not apply to Stop Loss.
PRES -RIPTION DRUGS - OUTPATIENT: Drugs and medicines (including injectables) which require a
prescription when provided at GHC Facilities and prescribed by a GHC Provider for a supply of thirty (30) days or
less of an outpatient prescription or refill is subject to the stated Copayment.
Covered subject to the lesser of GHC's charge or a$5 Copayment. Copayment does not apply to Stop Loss.
MENTAL HEALTH CARE:
• Outpatient Services
Twenty (20) visits covered per Member per calendar year subject to $20 Copayment per individual/family/couple
session and$10 per Member per group session; no coverage thereafter.Medication monitoring visits are subject to
the office visit copayment.
• Inpatient Services
Coverage Allowance up to 12 days at 80% per Member per calendar year at a GHC-approved mental health care
facility when authorized in advance by GHC.
Total expenses,Copayments and Coinsurance paid for mental health treatment do not apply to Stop Loss.
EMERGENCY CARE: All emergency care services are subject to the stated Copayment.
• At a GHC or GHC Designated Facility
$50 Copayment per Emergency visit per Member. Copayment is waived if Member is admitted directly from the
Emergency department.
• At a non-GHC Designated Facility
0036900-CO3046 54
$100 Deductible per Emergency visit per Member. Emergency Deductible does not apply to Stop Loss.
AMBULANCE SERVICES:
• Transport to a GHC Facility,GHC Designated Facility,or non-GHC Designated Facility.
Covered at 80%. Coinsurance amount does not apply to Stop Loss.
• Transfer to a GHC or GHC Designated Facility
Covered in full. No Copayment.
ORTHOPEDIC APPLIANCES:
• Orthopedic appliances when prescribed by a GHC Provider and listed as covered in the Orthopedic Appliance
Formulary.
Covered Services are subject to a 50%Coinsurance. Coinsurance amount does not apply to Stop Loss.
NASAL CPAP DEVICE:
• Nasal CPAP device when Medically Necessary and authorized in advance by GHC.
Covered Services are subject to a 50%Coinsurance. Coinsurance amount does not apply to Stop Loss.
POST-MASTECTOMY BRAS:
Covered Services are subject to a 50%Coinsurance. Coinsurance amount does not apply to Stop Loss.
TEMPOROMANDIBULAR JOINT(TMJ)SERVICES:
• Inpatient and outpatient TM)services when Medically Necessary and authorized by GHC.
$1,000 maximum per Member per calendar year
• Lifetime Maximum Benefit
$5,000 per Member
ENTERAL THERAPY:
Elemental formulas for malabsorption problems are covered at 80%. Over-the-counter enteral products for
access problems are excluded Coinsurance does not apply to stop loss.
SKILLED NURSING FACILITY:
0036900-CO3046 55
_S
• Care in a GHC-approved skilled nursing facility
Coverage allowance up to thirty(30)days per condition per Member.
PA-1133 - l/l/98
PA-1117-Service Area Map
CA-174-Medicare A&B
CA-175-Medicare B Only
CA-66-M&A
DA-420-MT-A
CA-18-PEC(0)
CA-573 -IM-U
CA-61 -SN-A
0036900-003046 56
AM
Dues Schedule
F attachment to Group Medical Coverage Agreement with:
KENT, CITY OF GROUP# 00369
This schedule reflects Group Health Cooperative monthly dues effective January 1,1998 and
guaranteed to January 1, 1999.
MONTHLY HEALTH CARE DUES
Subscriber only $162.05 per month
Subscriber and Spouse $362.58 per month
Subscriber and Child(ren) $326.82 per month
Subscriber and Family $519.07 per month
Spouse only $200.53 per month
Child(ren) only $164.77 per month
Spouse and child(ren) only $357.02 per month
COPAYMENT PROVISION
The following copayments apply to this plan. See Group Medical Coverage Agreement for benefit
details.
$5 Outpatient/Office Visit
$5 Outpatient Prescription Drugs
$0 Inpatient Co-pay
$50 Emergency Room
0 Month Pre-existing Condition
BILLING INFORMATION
Dues must be remitted on a calendar month basis on or before the first day of the
coverage month for which they become payable. Each remittance must be accompanied by a list of
subscribers for whom such dues are paid.
9.0 percent (9%) of each month's medical dues for each member and each family enrollee, as
scheduled above, is the budgeted prepayment for cost of all pharmaceuticals and prescriptions tc
dispersed on written orders of the Group Health Cooperative Medical Staff for the next fiscal year
under coverage of your medical coverage agreement.
Group Health Cooperative of Puget Sound does not discriminate on the basis of physical or mental
handicaps in its employment practices or services.
BILLING INFORMATION, Continued
Regardless of the effective aate of enrollment for a Subscriber and Family
Dependents, the Group will not be required to submit dues to the Cooperative
for the month of enrollment, and these Enrollees will appear on the subsequent
month's billing at the regular charge. When the Subscriber's enrollment
terminates, the group will submit the full amount of dues to the Cooperative
regardless of the specific date of termination for that month.
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Area of Detail
4/97 ADV70327
„u
Kent City Council Meeting
Date May 19, 1998
Category Consent Calendar
1. SUBJECT: RHODODENDRON ESTATES PRELIMINARY PLAT SU-97-2 -
SET MEETING DATE
2 . SUMMARY STATEMENT: Set June 2 , 1998, as the date for a
public meeting to consider the Hearing Examiner's
recommendation of approval with conditions for a preliminary
plat application by Bob Newman.
3 . EXHIBITS: None
4 . RECOMMENDED BY: Staff
(Committee, Staff, Examiner, Commission, etc. )
5 . UNBUDGETED FISCAL/PERSONNEL IMPACT: NO X YES
6. EXPENDITURE REQUIRED: $ _
SOURCE OF FUNDS: _
7 . CITY COUNCIL ACTION:
Councilmember moves, Councilmember seconds
DISCUSSION•
ACTION:
Council Agenda
Item No. 3M
Kent City Council Meeting
Date May 19, 1998
Category Consent Calendar
1. SUBJECT: NETWORK BACKBONE EQUIPMENT CONTRACT
2 . SUMMARY STATEMENT: Authorize the purchase of network
backbone equipment from Newbridge Networks Inc. in the amount
of $370, 122 .54 plus applicable sales tax and initiate an
ongoing hardware maintenance contract in the amount of
$59 , 518 . 91 plus applicable sales tax, as recommended by the
Operations Committee.
The City's network has been identified for a complete redesign
and overhaul as part of the 1998-2000 Technology Plan. A
technology known as ATM (Asynchronous Transfer Mode) has been
recommended to the City for implementation. The City
Information Services staff has identified a bid issued by the
Washington State Information Processing Cooperative, which
allows agencies to purchase ATM equipment from Newbridge
Networks at a 40% discount.
3 . EXHIBITS: Memo to Operations Committee, letter to Mayor,
Newbridge Networks Itemized Product Quote (980428-SKA-GC-Kent-
01) , Newbridge Networks Maintenance Contract Quote (980428-SKA-
GREEN, City of Kent Supplemental Term and Conditions Attachment
A, WSIPC Bid 25, and WSIPC Bid 25 Extension
4 . RECOMMENDED BY: Operations Committee
(Committee, Staff, Examiner, Commission, etc. )
5 . UNBUDGETED FISCAL/PERSONNEL IMPACT: NO X YES
6. EXPENDITURE REQUIRED: $429, 641. 45
SOURCE OF FUNDS: Technology Plan
7 . CITY COUNCIL ACTION:
Councilmember moves, Councilmember seconds
DISCUSSION•
ACTION•
Council Agenda
Item No. 3N
Memo
To: Council Operations Committee J
From: Marty Mulholland, Director of Information ServiceZT �rnt� 1
Prepared by: Joe Lorenz, Network Manager
Date: April 30, 1998
Re: Network Backbone Purchase
Current Situation:
The City's network has been identified for a complete redesign and overhaul as part of the 1998-2000
Technology Plan. A number of different technologies are available to serve as the "network backbone,"
which is the heart of the network. A technology known as ATM (Asynchronous Transfer Mode) was
recommended by the City's network consultant Moss Bay Group, Inc.
Information Services researched the proposed ATM technology and hired an independent network
consultant to participate in evaluating the ATM solution for Kent. Information Services staff also used the
services of the Gartner Group, an internationally recognized technology resource, to further validate the
appropriateness of using ATM technology and to gain an understanding of ATM implementation issues.
The cities of Bellevue and Renton have also chosen to use ATM solutions for their networks.
Unique Market Condition:
The City has identified an existing bid issued by the Washington State Information Processing
Cooperative (WSIPC), a state agency, which allows other agencies to purchase ATM equipment from the
Newbridge company at a discount of approximately forty percent (40%). Normal City discount for
equipment of this nature fall between twenty-five (25%) and thirty (30%) percent. Cisco, a leading
manufacturer of similar networking equipment discounts at twenty-seven percent (27%) for municipal
government. The purchase of this equipment utilizing this bid also saves the City the costs and
associated time delays of issuing and evaluating a complex bid of this nature.
The Newbridge ATM equipment satisfies the City's technical requirements and also is appealing in that it
allows for software updates rather than hardware component updates. The Gartner Group suggested
that the City seek out ATM equipment that had that feature.
The current estimated cost to purchase and install the necessary backbone equipment under the WSIPC
contract is $370,122.54 which constitutes a $30,763.60 savings over typical government agency
purchases.
Under the City's procurement code, bids conducted by other public agencies for substantially the same
purchase constitutes compliance with the advertised bid requirements. Sec. 3.70.030. The City's
Information Services staff has researched the matter and determined that going out to bid is not
recommendable. The Mayor has concurred with staff recommendation and authorized waiving
advertising bid requirements pursuant to Sec. 3.70.080 of the City's procurement code.
Summary:
A bid has been undertaken by another state agency (WSIPC) with very attractive prices and which also
satisfies the City's technical requirements for an ATM network backbone solution. Accordingly, the
Information Services Department requests that this committee and the Council authorize City staff to
enter into an agreement with Newbridge Networks to purchase and install an ATM network backbone
based on WSIPC pricing, subject to additional terms required by the City.
Attachments:
Letter to Mayor
Newbridge Networks Itemized Product Quote. 980428-SKA-GC-KENT-01.
Newbridge Networks Maintenance Quote. 980428-SKA-Green.
City of Kent Supplemental Terms and Conditions Attachment A.
WSIPC Bid 25.
WSIPC Bid 25 Extension.
i
Memo
To: Mayor Jim White From: Marty Mulholland, Director of Information Service Y
Prepared by Joe Lorenz, Network Manager
Date: 04/30/98
Re: Network Backbone Purchase
As part of the 1998 — 2000 Technology plan the network backbone was identified for a complete
redesign and overhaul. A numoer of network technologies are available to serve as the "network
backbone,"which is the heart of the network. The technology known as ATM (Asynchronous Transfer
Method)was recommended by the City's network consultant, Moss Bay Group, Inc.
Information Services researched the proposed ATM technology and hired an independent network
consultant to participate in evaluating the ATM solution for Kent. Information Services staff also used
the services of the Gartner Group, an internationally recognized technology resource, to further validate
the appropriateness of using ATM technolc^,y and to gain an understanding of ATM implementation
issues. The cities of Bellevue and Renton h ,le also chosen to use ATM solutions for their networks.
The City has identified an existing bid issued by WSIPC, a state agency, which allows other agencies
to purchase ATM equipment from the Newbridge Networks company at a discount of approximately
forty percent (40%). Normal City discounts for equipment of this nature fall between thirty (30%) and
thirty-five (35%) percent. The purchase of this equipment utilizing this bid also saves the City the costs
and attendant time delays of issuing and evaluating a complex bid of this nature.
Information Services staff has researched the matter and determined that going out to bid is not
recommendable in this situation. Under tie City's procurement code, Sec. 3.70.030, bids
conducted by other public agencies for su:s:antially the same purchase constitutes compliance
with the advertised bid requirements. Because of this, Information Services staff is requesting
waver pursuant to Sec. 3.70.080 of the City's procurement code.
Approved:
im White Date
Mayor
0 Page 1
980428-SKA-CG-KENT.01.xis NNI rev. 3.0
City of KentI NEWBRIDGEI
City of Kent Network Project
Attachment A
This Quote is Valid for 60 Da"from"Printed on"Date at the Bottom of this Quote January 1998 Priea List
Site: City of Kent,Washington 980428-SKA-GC-KENT-01C
Node Description: Kent Campus Network
Site Requirements: VIVID Switched Routed Network
Part Unit Intl. Ext- % Extended
Item Qty. Number Description Price Uplift Price Disc Disc.Price
•e Common Equipment ee
1 1 94-0359-01 VVD OR STARTER KIT 110V S 54,995 554,995 554,995 0% $54,995.00
2 43 3CI6942AUS SUPERSTACKII SWITCH 3000 101100(12 PORTS) 3,495 53,495 5150,285 30% 5105,199.50
3 6 90-2931-01 100BASET ORANGE RDG MMF 17,995 517,995 5107,970 4090 564,782.00
4 1 94-0227-01 ACS 4SL0T CHASSIS CONF S 19,500 $19,500 519,500 0% 519,500.00
5 1 94-0228-01 ACS MOT CHASSIS CONF S 26,500 526,500 526,500 0% 526,500.00
6 5 90-3002-01 VIVID ACS QUAD OC-3 MMF 3,875 53,875 519,375 40% 511,625.00
7 1 90-3006-01 VIVID ACS POWER SUPPLY HARDWARE S 1,050 53,050 $1,050 40% 5630.00
8 1 90-3113-01 VVD RACKMOUNT ROUTE SVR 35,000 $35,000 535,000 40% 521,000.00
9 8 90-3780-01 MCC 100BT MM FIBER ST ASP870-IOOMT S 850 5850 $6,800 30% 54,760.00
10 1 90-3787-01 MCC ENC 12SL0T 1PS ASP870-ENC S 895 S995 S895 30% 5626.50
11 1 90-3002-02 VIVID ACS QUAD OC-3 SMF 12,500 $12,500 512,500 40% 57,500.00
12 1 90-2931-02 100BASET ORANGE RDG SMF 21,995 521,995 521,995 40% 513,197.00
13 9 3C16920 SUPERSTACKII SWITCH 100BASE-FX FIBER MODULE 995 5995 58,955 30% 56,268.50
14
15
16
17
IS
19
2(l
22
23
24
25
26
27
Quotation Terms
Soawsre Licata: Software furnished 6y Nerbldge 111111 be aobjeot to appdabb"Newhtidge End User Liceew Agee asat tares.
Pticee gmted heroic an hosed upon the volome quoted add subjedtio Nmbddp's standard tmms and cmukb u fmpmwwn of the applioble Pmduco end eerriar,
®less other temu have bean nparatety negotimd and Moscally agmd span m wtttmg"a parries.
Standard tends(copin of which can be ptdndedopoo request)hmhMa the followmg:
Delivery:F.O.B.ongm with 6aight prepaid and bdled back as a eepants mvmw dam.
Payment net 30 days from dab of invoice which data shall ant precede the data of shipment
Tates.Dudes dt Fen:ALL haesmdoos Pmsuent to this Agteemanr aha8 be ronsidered iambic.udees Customer providr Newbndge with aPPmPnare vertdndon of eaempdon
Prices quoted ere for U.S.delivery ordy ad are aaclustva of my iopmt Of mryott cartel,fees or other charges imposed for deivery to any other country of fuel desdmdan.
Any such cbarps shall be the soie,responwbdtty OfQwmdra.
Staaderd Newbridee Wenraddn shalt apply 5465,820.00 5336,583.50
Equipment Total
0% 50.00
1 91-7001-01 Installation-5750.00 tttinunttm(Zone A) 12% 555,698.40 10% $33,539.04
0 Shipping 2.00% Estimated 50.00 SO•00
50.00
50.00
',. SITE TOTAL Total: 5370.12234
Not for Use or Disclosure outside of Newbridge Networks Inc. and Customer without prior written:authorization.
Printed On: 4120198 Page i of 1
980428SKA-GC-Green.xls NNI rev. 3.0
City of Kent NEWBRIDGE
-� City of Kent Network Project
Annual Service Price Talizma o Green
This Quote is Valid for 60 Dan from"Printed on"Date at the Bottom of this Quote January 1998 Pfi6a List
Site: City of Kent,Washington 980428-SKA-Green
Node Description: Kent Campus Network
Site Requirements: VIVID Switched Routed Network
Pan Unit Intl. Ezc % Extended
tern Qty. Number Desorption Price Uplift Price Disc _ Disc Price
' Common Equipment --
1 1 94-0359-01 VVD OR STARTER KIT IIOV S54,995 S54,995 S54,995 0% S54,995.00
43 3CI6942AUS SUPERSTACKII SWITCH 3000 101100(12 PORTS) 3,495 S3,495 S150,285 30% S105,199.50
3 6 90-2931-01 100BASET ORANGE ROG MMF 17,995 S17,995 S307,970 4090 S64,782.00
4 1 94-0227-01 ACS 4SLOT CHASSIS CONF S 19,500 SI9,500 S19,500 0% S19,500.00
5 1 94-0229-01 ACS 8SLOT CHASSIS CONF S 26,500 S26,500 S26,500 0% S26,500.00
6 5 90-3002-01 VIVID ACS QUAD OC-3 MMF 3,875 S3,875 S19,375 40% S11,625.00
7 1 90-3006-01 VIVID ACS POWER SUPPLY HARDWARE S 1,050 S1,050 S1,050 40% S630.00
8 1 90-3113-01 VVD RACKMOUNT ROUTE SVR 35,000 S35,000 $35,000 40% $21,000.00
9 8 90-3780-01 MCC IOOBT MM FIBER ST -ASPS70-I.00MT S 850 S850 S6,800 30% S4,760.00
:0 1 90-3787-01 MCC ENC 12SLOT ITS ASP870-ENC S 895 S895 $995 30% S626.50
11 1 90-3002-02 VIVID ACS QUAD OC3 SMF 12,500 S12,500 $12.500 4G% S7,500.00
1 90-2931-02 100BASET ORANGE RDG SMF 21,995 S21,995 S21,995 40% S13,197.00
1.3 9 3CI6920 SUPERSTACKII SWITCH l00BASE-FX FIBER MODULE 995 S995 S8,955 30% S6,268.50
,4
i5
16
17
18
19
20
24
25
26
27
Ouotation Terms
rawen tAceme: Software fmruded by Narbndga shall be eubjen tv apphoble Nvwbndp&idUeQ Lieaw Agennmt nmo.
�cn ginned henes an band opm the velums gmtad ad object to Nee bridgee mandard fe,tn and condition,foe reewiten of the applicable pmdum and ser eene,
uNm other term,ham been sepmtaly negotiated aced mutually agreed oponm writing by the parvie.
Standard tame(copies ofwhieh can be provided upon reque h)mehrde the foilowmg
elivery:F.O.B.Origin with 6srght prepaid and haled beck u a wparne uremia itmn.
aymeou net 30 day,6vrn dau of invoice which date%hail not precede the dab of thipmerrt
um Dutin&Fees:All traniuetmm paruant to the Agrownot%hall be eonndered tumble union Cartzrnerpvvida,Newbridge with appropriate ver finibon of eaempuoa
Pnen quoted are for U.S.delivery only and are eaduave of any unport Or export dative,fen Or other ehatgn impend fin delivery many other country of final deetimuoa
Any each charges eW be the We raponability of Cummer.
aedard Newbride,Warreaties shall apply
Equipment Total for Annual Maintenance S465,820.00 SO.00
SO.00
1 91-3023-01 Taken=Green-Standard 7x24x4(Zone A) 17% Annual Mmnt $79,189.40 25% S59,392.05
0 Shipping 7 00-/a Einmaud S0.00 SO.00
0 SO.oa
0 $0.00
SITE TOTAL Total: S59.518.91
Not for Use or Disclosure outside of Newbridee Networks,Inc. and Customer without prior written Authorization.
Printed On: 4/30/98 Page 1 of 1
SUPPLEMENTAL TERMS AND CONDITIONS
Attachment A to this document identifies the specific Newbridge Networks equipment
items and quantities to be acquired by the City of Kent under this agreement.
The City of Kent requires the following terms and conditions in order to procure the
equipment identified on Attachment A via the WSPIC Contract No. 25.
• Newbridge Networks must guarantee that they will pay prevailing wages to
anyone working on this project.
• The City of Kent will pay for equipment (terms net thirty days) upon receipt of the
entire order as identified in Attachment A.
• The City of Kent will pay for installation services (terms net thirty days) upon
successful operation for thirty (30) days after acceptance by the City —
Acceptance to be determined solely by the City, but not to be unreasonably
withheld.
Newbridge Networks will sell at a forty percent (40%) discount any other
Newbridge equipment consistent with use for this network for a period of not less
than twelve (12) months from the City's system acceptance date. Excluding 94-
level part numbers, which are special packages and discounted items.
• Newbridge Networks will sell at a thirty percent (30%) discount 3Com equipment
consistent with use for this network for a period of not less than twelve (12)
months from the City's system acceptance date.
• Newbridge Networks will discount all installation charges associated with the
network system at the same rate of forty percent (40%) as the WSIPC contract
requires.
• Newbridge Networks will discount any maintenance agreements with the City by
twenty-five percent (25%) for so long as the City utilizes Newbridge Networks for
maintenance.
• Newbridge Networks will provide full VIVID System Manager training to two City
personnel as part of the City's initial system purchase; however, the City shall be
responsible for all travel, lodging, and per diem expenses incurred by the two
City personnel to the extent necessary to obtain this training.
SIPUBUCVSn bndg.dx
l �
Washington
School
Information
_ Processing
..�.�
' Cooperative
Bid Number 25
September 26, 1995
WSIPC
Bay Networks Routers, Adtran CSU/DSU's, 3Com Hubs,
Newbridge Networks, Inc., and Micom Muzes
Request for Bid Proposal
WSIPC Bid No. 25
INVITATION TO BID
LEGAL NOTICE
Invitation to Bid
WASHINGTON SCHOOL INFORMATION PROCESSING COOPERATIVE
LYNNWOOD, WASHINGTON
WSIPC Bid No. 25
Date of Bid Opening: September 26, 1995
You are invited to provide Bay Networks Routers, Adtran CSU/DSU's, 3Com Hubs,
Newbridge Networks, Inc., and Micom Muxes for consideration by over 275 public and private
K-12 school districts, Educational Service Districts, Community Colleges and other Public
Organizations located in the state of Washington.
Seal each bid in an opaque envelope and deliver to Washington School Information
Processing Cooperative, 2000 - 200th Place SW, Lynnwood, Washington 98036. Sealed bids
must be received by 2:00 PM, September 26. 1995. At that time, bids will be publicly opened
and read aloud by WSIPC or its authorized representative at the above address. No bidder may
withdraw its bid after the date and hour set forth above for the bid opening. The public is invited
to attend the bid opening. Any bids received after the time for bid opening will not be
considered. WSIPC reserves the right to reject any or all bids, and to waive any informalities or
irregularities in the bid or the bidding.
Bona fide bidders may obtain bid and contract documents at the office of:
Washington School Information Processing Cooperative
ATTN: Judy Perry
2000 - 200th Place SW
Lynnwood, Washington 98036
Dated this 1st day of September, 1995.
WASHINGTON SCHOOL INFORMATION
PROCESSING COOPERATIVE
By:
Its:
WSIPC Bid No. 25 Revised: 9/7/95 5
TABLE OF CONTENTS
INVITATION TO BID........................................................................................................5
INSTRUCTIONS TO BIDDERS ........................................................................................7
BIDFORM........................................................................................................................I I
STANDARD TERMS AND CONDITIONS OF PURCHASE CONTRACT..................14
PURCHASECONTRACT................................................................................................20
DETAILED TECHNICAL SPECIFICATIONS ...............................................................22
INSTRUCTIONS TO BIDDERS
- Instructions to Bidders
WSIPC Bid No. 25
1. Preparation and Submission of Bids
1.1 All bids must be in strict conformity with the bid documents and any addenda.
1.2 All blank spaces in the Bid Form must be completed by the bidder in ink or
typewritten. Items which do not apply shall be marked "N/A". The Bid Form must be duly
executed by the bidder. Any interlineations, alterations, or modifications to the Bid Form must
be explained in writing. Explanations must be initialed, in ink, by the bidder. The completed
Bid Form must specify the full legal name, business address, and street address (if it differs from
its business address) of the bidder. Bids submitted by a partnership or joint venture must list the
full legal names and addresses of all partners or joint venturers. Bids submitted by a corporation
must specify the corporation's state of incorporation. The name of each signatory must be
typed or otherwise clearly imprinted below each signature. Satisfactory evidence of the authority
of any signatory to sign on behalf of the bidder must be furnished by the bidder upon request of
C.
13 Each bid must be submitted to WSIPC in triplicate in a sealed opaque envelope,
along with three signed copies of the Bid Form.. The following information shall be specified in
the upper left-hand comer of the envelope:
(a) the name and address of the bidder;
(b) WSIPC Bid No. 25; and
(c) "SEALED BID ENCLOSED".
1.4 Each bid must be received by WSIPC no later than 2:00 PM on September 26,
1995, at the following address:
Washington School Information Processing Cooperative
ATTN: Judy Perry
2000 - 200th Place SW
Lynnwood, Washington 98036-7096
Bids received after the time and date designated for receipt of bids will_q9t be considered.
1.5 The preparation and submission of a bid will be by and at the expense of the
bidder. All bids must be submitted in a form and manner so as to comply with all applicable
laws of the State of Washington.
WSIPC Bid No. 25 Revised: 9/7/95 7
2. Examination of Bid Documents and Conditions
2.1 Each bidder must carefully examine the bid documents and all addenda. If any
bidder (a) finds any discrepancies, omissions or ambiguities in the bid documents, (b) is
unc--rtam as to the intent or meaning of any provision of the bid documents, or (c) has any
question regarding the bid documents, the bidder must promptly notify WSIPG thereof. St
notification to the attention of Judy Perry at the address specified in paragraph 1.4 abc
Replies to such notices may be made in the form of addenda which will be issued simultaneorsty
to all persons who have obtained the bid documents from WSIPC.
3. Modification or Withdrawal of Bids
3.1 A bidder may modify or withdraw its bid by written request, provided that the
request is received by WSIPC in writing prior to the time specified in paragraph 1.4. Following
withdrawal of its bid, a bidder may submit a new bid, provided that such new bid is received by
WSIPC prior to the time specified in paragraph 1.4. Bids cannot be withdrawn for a period of
thirty (30) days after the official opening of the bids.
3.2 WSIPC may modify any provision of the bid documents at any time prior to the
time specified in paragraph 1.4 of the submission of bids. Such modifications will be made in
the form of addenda which will be issued simultaneously to all persons who have obtained the
bid documents from WSIPC.
4. Award or Rejection of Bids
4.1 All bids properly identified and received on time will be publicly opened and read
aloud; unless otherwise stated in the Invitation to Bid.
4.2 WSIPC reserves the right to reject any or all bids, to make an award to other than
the low bidder, to make awards to different bidders for particular goods, to make an award to a
bidder for only a portion of the goods described in its bid, to reject a bid not accompanied by any
data required by the bid, to reject a bid which is in any way incomplete or irregular, or to waive
any informality or irregularity in any bid received..
4.3 In award of the contract, all factors and information as may be secured by WSIPC
which have a bearing on the decision to select a bidder will be considered including, without
limitation, the following: (a) the price; (b) the ability, capacity and skill of the bidder to perform
the contract; (c) the character, integrity, reputation, judgment, experience and efficiency of the
bidder; (d) whether the bidder can perform the contract within the time specified; (e) the quality
of performance of previous contracts; and (f) the previous and existing compliance by the bidder
with laws relating to the contract.
WSIPC Bid No. 25 Revised: 9/7/95 8
5. Contract Execution
5.1 If requested by WSIPC, the successful bidder must assist and cooperate with
WSIPC in preparing the formal contract. Within thirty (30) days after presentation of the formal
contract, the successful bidder must duly execute the same and return it for execution by WSIPC.
The failure of the successful bidder to duly execute and return the contract, together with
certificates of insurance and any other required documents, will constitute a breach of contract by
such bidder and entitle WSIPC, in addition to all other rights and remedies of WSIPC, to award
the contract to any other bidder.
5.2 All bid documents shall remain the property of WSIPC. If requested by WSIPC, the
unsuccessful bidders shall return all bid documents to WSIPC at the address specified in
paragraph 1.4 above, without mutilation, marks or annotations.
6. Offshore Items
Upon completion of the Contract, pursuant to Chapter 39.25 RCW, the successful bidder
shall be required to furnish a statement certified by the bidder setting forth the nature and source
of offshore items in excess of Two Thousand Five Hundred Dollars ($2,500) which have been
utilized in the performance of the Contract. For this purpose, the term 'offshore items" shall
mean those items procured from sources beyond the territorial boundaries of the United States
including Alaska and Hawaii.
WSIPC Bid No. 25 Revised: 9/7/95 9
BID FORM
Bid Form
WSIPC Bid No. 25
TO: Washington School Information Processing Cooperative
Attn: Judy Perry
2000-200th Place SW
Lynnwood,Washington 98036
In response to your Invitation to Bid, the undersigned offers to furnish all of the Goods
described in the Schedule of Goods in accordance with the contract documents and any addenda
thereto and for the prices and in accordance with the delivery schedule set forth in the attached
Schedule of Prices.
The undersigned certifies that:
1. This bid constitutes a firm offer which cannot be withdrawn for thirty days after the
official opening of the bids;
2. It has examined and is fully familiar with all provisions of the contract documents
and any addenda thereto;
3. It has carefully checked all of the words and figures shown in the attached Schedule
of Prices;
4. It has carefully checked the accuracy of all statements in this bid;
5. By careful examination of the contract documents, all addenda thereto and all other
pertinent conditions and matters, satisfied itself as to the nature, location, character,
quality and quantity of the Goods required by the contract documents and as to the
conditions and other matters that may affect performance of the Work or the cost or
difficulty thereof,
6. If awarded the contract, the undersigned agrees to duly execute and deliver to
WSIPC, within thirty (30) days after presentation, the contract, together with all
documents required by the contract documents.
7. It acknowledges receipt, understanding and full consideration of Addenda Nos._,
and
Legal Name of Bidder
Business Address
(City) (State) (Zip Code)
(Phone)
Street Address
(City) (State) (Zip Code)
WSIPC Bid No. 25 Revised: 9/7/95 11
Signature of Corporation
[Corporate Name]
[State of Incorporation]
By:
Title:
Date Signed:
Signature of partnership or Joint Venture
[Name of Partnership or Joint Venture]
By (all partners or joint venturers):
Date Signed:
Date Signed:
Date Signed:
Date Signed:
Signature of Individuals
Date Signed:
Date Signed:
Date Signed:
Date Signed:
WSIPC Bid No. 25 Revised: 9/7/95 12
STANDARD TERMS AND CONDITIONS
OF PURCHASE CONTRACT
Standard Terms and Conditions
Of Purchase Contract
WSIPC Bid No. 25
1. Definitions
1.1 The following terms shall have the following definitions whenever used in this
Contract:
I.La uv " is defined as Washington School Information Processing
Cooperative ("WSIPC") , whether acting on its own behalf, and/or behalf of all public and
private school districts, educational service districts community colleges and other public
organizations located in the State of Washington, acquiring Goods under this Contract. All
rights, benefits and warranties conferred upon Buyer by this Contract shall accrue, be available
to, and are for the express benefit of such school districts, educational service districts and other
public organizations.
1.Lb "Indemnities" is defined as Buyer, their successors and assigns and the
respective directors, officers, employees, agents and representatives of Buyer and their
successors and assigns.
1.l.c "Seller" is defined as the Seller identified in the Contract. If Seller is
composed of more than one person or entity, then each such person or entity shall be jointly and
severally liable as Seller under this Contract.
2. Price and Payment
2.1 Payment of the specified Prices shall constitute full compensation for the Goods
and satisfactory performance of all the Seller's obligations under this Contract. Such Prices
shall be subject to adjustment only as specifically provided for elsewhere in this Contract.
Any decrease in the price of Goods publicly announced by Seller and made available to all
of its customers shall be made available to Buyer effective the date of the announcement.
Seller shall separately identify on the Schedule of Prices and the applicable invoice of Seller
any applicable taxes arising out of the sale of the Goods payable by Buyer. Any time periods
specified for accepting any discounts shall commence upon, and Buyer shall pay the
appropriate amounts due thirty (30) days after, the later of: (a) the date that Buyer receives
Seller's correct invoice therefor; or (b) the date that Buyer accepts the Goods (together with
any required documentation) at the specified destination. If Seller fails to perform in a timely
manner any of its obligations under this Contract then Buyer may, upon ten (10) days advance
written notice to Seller of Buyer's intention to do so, perform the same and deduct or offset
WSIPC Bid No. 25 Revised: 9/7/95 14
such amount from the compensation payable to Seller under this Contract or otherwise charge
to or recover from Seller the cost of such performance.
3. Delivery
-1 Seller shall properly package the Goods for protection against damage or
deterioration that may result from shipment, handling, storage or other cause. Seller shall ship
the Goods from the specified point of shipment no later than the specified shipment date and
shall deliver the Goods to Buyer FOB the specified destination no later than the specified
delivery date. Risk of loss or damage to the Goods shall remain with Seller until delivery of the
Goods to Buyer at the specified destination at which time title to the Goods and such risk pass to
Buyer.
4. Delays
4.1 Time is of the essence in the performance of Seller's obligations under this
Contract. However, Seller shall not be liable for delays in delivery due to causes which are not
reasonably foreseeable, which are beyond Seller's control and which cannot be overcome by the
exercise of reasonable diligence; provided that Seller gives Buyer prompt written notice of the
circumstances given rise to the delay, the anticipated duration of the delay and the action being
taken by Seller to overcome or mitigate the delay. The specified shipment delivery date shall be
extended by the period of any such delay.
5. Inspection
5.1 The Goods shall at all times be subject to inspection, testing and expediting by
Buyer. No Goods shall be deemed accepted prior to final inspection by Buyer at the specified
destination. No inspection, test, delay or failure to inspect or test, or failure to discover any
defect or non-compliance by Buyer shall constitute acceptance by Buyer, relieve Seller of any of
its obligations under this Contract or impair Buyer's right to reject defective or non-complying
Goods or any other right or remedy of Buyer, notwithstanding Buyer's knowledge of the defect
or non-compliance, its substantiality or the ease of its discovery.
6. Warranty
6.1 Seller warrants that: (a) the Goods shall be free from all defects in design,
materials, workmanship and title; (b) all materials, components, parts and other items
incorporated in Goods shall be new, merchantable and of suitable quality for their intended
purpose; and (c) the Goods shall conform with the attached Specifications and other
requirements of this Contract. Seller shall promptly correct any Goods that do not comply with
this warranty. If Buyer requires Seller to make any such correction and Seller thereafter fails or
indicates its inability or unwillingness to do so, then Buyer may correct (or cause to be corrected)
the non-compliance or otherwise achieve compliance by the most expeditious means available to
it and charge to or otherwise recover from Seller the cost thereof. If Buyer rejects any Goods
WSIPC Bid No. 25 Revised: 9/7/95 15
that do not comply with the foregoing warranty, Seller shall have a reasonable time to correct the
non-compliance; if Seller fails to correct the non-compliance within a reasonable time, Seller
may cancel this Contract as to the non-complying Goods without any liability or obligation of, or
cost to, Buyer with respect to such Goods and without prejudice to any other rights or remedies
of Buyer with respect to such non-compliance (e.g., as to damages or cover).
7. Activities on Buyer's Premises
7.1 If Seller or any of its subcontractors or suppliers of any tier performs any
activities on premises owned, leased, possessed or controlled by Buyer, Seller shall; (a) take all
precautions which are necessary to prevent injury (including death) to persons and damage to any
property or environment in connection with such activities; (b) release, defend, indemnify and
hold harmless the Indemnities from all claims, losses, harm, liabilities, damages, costs and
expenses (including, but not limited to, reasonable attorney's fees) that may arise in connection
with such activities; and without limiting the generality of the foregoing, Seller waives its
immunity under any applicable workers' compensation laws for purposes of this Section 7 and
assumes potential liability for actions brought by Seller's employees, subcontractors or suppliers
of any tier.
S. Infringement
8.1 Seller releases and shall defend, indemnity and hold harmless Buyer from all
claims, losses, harm, liabilities, damages, costs, expenses (including, but not limited to
reasonable attorneys' fees) and royalties related to any claim, action, suit or proceeding involving
the Goods or any use or intended use of the Goods, which claim, action, suit or proceeding is
based upon infringement (or alleged infringement) of any patent, copyright, mask work, trade
secret, trade name or trademark or upon the wrongful use (or alleged wrongful use) of any
confidential or proprietary concept, method, process, product, writing, information or other item.
Further, if any of the Goods or any use or intended use of the Goods constitutes an infringement
of any patent, copyright, mask work, trade secret, trade name or trademark or wrongful use of
any confidential or proprietary concept, method, process, product, writing, information or other
item, Seller shall: (a) procure for Buyer the right to use the infringing item; (b) replace the
infringing item with a substantially equal but non-infringing item; or (c) modify the infringing
item so that it becomes non-infringing.
9. Compliance with Laws
9.1 Seller shall comply (and shall ensure that the Goods and Seller's subcontractors
and suppliers of every tier comply) with all applicable laws, ordinances, rules, regulations,
orders, licenses, permits and other requirements, now or hereinafter in effect, of any
governmental authority. All laws, ordinances, rules, regulations and orders required to be
incorporated in agreements of this character are incorporated in this Contract by this reference.
Seller shall comply with Executive Order No. 11246, the Rehabilitation Act of 1973 and the
Vietnam Era Veterans' Readjustment Assistance Act, 1972 and all of the orders, rules and
WSIPC Bid No. 25 Revised: 9/7/95 16
regulations promulgated thereunder, all as the same may have been or may be amended. The
"equal opportunity clause" of 41 CFR § 60-14, the "Affirmative Action Obligations for Disabled
Veterans and Veterans of the Vietnam Era" clause of 41 CFR § 60-250.4 and the "Affirmative
Action for Handicapped Workers" clause of 41 CFR § 60-741.4 are incorporated herein by this
reference. Seller certifies that segregated facilities (within the meaning of 41 CFR § 60-1.8) are
not and will not be maintained or provided for Seller's employees and that Seller will not permit
its employees to work at any location under Seller's control where segregated facilities are
maintained. Seller shall obtain a similar certification from others as required by 41 CFR § 60-
1.8.
10. Changes
10.1 Buyer may from time to time make changes in the requirements of this Contract
(including, but not limited to, additions to or deletions from any Goods, changes in quantities,
drawings and specifications for the Goods, suspension of performance, changes in schedule and
changes in shipment and delivery dates) by giving Seller written notice of such changes. If any
such change causes an increase or decrease in the cost of or the time required for performance of
this Contract, an equitable adjustment in the prices and schedule under this Contract shall be
made to reflect such increase or decrease. Seller must, within thirty (30) days after Seller's
receipt of any notice under paragraph 10 that does not set forth an acceptable equitable
adjustment, submit to Buyer a written statement of any adjustment claimed. Seller shall not be
entitled to any adjustment unless such written statement is submitted within such thirty (30) day
period. Notwithstanding any dispute or delay in arriving at a mutually acceptable equitable
adjustment under paragraph 10, Seller shall immediately proceed with performance of this
Contract in accordance with any notice under paragraph 10.
11. Termination of Contract
11.1 Buyer may from time to time terminate this Contract as to all or any portion of the
Goods not then delivered to and accepted by Buyer by giving Seller written notice of such
termination. In the event of any such termination, an equitable adjustment shall be made in the
prices payable under this Contract with respect to the terminated Goods; provided that such
adjusted prices shall in no event exceed the total prices otherwise payable under this Contract for
the terminated Goods, less the sum of (a)the estimated costs (plus a reasonable allowance for
profit) which would have been incurred by Seller to complete performance with respect to the
terminated Goods and (b) the reasonable value of the terminated Goods at the time of such
termination. No such termination shall relieve Buyer or Seller of any of their respective
obligations under this Contract as to any Goods not terminated. If Buyer purports to terminate or
cancel all or any part of this Contract for Seller's breach or default and it is determined that Seller
was not in breach or default that would permit such termination or cancellation, then such
termination or cancellation shall be deemed to have been a termination pursuant to this paragraph
and the rights and obligations of the parties shall be determined accordingly.
WSIPC Bid No. 25 Revised: 9/7/95 17
12. Successors and Assigns
12.1 Seller shall not (by contract, operation of law or otherwise) assign this Contract
or any right or interest in this Contract, or delegate performance of any of its duties
obligations under this Contract, without the prior written consent of Buyer. Any such
assignment or delegation without Buyer's prior written consent shall be voidable at Buyer's
option. Subject to the foregoing restriction on assignment and delegation by Seller, this
Contract shall be fully binding upon, inure to the benefit of, and be enforceable by Seller,
Buyer, and their respective successors, assigns and legal representatives.
13. Nonwaiver
13.1 The failure of Buyer to insist upon or enforce strict performance by Seller of any
of the provisions of this Contract, or to exercise any rights or remedies under this Contract, shall
not be construed as a waiver of relinquishment to any extent of its right to assert or rely upon any
such provisions, rights or remedies in that or any other instance; rather, the same shall be and
remain in full force and effect.
14. Applicable Law; Courts
14.1 This Contract shall be interpreted, construed and enforced, in all respects, in
accordance with the laws of the state of Washington, without reference to its choice of law
principles. Seller shall not commence or prosecute any suit, proceeding, or claim (to enforce the
provisions of this Contract, to recover damages of, or default under this Contract or otherwise)
arising under or by reason of this Contract, other than in the courts of the state of Washington in
King County, or the United States District Court for the Western District of Washington at
Seattle. Seller irrevocably consents to the jurisdiction and venue of the courts identified in the
preceding sentence.
15. Entire Agreement
15.1 This Contract sets forth the entire agreement and supersedes any and all prior
agreements, between Seller and Buyer regarding the Goods. No amendment or modification of
any provision of this Contract shall be valid unless set forth in a written instrument signed by
both parties. Buyer shall not be bound by, and specifically objects to, any term, condition or
other provision which is different from or in addition to the provisions of this Contract (whether
or not it would materially alter this Contract) and which has been proffered by Seller in any
quotation, invoice, shipping document, acceptance, confirmation, correspondence or otherwise,
unless Buyer specifically agrees to such provision in a written instrument signed by Buyer. The
rights, remedies and warranties afforded to Buyer pursuant to any provision of this Contract are
in addition to and do not in any way limit any other rights, remedies or warranties afforded to
Buyer by any other provisions of this Contract, by any of Seller's subcontractors, suppliers of any
tier, or by law.
WSIPC Bid No. 25 Revised: 9/7/95 18
PURCHASE CONTRACT
+ Purchase Contract
WSIPC Bid No. 25
T ;, Contract is made by and between Buyer (as defined in the Standard Terms and
Conditions) and the Seller (as defined in the Standard Terms ar- Conditions). Buyer and Seller
agree as follows:
1. Description of Goods. During the Term of this Contract (as defined in the
Standard Terms and Conditions), Seller will sell and deliver to Buyer and Buyer will purchase
from Seller the goods, services, information, drawings, documents and other items described in
the Schedule of Goods ("Goods"), to be attached hereto, orderer, oy Buyer , if any, from time to
time during the Term of this Contract. Details that are necessary to carry out the intent of this
Contract, but that are not expressly required, shall be performed or furnished by Seller without
any increase in compensation otherwise payable under this: �.ontract.
2. Compensation. As full compensation for the Goods, Buyer will pay Seller the
applicable sums for the Goods ordered by Buyer , if any, set forth in the Schedule of Prices
("Prices"), to be attached hereto, in accordance with the payment provisions -'this Contract.
3. Term. The Term of this Contract ("Term") shalt _ommence on the date of this
Contract in accordance with Paragraph 5 below and, subject to earlier termination as provided in
the attached Standard Terms and Conditions, shall end eighteen (18) months thereafter. The
Term of this Contract may be extended upon mutual agreement between Buyer and Seller.
4. Performance of Work Contractor shall comply with all of the provisions of this
Contract which include the provisions set forth in the following -cuments (together with such
other documents that may be incorporated into or otherwise made a part of this Contract,
("Contract"):
(a) this Purchase Contract;
(b) the attached Schedule of Goods and Prices:
(c) the attached Standard Terms and Conditions; and
(d) the attached Specifications.
5. This Contract s-ail be effective as of the date approved by the Board of Directors
of Washington School Information Processing Cooperative.
Buyer : Seller:
Washington School Information
Processing Cooperative
By: By:
Title: Title:
Date Signed: Date Signed:
Address: 2000 - 200th Place SW Address:
Lynnwood, WA 98036
WSIPC Bid No. 25 Revised: 9/7/95 20
DETAILED TECEMCAL SPECIFICATIONS
Detailed Technical Specifications
WSIPC Bid No. 25
The purpose of this Bid will be to select Vendors to provide already established product lines.
Absolutely n-Q substitutions will be allowed under this Bid.
The Vendor is encouraged to subm--the pricing information in both paper and digital form. If
possible, the Vendor should provia� the digital price list in Microsoft Excel format on a 3.5"
diskette.
With respect to Items A through F the Vendor should submit pricing in the form of a percentage
discount off of the manufacturers suggested retail price.
A. Bay Networks Routers
The Vendor should bid the following models of Bay Networks routers, equipment,
software, and services.
A.1 All configurations of the Access Feeder Node.
A.2 All configurations of the Feeder Node.
A.3 The Link Node chassis.
A.4 The Concentrator Node chassis.
A.5 The Backbone Link Node chassis
A.6 The Backbone Concentrator Node chassis.
A.7 All models of Intelligent Link Interfaces.
A.8 All cable options.
A.9 All optional hardware (i.e., secondary power supplies).
A.10 All system software options.
A.11 All hardware/software maintenance options.
WSIPC Bid No. 25 Revised: 9/7/95 22
A.12 All Vendor-provided training.
B. Adtran 56Kb CSU/DSU's
The Vendor should bid all models of Adtran CSU/DSU's with multirate capabilities up
to and including 56Kb.
C. Adtran T-1 CSU/DSU's
The Vendor should bid all models of Adtran CSU/DSU's with multirate capabilities up to
and including TI.
D. 3Com 10base T Hubs, Fiber Optic Hubs and Accessories
The vendor should bid all categories of 3com Local Area Network hardware with the
exception of all 3Com Routers and router accessories. The response should be in the
form of a percentage discount off of list price.
E. Newbridge Networks, Inc.
The vendor should bid all categories of Newbridge Networks, Inc. hardware. The
response should be in the form of a percentage discount off of list price.
F. Micom Mutes (MB"X" and Marathon product lines)
The vendor should bid all categories of Micom Communications hardware. The response
should be in the form of a percentage discount off of list price.
WSIPC Bid No. 25 Revised: 9/7/95 23
04/01i98 WED 13:24 F.0 425 3496601 RSIPC ®005
ADDTI70NAL MATERIAL FROM THE=CDTIVE DIRECTOR
Agenda for February 28,1997 Meeting
1o:oo AM at WSIPC Everett Facility
1. Board sub-committer on Fadlitim
2. WS3PC(Perkins Coie Letter)on legal read on WSSDA,WASBA,and Alden Web page requests
Recommendation.- Cannot Legally Support Requertt
3. Microsoft Education Select Program
RCCoRms"jatian: proceed with BID for an Authorized Account Resdler
4. Policy*4710(Emergency Closure)
Recommendation: Rarffy Last Changerfram Legal
S. Bid#25(Networking Equipment Bid Extension)
Reeommandadon: ZvAmd
6. Bid 428(Alpba Systems&Peripberals)
Recammendadon: Award
7. UCT(User Communication Tracking System)
Info. Only
S. Recommendations from Faeeutive Committee
(Dec 911996) Info. Only
9. Recommendations from the F.xecatme Committee
(Fete 13,1997) Info- Only
10. Wise/Student Conversion Time Table
Info. Only
1L Sultan S.D.Letter re: WISE Coa►srsum
Infaa Only
12. Mukiiteo S.D.ILA
Refer to the lastparagraph: Answers quamioma as to wiatlic we can use
anther's Bid rego-Aw of date of Bid and HA We will pursue the ILA with Muldlleo after
Legal approval of changes.
13. Advisory Committee Procedures
Latest Changes from February 13,1997 Execist:.e Cammrltre Moding
14. ILA
Lames Change f sum February 13,1997 F"nuave Cmamwee Meeting
I& Budget Deliverables/WEdNet Update
c_ ztalrob=Wwlagen2-28.doc
U- ' ui,yo nnu �0 ra. dGa O-,aooU-
BID 25 Extension Background 5
and Recommendations
In fill cooperation and support of our role in the K-20 partnership, we do not recommend the re-
Bid of the items covered by Bid 25. However since our customers will still need to order items
contained in Bid 25, we believe that extension of this contract is the best available approach. Bid
25 for'Bay Networks Routers, Adtran CSU/DSU's, 3-Com Hubs,Newbridge Networks,
Products, and Micom Muxes" will expire on April 10, 1997 if we do not take action to extend the
awards. Board approval of such an extension is required The purchase contract contained a
provision for such extensions, as follows.
"3. Term. The Term of this Contract('Term) shall commence on the date of this Contract in
accordance with Paragraph 5 below and, subject to earlier termination as provided in the attached
Standard Terms and Condition, shall end eighteen (18) months thereafter. The Term of this
Contract may be extended upon mutual agreement between Buyer and SeUer."
The awards made under Bid 25 were as follows:
Category A-Bay Networks Wellfleet Routers and related products
Primary Vendor Award: GTE Northwest, Inc.,Everett, Washington
Category B -Adtran 56KB CSU/DSU Products
Primary Vendor Award: Nordata,Inc./Datatech, San Juan Capistrano, Califorroa
Category C-Adtran T-1 CSU/DSU Products
Primary Vendor Award: Nordata, Inc./Datatech, San Juan Capistrano, California
Category D -3-Com Networking Products
Primary Vendor Award: GTE Northwest, Inc., Everett, Washington
Category E-Newbridge Networks Products
Primary Vendor Award: GTE Northwest,Inc.,Everett,Washington
Category F -Micom Multiplexor Products
Primary Vendor Award: Communications Specialists Inc.,Redmond,Washington
Two of the vendors receiving these awards (GTE Northwest and Nordata Inc./Datatech) have
provided a written request to extend their respective awards by 18 months and guarantee to
continue to honor the pricing during the extension_ Both of these vendors have adequately
fulfilled their responsibilities under the contracts. Their pricing remains competitive in light of
current market conditions, and many of these products continue to be in demand by our clients
and for our own equipment needs. If we do not extend or rebid these products, we and our
clients will be unable to quickly acquire needed components for our networking activities under
this bid. An eighteen(18) month extension of these vendor's awards would be appropriate for our
clients needs and consistent with past practice and the contract provisions.
Such an extension is recommended.
04/01/98 WED 13:25 FAX 425 3496601 WSIPC Z007
The third vendor, Communications Specialists, Inc. has indicated that they will not be able to
continue to honor the Micom Multiplexor fine(Category F) at the bid pricing on Bid 25. CSI has
indicated that the manufacturer has reduced the discount that they could offer during an extension
from 396/9 off list to 308/9 off list. Interest in this product line has virtually disappeared. An
extension under the proposed conditions is not recommended.
There may be some questions raised about why we are seeking to extend the bid award for Bay
Networks (Wellfleet)routers in light of the emerging standard for the K-20 Network which will
use CISCO routers as it is built out to the ESDs and the schools. But this will in no way inhibit
any K-20 actions. In fact, we see this as a continuous partnership with K-20 to take advantage of
newly acquired bandwidth. We are completely and totally a partner in the K-20 project If the
bid is allowed to expire districts which prefer to "finish out"their internal networks with the
products they are currently installing would have to find other avenues of support, and WSIPC
would be unable to_gmiddy aaguireBay NIMMIks MdUcu using this Bid. We are currently
actively working with both CISCO and Bay to engineer a smooth and economical integration of
the product lines, and we are currently recowmen&ng CISCO solutions to districts where that
makes sense. However, we prefer to keep this important avenue open for our Customer's access
to the Bay Networks product line at this point. Additionally,it would be very time-consuming
and expensive to re-bid these items_
February 14, 1997 DATATECH
Specialists in Data Communications Equipment
Mr. Bob von Wotffradt, Executive Director
Washington School Information Processing Cooperative
2000 -2001"Place Southwest
Lynnwood, Washington 98036
Dear Mr. von Wolfliadt:
Mr. Tim Page has mformed me that WSIPC is seelang to extend the timefrazne for Bid
#25. On behalf of Nordata, Inc. (dba"Datatech-), we are also agreeable to extending the
terns of our contract award for any,products on both bid categories"B" and"C"for at
least 1-1/2 to 2 years at the option of WSIPC. This would also apply at the same relative
discounts to any newer Adtran products of the same kind as they become available.
As has been the case, please send any and all orders drafted under this agreement to:
Mr. Richard$elte
Datatech Northwest
18100 NE 95'6 #M097
Redmond, WA 99052
Phone: (206) 869-9330 or
(800) 785-5540
Fax: (206) 869-9412
Also, as in the past, all shipments and invoices will be generated by:
Datatech
27126A Paseo Espada #21602
San Juan CaPistrano. CA 92675
and this California address is also valid for the`Remit To" address.
Thank you for the past business relationship. We look forward to an even better
relationship in the future.
Sincerely,
Richard C. ITjelte
NW Regional Manager
DATATECH -27126A PASEO ESPAOA, SUITE 1602• SAN JUAN CAPISTRANO,CALIFORNIA 92675
TELEPHONE(714)493-2028
FAX: (714)493-1840
04/01/98 WED 13:26 F.•.1 325 3496601 WSIPC �0009
GTE Telephone
1 CV7i�� Operations
February 20, 1997
Mr. Jim Page
Washington School Information
Processing Cooperative
2000 -200th PI. S.W.
Lynnwood, WA 98036
Dear Jim:
This letter will serve as a confirmation that GTE Northwest is pleased to extend
their commitment on Bid #25 for an additional eighteen months.
The current contract will expire March 31, 1997, and the extension will cover
April 1, 1997 through September 30, 1998.
GTE will honor the discounts for the following categories through September 30,
1998:
Al-12 Bay Networks
D 3-Com
E Newbridge Networks, Inc.
GTE appreciates the opportunity to extend Bid #25 and we look forward to
continuing our valued relationship with Washington School Information
Processing Cooperative.
If I can be of assistance please call me at 206-261-7823.
Sincerely,
Mary Beth Hines
Senior Account Manager
c: Susan Ershler, GTE
A part of GTE Corocranon
ommunication /)
=)pecialisrs. Inc. Information Services
February 13, 1997
Mr.Robert von Wol$radt
Executive Director
WSIPC
200 200th Place S.W.
Lynnwood,WA 98036-7096
Dear Mr.Wolffradt:
It came to my attention through our salesman Gregg Zambrovitz,and to him from
Tim Paige that WSIPC is desirous of extending the length of time Micom System Is
can be purchased at the original bid discount-rate of 39%. I'm sorry to say we
cannot do this.
Micom Systems has lowered the discount rate to my distributor. Therefore,his dis-
count rate to us is lowered.
The best CSI can do at this juncture is the current Micom List priceless 30%. I'll
send a current price list or quote on any certain model as soon as I receive the new
one from my distributor. Hopefully,this will not inconvenience WSIPC.
The only caveat to the above is if WSIPC needs a larger known quantity. I could
then shop that requirement and perhaps could come up with a better discount. Let
me know when this is a possibility.
Sincerely,
&Hed
CSI Business Development Manager
e� Tim Paige,WSIPC Technical Director
Gregg Zambrovitz,CSI Account Manager
PO. Box 778 • Redmond, wA 98Of3-W78 TEL(206) 885 3100 FAX(206) 885-3551
Kent City Council Meeting
Date May 19 . 1998
Category Consent Calendar
1. SUBJECT: CANTERBURY GREENS TOWNHOMES FINAL PLAT FSU-96-4 -
SET MEETING DATE
2 . SUMMARY STATEMENT: Set June 2 , 1998, for a public meeting
to consider a final plat application by Canterbury Greens
Associates for the Canterbury Greens FSU-96-4 . The subject
subdivision is 4 . 21 acres in size and is located south of SE
264th Street at approximately 126th Place SE. The subdivision
contains 19 lots. The City Council approved the Hearing
Examiner' s September 25, 1996, recommendation of approval on
November 5, 1996.
3 . EXHIBITS: None
4 . RECOMMENDED BY: None
(Committee, Staff, Examiner, Commission, etc. )
5. UNBUDGETED FISCAL/PERSONNEL IMPACT: NO YES
6. EXPENDITURE REQUIRED: $
SOURCE OF FUNDS•
7 . CITY COUNCIL ACTION:
Councilmember moves, Councilmember seconds
DISCUSSION:
ACTION•
Council Agenda
Item No. 30
•� A
Kent City Council Meeting
Date May 19, 1998
Category Consent Calendar
1. SUBJECT: SENIOR CENTER CARPET REPLACEMENT - APPROVAL
2 . SUMMARY STATEMENT: Authorization to proceed with sole
source purchase of ADA required carpeting for the Senior Center
under King County Directors contract in the amount of $65, 000
including state sales tax, as recommended by the Operations
Committee.
After much searching for a product that would best meet our
needs, a carpet manufactured by Interface was discovered. This
product consists of carpet tiles which have two unique
features: it takes a minimal amount of glue to install and it
has a patented anti-microbial solution integral to the fiber.
This product has a 15-year wear warranty as opposed to 5-year
warranties on other carpets.
3 . EXHIBITS• Memo
4 . RECOMMENDED BY: Operations Committee
(Committee, Staff, Examiner, Commission, etc. )
5 . UNBUDGETED FISCAL/PERSONNEL IMPACT: NO X YES
6 . EXPENDITURE REQUIRED: $65 , 000 _
SOURCE OF FUNDS•
7 . CITY COUNCIL ACTION:
Councilmember moves, Councilmember seconds
DISCUSSION-
ACTION•
Council Agenda
Item No. 3P
t
Memorandum
To: City Council Operations Committee
CC: Brent McFall, &ief
From: Charlie Lindse`
Date: April 29, 1998
Subject: Replacement Carpet for Senior Activity Center
If any of you have been in the Senior Center you will agree that it is time to
replace the carpet and we have been working on accomplishing that. As
we explored the issues of what kind of carpet will best serve our needs it
became apparent that we needed to make accomodations for chemical
sensitivity in our buildings as air quality is an issue that arises frequently.
After much searching for a product that would best meet our needs we
have discovered a carpet manufactured by Interface. This product
consists of carpet tiles which has a couple of unique features. One it takes
a minimal amount of glue to install and two it has a patented anti-microbial
solution integral to the fiber. This product has a 15 year wear warranty as
opposed to 5 year warranties on other carpets.
Because of the above special market conditions required to make A.D.A.
accomodations I am requesting that we be allowed to purchase this
product, as we recarpet each of our buildings, from the King County
Directors Association (KCDA) contract which recently bid. The cost for the
Senior Center is $65,000 and is budgeted. With the proper care this
product should last 15 to 20 years.
Kent City Council Meeting
Date May 19 , 1998
Category Consent Calendar
1. SUBJECT: COUNCIL ABSENCE YINGLING - APPROVALS
2 . SUMMARY STATEMENT: Approval of an excused absence from
tonight's Council meeting for Councilmember Rico Yingling, he
will be unable to attend.
3 . EXHIBITS: Memorandum
4 . RECOMMENDED BY:
(Committee, Staff, Examiner, Commission, etc. )
5. UNBUDGETED FISCAL/PERSONNEL IMPACT: NO X YES
6. EXPENDITURE REQUIRED: $
SOURCE OF FUNDS:
7 . CITY COUNCIL ACTION:
Councilmember moves, Councilmember seconds
DISCUSSION:
ACTION
Council Agenda
Item No. 3Q
MEMORANDUM
TO: JIM WHITE, MAYOR
CITY COUNCIL MEMBERS
FROM: RICO YINGLING, CITY COUNCILMEMBER
DATE: MAY 13, 1998
SUBJECT: CITY COUNCIL EXCUSED ABSENCE
I would like to request an excused absence from the May 19, 1998. City Council meeting. I will be
unable to attend.
Thank you for your consideration.
RY:jb
- - -
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Kent City Council Meeting
Date May 19 , 1998
Category Bids
1. SUBJECT: RUSSELL ROAD BALLFIELD COMPLEX IMPROVEMENTS
2 . SUMMARY STATEMENT: The bid opening for this project was
held on May 15, 1998. Due to time constraints, the low bid
results and recommendations will be presented at the Council
meeting.
3 . EXHIBITS: None
4 . RECOMMENDED BY: Staff
(Committee, Staff, Examiner, Commission, etc. )
5. UNBUDGETED FISCAL/PERSONNEL IMPACT: NO X YES
6. EXPENDITURE REQUIRED: Engineer ' s Estimate $881, 525.75
SOURCE OF FUNDS: CIP
7 . CITY COUNCIL ACTION:Councilmember l )eyA moves, Councilmember am seconds
that �• be awarded the Russea1 Road Ballfield
Complex Impro em nts for the bid amount o S 006 .T laz
DISCUSSI N• i dVq 46noo �
Y65 ACT ON E 'Y` -
d,� yC'J� c000 DD, U� Council Agenda
/�// �� C�J �`✓�-y+/`-eI , ,/,' Item No. 5A
CONTINUED COMMUNICATIONS
A.
R E P O R T S
A. COUNCIL PRESIDENT
B. OPERATIONS/PUBLIC SAFETY COMMITTEE
C. PUBLIC WORKS/PLANNING COMMITTEE
D. PARKS COMMITTEE
E. ADMINISTRATIVE REPORTS
EXECUTIVE SESSION - Property Acquisition
� , � ,
PUBLIC WORIGS/PLANNING COMMITTEE
May 4, 1998
PRESENT: Tim Clark Tom Brubaker
Rico Angling Don Wickstrom
Leona Orr Jim Harris
108th Avenue SE Sanitary Sewer Extension
Wickstrom explained that this project is 90% over the original contract amount because
of additional work required after the project was started. He said that this sewer project
is in the area of the S. 277th &- 108th Ave S.E., immediately adjacent to our new
corridor project and involved connecting sewer to two houses to relocate for resale.
When this contract was released, it was decided by the Public Works Dept that
maintenance roads along the top of the banks to do maintenance work along the slopes
of the road would be required. Rather than going out for bid on this work, we got a price
from this VLS Construction, the contractor for the sewer project, to do the job and he
just added the cost to the 108th Sewer contract. We also had to do some cleaning up
on the houses and can hopefully put them on the market for sale.
Committee unanimously recommended to accept as complete the 108th Ave SE Sanitary
Sewer Extension project.
WSDOT Detour Agreement - 84th Ave/Grady
Wickstrom explained that the State is doing roadwork along the valley freeway; they are
also installing signals at the various on/off ramps to coordinate traffic flow onto the
freeway. He said that this agreement with Kent would allow the State to detour traffic
onto some of our city streets.
Committee unanimously recommended authorization of the Mayor's signature on the
Dept of Transportation Detour Agreement for the SR 167 - 84th Ave to Grady Way
project.
King County Waste Reduction Agreement
Wickstrom said this is a grant we received to expand our recycling program into the
commercial business area. This grant ($33,187) offers education for commercial
businesses which includes mailing information packets and two scheduled recycling fairs
where businesses can discuss what they are doing about their recycling program.
1
Committee unanimously recommended authorizing the Mayor to sign the grant
agreement, direct staff to accept the grant and establish a budget for $33,187.00.
Wickstrom noted that we are trying to provide businesses with as much information as
possible. Relative to performance measures, commercial recycling is regulated by
WUTC. All we can do is facilitate the program. Wickstrom also noted, regarding
staffing for this program, Robyn Bartelt who handles all of the conservation programs,
manages the garbage and recyclin7 contracts is the only staff person for the entire
recycling program.
Surplus Vehicles
Wickstrom referenced a list of vehicles that we are proposing to surplus at the next
public auction. These vehicles have all met the point system. The Fleet Manager works
with the different departments and City Administration to establish a point system of
when vehicles reach certain age and can then be declared as surplus.
Committee unanimously recommended authorization to declare this equipment as
surplus and authorize the sale thereof at the next public auction.
Burlington Northern - Santa Fe Railroad Depot
Jim Harris stated that on March 2nd, the Committee received an over-view of some
downtown depot issues and that is, preserving the downtown depot. At this time he
wanted to have more explicit direction from the Committee. Harris presented copies of
the "Adoptive Reuse" study which was done in 1989 for the Planning Dept which
included four alternatives presented for use of the depot. Some of these alternatives were
based on the thought that the depot would be the Regional Transit Authority's depot,
however that is not going to happen now. Harris said we still have an opportunity to do
something with that depot. Our problem in 1989, 90 and '91 was in working with the
Railroad on how we might get our hands on the depot. Now that there is a Burlington
Northern/Sante Fe Railroad and there are more things happening in the valley with rail,
we may have a better chance to talk with them.
J
Linda Johnson, Downtown Partnership, stated the following. The last time we reviewed
the use of the railroad site, we were told that the Railroad is using it as a working depot.
We have been advised by consultants to go after ISTEA funds and possibly use the
pedestrian orientation money to restore that depot as an historic building. The
Partnership felt that even if it were not going to be used as the train station itself, the
parking lot area could possibly be used as the depot. Commercial use could then go back
into the train station. Harris suggested that the City work with the Downtown
Partnership. Yingling asked how the downtown would be linked with the new rail site.
Harris said if the RTA depot goes to the south end it could be linked to the downtown
2
area by bringing in retail and if the depot goes to the north end, there is still a proximity
to other uses.
Committee unanimously recommended that staff be directed to re-open dialog with the
Railroad and work with Kent Downtown Partnership and RTA to find out what interests
are there and pursue any options we have for preserving the station.
Chamber of Commerce Freight Mobility Systems Alignment Proposal
Wickstrom said that we have been approached by the Chamber to be a co-sponsor for
this proposal in the amount of a $10,000 grant. This is a system wide approach to
freight mobility looking at all factors in trying to find low cost implementable ideas or
mechanisms that can move freight faster without and extensive amount of money. To
move freight faster in Kent would mean our buildings and warehouses would be efficient
and generate more revenue in terms of sales tax and etc. Wickstrom said he feels it's a
worthy investment; we do have money in the South Icing County Area Transportation
Improvement Board (SCATBD) which meets monthly. Rico Yingling noted that he is
co-chair on the SCATBD Committee looking at the business side of freight mobility
throughout the state. We are looking at how we can use improvement strategies for the
business side of the equation rather than infrastructure. Yingling said there are many
organizations dealing with freight mobility; State Agencies, Customs, Ports, Maritime
Industries, etc. If a system uses five different organizations to move freight and if each
one is working at 90% efficiency, the problem is when five are working together, handing
off the freight from one to the next, even at 90% efficiency the entire system only works
at 60% efficiency. If each one of those groups works to improve their efficiency just a
little, the entire system improves alot. Yingling said no one else in the system is working
on it from that directive and the idea is, within 18 months we have three to six very
concrete implementable ideas for improvement and we also have new performance
measures for our Puget Sound area.
Committee unanimously recommended that the City expend $10,000 to co-sponsor the
Kent Chamber Freight Mobility System Alignment Proposal and authorize the monies
to come out of the Green River Transportation Benefit District Project fund (R52).
As a point of clarification, Tom Brubaker stated that in the Public Works document we
used the word 'grant' but what the City is actually doing is co-sponsoring with the
Chamber of Commerce. There is a constitutional prohibition against the use of gift of
public funds and this is actually a quid-pro-quo arrangement; we are co-sponsors with the
Chamber and we will be receiving valuable benefit from this study. We are sharing in
the cost but it is not truly a grant.
Meeting adjourned: 4:18 p.m.
3