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HomeMy WebLinkAboutCity Council Meeting - Council - Agenda - 05/19/1998 7 Cloty of Kent ClotyCouncil Meeting Agenda CITY OF i _ 1 � S S .W 1 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 C� CO G �c 00 O v U A W N eo H y a O Ox o G d CD CD o y w 3 � o = c w o v o m OCD O CAto rJ O O C et eb .. O iC -I O O W 000 Q' rnco "i• U O 00 n dam' _. RCD O n1 M C eti C w5 on C) 0 9 o ti o o CDc- y N O w I fry H � I I O• l 1 N � C A o y < n y. I � � y p to c 65 69 69 (09 69 69 E09 69 69 69 6) 69 69169 69 y Q0 va tj N Lh 1U -j A 00 �c in O U1 00 N O O� O0 T N R O O O O p to O (A � O to O N 00 W C O O O Z O 69 69 69 b9 69 69 64 69 i 69 6R (IQ su rZ n � y rA N N pN 00 O 0ppLA 0 fA O O O 0 0 0 O O I O 69 69 69 69 69 69 69 69 69 69 69 69 69 69 69 iA 69 n O O I � I �O A W W! ANI NiN !V1 r C O I L C'r, 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. z w = m0mc> > mOmm K C g O W O O m = c n X C m O O m N �, 6> (D CE N LaN ° 7v► H a73, 7A CD y CD O y fA CD M CO < M M C N �_ C CD N M aCl) CD G 7 C7 CD FAm m o ? o - = " 7C - co .0 CD m 'fl CD C) y ?fy=r CO ( N ad � Ny< a < CND t H T y rr � rn f l CS O O O N C) y d \ CD O n H ° O 3 c O � II� � ` a C o' x 7 7 8CL co O COD 'O N O U9 _a CD xn .bqN O X O Ul M 00 O co _ O Cp co v`G < N'�G < 7 m a Gm x m y m < ON p m' a1X to o ov C:° m En •c o En H b9 �p a) C J W N b9 A .69 Erg E9 EA m Cl) CD Q7 0 ro 4. O i - C) 0 CD N CIO O (n N O O N N N O O O CD fA m O O O Ui O O O Cn CJf O O O -� O O O O O O O O O O O O O O O O 69 O O e4 mm ommo a O o ti Q. 7 � o ��o f9 c� `J co 0 n CD En cro f/l I Z Oi0 Y � r h . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . z a - y a as q � ax Co in �r 3co 0 = z m a CV R a G y 0 a F y .t OCD O O O C r . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . C . . . . . . . . . . .. . . . . ■ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ■ ■ . . . . . ■ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . z Immomman 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . d r-� 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 . 4z6 o co fA H m Orr Vl O �I MM• ONO O 7 O V] �r 'O r rr• V !"P O 08 � O oQ O 1� y N ^� s s b � g A cl nIwo e y CD 3 VI r O ° ~• co 3 � � .; CrQ ME" ow g r • y Q A n' v �y n y O C woo co r� L cm O ow ^^� T�✓✓ Vl Now WAIO • y < y S G N ?' 7 A k � 3 A �7 �: 00 _� I� " C O � � �.. n '� r-. u S c � �... 3 � ° �. ►.+ 3 w � � r, CJ ,... CJQ .... ..+ r- 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 ® A k 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 , ® / k 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 A k 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 ok A hk 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 $50 Emergency Room 0 Month Pre-existing Condition BILLING INFORMATION Dues must be remitted on a calendar month basis on or before the first day of the coverage month for which they become payable. Each remittance must be accompanied by a list of subscribers for whom such dues are paid. 9.0 percent (9%) of each month's medical dues for each member and each family enrollee, as scheduled above, is the budgeted prepayment for cost of all pharmaceuticals and prescriptions tc dispersed on written orders of the Group Health Cooperative Medical Staff for the next fiscal year under coverage of your medical coverage agreement. Group Health Cooperative of Puget Sound does not discriminate on the basis of physical or mental handicaps in its employment practices or services. BILLING INFORMATION, Continued Regardless of the effective aate of enrollment for a Subscriber and Family Dependents, the Group will not be required to submit dues to the Cooperative for the month of enrollment, and these Enrollees will appear on the subsequent month's billing at the regular charge. When the Subscriber's enrollment terminates, the group will submit the full amount of dues to the Cooperative regardless of the specific date of termination for that month. WashD d A Ik �1 Heath Where to get care in Western Washington tt Cooperative of Puget Samd `.L}2SbmM x Orcarlrinnd dr� r �F d� EastsOUad6 San tNl"n aan d FndOy d3= Q,gd4Elt F HBrt%7�:. 6ioprz Lopez Island PX AF H rr f Kcoupevilld. tilti+ od laltandAsimEtnth _ ' IAA ppst.t�thgeles i s =.s x x 1»ISeghum �� �aplalotnitait F �+ J - (tii1tt11laEes � �"� Tin < h, R x ° k3 yy� SSta Y i aulSh0.t�II.::. ".fc3$AIfsll '.: R d Kitst� lfeod> C _"4 r Sl`tYCrdalt:{7 < .. IF ? `$ `. �CCllatd SgGle �. 1t�t1 ` Utl¢G ., : y891iF1n ." z Etralfs Federal Vdiy■C 1#arbor _ ' �lyael� � , LEGEND AThtlritWl O Group Health Primary Caro Medical Centers d s s 0 Group HealthlVlrginla i71Centtxlja Mason Primary Caro ' Medical Centers GHC Specialty Centers LfWFs` j ❑ Participating Medical CentersMU ♦ Group Health/Virginia > Mason Hospitals Designated Hospitals = ' q Each symbol tells you which type of facility is available.Refer to the list inside for the names and exact locations of all facilities. Services are available INSIDE the solid lines only. i 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 - - - %� f �; tf_, ��« �� ��, �a��� �i� �avuEu G 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