HomeMy WebLinkAboutHR15-303 - Original - First Choice Health - 2016 Employee Assistance Program - 10/28/2014 gy
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CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission
to City Clerks Office. All portions are to be completed.
If you have questions, please contact City Clerk's Office.
Vendor Name tl gr s 031 G H-fCk'tt'y
Vendor Number:
JD Edwards Number
Contract Number:
This is assigned by City Clerk's Office
Project Name: G
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ( Contract
❑ Other:
Contract Effective Date: 12-!i Lip Termination Date:
Contract Renewal Notice (Days): !1ftt ! �
Number of days required notice for termini renewal or amendment
Contract Manager: Department: - l
Contract Amount:
Approval Authority: ❑ Department Director QMayor ❑City Council
Detail: (i.e. address, location, parcel number, tax id, etc.):
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TO INITIATE RAP, MAP, OR PAP SERVICES PLEASE SIGN AND RETURN ONE COPY OF
THE FOLLOWING GROUP SERVICE AGREEMENT
First Choice Health Employee Assistance Program
600 University Street, State 1400 o Seattle,WA 98101
Phone (800) 777-4114 • Fax 206-268-2433 • eap@fchn.com
GROUP SERVICE AGREEMENT
THIS AGREEMENT is entered by and between First Choice Health Employee Assistance Program, a
division of First Choice Health Network, (hereinafter "First Choice Health EAP" or "FCH LAP"),and The
City of Kent(hereinafter"Company").
This Agreement will be effective on ianuary 1, 2016 and will remain in effect until the first of the month
following 30 days advance written notice of cancellation by either party.
WHEREAS,First Choice Health EAP makes available to Company an Employee Assistance Program (EAP),
a Member Assistance Program (MAP),and/or a Physician Assistance Program(PAP);mid
WHEREAS, Company desires to contract with First Choice Health EAP for the purpose of providing EAP
services to covered Company employees and will be responsible for payment to PCH EAP for services
provided to Company.
NOW THEREFORE,the parties agree as follows:
I. FIRST CHOICE HEALTH EAP OBLIGATIONS
A. Services Included.
1. Toll Free Phone Lines
First Choice Health EAP has toll free lines available to all employee families 24 hours a day
seven days a week. The lines are promptly answered and there is always a counselor available to
assist families in crisis or distress. In emergency situations, FCH EAP will utili2c local resources
such as police, fire or emergency mental health resource facilities to stabilize the situation or
provide ongoing emergent care.
2. Typical Problems Addressed
First Choice Health EAP is a confidential resource located outside the workplace for employees
and their covered family members to utilize whenever they are experiencing a wide range of
concerns. There is no charge to the employee or family member for any EAP/MAP/PAP
service The EAP/MAP/PAP is an employer-sponsored program. The ,following list is
representative of frequently seed problems.
Substance Abuse Marital Problems Parenting Issues Retirement
Work Conflict Anxiety&Stress Depression Financial Concerns
Gambling Issues Anger Control School Problems Eating Disorders
3. Assessment and Referral Service
a) Professional assessment and referral services will be provided to employees and their
immediate fatnily members (spouse,partner,children up to age 26) through the First Choice
Health EAP Provider Network, The goal of FCH EAP will be to assess the presenting
FCH EAP 2014 Standard Contiact Tentplalc
problem,solve that problem or conflict when possible, or develop a treatment plan slid
assist the employee family in implementing that treatment plan in the community. Under the
ternas'of this Agreement and based upon the specific program design purchased by the
Company and selected in Addendum A, each employee may utilize up to the number of
assessment and referral visits chosen by the Company xith a licensed behavioral health
provider on a per..condition basis every twelve months
b) Appointments nrill be offered in a geographic location that is near the employee family's
home or work and at a time of convenience to the employee. Normally appointments are
available within 24 4R hours of the initial call requesting services. In an emergent situation,
referral -,wall be made immediately to community emergency services of other appropriate
care facility.
e) Employees who do not show up for a scheduled appointment, or who cancel with less than
24 hours advance notice, will have that appointment counted ;is one of thew maximum
number of sessions allowed under this contract. A cancellation that is cancelled be or
excused by the counselor will not be counted as one of the employee's allowable sessions.
d) Exclusions: Special evaluations such as-those required by the Department of Transportation
and FAA tvith services provided by Substance Abuse Professionals (licensed providers who
specialize in chemical dependency evaltatons and ate required by the Department of
Transportation to conduct all assessments on employees in safety sensitive positions) are
usually- paid by the employee and not covered by FCII EAR In addition, the following
services are not covered unless pre approved by F' J I FAR those required by court order or
as a condition of parole or probation, evaluation or diagnostic testing related to learning
disorders, developmental delays, and congenital and/or organic disorders, psychological or
IQ testing, services related to medication management or medication consultation with a
psychiatrist,fitness for duty evaluations, or services received from a non-network provider.
4. Employee Orientation
Upon the request of the Company, First Choice Health EAP will provide onsite orientation
classes lasting about 20 minutes for employees. "Etese presentations are nonindly presented ill
parallel with the Supervisor Orientation. Included will be a brief review of program components
and assurances of confidentiality.A contracted number of Employee Orientations are included at
the primary Company location at no fee,as described in.Addeiulum A. Webinar Orientations can
be substituted for these onsite orientations. Additional orientations or onsite orientations
provided at other locations would be provided at an additional hourly fee, portal to portal, in
accordance with Addendum A. Company may elect to utilize the free online Employee
Orientation on the First Choice Health EAP Internet site bn an unlimited basis.
5. .Supervisor/ Manager Orientation
It is recommended that a Supervisor/1Ntanager Orientation be held in conjunction with the
'Employee Orientation classes and be attended by all managers and supervisors. A Supervisor
a, Manual will be dstributed to all staff in a leadership position, a review of the EAF/_Wt P/PAP
'.'program will be presented, .and the referral process reviewed. Methods of identifying and '.
approachntg troubled employee will be discussed, as well as making mandatory referrals,
encouraging employees, and a variety of other topics. A contracted number of 60-minute
Supervisor Trainings are included at the primary Company location at no fee, as described in
Addendum A. Additional orientations or onsite orientations provided at other locations would
be provided at an additional hourly fee, portal to portal, in accordance with Addendum A.
Company may elect to utilize the free online Supervisor Orientation on the FCI I EAP Internet
site on an urdiniited basis.
FCH EAP 2014 Standard Contract Template 2
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6. Benefit/Wellness/Safety Fair/Open Enrollment Attendance
EAP can attend an Open Enrollment meeting or a benefit/sfety/wellness fair to increase
visibility of the EAP/MAP/PAP and distribute brochures and materials. Hours are available at
an additional hourly fee,portal to portal,in accordance with Addendum A.
7. Training
a) Online Premium Level Internet training is included under this contract. The Company will
have unlimited access for supervisors and employees to Web site based training provided at
www.firstchoiceeap.com as part of services.This training includes topics such as Harassment
Prevention,Workplace Diversity, Conflict Resolution,Drug Free Workplace and DOT level
Supervisor and employee training.
b) Onsite Training on a variety of subjects can be provided under this contract at an additional
hourly fee, portal to portal, in accordance with Addendum A. The price of additional
trainings is negotiated in advance, arid depends on the nature of the training and
customization requested by the Company. A current list of available trainings is available on
the FCII EAP websne
8. Critical Incident Services
Debriefing, defusing, and educational services can be.provided :upon request to individuals,
teams, and company-wide related to workplace disruptions due to accidents, violence, criminal
activity, natural disasters, death, etc. A contracted number of onsite Critical Incident/Trauma
Services are included each year, as specified in Addendum A, The rate for additional hours is
$200 per hour,portal to portal.'
9. Promotional Materials
A variety of promotional materials will be provided to the Company for distribution to employee
families at the time of program initiation with additional supplies available on an annual basis.
These materials will include:
a) Letter of Introduction: for each employee family:
b) EAP Referral Cards: for each employee with a 20% additional supply for supervisors and
I Iuman Resources to utdve in making referrals.
c) Posters: for each location,normally one per 50 employees.
d) Program Pamphlets: for each employee with 10%extra supply for Human Resources for use
with new employees.
c) Newsletters: will be distributed electronically to the Company every month for distribution
to employees.
10. Leadersbip Consultation
Managers, supervisors and Human Resources will be encouraged to contact the EAP for
Consultation regarding. any difficult work place problem or for assistance to identify and
approach troubled employees, discuss documentation, employee motivation and other concerns
that may be appropriate. Unhinited telephonic management consultations are provided for
supervisors and managers in the Mandatory Referral process.
11. Quality Assurance and Utilization Reporting
Utilization Reports will be prepared and sent to the Company on the following basis based on
Company size: Quarterly for Companies with more than 100 employees, Sem Annually for
Companies with 50 to 100 employees, and Annually for Companies with fewer than 50
employees. Every employee who utilizes the EAP will be offered an opportunity to complete an
Employee Eimlualio t of Soivice form. This form witl ask for their rating and comments regarding the
service they received from die EAP. A summary of comments will be provided the company.
FCH EAP 2014 Standard Contract Template 3
12. Enhanced Services. (Optional)'
If the Company selects the Enhanced Services plan, the WorkLife Enhanced services wll be
accessible to employees This includes:
a) Web Content supplies content and including over 8,000 articles and fact sheets, personal
self-assessments, Cools, and calculators. 92 online training programs are offered offering
printable certificates of completion,monthly online sctuinars are delivered live and archived
for later listening, and a comprehensive Wellness (.enter and Relocation Center is available.
There is a Spanish language site also available.
b) LWI Consultation: 24/7 access to assessment and referral services, providing it no-cost 30-
minute consultation with a legal professional by phone or in.person, with a discounted rate
of 29% off their hourly rate for ongoing services. Enhanced legal content includes over 100
legal forms. Some exceptions apply,including no availability for work related matters.
c) Financial Services Consultatoin: Financial counselors and educators to assist with budgeting,
debt management,bankruptcy prevention,credit issues,and sinilar financial issues.
d) Eldercare Consultation and referral for assistance and referrals that assist employees and
their family members deal with the issues of supporting elderly parents or relatives.
e) Childcare Consultation and referral for assistance and referrals that assist employees and
their family members with finding childcare and daycare and with issues such as adoption,
education (K,12,higher education,continuing education); and other parenting issues.
f) ID 'llieft Prevention: An interactive advocacy service that provides education, guidance,
support, and legal/financial assistance to victims of fraud related crimes. Toll-free,
telephonic,34 minute consultation with a Certified Consumer Credit Counselor is available.
g) ';work Life Program Promotion: Posters and Handouts for the Enhanced LAP Services will
be provided for distribution to all employees.
14. Other Optional Services.
a) `x'etlness Coacl If Company purchases this package . for a minimum one year
comsriitment, employees are eligible to receive wellness telephonic and internet coaching,
information, education, and referral services accessed through q toll-free number. Wellness
coaches consult with employees on W'eight 'Managememr, Smoking Cessation, Fitness and
Exercise, Nutrition, and Chronic Disease or conditions including aolinha, diabetes,
cardiovascular disease,back pain,menopause,and pre-and post-natal issues. Employees have
an intake and goal setting session followed by four 'I5-30 minute follow up sessions, and
additional follow-tip with personalized Mails and coach-chosen materials. Employees may
also choose online interactive programs for Weight Management (12 .sessions), Smoking
Cessation (10 sessions), orNN,'alking(90 daps).
b) Health Risk Assessment. If Company purchases this package for a minimum one year
commitment, employees may access an online confidential HRA tool that provides
statistically measurable, actionable information regarding the health status of the workplace
population as a whole_This tool assists in developing an accurate assessment of Company's
employees' health and fitness, providing "before .and after" data on wellness initiatives, and
can target particular health challenges within the workforce, The HRA coven key health
issues including; cancer risk, fitness, heart health, nutrition, safety, smoking, stress and
weight management.
,c) Nurse Lune: If Company purchases this package .for a minimum one:year commitment,
employees may access a Registered Nurse through a toll free number 24 hours a day, who
will provide clinical assessment of the callers'.. symptoms andprovide health care
'. information, direct callers to the appropriate level of care or provide self-care instructions,
and provide general health education and care options.
FCII EAT'2014 Standard Contract Template 4
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B. Insurance.
First Choice Health EAP will maintain liability insurance in the amount of $1,000,000.00. In
addition; First Choice Health EAP requires that its Network Providers (Licensed Mental Health
Care Professionals) catrj7 a minimurn of$1,000,000.00 in malpractice insurance with $3,000,000.00
Aggregate.
C. Compliance.
First Choice I-Iealth EAP, in carrying out its obligations under this Agreement, shall comply with all
applicable federal and state laws and regulations.
D. Responsibility for ERISA Plan:
If you are offering the EAP benefits to your Employees under a Plan governed by the Employee
Retirement Income Security Act of 1974 as amended ("ERISA Plan'),you have sole authority and
responsibility for the ERISA Plan and are solely responsible for complying with ERISA and any
related laws.All final determinations as to a Participant's RAP eligibility and benefits are to be made
by you, including any determination upon appeal of a dented claim for EAP services. Without
limiting your responsibilities,you have the sole duty and responsibility as to the ERISA Plan benefit
design, administering the appeals process, the preparation and contents of any ERISA Plan,
Summary Plan Description,Trust Agreement, and any other documents required under ERISA and
related laws (collectively "ERISA Plan Documents"), and all amendments related thereto,including
the description of the EAP services in the ERISA Plan Documents.You represent that the ERISA
Plan Documents are consistent with this Agreement. You will provide us with all ERISA Plain
Documents prior to the commencement of services under this Agreement.You shall be responsible
for printing, maintaining a supply of and distributing the Summary Plan Description and all other
information and forms necessary for Participants' enrollment and continued eligibility for services
under this Agreement and will provide us with copies of the ERISA Plan Documents and
Participant communications pertaining to the services provided under this Agreement prior to
distributing such materials to Participants or third parties.You will amend ERISA Plan Documents
and Participant communications if we determine that references to us are not acccptablc, or any
ERISA Plan or EAP provision is not consistent with this Agreement or the services that we are
providing.We are not the Plan Administrator of the ERISA Plan.
You will be solely responsible for: ensuring compliance with COBRA; performing required
nondiscrimination testing; amending the ERISA Plan as required to ensure ongoing compliance
with applicable law and providing us copies of any such amendments prior to their adoption; filing
an),required tax or governmental returns (including Form 5500 returns) relating to the ERISA Plan;
determining if and when a valid election change has occurred; executing and retaining required
ERISA Plan and claims documentation;and taking all other steps necessary to maintain and operate
the ERISA Plan in compliance with applicable provisions of the ERISA Plan, ERISA, and other
applicable state and federal laws.
II. COMPANY'S OBLIGATIONS
A. Payment for Services.
The Company will make payments to First Choice Health EAP in accordance with Addendum A,
attached to this Contract.
B. Group Enrollment Form.
The Company will provide to First Choice Health EAP for each group enrolled a completed Group
Enrollment Form as set forth in Addendum B.
FCH EAP 2014 Standard Contract Template 5
C. EAP Liaison.
The Company will aseist First Choice Health EAP in group implementation as heeded, and will act
as a liaison between the EAP and all groups enrolled pursuant to this Agreement.
D. Compliance,
The Company, in carrying out its obligations under this Agreement,shall comply with all applicable
federal and state laws and regulations,provided that nothing in this Agreement shall be construed as
providing a type of medical benefit or service subject to the requirements of the Employee
Retirement Income Security Act of 1974 (Pub_L. 93-406,Sept.2, 1974),
III. CONFIDENTIALITY OF HEALTH INFORMATION
The parties acknowledge that as a result of this agreement, either par h may have access to and receive
from the other party individually identifiable health information (`'Health Information") as that term is
defined under the Health Insurance Portability and Accountability Act of 1996, Section 1171 of Public
Iaw 104-191 ("HIPAX), and Chapter 70.02 RCW, the Washington State health Care Information
Access and Disclosure of 1991. Both parties agree to maintain the confidentiality of such Health
Information and to not use or disclose such Health Information other than as may be permitted or
required by federal or state lain or regulations currently in effect, or becoming effective during the term
of this Agreement,including,but not limited to,the federal HIPAA Privacy regulations.
To the extent either party,in cartying out its responsibilities under this Agreement, conducts Standard
Transaction(s) as that term is defined under HIPAA. that pare shall, without limitation, comply'vidt
the I-ITPAA regulations,"Adininistrativc Requirements for'Crensactions:,'45 CFR 162.200 et seq.
IV. TERM AND TERMINA11ON
This Agreement will be effective on the date set forth on page one and will remain in effect until the
first of the month following 30 days'-advance written notice of cancellation by either part}'- Upon
cancellauon by either party,First Choice Health Assistance Services will continue to provide services to
the termination date of this ngreement.i
V. INDEPENDENT CONTRACTOR STATUS
First Choice Health EAP is an independent contractor and in no way should this contract be construed
to create an employer-employee relationship. All payments made hereunder for services performed
shall be made to First Choice Health EAP as an independent contractor.
VI. ASSIGNABILITY
First Choice Health FAP will not assign or transfer any interest in this contract without written notice
to the Company; PROVIDED HOWEVER that claims for money due or to become due to First
Choice Health FAP under this contract may be assigned to a bank, trust company or other financial
institution without such approval
VII. DISPUTE RESOLUTION
In entering this agreement, it is assumed that a relationship of cooperation and understanding will be
maintained between the parues. However, in the event of any dispute, or disagreement over the terms
and conditions contained herein, such dispute will be settled through binding arbitration in accordance
with the rules of the American Arbitrations Association,and judgment upon the award rendered by the
arbitrator(s) may be entered in any court having jurisdiction thereof Such arbitration shall occur within
Bing County, \i7ashington, unless the parties mutually agree to have such proceedings in some other
locale. The arbitrator(s) may in any such proceeding award attorney's fees and costs to the prevailing
party.
FCH EAP 2014 Standard Contract Template 6
VIII.AMENDMENTS
This agreement .contains the full understanding of the parties and supersedes and cancels all prior
negotiations, correspondence or communication between the parties. No oral modification to this
Agreement shall be effective however; this Agreement may be modified or amended by a written
sighed agreement by both parties.
IX. NOTICES
Any notice by the Company to First Choice Health Assistance Service's, may be delivered by certified
or registered mail postage prepaid addressed to:
First Choice Health EAP
600 University Street,Suite 1400
Seattle,WA 98101
Notice by First Choice Health LAP to the Company may be delivered by certified or registered mail
postage pre-paid,addressed to the group at the address designated by the Company via written notice.
X. GOVERNING LAW
This agreement is made pursuant to and shall be construed in accordance with the laws of the State of
Washington.
TN WITNESS WHEREOF,the parties hereto have executed this agreement on the date indicated above.
FIRST CHOICE HEALTH THE CITY OF KENT
EMPLOYEE ASSISTANCE PROGRAM ,
B, l By
Emy Holl9fi er Suidtte CT,00ke F
Interim Dirictor, FCH EAP Tv{ayor pf Kent
f/ 1�
Date
r
FCH EAP 2014 Standard Contract Template 7
ADDENDUM A: PRICING
• ! ® 9
Enhanced EAP Services
Includes:
• 2417 toll-free phone coverage
• Employee and family assessment and referral services
• Internet Training services
• Promotional Materials
• Leadership Consultation and Mandatory Referrals
• Language Line and Translation Service
• Online Appointment Scheduling
• Dedicated Account Manager h to
Three
• "Right Referral First Time'approach $1.96 pepm Q
• Strong regional provider network and national provider network Visit
Model
• Monthly electronic Employee Newsletters(in English&Spanish),
Supervisor Newsletter,Webinar flyer
• Enhanced EAP Consultation Services:
• Elder Care Consultation
• Child CarelDayeare Consultation
• Financial Services
• ID Theft Prevention
• Legal Consultation and 25% Discount in attorney's normal
hourly fees
Quarterly UtRzation Reports Included
Critical Incident Debriefing Six Hours included each year,$2001hr after'
Unlimited Online Orientations;
Employee Orientations Ten Onsite 20-minute Employee Orientations
included each year,$1501hrafter'
Additional Supervisor/Manager Orientation and Unlimited Online Orientations,
Services: Leadership Training—Onsite or Webinar Four 60-minute Supervisor orientations
included each year,$150Ihr after
Unlimited Online Trainings Harassment,Violence Prevention,Diversity,
Conflict Resolution,and Drug Free Workplace
Onsite Trainin s Onsite trainin s$175 $3501hrl
Benefit/Wellness/Safety Fair, Open Enrollment $100/hO
1 Haurs of Onsite Services are provided on a portal-to-portal basis plus necessary travel costs when necessary as agreed to in advance.
This quote is based upon approximately 623 employees.
Standard broker commission is included in these rates.
rCH GAP 2014 Standard Contract,remplate 8