HomeMy WebLinkAboutHR17-010 - Original - First Choice Health - 2017 Employee Assistance Program - 01/03/2017 Records '' #n w
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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.
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Vendor Name: F), ,L;
Vendor Number: _
ID Edwards Number
Contract Number: HV-11- 0V O
This is assigned by City Clerk's Office
Project Name: y a t � fYl 1 s
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment Contract
❑ Other:
Contract 'Effective Date: 1 -t�, Termination Date:
Contract Renewal Notice (Days): --
Number of days required notice for termination or renewal or amendment
Contract Manager:;6 4,<,4 � ',N€ t ®epartment:
Contract Amount: 1rf
Approval Authority: ❑ Department Director Ej Mayor ❑ City Council
Detail: (i.e. address, location, parcel number, tax id, etc.):
As of: 08/27/14
TO INITIATE EAP,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,Suite 1400 • Seattle,WA 98101
Phone (800) 7774114• Fax 206-268-2433 e cap@fchn.com
GROUP SERVICE AGREEMENT
THIS AGREEMENT is entered by and between First Choice Health Empl=e Assistance Program a
division of First Choice Health Network, Inc,(hereinafter "First Choice Health EAP" or "FCH EAP'), and
The City of Kent(hereinafter"Company").
This Agreement will be effective on lanuary 7. 20172017 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(NLAP),and/or a Physician Assistance Program(PAP);and
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 FCH 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 utilize 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-seen 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 family 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 FAF 2014 Swndud Contract Template I
problem, solve that problem or conflict when possible, or develop a treatment plan and
assist the employee family in implementing that treatment plan in the community. Under the
terms of this Agreement and based upon the specific program design purchascd 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 with a licensed behavioral health
prodder on a per condition basis every twelve months.
b) Appointments will be offered in a geographic location that is near the employee family's
home or work mid at a time of convenience to the employee. Normally appointments are
available within 24-48 hours of the initial call requesting services. In an emergent situation,
referral will be made immediately to conummity emergency services or other appropriate
care facility.
c) 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 as one of their maximum
number of sessions allowed under this contract. A cancellation that is cancelled by or
excused by the counselor will not be counted as one of the employee's allowable sessions.
d) Exclusionsi Special evaluations such as those required by the Department of Transportation
and FAA with services provided by Substance Abuse Professionals (licensed providers who
.specialize in chemical dependency evaluations and are 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 FCH EAP. In addition, the following
services are not covered uiless pre-approved by FCH EAP: those required by court order or
as a condition of parole or probation, evaluation or diagnostic testing related to learning
disorder's, 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. These presentations are normally presented in
parallel with the Supervisor Orientation. Included will be a brief review of program components
mid assurances of confidentiality..A contracted number of Employee Orientations are inchidtil at
the primary Company location at no fee,as described in Addendum 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 on an unlimited basis.
5. Supervisor/Manager Orientation
It is recommended that a Supervisor/Manager Orientation be held in conjunction with the
Employee Orientation classes and be attended by all managers and supervisors. A Supervisor
Manual will be distributed to all staff in a leadership position, a review of the EAP/MAP/PAP
program will be presented, and the referral process reviewed. Methods of identifying and
approaching 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 Ttainings 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 FCH EAP Internet
site on an unlimited basis.
r0l EAP 2014 Standard Contract Template 2
6. Benefit/Wellness/Safety Fair/Open Enrollment Attendance
EAP can attend an Open Enrollment meeting or a benefit/safety/wellness fain 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 unlinvted access for supervisors and employees to Web site based training provided at
www.frstchoiceeap.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 tinder this contract at an additional
hourly fee, portal to portal, in accordance with Addendum A. The price of additional
traivngs is negotiated it advance, and depends on the nature of the training and
customization requested by the Company. A current list of available trainings is available on
the FCH EAP website.
S. 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
Human Resources to utilize 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.
e) Newsletters: will be distributed electronically to the Company every month for distribution
to employees.
10. Leadership 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. Unlimited telephonic management consultations are provided for
supervisors and managers in the Mandatory Referral process.
It. 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, Semi-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 Eija/urrtion ofSenie form. This form will ask for their rating and comments regarding the
service they received from the EAP.A suurnmary of continents will be provided the company.
F'CN F:AP 2014 Standard Contract Templute 3
12. Enhanced Services. (Optional)
If the Company selects- the Enhanced Services plan, the tW'orkLife Enhanced services will be
accessible to employees.This includes:
a) \W'cb Content supplies content and including over 8,000 articles and fact sheets, personal
self-assessments, tools, and calculators. 92 online training programs are offered offering
printable certificates of completion,monthly online seminars are delivered live and archived
for later listening, and a comprehensive\Fellness Center and Relocation Center is available.
There is a Spanish language site also available.
b) Legal Consultation: 24/7 access to assessment and referral services,providing a no-cost 30-
minute consultation with a legal professional by phone or in person,with a discounted rate
of 25%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 Consultation: Financial counselors and educators to assist with budgeting,
debt management,bankruptcy prevention,credit issues,and similar 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.
c) 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-I2,higher education,continuing education),and other parenting issues.
f) ID Theft Prevention: An interactive advocacy service that provides education, guidance,
support, and legal/financial assistance to victims of fraud related crimes. 'Poll-free,
telephonic,30-minute consultation with a Certified Consumer Credit Counselor is available.
g) Work Life Program Promotion: Posters and Handouts for the Enhanced FAP.Services will
be provided for distribution to all employees.
14. Other Optional Services.
a) Wellness Combing. If Company purchases this package for a minirnwn one tear
commitment, employees are eligible to receive wellness telephonic and internee coaching,
information, education, and referral services accessed through a toll-free number. Wellness
coaches consult with employees on \W'ei& Alanageinent, Smoking Cessation, Fitness and
Exercise, Nutrition, and Chronic Disease or conditions including asthma, diabetes,
cardiovascular disease, back pain,menopause,and pie-and post-natal issues.Employees have
an intake and goal setting session followed by four 15-30 minute follow-up sessions, and
additional follow-up wrath personalized emails and coach-chosen materials. Employees may
also choose online interactive programs for Weight Management (12 sessions), Smoking
Cessation (10 sessions),or Walking(90 days).
b) Health I�j,sli.Asse§sment. If Company purchases this package for a minimum one yea
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 welhness initiatives, and
can target particular health challenges within the workforce. The HRA covers key health
issues including: cancer risk, fitness, heart health, nutrition, safety, smoking, stress and
weight management.
c) Nurse Line. If Company purchases this package for a minimum one year comiitment,
employees may access a Registered Nurse through a toll-free number 24 hours a day, who
will provide clinical assessment of the callers' symptoms and provide health care
information, direct callers to the appropriate level of care or provide self-care instructions,
and provide general health education and care options.
FC1i E.AP 2014 Standard Contract I'capture 4
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) carry a minimum of$1,000,000.00 in malpractice insurance with $3,000,000.00
Aggregate.
C. Compliance.
First Choice Health 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 EAP eligibility and benefits are to be made
by you, including any determination upon appeal of a denied claim for EAP services. Without
(uniting 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 Plan
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 comnwrrications 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 cornrnunications if we determine that references to us are not acceptable, or any
ERISA Platt or FfXP provision is not consistent with this Agreement or the services that we are
providing.We are not the Plan Administrator of the ERISA Phan.
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
any 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. Pgyment 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 assist First Choice Health LAP in group implementation as needed, and will act
as a liaison between the EAP and all groups enrolled pursuant to this Agreement.
D. Complignm
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 party 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
Law 104-191 ("HIMA"), and Chapter 70.02 RCW, the Washtngmn 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 law 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 carrying out its responsibilities under this Agreement, conducts Standard
Transacrion(s) as that term is defined under HIP AA, that party shall,without limitation, comply with
the IIIPAA regulations,"Administrative Requirements for Trans-actions,"45 CFR 162.200 et seq.
IV. TERM AND TERMINATION
This Agreement will be effective on the date set forth on page one and will remain in effect until the
fast of the month following 30 days advance written notice of cancellation by either party. Upon
cancellation by either party,First Choice IIealth Assistance Services will continue to provide services to
the termination date of this agreement.
V. INDEPENDENT CONTRACTOR STATUS
First Choice Health FAP is an independent contractor and in no way should this contract he 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 EAP 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 EAP under this contract may be assigned to a bank, trust company or other fmancial
institution without such approval.
VII. DISPUTE RESOLUTION
If the parties are unable to settle any dispute, difference or claim arising from the parties'
performance of this Agreement, the exclusive means of resolving that dispute, difference or claim,
shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County
Superior Court, ping County, Washington, unless the parties agree en writing to an alternative
dispute resolution process. In any claim or lawsuit for damages arising from the parties'performance
of this Agreement,each party shall pay all its legal costs and attorneys fees incurred in defending or
bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award
provided by lays.
FC11 EAP 2014 Standard Contract Icinpim 6
VHL 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
signed agreement by both parties.
IX. NOTICES
Any notice by the Company to First Choice Health Assistance Services, may be delivered by certified
or registered mail postage prepaid addressed to;
First Choice Health RAP
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.
IN WITNESS WHEREOF,the parties hereto have executed this agreement on the date indicated above.
FIRST CHOICE HEALTH THE CITY OF KENT
EMPLOYEE ASSISTWPROGgy t.bli�- By
Curtis Taylor Suitt Co�fke -- -�
Chief Marketing officer tyfayor of Dent
First Choice Health
Date - yL.- Date X �
17CH LAP 2014 Standard Contract Template 7
ADDENDUM A-, PRICING
Enhanced EAP Services
Includes
• 24R toll-free phone coverage
• Employee and family assessment and referral services
• Internet Training services
Promotional Materials
• Leadership Consultation and Mandatory Referrals
Y Language Line and Translation Service
• Online Appointment Scheduling up to:
• Dedicated Account Manager Three
• "Right Referral First Time"approach Visit $1.96 pepm
• Strong regional provider network and national provider network Model
• Monthly electronic Employee Newsletters(in English&Spanish),
Supervisor Newsletter,Webmar flyer
Enhanced EAP Consultation Services:
• Eider Care Consultation
• Child Care/Daycare Consultation
Financial Services
• ID Theft Prevention
• Legal Consultation and 25%Discount in attorney's;normal
hourly fees
Quarlerlv Utilization Reports Included
Critical Incident Debriefing Six Hours included each ear,$200lhrafter'
Unlimited Online Orientations;
Employee Orientations Ten Onsite 20-minute Employee Orientations
ncluded each ear,$1501hr after
Unlimited Online Orientations,
Additional
Supervisor/Manager Orientation and Four 60-minute Supervisor orientations
Services: Leadership Training-Onsite or Webinar included each year,$1501hr after'
Unlimited Online 7rainings Harassment,Violence Prevention,Diversity,
Conflict Resolution,and Drug Free Workplace
Onsite Trainin s Onsite trainin s$175-$350Bu1
be—nefitlWellnesslSafety Fair,Open Enrollment $1001hr1
1 Houts of onsite Services are provided on a octal-to- ortal basis Elus necessafy travel costs when necessary as i o reed to in advance.
This quote is based upon approximately 623 employees.
Standard broker commission is included in these rates.
PCH GAP 2014 Standard Contract Temlaw 8
REQUEST FOR MAYOR'S SIGNATURE
g� y® ®
�g Print on Cherry-Colored Paper
tlA�dWB
Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPAfETM
Approved by DirecFpr=b..,.
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Originator: € k�_ t-r , ,,..t �w Phone_(Originator):
Date Sent: apt- -L-� Date Re uired: i
Return Signed Document to: Contract Termination Date: i��j ,5� -
VENDOR NAME, Date Finance Notified:
ii (Only required on contracts
10000 and over or on any Grant) 1DATE OF OF COUNCIL APPROVAL: Date Risk Manager Notified: -
(Required on Non-City Standard Contracts A reements
Has this Document been Specifically Account Number:
Authorized in the Budget? a YES 0 NO
Brief Explanation of Document:
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t All L onracs Whist Be Routed Through The Law Department
(This area to be completed by the Law Department)
Received:
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APP to Lpv% DieVV° J"-
Law Dept. Comments:
Date Forwarded to Mayor:
Shaded Areas To Be Completed By Administration Staff
Received:
Recommendations and Comments:
Y
Disposition: c
Date Returned:
P ICIVIRF oument`Ice N1IR.1Ne1NarMINT.1,,.Ne1—