HomeMy WebLinkAboutCity Council Committees - Operations Committee - 04/15/2008
Operations Committee Agenda
Councilmembers: Debbie Raplee*Les Thomas*Tim Clark, Chair
Unless otherwise noted, the Operations Committee meets at 4:00 p.m. on the 1st and 3rd
Tuesdays of each month. Council Chambers East, Kent City Hall, 220 4th Avenue South,
Kent, 98032-5895. Dates and times are subject to change. For information please contact
Renee Cameron at (253) 856-5770.
Any person requiring a disability accommodation should contact the City Clerk’s
Office at (253) 856-5725 in advance.
For TDD relay service call the Washington Telecommunications Relay Service at 1-
800-833-6388.
April 15, 2008
4:00 p.m.
Item Description Action Speaker Time Page
1. Approval of minutes dated April 1, 2008 YES 1
2. Approval of vouchers dated YES Bob Nachlinger 05 Min.
March 31, 2008
3. Formation of Planning Committee for YES Chief Schneider 10 Min. 3
Regional Fire Protection Service
Authority - Authorize
4. Agreement for Installation of Fire YES Chief Schneider 05 Min. 9
Sprinkler System and Upgrade of
Fire Alarm System – Approve
5. Renew Group Health Cooperative of YES Ray Luevanos 05 Min. 29
Puget Sound Management
(HMO) – Approve
6. Agreement for Pest Abatement Services YES Jeff Watling 05 Min. 91
for Various City Buildings - Approve
7. Agreement for the Upgrade and YES Jeff Watling 05 Min. 105
Installation of a Security Card
Reader System - Approve
8. 4th Quarter Financial Report NO Bob Nachlinger 10 Min. 121
for informational purpose only
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FIRE ADMINISTRATION
Jim Schneider
Fire Chief/Director of Emergency Management
24611 116th Ave. SE
Kent, WA 98030
Fax: 253-856-6300
PHONE: 253-856-4300
City of Kent Fire Department- Internationally Accredited Fire Agency
April 15, 2008
To: Operations Committee
From: Jim Schneider, Fire Chief
Regarding: Authorization to form a Planning Committee for Regional Fire Protection
Service Authority (“RFPSA”)
MOTION: Recommend Council, at its May 6, 2008 meeting, authorize the
Kent Fire Department to proceed with the formation of a planning committee
to develop a recommended structure for a Regional Fire Protection Service
Authority.
SUMMARY: The Kent Fire Department, has completed a nine month process of meetings
and discussions with the Fire Authority Stakeholders Group (FASG), which was comprised
of various interests related to fire protection in the City of Kent and King County Fire
District 37.
The FASG evaluated three alternatives in providing future fire protection services. The
first alternative included continuing with the current joint agreement between the City of
Kent and King County Fire District 37; the second alternative included consideration of
the possibility that the City of Kent could annex into Fire District 37; the third alternative
considered the possibility that would create a new entity, the RFPSA, as permitted by
State law.
On January 24, 2008, the FASG reached consensus on the selection of Alternative 3, the
RFPSA, as their preferred alternative. This recommendation will be submitted to the Kent
City Council and the Board of Commissioners of Fire District 37, for their respective
consideration.
If the elected officials of both jurisdictions concur, then a planning committee would be
formed to define the specific organization, funding sources, capital assets, and
operational aspects of the RFPSA.
The recommendation before the City of Kent, is only to proceed forward in forming a
planning committee, consisting of elected officials, of which three of the six planning
committee members would be from the City of Kent, to put the plan together of what a
RFPSA would look like.
EXHIBIT: Executive Summary of the City of Kent and King County Fire District 37
Regional Fire Protection Stakeholders Report
BUDGET IMPACT: None
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Kent Fire/Fire District #37 - Fire Authority Stakeholder’s Report Page 1
City of Kent and King County Fire District #37
Regional Fire Protection Stakeholders Report
Executive Summary
February 6, 2008
Prepared For:
City of Kent Fire Department
24611 116th Ave SE
Kent, WA 98030
King County Fire District #37
24611 116th Avenue SE
Kent, WA 98030
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Kent Fire/Fire District #37 – Executive Summary Page 2
Executive Summary
This report is the product of a 9-month process of meetings and discussions by the Fire
Authority Stakeholders Group (FASG). The FASG was formed in April 2007 to
represent the various interests related to fire protection in the Kent area. Led by Bill
Stewart (Fire District #37 Commissioner) and Ron Harmon (Kent City Council
Member), the 17-member FASG met monthly to discuss the current situation of fire
services, pressures from population growth, and alternative solutions.
Currently fire protection services are provided under a joint agreement between the City
of Kent and Fire District #37. The joint entity (herein called Kent Fire/Fire District #37)
serves Kent, nearby portions of unincorporated King County, and the City of Covington.
The FASG reviewed data presented by Kent Fire/Fire District #37 defining the problems
faced by the District. In brief, these data include:
• Population growth data for 1991 to 2006 showing an increase of 54%, and
emergency incidents increasing by 65%, while daily staffing of the fire department
increased only 8%.
• Budget trends from 1996 to 2006 that indicate fire services represent a declining
portion of the City’s budget (from 27.4% to 25%), while overall budget levels have
increased.
• Revenue limits, based on voter initiatives that have capped property tax increases to
1%. This is particularly limiting for the Fire District, which relies heavily on
property tax, rather than the City of Kent, which has more diverse sources of
revenues.
• Performance levels, which show that Kent Fire/Fire District #37 is exceeding its 4
minute and 15 second drive time goal 35% of the time for EMS responses and 46%
of the time for fire responses. Because of traffic congestion, drive times for fire
responses have increased 59 seconds since 2000.
• Comparisons with six other fire districts/departments that show the Kent Fire/Fire
District #37 has the highest level of daily incidents per firefighter of the group
surveyed.
• Evaluations of future growth that show a potential increase of population by 2016 of
43,000 and a potential increase in commercial development of 38 million square
feet.
• Evaluations of current and future needs for service based on anticipated growth
through 2016 that identify specific locations for additional fire stations needed to
address growth, and estimates of equipment and personnel required to meet level of
service goals.
The primary alternatives evaluated by the group include:
• Alternative 1 examines the current situation and provides a baseline comparison.
In this situation, Fire District #37 (which includes the City of Covington) operates
jointly with the Kent Fire Department. The combined budget is generated by
property taxes and a variety of other taxes and revenues which support the City’s
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Kent Fire/Fire District #37 – Executive Summary Page 3
General Fund. Additional sources of revenue could include development impact
fees or borrowing for capital improvements, although these cannot used for
personnel costs.
• Alternative 2 considers the possibility that the City of Kent could annex into Fire
District #37, as has the City of Covington. In this event, the Kent Fire Department
would be eliminated and all services for the combined service area would be
provided by the newly expanded Fire District #37. This option could include a fire
benefit charge to generate additional funds, in addition to the property tax.
• Alternative 3 considers the possibility that the City of Kent and Fire District #37
could jointly form a Regional Fire Protection Service Authority (RFPSA). In this
event, the RFPSA would be governed by a board consisting of elected
representatives from the current Fire District and the City of Kent. This option could
include a fire benefit charge to generate additional funds, in addition to the property
tax.
The alternatives offer different approaches to resolving the problems faced by Kent
Fire/Fire District #37. The primary advantages and disadvantage of each alternative are
highlighted briefly below:
• Alternative 1 allows for increases in revenue through the use of impact fees and
bonds (borrowing) for the city and fire benefit charges for the District. The city
sources could provide additional funds for capital facilities, but these funds would
not be available for personnel costs. The District could impose a fire benefit charge,
but this charge cannot apply to areas within the City of Kent. The primary
advantage of this alternative is that it is relatively simple to implement and would
not involve changes to the current organizational structure.
• Alternative 2 involves the City of Kent annexing into Fire District #37. This
approach offers the advantage of an existing operating entity and a known procedure
to implement. The City of Kent may consider it a disadvantage that they would not
have direct administrative control of the expanded Fire District, but citizens of Kent
would participate in electing the Board members. If this alternative is chosen, the
implementation must occur quickly, before the City of Kent reaches 100,000 in
population, as state regulations prohibit cities over that size from annexing into a fire
district.
• Alternative 3 creates a new entity, the Regional Fire Protection Service Authority
(RFPSA), as permitted by state laws. This approach offers the advantage of creating
a new organization that can easily expand over time and could allow for greater
efficiencies in service. Another advantage is that the City of Kent would still have
some administrative control of the new entity, since the governing board is formed
by choosing elected officials from each of the entities involved. One disadvantage of
this approach is that it is relatively new and that there are a number of details to be
planned and negotiated, without many established models to follow.
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Kent Fire/Fire District #37 – Executive Summary Page 4
The FASG examined the financial implications of each of the three alternatives. In
general, both Alternative 2 and Alternative 3 have the same financial implications, as
each includes the use of a fire benefit charge to generate additional funds for fire service
personnel and facilities. This change from a general fund tax base to a fire benefit
charge and property tax represents a change in philosophy about fire service – from a
public service with funding based on the property’s assessed value to a semi-public
service with a funding method that looks at a combination of assessed value, potential
risk, and the degree the property benefits from the protection provided by the fire
department.
In terms of costs to the taxpayer, the calculations for system-wide effects show that costs
(property tax and the fire benefit charge combined) may increase over current levels by
8.7% for taxpayers in the Fire District and 5.1% to 24.6% for taxpayers in the City of
Kent. These increases are based on budget projections that provide the additional fire
stations, personnel, and equipment needed to maintain or improve levels of service to
serve the growing population and to meet the service goals established in the Fire
District’s accreditation process. These are preliminary estimates based on current taxes,
assumptions about future budgets, and depend on a series of choices and negotiations by
both the City of Kent and the Fire District.
The implications of the increased costs for individual taxpayers will depend on land use
types and development characteristics. These are highly variable, based on a number of
factors and can include decreases of costs for some taxpayers and increases for others in
all categories. Based on the proposed formulas, owners of multi-family parcels will see
the largest potential increases, with a median increase of 12.13%. Commercial and
industrial parcel owners would see a median increase of 2.3%. For all single-family
parcel sizes combined, the median increase is projected to be 2.6%. These formulas are
proposed at this time and likely would be further adjusted during the planning process.
The FASG meeting of January 24, 2008 was the culmination of the 9-month study. At
this meeting, the FASG reached three decisions:
1. Agree upon the language for the objectives of the study,
2. Agree upon a process to reach consensus on the alternatives, and
3. Apply that process in the selection of a preferred alternative.
The final language agreed upon for the objectives of the study is provided in Section 1.4
of this document. The process to reach consensus is described in Section 8.1 of this
document. The FASG reached consensus on the selection of Alternative 3, the Regional
Fire Protection Service Authority (RFPSA), as their preferred alternative. This
recommendation will be submitted to the Board of Commissioners of Fire District #37
and the Kent City Council for their consideration. If the elected officials of both groups
concur, then a Planning Committee would be formed to define the specific organization,
funding sources, capital assets, and operational aspects of the RFPSA. If the elected
officials of both groups concur with the recommendations of the Planning Committee,
the proposed RFPSA would be submitted to the voters for approval. This process is
expected to require a year or more and is targeted for completion in 2009 or 2010.
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Parks, Recreation and Community Services
Jeff Watling, Director
Phone: 253-856-5007
Fax: 253-856-6050
Address: 220 Fourth Avenue S.
Kent, WA. 98032-5895
DATE: April 15, 2008
TO: Operations Committee
FROM: Charlie Lindsey, Superintendent of Facilities
THROUGH: Jeff Watling, Director, Parks, Recreation and Community Services
RE: Agreement for Installation of Fire Sprinkler System at Kent Fire Station
76 Maintenance Facility and Upgrade of Fire Alarm System at Kent Fire
Station 76 and Fire Station 76 Facility Maintenance – Approve
__________________________________________________________________
MOTION: Recommend Council authorize the Mayor to sign an agreement
with Smith Fire Systems, Inc. in the amount of $85,174.78, for the
installation of a fire sprinkler system at the Fire Station 76 Maintenance
Facility, and for the upgrade of the existing fire alarm system installed at
Fire Station 76 and its maintenance facility.
Summary:
Under this agreement, Smith Fire Systems will provide all necessary equipment and
will install a fire sprinkler system at the City’s Fire Station 76 Maintenance Facility.
Additionally, Smith Fire Systems will update the fire alarm system installed at Fire
Station 76 and its Maintenance Facility. The updates are needed because the
existing system is not adequate to support both Fire Station 76 and its Maintenance
Facility.
If approved, the work provided for under this agreement will be completed within
90 days.
Exhibits: Public Works Agreement with Smith Fire Systems, Inc.
Budget Impact: Funding for work under this agreement is within the City’s
established budget.
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PUBLIC WORKS AGREEMENT - 1
PUBLIC WORKS AGREEMENT
between City of Kent and
Smith Fire Systems, Inc.
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal
corporation (hereinafter the "City"), and Smith Fire Systems, Inc. organized under the laws of
the State of Washington, located and doing business at 1106 54th Ave East, Tacoma, Wa
98424,253-926-1880, John Lutterloh (hereinafter the "Contractor").
AGREEMENT
The parties agree as follows:
I. DESCRIPTION OF WORK.
Contractor shall perform the following services for the City in accordance with the
following described plans and/or specifications:
Provide all equipment and labor necessary to install a fire sprinkler system for Kent
Fire Station 76 Maintenance Facility, and upgrade the fire alarm system at both the
Kent Fire Station 76 and the Maintenance Facility located at 20676 72nd Ave S., in
the City of Kent, in accordance with Vendor's Scope of Work and price quote
attached and incorporated as Exhibit A.
Contractor further represents that the services furnished under this Agreement will be
performed in accordance with generally accepted professional practices in effect at the time such
services are performed.
II. TIME OF COMPLETION. The parties agree that work will begin on the tasks
described in Section I above immediately upon execution of this Agreement. Upon the effective
date of this Agreement, the Contractor shall complete the work described in Section I within 90
days.
III. COMPENSATION. The City shall pay the Contractor a total amount not to exceed
$85,174.78, plus any applicable Washington State Sales Tax, for the work and services
contemplated in this Agreement. The Contractor shall invoice the City monthly. The City will
pay for the portion of the work described in the invoice that has been completed by the
Contractor and approved by the City. The City’s payment shall not constitute a waiver of the
City’s right to final inspection and acceptance of the project.
A. Performance Bond. Pursuant to Chapter 39.08 RCW, the Contractor, shall
provide the City a performance bond for the full contract amount to be in effect until sixty (60)
days after the date of final acceptance, or until receipt of all necessary releases from the State
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PUBLIC WORKS AGREEMENT - 2
Department of Revenue and the State Department of Labor and Industries and until settlement
of any liens filed under Chapter 60.28 RCW, whichever is later.
B. Retainage. The City shall hold back a retainage in the amount of five percent
(5%) of any and all payments made to contractor for a period of sixty (60) days after the date
of final acceptance, or until receipt of all necessary releases from the State Department of
Revenue and the State Department of Labor & Industries and until settlement of any liens filed
under Chapter 60.28 RCW, whichever is later. The amount retained shall be placed in a fund by
the City pursuant to RCW 60.28.011(4)(a), unless otherwise instructed by the Contractor.
C. Defective or Unauthorized Work. The City reserves its right to withhold
payment from Contractor for any defective or unauthorized work. Defective or unauthorized
work includes, without limitation: work and materials that do not conform to the requirements
of this Agreement; and extra work and materials furnished without the City’s written approval.
If Contractor is unable, for any reason, to satisfactorily complete any portion of the work, the
City may complete the work by contract or otherwise, and Contractor shall be liable to the City
for any additional costs incurred by the City. “Additional costs” shall mean all reasonable costs,
including legal costs and attorney fees, incurred by the City beyond the maximum Contract price
specified above. The City further reserves its right to deduct the cost to complete the Contract
work, including any Additional Costs, from any and all amounts due or to become due the
Contractor.
D. Final Payment: Waiver of Claims. THE CONTRACTOR’S ACCEPTANCE OF
FINAL PAYMENT (EXCLUDING WITHHELD RETAINAGE) SHALL CONSTITUTE A WAIVER OF
CONTRACTOR’S CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED
BY CONTRACTOR AS UNSETTLED AT THE TIME FINAL PAYMENT IS MADE AND ACCEPTED.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent
Contractor-Employer Relationship will be created by this Agreement and that the Contractor has
the ability to control and direct the performance and details of its work, the City being interested
only in the results obtained under this Agreement.
V. TERMINATION. The City may terminate this Agreement for good cause. “Good
cause” shall include, without limitation, any one or more of the following events:
A. The Contractor’s refusal or failure to supply a sufficient number of properly
skilled workers or proper materials for completion of the Contract work.
B. The Contractor’s failure to complete the work within the time specified in this
Agreement.
C. The Contractor’s failure to make full and prompt payment to subcontractors
or for material or labor.
D. The Contractor’s persistent disregard of federal, state or local laws, rules or
regulations.
E. The Contractor’s filing for bankruptcy or becoming adjudged bankrupt.
F. The Contractor’s breach of any portion of this Agreement.
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PUBLIC WORKS AGREEMENT - 3
If the City terminates this Agreement for good cause, the Contractor shall not receive any
further money due under this Agreement until the Contract work is completed. After
termination, the City may take possession of all records and data within the Contractor’s
possession pertaining to this project which may be used by the City without restriction.
VI. PREVAILING WAGES. Contractor shall file a “Statement of Intent to Pay
Prevailing Wages,” with the State of Washington Department of Labor & Industries prior to
commencing the Contract work. Contractor shall pay prevailing wages in effect on the date the
bid is accepted or executed by Contractor, and comply with Chapter 39.12 of the Revised Code
of Washington, as well as any other applicable prevailing wage rate provisions. The latest
prevailing wage rate revision issued by the Department of Labor and Industries is attached.
VII. CHANGES. The City may issue a written change order for any change in the
Contract work during the performance of this Agreement. If the Contractor determines, for any
reason, that a change order is necessary, Contractor must submit a written change order
request to the person listed in the notice provision section of this Agreement, section XV(D),
within fourteen (14) calendar days of the date Contractor knew or should have known of the
facts and events giving rise to the requested change. If the City determines that the change
increases or decreases the Contractor's costs or time for performance, the City will make an
equitable adjustment. The City will attempt, in good faith, to reach agreement with the
Contractor on all equitable adjustments. However, if the parties are unable to agree, the City
will determine the equitable adjustment as it deems appropriate. The Contractor shall proceed
with the change order work upon receiving either a written change order from the City or an oral
order from the City before actually receiving the written change order. If the Contractor fails to
require a change order within the time specified in this paragraph, the Contractor waives its
right to make any claim or submit subsequent change order requests for that portion of the
contract work. If the Contractor disagrees with the equitable adjustment, the Contractor must
complete the change order work; however, the Contractor may elect to protest the adjustment
as provided in subsections A through E of Section VIII, Claims, below.
The Contractor accepts all requirements of a change order by: (1) endorsing it, (2)
writing a separate acceptance, or (3) not protesting in the way this section provides. A change
order that is accepted by Contractor as provided in this section shall constitute full payment and
final settlement of all claims for contract time and for direct, indirect and consequential costs,
including costs of delays related to any work, either covered or affected by the change.
VIII. CLAIMS. If the Contractor disagrees with anything required by a change order,
another written order, or an oral order from the City, including any direction, instruction,
interpretation, or determination by the City, the Contractor may file a claim as provided in this
section. The Contractor shall give written notice to the City of all claims within fourteen (14)
calendar days of the occurrence of the events giving rise to the claims, or within fourteen (14)
calendar days of the date the Contractor knew or should have known of the facts or events
giving rise to the claim, whichever occurs first . Any claim for damages, additional payment for
any reason, or extension of time, whether under this Agreement or otherwise, shall be
conclusively deemed to have been waived by the Contractor unless a timely written claim is
made in strict accordance with the applicable provisions of this Agreement.
At a minimum, a Contractor's written claim shall include the information set forth in
subsections A, items 1 through 5 below.
FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM
WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY
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PUBLIC WORKS AGREEMENT - 4
CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS
SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY.
A. Notice of Claim. Provide a signed written notice of claim that provides the following
information:
1. The date of the Contractor's claim;
2. The nature and circumstances that caused the claim;
3. The provisions in this Agreement that support the claim;
4. The estimated dollar cost, if any, of the claimed work and how that
estimate was determined; and
5. An analysis of the progress schedule showing the schedule change or
disruption if the Contractor is asserting a schedule change or
disruption.
B. Records. The Contractor shall keep complete records of extra costs and time
incurred as a result of the asserted events giving rise to the claim. The City shall
have access to any of the Contractor's records needed for evaluating the protest.
The City will evaluate all claims, provided the procedures in this section are
followed. If the City determines that a claim is valid, the City will adjust payment
for work or time by an equitable adjustment. No adjustment will be made for an
invalid protest.
C. Contractor's Duty to Complete Protested Work. In spite of any claim, the
Contractor shall proceed promptly to provide the goods, materials and services
required by the City under this Agreement.
D. Failure to Protest Constitutes Waiver. By not protesting as this section provides,
the Contractor also waives any additional entitlement and accepts from the City any
written or oral order (including directions, instructions, interpretations, and
determination).
E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures
of this section, the Contractor completely waives any claims for protested work and
accepts from the City any written or oral order (including directions, instructions,
interpretations, and determination).
IX. LIMITATION OF ACTIONS. CONTRACTOR MUST, IN ANY EVENT, FILE ANY
LAWSUIT ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR
DAYS FROM THE DATE THE CONTRACT WORK IS COMPLETE OR CONTRACTOR’S ABILITY TO
FILE THAT CLAIM OR SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY
APPLICABLE STATUTORY LIMITATIONS PERIOD.
X. WARRANTY. Upon acceptance of the contract work, Contractor must provide the
City a one-year warranty bond in a form and amount acceptable to the City. The Contractor
shall correct all defects in workmanship and materials within one (1) year from the date of the
City’s acceptance of the Contract work. In the event any parts are repaired or replaced, only
original replacement parts shall be used—rebuilt or used parts will not be acceptable. When
defects are corrected, the warranty for that portion of the work shall extend for one (1) year
from the date such correction is completed and accepted by the City. The Contractor shall begin
to correct any defects within seven (7) calendar days of its receipt of notice from the City of the
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PUBLIC WORKS AGREEMENT - 5
defect. If the Contractor does not accomplish the corrections within a reasonable time as
determined by the City, the City may complete the corrections and the Contractor shall pay all
costs incurred by the City in order to accomplish the correction.
XI. DISCRIMINATION. In the hiring of employees for the performance of work under
this Agreement or any sub-contract, the Contractor, its sub-contractors, or any person acting on
behalf of the Contractor or sub-contractor shall not, by reason of race, religion, color, sex, age,
sexual orientation, national origin, or the presence of any sensory, mental, or physical disability,
discriminate against any person who is qualified and available to perform the work to which the
employment relates.
Contractor shall execute the attached City of Kent Equal Employment Opportunity Policy
Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract
work, file the attached Compliance Statement.
XII. INDEMNIFICATION. Contractor shall defend, indemnify and hold the City, its
officers, officials, employees, agents and volunteers harmless from any and all claims, injuries,
damages, losses or suits, including all legal costs and attorney fees, arising out of or in
connection with the Contractor's performance of this Agreement, except for that portion of the
injuries and damages caused by the City's negligence.
The City's inspection or acceptance of any of Contractor's work when completed shall not
be grounds to avoid any of these covenants of indemnification.
Should a court of competent jurisdiction determine that this Agreement is subject to RCW
4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or
damages to property caused by or resulting from the concurrent negligence of the Contractor
and the City, its officers, officials, employees, agents and volunteers, the Contractor's liability
hereunder shall be only to the extent of the Contractor's negligence.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'S WAIVER OF
IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF
THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY
NEGOTIATED THIS WAIVER.
The provisions of this section shall survive the expiration or termination of this
Agreement.
XIII. INSURANCE. The Contractor shall procure and maintain for the duration of the
Agreement, insurance of the types and in the amounts described in Exhibit B attached and
incorporated by this reference.
XIV. WORK PERFORMED AT CONTRACTOR'S RISK. Contractor shall take all
necessary precautions and shall be responsible for the safety of its employees, agents, and
subcontractors in the performance of the contract work and shall utilize all protection necessary
for that purpose. All work shall be done at Contractor's own risk, and Contractor shall be
responsible for any loss of or damage to materials, tools, or other articles used or held for use in
connection with the work.
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PUBLIC WORKS AGREEMENT - 6
XV. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City
requires its contractors and consultants to use recycled and recyclable products whenever
practicable. A price preference may be available for any designated recycled product.
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of
any of the covenants and agreements contained in this Agreement, or to exercise any option
conferred by this Agreement in one or more instances shall not be construed to be a waiver or
relinquishment of those covenants, agreements or options, and the same shall be and remain in
full force and effect.
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by
and construed in accordance with the laws of the State of Washington. 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,
King County, Washington, unless the parties agree in 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 attorney's fees incurred in defending or
bringing such claim or lawsuit, in addition to any other recovery or award provided by law;
provided, however, nothing in this paragraph shall be construed to limit the City's right to
indemnification under Section XII of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the
parties at the addresses listed on the signature page of the Agreement, unless notified to the
contrary. Any written notice hereunder shall become effective three (3) business days after the
date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to
the addressee at the address stated in this Agreement or such other address as may be
hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written
consent of the non-assigning party shall be void. If the non-assigning party gives its consent to
any assignment, the terms of this Agreement shall continue in full force and effect and no
further assignment shall be made without additional written consent.
F. Modification. No waiver, alteration, or modification of any of the provisions of this
Agreement shall be binding unless in writing and signed by a duly authorized representative of
the City and Contractor.
G. Entire Agreement. The written provisions and terms of this Agreement, together
with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or
other representative of the City, and such statements shall not be effective or be construed as
entering into or forming a part of or altering in any manner this Agreement. All of the above
documents are hereby made a part of this Agreement. However, should any language in any of
the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms
of this Agreement shall prevail.
H. Compliance with Laws. The Contractor agrees to comply with all federal, state, and
municipal laws, rules, and regulations that are now effective or in the future become applicable
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PUBLIC WORKS AGREEMENT - 7
to Contractor's business, equipment, and personnel engaged in operations covered by this
Agreement or accruing out of the performance of those operations.
IN WITNESS, the parties below execute this Agreement, which shall become
effective on the last date entered below.
CONTRACTOR:
By: (signature)
Print Name:
Its
(Title)
DATE:
CITY OF KENT:
By:
(signature)
Print Name: Suzette Cooke
Its Mayor (Title)
DATE:
NOTICES TO BE SENT TO:
CONTRACTOR:
John Lutterloh
Smith Fire Systems, Inc.
1106 54th Ave East
Tacoma, Wa. 98424
253-926-1880 (telephone)
253-926-2350 (facsimile)
NOTICES TO BE SENT TO:
CITY OF KENT:
Charles (Charlie) Lindsey, Supertintendent of
Facilities
City of Kent
220 Fourth Avenue South
Kent, WA 98032
(253) 856-5082 (telephone)
(253) 856-6080 (facsimile)
APPROVED AS TO FORM:
Kent Law Department
Smithfirestatsprinkle
17
EEO COMPLIANCE DOCUMENTS - 1
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City’s equal employment opportunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City’s sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing below, I agree to fulfill the five requirements referenced above.
Dated this day of ____, 200__.
By:___________________________________________
For: __________________________________________
Title: _________________________________________
Date: _________________________________________
18
EEO COMPLIANCE DOCUMENTS - 2
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and
state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee
equal employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City’s
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City’s equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
19
EEO COMPLIANCE DOCUMENTS - 3
CITY OF KENT
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT
This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the
Agreement.
I, the undersigned, a duly represented agent of
Company, hereby acknowledge and declare that the before-mentioned company was the prime
contractor for the Agreement known as that was entered into on the
(date) , between the firm I represent and the City of Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City
of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity
Policy that was part of the before-mentioned Agreement.
Dated this day of , 200___.
By:___________________________________________
For: __________________________________________
Title: _________________________________________
Date: _________________________________________
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24
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28
BENEFITS DIVISION
Becky Fowler
Manager
400 West Gowe
Kent, WA 98032
Fax: 253-856-6270
OFFICE: 253-856-5290
City of Kent Employee Services Department
April 15, 2008
TO: Operations Committee
FROM: Ray Luevanos, Senior Human Resources Analyst
THRU: Becky Fowler, Benefits Manager
SUBJECT: Group Health Cooperative 2008 Contract
MOTION: I move to recommend the 2008 Group Health Cooperative contract
for the city’s insured HMO plan be placed on the City Council consent calendar
for the April 22, 2008 meeting.
SUMMARY: Renewal of the Group Health Cooperative of Puget Sound contract for the
city’s insured health maintenance organization (HMO). The 2008 contract reflects an
approximate 13.2% increase in the health care premiums charged by Group Health
Cooperative and is budgeted in the health and welfare fund.
BUDGET IMPACT: $370,495.
BACKGROUND: The city purchases insurance with Group Health Cooperative of Puget
Sound. Group Health is a non-profit, health maintenance organization (HMO)
providing primary care medical and specialty center throughout the Pacific Northwest.
Approximately 38 employees and their families are covered under our Group Health
Cooperative plan.
Sue Viseth, Director
29
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30
1
Group Medical Coverage Agreement
Group Health Cooperative (also referred to as “GHC”) is a nonprofit health maintenance organization furnishing
health care coverage on a prepayment basis. The Group identified below wishes to purchase such coverage. This
Agreement sets forth the terms under which that coverage will be provided, including the rights and responsibilities
of the contracting parties; requirements for enrollment and eligibility; and benefits to which those enrolled under this
Agreement are entitled.
The Agreement between GHC and the Group consists of the following:
• Standard Provisions
• Attached Benefit Booklet
• Signed Group application
• Premium Schedule
• All attachments and endorsements included or issued hereafter
Group Health Cooperative
Signed:
Title: President and Chief Executive Officer
City of Kent, 0036900
Signed:
Title:
This Agreement will continue in effect until terminated or renewed as herein provided for and is
effective January 1, 2008.
PA-113302
C02733 - 0036900
31
C02733 - 0036900 2
Group Medical Coverage Agreement
Table of Contents
Standard Provisions
Attachment 1 Benefit Booklet
Attachment 2 Premium Schedule
Attachment 3 Medicare Endorsement
32
C02733 - 0036900 3
Standard Provisions
1. GHC agrees to provide benefits as set forth in the attached Benefit Booklet to enrollees of the Group.
2. Monthly Premium Payments. For the initial term of this Agreement, the Group shall submit to GHC for each
Member the monthly premiums set forth in the current Premium Schedule and a verification of enrollment.
Payment must be received on or before the due date and is subject to a grace period of ten (10) days. Premiums
are subject to change by GHC upon thirty (30) days written notice. Premium rates will be revised as a part of
the annual renewal process.
In the event the Group increases or decreases enrollment at least twenty-five percent (25%) or more, GHC
reserves the right to require re-rating of the Group.
3. Dissemination of Information. Unless the Group has accepted responsibility to do so, GHC will disseminate
information describing benefits set forth in the Benefit Booklet attached to this Agreement.
4. Identification Cards. GHC will furnish cards, for identification purposes only, to all Members enrolled under
this Agreement.
5. Administration of Agreement. GHC may adopt reasonable policies and procedures to help in the
administration of this Agreement. GHC reserves the right to construe the provisions of this Agreement and
make all determinations regarding benefit entitlement and coverage.
6. Modification of Agreement. Except as required by federal and Washington State law, this Agreement may not
be modified without agreement between both parties.
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.
7. 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, negligent
performance or willful misconduct of its directors, officers, employees and agents of their express obligations
under this Agreement.
The Group agrees to indemnify and hold GHC harmless against all claims, damages, losses and expenses,
including reasonable attorney’s fees, arising out of the Group’s failure to perform, negligent performances or
willful misconduct of its directors, officers, employees and agents of their express obligations under this
Agreement.
The indemnifying party shall give the other party prompt notice of any claim covered by this section and
provide reasonable assistance (at its expense). The indemnifying party shall have the right and duty to assume
the control of the defense thereof with counsel reasonably acceptable to the other party. Either party may take
part in the defense at its own expense after the other party assumes the control thereof.
8. Compliance With Law. The Group and GHC shall comply with all applicable state and federal laws and
regulations in performance of this Agreement.
This Agreement is entered into and governed by the laws of Washington State, except as otherwise pre-empted
by ERISA and other federal laws.
9. Governmental Approval. If GHC has not received any necessary government approval by the date when
notice is required under this Agreement, GHC will notify the Group of any changes once governmental
approval has been received. GHC may amend this Agreement by giving notice to the Group upon receipt of
government approved rates, benefits, limitations, exclusions or other provisions, in which case such rates,
benefits, limitations, exclusions or provisions will go into effect as required by the governmental agency. All
33
C02733 - 0036900 4
amendments are deemed accepted by the Group unless the Group gives GHC written notice of non-acceptance
within thirty (30) days after receipt of amendment, in which event this Agreement and all rights to services and
other benefits terminate the first of the month following thirty (30) days after receipt of non-acceptance.
10. Confidentiality. Each party acknowledges that performance of its obligations under this Agreement may
involve access to and disclosure of data, procedures, materials, lists, systems and information, including
medical records, employee benefits information, employee addresses, social security numbers, e-mail addresses,
phone numbers and other confidential information regarding the Group’s employees (collectively the
“information”). The information shall be kept strictly confidential and shall not be disclosed to any third party
other than: (i) representatives of the receiving party (as permitted by applicable state and federal law) who have
a need to know such information in order to perform the services required of such party pursuant to this
Agreement, or for the proper management and administration of the receiving party, provided that such
representatives are informed of the confidentiality provisions of this Agreement and agree to abide by them, (ii)
pursuant to court order or (iii) to a designated public official or agency pursuant to the requirements of federal,
state or local law, statute, rule or regulation. The disclosing party will provide the other party with prompt
notice of any request the disclosing party receives to disclose information pursuant to applicable legal
requirements, so that the other party may object to the request and/or seek an appropriate protective order
against such request. Each party shall maintain the confidentiality of medical records and confidential patient
and employee information as required by applicable law.
11. Arbitration. Any dispute, controversy or difference between GHC and the Group arising out of or relating to
this Agreement, or the breach thereof, shall be settled by arbitration in Seattle, Washington in accordance with
the Commercial Arbitration Rules of the American Arbitration Association, and judgment on the award
rendered by the arbitrator(s) may be entered in any court having jurisdiction thereof. Except as may be required
by law, neither party nor arbitrator may disclose the existence, content or results of any arbitration hereunder
without the prior written consent of both parties.
12. HIPAA.
Definition of Terms. Terms used, but not otherwise defined, in this Section shall have the same meaning as
those terms have in the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).
Transactions Accepted. GHC will accept Standard Transactions, pursuant to HIPAA, if the Group elects to
transmit such transactions. If the Group sends transactions to GHC that do not comply with applicable HIPAA
standards, the Group will be deemed by such action to be representing and warranting that it is not a Covered
Entity or otherwise required to comply with HIPAA standards for electronic transactions, either directly, or as
an agent of another individual or entity. The parties agree that all the terms, conditions, representations and
warranties contained in this section are express obligations of the Group, and the Group shall indemnify GHC
for any breach of this section.
13. Termination of Entire Agreement. This is a guaranteed renewable Agreement and cannot be terminated
without the mutual approval of each of the parties, except in the circumstances set forth below.
a. Nonpayment or Non-Acceptance of Premium. Failure to make any monthly premium payment or
contribution in accordance with subsection 2 above shall result in termination of this Agreement as of the
premium due date. The Group’s failure to accept the revised premiums provided as part of the annual
renewal process shall be considered nonpayment and result in non-renewal of this Agreement. The Group
may terminate this Agreement upon fifteen (15) days written notice of premium increase, as set forth in
subsection 2 above.
b. Misrepresentation. GHC may rescind or terminate this Agreement upon written notice in the event that
material misrepresentation, fraud or omission of information was used in order to obtain Group coverage.
Either party may terminate this Agreement in the event of material misrepresentation, fraud or omission of
information by the other party in performance of its responsibilities under this Agreement.
34
C02733 - 0036900 5
c. Underwriting Guidelines. GHC may terminate or non-renew this Agreement in the event the Group no
longer meets underwriting guidelines established by GHC that were in effect at the time the Group was
accepted.
14. Withdrawal or Cessation of Services.
a. GHC may determine to withdraw from a Service Area or from a segment of its Service Area after GHC has
demonstrated to the Washington State Office of the Insurance Commissioner that GHC’s clinical, financial
or administrative capacity to service the covered Members would be exceeded.
b. GHC may determine to cease to offer the Group’s current plan and replace the plan with another plan
offered to all covered Members within that line of business that includes all of the health care services
covered under the replaced plan and does not significantly limit access to the services covered under the
replaced plan. GHC may also allow unrestricted conversion to a fully comparable GHC product.
GHC will provide written notice to each covered Member of the discontinuation or non-renewal of the plan at
least ninety (90) days prior to discontinuation.
35
1
Dear Group Health Subscriber:
This booklet contains important information about your healthcare plan.
This is your 2008 Group Health Benefit Booklet (Certificate of Coverage). It explains the services and benefits you
and those enrolled on your contract are entitled to receive from Group Health Cooperative. Sections of this
document may be bolded and italicized, which identifies changes that Group Health has made to the plan. The
benefits reflected in this booklet were approved by your employer or association who contracts with Group Health
for your healthcare coverage. If you are eligible for Medicare, please read Section IV.J. as it may affect your
prescription drug coverage.
We recommend you read it carefully so you’ll understand not only the benefits, but the exclusions, limitations, and
eligibility requirements of this certificate. Please keep this certificate for as long as you are covered by Group
Health. We will send you revisions if there are any changes in your coverage.
This certificate is not the contract itself; you can contact your employer or group administrator if you wish to see a
copy of the contract (Medical Coverage Agreement).
We’ll gladly answer any questions you might have about your Group Health benefits. Please call our Group Health
Customer Service Center at (206) 901-4636 in the Seattle area, or toll-free in Washington, 1-888-901-4636.
Thank you for choosing Group Health Cooperative. We look forward to working with you to preserve and enhance
your health.
Very truly yours,
Scott Armstrong
President
PA-113302a, CA-139502,CA-2220,CA-1984,CA-107600 ,CA-3341,CA-3344,CA-1385,CA-6100
C02733 - 0036900a
36
C02733 - 0036900a 2
Benefit Booklet
Table of Contents
Section I. Introduction
A. Accessing Care
B. Cost Shares
C. Subscriber’s Liability
D. Claims
Section II. Allowances Schedule
Section III. Eligibility, Enrollment and Termination
A. Eligibility
B. Enrollment
C. Effective Date of Enrollment
D. Eligibility for Medicare
E. Termination of Coverage
F. Services After Termination of Agreement
G. Continuation of Coverage Options
Section IV. Schedule of Benefits
A. Hospital Care
B. Medical and Surgical Care
C. Chemical Dependency Treatment
D. Plastic and Reconstructive Services
E. Home Health Care Services
F. Hospice Care
G. Rehabilitation Services
H. Devices, Equipment and Supplies
I. Tobacco Cessation
J. Drugs, Medicines, Supplies and Devices
K. Mental Health Care Services
L. Emergency/Urgent Care
M. Ambulance Services
N. Skilled Nursing Facility
Section V. General Exclusions
Section VI. Grievance Processes for Complaints and Appeals
Section VII. General Provisions
A. Coordination of Benefits
B. Subrogation and Reimbursement Rights
C. Miscellaneous Provisions
Section VIII. Definitions
Attachment: Group Medicare Coverage
37
C02733 - 0036900a 3
Section I. Introduction
Group Health Cooperative (also referred to as “GHC”) is a nonprofit health maintenance organization furnishing
health care primarily on a prepayment basis.
Read This Benefit Booklet Carefully
This Benefit Booklet is a statement of benefits, exclusions and other provisions, as set forth in the Group Medical
Coverage Agreement (“Agreement”) between GHC and the employer or Group.
A full description of benefits, exclusions, limits and Out-of-Pocket Expenses can be found in the Schedule of
Benefits, Section IV; General Exclusions, Section V; and Allowances Schedule, Section II. These sections must be
considered together to fully understand the benefits available under the Agreement. Words with special meaning are
capitalized. They are defined in Section VIII.
A. Accessing Care
Members are entitled to Covered Services only at GHC Facilities and from GHC Personal Physicians.
Except as follows:
• Emergency care,
• Self-Referral to women’s health care providers, as set forth below,
• Visits with GHC-Designated Self-Referral Specialists, as set forth below,
• Care provided pursuant to a Referral. Referrals must be requested by the Member’s Personal Physician and
approved by GHC, and
• Other services as specifically set forth in the Allowances Schedule and Section IV.
Primary Care. Members must select a GHC Personal Physician when enrolling under the Agreement. One
Personal Physician may be selected for an entire family, or a different Personal Physician may be selected for
each family member. If the Personal Physician is not selected at the time of enrollment, GHC will assign a
Personal Physician, and a letter of explanation will be sent to the Member.
Selecting a Personal Physician or changing from one Personal Physician to another can be accomplished by
contacting GHC Customer Service, or accessing the GHC website at www.ghc.org. The change will be made
within twenty-four (24) hours of the receipt of the request, if the selected physician’s caseload permits.
A listing of GHC Personal Physicians, Referral specialists, women’s health care providers and GHC-Designated
Self-Referral Specialists is available by contacting GHC Customer Service at (206) 901-4636 or (888) 901-
4636, or by accessing GHC’s website at www.ghc.org.
In the case that the Member’s Personal Physician no longer participates in GHC’s network, the Member will be
provided access to the Personal Physician for up to sixty (60) days following a written notice offering the
Member a selection of new Personal Physicians from which to choose.
Specialty Care. Unless otherwise indicated in this section, the Allowances Schedule or Section IV., Referrals
are required for specialty care and specialists.
GHC-Designated Self-Referral Specialist. Members may make appointments directly with GHC-Designated
Self-Referral Specialists at Group Health-owned or -operated medical centers without a Referral from their
Personal Physician. Self-Referrals are available for the following specialty care areas: allergy, audiology,
cardiology, chemical dependency, chiropractic/manipulative therapy, dermatology, gastroenterology, general
surgery, hospice, manipulative therapy, mental health, nephrology, neurology, obstetrics and gynecology,
occupational medicine*, oncology/hematology, ophthalmology, optometry, orthopedics, otolaryngology (ear,
nose and throat), physical therapy*, smoking cessation, speech/language and learning services* and urology.
38
C02733 - 0036900a 4
* Medicare patients need a Referral for these specialists.
Women’s Health Care Direct Access Providers. Female Members may see a participating General and
Family Practitioner, Physician’s Assistant, Gynecologist, Certified Nurse Midwife, Licensed Midwife, Doctor
of Osteopathy, Pediatrician, Obstetrician or Advanced Registered Nurse Practitioner who is contracted by GHC
to provide women’s health care services directly, without a Referral from their Personal Physician, for
Medically Necessary maternity care, covered reproductive health services, preventive care (well care) and
general examinations, gynecological care and follow-up visits for the above services. Women’s health care
services are covered as if the Member’s Personal Physician had been consulted, subject to any applicable Cost
Shares, as set forth in the Allowances Schedule. If the Member’s women’s health care provider diagnoses a
condition that requires Referral to other specialists or hospitalization, the Member or her chosen provider must
obtain preauthorization and care coordination in accordance with applicable GHC requirements.
Second Opinions. The Member may access, upon request, a second opinion regarding a medical diagnosis or
treatment plan from a GHC Provider.
Emergent and Urgent Care. Emergent care is available at GHC Facilities. If Members cannot get to a GHC
Facility, Members may obtain Emergency services from the nearest hospital. Members or persons assuming
responsibility for a Member must notify GHC by way of the GHC Emergency Notification Line within twenty-
four (24) hours of admission to a non-GHC Facility, or as soon thereafter as medically possible. Members may
refer to Section IV. for more information about coverage of Emergency services.
In the GHC Service Area, urgent care is covered only at GHC medical centers, GHC urgent care clinics or GHC
Provider’s offices. Urgent care received at any hospital emergency department is not covered unless authorized
in advance by a GHC Provider. Members may refer to Section IV. for more information about coverage of
urgent care services.
Outside the GHC Service Area, urgent care is covered at any medical facility. Members may refer to Section
IV. for more information about coverage of urgent care services.
Recommended Treatment. GHC’s Medical Director or his/her designee will determine the necessity, nature
and extent of treatment to be covered 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 any
recommended treatment or diagnostic plan to the extent permitted by law. Members who obtain care not
recommended by GHC, do so with the full understanding that GHC has no obligation for the cost, or liability
for the outcome, of such care. Coverage decisions may be appealed as set forth in Section VI.
Major Disaster or Epidemic. In the event of a major disaster or epidemic, GHC will provide coverage
according to GHC’s best judgment, within the limitations of available facilities and personnel. GHC has no
liability 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.
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 while its facilities and services are so
affected. In no case shall GHC have any liability or obligation on account of delay or failure to provide or
arrange such services.
B. Cost Shares
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C02733 - 0036900a 5
The Subscriber shall be liable for the following Cost Shares when services are received by the Subscriber and
any of his/her Dependents.
1. Copayments. Members shall be required to pay Copayments at the time of service as set forth in the
Allowances Schedule. Payment of a Copayment does not exclude the possibility of an additional billing if
the service is determined to be a non-Covered Service.
2. Coinsurance. Members shall be required to pay coinsurance for certain Covered Services as set forth in the
Allowances Schedule.
3. Out-of-Pocket Limit. Total Out-of-Pocket Expenses incurred during the same calendar year shall not
exceed the Out-of-Pocket Limit set forth in the Allowances Schedule. Out-of-Pocket Expenses which apply
toward the Out-of-Pocket Limit are set forth in the Allowances Schedule.
4. Deductibles. In addition to any applicable annual Deductible, there may be service-specific Deductibles as
set forth in the Allowances Schedule.
C. Subscriber's Liability
The Subscriber is liable for (1) payment to the Group of his/her contribution toward the monthly premium, if
any; (2) payment of Cost Share amounts for Covered Services provided to the Subscriber and his/her
Dependents, as set forth in the Allowances Schedule; and (3) payment of any fees charged for non-Covered
Services provided to the Subscriber and his/her Dependents, at the time of service.
Payment of an amount billed by GHC must be received within thirty (30) days of the billing date.
D. Claims
Claims for benefits may be made before or after services are obtained. To make a claim for benefits under the
Agreement, a Member (or the Member’s authorized representative) must contact GHC Customer Service, or
submit a claim for reimbursement as described below. Other inquiries, such as asking a health care provider
about care or coverage, or submitting a prescription to a pharmacy, will not be considered a claim for benefits.
If a Member receives a bill for services the Member believes are covered under the Agreement, the Member
must, within ninety (90) days of the date of service, or as soon thereafter as reasonably possible, either (1)
contact GHC Customer Service to make a claim or (2) pay the bill and submit a claim for reimbursement of
Covered Services to GHC, P.O. Box 34585, Seattle, WA 98124-1585. In no event, except in the absence of
legal capacity, shall a claim be accepted later than one (1) year from the date of service.
GHC will generally process claims for benefits within the following timeframes after GHC receives the claims:
• Pre-service claims – within fifteen (15) days.
• Claims involving urgently needed care – within seventy-two (72) hours.
• Concurrent care claims – within twenty-four (24) hours.
• Post-service claims – within thirty (30) days.
Timeframes for pre-service and post-service claims can be extended by GHC for up to an additional fifteen (15)
days. Members will be notified in writing of such extension prior to the expiration of the initial timeframe.
40
C02733 - 0036900a 6
Section II. Allowances Schedule
The benefits described in this schedule are subject to all provisions, limitations and exclusions set forth in the Group
Medical Coverage Agreement.
“Welcome” Outpatient Services Waiver
Not applicable.
Annual Deductible
No annual Deductible.
Plan Coinsurance
No Plan Coinsurance.
Lifetime Maximum
$2,000,000 per Member for Covered Services incurred, unless otherwise indicated. Up to $5,000 is restored
automatically each January 1 for benefits paid by GHC during the prior calendar year.
Hospital Services
• Covered inpatient medical and surgical services, including acute chemical withdrawal (detoxification)
Covered in full.
• Covered outpatient hospital surgery (including ambulatory surgical centers)
Covered subject to the lesser of GHC’s charge or the applicable outpatient services Copayment.
Outpatient Services
• Covered outpatient medical and surgical services
Covered subject to the lesser of GHC's charge or a $10 outpatient services Copayment per Member per visit.
• Allergy testing
Covered subject to the lesser of GHC’s charge or the applicable outpatient services Copayment.
• Oncology (radiation therapy, chemotherapy)
Covered subject to the lesser of GHC’s charge or the applicable outpatient services Copayment.
Drugs – Outpatient (including mental health drugs, contraceptive drugs and devices and diabetic supplies)
• Prescription drugs, medicines, supplies and devices for a supply of thirty (30) days or less when listed in the
GHC drug formulary
Covered subject to the lesser of GHC’s charge or a $10 Copayment.
• Over-the-counter drugs and medicines
41
C02733 - 0036900a 7
Not covered.
• Allergy serum
Covered subject to the lesser of GHC’s charge or the applicable prescription drug Cost Share (as set forth
above) for each thirty (30) day supply.
• Injectables
Injections that can be self-administered are subject to the lesser of GHC’s charge or the applicable prescription
drug Cost Share (as set forth above). Injections necessary for travel are not covered.
• Mail order drugs and medicines
Covered subject to the lesser of GHC’s charge or the applicable prescription drug Cost Share (as set forth
above) for each thirty (30) day supply or less.
• Growth hormones
Covered in full.
Out-of-Pocket Limit
Limited to an aggregate maximum of $2,000 per Member or $4,000 per family per calendar year. Except as
otherwise noted in this Allowances Schedule, the total Out-of-Pocket Expenses for the following Covered Services
are included in the Out-of-Pocket Limit:
• Inpatient services
• Outpatient services
• Emergency care at a GHC or non-GHC Facility
• Ambulance services
Acupuncture
Covered subject to the lesser of GHC’s charge or the applicable outpatient services Copayment for Self-Referrals to
a GHC Provider up to a maximum of eight (8) visits per Member per medical diagnosis per calendar year. When
approved by GHC, additional visits are covered.
Ambulance Services
• Emergency ground/air transport
Covered at 80%.
• Non-emergent ground/air interfacility transfer
Covered at 80% for GHC-initiated transfers, except hospital-to-hospital ground transfers covered in full.
Chemical Dependency
• Inpatient services
Covered subject to the lesser of GHC’s charge or the applicable inpatient services Copayment.
42
C02733 - 0036900a 8
• Outpatient services
Covered subject to the lesser of GHC’s charge or the applicable outpatient services Copayment.
• Benefit period Allowance
Covered up to $14,000 per Member per any twenty-four (24) consecutive calendar month period.
Acute detoxification covered as any other medical service. Charges incurred are not subject to the twenty-four (24)
month maximum.
Dental Services (including accidental injury to natural teeth)
Not covered, except as set forth in Section IV.B.24.
Devices, Equipment and Supplies (for home use)
Covered at 80% for:
• Durable medical equipment
• Orthopedic appliances
• Post-mastectomy bras limited to two (2) every six (6) months
Covered at 80% for:
• Ostomy supplies
• Prosthetic devices
When provided in a home health setting in lieu of hospitalization as described in Section IV.A.3., benefits will be
the greater of benefits available for devices, equipment and supplies, home health or hospitalization. See Hospice
for durable medical equipment provided in a hospice setting.
Diabetic Supplies
Insulin, needles, syringes and lancets - see Drugs-Outpatient. External insulin pumps, blood glucose monitors,
testing reagents and supplies - see Devices, Equipment and Supplies. When Devices, Equipment and Supplies have
a dollar maximum, diabetic supplies are not subject to this maximum benefit limit.
Diagnostic Laboratory and Radiology Services
Covered in full.
Emergency Services
• At a GHC Facility
Covered subject to the lesser of GHC’s charge or a $75 Copayment per Member per Emergency visit.
Copayment is waived if the Member is admitted as an inpatient to the hospital directly from the emergency
department. Emergency admissions are covered subject to the applicable inpatient services Cost Share.
• At a non-GHC Facility
Covered subject to the lesser of GHC’s charge or a $125 Deductible per Member per Emergency visit.
Emergency care Deductible is waived if the Member is admitted as an inpatient to the hospital directly from the
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C02733 - 0036900a 9
emergency department. Emergency admissions are covered subject to the applicable inpatient services Cost
Share.
Hearing Examinations and Hearing Aids
• Hearing examinations to determine hearing loss
Covered subject to the lesser of GHC’s charge or the applicable outpatient services Copayment.
• Hearing aids, including hearing aid examinations
Not covered.
Home Health Services
Covered in full. No visit limit.
Hospice Services
Covered in full. Inpatient respite care is covered for a maximum of five (5) consecutive days per occurrence.
Infertility Services (including sterility)
Not covered.
Manipulative Therapy
Covered subject to the lesser of GHC’s charge or the applicable outpatient services Copayment for Self-Referrals to
a GHC Provider for manipulative therapy of the spine and extremities in accordance with GHC clinical criteria up to
a maximum of ten (10) visits per Member per calendar year. When approved by GHC, additional manipulation visits
are covered.
Maternity and Pregnancy Services
• Delivery and associated Hospital Care
Covered subject to the lesser of GHC’s charge or the applicable inpatient services Copayment.
• Routine prenatal and postpartum care
Covered subject to the lesser of GHC’s charge or the applicable outpatient services Copayment.
• Pregnancy termination
Covered subject to the lesser of GHC’s charge or the applicable Copayment for involuntary/voluntary
termination of pregnancy.
Mental Health Services
• Inpatient services
Covered subject to the lesser of GHC’s charge or the applicable inpatient services Copayment for up to twelve
(12) days per Member per calendar year at a GHC-approved mental health care facility.
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• Outpatient services
Covered subject to the lesser of GHC’s charge or the applicable outpatient services Copayment for up to twenty
(20) visits per Member per calendar year.
Naturopathy
Covered subject to the lesser of GHC’s charge or the applicable outpatient services Copayment for Self-Referrals to
a GHC Provider up to a maximum of three (3) visits per Member per medical diagnosis per calendar year. When
approved by GHC, additional visits are covered.
Nutritional Services
• Phenylketonuria (PKU) supplements
Covered in full.
• Enteral therapy (formula)
Covered at 80% for elemental formulas. Necessary equipment and supplies are covered under Devices,
Equipment and Supplies.
• Parenteral therapy (total parenteral nutrition)
Covered in full for parenteral formulas. Necessary equipment and supplies are covered under Devices,
Equipment and Supplies.
Obesity Related Services
Covered subject to the lesser of GHC’s charge or the applicable Copayment for bariatric surgery. Weight loss
programs, medications and related physician visits for medication monitoring are not covered.
On the Job Injuries or Illnesses
Not covered, including injuries or illnesses incurred as a result of self-employment.
Optical Services
• Routine eye examinations
Covered subject to the lesser of GHC’s charge or the applicable outpatient services Copayment once every
twelve (12) months.
• Lenses, including contact lenses, and frames
Not covered, except contact lens after cataract surgery is covered in full when in lieu of an intraocular lens.
Organ Transplants
Covered subject to the lesser of GHC’s charge or the applicable Copayment up to a $250,000 lifetime benefit
maximum (including organ acquisition, matching and donor costs up to $50,000), and a six (6) month benefit wait
period.
Plastic and Reconstructive Services (plastic surgery, cosmetic surgery)
45
C02733 - 0036900a 11
• Surgery to correct a congenital disease or anomaly, or conditions following an injury or resulting from surgery
Covered subject to the lesser of GHC’s charge or the applicable Copayment.
• Cosmetic surgery, including complications resulting from cosmetic surgery
Not covered.
Podiatric Services
• Medically Necessary foot care
Covered subject to the lesser of GHC’s charge or the applicable Copayment.
• Foot care (routine)
Not covered, except in the presence of a non-related Medical Condition affecting the lower limbs.
Pre-Existing Condition
Covered with no wait.
Preventive Services (well adult and well child physicals, immunizations, pap smears, mammograms and
prostate/colorectal cancer screening)
Covered subject to the lesser of GHC’s charge or the applicable outpatient services Copayment when in accordance
with the well care schedule established by GHC. Eye refractions are not included under preventive care. Physicals
for travel, employment, insurance or license are not covered.
Rehabilitation Services
• Inpatient physical, occupational and restorative speech therapy services combined, including services for
neurodevelopmentally disabled children age six (6) and under
Covered subject to the lesser of GHC’s charge or the applicable inpatient services Copayment for up to sixty
(60) days per calendar year.
• Outpatient physical, occupational and restorative speech therapy services combined, including services for
neurodevelopmentally disabled children age six (6) and under
Covered subject to the lesser of GHC’s charge or the applicable outpatient services Copayment for up to sixty
(60) visits per calendar year.
Sexual Dysfunction Services
Not covered.
Skilled Nursing Facility (SNF)
Covered in full up to thirty (30) days per condition per Member per calendar year.
Sterilization (vasectomy, tubal ligation)
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C02733 - 0036900a 12
Covered subject to the lesser of GHC’s charge or the applicable Copayments.
Temporomandibular Joint (TMJ) Services
• Inpatient and outpatient TMJ services
Covered subject to the lesser of GHC’s charge or the applicable Copayment up to $1,000 maximum per
Member per calendar year.
• Lifetime benefit maximum
Covered up to $5,000 per Member.
Tobacco Cessation
• Individual/group sessions
Covered in full.
• Approved pharmacy products
Covered in full when prescribed as part of the GHC-designated tobacco cessation program and dispensed
through the GHC mail order service.
Section III. Eligibility, Enrollment and Termination
A. Eligibility
In order to be accepted for enrollment and continuing coverage under the Agreement, individuals must meet any
eligibility requirements imposed by the Group, reside or work in the Service Area and meet all applicable
requirements set forth below, except for temporary residency outside the Service Area for purposes of attending
school, court-ordered coverage for Dependents or other unique family arrangements, when approved in advance
by GHC. GHC has the right to verify eligibility.
1. Subscribers. Bona fide employees and LEOFF II employees who have been continuously employed on a
regularly scheduled basis of not less than twenty-one (21) hours per week, or jobshare, shall be eligible for
enrollment. Elected officials and council members shall be eligible for enrollment. LEOFF I employees
will not be covered under this Agreement.
2. Dependents. The Subscriber may also enroll the following:
a. The Subscriber's legal spouse;
b. Unmarried dependent children who are under the age of twenty-five (25) and are dependent on the
Subscriber for support and maintenance, provided proof of such dependency is furnished to GHC upon
request.
"Children" means the children of the Subscriber, including adopted children, stepchildren, 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.
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C02733 - 0036900a 13
Eligibility may be extended past the Dependent's limiting age as set forth above if the Dependent is
totally incapable of self-sustaining employment because of a developmental or physical disability
incurred prior to attainment of the limiting age set forth above, 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 GHC upon
request, but not more frequently than annually after the two (2) year period following the Dependent's
attainment of the limiting age.
3. Temporary Coverage for Newborns. When a Member gives birth, the newborn will be entitled to the
benefits set forth in Section IV. from birth 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 the
Agreement. All contract provisions, limitations and exclusions will apply except Section III.F. and III.G.
B. Enrollment
1. Application for Enrollment. Application for enrollment must be made on an application approved by
GHC. Applicants will not be enrolled or premiums accepted until the completed application has been
approved by GHC. The Group is responsible for submitting completed applications to GHC.
GHC reserves the right to refuse enrollment to any person whose coverage under any Medical Coverage
Agreement issued by Group Health Cooperative or Group Health Options, Inc. has been terminated for
cause, as set forth in Section III.E. below.
a. Newly Eligible Persons. Newly eligible Subscribers and their Dependents may apply for enrollment in
writing to the Group within thirty-one (31) days of becoming eligible.
b. New Dependents. A written application for enrollment of a newly dependent person, other than a
newborn or adopted newborn child, must be made to the Group within thirty-one (31) days after the
dependency occurs.
A written application for enrollment of a newborn child must be made to the Group within sixty (60)
days following the date of birth, when there is a change in the monthly premium payment as a result of
the additional Dependent.
A written application for enrollment of an adoptive child must be made to the Group within sixty (60)
days from the day the child is placed with the Subscriber for the purpose of adoption and the
Subscriber assumes total or partial financial support of the child, if there is a change in the monthly
premium payment as a result of the additional Dependent.
When there is no change in the monthly premium payment, it is strongly advised that the Subscriber
enroll the newborn or newly adoptive child as a Dependent with the Group to avoid delays in the
payment of claims.
c. Open Enrollment. GHC will allow enrollment of Subscribers and Dependents, who did not enroll
when newly eligible as described above, during a limited period of time specified by the Group and
GHC.
d. Special Enrollment.
1) GHC will allow special enrollment for persons:
a) who initially declined enrollment when otherwise eligible because such persons had other health
care coverage and have had such other coverage terminated due to one of the following events:
• cessation of employer contributions,
• exhaustion of COBRA continuation coverage,
• loss of eligibility, except for loss of eligibility for cause; or
b) who have had such other coverage exhausted because such person reached a Lifetime Maximum
limit.
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C02733 - 0036900a 14
GHC or the Group may require confirmation that when initially offered coverage such persons
submitted a written statement declining because of other coverage. Application for coverage under
the Agreement must be made within thirty-one (31) days of the termination of previous coverage.
2) GHC will allow special enrollment for the person eligible to be a Subscriber, his/her spouse and
the newly acquired Dependent in the event one of the following occurs:
• marriage. Application for coverage under the Agreement must be made within thirty-one (31)
days of the date of marriage.
• birth. Application for coverage under the Agreement must be made within sixty (60) days of
the date of birth.
• adoption or placement for adoption. Application for coverage under the Agreement must be
made within sixty (60) days of the adoption or placement for adoption.
• eligibility for medical assistance: provided such person is otherwise eligible for coverage
under this Agreement, when approved and requested in advance by the Department of Social
and Health Services (DSHS).
2. Limitation on Enrollment. The Agreement will be open for applications for enrollment as set forth in this
Section III.B. Subject to prior approval by the Washington State Office of the Insurance Commissioner,
GHC may limit enrollment, establish quotas or set priorities for acceptance of new applications if it
determines that GHC’s capacity, in relation to its total enrollment, is not adequate to provide services to
additional persons.
C. Effective Date of Enrollment
1. Provided eligibility criteria are met and applications for enrollment are made as set forth in Sections III.A.
and III.B. above, enrollment will be effective as follows:
• Enrollment for a newly eligible Subscriber and listed Dependents is effective on the date of hire
provided the Subscriber's application has been submitted to and approved by GHC.
• Subscribers who return to work from a leave without pay status within ninety (90) days shall be
eligible for enrollment on the first (1st) of the month following the date of return to work.
• Enrollment for a newly dependent person, other than a newborn or adoptive child, is effective on the
first (1st) of the month following the date eligibility requirements are met.
• Enrollment for newborns is effective from the date of birth.
• Enrollment for adoptive children is effective from the date that the adoptive child is placed with the
Subscriber for the purpose of adoption and the Subscriber assumes total or partial financial support of
the child.
2. Commencement of Benefits for Persons Hospitalized on Effective Date. Members who are admitted to
an inpatient facility prior to their enrollment under the Agreement, and who do not have coverage under
another agreement, will receive covered benefits beginning on their effective date, as set forth in subsection
C.1. above. If a Member is hospitalized in a non-GHC Facility, GHC reserves the right to require transfer
of the Member to a GHC Facility. The Member will be transferred when a GHC Provider, in consultation
with the attending physician, determines that the Member is medically stable to do so. If the Member
refuses to transfer to a GHC Facility, all further costs incurred during the hospitalization are the
responsibility of the Member.
D. Eligibility for Medicare
Actively Employed Members and Spouses. Under the Tax Equity and Fiscal Responsibility Act of 1982
(TEFRA), actively employed Members and their spouses who are eligible for Medicare benefits must decide
whether to choose the benefits of the Agreement or the Medicare program as their primary source of health care
coverage. The Group is responsible for providing the Member with necessary information regarding TEFRA
eligibility and the selection process.
Members Residing Outside the GHC Medicare Advantage Service Area and Not Actively Employed. If a
Member who is not actively employed or their spouse is or becomes eligible for Medicare, GHC requests that,
effective the date that Medicare becomes the primary payer, the Member or their spouse enroll in and maintain
both Medicare Parts A and B coverage.
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C02733 - 0036900a 15
An individual shall be deemed eligible for Medicare when he/she has the option to receive Part A Medicare
benefits.
Medicare primary/secondary payer guidelines and regulations will determine primary/secondary payer status.
Members Residing Inside the GHC Medicare Advantage Service Area and Not Actively Employed. If a
Member who is not actively employed or their spouse is or becomes eligible for Medicare, they must, effective
the date that Medicare becomes the primary payer, enroll in and maintain both Medicare Parts A and B
coverage and enroll in the GHC Medicare Advantage Plan. Failure to do so upon the effective date of Medicare
eligibility will result in termination of coverage under the Agreement.
An individual shall be deemed eligible for Medicare when he/she has the option to receive Part A Medicare
benefits.
All applicable provisions of the GHC Medicare Advantage Plan are fully set forth in the Medicare
Endorsement(s) attached to the Agreement (if applicable).
E. Termination of Coverage
1. Termination of Specific Members. Specific Members may be terminated from the Agreement for any of
the following reasons:
a. Loss of Eligibility. If a Member no longer meets the eligibility requirements set forth in Section III.,
and is not enrolled for continuation coverage as described in Section III.G. below, coverage under the
Agreement will terminate at the end of the month during which the loss of eligibility occurs, unless
otherwise specified by the Group.
b. For Cause. Coverage of a Member may be terminated upon ten (10) working days written notice for:
i. Material misrepresentation, fraud or omission of information in order to obtain coverage.
ii. Permitting the use of a GHC identification card or number by another person, or using another
Member’s identification card or number to obtain care to which a person is not entitled.
iii. Nonpayment of charges, as set forth in Section I.C.
In the event of termination for cause, GHC reserves the right to pursue all civil remedies allowable
under federal and state law for the collection of claims, losses or other damages.
c. Premium Payments. Nonpayment of premiums or contribution for a specific Member by the Group.
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 the Agreement.
Any Member may appeal a termination decision through GHC’s grievance process as set forth in Section
VI.
2. Certificate of Creditable Coverage. Unless the Group has chosen to accept this responsibility, a
certificate of creditable coverage (which provides information regarding the Member’s length of coverage
under the Agreement) will be issued automatically upon termination of coverage, and may also be obtained
upon request.
F. Services After Termination of Agreement
1. Members Hospitalized on the Date of Termination. A Member who is receiving Covered Services as a
registered bed patient in a hospital on the date of termination shall continue to be eligible for Covered
Services while an inpatient for the condition which the Member was hospitalized, until one of the following
events occurs:
• According to GHC clinical criteria, it is no longer Medically Necessary for the Member to be an
inpatient at the facility.
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C02733 - 0036900a 16
• The remaining benefits available under the Agreement for the hospitalization are exhausted, regardless
of whether a new calendar year begins.
• The Member becomes covered under another agreement with a group health plan that provides benefits
for the hospitalization.
• The Member becomes enrolled under an agreement with another carrier that would provide benefits for
the hospitalization if the Agreement did not exist.
• The Member becomes eligible for Medicare.
This provision will not apply if the Member is covered under another agreement that provides benefits for
the hospitalization at the time coverage would terminate, except as set forth in this section, or if the
Member is eligible for COBRA continuation coverage as set forth in subsection G. below.
2. Services Provided After Termination. The Subscriber shall be liable for payment of all charges for
services and items provided to the Subscriber and all Dependents after the effective date of termination,
except those services covered under subsection F.1. above. Any services provided by GHC will be charged
according to the Fee Schedule.
G. Continuation of Coverage Options
1. Continuation Option. A Member no longer eligible for coverage under the Agreement (except in the
event of termination for cause, as set forth in Section III.E.) may continue coverage for a period of up to
three (3) months subject to notification to and self-payment of premiums to the Group. This provision will
not apply if the Member is eligible for the continuation coverage provisions of the Consolidated Omnibus
Budget Reconciliation Act of 1985 (COBRA). This continuation option is not available if the Group no
longer has active employees or otherwise terminates.
2. Leave of Absence. While on a Group approved leave of absence, the Subscriber and listed Dependents can
continue to be covered under the Agreement provided:
• They remain eligible for coverage, as set forth in Section III.A.,
• Such leave is in compliance with the Group’s established leave of absence policy that is consistently
applied to all employees,
• The Group’s leave of absence policy is in compliance with the Family and Medical Leave Act when
applicable, and
• The Group continues to remit premiums for the Subscriber and Dependents to GHC.
3. Self-Payments During Labor Disputes. In the event of suspension or termination of employee
compensation due to a strike, lock-out or other labor dispute, a Subscriber may continue uninterrupted
coverage under the Agreement through payment of monthly premiums 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 Agreement is no longer available, the Subscriber shall have the opportunity to apply for an individual
GHC Group Conversion Plan or, if applicable, continuation coverage (see subsection 4. below), 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.
4. Continuation Coverage Under Federal Law. This section applies only to 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.
Upon loss of eligibility, continuation of Group coverage may be available to a Member for a limited time
after the Member would otherwise lose eligibility, if required by COBRA. The Group shall inform
Members of the COBRA election process and how much the Member will be required to pay directly to the
Group.
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C02733 - 0036900a 17
5. GHC Group Conversion Plan. Members whose eligibility for coverage under the Agreement, including
continuation coverage, is terminated for any reason other than cause, as set forth in Section III.E.1.b., and
who are not eligible for Medicare or covered by another group health plan, may convert to GHC’s Group
Conversion Plan. If the Agreement terminates, any Member covered under the Agreement at termination
may convert to a GHC Group Conversion Plan, unless he/she is eligible to obtain other group health
coverage within thirty-one (31) days of the termination of the Agreement.
An application for conversion must be made within thirty-one (31) days following termination of coverage
under the Agreement. Coverage under GHC’s Group Conversion Plan is subject to all terms and conditions
of such plan, including premium payments. A physical examination or statement of health is not required
for enrollment in GHC’s Group Conversion Plan. The Pre-Existing Condition limitation under GHC’s
Group Conversion Plan will apply only to the extent that the limitation remains unfulfilled under the
Agreement.
By exercising Group Conversion rights, the Member may waive guaranteed issue and Pre-Existing
Condition waiver rights under Federal regulations.
Persons wishing to purchase GHC’s Individual and Family coverage should contact GHC Marketing.
Section IV. Schedule of Benefits
Benefits are subject to all provisions of the Group Medical Coverage Agreement, including, without
limitation, the Accessing Care provisions and General Exclusions. Members must refer to Section II., the
Allowances Schedule, for Cost Shares and specific benefit limits that apply to benefits listed in this Schedule
of Benefits. Members are entitled to receive only benefits and services that are Medically Necessary and
clinically appropriate for the treatment of a Medical Condition as determined by GHC's Medical Director, or
his/her designee, and as described herein. All Covered Services are subject to case management and
utilization review at the discretion of GHC.
A. Hospital Care
Hospital coverage is 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. Alternative care arrangements may be covered as a cost-effective alternative in lieu of otherwise covered
Medically Necessary hospitalization, or other covered Medically Necessary institutional care. Alternative
care arrangements in lieu of covered hospital or other institutional care must be determined to be
appropriate and Medically Necessary based upon the Member’s Medical Condition. Coverage must be
authorized in advance by GHC as appropriate and Medically Necessary. Such care will be covered to the
same extent the replaced Hospital Care is covered under the Agreement.
4. Drugs and medications administered during confinement.
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 between a GHC Provider and the attending physician. If the Member refuses
to transfer, all further costs incurred during the hospitalization are the responsibility of the Member.
B. Medical and Surgical Care
Medical and surgical coverage is limited to the following:
1. Surgical services.
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C02733 - 0036900a 18
2. Diagnostic x-ray, nuclear medicine, ultrasound and laboratory services.
3. Family planning counseling services.
4. Hearing examinations to determine hearing loss.
5. Blood and blood derivatives and their administration.
6. Preventive care (well care) services for health maintenance in accordance with the well care schedule
established by GHC. Preventive care includes: routine mammography screening, physical examinations
and routine laboratory tests for cancer screening in accordance with the well care schedule established by
GHC, and immunizations and vaccinations listed as covered in the GHC drug formulary (approved drug
list). A fee may be charged for health education programs. The well care schedule is available in GHC
clinics, by accessing GHC’s website at www.ghc.org, or upon request.
Covered Services provided during a preventive care visit, which are not in accordance with the GHC well
care schedule, are subject to the applicable Cost Shares.
7. Radiation therapy services.
8. Reduction of a fracture or dislocation of the jaw or facial bones; excision of tumors or non-dental cysts of
the jaw, cheeks, lips, tongue, gums, roof and floor of the mouth; and incision of salivary glands and ducts.
9. Medical implants.
Excluded: internally implanted insulin pumps, artificial hearts, artificial larynx and any other implantable
device that has not been approved by GHC's Medical Director, or his/her designee.
10. Respiratory therapy.
11. Outpatient total parenteral nutritional therapy; outpatient elemental formulas for malabsorption; and dietary
formula for the treatment of phenylketonuria (PKU). Coverage for PKU formula is not subject to a Pre-
Existing Condition waiting period, if applicable.
Equipment and supplies for the administration of enteral and parenteral therapy are covered under Devices,
Equipment and Supplies.
Excluded: any other dietary formulas, oral nutritional supplements, special diets, prepared foods/meals and
formula for access problems.
12. Visits with GHC Providers, including consultations and second opinions, in the hospital or provider’s
office.
13. Optical services.
Routine eye examinations and refractions received at a GHC Facility once every twelve (12) months,
except when Medically Necessary.
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 covered only when needed due to a change in the Member’s Medical
Condition, but no more than once in a twelve (12) month period.
Excluded: evaluations and surgical procedures to correct refractions not related to eye pathology and
complications related to such procedures, and contact lens fittings and related examinations, except as set
forth above.
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C02733 - 0036900a 19
14. 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, and in accordance with Board of Health
standards for screening and diagnostic tests during pregnancy.
Hospitalization and delivery, including home births for low risk pregnancies. Planned home births must be
authorized in advance by GHC.
Voluntary (not medically indicated and nontherapeutic) or involuntary termination of pregnancy.
The Member’s physician, in consultation with the Member, will determine the Member’s length of
inpatient stay following delivery. Pregnancy will not be excluded as a Pre-Existing Condition under the
Agreement. Treatment for post-partum depression or psychosis is covered only under the mental health
benefit.
Excluded: birthing tubs and genetic testing of non-Members for the detection of congenital and heritable
disorders.
15. Transplant services, including heart, heart-lung, single lung, double lung, kidney, pancreas, cornea,
intestinal/multi-visceral, bone marrow, liver transplants and stem cell support (obtained from allogeneic or
autologous peripheral blood or marrow) with associated high dose chemotherapy. Services are limited to
the following:
a. Inpatient and outpatient medical expenses listed below for transplantation procedures. Covered
Services must be directly associated with, and occur at the time of, the transplant. The following
transplantation expenses are subject to the organ recipient’s lifetime benefit maximum set forth in the
Allowances Schedule:
• Evaluation testing to determine recipient candidacy,
• Donor matching tests,
• Hospital charges,
• Procurement center fees,
• Professional fees,
• Travel costs for a surgical team,
• Excision fees, and
• Donor costs for a covered organ recipient are limited to procurement center fees, travel costs for a
surgical team and excision fees.
b. Follow-up services for specialty visits,
c. Rehospitalization, and
d. Maintenance medications.
Excluded: donor costs to the extent that they are reimbursable by the organ donor’s insurance, treatment of
donor complications, living expenses and transportation expenses, except as set forth under Section IV.M.
Coverage for all transplants and any related services and items shall be excluded until the Member has been
continuously enrolled under the Agreement, or any prior GHC or GHO Medical Coverage Agreement, for
six (6) consecutive months without any lapse in coverage, except for children who have been continuously
enrolled with GHC since birth, or if 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.
16. Manipulative therapy.
Self-Referrals for manipulative therapy of the spine and extremities are covered as set forth in the
Allowances Schedule when provided by GHC Providers.
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C02733 - 0036900a 20
Additional visits are covered when approved by GHC.
Excluded: supportive care rendered primarily to maintain the level of correction already achieved, care
rendered primarily for the convenience of the Member, care rendered on a non-acute, asymptomatic basis
and charges for any other services that do not meet GHC clinical criteria as Medically Necessary.
17. Medical and surgical services and related hospital charges, including orthognathic (jaw) surgery, for the
treatment of temporomandibular joint (TMJ) disorders. 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 Section IV.H.1., Orthopedic Appliances.
Orthognathic (jaw) surgery for the treatment of TMJ disorders, radiology services and TMJ specialist
services, including fitting/adjustment of splints are subject to the benefit limit set forth in the Allowances
Schedule.
Excluded are the following: orthognathic (jaw) surgery in the absence of a TMJ or severe obstructive sleep
apnea diagnosis except for congenital anomalies, treatment for cosmetic purposes, dental services,
including orthodontic therapy and any hospitalizations related to these exclusions.
18. Treatment of growth disorders by growth hormones.
19. Diabetic training and education.
20. Detoxification services for alcoholism and drug abuse.
For the purposes of this section, "acute chemical withdrawal" means withdrawal of alcohol and/or drugs
from a Member for whom consequences of abstinence are so severe that they require medical/nursing
assistance in a hospital setting, which is needed immediately to prevent serious impairment to the Member's
health.
Coverage for acute chemical withdrawal is provided without prior approval. If a Member is hospitalized in
a non-GHC Facility/program, coverage is subject to payment of the Emergency Deductible. The Member
or person assuming responsibility for the Member must notify 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 Facility/program, GHC reserves the right to require
transfer of the Member to a GHC Facility/program upon consultation between a GHC Provider and the
attending physician. If the Member refuses transfer to a GHC Facility/program, all further costs incurred
during the hospitalization are the responsibility of the Member.
21. Circumcision.
22. Bariatric surgery and related hospitalizations when GHC criteria are met.
Excluded: pre and post surgical nutritional counseling and related weight loss programs, prescribing and
monitoring of drugs, structured weight loss and/or exercise programs and specialized nutritional
counseling.
23. Sterilization procedures.
24. General anesthesia services and related facility charges for dental procedures will be covered for Members
who are under seven (7) years of age, or are physically or developmentally disabled or have a Medical
Condition where the Member’s health would be put at risk if the dental procedure were performed in a
dentist’s office. Such services must be authorized in advance by GHC and performed at a GHC hospital or
ambulatory surgical facility.
Excluded: dentist’s or oral surgeon’s fees.
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25. Self-Referrals to GHC acupuncturists and naturopaths for Covered Services, as set forth in the Allowances
Schedule. Additional visits are covered when approved by GHC. Laboratory and radiology services are
covered only when obtained through a GHC Facility.
Excluded: herbal supplements, preventive care visits to acupuncturists and any services not within the
scope of their licensure.
26. Once Pre-Existing Condition wait periods, if any, have been met, Pre-Existing Conditions are covered in
the same manner as any other illness.
C. Chemical Dependency Treatment.
Chemical dependency means an illness characterized by a physiological or psychological dependency, or both,
on a controlled substance and/or alcoholic beverages, and where the user's health is substantially impaired or
endangered or his/her social or economic function is substantially disrupted.
For the purposes of this section, the definition of Medically Necessary shall be expanded to include those
services necessary to treat a chemical dependency condition that is having a clinically significant impact on a
Member’s emotional, social, medical and/or occupational functioning.
Chemical dependency treatment services are covered as set forth below at a GHC Facility or GHC-approved
treatment program, subject to the benefit period Allowance set forth in the Allowances Schedule. Any Cost
Shares for chemical dependency services under the terms of the Agreement shall not be applied toward the
benefit period Allowance.
1. Chemical Dependency Treatment Services. All alcoholism and/or drug abuse treatment services must be:
(a) provided at a facility as described above; and (b) deemed Medically Necessary as defined above.
Chemical dependency treatment may include the following services received on an inpatient or outpatient
basis: diagnostic evaluation and education, organized individual and group counseling and/or prescription
drugs and medicines.
Court-ordered treatment shall be covered only if determined to be Medically Necessary as defined above.
2. Benefit Period. For the purposes 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 and shall continue for twenty-four (24)
consecutive calendar months, provided that coverage under the Agreement remains in force. All subsequent
benefit periods thereafter will begin on the first day Covered Services are received after the expiration of
the previous twenty-four (24) month benefit period.
D. Plastic and Reconstructive Services. Plastic and reconstructive services are covered as set forth below:
1. Correction of a congenital disease or congenital anomaly, as determined by a GHC Provider. A congenital
anomaly will be considered to exist if the Member’s appearance resulting from such condition is not within
the range of normal human variation.
2. Correction of a Medical Condition following an injury or resulting from surgery covered by GHC which
has produced a major effect on the Member's appearance, when in the opinion of a GHC Provider, such
services can reasonably be expected to correct the condition.
3. Reconstructive surgery and associated procedures, including internal breast prostheses, following a
mastectomy, regardless of when the mastectomy was performed.
Members will be covered for all stages of reconstruction on the non-diseased breast to make it equivalent in
size with the diseased breast.
Complications of covered mastectomy services, including lymphedemas, are covered.
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Excluded: complications of noncovered surgical services.
E. Home Health Care Services. Home health care services, as set forth in this section, shall be covered when
provided by and 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/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.
3. A GHC Provider has determined that such services are Medically Necessary and are most appropriately
rendered in the Member's home.
For the purposes of this section, “skilled home health care” means 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.
Covered Services for home health care may include the following when rendered pursuant to an approved home
health care plan of treatment: nursing care, physical therapy, occupational therapy, respiratory therapy,
restorative speech therapy, durable medical equipment and medical social worker and limited home health aide
services. Home health services are covered 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: 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 do not meet the definition of
skilled home health care above or are not specifically listed as covered under the Agreement.
F. Hospice Care. Hospice care is covered in lieu of curative treatment for terminal illness for Members who meet
all of the following criteria:
• A GHC Provider has determined that the Member's illness is terminal and life expectancy is six (6) months
or less.
• The Member has chosen a palliative treatment focus (emphasizing comfort and supportive services rather
than treatment aimed at curing the Member's terminal illness).
• The Member has elected in writing to receive hospice care through GHC's Hospice Program or GHC’s
approved hospice program.
• The Member has available a primary care person who will be responsible for the Member's home care.
• A GHC Provider and GHC's Hospice Director, or his/her designee, have determined that the Member's
illness can be appropriately managed in the home.
Hospice care shall mean a coordinated program of palliative and supportive care for dying Members by an
interdisciplinary team of professionals and volunteers centering primarily in the Member's home.
1. Covered Services. Care 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 social worker, physical therapist, speech therapist, occupational therapist,
respiratory therapist, limited services by a Home Health Aide under the supervision of a
Registered Nurse and homemaker services.
ii. Continuous care services in the Member's home when prescribed by a GHC Provider, as set forth
in this paragraph. “Continuous care” means skilled nursing care provided in the home during a
period of crisis in order to maintain the terminally ill Member at home. Continuous care may be
provided for pain or symptom management by a Registered Nurse, Licensed Practical Nurse or
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Home Health Aide under the supervision of a Registered Nurse. Continuous care is covered up to
twenty-four (24) hours per day during periods of crisis. 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. For short-term care, inpatient hospice services shall be covered in a
facility designated by GHC's Hospice Program or GHC-approved hospice program when authorized in
advance by a GHC Provider and GHC's Hospice Program or GHC-approved hospice program.
Inpatient 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).
c. Other covered hospice services may include the following:
i. Drugs and biologicals that are used primarily for the relief of pain and symptom management.
ii. Medical appliances and supplies primarily for the relief of pain and symptom management.
iii. Durable medical equipment.
iv. Counseling services for the Member and his/her primary care-giver(s).
v. Bereavement counseling services for the family.
2. Hospice Exclusions. All services not specifically listed as covered in this section are excluded, including:
a. Financial or legal counseling services.
b. Meal services.
c. Custodial or maintenance care in the home or on an inpatient basis, except as provided above.
d. Services not specifically listed as covered by the Agreement.
e. Any services provided by members of the patient's family.
f. All other exclusions listed in Section V., General Exclusions, apply.
G. Rehabilitation Services.
1. 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 the Agreement, including the following:
a. All services must be provided at a GHC or 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.
b. Services are limited to those necessary to restore or improve functional abilities when physical,
sensori-perceptual and/or communication impairment exists due to injury, illness or surgery. 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 a.,
above.
c. Coverage for inpatient and outpatient services is limited to the Allowance set forth in the Allowances
Schedule.
Excluded: 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 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 as set forth in subsection 2. below); recreational, life-enhancing, relaxation or palliative
therapy; implementation of home maintenance programs; programs for treatment of learning problems; any
services not specifically included as covered in this section; and any services that are excluded under
Section V.
2. Neurodevelopmental Therapies for Children Age Six (6) and Under. Physical therapy, occupational
therapy and speech therapy services for the restoration and improvement of function for
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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 Allowances Schedule.
Excluded: 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 programs offered by public school districts; recreational, life-
enhancing, relaxation or palliative therapy; implementation of home maintenance programs; programs for
treatment of learning problems; any services not specifically included as covered in this section; and any
services that are excluded under Section V.
H. Devices, Equipment and Supplies.
Devices, equipment and supplies, which restore or replace functions that are common and necessary to perform
basic activities of daily living, are covered as set forth in the Allowances Schedule. Examples of basic activities
of daily living are dressing and feeding oneself, maintaining personal hygiene, lifting and gripping in order to
prepare meals and carrying groceries.
1. Orthopedic Appliances. 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.
Excluded: arch supports, including custom shoe modifications or inserts and their fittings except for
therapeutic shoes, modifications and shoe inserts for severe diabetic foot disease; and orthopedic shoes that
are not attached to an appliance.
2. Ostomy Supplies. Ostomy supplies for the removal of bodily secretions or waste through an artificial
opening.
3. Durable Medical Equipment. Durable medical equipment is equipment which can withstand repeated
use, is primarily and customarily used to serve a medical purpose, is useful only in the presence of an
illness or injury and used in the Member’s home. Durable medical equipment includes: hospital beds,
wheelchairs, walkers, crutches, canes, glucose monitors, external insulin pumps, oxygen and oxygen
equipment. GHC, in its sole discretion, will determine if equipment is made available on a rental or
purchase basis.
4. Prosthetic Devices. Prosthetic devices are items which replace all or part of an external body part, or
function thereof.
When authorized in advance, repair, adjustment or replacement of appliances and equipment is covered.
Excluded: items which are not necessary to restore or replace functions of basic activities of daily living; and
replacement or repair of appliances, devices and supplies due to loss, breakage from willful damage, neglect or
wrongful use, or due to personal preference.
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. approved pharmacy products provided the Member is actively participating in a GHC-designated tobacco
cessation program.
J. Drugs, Medicines, Supplies and Devices. This benefit, for purposes of creditable coverage, is actuarially
equal to or greater than the Medicare Part D prescription drug benefit. Eligible Members who are also eligible
for Medicare Part D pharmacy benefits can remain covered under the Agreement and not be subject to
Medicare-imposed late enrollment penalties should they decide to enroll in a Medicare Part D pharmacy plan at
a later date.
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The Agreement may include Medicare Part D pharmacy benefits as part of the GHC Medicare Advantage Plan
required for Medicare eligible Members who live in the GHC Medicare Advantage Service Area. See Section
III.D. for more information.
A Member who discontinues coverage under the Agreement must meet eligibility requirements in order to re-
enroll.
Legend medications are drugs which have been approved by the Food and Drug Administration (FDA) and
which can, under federal or state law, be dispensed only pursuant to a prescription order. These drugs,
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), contraceptive drugs and
devices and their fitting, diabetic supplies, including insulin syringes, lancets, urine-testing reagents, blood-
glucose monitoring reagents and insulin, are covered as set forth below.
All drugs, supplies, medicines and devices must be prescribed by a GHC Provider for conditions covered by the
Agreement, obtained at a GHC pharmacy and, unless approved by GHC in advance, be listed in the GHC drug
formulary. The prescription drug Cost Share, as set forth in the Allowances Schedule, applies to each thirty
(30) day supply. Cost Shares for single and multiple thirty (30) day supplies of a given prescription are payable
at the time of delivery. Injectables that can be self-administered are also subject to the prescription drug Cost
Share. Drug formulary (approved drug list) is defined as a list of preferred pharmaceutical products, supplies
and devices developed and maintained by GHC. A limited supply of prescription drugs obtained at a non-
GHC pharmacy is covered when dispensed or prescribed in connection with covered Emergency treatment.
Generic drugs will be dispensed whenever available. Brand name drugs will be dispensed if there is not a
generic equivalent. In the event the Member elects to purchase brand-name drugs instead of the generic
equivalent (if available), or if the Member elects to purchase a different brand-name or generic drug than that
prescribed by the Member’s Provider, and it is not determined to be Medically Necessary, the Member will also
be subject to payment of the additional amount above the applicable pharmacy Cost Share set forth in the
Allowances Schedule. A generic drug is defined as a drug that is the pharmaceutical equivalent to one or more
brand name drugs. Such generic drugs have been approved by the Food and Drug Administration as meeting
the same standards of safety, purity, strength and effectiveness as the brand name drug. A brand name drug is
defined as a prescription drug that has been patented and is only available through one manufacturer.
“Standard reference compendia” means the American Hospital Formulary Service-Drug Information; the
American Medical Association 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: over-the-counter drugs, medicines, supplies and devices not requiring a prescription under state law
or regulations; drugs used in the treatment of sexual dysfunction disorders; medicines and injections for
anticipated illness while traveling; vitamins, including Legend (prescription) vitamins; and any other drugs,
medicines and injections not listed as covered in the GHC drug formulary unless approved in advance by GHC
as Medically Necessary.
The Member will be charged for replacing lost or stolen drugs, medicines or devices.
The Member’s Right to Safe and Effective Pharmacy Services.
State and federal laws establish standards to assure safe and effective pharmacy services, and to guarantee
Members’ right to know what drugs are covered under the Agreement and what coverage limitations are in the
Agreement. Members who would like more information about the drug coverage policies under the Agreement,
or have a question or concern about their pharmacy benefit, may contact GHC at (206) 901-4636 or (888) 901-
4636.
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Members who would like to know more about their rights under the law, or think any services received while
enrolled may not conform to the terms of the Agreement, may contact the Washington State Office of Insurance
Commissioner at (800) 562-6900. Members who have a concern about the pharmacists or pharmacies serving
them, may call the Washington State Department of Health at 1 (800) 525-0127.
K. Mental Health Care Services. GHC and Washington State law have established standards to assure the
competence and professional conduct of mental health service providers, to guarantee Members’ rights to
informed consent to treatment, to assure the privacy of their medical information, to enable Members to know
which services are covered under the Agreement and to know the limitations on their coverage. Members who
would like a more detailed description than is provided here of covered benefits for mental health services
under the Agreement, or have questions or concerns about any aspect of their mental health benefits, may
contact GHC at (888) 901-4636.
Members who would like to know more about their rights under the law, or think any services received while
enrolled may not conform to the terms of the Agreement or their rights under the law, may contact the
Washington State Office of the Insurance Commissioner at (800) 562-6900. Members who have a concern
about the qualifications or professional conduct of their mental health provider may call the Washington State
Department of Health at 1 (800) 525-0127.
Services that are provided by a mental health practitioner will be covered as mental health care, regardless of
the cause of the disorder.
1. Outpatient Services. Outpatient mental health services place priority on restoring the Member to his/her
level of functioning prior to the onset of acute symptoms or to achieve a clinically appropriate level of
stability as determined by GHC’s Medical Director, or his/her designee. Treatment for clinical conditions
may utilize psychiatric, psychological and/or psychotherapy services to achieve these objectives.
Coverage for each Member is provided according to the outpatient mental health care Allowance set forth
in the Allowances Schedule. Psychiatric medical services, including medical management and
prescriptions, are covered as set forth in Sections IV.B. and IV.J.
2. Inpatient Services. Charges for services described in this section, including psychiatric Emergencies
resulting in inpatient services, shall be covered up to the maximum benefit set forth in the 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. Coverage for services incurred at non-GHC Facilities shall
exclude any charges that would otherwise be excluded for hospitalization within a GHC Facility.
Partial hospitalization is covered subject to the maximum inpatient benefit limit described in the
Allowances Schedule. Every two (2) partial hospitalization days 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 Allowances Schedule.
Subject to the maximum inpatient mental health care Allowance set forth in the Allowances Schedule,
services provided under involuntary commitment statutes shall be covered at facilities approved by GHC.
Services for any involuntary court-ordered treatment program beyond seventy-two (72) hours shall be
covered only if determined to be Medically Necessary by GHC's Medical Director, or his/her designee.
Coverage for voluntary/involuntary Emergency inpatient psychiatric services is subject to the Emergency
care benefit set forth in Section IV.L., including the twenty-four (24) hour notification and transfer
provisions.
Outpatient electro-convulsive therapy treatment is covered subject to the outpatient surgery Cost Share.
3. Exclusions and Limitations for Outpatient and Inpatient Mental Health Treatment Services.
Covered Services are limited to those authorized by GHC's Medical Director, or his/her designee, for
covered clinical conditions for which the reduction or removal of acute clinical symptoms or stabilization
can be expected given the most clinically appropriate level of mental health care intervention.
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Partial hospitalization programs are covered only under subsection K.2. (Inpatient Services).
Excluded: learning, communication and motor skills disorders; mental retardation; academic or career
counseling; sexual and identity disorders; and personal growth or relationship enhancement. Also
excluded: assessment and treatment services that are primarily vocational and academic; court-ordered or
forensic treatment, including reports and summaries, not considered Medically Necessary; work or school
ordered assessment and treatment not considered Medically Necessary; counseling for overeating; nicotine
related disorders; relationship counseling or phase of life problems (V code only diagnoses); and custodial
care.
Any other services not specifically listed as covered in this section. All other provisions, exclusions and
limitations under the Agreement also apply.
L. Emergency/Urgent Care.
All services are covered subject to the Cost Shares set forth in the Allowances Schedule.
Emergency Care (See Section VIII. for a definition of Emergency.)
1. At a GHC Facility. GHC will cover Emergency care for all Covered Services.
2. At a Non-GHC Facility. Usual, Customary and Reasonable charges for Emergency care for Covered
Services are covered subject to:
a. Payment of the Emergency care Deductible; 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.
3. Waiver of Emergency Care Cost Share.
a. Waiver for Multiple Injury Accident. If two or more Members in the same Family Unit require
Emergency care as a result of the same accident, coverage for all Members will be subject to only one
(1) Emergency care Cost Share.
b. Emergencies Resulting in an Inpatient Admission. If the Member is admitted to a GHC Facility
directly from the emergency room, the Emergency care Copayment is waived. However, coverage will
be subject to the inpatient services Cost Share.
4. Transfer and Follow-up Care. 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 between a GHC Provider and the
attending physician. 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 from GHC Providers, unless a
GHC Provider has authorized such follow-up care from a non-GHC Provider in advance.
Urgent Care (See Section VIII. for a definition of Urgent Condition.)
Inside the GHC Service Area, care for Urgent Conditions is covered only at GHC medical centers, GHC urgent
care clinics or GHC Providers’ offices, subject to the applicable Cost Share. Urgent care received at any
hospital emergency department is not covered unless authorized in advance by a GHC Provider.
Outside the GHC Service Area, Usual, Customary and Reasonable charges are covered for Urgent Conditions
received at any medical facility, subject to the applicable Cost Share.
M. Ambulance Services. 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 VIII.).
1. Emergency Transport to any Facility. Each Emergency is covered as set forth in the Allowances
Schedule.
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2. Interfacility Transfers. GHC-initiated non-emergent transfers to or from a GHC Facility are covered as
set forth in the Allowances Schedule.
N. Skilled Nursing Facility (SNF). Skilled nursing care in a GHC-approved skilled nursing facility when full-
time skilled nursing care is necessary in the opinion of the attending GHC Provider, is covered as set forth in
the Allowances Schedule.
When prescribed by a GHC Provider, such care may include room and board; 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: personal comfort items such as telephone and television, rest cures and custodial, domiciliary or
convalescent care.
Section V. General Exclusions
In addition to exclusions listed throughout the Agreement, the following are not covered:
1. Services or supplies not specifically listed as covered in the Schedule of Benefits, Section IV.
2. Except as specifically listed and identified as covered in Sections IV.B., IV.D., IV.H. and IV.J., corrective
appliances and artificial aids including: eyeglasses; contact lenses and services related to their fitting; hearing
devices and hearing aids, including related examinations; take-home drugs, dressings and supplies following
hospitalization; and any other supplies, dressings, appliances, devices or services which are not specifically
listed as covered in Section IV.
3. Cosmetic services, including treatment for complications resulting from cosmetic surgery, except as provided in
Section IV.D.
4. Convalescent or custodial care.
5. Durable medical equipment such as hospital beds, wheelchairs and walk-aids, except while in the hospital or as
set forth in Section IV.B., IV.E., IV.F. or IV.H.
6. Services rendered as a result of work-related injuries, illnesses or conditions, including injuries, illnesses or
conditions incurred as a result of self-employment.
7. Those parts of an examination and associated reports and immunizations required for employment, unless
otherwise noted in Section IV.B., immigration, license, travel or insurance purposes that are not deemed
Medically Necessary by GHC for early detection of disease.
8. Services and supplies related to sexual reassignment surgery, such as sex change operations or transformations
and procedures or treatments designed to alter physical characteristics.
9. Diagnostic testing and medical treatment of sterility, infertility and sexual dysfunction, regardless of origin or
cause, unless otherwise noted in Section IV.B.
10. Any services to the extent benefits are “available” to the Member as defined herein 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 medical coverage, medical “no fault” coverage, Personal
Injury Protection coverage or similar medical 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, or otherwise has the right to receive first party benefits under the policy.
The Member and his/her agents must cooperate fully with GHC in its efforts to enforce this exclusion. This
cooperation shall include supplying GHC with information about, or related to, the availability of other
insurance coverage. The Member and his/her agent 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/her
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agents shall do nothing to prejudice GHC’s right to enforce this exclusion. In the event the Member fails to
cooperate fully, GHC reserves the right to deny coverage and the Member shall be responsible for reimbursing
GHC for such medical expenses.
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.
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. Under no circumstances will GHC pay legal fees
for services which were not reasonably and necessarily incurred to secure recovery and/or which do not benefit
GHC.
11. Voluntary (not medically indicated and nontherapeutic) termination of pregnancy, unless otherwise noted in
Section IV.B.
12. The cost of services and supplies resulting from a Member's loss of or willful damage to appliances, devices,
supplies and materials covered by GHC for the treatment of disease, injury or illness.
13. Orthoptic therapy (i.e., eye training).
14. Specialty treatment programs such as weight reduction, “behavior modification programs” and rehabilitation,
including cardiac rehabilitation.
15. Services or care needed for injuries or conditions resulting from active or reserve military service, whether such
injuries or conditions result from war or otherwise. This exclusion will not apply to conditions or injuries
resulting from previous military service unless the condition has been determined by the U.S. Secretary of
Veterans Affairs to be a condition or injury incurred during a period of active duty. Further, this exclusion will
not be interpreted to interfere with or preclude coordination of benefits under Tri-Care.
16. Nontherapeutic sterilization, unless otherwise noted in Section IV.B., and procedures and services to reverse a
therapeutic or nontherapeutic sterilization.
17. Dental care, surgery, services and appliances, including: treatment of accidental injury to natural teeth,
reconstructive surgery to the jaw in preparation for dental implants, dental implants, periodontal surgery and
any other dental service not specifically listed as covered in Section IV. GHC’s Medical Director, or his/her
designee, will determine whether the care or treatment required is within the category of dental care or service.
18. Drugs, medicines and injections, except as set forth in Section IV.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.
19. Experimental or investigational services.
GHC consults with GHC’s Medical Director and then uses the criteria described below to decide if a particular
service is experimental or investigational.
a. A service is considered experimental or investigational for a Member’s condition if any of the following
statements apply to it at the time the service is or will be provided to the Member.
i. The service cannot be legally marketed in the United States without the approval of the Food and Drug
Administration (“FDA”) and such approval has not been granted.
ii. The service is the subject of a current new drug or new device application on file with the FDA.
iii. The service is provided as part of a Phase I or Phase II clinical trial, as the experimental or research
arm of a Phase III clinical trial, or in any other manner that is intended to evaluate the safety, toxicity
or efficacy of the service.
iv. The service is provided pursuant to a written protocol or other document that lists an evaluation of the
service’s safety, toxicity or efficacy as among its objectives.
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v. The service is under continued scientific testing and research concerning the safety, toxicity or efficacy
of services.
vi. The service is provided pursuant to informed consent documents that describe the service as
experimental or investigational, or in other terms that indicate that the service is being evaluated for its
safety, toxicity or efficacy.
vii. The prevailing opinion among experts, as expressed in the published authoritative medical or scientific
literature, is that (1) the use of such service should be substantially confined to research settings, or (2)
further research is necessary to determine the safety, toxicity or efficacy of the service.
b. In making determinations whether a service is experimental or investigational, the following sources of
information will be relied upon exclusively:
i. The Member’s medical records,
ii. The written protocol(s) or other document(s) pursuant to which the service has been or will be
provided,
iii. Any consent document(s) the Member or Member’s representative has executed or will be asked to
execute, to receive the service,
iv. The files and records of the Institutional Review Board (IRB) or similar body that approves or reviews
research at the institution where the service has been or will be provided, and other information
concerning the authority or actions of the IRB or similar body,
v. The published authoritative medical or scientific literature regarding the service, as applied to the
Member’s illness or injury, and
vi. Regulations, records, applications and any other documents or actions issued by, filed with or taken by,
the FDA or other agencies within the United States Department of Health and Human Services, or any
state agency performing similar functions.
Appeals regarding denial of coverage can be submitted to the Member Appeals Department, or to GHC's
Medical Director at P.O. Box 34593, Seattle, WA 98124-1593. GHC will respond in writing within twenty (20)
working days of the receipt of a fully documented appeal request. An expedited appeal is available if a delay
would jeopardize the Member’s life or health.
20. Mental health care, except as specifically provided in Section IV.K.
21. Hypnotherapy, and all services related to hypnotherapy.
22. Genetic testing and related services, unless determined Medically Necessary by GHC’s Medical Director, or
his/her designee, and in accordance with Board of Health standards for screening and diagnostic tests, or
specifically provided in Section IV.B. Testing for non-Members is also excluded.
23. Follow-up visits related to a non-Covered Service.
24. Fetal ultrasound in the absence of medical indications.
25. Routine foot care, except in the presence of a non-related Medical Condition affecting the lower limbs.
26. Complications of non-Covered Services.
27. Obesity treatment and treatment for morbid obesity, including any medical services, drugs, supplies or any
bariatric surgery (such as gastroplasty or intestinal bypass), regardless of co-morbidities, complications of
obesity or any other Medical Condition, except as set forth in Section IV.B.
28. Services or supplies for which no charge is made, or for which a charge would not have been made if the
Member had no health care coverage or for which the Member is not liable; services provided by a member of
the Member’s family.
29. Autopsy and associated expenses.
30. Services provided by government agencies, except as required by federal or state law.
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31. Services related to temporomandibular joint disorder (TMJ) and/or associated facial pain or to correct
congenital conditions, including bite blocks and occlusal equilibration, except as specified as covered in Section
IV.B.
32. Services covered by the national health plan of any other country.
33. Pre-Existing Conditions, except as specifically provided in Section IV.B.26.
Section VI. Grievance Processes for Complaints and Appeals
The grievance processes to express a complaint and appeal a denial of benefits are set forth below.
Filing a Complaint or Appeal
The complaint process is available for a Member to express dissatisfaction about customer service or the quality or
availability of a health service.
The appeals process is available for a Member to seek reconsideration of a denial of benefits.
Complaint Process
Step 1: The Member should contact the person involved, explain his/her concerns and what he/she would like to
have done to resolve the problem. The Member should be specific and make his/her position clear.
Step 2: If the Member is not satisfied, or if he/she prefers not to talk with the person involved, the Member should
call the department head or the manager of the medical center or department where he/she is having a problem. That
person will investigate the Member’s concerns. Most concerns can be resolved in this way.
Step 3: If the Member is still not satisfied, he/she should call the GHC Customer Service Center toll free at (888)
901-4636. Most concerns are handled by phone within a few days. In some cases the Member will be asked to
write down his/her concerns and state what he/she thinks would be a fair resolution to the problem. A Customer
Service Representative or Member Quality of Care Coordinator will investigate the Member’s concern by consulting
with involved staff and their supervisors, and reviewing pertinent records, relevant plan policies and the Member
Rights and Responsibilities statement. This process can take up to thirty (30) days to resolve after receipt of the
Member’s written statement.
If the Member is dissatisfied with the resolution of the complaint, he/she may contact the Member Quality of Care
Coordinator or the Customer Service Center.
Appeals Process
Step 1: If the Member wishes to appeal a decision denying benefits, he/she must submit a request for an appeal
either orally or in writing to the Member Appeals Department, specifying why he/she disagrees with the decision.
The appeal must be submitted within 180 days of the denial notice he/she received. If the Member is located west of
the Cascade Mountains, appeals should be directed to GHC’s Member Appeals Department, P.O. Box 34593,
Seattle, WA 98124-1593, (206) 901-7350 or toll free (888) 901-4636; or if the Member is located east of the
Cascade Mountains, to GHC’s Member Appeals Department, P.O. Box 204, Spokane, WA 99210-0204, (509) 241-
7622 or toll free (888) 901-4636.
An Appeals Coordinator will review initial appeal requests. GHC will then notify the Member of its determination
or need for an extension of time within fourteen (14) days of receiving the request for appeal. Under no
circumstances will the review timeframe exceed thirty (30) days without the Member’s written permission.
If the appeal request is for an experimental or investigational exclusion or limitation, GHC will make a
determination and notify the Member in writing within twenty (20) working days of receipt of a fully documented
request. In the event that additional time is required to make a determination, GHC will notify the Member in
writing that an extension in the review timeframe is necessary. Under no circumstances will the review timeframe
exceed twenty (20) days without the Member’s written permission.
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There is an expedited appeals process in place for cases which meet criteria or where the Member’s provider
believes that the standard thirty (30) day appeal review process will seriously jeopardize the Member’s life, health or
ability to regain maximum function or subject the Member to severe pain that cannot be managed adequately
without the requested care or treatment. The Member can request an expedited appeal in writing to the above
address, or by calling GHC’s Member Appeals Department in western Washington at (206) 901-7350 or toll free
(888) 901-4636, or in eastern Washington at (509) 241-7622 or toll free (888) 901-4636. The Member’s request for
an expedited appeal will be processed and a decision issued no later than seventy-two (72) hours after receipt.
Step 2: If the Member is not satisfied with the decision in Step 1 regarding a denial of benefits, or if GHC fails to
grant or reject the Member’s request within the applicable required timeframe, he/she may request a second level
review by an external independent review organization as set forth under subsection A. below. The Member may
also choose to pursue review by an appeals committee prior to requesting a review by an independent review
organization as set forth under subsection B. below. This is not a required step in the appeals process.
A. Request a review by an independent review organization. An independent review organization is not legally
affiliated or controlled by GHC. Once a decision is made through an independent review organization, the
decision is final and cannot be appealed through GHC. *
A request for a review by an independent review organization must be made within 180 days after the date of
the Step 1 decision notice, or within 180 days after the date of a GHC appeals committee decision notice.
B. Request an optional hearing by the GHC appeals committee:
The appeals committee hearing is an informal process. The hearing will be conducted within thirty (30) working
days of the Member's request and notification of the appeal committee’s decision will be mailed to the Member
within five (5) working days of the hearing.
Members electing the appeals committee maintain their right to appeal further to an independent review
organization as set forth in paragraph A. above.
Review by the appeals committee is not available if the appeal request is for an experimental or investigational
exclusion or limitation.
A request for a hearing by the appeals committee must be made within thirty (30) days after the date of the Step
1 decision notice.
If the Member is located west of the Cascade Mountains, the request can be mailed to GHC’s Member Appeals
Department, P.O. Box 34593, Seattle, WA 98124-1593, or if the Member is located east of the Cascade
Mountains, to GHC’s Member Appeals Department, P.O. Box 204, Spokane, WA 99210-0204. *
* If the Member’s health plan is governed by the Employee Retirement Income Security Act, known as “ERISA”
(most employment related health plans, other than those sponsored by governmental entities or churches – ask
employer about plan), the Member has the right to file a lawsuit under Section 502(a) of ERISA to recover benefits
due to the Member under the plan at any point after completion of Step 1 of the appeals process. Members may have
other legal rights and remedies available under state or federal law.
Section VII. General Provisions
A. Coordination of Benefits
The coordination of benefits (COB) provision applies when a Member has health care coverage under more
than one plan. Plan is defined below.
The order of benefit determination rules govern the order in which each plan will pay a claim for benefits.
The plan that pays first is called the primary plan. The primary plan must pay benefits according to its policy
terms without regard to the possibility that another plan may cover some expenses. The plan that pays after
the primary plan is the secondary plan. The secondary plan may reduce the benefits it pays so that payments
from all plans do not exceed 100% of the total allowable expense.
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If the Member is covered by more than one health benefit plan, the Member or the Member’s provider
should file all the Member’s claims with each plan at the same time. If Medicare is the Member’s primary
plan, Medicare may submit the Member’s claims to the Member’s secondary carrier.
1. Definitions.
a. Plan. A plan is any of the following that provides benefits or services for medical or dental care or
treatment. If separate contracts are used to provide coordinated coverage for Members of a Group,
the separate contracts are considered parts of the same plan and there is no COB among those
separate contracts. However, if COB rules do not apply to all contracts, or to all benefits in the
same contract, the contract or benefit to which COB does not apply is treated as a separate plan.
1) Plan includes: group, individual or blanket disability insurance contracts and group or
individual contracts issued by health care service contractors or health maintenance
organizations (HMO), closed panel plans or other forms of group coverage; medical care
components of long-term care contracts, such as skilled nursing care; and Medicare or any
other federal governmental plan, as permitted by law.
2) Plan does not include: hospital indemnity or fixed payment coverage or other fixed indemnity
or fixed payment coverage; accident only coverage; specified disease or specified accident
coverage; limited benefit health coverage, as defined by state law; school accident type
coverage; benefits for non-medical components of long-term care policies; automobile
insurance policies required by statute to provide medical benefits; Medicare supplement
policies; Medicaid coverage; or coverage under other federal governmental plans; unless
permitted by law.
Each contract for coverage under subsection 1) or 2) is a separate plan. If a plan has two parts and
COB rules apply only to one of the two, each of the parts is treated as a separate plan.
b. This plan means, in a COB provision, the part of the contract providing the health care benefits to
which the COB provision applies and which may be reduced because of the benefits of other plans.
Any other part of the contract providing health care benefits is separate from this plan. A contract
may apply one COB provision to certain benefits, such as dental benefits, coordinating only with
similar benefits, and may apply another COB provision to coordinate other benefits.
c. The order of benefit determination rules determine whether this plan is a primary plan or secondary
plan when the Member has health care coverage under more than one plan.
When this plan is primary, it determines payment for its benefits first before those of any other plan
without considering any other plan’s benefits. When this plan is secondary, it determines its
benefits after those of another plan and must make payment in an amount so that, when combined
with the amount paid by the primary plan, the total benefits paid or provided by all plans for the
claim equal 100% of the total allowable expense for that claim. This means that when this plan is
secondary, it must pay the amount which, when combined with what the primary plan paid, totals
100% of the highest allowable expense. In addition, if this plan is secondary, it must calculate its
savings (its amount paid subtracted from the amount it would have paid had it been the primary
plan) and record these savings as a benefit reserve for the covered Member. This reserve must be
used to pay any expenses during that calendar year, whether or not they are an allowable expense
under this plan. If this plan is secondary, it will not be required to pay an amount in excess of its
maximum benefit plus any accrued savings.
d. Allowable Expense. Allowable expense is a health care expense, including deductibles, coinsurance
and copayments, that is covered at least in part by any plan covering the person. When a plan
provides benefits in the form of services, the reasonable cash value of each service will be
considered an allowable expense and a benefit paid. An expense that is not covered by any plan
covering the Member is not an allowable expense.
The following are examples of expenses that are not allowable expenses:
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1) The difference between the cost of a semi-private hospital room and a private hospital room is
not an allowable expense, unless one of the plans provides coverage for private hospital room
expenses.
2) If a Member is covered by two or more plans that compute their benefit payments on the basis
of usual and customary fees or relative value schedule reimbursement method or other similar
reimbursement method, any amount in excess of the highest reimbursement amount for a
specific benefit is not an allowable expense.
3) If a Member is covered by two or more plans that provide benefits or services on the basis of
negotiated fees, an amount in excess of the highest of the negotiated fees is not an allowable
expense.
e. Closed panel plan is a plan that provides health care benefits to covered persons in the form of
services through a panel of providers who are primarily employed by the plan, and that excludes
coverage for services provided by other providers, except in cases of emergency or referral by a
panel member.
f. Custodial parent is the parent awarded custody by a court decree or, in the absence of a court
decree, is the parent with whom the child resides more than one half of the calendar year excluding
any temporary visitation.
2. Order of Benefit Determination Rules.
When a Member is covered by two or more plans, the rules for determining the order of benefit payments
are as follows:
a. The primary plan pays or provides its benefits according to its terms of coverage and without regard
to the benefits under any other plan.
b. Except as provided below, a plan that does not contain a coordination of benefits provision that is
consistent with this chapter is always primary unless the provisions of both plans state that the
complying plan is primary.
Coverage that is obtained by virtue of membership in a Group that is designed to supplement a part
of a basic package of benefits and provides that this supplementary coverage is excess to any other
parts of the plan provided by the Subscriber. Examples include major medical coverages that are
superimposed over hospital and surgical benefits, and insurance type coverages that are written in
connection with a closed panel plan to provide out-of-network benefits.
c. A plan may consider the benefits paid or provided by another plan in calculating payment of its
benefits only when it is secondary to that other plan.
d. Each plan determines its order of benefits using the first of the following rules that apply:
1) Non-Dependent or Dependent. The plan that covers the Member other than as a Dependent, for
example as an employee, member, policyholder, Subscriber or retiree is the primary plan and
the plan that covers the Member as a Dependent is the secondary plan. However, if the person is
a Medicare beneficiary and, as a result of federal law, Medicare is secondary to the plan
covering the Member as a Dependent, and primary to the plan covering the Member as other
than a Dependent (e.g., a retired employee), then the order of benefits between the two plans is
reversed so that the plan covering the Member as an employee, member, policyholder,
Subscriber or retiree is the secondary plan and the other plan is the primary plan.
2) Dependent child covered under more than one plan. Unless there is a court decree stating
otherwise, when a dependent child is covered by more than one plan the order of benefits is
determined as follows:
a) For a dependent child whose parents are married or are living together, whether or not they
have ever been married:
• The plan of the parent whose birthday falls earlier in the calendar year is the primary
plan; or
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• If both parents have the same birthday, the plan that has covered the parent the longest
is the primary plan.
b) For a dependent child whose parents are divorced or separated or not living together,
whether or not they have ever been married:
(1) If a court decree states that one of the parents is responsible for the dependent child’s
health care expenses or health care coverage and the plan of that parent has actual
knowledge of those terms, that plan is primary. This rule applies to claim
determination periods commencing after the plan is given notice of the court decree;
(2) If a court decree states one parent is to assume primary financial responsibility for the
dependent child but does not mention responsibility for health care expenses, the plan
of the parent assuming financial responsibility is primary;
(3) If a court decree states that both parents are responsible for the dependent child’s
health care expenses or health care coverage, the provisions of a) above determine the
order of benefits;
(4) If a court decree states that the parents have joint custody without specifying that one
parent has responsibility for the health care expenses or health care coverage of the
dependent child, the provisions of subsection a) above determine the order of benefits;
or
(5) If there is no court decree allocating responsibility for the dependent child’s health
care expenses or health care coverage, the order of benefits for the child are as follows:
• The plan covering the custodial parent, first;
• The plan covering the spouse of the custodial parent, second;
• The plan covering the non-custodial parent, third; and then
• The plan covering the spouse of the non-custodial parent, last.
c) For a dependent child covered under more than one plan of individuals who are not the
parents of the child, the provisions of subsection a) or b) above determine the order of
benefits as if those individuals were the parents of the child.
3) Active employee or retired or laid-off employee. The plan that covers a Member as an active
employee, that is, an employee who is neither laid off nor retired, is the primary plan. The plan
covering that same Member as a retired or laid off employee is the secondary plan. The same
would hold true if a Member is a Dependent of an active employee and that same Member is a
Dependent of a retired or laid-off employee. If the other plan does not have this rule, and as a
result, the plans do not agree on the order of benefits, this rule is ignored. This rule does not
apply if the rule under section d 1) can determine the order of benefits.
4) COBRA or State Continuation Coverage. If a Member whose coverage is provided under
COBRA or under a right of continuation provided by state or other federal law is covered under
another plan, the plan covering the Member as an employee, member, Subscriber or retiree or
covering the Member as a Dependent of an employee, member, Subscriber or retiree is the
primary plan and the COBRA or state or other federal continuation coverage is the secondary
plan. If the other plan does not have this rule, and as a result, the plans do not agree on the
order of benefits, this rule is ignored. This rule does not apply if the rule under section d 1) can
determine the order of benefits.
5) Longer or shorter length of coverage. The plan that covered the Member as an employee,
member, Subscriber or retiree longer is the primary plan and the plan that covered the Member
the shorter period of time is the secondary plan.
6) If the preceding rules do not determine the order of benefits, the allowable expenses must be
shared equally between the plans meeting the definition of plan. In addition, this plan will not
pay more than it would have paid had it been the primary plan.
3. Effect on the Benefits of this Plan.
When this plan is secondary, it may reduce its benefits so that the total benefits paid or provided by all
plans during a claim determination period are not more than the total allowable expenses. In
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determining the amount to be paid for any claim, the secondary plan must make payment in an amount
so that, when combined with the amount paid by the primary plan, the total benefits paid or provided by
all plans for the claim equal one hundred percent of the total allowable expenses for that claim. Total
allowable expense is the highest allowable expenses of the primary plan or the secondary plan. In
addition, the secondary plan must credit to its plan deductible any amounts it would have credited to its
deductible in the absence of other health care coverage.
4. Right to Receive and Release Needed Information.
Certain facts about health care coverage and services are needed to apply these COB rules and to
determine benefits payable under this plan and other plans. GHC may get the facts it needs from or give
them to other organizations or persons for the purpose of applying these rules and determining benefits
payable under this plan and other plans covering the Member claiming benefits. GHC need not tell, or
get the consent of, any Member to do this. Each Member claiming benefits under this plan must give
GHC any facts it needs to apply those rules and determine benefits payable.
5. Facility of Payment.
If payments that should have been made under this plan are made by another plan, GHC has the right,
at its discretion, to remit to the other plan the amount it determines appropriate to satisfy the intent of
this provision. The amounts paid to the other plan are considered benefits paid under this plan. To the
extent of such payments, GHC is fully discharged from liability under this plan.
6. Right of Recovery.
GHC has the right to recover excess payment whenever it has paid allowable expenses in excess of the
maximum amount of payment necessary to satisfy the intent of this provision. GHC may recover excess
payment from any person to whom or for whom payment was made or any other issuers or plans.
Questions about Coordination of Benefits? Contact the State Insurance Department.
7. Effect of Medicare.
Members Residing Outside the GHC Medicare Advantage Service Area. Medicare primary/secondary
payer guidelines and regulations will determine primary/secondary payer status.
When GHC renders care to a Member who is eligible for Medicare benefits, and Medicare is deemed to be
the primary bill payer under Medicare primary/secondary payer guidelines and regulations, GHC will seek
Medicare reimbursement for all Medicare covered services.
B. Subrogation and Reimbursement Rights
The benefits under this Agreement will be available to a Member for injury or illness caused by another party,
subject to the exclusions and limitations of this Agreement. If GHC provides benefits under this Agreement for
the treatment of the injury or illness, GHC will be subrogated to any rights that the Member may have to
recover compensation or damages related to the injury or illness. This section VII.B. more fully describes
GHC’s subrogation and reimbursement rights.
“Injured Person” under this section means a Member covered by the Agreement who sustains an injury and any
spouse, dependent or other person or entity that may recover on behalf of such Member, including the estate of
the Member and, if the Member is a minor, the guardian or parent of the Member. When referred to in this
section, “GHC’s Medical Expenses” means the expenses incurred and the reasonable value of the benefits
provided by GHC for the care or treatment of the injury sustained by the Injured Person.
If the Injured Person’s injuries were caused by a third party giving rise to a claim of legal liability against the
third party and/or payment by the third party to the Injured Person and/or a settlement between the third party
and the Injured Person, GHC shall have the right to recover GHC’s Medical Expenses from any source
available to the Injured Person as a result of the events causing the injury, including but not limited to funds
available through applicable third party liability coverage and uninsured/underinsured motorist coverage. This
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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 subrogation and reimbursement rights shall be limited to the excess of the amount required to fully
compensate the Injured Person for the loss sustained, including general damages. However, in the case of
Medicare Advantage Members, GHC’s right of subrogation shall be the full amount of GHC’s Medical
Expenses and is limited only as required by Medicare.
Subject to the above provisions, if the Injured Person is entitled to or does receive money from any source as a
result of the events causing the injury, including but not limited to any party’s liability insurance or
uninsured/underinsured motorist funds, then GHC’s Medical Expenses provided or to be provided to the Injured
Person are secondary, not primary. As a condition of receiving benefits under the Agreement, the Injured
Person agrees that acceptance of GHC services is constructive notice of this provision in its entirety and agrees
to reimburse GHC for the benefits the Injured Person received as a result of the events causing the injury.
The Injured Person and his/her agents shall cooperate fully with GHC in its efforts to collect GHC’s Medical
Expenses. This cooperation includes, but is not limited to, supplying GHC with information about any third
parties, defendants and/or insurers related to the Injured Person’s claim and informing GHC of any settlement
or other payments relating to the Injured Person’s injury. The Injured Person and his/her agents shall permit
GHC, at GHC’s option, to associate with the Injured Person or to intervene in any legal, quasi-legal, agency or
any other action or claim filed. If the Injured Person takes no action to recover money from any source, then the
Injured Person agrees to allow GHC to initiate its own direct action for reimbursement or subrogation,
including, but not limited to, billing the Injured Person directly for GHC’s Medical Expenses.
The Injured Person and his/her agents shall do nothing to prejudice GHC’s subrogation and reimbursement
rights. The Injured Person shall promptly notify GHC of any tentative settlement with a third party and shall not
settle a claim without protecting GHC’s interest. If the Injured Person fails to cooperate fully with GHC in
recovery of GHC’s Medical Expenses, the Injured Person shall be responsible for directly reimbursing GHC for
GHC’s Medical Expenses and GHC retains the right to bill the Injured Person directly for GHC’s Medical
Expenses.
To the extent that the Injured Person recovers funds from any source that may serve to compensate for medical
injuries or medical expenses, the Injured Person agrees to hold such monies in trust or in their possession until
GHC’s subrogation and reimbursement rights are fully determined.
GHC shall not pay any attorneys’ fees or collection costs to attorneys representing the Injured Person 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. Under no circumstance
will GHC pay legal fees for services which were not reasonably and necessarily incurred to secure recovery,
which do not benefit GHC or where no written fee agreement has been entered into with GHC.
To the extent the provisions of this Subrogation and Reimbursement section are deemed governed by ERISA,
implementation of this section shall be deemed a part of claims administration under the Agreement and GHC
shall therefore have sole discretion to interpret its terms.
C. Miscellaneous Provisions
1. Identification Cards. GHC will furnish cards, for identification purposes only, to all Members enrolled
under the Agreement.
2. Administration of Agreement. GHC may adopt reasonable policies and procedures to help in the
administration of the Agreement. GHC reserves the right to construe the provisions of the Agreement and
to make all determinations regarding benefit entitlement and coverage.
3. Modification of Agreement. No oral statement of any person shall modify or otherwise affect the benefits,
limitations and exclusions of the Agreement, convey or void any coverage, increase or reduce any benefits
under the Agreement or be used in the prosecution or defense of a claim under the Agreement.
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4. Confidentiality. GHC and the Group shall keep Member information strictly confidential and shall not
disclose any information to any third party other than: (i) representatives of the receiving party (as
permitted by applicable state and federal law) who have a need to know such information in order to
perform the services required of such party pursuant to the Agreement, or for the proper management and
administration of the receiving party, provided that such representatives are informed of the confidentiality
provisions of the Agreement and agree to abide by them, (ii) pursuant to court order or (iii) to a designated
public official or agency pursuant to the requirements of federal, state or local law, statute, rule or
regulation.
5. Nondiscrimination. GHC does not discriminate on the basis of physical or mental disabilities in its
employment practices and services.
Section VIII. Definitions
Agreement: The Medical Coverage Agreement between GHC and the Group.
Allowance: The maximum amount payable by GHC for certain Covered Services under the Agreement, as set forth
in the Allowances Schedule.
Contracted Network Pharmacy: A pharmacy that has contracted with GHC to provide covered legend
(prescription) drugs and medicines for outpatient use under the Agreement.
Copayment: The specific dollar amount a Member is required to pay at the time of service for certain Covered
Services under the Agreement, as set forth in the Allowances Schedule.
Cost Share: The portion of the cost of Covered Services the Member is liable for under the Agreement. Cost
Shares for specific Covered Services are set forth in the Allowances Schedule. Cost Share includes Copayments,
coinsurances and/or Deductibles.
Covered Services: The services for which a Member is entitled to coverage under the Agreement.
Deductible: A specific amount a Member is required to pay for certain Covered Services before benefits are
payable under the Agreement. The applicable Deductible amounts are set forth in the Allowances Schedule.
Dependent: Any member of a Subscriber’s family who meets all applicable eligibility requirements, is enrolled
hereunder and for whom the premium prescribed in the Premium Schedule has been paid.
Emergency: The emergent and acute onset of a symptom or symptoms, including severe pain, that would lead a
prudent lay person acting reasonably to believe that a health condition exists that requires immediate medical
attention, if failure to provide medical attention would result in serious impairment to bodily function or serious
dysfunction of a bodily organ or part, or would place the Member's health in serious jeopardy.
Family Unit: A Subscriber and all his/her Dependents.
Fee Schedule: A fee-for-service schedule adopted by GHC, setting forth the fees for medical and hospital services.
GHC-Designated Self-Referral Specialist: A GHC specialist specifically identified by GHC to whom Members
may self-refer.
GHC Facility: A facility (hospital, medical center or health care center) owned, operated or otherwise designated
by GHC.
GHC Medicare Plan: A plan of coverage for persons enrolled in Medicare Part A (hospital insurance) and Part B
(medical insurance).
GHC Personal Physician: 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 the Agreement which a Member can access without a Referral.
Personal Physicians must be capable of and licensed to provide the majority of primary health care services required
by each Member.
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C02733 - 0036900a 39
GHC Provider: The medical staff, clinic associate staff and allied health professionals employed by GHC, and any
other health care professional or provider with whom GHC has contracted to provide health care services to
Members enrolled under the Agreement, including, but not limited to physicians, podiatrists, nurses, physician
assistants, social workers, optometrists, 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 Revised Code of
Washington.
Group: An employer, union, welfare trust or bona-fide 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. 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.
Lifetime Maximum: The maximum value of benefits provided for Covered Services under the Agreement after
which benefits under the Agreement are no longer available as set forth in the Allowances Schedule. The value of
Covered Services is based on the Fee Schedule, as defined above. The lifetime maximum applies to this Agreement
or in combination with any other medical coverage agreement between GHC and Group.
Medical Condition: A disease, illness or injury.
Medically Necessary: Appropriate and clinically necessary services, as determined by 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 a Medical Condition and which meet the standards set forth below.
In order to be Medically Necessary, services and supplies must meet the following requirements: (a) are not solely
for the convenience of the Member, 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 Member; (c) are for the diagnosis or
treatment of an actual or existing Medical Condition 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 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 Member’s
condition or the quality of health services rendered; (f) as to inpatient care, could not have been provided in a
provider’s office, the outpatient department of a hospital or a non-residential facility without affecting the Member’s
condition or quality of health services rendered; (g) are not primarily for research and data accumulation; and (h) are
not experimental or investigational. The length and type of the treatment program and the frequency and modality
of visits covered shall be determined by GHC’s Medical Director, or his/her designee. In addition to being
medically necessary, to be covered, services and supplies must be otherwise included as a Covered Service as set
forth in Section IV. of the Agreement and not excluded from coverage. The cost of non-covered services and
supplies shall be the responsibility of the Member.
Medicare: The federal health insurance program for the aged and disabled.
Member: Any Subscriber or Dependent enrolled under the Agreement.
Out-of-Pocket Expenses: Those Cost Shares paid by the Subscriber or Member for Covered Services which are
applied to the Out-of-Pocket Limit.
Out-of-Pocket Limit: The maximum amount of Out-of-Pocket Expenses incurred and paid during the calendar
year for Covered Services received by the Subscriber and his/her Dependents within the same calendar year. The
Out-of-Pocket Limit amount and Cost Shares that apply are set forth in the Allowances Schedule. Charges in excess
of UCR, services in excess of any benefit level and services not covered by the Agreement are not applied to the
Out-of-Pocket Limit.
Plan Coinsurance: The percentage amount the Member and GHC are required to pay for Covered Services
received under the Agreement. Percentages for Covered Services are set forth in the Allowances Schedule.
Pre-Existing Condition: A condition for which there has been diagnosis, treatment or medical advice within the
three (3) month period prior to the effective date of coverage. The Pre-Existing Condition wait period will begin on
the first day of coverage, or the first day of the enrollment waiting period if earlier.
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C02733 - 0036900a 40
Referral: A written temporary agreement requested in advance by a GHC Provider and approved by GHC that
entitles a Member to receive Covered Services from a specified 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 the
Agreement. Members who have a complex or serious medical or psychiatric condition may receive a standing
Referral for specialist services.
Self-Referred: Covered Services received by a Member from a designated women’s health care specialist or GHC-
Designated Self-Referral Specialist that are not referred by a GHC Personal Physician.
Service Area: Washington counties of Benton, Columbia, Franklin, Island, King, Kitsap, Kittitas, Lewis, Mason,
Pierce, San Juan, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Whatcom, Whitman and Yakima; Idaho
counties of Kootenai and Latah; and any other areas designated by GHC.
Subscriber: A person employed by or belonging to the Group who meets all applicable eligibility requirements, is
enrolled under the Agreement and for whom the premium specified in the Premium Schedule has 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 (UCR): A term used to define the level of benefits which are payable by GHC
when expenses are incurred from a non-GHC Provider. Expenses are considered Usual, Customary and Reasonable
if the charges are consistent with those normally charged to others by the provider or organization for the same
services or supplies; and the charges are within the general range of charges made by other providers in the same
geographical area for the same services or supplies.
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EMPLOYER GROUP PROGRAMS
GROUP MEDICARE COVERAGE
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Group Health Cooperative Medicare Advantage Plan (GHMA Plan)
Following is a brief outline of the benefits available to Group Members who are also enrolled in
the Group Health Cooperative Medicare Advantage plan. A more detailed plan summary is
provided to GHMA Plan Members directly.
In no event shall the benefits of the GHMA plan duplicate the benefits under the Group Medical
Coverage Agreement. The benefits available to persons enrolled in both the Group Health
Cooperative Medical Coverage Agreement and the Group Health Cooperative Medicare
Advantage Plan will be the higher level of benefit available under the plans, as determined by
Group Health Cooperative.
Unless otherwise stated, the provisions, limitations and exclusions, including provider access
requirements of the Group Medical Coverage Agreement apply to the benefits available under
the Group Health Cooperative Medicare Advantage Plan.
The benefits described in this outline apply only to Members who are covered under Medicare
Part A and Part B, and who are enrolled in the Group Health Cooperative Medicare Advantage
Plan as set forth in the Group Medical Coverage Agreement. This includes those Members with
Medicare Part B only, who have been continuously enrolled in the Group Health Cooperative
Medicare Advantage Plan (formerly known as Medicare+Choice), since December 31, 1998.
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SUMMARY OF BENEFITS
Benefit Category Original Medicare GHC Medicare Employer
Group Plan
INPATIENT CARE
1 - Inpatient Hospital
Care (Includes
Substance Abuse and
Rehabilitation Services)
For each benefit period:
Days 1 - 60: $1,024
deductible.
Days 61 - 90: $256 per day.
Days 91 - 150: $512 per
lifetime reserve day.
Please call 1-800-
MEDICARE
(1-800-633-4227) for
information about lifetime
reserve days.
Lifetime reserve days can
only be used once.
A “benefit period” starts the
day you go into a hospital or
skilled nursing facility. It ends
when you go for 60 days in a
row without hospital or skilled
nursing care. If you go into
the hospital after one benefit
period has ended, a new
benefit period begins. You
must pay the inpatient hospital
deductible for each benefit
period. There is no limit to the
number of benefit periods you
can have.
In-Network:
For Medicare-covered
hospital stays you pay the
lesser of the Group cost share
or the following copayments:
Days 1-5: $200 copay per day
Days 6-90: $0 copay per day
$0 copay for additional
hospital days.
No limit to the number of
days covered by the plan each
benefit period.
Except in an emergency, your
doctor must tell the plan that
you are going to be admitted
to the hospital.
2 - Inpatient Mental
Health Care
You pay the same deductible
and copayments as inpatient
hospital care (above) except
Medicare beneficiaries may
only receive 190 days in a
Psychiatric Hospital in a
lifetime.
For Medicare-covered
hospital stays you pay the
lesser of the Group cost share
or the following copayments:
Days 1-5: $200 copay per day
Days 6-90: $0 copay per day
You get up to 190 days in a
Psychiatric Hospital in a
lifetime.
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Benefit Category Original Medicare GHC Medicare Employer
Group Plan
Inpatient Mental
Health Care (cont.)
Except in an emergency, your
doctor must tell the plan that
you are going to be admitted
to the hospital.
3 - Skilled Nursing
Facility (in a Medicare-
certified skilled nursing
facility)
For each benefit period after
at least a 3-day covered
hospital stay:
Days 1 - 20: $0 per day.
Days 21 - 100: $128 per day.
100 days for each benefit
period.
A benefit period begins the
day you go to a hospital or
skilled nursing facility. The
benefit period ends when you
have not received hospital or
skilled nursing care for 60
days in a row. If you go into
the hospital after one benefit
period has ended, a new
benefit period begins. You
must pay the inpatient hospital
deductible for each benefit
period. There is no limit to the
number of benefit periods you
can have.
There is no copayment for
services received at a Skilled
Nursing Facility.
No prior hospital stay is
required.
You are covered for 100 days
each benefit period.
Prior authorization is required
4 - Home Health Care
(Includes medically
necessary intermittent
skilled nursing care,
home health aide
services, and
rehabilitation services,
etc.)
$0 copay Authorization rules may
apply.
$0 copay for Medicare-
covered home health visits.
5 - Hospice You pay part of the cost for
outpatient drugs and inpatient
respite care.
You must receive care from a
Medicare-certified hospice.
You must receive care from a
Medicare-certified hospice.
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Benefit Category Original Medicare GHC Medicare Employer
Group Plan
OUTPATIENT CARE
6 - Doctor Office Visits 20% coinsurance General
See “Routine Physical
Exams” for more information.
Authorization rules may
apply.
In-Network
You pay the lesser of the
Group cost share or $20 copay
for each primary care doctor
office visit for Medicare-
covered services.
You pay the lesser of the
Group cost share or $20 copay
for each specialist visit for
Medicare-covered services.
7 - Chiropractic
Services
20% coinsurance
Routine care not covered
20% coinsurance for manual
manipulation of the spine to
correct subluxation if you get
it from a chiropractors or
other qualified provider.
You pay 100% for routine
care.
In-Network
You pay the lesser of the
Group cost share or $20 copay
for Medicare-covered visits.
Medicare-covered chiropractic
visits are for manual
manipulation of the spine to
correct a displacement or
misalignment of a joint or
body part.
8 - Podiatry Services 20% coinsurance
Routine care not covered.
20% coinsurance for
medically necessary foot care,
including care for medical
conditions affecting the lower
limbs.
General
Authorization rules may
apply.
In-Network
You pay the lesser of the
Group cost share or $20 copay
for Medicare-covered visits.
Medicare-covered podiatry
benefits are for medically-
necessary foot care.
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Benefit Category Original Medicare GHC Medicare Employer
Group Plan
9 - Outpatient Mental
Health Care
50% coinsurance for most
outpatient mental health
services.
In-Network
You pay the lesser of the
Group cost share or $20 copay
for each Medicare-covered
individual or group therapy
visit.
10 - Outpatient
Substance Abuse Care
20% coinsurance In-Network
$0 copay for Medicare-
covered visit.
11 - Outpatient
Services/Surgery
20% coinsurance for the
doctor
20% of outpatient facility
General
Authorization rules may
apply.
In-Network
You pay the lesser of the
Group cost share or $200 for
each Medicare-covered
ambulatory surgical center
visit.
You pay the lesser of the
Group cost share or $200 for
each Medicare-covered
outpatient hospital facility
visit.
12 - Ambulance
Services
(medically necessary
ambulance services)
20% coinsurance General
Authorization rules may
apply.
In-Network
You pay the lesser of the
Group cost share or $150 for
Medicare-covered ambulance
services.
13 - Emergency Care
(You may go to any
emergency room if you
reasonably believe you
need emergency care.)
20% coinsurance for the
doctor
20% of facility charge or a set
copay per emergency room
visit.
You don’t have to pay this
amount if you are admitted to
the hospital for the same
condition within 3 days of the
emergency room visit.
In-Network
You pay the lesser of the
Group cost share or $ 50 for
each Medicare-covered
emergency room visits.
Out-of-Network
Worldwide coverage.
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C02733 - 0036900a 7
Benefit Category Original Medicare GHC Medicare Employer
Group Plan
Emergency Care
(cont.)
NOT covered outside the U.S.
except under limited
circumstances.
In and Out-of-Network
If you are admitted to the
hospital within 1 day for the
same condition, you pay $0
for the emergency room visits.
14 - Urgently Needed
Care
(This is NOT
emergency care, and in
most cases, is out of the
service area.)
20% coinsurance, or a set
copay
NOT covered outside the U.S.
except under limited
circumstances.
You pay the lesser of the
Group cost share or $20 for
each Medicare-covered
urgently needed care visit.
15 - Outpatient
Rehabilitation Services
(Occupational Therapy,
Physical Therapy,
Speech and Language
Therapy)
20% coinsurance General
Authorization rules may
apply.
In-Network
You pay the lesser of the
Group cost share or $20 for
Medicare-covered
Occupational Therapy visits.
You pay the lesser of the
Group cost share or $20 for
Medicare-covered Physical
Therapy and/or
Speech/Language Therapy
visits.
OUTPATIENT MEDICAL SERVICES AND SUPPLIES
16 - Durable Medical
Equipment
(Includes wheelchairs,
oxygen, etc.)
20% coinsurance General
Authorization rules may
apply.
In-Network
You pay the lesser of the
Group cost share or 20% of
the cost for Medicare-covered
items.
17 - Prosthetic Devices
(Includes braces,
artificial limbs and eyes,
etc.)
20% coinsurance General
Authorization rules may
apply.
In-Network
You pay the lesser of the
Group cost share or 20% of
the cost for Medicare-covered
items.
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C02733 - 0036900a 8
Benefit Category Original Medicare GHC Medicare Employer
Group Plan
18 - Diabetes Self-
Monitoring Training
and Supplies
(includes coverage for
glucose monitors, test
strips, lancets, and self-
management training)
20% coinsurance General
Authorization rules may
apply.
In-Network
$0 copay for Diabetes self-
monitoring training.
You pay the lesser of the
Group cost share or 20% of
the cost for Medicare-covered
Diabetes Supply items.
19 - Diagnostic Tests,
X-Rays, and Lab
Services
20% coinsurance for
diagnostic tests and X-rays
$0 copay for Medicare-
covered lab services
Lab Services: Medicare
covers medically necessary
diagnostic lab services that are
ordered by your treating
doctor when they are provided
by a Clinical Laboratory
Improvement Amendments
(CLIA) certified laboratory
that participates in Medicare.
Diagnostic lab services are
done to help your doctor
diagnose or rule out a
suspected illness or condition.
Medicare does not cover most
routine screening tests, like
checking your cholesterol.
General
Authorization rules may apply.
In-Network
$0 copay for Medicare-
covered:
- lab services
- diagnostic procedures and tests
- X-rays
- Diagnostic radiology
services (not including X-
rays)
- therapeutic radiology
services
PREVENTIVE SERVICES
20 - Bone Mass
Measurement
(for people with
Medicare who are at
risk)
20% coinsurance
Covered once every 24
months (more often if
medically necessary) if you
meet certain medical
conditions.
General
Authorization rules may
apply.
In-Network
$0 copay
21 - Colorectal
Screening Exams
(for people with
Medicare age 50 and
older)
20% coinsurance
Covered when you are high
risk or when you are age 50
and older.
General
Authorization rules may
apply.
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C02733 - 0036900a 9
Benefit Category Original Medicare GHC Medicare Employer
Group Plan
Colorectal Screening
Exams (cont.)
In-Network
$0 copay for Medicare-
covered Colorectal
Screenings.
22 - Immunizations
(Flu vaccine, Hepatitis
B vaccine for people
with Medicare who are
at risk, Pneumonia
vaccine)
$0 copay for Flu and
Pneumonia vaccines
20% coinsurance for Hepatitis
B vaccine.
You may only need the
Pneumonia vaccine once in
your lifetime. Call your doctor
for more information..
General
Authorization rules may
apply.
In-Network
$0 copay for Flu and
Pneumonia vaccines.
$0 copay for Hepatitis B
vaccine
No referral necessary for Flu
and Pneumonia vaccines.
Referral required for other
immunizations.
23 - Mammograms
(Annual Screening)
(for women with
Medicare age 40 and
older)
20% coinsurance
No referral needed.
Covered once a year for all
women with Medicare age 40
and older. One baseline
mammogram covered for
women with Medicare
between age 35 and 39.
In-Network
$0 copay for Medicare-
covered screening
mammograms.
24 - Pap Smears and
Pelvic Exams
(for women with
Medicare)
$0 copay for Pap Smears once
every 2 years. Covered once a
year for women with
Medicare at high risk.
20% coinsurance for pelvic
exams.
In-Network
$0 copay for Medicare-
covered pap smears and pelvic
exams.
25 - Prostate Cancer
Screening Exams
(For men with Medicare
age 50 and older.)
20% coinsurance for the
digital rectal exam.
$0 for the PSA test; 20%
coinsurance for other related
services.
Covered once a year for all
men with Medicare over age
50.
General
Authorization rules may
apply.
In-Network
$0 copay for Medicare-
covered prostate cancer
screenings.
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C02733 - 0036900a 10
Benefit Category Original Medicare GHC Medicare Employer
Group Plan
26 – ESRD 20% coinsurance for dialysis General
Authorization rules may
apply.
Out-of-area Renal Dialysis
services do not require
Authorization.
In-Network
$0 copay for in and out-of-
area dialysis
$0 copay for Nutrition
Therapy for Renal Disease.
27 - Outpatient
Prescription
Drugs
Drugs covered under
Medicare Part B
(Original Medicare)
Drugs covered under
Part D (Prescription
Drug Benefit)
Most drugs not covered.
(You can add prescription
drug coverage to Original
Medicare by joining a
Medicare Prescription Drug
Plan).
Your Employer Group
Outpatient Prescription drug
benefit applies.
Please contact the plan for
details.
28 - Dental Services Preventive dental services
(such as cleaning) not
covered.
In-Network
Dental benefits not covered.
29 - Hearing Services
Routine hearing exams and
hearing aids not covered.
20% coinsurance for
diagnostic hearing exams.
Your Employer Group benefit
applies.
30 – Vision Services
20% coinsurance for
diagnosis and treatment of
diseases and conditions of the
eye.
Routine eye exams and
glasses not covered.
Medicare pays for one pair of
eyeglasses or contact lenses
after cataract surgery.
Annual glaucoma screenings
covered for people at risk.
Your Employer Group benefit
applies.
85
C02733 - 0036900a 11
Benefit Category Original Medicare GHC Medicare Employer
Group Plan
31 - Physical Exams 20% coinsurance for one
exam within the first 6 months
of your new Medicare Part B
coverage.
The coverage does not include
lab tests.
$0 copay for routine exams.
Health/Wellness
Education
Not covered In-Network
This plan covers
health/wellness education
benefits.
- Smoking Cessation
- Health Club
Membership/Fitness Classes
Transportation
(Routine)
Not covered General
Authorization rules may
apply.
In-Network
$150 copay for one-way trips
to a Plan-approved location.
US Visitor/Traveler
Benefit
Non-emergent and/or non-
urgently needed care received
while temporarily traveling
outside GHC’s Medicare
Service Area is payable at
Medicare benefit levels up to
$2,000 per Member per
calendar year. The GHC MA
Plan pays 80% of Medicare
allowable reimbursement
schedules for Medicare
covered services ONLY.
Member is responsible for all
Medicare inpatient and
outpatient Deductibles and
Coinsurances.
Member pays the lesser of the
Group Cost Share or 20% of
the cost for each stay in a non-
network hospital or inpatient
psychiatric hospital.
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C02733 - 0036900a 12
IMPORTANT INFORMATION ABOUT YOUR OUTPATIENT CARE APPEAL RIGHTS
For more information about your appeal rights, call us toll free at: 1-888-901-4636.
There Are Two Kinds of Appeals You Can File
Standard (30 days)- You can ask for a standard appeal. We must give you a decision
no later than 30 days after we get your appeal. (We may extend this time by up to 14
days if you request an extension, or if we need additional information and the extension
benefits you.)
Fast (72 hour review)- You can ask for a fast appeal if you or your doctor believes that
your health could be seriously harmed by waiting too long for a decision. We must
decide on a fast appeal no later than 72 hours after we get your appeal. (We may
extend this time by up to 14 days if you request an extension, or if we need additional
information and the extension benefits you.)
• If any doctor asks for a fast appeal for you, or supports you in asking for one, and
the doctor indicates that waiting for 30 days could seriously harm your health, we will
automatically give you a fast appeal.
• If you ask for a fast appeal without support from a doctor, we will decide if your
health requires a fast appeal. If we do not give you a fast appeal, we will decide
your appeal within 30 days.
What Do I Include With My Appeal?
You should include: your name, address, Member ID number, reasons for appealing,
and any evidence you wish to attach. You may send in supporting medical records,
doctors' letters, or other information that explains why we should provide the service.
Call your doctor if you need this information to help you with your appeal. You may send
in this information or present this information in person if you wish.
How Do I File An Appeal?
For a Standard Appeal: You or your authorized representative should mail or deliver
your written appeal to the address (es) below:
MAIL:
Group Health Cooperative
GHC Appeals Department
PO Box 34593
Seattle, WA 98124-1593
Attn.: Appeals’ Coordinator
HAND DELIVER:
12400 E. Marginal Way South
Seattle, WA 98168-2559
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C02733 - 0036900a 13
For a Fast Appeal: You or your authorized representative should contact us by
telephone or fax: telephone: 206-901-7350, fax: 206-901-7340
What Happens Next? If you appeal, we will review our decision. After we review our
decision, if any of the services you requested are still denied, Medicare will provide you
with a new and impartial review of your case by a reviewer outside of your Medicare
Advantage (formerly Medicare Plus Choice) Organization. If you disagree with that
decision, you will have further appeal rights. You will be notified of those appeal rights if
this happens.
Contact Information:
If you need information or help, call us at:
Toll Free: 1-888-901-4636
TTY/TTD: 1-800-833-6388
Other Resources To Help You:
Medicare Rights Center: 1-800-445-6941
Toll Free: 1-888-HMO-9050
TTY/TTD: 1-800-521-8890
Elder Care Locator
Toll Free: 1-800-677-1116
1-800-MEDICARE (1-800-633-4227)
TTY/TTD: 1-877-486-2048
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C02733 - 0036900a 14
IMPORTANT INFORMATION ABOUT YOUR HOSPITAL CARE APPEAL RIGHTS
For more information about your appeal rights, call us toll free at: 1-888-901-4636.
How Do You Get an Immediate Review?
QualisHealth is the name of the Quality Improvement Organization (QIO) authorized by
Medicare to review the Hospital care provided to Medicare patients. You or your
authorized representative, attorney, or court appointed guardian must contact the
QIO by telephone or in writing:
QualisHealth - QIO
10700 Meridian Avenue
Seattle, WA 98133
Toll Free: 1-800-445-6941, option 2
Local: 206-364-9700
FAX: 206-368-2419
TTY: 1-800-251-8890
1. If you file a written request, please write, “I want an immediate review”.
2. Your request must be made no later than noon of the first working day after
you receive this notice.
3. The QIO will make a decision within one full working day after it receives your
request, your medical records, and any other information it needs to make a
decision.
4. While you remain in the Hospital, Group Health will continue to be responsible for
paying the costs of your stay until noon of the calendar day following the day the
QIO notifies you of its official Medicare coverage decision.
What If the QIO Agrees With Our Coverage Decision?
If the QIO agrees, you will be responsible for paying the cost of your hospital stay
beginning at noon of the calendar day following the day the QIO notifies you of its
Medicare coverage decision.
What If the QIO Disagrees With Our Coverage Decision?
You will not be responsible for paying the cost of your additional hospital days, except
for certain convenience services or items not covered by your contract.
What If You Don’t Request an Immediate Review?
If you remain in the hospital and do not request an immediate review by the QIO, you
may be financially responsible for the cost of many of the services you receive beginning
[specify the date of the first non-covered day].
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C02733 - 0036900a 15
If you leave before the day following the date of this notice you will not be responsible for
the cost of care. As with all hospitalizations, you may have to pay for certain convenience
services or items not covered by your Health Plan.
What If You Are Late Or Miss the Deadline To File For an Immediate Review?
If you are late or miss the noon deadline to file for an immediate review by your QIO,
you may still request an expedited (fast) appeal from Group Health. A “fast” appeal
means Group Health will have to review your request within 72 hours. However, you will
not have automatic financial protection during the course of your appeal. This means
you could be responsible for paying the costs of your hospital stay beginning the day
following the date of this notice.
For a Fast Appeal: You or your authorized representative should contact us by
telephone or fax: telephone: 206-901-7350, fax: 206-901-7340
1. When you do so say or write: “I want a fast appeal.”
2. If you filed for an immediate QIO review but missed the deadline the QIO will forward
the request to Group Health to process a fast appeal.
90
Parks, Recreation and Community Services
Jeff Watling, Director
Phone: 253-856-5007
Fax: 253-856-6050
Address: 220 Fourth Avenue S.
Kent, WA. 98032-5895
DATE: April 15, 2008
TO: Operations Committee
FROM: Charlie Lindsey, Superintendent of Facilities
THROUGH: Jeff Watling, Director, Parks, Recreation and Community Services
RE: Agreement for Pest Abatement Services for Various City Buildings -
Approve
__________________________________________________________________
MOTION: Recommend Council authorize the Mayor to sign a 3 year Goods
and Services Agreement with AAA Pest Control Services, Inc., in the
annual amount of $14,305.53, for pest inspection and abatement services
at various City buildings.
Summary
Under this agreement, AAA Pest Control will provide pest inspection and abatement
services for various Kent City Buildings through December 31, 2010. The annual
cost to the City for these services is $14,305.53. The City will receive a 5%
discount off of the cost for the current year’s services if the City remits advance
payment to AAA Pest Control. The City has used AAA Pest Control’s services in the
past and has been pleased with its performance.
Exhibits: Goods & Services Agreement with AAA Pest Control Services, Inc.
Budget Impact: Funding for work under this agreement is within the City’s
established budget.
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92
GOODS & SERVICES AGREEMENT - 1
(Over $10,000.00, including WSST)
GOODS & SERVICES AGREEMENT
between the City of Kent and
AAA Pest Control, Inc.
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal
corporation (hereinafter the "City"), and AAA Pest Control, Inc. organized under the laws of the
State of Washington, located and doing business at 304 1st Ave S., Kent, Wa. 98032 253-854-
7117 (hereinafter the "Vendor").
AGREEMENT
I. DESCRIPTION OF WORK.
Vendor shall provide the following goods and materials and/or perform the following
services for the City:
Provide monthly pest inspection and abatement services at various City buildings and
facilties in accordance with Vendor's February 15, 2008, proposal attached and incorporated
as Exhibit A.
Vendor acknowledges and understands that it is not the City’s exclusive provider of these
goods, materials, or services and that the City maintains its unqualified right to obtain these
goods, materials, and services through other sources.
II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall
complete the work and provide all goods, materials, and services by December 31, 2010.
III. COMPENSATION. The City shall pay the Vendor an amount not to exceed
$14,305.53, annually, including applicable Washington State Sales Tax, for the goods, materials,
and services contemplated in this Agreement. This annual amount shall remain fixed during the
term of this Agreement. The City shall pay the Vendor the following amounts according to the
following schedule:
The Vendor shall invoice the City annually for services provided in the years 2008, 2009,
and 2010. Although payment under this Agreement is not due until thirty (30) days after
such services are provided and invoiced for the prior calendar year, the City will receive a
5% discount off of the cost for the current year's services if the City remits advance
payment to Vendor.
In the event either party terminates this Agreement in accordance with Section V,
Termination, and the City has remitted advance payment to Vendor, the Vendor shall
reimburse the City the pro rata portion of the services paid for by the City for the current
calendar year but which were not provided by Vendor due to termination of this Agreement.
93
GOODS & SERVICES AGREEMENT - 2
(Over $10,000.00, including WSST)
If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves
the option to only pay that portion of the invoice not in dispute. In that event, the parties will
immediately make every effort to settle the disputed portion.
A. Defective or Unauthorized Work. The City reserves its right to withhold payment
from Vendor for any defective or unauthorized goods, materials or services. If
Vendor is unable, for any reason, to complete any part of this Agreement, the City
may obtain the goods, materials or services from other sources, and Vendor shall
be liable to the City for any additional costs incurred by the City. "Additional costs"
shall mean all reasonable costs, including legal costs and attorney fees, incurred by
the City beyond the maximum Agreement price specified above. The City further
reserves its right to deduct these additional costs incurred to complete this
Agreement with other sources, from any and all amounts due or to become due the
Vendor.
B. Final Payment: Waiver of Claims. THE MAKING OF FINAL PAYMENT SHALL
CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY
MADE AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME REQUEST FOR
FINAL PAYMENT IS MADE.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent
Contractor-Employer Relationship will be created by this Agreement and that the Vendor has the
ability to control and direct the performance and details of its work, the City being interested
only in the results obtained under this Agreement.
V. TERMINATION. Either party may terminate this Agreement, with or without
cause, upon providing the other party thirty (30) days written notice at its address set forth on
the signature block of this Agreement.
VI. CHANGES. The City may issue a written amendment for any change in the goods,
materials or services to be provided during the performance of this Agreement. If the Vendor
determines, for any reason, that an amendment is necessary, Vendor must submit a written
amendment request to the person listed in the notice provision section of this Agreement,
section XIV(D), within fourteen (14) calendar days of the date Vendor knew or should have
known of the facts and events giving rise to the requested change. If the City determines that
the change increases or decreases the Vendor's costs or time for performance, the City will
make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the
Vendor on all equitable adjustments. However, if the parties are unable to agree, the City will
determine the equitable adjustment as it deems appropriate. The Vendor shall proceed with the
amended work upon receiving either a written amendment from the City or an oral order from
the City before actually receiving the written amendment. If the Vendor fails to require an
amendment within the time allowed, the Vendor waives its right to make any claim or submit
subsequent amendment requests for that portion of the contract work. If the Vendor disagrees
with the equitable adjustment, the Vendor must complete the amended work; however, the
Vendor may elect to protest the adjustment as provided in subsections A through E of Section
VII, Claims, below.
The Vendor accepts all requirements of an amendment by: (1) endorsing it, (2) writing a
separate acceptance, or (3) not protesting in the way this section provides. An amendment that
is accepted by Vendor as provided in this section shall constitute full payment and final
settlement of all claims for contract time and for direct, indirect and consequential costs,
including costs of delays related to any work, either covered or affected by the change.
94
GOODS & SERVICES AGREEMENT - 3
(Over $10,000.00, including WSST)
VII. CLAIMS. If the Vendor disagrees with anything required by an amendment,
another written order, or an oral order from the City, including any direction, instruction,
interpretation, or determination by the City, the Vendor may file a claim as provided in this
section. The Vendor shall give written notice to the City of all claims within fourteen (14)
calendar days of the occurrence of the events giving rise to the claims, or within fourteen (14)
calendar days of the date the Vendor knew or should have known of the facts or events giving
rise to the claim, whichever occurs first . Any claim for damages, additional payment for any
reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively
deemed to have been waived by the Vendor unless a timely written claim is made in strict
accordance with the applicable provisions of this Agreement.
At a minimum, a Vendor's written claim shall include the information set forth in
subsections A, items 1 through 5 below.
FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM
WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY
CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS
SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY.
A. Notice of Claim. Provide a signed written notice of claim that provides the following
information:
1. The date of the Vendor's claim;
2. The nature and circumstances that caused the claim;
3. The provisions in this Agreement that support the claim;
4. The estimated dollar cost, if any, of the claimed work and how that
estimate was determined; and
5. An analysis of the progress schedule showing the schedule change or
disruption if the Vendor is asserting a schedule change or disruption.
B. Records. The Vendor shall keep complete records of extra costs and time incurred
as a result of the asserted events giving rise to the claim. The City shall have
access to any of the Vendor's records needed for evaluating the protest.
The City will evaluate all claims, provided the procedures in this section are
followed. If the City determines that a claim is valid, the City will adjust payment
for work or time by an equitable adjustment. No adjustment will be made for an
invalid protest.
C. Vendor's Duty to Complete Protested Work. In spite of any claim, the Vendor shall
proceed promptly to provide the goods, materials and services required by the City
under this Agreement.
D. Failure to Protest Constitutes Waiver. By not protesting as this section provides,
the Vendor also waives any additional entitlement and accepts from the City any
written or oral order (including directions, instructions, interpretations, and
determination).
E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures
of this section, the Vendor completely waives any claims for protested work and
95
GOODS & SERVICES AGREEMENT - 4
(Over $10,000.00, including WSST)
accepts from the City any written or oral order (including directions, instructions,
interpretations, and determination).
VIII. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT
ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM
THE DATE THE CONTRACT WORK IS COMPLETE OR VENDOR’S ABILITY TO FILE THAT SUIT
SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY
LIMITATIONS PERIOD.
IX. WARRANTY. This Agreement is subject to all warranty provisions established
under the Uniform Commercial Code, Title 62A, Revised Code of Washington. Vendor warrants
goods are merchantable, are fit for the particular purpose for which they were obtained, and will
perform in accordance with their specifications and Vendor’s representations to City. The Vendor
shall correct all defects in workmanship and materials within one (1) year from the date of the
City's acceptance of the Contract work. In the event any part of the goods are repaired, only
original replacement parts shall be used—rebuilt or used parts will not be acceptable. When
defects are corrected, the warranty for that portion of the work shall extend for one (1) year
from the date such correction is completed and accepted by the City. The Vendor shall begin to
correct any defects within seven (7) calendar days of its receipt of notice from the City of the
defect. If the Vendor does not accomplish the corrections within a reasonable time as
determined by the City, the City may complete the corrections and the Vendor shall pay all costs
incurred by the City in order to accomplish the correction.
X. DISCRIMINATION. In the hiring of employees for the performance of work under
this Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on
behalf of the Vendor or sub-contractor shall not, by reason of race, religion, color, sex, age,
sexual orientation, national origin, or the presence of any sensory, mental, or physical disability,
discriminate against any person who is qualified and available to perform the work to which the
employment relates.
Vendor shall execute the attached City of Kent Equal Employment Opportunity Policy
Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract
work, file the attached Compliance Statement.
XI. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its
officers, officials, employees, agents and volunteers harmless from any and all claims, injuries,
damages, losses or suits, including all legal costs and attorney fees, arising out of or in
connection with the Vendor's performance of this Agreement, except for that portion of the
injuries and damages caused by the City's negligence.
The City's inspection or acceptance of any of Vendor's work when completed shall not be
grounds to avoid any of these covenants of indemnification.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY
UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS
INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY
NEGOTIATED THIS WAIVER.
The provisions of this section shall survive the expiration or termination of this
Agreement.
96
GOODS & SERVICES AGREEMENT - 5
(Over $10,000.00, including WSST)
XII. INSURANCE. The Vendor shall procure and maintain for the duration of the
Agreement, insurance of the types and in the amounts described in Exhibit B attached and
incorporated by this reference.
XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor shall take all necessary
precautions and shall be responsible for the safety of its employees, agents, and subcontractors
in the performance of the contract work and shall utilize all protection necessary for that
purpose. All work shall be done at Vendor's own risk, and Vendor shall be responsible for any
loss of or damage to materials, tools, or other articles used or held for use in connection with the
work.
XIV. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City
requires its contractors and consultants to use recycled and recyclable products whenever
practicable. A price preference may be available for any designated recycled product.
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of
any of the covenants and agreements contained in this Agreement, or to exercise any option
conferred by this Agreement in one or more instances shall not be construed to be a waiver or
relinquishment of those covenants, agreements or options, and the same shall be and remain in
full force and effect.
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by
and construed in accordance with the laws of the State of Washington. 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,
King County, Washington, unless the parties agree in 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 attorney's fees incurred in defending or
bringing such claim or lawsuit, in addition to any other recovery or award provided by law;
provided, however, nothing in this paragraph shall be construed to limit the City's right to
indemnification under Section XI of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the
parties at the addresses listed on the signature page of the Agreement, unless notified to the
contrary. Any written notice hereunder shall become effective three (3) business days after the
date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to
the addressee at the address stated in this Agreement or such other address as may be
hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written
consent of the non-assigning party shall be void. If the non-assigning party gives its consent to
any assignment, the terms of this Agreement shall continue in full force and effect and no
further assignment shall be made without additional written consent.
F. Modification. No waiver, alteration, or modification of any of the provisions of this
Agreement shall be binding unless in writing and signed by a duly authorized representative of
the City and Vendor.
97
GOODS & SERVICES AGREEMENT - 6
(Over $10,000.00, including WSST)
G. Entire Agreement. The written provisions and terms of this Agreement, together
with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or
other representative of the City, and such statements shall not be effective or be construed as
entering into or forming a part of or altering in any manner this Agreement. All of the above
documents are hereby made a part of this Agreement. However, should any language in any of
the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms
of this Agreement shall prevail.
H. Compliance with Laws. The Vendor agrees to comply with all federal, state, and
municipal laws, rules, and regulations that are now effective or in the future become applicable
to Vendor's business, equipment, and personnel engaged in operations covered by this
Agreement or accruing out of the performance of those operations.
IN WITNESS, the parties below execute this Agreement, which shall become
effective on the last date entered below.
VENDOR:
By:
(signature)
Print Name:
Its
(Title)
DATE:
CITY OF KENT:
By:
(signature)
Print Name: Suzette Cooke
Its Mayor
DATE:
NOTICES TO BE SENT TO:
VENDOR:
Joe Naimo
AAA Pest Control
304 1st Ave S
Kent, Wa. 98032
253-854-7117 (telephone)
253-859-3753 (facsimile)
NOTICES TO BE SENT TO:
CITY OF KENT:
Charlie Lindsey, Superintendent of Facilities
City of Kent
220 Fourth Avenue South
Kent, WA 98032
(253) 856-5081 (telephone)
(253) 856-6080 (facsimile)
APPROVED AS TO FORM:
Kent Law Department
AAAPestContract2008
98
EEO COMPLIANCE DOCUMENTS - 1 of 3
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City’s equal employment opportunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City’s sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing below, I agree to fulfill the five requirements referenced above.
Dated this day of ____, 200__.
By:___________________________________________
For: __________________________________________
Title: _________________________________________
Date: _________________________________________
99
EEO COMPLIANCE DOCUMENTS - 2 of 3
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and
state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee
equal employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City’s
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City’s equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
100
EEO COMPLIANCE DOCUMENTS - 3 of 3
CITY OF KENT
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT
This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the
Agreement.
I, the undersigned, a duly represented agent of
Company, hereby acknowledge and declare that the before-mentioned company was the prime
contractor for the Agreement known as that was entered into on the
(date) , between the firm I represent and the City of Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City
of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity
Policy that was part of the before-mentioned Agreement.
Dated this day of , 200___.
By:___________________________________________
For: __________________________________________
Title: _________________________________________
Date: _________________________________________
101
102
103
104
Parks, Recreation and Community Services
Jeff Watling, Director
Phone: 253-856-5007
Fax: 253-856-6050
Address: 220 Fourth Avenue S.
Kent, WA. 98032-5895
DATE: April 15, 2008
TO: Operations Committee
FROM: Charlie Lindsey, Superintendent of Facilities
THROUGH: Jeff Watling, Director, Parks, Recreation and Community Services
RE: Agreement with Protection Technologies, Inc. for the Upgrade of the
City-wide Security Card Reader System and for the Installation of a
Security Card Reader System at Fire Station 74 - Approve
__________________________________________________________________
MOTION: Recommend Council authorize the Mayor to sign an agreement
with Protection Technologies, Inc. in the amount of $51,825.14 for the
upgrade of the City-wide security card reader system and for the
installation of a card reader system at Fire Station 74 and its training
facility.
Summary:
Under this agreement, Protection Technologies, Inc. will provide all necessary
equipment, software, hardware, and labor necessary to upgrade the City-wide
security card reader system and to install a security card reader system at Fire
Station 74 and its training facility. Protection Technologies will additionally provide
all necessary software licenses and training for City staff.
If approved, the work provided for under this agreement will be completed within
60 days.
Exhibits: Goods and Services Agreement with prevailing wage and performance
bond provisions.
Budget Impact: Funding for work under this agreement is within the City’s
established budget.
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City of Kent, Washington
Summary Financial Report
As of December 31, 2007
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City of Kent
QUARTERLY FINANCIAL REPORT
Table of Contents
Executive Summary and Graphic Analyses
Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
General Fund Revenues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
General Fund Expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Property Tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Sales Tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Utility Tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Building Permits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Plan Check Fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Recreation Fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Fines And Forfeitures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Water Operating Revenues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Sewer & Drainage Operating Revenues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Golf Operating Revenues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Golf Operating Expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
CURRENT BUDGET ANALYSIS AND FORECAST
General Fund Analysis and Forecast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Street Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Lodging Tax Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Youth / Teen Programs Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Capital Improvement Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Criminal Justice Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
INTERNAL SERVICE FUNDS PROFIT AND LOSS
Equipment Rental & Fire Equipment Replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Central Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Information Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Unemployment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Workers Compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Health Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Liability Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Property Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
REVENUE AND EXPENSE SUMMARIES - System Reports
General Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Special Revenue Operating Funds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Debt Service Funds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Water Utility Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Sewerage Utility Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Golf Course Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Internal Services - excluding Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Insurance Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Street Capital Projects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Parks Capital Projects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Other Capital Projects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Technology Capital Projects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Facilities Capital Projects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Water Capital Projects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Sewerage Capital Projects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
100012Final.xls 4/8/2008
122
April 7, 2008
City Of Kent
December 2007
Quarterly Financial Summary
General Fund
Summary
Bottom Line –General Fund ending fund balance for 2007 was $8,026,008, or 10.5% of
expenditures. Revenues came in less than expected and is mostly due to decreases in
sales tax. However, expenditures ended the year at $4.9 million or 6% under budget so
offsets the slowing revenues.
Revenues
• Revenues overall ended about $1,530,000, or 1.9% below the adjusted budget.
• Sales taxes ended the year about $1.5 million or 7.6% under budget. We suspect the
decrease is related to taxpayers implementing streamline sales tax procedures early. We
will be working with the Department of Revenue to confirm and correct this.
• Utility taxes ended the year about $229,000, or 1.7% over budget. The increase is
primarily in the garbage and telephone utilities.
• Building Permits are currently about $322,700 or 17.7% over budget. Plan Check Fees are
down about $385,000 or 10.4% year to date. Both of these are volatile revenues that may
vary widely from one quarter to the next based on the progress of significant construction
projects.
• Recreation Fees are about $222,000 or 15.8% under budget at the end of the year.
• Fines & Forfeitures are about 9.3% or $140,000 under budget. This is a slight
improvement over last quarter and last year..
Expenditures
• Closing of 2007 showed expenditures and transfers out to be about $4.9 million or 6%
under budget.
123
Fund Balance
• The ending fund balance for 2007 is about $8,026,000 or 10.5% of expenditures.
Other Funds
• The Medical Insurance Fund has continued to improve and expenditures are about
$1,990,500 under budget. Our expenditures have been growing at a slower rate than the
national trends for the last few years. We have accumulated a fund balance now that
allowed us to go into the 2008 budget cycle without increasing our internal rates for health
care costs. Costs are expected to continue to increase however, and we will adjust rates in
future years to be in alignment with them, and to maintain a reasonably safe fund balance.
Overall, City operations are looking good at the end of 2007, we have maintained our goal of a
10% reserve and the 2008 budget continues to provide for a high level of service to our
citizens. Although our fund balance is about $500,000 less than anticipated when preparing
the 2008 budget, we will be monitoring our revenues closely as we move through the first
months of 2008.
124
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 4,121,329 4,096,137 4,591,944 11,324,982 9,093,562 6,113,468 4,233,238 4,230,099 4,035,135 13,259,829 6,335,705 6,490,542
07 ACT 4,174,372 4,371,298 4,436,578 14,480,342 5,893,598 5,899,476 4,312,107 3,749,369 4,129,580 14,018,822 4,710,667 6,396,518
+/-53,043 275,161 (155,366) 3,155,360 (3,199,964) (213,992) 78,869 (480,730) 94,445 758,993 (1,625,038) (94,024)
PCT +/- 1.3% 6.7% -3.4% 27.9% -35.2% -3.5% 1.9% -11.4% 2.3% 5.7% -25.6% -1.4%
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 4,121,329 8,217,466 12,809,410 24,134,392 33,227,954 39,341,422 43,574,660 47,804,759 51,839,894 65,099,723 71,435,428 77,925,970
07 ACT 4,174,372 8,545,670 12,982,248 27,462,590 33,356,188 39,255,664 43,567,771 47,317,140 51,446,720 65,465,542 70,176,209 76,572,727
+/-53,043 328,204 172,838 3,328,198 128,234 (85,758) (6,889) (487,619) (393,174) 365,819 (1,259,219) (1,353,243)
PCT +/- 1.3% 4.0% 1.3% 13.8% 0.4% -0.2% 0.0% -1.0% -0.8% 0.6% -1.8% -1.7%
GENERAL FUND REVENUES
0
2,000,000
4,000,000
6,000,000
8,000,000
10,000,000
12,000,000
14,000,000
16,000,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
MONTHLY BUDGET VS ADJUSTED ACTUAL
07 BUD 07 ACT
GENERAL FUND REVENUES
0
10,000,000
20,000,000
30,000,000
40,000,000
50,000,000
60,000,000
70,000,000
80,000,000
90,000,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
CUMULATIVE BUDGET VS ACTUAL
07 BUD 07 ACT
gr12final.xls 3/28/2008
125
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 5,960,131 6,208,207 6,287,407 6,492,894 6,491,814 6,757,378 6,807,057 6,564,180 6,625,672 6,600,773 7,029,061 7,165,226
07 ACT 5,885,448 6,083,360 6,073,874 6,325,871 6,654,796 6,313,176 6,796,208 6,371,628 6,468,718 6,272,698 6,424,455 6,733,542
+/-(74,683) (124,847) (213,533) (167,023) 162,982 (444,202) (10,849) (192,552) (156,954) (328,075) (604,606) (431,684)
PCT +/- -1.3% -2.0% -3.4% -2.6% 2.5% -6.6% -0.2% -2.9% -2.4% -5.0% -8.6% -6.0%
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 5,960,131 12,168,338 18,455,745 24,948,639 31,440,453 38,197,831 45,004,888 51,569,068 58,194,740 64,795,513 71,824,574 78,989,800
07 ACT 5,885,448 11,968,808 18,042,682 24,368,553 31,023,349 37,336,525 44,132,733 50,504,361 56,973,079 63,245,777 69,670,232 76,403,774
+/-(74,683) (199,530) (413,063) (580,086) (417,104) (861,306) (872,155) (1,064,707) (1,221,661) (1,549,736) (2,154,342) (2,586,026)
PCT +/- -1.3% -1.6% -2.2% -2.3% -1.3% -2.3% -1.9% -2.1% -2.1% -2.4% -3.0% -3.3%
GENERAL FUND EXPENDITURES
0
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
7,000,000
8,000,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
MONTHLY BUDGET VS ADJUSTED ACTUAL
07 BUD 07 ACT
GENERAL FUND EXPENDITURES
0
10,000,000
20,000,000
30,000,000
40,000,000
50,000,000
60,000,000
70,000,000
80,000,000
90,000,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
CUMULATIVE BUDGET VS ACTUAL
07 BUD 07 ACT
gr12final.xls 3/28/2008
126
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 392 154,948 627,370 7,513,461 4,981,985 124,068 56,848 127,538 540,939 8,423,730 2,811,849 230,903
07 ACT 0 196,033 593,142 10,352,099 1,985,896 120,717 51,173 (162,126) 544,643 10,085,092 1,296,303 212,539
+/-0 41,085 (34,228) 2,838,638 (2,996,089) (3,351) (5,675) (289,664) 3,704 1,661,362 (1,515,546) (18,364)
PCT +/- 0.0% 26.5% -5.5% 37.8% -60.1% -2.7% -10.0% -227.1% 0.7% 19.7% -53.9% -8.0%
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 392 155,340 782,710 8,296,171 13,278,156 13,402,224 13,459,072 13,586,610 14,127,549 22,551,279 25,363,128 25,594,031
07 ACT 0 196,033 789,175 11,141,274 13,127,170 13,247,887 13,299,060 13,136,934 13,681,577 23,766,669 25,062,972 25,275,511
+/-0 40,693 6,465 2,845,103 (150,986) (154,337) (160,012) (449,676) (445,972) 1,215,390 (300,156) (318,520)
PCT +/- 0.0% 26.2% 0.8% 34.3% -1.1% -1.2% -1.2% -3.3% -3.2% 5.4% -1.2% -1.2%
Aug-Ad Valoren Refund $268,739.52
PROPERTY TAX
(2,000,000)
0
2,000,000
4,000,000
6,000,000
8,000,000
10,000,000
12,000,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
MONTHLY BUDGET VS ACTUAL
07 BUD 07 ACT
PROPERTY TAX
0
5,000,000
10,000,000
15,000,000
20,000,000
25,000,000
30,000,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
CUMULATIVE BUDGET VS ACTUAL
07 BUD 07 ACT
gr12final.xls 3/28/2008
127
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 1,474,431 1,895,441 1,421,806 1,366,711 1,786,588 1,689,065 1,605,060 1,887,138 1,635,304 1,709,899 1,914,225 1,732,394
07 ACT 1,338,173 1,804,875 1,340,270 1,280,330 1,724,844 1,479,232 1,478,621 1,835,405 1,563,596 1,514,464 1,661,648 1,567,784
+/-(136,258) (90,566) (81,536) (86,381) (61,744) (209,833) (126,439) (51,733) (71,708) (195,435) (252,577) (164,610)
PCT +/- -9.2% -4.8% -5.7% -6.3% -3.5% -12.4% -7.9% -2.7% -4.4% -11.4% -13.2% -9.5%
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 1,474,431 3,369,872 4,791,678 6,158,389 7,944,977 9,634,042 11,239,102 13,126,240 14,761,544 16,471,443 18,385,668 20,118,062
07 ACT 1,338,173 3,143,048 4,483,318 5,763,648 7,488,492 8,967,724 10,446,345 12,281,750 13,845,346 15,359,810 17,021,458 18,589,242
+/-(136,258) (226,824) (308,360) (394,741) (456,485) (666,318) (792,757) (844,490) (916,198) (1,111,633) (1,364,210) (1,528,820)
PCT +/- -9.2% -6.7% -6.4% -6.4% -5.7% -6.9% -7.1% -6.4% -6.2% -6.7% -7.4% -7.6%
SALES TAX
0
500,000
1,000,000
1,500,000
2,000,000
2,500,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
MONTHLY BUDGET VS ACTUAL
07 BUD 07 ACT
SALES TAX
0
5,000,000
10,000,000
15,000,000
20,000,000
25,000,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
CUMULATIVE BUDGET VS ACTUAL
07 BUD 07 ACT
gr12final.xls 3/28/2008
128
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 1,423,851 1,125,892 1,132,492 1,339,325 1,036,111 960,789 1,177,100 1,011,020 997,049 1,172,346 1,065,133 1,256,950
07 ACT 1,505,911 1,224,453 1,230,555 1,358,181 1,022,062 997,530 1,288,596 962,778 1,006,935 1,189,241 1,036,594 1,104,070
+/-82,060 98,561 98,063 18,856 (14,049) 36,741 111,496 (48,242) 9,886 16,895 (28,539) (152,880)
PCT +/- 5.8% 8.8% 8.7% 1.4% -1.4% 3.8% 9.5% -4.8% 1.0% 1.4% -2.7% -12.2%
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 1,423,851 2,549,743 3,682,235 5,021,560 6,057,671 7,018,460 8,195,560 9,206,580 10,203,629 11,375,975 12,441,108 13,698,058
07 ACT 1,505,911 2,730,364 3,960,919 5,319,100 6,341,162 7,338,692 8,627,288 9,590,066 10,597,001 11,786,242 12,822,836 13,926,906
+/-82,060 180,621 278,684 297,540 283,491 320,232 431,728 383,486 393,372 410,267 381,728 228,848
PCT +/- 5.8% 7.1% 7.6% 5.9% 4.7% 4.6% 5.3% 4.2% 3.9% 3.6% 3.1% 1.7%
UTILITY TAX
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
1,600,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
MONTHLY BUDGET VS ACTUAL
07 BUD 07 ACT
UTILITY TAX
0
2,000,000
4,000,000
6,000,000
8,000,000
10,000,000
12,000,000
14,000,000
16,000,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
CUMULATIVE BUDGET VS ACTUAL
07 BUD 07 ACT
gr12final.xls 3/28/2008
129
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
2006 23,637,782 12,166,435 34,627,683 10,644,313 15,742,528 11,952,908 14,104,585 20,087,916 27,199,261 10,799,637 11,171,581 5,733,478
2007 7,288,487 14,161,901 18,830,236 25,921,259 13,088,065 6,789,737 30,610,201 19,905,162 12,177,328 7,935,402 6,880,165 53,569,947
+/-(16,349,295) 1,995,466 (15,797,447) 15,276,946 (2,654,463) (5,163,171) 16,505,616 (182,754) (15,021,933) (2,864,235) (4,291,416) 47,836,469
PCT +/--69.2% 16.4% -45.6% 143.5% -16.9% -43.2% 117.0% -0.9% -55.2% -26.5% -38.4% 834.3%
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
2006 23,637,782 35,804,217 70,431,900 81,076,213 96,818,741 108,771,649 122,876,234 142,964,150 170,163,411 180,963,048 192,134,629 197,868,107
2007 7,288,487 21,450,388 40,280,624 66,201,883 79,289,948 86,079,685 116,689,886 136,595,048 148,772,376 156,707,778 163,587,943 217,157,890
+/-(16,349,295) (14,353,829) (30,151,276) (14,874,330) (17,528,793) (22,691,964) (6,186,348) (6,369,102) (21,391,035) (24,255,270) (28,546,686) 19,289,783
PCT +/--69.2% -40.1% -42.8% -18.3% -18.1% -20.9% -5.0% -4.5% -12.6% -13.4% -14.9%9.7%
Building Permits 2007 vs 2006 Actual
Year to Date Valuation
0
50,000,000
100,000,000
150,000,000
200,000,000
250,000,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
2006 2007
Building Permits 2007 vs 2006 Actual
Valuation by Month
0
10,000,000
20,000,000
30,000,000
40,000,000
50,000,000
60,000,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
2006 2007
bp12.xls 4/8/2008
130
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 169,661 129,742 192,886 138,188 161,023 169,943 122,779 160,240 197,841 149,524 106,491 127,989
07 ACT 102,704 144,443 160,734 221,271 186,877 172,037 259,755 187,966 167,781 128,019 114,621 302,859
+/-(66,957) 14,701 (32,152) 83,083 25,854 2,094 136,976 27,726 (30,060) (21,505) 8,130 174,870
PCT +/- -39.5% 11.3% -16.7% 60.1% 16.1% 1.2% 111.6% 17.3% -15.2% -14.4% 7.6% 136.6%
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 169,661 299,403 492,289 630,477 791,500 961,443 1,084,222 1,244,462 1,442,303 1,591,827 1,698,318 1,826,307
07 ACT 102,704 247,147 407,881 629,152 816,029 988,066 1,247,821 1,435,787 1,603,568 1,731,587 1,846,208 2,149,067
+/-(66,957) (52,256) (84,408) (1,325) 24,529 26,623 163,599 191,325 161,265 139,760 147,890 322,760
PCT +/- -39.5% -17.5% -17.1% -0.2% 3.1% 2.8% 15.1% 15.4% 11.2% 8.8% 8.7% 17.7%
BUILDING PERMITS
0
50,000
100,000
150,000
200,000
250,000
300,000
350,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
MONTHLY BUDGET VS ACTUAL
07 BUD 07 ACT
BUILDING PERMITS
0
500,000
1,000,000
1,500,000
2,000,000
2,500,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
CUMULATIVE BUDGET VS ACTUAL
07 BUD 07 ACT
gr12final.xls 3/28/2008
131
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 160,833 293,255 335,217 229,894 224,216 551,792 413,362 425,675 306,595 353,492 206,312 204,596
07 ACT 128,574 459,934 180,671 429,903 259,547 517,831 204,369 289,791 215,902 206,412 154,121 273,221
+/-(32,259) 166,679 (154,546) 200,009 35,331 (33,961) (208,993) (135,884) (90,693) (147,080) (52,191) 68,625
PCT +/- -20.1% 56.8% -46.1% 87.0% 15.8% -6.2% -50.6% -31.9% -29.6% -41.6% -25.3% 33.5%
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 160,833 454,088 789,305 1,019,199 1,243,415 1,795,207 2,208,569 2,634,244 2,940,839 3,294,331 3,500,643 3,705,239
07 ACT 128,574 588,508 769,179 1,199,082 1,458,629 1,976,460 2,180,829 2,470,620 2,686,522 2,892,934 3,047,055 3,320,276
+/-(32,259) 134,420 (20,126) 179,883 215,214 181,253 (27,740) (163,624) (254,317) (401,397) (453,588) (384,963)
PCT +/- -20.1% 29.6% -2.5% 17.6% 17.3% 10.1% -1.3% -6.2% -8.6% -12.2% -13.0% -10.4%
PLAN CHECK FEES
0
100,000
200,000
300,000
400,000
500,000
600,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
MONTHLY BUDGET VS ACTUAL
07 BUD 07 ACT
PLAN CHECK FEES
0
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
3,500,000
4,000,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
CUMULATIVE BUDGET VS ACTUAL
07 BUD 07 ACT
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132
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 212,297 170,952 249,791 73,260 75,050 148,691 165,155 150,865 63,975 28,056 32,325 33,802
07 ACT 183,672 157,291 185,758 55,510 79,678 109,725 149,461 115,586 50,230 50,431 77,239 (32,310)
+/-(28,625) (13,661) (64,033) (17,750) 4,628 (38,966) (15,694) (35,279) (13,745) 22,375 44,914 (66,112)
PCT +/- -13.5% -8.0% -25.6% -24.2% 6.2% -26.2% -9.5% -23.4% -21.5% 79.8% 138.9% -195.6%
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 212,297 383,249 633,040 706,300 781,350 930,041 1,095,196 1,246,061 1,310,036 1,338,092 1,370,417 1,404,219
07 ACT 183,672 340,963 526,721 582,231 661,909 771,634 921,095 1,036,681 1,086,911 1,137,342 1,214,581 1,182,271
+/-(28,625) (42,286) (106,319) (124,069) (119,441) (158,407) (174,101) (209,380) (223,125) (200,750) (155,836) (221,948)
PCT +/- -13.5% -11.0% -16.8% -17.6% -15.3% -17.0% -15.9% -16.8% -17.0% -15.0% -11.4% -15.8%
RECREATION FEES
(50,000)
0
50,000
100,000
150,000
200,000
250,000
300,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
MONTHLY BUDGET VS ACTUAL
07 BUD 07 ACT
RECREATION FEES
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
1,600,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
CUMULATIVE BUDGET VS ACTUAL
07 BUD 07 ACT
gr12final.xls 3/28/2008
133
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 116,568 117,341 144,089 118,755 117,429 151,472 119,412 142,202 120,033 123,933 121,657 120,627
07 ACT 81,008 118,605 135,469 114,799 125,223 108,098 118,396 118,099 116,928 121,042 112,838 108,240
+/-(35,560) 1,264 (8,620) (3,956) 7,794 (43,374) (1,016) (24,103) (3,105) (2,891) (8,819) (12,387)
PCT +/- -30.5% 1.1% -6.0% -3.3% 6.6% -28.6% -0.9% -16.9% -2.6% -2.3% -7.2% -10.3%
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 116,568 233,909 377,998 496,753 614,182 765,654 885,066 1,027,268 1,147,301 1,271,234 1,392,891 1,513,518
07 ACT 81,008 199,613 335,082 449,881 575,104 683,202 801,598 919,697 1,036,625 1,157,667 1,270,505 1,378,745
+/-(35,560) (34,296) (42,916) (46,872) (39,078) (82,452) (83,468) (107,571) (110,676) (113,567) (122,386) (134,773)
PCT +/- -30.5% -14.7% -11.4% -9.4% -6.4% -10.8% -9.4% -10.5% -9.6% -8.9% -8.8% -8.9%
FINES & FORFEITURES
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
MONTHLY BUDGET VS ACTUAL
07 BUD 07 ACT
FINES & FORFEITURES
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
1,600,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
CUMULATIVE BUDGET VS ACTUAL
07 BUD 07 ACT
gr12final.xls 3/28/2008
134
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 502,433 435,691 479,655 462,850 649,877 672,085 913,951 865,704 1,100,381 613,235 544,812 485,185
07 ACT 568,002 474,210 517,360 526,635 681,510 795,405 1,082,049 884,127 1,087,133 597,805 598,650 526,303
+/-65,569 38,519 37,705 63,785 31,633 123,320 168,098 18,423 (13,248) (15,430) 53,838 41,118
PCT +/- 13.1% 8.8% 7.9% 13.8% 4.9% 18.3% 18.4% 2.1% -1.2% -2.5% 9.9% 8.5%
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 502,433 938,124 1,417,779 1,880,629 2,530,506 3,202,591 4,116,542 4,982,246 6,082,627 6,695,862 7,240,674 7,725,859
07 ACT 568,002 1,042,212 1,559,572 2,086,207 2,767,717 3,563,122 4,645,171 5,529,298 6,616,431 7,214,236 7,812,886 8,339,189
+/-65,569 104,088 141,793 205,578 237,211 360,531 528,629 547,052 533,804 518,374 572,212 613,330
PCT +/- 13.1% 11.1% 10.0% 10.9% 9.4% 11.3% 12.8% 11.0% 8.8% 7.7% 7.9% 7.9%
WATER OPERATING REVENUES
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
MONTHLY BUDGET VS ACTUAL
07 BUD 07 ACT
WATER OPERATING REVENUES
0
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
7,000,000
8,000,000
9,000,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
CUMULATIVE BUDGET VS ACTUAL
07 BUD 07 ACT
gr12final.xls 3/28/2008
135
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 2,491,001 1,895,561 2,049,794 1,969,313 2,108,277 1,976,074 2,195,228 2,048,741 2,222,282 2,046,886 2,048,969 2,001,163
07 ACT 2,701,796 1,955,611 2,132,540 2,108,926 2,241,804 2,186,580 2,418,709 2,134,959 2,367,476 2,094,264 2,273,305 2,098,705
+/-210,795 60,050 82,746 139,613 133,527 210,506 223,481 86,218 145,194 47,378 224,336 97,542
PCT +/- 8.5% 3.2% 4.0% 7.1% 6.3% 10.7% 10.2% 4.2% 6.5% 2.3% 10.9% 4.9%
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
07 BUD 2,491,001 4,386,562 6,436,356 8,405,669 10,513,946 12,490,020 14,685,248 16,733,989 18,956,271 21,003,157 23,052,126 25,053,289
07 ACT 2,701,796 4,657,407 6,789,947 8,898,873 11,140,677 13,327,257 15,745,966 17,880,925 20,248,401 22,342,665 24,615,970 26,714,675
+/-210,795 270,845 353,591 493,204 626,731 837,237 1,060,718 1,146,936 1,292,130 1,339,508 1,563,844 1,661,386
PCT +/- 8.5% 6.2% 5.5% 5.9% 6.0% 6.7% 7.2% 6.9% 6.8% 6.4% 6.8% 6.6%
SEWER AND DRAINAGE OPERATING REVENUES
0
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
MONTHLY BUDGET VS ACTUAL
07 BUD 07 ACT
SEWER AND DRAINAGE OPERATING REVENUES
0
5,000,000
10,000,000
15,000,000
20,000,000
25,000,000
30,000,000
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
CUMULATIVE BUDGET VS ACTUAL
07 BUD 07 ACT
gr12final.xls 3/28/2008
136
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138
2006 2007 2007 2008
Actual Budget YTD Budget
Beginning Fund Balance 5,938,789 9,372,141 7,137,339 8,519,963
Revenues
Taxes:
Property 24,275,092 25,594,032 25,275,510 26,625,624
Sales Tax 18,205,122 20,118,064 18,589,242 20,066,326
Utility 13,132,383 13,698,057 13,926,905 15,169,319
Other 540,537 738,809 573,306 738,809
Licenses and permits 2,608,065 2,535,320 2,809,392 2,535,320
Intergovernmental revenue 5,812,554 5,987,637 6,672,478 7,734,025
Charges for services 5,089,510 5,610,135 5,049,138 5,869,876
Fines and forfeitures 1,180,557 1,513,517 1,373,235 1,483,307
Interest income 984,907 1,071,829 1,003,577 1,276,043
Fair Market Value Gain (Loss)3,715 (4,944)
Miscellaneous revenue 995,062 1,058,585 1,128,149 723,996
Total Revenues 72,827,504 77,925,985 76,395,989 82,222,645
Transfers In 1,034,595 1,234,595 1,236,335 1,262,765
TOTAL RESOURCES 79,800,887 88,532,721 84,769,662 92,005,373
Operating Expenditures
Salaries & Benefits 54,209,927 59,738,792 57,088,071 63,115,665
Supplies 2,403,911 3,015,825 3,052,887 3,469,381
Services & charges 19,010,142 21,762,904 21,019,412 22,542,670
Capital outlay 57,808 200,604 161,495
Cost allocation (5,050,251) (5,728,324) (4,917,893) (5,957,457)
Total Operating Expenditures 70,631,536 78,989,801 76,403,972 83,170,259
Transfers Out 2,032,012 2,637,259 339,682 438,068
TOTAL EXPENDITURES & USES 72,663,548 81,627,060 76,743,654 83,608,327
Increase (Decrease)1,198,550 (2,466,480) 888,669 (122,917)
Ending Fund Balance
10% Target for Contingency 6,859,952 7,898,980 7,745,577 8,317,026
Undesignated 277,387 (993,319) 280,430 80,020
Total Ending Balance 7,137,339 6,905,661 8,026,008 8,397,046
10.1%8.7% 10.5%10.1%
Original Budget Ending Fund Balance 7,909,209
10.0%
GENERAL FUND
BUDGET ANALYSIS
As of December 31, 2007
100012Final.xls 4/8/2008 Page 1 of 1
139
2006 2007 2007 2008
Actual Budget YTD Budget
FINANCIAL RESOURCES
Beginning Fund Balance 1,647,905 1,480,475 1,663,094 876,305
Intergovernmental Revenue
Fuel Tax - Unrestricted 1,969,843 2,002,068 2,064,112 2,111,445
Utility Taxes
Water 81,722 84,438 82,756 73,463
Sewer 167,504 211,838 179,316 189,821
Drainage 81,817 103,197 86,589 92,935
Electric 895,642 1,198,003 968,958 1,069,006
Gas 377,391 450,067 401,177 531,921
Garbage 235,878 233,778 219,304 243,749
Telephone 684,460 823,656 747,334 829,623
Interest Income 106,633 121,581 86,558 133,739
Misc Revenues (82)
Total Revenues 4,600,808 5,228,626 4,836,104 5,275,702
TOTAL RESOURCES 6,248,712 6,709,101 6,499,199 6,152,007
EXPENDITURES & TRANSFERS
Debt Service
PW Trust Fund Loan 493,054 521,147 521,148 518,757
LTGO Bonds 1999 63,540 67,509 67,509 70,197
LTGO Bonds 2000 367,668 359,773 359,773 336,506
LTGO Bonds 2002 649,910 648,204 648,205 649,628
GO Refund (96) 2004 104,044 131,703 131,703 130,153
LTGO / Taxable Bonds 2003 14,758 14,739 14,739
GO Refund 2005 (93,95,00,96TF)37,865 37,682 37,683 37,875
Total Debt Service 1,730,839 1,780,757 1,780,760 1,743,116
Effective Transportation System
Operating Costs
Street Utility Operations 138,803 119,453 220,287 178,092
Street Tree Maintenance Program 181,707 221,030 218,706 232,768
Engineering Services Allocation 388,269 407,682 407,682 423,989
Total Operating Expenditures 708,778 748,165 846,674 834,849
Arterials
2nd Avenue (Smith-Meeker)50,000
256th (Kent Kangley-116th)100,000 104,179
Hwy 99 HOV Lanes - Phase 1 1,970,466 1,970,466
4th Avenue North Improvements 1,500,000
Central Avenue Pavement Rehabilitation 1,000
1st Avenue North Improvements
Total Arterials 51,000 2,070,466 2,074,645 1,500,000
CURRENT BUDGET ANALYSIS
STREET FUND
as of December 31, 2007
140
2006 2007 2007 2008
Actual Budget YTD Budget
CURRENT BUDGET ANALYSIS
STREET FUND
as of December 31, 2007
Intersection Improvements
124th Avenue Improvements 75,000 75,000
248th Street Improvements 75,000 75,000
Kent Station 600,000
Willis & 4th Avenue
124th & SE 248th Street Improvements 250,000
Total Intersection Improvements 250,000 150,000 150,000 600,000
Other Improvements
Traffic Lighting & Safety
Citywide Guardrail & Safety Improvements 30,000 (120,029) (120,030)
Transportation Master Plan 425,000 425,000 425,000 450,000
Street Striping Program 89,000 (92,467) (92,467) 89,000
Transit Now Partnership Program 260,000
Signal Battery Backup 120,000
Neighborhood Traffic Control 75,000 75,000
Alternative Modes & Paths
Sidewalk Rehabilitation 199,000 (851,680) (851,680) 500,000
Kent Shuttle Service 35,000 35,000 35,000 35,000
Bike Paths/ Canyon Drive Improvements 50,000 (200,000) (200,000)
Misc Projects
Asphalt Overlays/Slurry Seal Program 642,758 217,710 217,710
Pavement Rating Survey 15,000 15,000 15,000 15,000
SR 167 Study 100,000
Neighborhood Demos 50,000
PW Engineering Remodel 14,243
East Hill M&O Facility Land (150,580) (150,580)
Downtown ITS Improvements 300,000 300,000
BNSF Grade Separation 1,425,000 1,425,000
East Hill Operations Center 150,580 150,580
Closed Projects
Total Other Improvements 1,845,001 1,153,534 1,153,533 1,424,000
Total Effective Transportation System 2,854,779 4,122,165 4,224,852 4,358,849
TOTAL EXPENDITURES & TRANSFERS 4,585,618 5,902,922 6,005,612 6,101,965
Change In Fund Balance 15,190 (674,296) (1,169,508) (826,263)
Ending Fund Balance
Unrestricted 1,663,094 4,934,265 493,587 50,042
Total Ending Fund Balance 1,663,094 806,179 493,587 50,042
141
2006 2007 2007 2008
Actual Budget YTD Budget
BEGINNING FUND BALANCE 108,692 93,085 145,604 259,790
REVENUES
Lodging Tax 167,426 145,000 195,667 185,000
Interest Income 4,985 5,000 8,148 5,500
TOTAL REVENUES 172,411 150,000 203,815 190,500
TOTAL RESOURCES 281,103 243,085 349,419 450,290
EXPENDITURES
Strong Local Economy
Tourism Marketing
Softball 17,500 4,788 4,788
Bike Race
Dragon Boat Race
Tourism Chamber 18,000 15,000 15,000 19,000
Seattle Southside Visitor Services 99,999 100,000 100,000 120,000
Downtown Partnership Maps 5,000 5,000
2008 Sponsorship Seattle Convention Center 16,667 16,667
Tourism Unallocated 3,333 3,000 20,000
TOTAL EXPENDITURES (TRANSFERS)135,499 144,788 144,455 159,000
Change in Fund Balance 36,912 5,212 59,360 31,500
ENDING FUND BALANCE 145,604 98,297 204,964 291,290
as of December 31, 2007
CURRENT BUDGET ANALYSIS
LODGING TAX OPERATING FUND
142
2006 2007 2007 2008
Actual Budget YTD Budget
BEGINNING FUND BALANCE 8,417 95,962 95,962 302,965
REVENUES
Utility Taxes:
Water 24,517 20,112 24,827 22,039
Sewer 50,251 50,874 53,795 56,946
Drainage 24,545 25,109 25,977 27,880
Electric 268,693 289,318 290,687 320,702
Gas 113,217 124,864 120,353 154,244
Garbage 70,763 57,049 65,791 73,125
Telephone 205,338 201,684 224,200 225,272
Interest Income 9,816 5,268 14,756 5,795
Gain/(Loss) Adjustment for FMV
TOTAL REVENUES 767,140 774,278 820,386 886,003
TOTAL RESOURCES 775,557 870,240 916,348 1,188,968
EXPENDITURES
Valued Government Services
Transfer Out - General Fund Teen Programs 559,595 584,595 584,595 862,220
Transfer Out - Parks Capital Projects 55,000 5,000 5,000 75,000
Teen Golf Program 40,000 42,000 42,000 42,000
Transfer Out - Skateboard Park Projects
Transfer Out - GF Aquatics 25,000
TOTAL EXPENDITURES (TRANSFERS)679,595 631,595 631,595 979,220
Change In Fund Balance 87,545 142,683 188,791 (93,217)
ENDING FUND BALANCE 95,962 238,645 284,753 209,748
CURRENT BUDGET ANALYSIS
YOUTH/TEEN PROGRAMS OPERATING FUND
As of December 31, 2007
143
2006 2007 2007 2008
Actual Adj Budget YTD Budget
TOTAL BEGINNING FUND BALANCE 2,995,135 2,060,408 4,328,914 3,656,228
REVENUES AND OTHER FINANCIAL SOURCES
Sales Tax 5,960,406 6,318,805 6,099,633 6,318,805
Sales Tax - Nonrecurring events
Real Estate Excise Tax 2,736,589 2,283,012 2,306,407 2,283,012
Real Estate Excise Tax - 2nd Qtr Percent 2,736,589 2,283,230 2,306,373 2,283,230
Real Estate Excise Tax - State 41,685 339,600
Interest 247,745 251,118 266,427 276,230
Sale of Property 1,154,821
TOTAL REVENUES/OTHER FINANCIAL SOURCES 12,877,835 11,136,165 11,318,440 11,161,277
TOTAL RESOURCES 15,872,970 13,196,573 15,647,354 14,817,505
EXPENDITURES (TRANSFERS)
Debt Service
SubledgerTitle
Non-Voted Debt Service 197,221 221,100 135,275 85,000
LTGO Bonds 1999 296,684 290,417 290,417 286,175
LTGO Bonds 2000 2,175,055 1,741,938 1,741,937 1,579,428
Valley Communications 199,681 159,141 159,141 250,479
LTGO Bonds 2002 509,340 506,245 506,245 509,222
LTGO / Taxable Bonds 2003 989,131 988,735 988,735 666,164
GO Refund (96) 2004 1,328,428 1,398,036 1,398,036 1,381,578
GO Refund 2005 (93,95,00,96TF)63,235 62,931 62,932 63,254
LTGO Bonds 2006 470,517 518,000 518,000 718,000
Golf Debt Service 260,000 260,000 260,000 260,000
Subtotal Debt Service 6,489,292 6,146,543 6,060,718 5,799,300
Safe Community
Fire - Replacement Radio Fund 400,000
Fire Dept. Property Purchases 829,460 (0)
Fire Equipment 400,000 400,000 400,000 600,000
Fire - Breathing Apparatus 590,000 120,000 120,000 150,000
Fire - Replacement Fire Hose 15,000
Fire - Exhaust Systems (2)55,000 55,000 55,000 62,000
Fire - Sleeping Quarters/Restrooms 25,000 200,000
Fire - Security Fences 57,000 57,000 62,000
Police-Corrections-Camera Upgrade/Renovations (0) 30,000
Police - HQ Livescan 25,000
Subtotal Safe Community 1,899,460 632,000 631,936 1,544,000
Valued Government Services
Contribution to LEOFF1 Retirement Medical 250,000 250,000
Citywide Aerial Flight / Annexation Study 95,143 100,000 4,986
Scanner 29,654
Parks Equipment 48,944 40,272
Grant Matching - Land Acquisition 186,337 75,000 75,000 75,000
Park Development - REET
Service Club Ballfields 823,000
Lake Meridian Boat Ramp Renovations 50,000
Riverwalk/Riverview Park Development 25,000 900,000 900,000 454,000
West Fenwick Renovations 100,000 415,000 415,000 500,000
Park Lifecycle Repairs and Renovations 191,951 250,000 250,000 250,000
Lifecycle-Play Equipment 50,000 50,000 50,000 60,000
Lifecycle- Ballfields 25,000 25,000 25,000 25,000
Lifecycle-Irrigation 25,000 25,000 25,000 25,000
Aquatic Center Study 250,000 250,000
Adopt-a-Park 35,000 35,000 35,000 35,000
Clark Lake Outfall 776
East Hill "X" Park / Skate Park 300,000 260,000 260,000
Three Friends Park 100,000
CAPITAL IMPROVEMENT OPERATING FUND
CURRENT BUDGET ANALYSIS
As of December 31, 2007
INCLUDING BOTH PORTIONS OF ESTATE EXCISE TAXES
144
2006 2007 2007 2008
Actual Adj Budget YTD Budget
CAPITAL IMPROVEMENT OPERATING FUND
CURRENT BUDGET ANALYSIS
As of December 31, 2007
INCLUDING BOTH PORTIONS OF ESTATE EXCISE TAXES
Wilson Playfields (91,337)200,000
Aquatic Center Land Acquisition and Plan 1,000,000
Urban Forestry 5,000 5,000 5,000 5,000
Eagle Scout Projects 25,000 25,000 25,000 25,000
228th Corridor Park/Trailhead 50,000 50,000 10,000
Softball/Soccer Field Developm 20,000 20,000
Life Cycle - Infield Soil 40,000 40,000 25,000
Master Plans 10,000 25,000 25,000 25,000
Architect/Engineering 19,273 10,000 10,000
Uplands Playfield Parking/Stre 250,000 250,000 25,000
General Government Projects
Senior Center Greenhouse Upgrades & Expansion 166,077 173,427 173,427
Replacement Furniture (Lifecycle)(16,077)25,000 25,000 25,000
Senior Center Upgrades 40,000
City Hall Upgrades 25,000
Range Netting-(Golf)25,000
Sealcoat Parking Lots 17,000 1 110,000
Finance Tenant Improvement 20,000
Miscellaneous Facilities Projects 160,000 40,000
Comprehensive Plan EIS Update 75,000 75,000 75,000
ERP System Upgrade 500,000 500,000
Valley Comm Mobile Mapping 28,000
Events Center Study/Lifecycle 50,000 300,000
Neighborhood Study 40,000 75,000 75,000 75,000
Annexation Study 100,000 100,000
Department Equipment 150,000 150,000 121,500
IT Annex Furniture/CATV Furnit 15,000 15,000
Resource Center Security Upgra 25,000 25,000
CKCF Improvements (Study)75,000 75,000
Shoreline Master Program 10,000
Police Patrol Remodel 30,000 30,000
Expansion Police/Fire Training 30,000 30,000
Remodel Washington Ave Fire St 150,000 150,000
Patrol Audio/Video Recording E 75,000 75,000
Taser Unit 25,000 25,000
Patrol Less Than Lethal Equipm 25,000 25,000
Downtown Gateways, Phase 2 75,000 75,000 100,000
Kent Parks Foundation 25,000 25,000 25,000
HVAC Lifecycle Replacements 275,000 275,000 175,000
Centennial Garage Seismic 178,799 178,799
Technology Projects 520,000 520,000 450,000
Fire Station Grounds Renovation 50,000
Major Entries into Kent 50,000
LID 329-Willis & 74th Ave 61,561
Other Projects (0) 500,000 500,000 275,000
Subtotal Valued Government Services 3,155,303 5,722,498 5,587,213 5,135,500
TOTAL EXPENDITURES (TRANSFERS)11,544,055 12,501,041 12,279,868 12,478,800
Change in Fund Balance 1,333,780 (1,364,876) (961,428) (1,317,523)
TOTAL ENDING FUND BALANCE 4,328,914 695,532 3,367,487 2,338,705
145
2006 2007 2007 2008
Actual Budget YTD Budget
BEGINNING FUND BALANCE 283,361 391,395 451,357 870,184
Revenues
Sales Tax - Local Option (1)1,933,796 2,062,425
1 2,123,885 2,139,869
MVET - Basic & High Crime 150,337 66,379 253,449 224,702
MVET - Special Programs 64,283 84,652 66,746 75,934
Interest & Miscellaneous Revenues 12,021 3,514 23,473 3,865
Total Revenues 2,160,437 2,216,970 2,467,552 2,444,370
Transfers In 46,236 46,237
Total Resources 2,443,798 2,654,601 2,965,147 3,314,554
Expenditures
Law
Salaries & Benefits 355,139 388,776 356,465 491,935
Supplies 9,681 17,314 14,432 20,878
Services & Charges 7,343 7,715 8,997 47,715
Domestic Violence
Salaries & Benefits 170,315 266,968 190,592 271,521
Supplies
Services & Charges 5,544 7,757 5,808 7,749
Capital Outlay
Project Lighthouse
Services & Charges 23,996 25,195 25,195 25,195
Police
Salaries & Benefits 1,193,018 1,561,005 1,291,274 1,635,628
Supplies 18,426 36,812 34,008 37,814
Services & Charges 71,955 68,634 60,457 73,270
Capital Outlay 46,236 49,438 170,000
Total Expenditures 1,855,418 2,426,412 2,036,667 2,781,705
Transfers Out 137,022 10,000 (38,739) 300,149
Total Expenditures and Transfers 1,992,440 2,436,412 1,997,928 3,081,854
Increase (Decrease) In Fund Balance 167,997 (173,206) 515,861 (637,484)
ENDING FUND BALANCE 451,357 218,189 967,219 232,700
1) Council resolution allocated 11% of Criminal Justice sales tax to Domestic Violence.
CITY OF KENT
CURRENT BUDGET ANALYSIS AND FORECAST
CRIMINAL JUSTICE OPERATING FUND
As of December 31, 2007
4/8/2008 160012pb.xls
146
City of Kent
2006 2007 2007 2008
Description Actual Budget YTD Budget
Beginning Working Capital 3,653,307 1,450,758 1,603,535 1,539,095
OPERATING REVENUE
Fleet Operations 1,792,015 2,139,525 2,285,253 2,155,826
Fleet Replacement 1,248,639 1,367,293 1,311,057 1,439,655
Fire Equipment Replacement 266,000 458,000 458,000 577,080
Interest Income 145,273 48,835 127,339 125,062
Total Operating Revenue 3,451,927 4,013,653 4,181,649 4,297,623
Other Income
Gain (Loss) On Sale Of Assets (90,199)(33,509)
Transfers In 400,000 400,000 400,000 300,000
Total Other Income 309,801 400,000 366,491 300,000
Total Resources 7,415,035 5,864,411 6,151,675 6,136,718
Operating Expense By Division
Fleet Operations 4,040,050 3,744,444 3,465,699 4,762,782
Fire Equipment 106,276 619,897 82,088 865,067
Total Operating Expense 4,146,326 4,364,341 3,547,786 5,627,849
Operating Expense By Object
Salaries 599,760 588,980 602,525 615,015
Benefits 206,848 240,106 201,152 242,610
Supplies 1,192,736 1,272,990 1,221,544 1,385,736
Services 580,942 789,356 653,849 808,511
Capital Outlay 1,566,040 1,472,909 868,716 2,575,977
Total Operating Expense 4,146,326 4,364,341 3,547,786 5,627,849
Other Financial Uses
Transfers Out 1,665,175 762,572 762,572
Total Other Uses 1,665,175 762,572 762,572
Total Expenses and Uses 5,811,500 5,126,913 4,310,358 5,627,849
Net Change In Working Capital (2,049,772) (713,260) 237,782 (1,030,226)
Total Working Capital 1,603,535 737,498 1,841,317 508,869
Equipment Rental and Fire Equipment Replacement
As of December 31, 2007
147
2006 2007 2007 2008
Description Actual Budget YTD Budget
Beginning Working Capital 49,692 31,533 10,699 10,699
REVENUE
Central Stores 269,259 280,740 259,336 291,174
Postage 222,115 260,311 262,642 292,561
Photocopy 130,075 166,592 126,638 159,625
Total Revenue 621,449 707,643 648,615 743,360
Total Resources 671,141 739,176 659,314 754,059
EXPENSE
Central Stores 298,710 280,740 268,459 280,740
Postage 226,372 260,309 256,290 293,972
Photocopy 135,360 159,625 155,057 98,790
Total Expense 660,442 700,674 679,806 673,502
Net Operating Income (38,993) 6,969 (31,191) 69,858
Ending Working Capital 10,699 38,502 (20,492) 80,557
Central Services
As of December 31, 2007
148
2006 2007 2007 2008
Description Actual Budget YTD Budget
Beginning Working Capital 131,997 503,703 148,682 329,859
REVENUE
Contributions & Other 4,232,411 4,243,335 4,255,858 4,461,585
Total Revenue 4,232,411 4,243,335 4,255,858 4,461,585
Transfers In
Total Resources 4,364,408 4,747,038 4,404,539 4,791,444
EXPENSE
Data Processing
Salaries & Benefits 1,446,294 1,705,179 1,593,814 1,865,401
Supplies 111,224 42,540 75,208 37,076
Services and charges 886,995 1,009,578 1,069,371 1,111,535
Equipment
Sub-total 2,444,513 2,757,297 2,738,394 3,014,012
Telecommunications
Salaries & Benefits 118,649 125,578 128,379 133,838
Supplies 76,864 20,382 81,777 18,575
Services and charges 322,124 430,512 360,933 407,639
Equipment 13,022 1,872
Sub-total 530,659 576,472 572,960 560,052
Printing/Graphics/Cable TV
Salaries & Benefits 519,583 617,009 575,744 685,093
Supplies 78,239 97,246 80,399 97,605
Services and charges 192,732 218,195 166,783 219,947
Equipment
Sub-total 790,555 932,450 822,926 1,002,645
Total Operating Expense 3,765,727 4,266,219 4,134,280 4,576,709
Transfers Out 450,000 450,000 200,000
Total Expenses & Transfers 4,215,727 4,716,219 4,334,280 4,576,709
Net Income 16,684 (472,884) (78,422) (115,124)
Ending Working Capital 148,682 30,819 70,260 214,735
City of Kent
Information Technology
As of December 31, 2007
149
2006 2007 2007 2008
Description Actual Budget YTD Budget
Beginning Working Capital 309,692 (68,038) (68,038) 55,693
Operating Revenue
Rental Fees - Internal 3,918,073 4,450,735 4,449,616 4,778,024
Interest 22,960 26,608 22,286 29,269
Grants 0 92,991 2,389 0
Other revenue 78,870 73,109 41,811 73,109
Total revenue 4,019,903 4,643,443 4,516,102 4,880,402
Total Resources 4,329,595 4,575,405 4,448,064 4,936,095
Operating Expense
Salaries and benefits 1,850,083 2,144,815 1,968,161 2,243,164
Supplies 354,971 336,803 360,038 337,662
Services and charges 4,058,630 4,389,090 4,313,442 4,646,585
Capital outlay 838 22,000 0 0
Cost allocation (2,375,222) (2,549,440) (2,569,083) (2,767,878)
Total Operating Expense 3,889,301 4,343,268 4,072,559 4,459,533
Other Financial Uses
Transfers-(out) - Projects 335,000 300,000 300,000 300,000
Transfers-(out)-Debt 173,332 152,903 152,903 152,903
Total Non Operating Rev (Exp)508,332 452,903 452,903 452,903
Total Expenses and Uses 4,397,632 4,796,171 4,525,462 4,912,436
Net Change In Working Capital (377,730) (152,728) (9,359) (32,034)
Working Capital, 12/31 (1)(68,038) (220,766) (77,397) 23,659
(1) Operating fund 540 only reported
City of Kent
Facilities Fund
As of December 31, 2007
4/8/2008 540012pb.xls
150
2006 2007 2007 2008
Description Actual Budget YTD Budget
Beginning Working Capital 109,186 63,806 68,321 41,639
REVENUE
Contributions 69,982 69,949 71,372 80,000
Interest Income 4,013 6,297 1,841 6,927
Total Revenue 73,995 76,246 73,213 86,927
Total Resources 183,181 140,052 141,535 128,566
EXPENSE
Salaries and benefits 16,178 19,403 20,350 20,063
Supplies 3,751 3,751
Claims Paid
1st Quarter 30,870 24,000 18,235 26,006
2nd Quarter 16,936 20,000 24,489 22,500
3rd Quarter 28,878 20,000 28,101 22,500
4th Quarter 19,298 20,000 23,755 22,500
Personnel Costs
Other services and charges 2,700 7,680 2,925 7,680
Transfer to Worker's Comp
Capital Outlay
Total Expenses 114,860 114,834 117,855 125,000
Net Income (40,865) (38,588) (44,642) (38,073)
Ending Working Capital 68,321 25,218 23,680 3,566
Unemployment
As of December 31, 2007
3/28/2008 560012final.xls
151
2006 2007 2007 2008
Description Actual Budget YTD Budget
Beginning Working Capital 181,989 70,845 187,001 274,726
REVENUE
Contributions 1,331,084 1,339,668 1,398,871 1,406,651
Interest Income 74,890 100,056 73,898 110,062
Total Revenue 1,405,975 1,439,724 1,472,768 1,516,713
Transfers In
Total Resources 1,587,964 1,510,569 1,659,769 1,791,439
EXPENSE
Salaries and benefits 79,850 86,562 80,827 90,598
Judgements & Damages 1,028,705 883,050 865,432 883,050
Ultimate Loss Adjustment (134,826)331,271
Liability insurance 66,383 83,334 68,721 83,334
Intergovernmental services 229,574 204,750 181,078 204,750
Administrative costs 66,770 49,701 58,807 49,701
Debt and financial services 12,245 9,348 10,000 9,348
Other 36,758 14,685 90,492 14,685
Safety program 15,504 100,111 34,623 100,111
Total Expense 1,400,963 1,431,541 1,721,251 1,435,577
Net Income 5,011 8,183 (248,482) 81,136
Ending Working Capital 187,001 79,028 (61,482) 355,862
Workers Compensation
As of December 31, 2007
3/28/2008 560012final.xls
152
2006 2007 2007 2008
Description Actual Budget YTD Budget
Beginning Working Capital 4,900,193 5,652,211 6,268,067 6,549,270
REVENUE
Contributions
Blue Cross 8,977,260 9,353,106 7,537,457 9,970,846
Group Health 325,504 363,602 304,373 363,602
Employee Share
Blue Cross 828,879 925,644 745,982 925,644
Group Health 43,554 43,521 9,082 43,521
COBRA 112,214 70,974 79,289 104,703
LEOFF1 Retirees 138,068 (24) 121,418
Interest 293,585 283,014 401,945 311,315
Miscellaneous 136,890 119,106 156,043 119,106
Total Revenue 10,855,953 11,158,967 9,234,147 11,960,155
Total Resources 15,756,146 16,811,178 15,502,213 18,509,425
EXPENSE
Salaries and benefits 191,959 207,231 218,475 232,788
Blue Cross Claims 7,845,933 9,395,689 7,119,497 9,194,872
Blue Cross Admin Fees 579,730 338,495 603,037 598,993
Blue Cross Audit Fees 54,835 640 54,835
Stop Loss Fees 605,395 421,603 400,407 442,683
Stop Loss Reimbursements (269,954) (344,679) (91,238) (392,934)
Group Health Premiums 369,057 324,996 375,494 370,495
IBNR adjustment (49,000) 205,657 (133,700) 234,449
Wellness 31,136 38,222 30,396 38,231
Other Professional Services 183,823 57,751 186,268 61,810
Total Expense 9,488,079 10,699,800 8,709,276 10,836,222
Change in Working Capital 1,367,874 459,167 524,871 1,123,933
Ending Working Capital 6,268,067 6,111,378 6,792,937 7,673,203
IBNR- 2006 905,000
Target Fund Bal @ 2 X IBNR 1,810,000
Health and Employee Wellness Fund
As of December 31, 2007
560012final.xls 3/28/2008
153
2006 2007 2007 2008
Description Actual Budget YTD Budget
Beginning Working Capital 289,530 352,568 644,466 827,999
REVENUE
Contributions 1,634,252 1,674,046 1,797,492 1,797,564
Interest 64,772 56,354 73,593 61,989
Total Revenue 1,699,025 1,730,400 1,871,085 1,859,553
EXPENSE
Salaries and benefits 64,710 77,562 81,397 80,201
Claims & Judgements 500,451 702,799 797,525 702,799
Loss reserves adjustment
Insurance Premiums 722,280 955,154 807,531 955,612
Other Expenses 56,648 116,072 249,594 116,072
Total Expense 1,344,089 1,851,587 1,936,048 1,854,684
Transfers Out
Total Expenses & Transfers 1,344,089 1,851,587 1,936,048 1,854,684
Net Income 354,936 (121,187) (64,963)4,869
Ending Working Capital 644,466 231,381 579,503 832,868
Liability Insurance
As of December 31, 2007
3/28/2008 560012final.xls
154
2006 2007 2007 2008
Description Actual Budget YTD Budget
Beginning Working Capital 41,869 58,220 42,833 67,515
REVENUE
Contributions 261,651 262,277 287,808 302,212
Interest 290 282 448 310
Reimbursement-Loss/Damages
Total Revenue 261,940 262,559 288,257 302,522
Total Resources 303,809 320,779 331,090 370,037
EXPENSE
Brokerage Fees 14,000 17,136 14,000 17,136
Insurance Premiums 213,565 264,550 217,648 277,778
Property Claims/Deductibles 17,233 23,269 (9,275)23,269
Other costs 16,178 19,403 25,852 20,063
Total Expense 260,976 324,358 248,225 338,246
Net Income 965 (61,799)40,032 (35,724)
Working Capital 42,833 (3,579)82,865 31,791
Property Insurance
As of December 31, 2007
560012final.xls 3/28/2008
155
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Av
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R
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To
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59
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7
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5
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3
5
8
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6
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8
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6
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28
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9
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3
6
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9
6
7
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1
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7
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1
9
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6
To
t
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v
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u
e
13
,
6
7
6
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7
5
1
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3
5
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7
7
6
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6
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9
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1
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7
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To
t
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a
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s
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9
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3
5
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6
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9
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p
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t
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s
13
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8
6
5
,
0
2
6
2
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5
3
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5
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0
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5
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2
6
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1
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2
3
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0
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8
7
%
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1
5
9
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5
5
3
83
,
4
8
3
2
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9
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9
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52
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9
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To
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8
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4
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_
_
_
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_
_
_
_
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_
_
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_
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_
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Av
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R
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5,
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0
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%
5,
6
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3
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3
1
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6
9
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3
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To
t
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F
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d
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58
.
2
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58
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m
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t
s
13
2
,
4
3
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5
77
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2
0
0
55
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2
3
4
77
,
2
0
0
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.
8
9
%
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6
.
8
9
%
Ch
a
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s
f
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r
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c
e
s
24
,
9
2
0
,
8
5
4
2
,
0
9
6
,
6
8
0
2
6
,
6
3
7
,
4
7
5
(
1
,
7
1
6
,
6
2
1
)
26
,
6
3
7
,
4
7
5
16
6
.
8
1
%
16
6
.
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26
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8
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31
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To
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To
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43
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7
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To
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165
City of Kent 3/25/2008 10:54:24R55JC021
Street Capital Projects FundFiscal Year: Period: 127 1Page -
Fiscal YTD Prj to Date Variance % Prior Years Budget
Beginning Fund Balance 87,009- 84,261.60-84,261.60- 2,747.40- 96.84
Fund Balance Adjustments 2,747 2,747.00
Licenses & Permits 9,260- 9,260.00-9,260.00-100.00
Intergovernmental 52,798,191- 35,182,757.50- 6,114,843.45- 41,297,600.95- 11,500,590.05- 78.22
Charges for Services 74,663- 433,906.64- 343,191.33 90,715.31- 16,052.31 121.50
Miscellaneous Revenues 23,070,975- 17,894,258.39- 1,162,749.43- 19,057,007.82- 4,013,967.18- 82.60
Non Revenues 16,150,863- 20,755,931.77- 28,971.67- 20,784,903.44- 4,634,040.44 128.69
Other Financing Sources 16,769,795- 17,983,186.40- 1,191,606.10 16,791,580.30- 21,785.30 100.13
Operating Transfers In 15,806,852- 11,973,773.24- 3,889,253.54- 15,863,026.78- 56,174.78 100.36
124,764,861-104,317,335.54-9,661,020.66-113,978,356.20-10,786,504.80-91.35Total Available Resources
Unallocated Street Projects 18,728 18,728.00
Street Mitigation Receipts 429,923 429,923.00
Central Ave Pavement Rehab 501,000 24,459.48 157.81 24,617.29 476,382.71 4.91
Street Light Wiring Upgrade 120,000 30,390.11 30,390.11 89,609.89 25.33
LID 329-Willis & 74th Ave 244,186 620,980.24 19,592.17 640,572.41 396,386.41- 262.33
Misc Intersection Signals 200,000 124,407.95 124,407.95 75,592.05 62.20
Pedestrian Walkways 206,273 186,273.34 14,497.14 200,770.48 5,502.52 97.33
Traf Signal Control Cabinets 209,183 138,808.88 63,575.01 202,383.89 6,799.11 96.75
Signal Battery Backup 379,776 298,546.18 10,437.78 308,983.96 70,792.04 81.36
124th Avenue Improvements 75,000 75,000.00
248th Street Improvements 75,000 75,000.00
Asphalt Overlays 2005 964,710 825,791.30 138,918.70 964,710.00 100.00
Asphalt Overlays 2006 325,710 227,869.08 97,840.92 325,710.00 100.00
Asphalt Overlays 2007 1,213,029 1,082,232.06 1,082,232.06 130,796.94 89.22
Sidewalk Renovations 2005 325,222 325,221.94 325,221.94 .06 100.00
Sidewalk Renovations 2007 85,000 85,000.00 85,000.00 100.00
Sidewalk Renovations 2008 85,000 85,000.00
Citywide Guardrails 2004 9,681 9,680.37 9,680.37 .63 99.99
Kent Station 4,138,550 3,090,263.66 128,691.36 3,218,955.02 919,594.98 77.78
Downtown ITS Improvements 3,850,489 4,104,433.36 190,550.25 4,294,983.61 444,494.61- 111.54
196th Street Corridor-East 1,016,911 618,641.53 111.54 618,753.07 398,157.93 60.85
84th Avenue Rehabilitation 314,958 159,325.07 504,608.60 663,933.67 348,975.67- 210.80
Lincoln Ave/Smith St Improv 5,156.82 113.20 5,270.02 5,270.02-
256th Street - 116th to 132nd 315,277 16,622.75 16,622.75 298,654.25 5.27
116th & 248th Intersection 330,406 617.80 617.80 329,788.20 .19
BNSF Grade Separation 12,138,619 1,579,473.92 1,725,494.28 3,304,968.20 8,833,650.80 27.23
Military/Reith Intersection 100,000 29,711.57 319.44 30,031.01 69,968.99 30.03
272nd Extension (KK to 256th)4,654,081 2,522,386.64 2,708,194.96 5,230,581.60 576,500.60- 112.39
2nd Avenue Pedestrian Imp 392,710 18,082.20 73,118.57 91,200.77 301,509.23 23.22
LID 361 - 272nd Extension 14,603.21 198,565.10 213,168.31 213,168.31-
124th Ave & SE 248th St. Imp.257,982 257,982.00
2nd Avenue (Smith & Meeker)50,000 50,000.00
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Street Capital Projects FundFiscal Year: Period: 127 2Page -
Fiscal YTD Prj to Date Variance % Prior Years Budget
4th Ave Impr (James to Cloudy)276,988.60 276,988.60 276,988.60-
Willis St UPRR/BNRR Grade Sepr 146,326.22 146,326.22 146,326.22-
James Ave Impr (4th to UPRR)134,437.88 134,437.88 134,437.88-
Event Ctr Floodplain Mitigatio 672,438.34 672,438.34 672,438.34-
256th Imps(Kent Kangley-116th)2,100,000 13,368.06 13,368.06 2,086,631.94 .64
LID 341-196th Corridor Mid 35,333,026 33,850,794.03 519.61 33,851,313.64 1,481,712.36 95.81
LID 353 224th-228th Corridor 33,526,911 27,061,202.04 3,426,847.61 30,488,049.65 3,038,861.35 90.94
224th-228th Corridor East Leg 1,873,505 718,211.73 120,152.43 838,364.16 1,035,140.84 44.75
Russell Road Maint. Facility 178,819.10 178,819.10 178,819.10-
East Hill Operations Center 150,580 1,602,087.32 1,602,087.32 1,451,507.32- ********
Hwy 99 HOV Lanes - Phase 1 4,398,063 1,087,030.40 286,399.04 1,373,429.44 3,024,633.56 31.23
Hwy 99 HOV - 240th-252nd 307,075 698,057.48 698,057.48 390,982.48- 227.32
Hwy 99 HOV - 252nd-SR516 6,727,503 6,913,613.77 244,687.09 7,158,300.86 430,797.86- 106.40
Hwy 99 HOV Lanes - Phase 2 7,320,794 8,451,451.24 420,256.73 8,871,707.97 1,550,913.97- 121.19
124,764,861 93,734,867.54 14,582,587.47 108,317,455.01 16,447,405.99 86.82Total Expenditures
10,582,468.00-4,921,566.81 5,660,901.19-Ending Balance
167
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Parks Capital Projects FundFiscal Year: Period: 127 1Page -
Fiscal YTD Prj to Date Variance % Prior Years Budget
Beginning Fund Balance 1,145,480- 1,149,387.38-1,149,387.38- 3,907.38 100.34
Intergovernmental 4,853,544- 3,293,473.86- 307,638.03- 3,601,111.89- 1,252,432.11- 74.20
Charges for Services 4,794- 3,576.03- 1,286.77- 4,862.80-68.80 101.44
Miscellaneous Revenues 3,006,117- 2,326,437.76- 665,983.04- 2,992,420.80- 13,696.20- 99.54
Other Financing Sources 33,109- 33,108.45-33,108.45-.55- 100.00
Operating Transfers In 30,656,369- 24,071,521.35- 6,979,356.57- 31,050,877.92- 394,508.92 101.29
39,699,413-30,877,504.83-7,954,264.41-38,831,769.24-867,643.76-97.81Total Available Resources
Lake Fenwick 55,000 10,443.17 10,443.17 44,556.83 18.99
Parks Fee-in-Lieu 1,794,096 1,471,511.53 322,583.00 1,794,094.53 1.47 100.00
Lake Meridian Boat Ramp Renov 358,414 49,725.52 448,508.22 498,233.74 139,819.74- 139.01
Paths and Trails 74,243 44,955.99 6,374.03 51,330.02 22,912.98 69.14
Three Friends 646,486 509,429.19 140,935.51 650,364.70 3,878.70- 100.60
Adopt-a-Park Program 279,383 220,868.56 42,967.35 263,835.91 15,547.09 94.44
Service Club Ballfields 7,298,410 6,842,765.17 110,409.29 6,953,174.46 345,235.54 95.27
Clark Lake Outfall 105,879 108,930.55 108,930.55 3,051.55- 102.88
Clark Lake Mgmt Plan/Develop 201,559 144,366.16 22,526.41 166,892.57 34,666.43 82.80
Soccer Field Development 14,967 14,966.52 14,966.52 .48 100.00
Russell Road Maint Shop 60,000 8,014.55 14,716.31 22,730.86 37,269.14 37.88
Kent Meridian Pool 224,685 195,745.26 195,745.26 28,939.74 87.12
Glenn Nelson Park 433,321 424,320.86 424,320.86 9,000.14 97.92
Grandview Off-Leash Park 36,956 36,853.00 103.20 36,956.20 .20- 100.00
Turnkey Neighborhood Park 187,041 2,978.36 10,863.55 13,841.91 173,199.09 7.40
Pool/Community Center Study 125,992 72,693.20 53,298.80 125,992.00 100.00
Native Plants 52,037 52,037.27 52,037.27 .27- 100.00
Street Tree Replacements 155,103 46,406.97 1,860.79 48,267.76 106,835.24 31.12
East Hill "X" Park 1,965,950 1,564,020.01 307,700.07 1,871,720.08 94,229.92 95.21
Rental Houses Demolition 100,000 88,035.66 88,035.66 11,964.34 88.04
Park Land Acquisition 3,499,608 2,685,257.55 1,562,834.64 4,248,092.19 748,484.19- 121.39
BMX Track 15,000 7,124.28 7,875.72 15,000.00 100.00
Van Doren's River Emer Access 20,000 16,929.78 16,929.78 3,070.22 84.65
Seven Oaks Park Improvements 127,947 6,710.15 6,710.15 121,236.85 5.24
Eagle Creek Park Development 187,395 84,065.49 20,000.00 104,065.49 83,329.51 55.53
Botanical Garden 10,000 10,000.00
Town Square Park 3,444,578 674,309.30 4,316,192.96 4,990,502.26 1,545,924.26- 144.88
Riverwalk / Riverview Park Dev 1,446,836 127,853.47 209,096.92 336,950.39 1,109,885.61 23.29
West Fenwick Renovations 813,724 110,475.67 34,854.67 145,330.34 668,393.66 17.86
Big Blue Mobile Computer Lab 85,000 85,000.00
Tudor Square Renovations 74,768 74,768.00
Portable Stage 102,500 94,163.98 8,336.02 102,500.00 100.00
Kent Parks Foundation 25,000 8,127.41 8,127.41 16,872.59 32.51
132nd Street Park 178,960 121,042.53 15,000.00 136,042.53 42,917.47 76.02
Clark Lake Trails 38,500 22,044.91 7,671.64 29,716.55 8,783.45 77.19
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Parks Capital Projects FundFiscal Year: Period: 127 2Page -
Fiscal YTD Prj to Date Variance % Prior Years Budget
Clark Lake Outfall IV 21,500 12,365.13 12,365.13 9,134.87 57.51
Uplands Playfield Parking/St.250,000 250,000.00 250,000.00 100.00
Light Pole Replacement 419,552 251,212.59 36,161.20 287,373.79 132,178.21 68.50
Wilson Playfields 5,571,237 5,558,066.71 19,672.80 5,577,739.51 6,502.51- 100.12
Basketball Court Dev 153,497 138,891.66 138,891.66 14,605.34 90.48
Wilson Playfields Acq & Dev 426,336 333,765.28 2,042.16 335,807.44 90,528.56 78.77
Aquatics Land Acquisition 5,826,316 5,596,494.13 443,117.24 6,039,611.37 213,295.37- 103.66
Parks Land Acquisition 2006 95,000 17,100.00 77,900.00 95,000.00 100.00
Urban Forestry 10,000 1,440.00 1,440.00 8,560.00 14.40
Eagle Scout Projects 54,376 8,162.13 27,561.75 35,723.88 18,652.12 65.70
Russell Road Infield Soil 25,000 14,189.74 14,189.74 10,810.26 56.76
228th Corridor Park/Trailhead 50,000 50,000.00 50,000.00 100.00
Multi-use Ballfields/KSD 20,000 20,000.00
Earthworks Stairs 66,246 66,246.00
272nd Neighbor Park Acq & Dev 267,711 191,131.66 2,000.00 193,131.66 74,579.34 72.14
Local Off-Leash Parks 15,000 1,427.27 1,473.45 2,900.72 12,099.28 19.34
Canterbury Park 620,745 522,119.65 522,119.65 98,625.35 84.11
Grant Matching Funds/Land Acq.75,000 3,500.00 3,500.00 71,500.00 4.67
Downtown Gateways, Phase 2 75,000 75,000.00 75,000.00 100.00
Parks Grant Matching 246,655 78,329.08 226.49- 78,102.59 168,552.41 31.66
Park Lifecycle Mtc 2006 331,942 143,672.10 188,269.90 331,942.00 100.00
Park Lifecycle Mtc 2007 254,078 254,078.00 254,078.00 100.00
Park Lifecycle Mtc 2008 74,618 74,618.00
Park Master Plans 2006 23,831 23,831.00 23,831.00 100.00
Park Master Plans 2007 37,644 37,643.70 37,643.70 .30 100.00
Misc Contract Services 2005 51,413 31,453.41 19,960.02 51,413.43 .43- 100.00
Misc Contract Services 2006 19,960 5,754.01- 21,466.60 15,712.59 4,247.41 78.72
Misc Contract Services 2007 10,000 10,000.00 10,000.00 100.00
Lifecycle-Play Equipment 2006 68,900 68,900.00 68,900.00 100.00
Lifecycle-Play Equipment 2007 113,721 12,571.50 12,571.50 101,149.50 11.05
Lifecycle-Ballfields 2006 25,000 25,000.00 25,000.00 100.00
Lifecycle-Ballfields 2007 44,797 39,405.47 39,405.47 5,391.53 87.96
Lifecycle-Irrigation 2006 25,000 25,000.00 25,000.00 100.00
Lifecycle-Irrigation 2007 50,000 13,650.25 13,650.25 36,349.75 27.30
Lifecycle-Infield Soil 2007 40,000 37,694.39 37,694.39 2,305.61 94.24
39,699,413 28,854,664.06 9,336,956.53 38,191,620.59 1,507,792.41 96.20Total Expenditures
2,022,840.77-1,382,692.12 640,148.65-Ending Balance
169
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Other Capital Projects FundFiscal Year: Period: 127 1Page -
Fiscal YTD Prj to Date Variance % Prior Years Budget
Beginning Fund Balance 106,057- 106,057.02-106,057.02-.02 100.00
Fund Balance Adjustments 770 770.00
Intergovernmental 78,600,000-78,600,000.00-
Charges for Services 20,000- 20,000.00-20,000.00-100.00
Miscellaneous Revenues 641,092- 1,318,260.77- 120,677.74- 1,438,938.51- 797,846.16 224.45
Non Revenues 13,280,774- 13,280,773.83- 1,600,000.00- 14,880,773.83- 1,599,999.83 112.05
Other Financing Sources 63,113,730- 58,061,848.58-58,061,848.58- 5,051,881.42- 92.00
Operating Transfers In 10,067,630- 7,596,124.05- 2,482,071.39- 10,078,195.44- 10,565.44 100.10
165,828,513-80,383,064.25-4,202,749.13-84,585,813.38-81,242,699.97-51.01Total Available Resources
Kent Station 39,454,424 31,989,106.28 4,070,000.00 36,059,106.28 3,395,317.72 91.39
Event Center 78,600,000 16,600,838.32 16,600,838.32 61,999,161.68 21.12
LTGO Bonds - 2000 16,694,696 16,317,871.69 316,851.10 16,634,722.79 59,973.21 99.64
LTGO Bonds 2002 8,636,958 8,373,998.43 312,071.59 8,686,070.02 49,111.67- 100.57
LTGO / Taxable Bonds 2003 7,518,000 7,167,155.75 342,787.41 7,509,943.16 8,056.84 99.89
LTGO Bonds 2006 12,000,000 9,308,807.70 3,085,702.88 12,394,510.58 394,510.58- 103.29
Downtown Gateways 538,427 517,503.78 20,883.84 538,387.62 39.38 99.99
Fire Radio Equipment 326,000 132,399.40 132,399.40 193,600.60 40.61
Fire Dept Property Purchases 829,460 836,468.63 7,008.83- 829,459.80 .20 100.00
Olympic Pipeline Project 20,000 16,571.78 16,571.78 3,428.22 82.86
ECC Operating Equipment 180,000 58,336.15 2,607.10 60,943.25 119,056.75 33.86
Breathing Apparatus Cylinders 1,030,548 871,112.47 2,473.16- 868,639.31 161,908.69 84.29
165,828,513 75,589,332.06 24,742,260.25 100,331,592.31 65,496,921.04 60.50Total Expenditures
4,793,732.19-20,539,511.12 15,745,778.93Ending Balance
170
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Technology Capital ProjectsFiscal Year: Period: 127 1Page -
Fiscal YTD Prj to Date Variance % Prior Years Budget
Charges for Services 8,231- 8,479.24-8,479.24- 248.24 103.02
Miscellaneous Revenues 23,503- 41,562.33- 4,091.96- 45,654.29- 22,151.29 194.25
Non Revenues 190,626.88 190,626.88 190,626.88-
Operating Transfers In 24,071,798- 22,715,718.33- 1,062,787.41- 23,778,505.74- 293,292.26- 98.78
24,103,532-22,575,133.02-1,066,879.37-23,642,012.39-461,519.61-98.09Total Available Resources
Tech Equipment 2001 522,668 469,959.91 469,959.91 52,708.09 89.92
Communications Replacement 1,527,292 1,530,000.00 1,530,000.00 2,708.00- 100.18
Technology Plan 1998 12,380,572 12,221,181.16 500.00 12,221,681.16 158,890.84 98.72
ERP System Upgrade 500,000 148,664.10 148,664.10 351,335.90 29.73
Police Project 1,870,197 1,712,406.57 22,774.95 1,735,181.52 135,015.48 92.78
Wireless Pilot 25,602 25,602.18 25,602.18 .18- 100.00
Municipal Court 74,000 2,329.75 2,329.75 71,670.25 3.15
Legal/Prosecution 80,000 18,157.49 18,157.49 61,842.51 22.70
Network Backbone Phase I 354,173 354,172.83 354,172.83 .17 100.00
Network Backbone Phase II 154,996 154,995.72 154,995.72 .28 100.00
Lifecycle Server Replacement 285,494 285,494.37 285,494.37 .37- 100.00
Exchange 2003 Upgrade 75,961 75,960.46 75,960.46 .54 100.00
Building Wiring 90,000 56,438.39 7,009.13 63,447.52 26,552.48 70.50
Network Security 40,564 40,563.68 40,563.68 .32 100.00
Training 19,127 19,126.70 19,126.70 .30 100.00
Online Permits 60,000 60,000.00
Online Payment Infrastructure 51,000 16,885.98 16,885.98 34,114.02 33.11
Website Redesign 58,000 46,773.25 56,055.75 102,829.00 44,829.00- 177.29
Electronic Forms Infrastructur 51,220 51,219.97 51,219.97 .03 100.00
Online City Code 1,592 1,591.20 1,591.20 .80 99.95
Contingency Other 84,640 17,414.46 34,950.09 52,364.55 32,275.45 61.87
Document Management 2003 47,860 47,860.00 47,860.00 100.00
Document Management 2004 39,395 39,395.00 39,395.00 100.00
Accella GIS 30,314 30,314.00 30,314.00 100.00
Kiva 7.1 Upgrade 23,225 22,075.00 12,749.59 34,824.59 11,599.59- 149.94
Database Projects 6,357 6,356.42 6,356.42 .58 99.99
Software Tools 9,855 9,855.07 9,855.07 .07- 100.00
Parks Planning CAD 3,324 3,323.44 3,323.44 .56 99.98
Pathlore LMS 18,000 18,000.00
Clerk Records Tracking System 2,056 2,055.62 2,055.62 .38 99.98
UPS Upgrade 122,658 122,657.98 122,657.98 .02 100.00
Replace Cable TV Equipment 30,606 30,605.87 30,605.87 .13 100.00
Cable TV Mastering Station 8,141 8,141.20 8,141.20 .20- 100.00
Call Pilot Upgrade 3,012 3,011.58 3,011.58 .42 99.99
Symposium Upgrade 35,975 35,975.19 35,975.19 .19- 100.00
Training 20,270 20,269.91 20,269.91 .09 100.00
Training Room Update 9,345 9,344.77 9,344.77 .23 100.00
171
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Technology Capital ProjectsFiscal Year: Period: 127 2Page -
Fiscal YTD Prj to Date Variance % Prior Years Budget
Laptop Replacement 78,348 78,347.64 78,347.64 .36 100.00
MDC Replacement 116,268 116,268.38 116,268.38 .38- 100.00
Online Training Content 20,622 20,622.00 20,622.00 100.00
Third-Party Software Licenses 14,328 14,328.10 14,328.10 .10- 100.00
Microsoft License Management 306,398 306,397.68 306,397.68 .32 100.00
Customer Services Cashiering 19,000 18,609.19 18,609.19 390.81 97.94
Fire Systems 15,000 7,042.65 1,018.00- 6,024.65 8,975.35 40.16
Utility Billing System 443,345 217,107.21 20,056.29 237,163.50 206,181.50 53.49
Streaming Video 18,000 17,533.67 17,533.67 466.33 97.41
Network Upgrade/Reconfigure 11,000 2,669.41 9,225.48 11,894.89 894.89- 108.14
GIS Migration 76,686 55,368.77 10,731.60 66,100.37 10,585.63 86.20
Document Management 2005 16,971 10,930.75 1,295.54 12,226.29 4,744.71 72.04
Wireless Network 264,762 40,792.54 11,248.25 52,040.79 212,721.21 19.66
Wireless Evidence Barcoding 985 1,064.19 1,064.19 79.19- 108.04
Crime Analysis 70,000 70,000.00
Tiburon Upgrade 62,950 62,950.00
Public Safety IT Staffing 204,892 206,494.93 144,499.57 350,994.50 146,102.50- 171.31
Server Replacement 2005 51,633 51,632.59 51,632.59 .41 100.00
Server Replacement 2006 50,000 60,670.14 60,670.14 10,670.14- 121.34
ERP IT Staffing 201,000 171,918.94 126,509.78 298,428.72 97,428.72- 148.47
Fire MDC Replacement 155,982 155,981.59 155,981.59 .41 100.00
Pending Proj - End User HW/SW 20,252 4,854.22 4,854.22 15,397.78 23.97
Microsoft Licensing 2005 93,602 91,215.55 91,215.55 2,386.45 97.45
Laptop Replacement 2005 50,000 32,456.13 32,456.13 17,543.87 64.91
Kent Station Hot Zone 50,000 41,515.50 41,515.50 8,484.50 83.03
Pending Proj - Public Safety 16,058 5,744.64 5,744.64 10,313.36 35.77
Training 2006 25,000 19,076.05 19,076.05 5,923.95 76.30
Backup & Recovery Solution 150,000 143,814.74 143,814.74 6,185.26 95.88
Lifecycle Replacements 1,127,690 336,422.86 300,090.02 636,512.88 491,177.12 56.44
Multimedia eForm 10,000 10,000.00
Permit Center Fill/Print Forms 30,771 30,771.35 30,771.35 .35- 100.00
ERP 8.12 Training/Consulting 30,000 17,572.50 17,572.50 12,427.50 58.58
Large Format Scanning 24,196 641.82 2,620.13 3,261.95 20,934.05 13.48
Utility Billing Backfill 65,000 61,234.28 14,836.64 76,070.92 11,070.92- 117.03
Centralized AP OT 2005/2006 17,000 1,334.94 1,334.94 15,665.06 7.85
JE Workflow Scanners/Equip 45,000 27,753.08 10,242.76 37,995.84 7,004.16 84.44
P-Cards Backfill 2005/2006 35,000 40,516.20 5,759.34 46,275.54 11,275.54- 132.22
Sunpro Citrix Servers 10,003 10,003.08 10,003.08 .08- 100.00
Digital Cable Upgrade 110,040 294,369.25 294,369.25 184,329.25- 267.51
Valley Comm. Mobile Mapping 28,000 12,337.92 12,337.92 15,662.08 44.06
2006 PC Replacements 235,238 174,650.12 174,650.12 60,587.88 74.24
JDE Upgr Customer Trng/Backfil 48,000 3,401.22 3,401.22 44,598.78 7.09
Enterprise GIS Planning 67,470 49,600.00 49,600.00 17,870.00 73.51
Training 77,500 13,016.27 13,016.27 64,483.73 16.80
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Technology Capital ProjectsFiscal Year: Period: 127 3Page -
Fiscal YTD Prj to Date Variance % Prior Years Budget
Content Management System 300,000 76,395.20 76,395.20 223,604.80 25.47
Connected Comm. Prog/Prog Mgr 58,000 49,518.78 49,518.78 8,481.22 85.38
Staff 86,754 86,754.00
Software Projects 34,700 6,213.83 6,213.83 28,486.17 17.91
Hardware Projects 80,000 46,515.49 46,515.49 33,484.51 58.14
Network Projects 19,600 9,029.72 9,029.72 10,570.28 46.07
Comcast Cable Franchise Negot.77,952 77,952.00
Video Projects 60,000 60,000.00
In-plant Bus. Product Phase I 55,000 55,000.00
24,053,487 20,037,550.21 1,546,521.03 21,584,071.24 2,469,415.76 89.73Total Expenditures
50,045-2,537,582.81-479,641.66 2,057,941.15-Ending Balance
173
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Facilities Capital ProjectsFiscal Year: Period: 127 1Page -
Fiscal YTD Prj to Date Variance % Prior Years Budget
Charges for Services 2,703- 2,702.22-45.91- 2,748.13-45.13 101.67
Miscellaneous Revenues 157,458- 160,852.90- 3,394.52 157,458.38-.38 100.00
Operating Transfers In 8,888,959- 7,867,012.81- 993,105.08- 8,860,117.89- 28,841.11- 99.68
9,049,120-8,030,567.93-989,756.47-9,020,324.40-28,795.60-99.68Total Available Resources
Senior Center Greenhouse Exp 652,981 642,416.61 10,564.59 652,981.20 .20- 100.00
Municipal Lot 125,000 256,434.42 42,826.64 299,261.06 174,261.06- 239.41
Finance Tenant Improvements 220,000 220,000.00 220,000.00 100.00
Fire Pump Test Pit 166,927 166,926.72 166,926.72 .28 100.00
Fire Security Fences 78,000 67,596.50 67,596.50 10,403.50 86.66
Fire Exhaust Systems 280,608 226,750.27 36,229.93 262,980.20 17,627.80 93.72
Facility Minor Renovations 187,153 117,049.79 38,394.35 155,444.14 31,708.86 83.06
PW Engineering Remodel 446,871 446,872.11 446,872.11 1.11- 100.00
Police Records Renovation 25,000 25,000.00 25,000.00 100.00
Police Firing Range Upgrades 125,055 125,055.15 125,055.15 .15- 100.00
Resource Ctr Security Upgrades 25,000 14,213.16 14,213.16 10,786.84 56.85
Fire Sleeping Qrtrs/Restrooms 25,000 25,000.00 25,000.00 100.00
City Hall Plumbing 250,092 250,091.91 250,091.91 .09 100.00
Courtyard & Sidewalk Renov 737,982 725,189.02 22,286.81 747,475.83 9,493.83- 101.29
IT Annex Furniture/CATV Furn.15,000 9,914.46 9,914.46 5,085.54 66.10
Centennial Garage Seismic 657,653 654,644.67 654,644.67 3,008.33 99.54
Legal and Parks Renovations 350,632 85,245.28 246,700.81 331,946.09 18,685.91 94.67
East Hill Shops Artwork 50,000 50,000.00
Corrections Improvements 2003 465,243 97,763.00 338,635.73 436,398.73 28,844.27 93.80
East Hill M&O Facility Land 3,954,923 3,936,727.20 18,195.80 3,954,923.00 100.00
Remodel Washington Av Fire Stn 150,000 8,604.83 8,604.83 141,395.17 5.74
Permit Center Minor Renovation 490.49 490.49 490.49-
Police Patrol Remodel 30,000 13,737.29 13,737.29 16,262.71 45.79
Expansion Police/Fire Trng Ctr 30,000 32,240.20 32,240.20 2,240.20- 107.47
9,049,120 8,001,166.15 900,631.59 8,901,797.74 147,322.26 98.37Total Expenditures
29,401.78-89,124.88-118,526.66-Ending Balance
174
City of Kent 4/8/2008 9:15:46R55JC021
Water FundFiscal Year: Period: 127 1Page -Projects Only
Fiscal YTD Prj to Date Variance % Prior Years Budget
Beginning Fund Balance 193,927- 193,926.30-193,926.30-.70- 100.00
Intergovernmental 751,892- 591,020.75-591,020.75- 160,871.25- 78.60
Charges for Services 1,488- 3,234.84- 183.65- 3,418.49- 1,930.49 229.74
Miscellaneous Revenues 723,891- 1,938,337.14- 489,728.12- 2,428,065.26- 1,704,174.62 335.42
Non Revenues 20,024,729- 19,524,728.53- 500,000.00- 20,024,728.53-100.00
Other Financing Sources 2,500,903.04-2,500,903.04- 2,500,903.04
Operating Transfers In 27,936,093- 21,800,752.29- 6,135,340.55- 27,936,092.84-.16- 100.00
49,632,019-46,552,902.89-7,125,252.32-53,678,155.21-4,046,136.04 108.15Total Available Resources
Seismic Vulnerability Assess 901,311 514,754.09 514,754.09 386,556.91 57.11
Water Comp Plan Update 2007 150,000 2,138.64 2,138.64 147,861.36 1.43
Groundwater Study 100,000 9,857.64 168,440.37 178,298.01 78,298.01- 178.30
Elec/Mech Engr Analysis 75,000 75,000.00
Water Conservation Plan 407,000 376,579.05 34,885.00 411,464.05 4,464.05- 101.10
Water Unallocated Projects 200,000 200,000.00
Rock Creek Mitigation Projects 550,000 62.50 62.50 549,937.50 .01
Russell Road Nursery 250,000 2,381.90 2,381.90 247,618.10 .95
Clark Springs HCP 167,016 218,958.98 184,451.39 403,410.37 236,394.37- 241.54
Tacoma Intertie 32,509,252 25,973,053.47 1,297,708.79 27,270,762.26 5,238,489.38 83.89
CS Monitor/CS Roof/CS Well 18,000 18,000.00
3.5 Mixing/Blue Boy Mix/98th 105,000 105,000.00
Corrosion Control 1,974,470 1,363,688.82 86,739.72 1,450,428.54 524,041.46 73.46
Pump Station #3 Replacement 721,572 105,321.16 105,321.16 616,250.84 14.60
Kent Springs Source Upgrade 527,779 319,284.46 319,284.46 208,494.07 60.50
Pump Station #5 Add Pump 113,457 113,714.30 113,714.30 257.30- 100.23
Misc Water Improvements 500,000 414,557.23 414,557.23 85,442.77 82.91
Additional Water Source Dev 1,554,824 1,035,845.60 1,035,845.60 518,978.40 66.62
Well Head Protection 271,384 162,648.51 162,648.51 108,735.49 59.93
Security Improvement per VA 10,000 10,000.00
Impoundment Reservoir 1,075,000 2,054,735.63 31,440.16 2,086,175.79 1,011,175.79- 194.06
East Hill Reservoir 474,000 244,303.81 244,303.81 229,696.19 51.54
East Hill Well Supply Assess.200,000 1,145.25 1,145.25 198,854.75 .57
Kent Kangley Road Repair 350,000 4,867.00 4,867.00 345,133.00 1.39
Asset Management System 26,532 5,000.00 5,000.00 21,532.00 18.85
Misc Water Mains 2005 1,414,187 1,131,003.92 283,183.08 1,414,187.00 100.00
Hydrant Replacement 2005 115,043 8,044.92 8,044.92 106,998.08 6.99
Large Meter/Vault Replace 2005 47,336 12,994.63 34,341.22 47,335.85 .15 100.00
Large Meter/Vault Replace 2007 64,000 64,000.00 64,000.00 100.00
Large Meter/Vault Replace 2008 98,341 98,341.00
Kent Station - Water 117,982 109,197.68 109,197.68 8,784.32 92.55
Downtown ITS Improvements 145,100 233,131.16 233,131.16 88,031.16- 160.67
Remote Telemetry Upgrade 448,368 326,134.47 99,603.48 425,737.95 22,630.05 94.95
BNSF Grade Separation 205,000 205,000.00
175
City of Kent 4/8/2008 9:15:46R55JC021
Water FundFiscal Year: Period: 127 2Page -Projects Only
Fiscal YTD Prj to Date Variance % Prior Years Budget
272nd Extension (KK to 116th)178 39.17 300,441.26 300,480.43 300,302.43- ********
LID 341-196th Corridor Mid 194,888 194,002.60 194,002.60 885.40 99.55
LID 353 224th-228th Corridor 100,000 82,319.61 66,779.89 149,099.50 49,099.50- 149.10
Russell Road Maint. Facility 600,000 2,639.64 2,639.64 597,360.36 .44
East Hill Operations Center 2,850,000 1,867.40 1,867.40 2,848,132.60 .07
Hwy 99 HOV Lanes - Phase 1 171,622.33 157,512.01- 14,110.32 14,110.32-
49,632,019 34,766,298.51 2,924,099.41 37,690,397.92 11,941,621.25 75.94Total Expenditures
11,786,604.38-4,201,152.91-15,987,757.29-Ending Balance
176
City of Kent 4/8/2008 9:16:21R55JC021
Sewerage FundFiscal Year: Period: 127 1Page -Projects Only
Fiscal YTD Prj to Date Variance % Prior Years Budget
Beginning Fund Balance 2,417,078- 2,417,078.39-2,417,078.39-.39 100.00
Intergovernmental 3,265,173- 1,654,509.64-1,654,509.64- 1,610,663.36- 50.67
Charges for Services 5,613- 11,380.50- 283,858.68- 295,239.18- 289,626.18 ********
Miscellaneous Revenues 418,181- 374,738.24-374,738.24- 43,442.76- 89.61
Non Revenues 657,572- 525,791.92-525,791.92- 131,780.08- 79.96
Other Financing Sources 1,500,000-1,500,000.00- 1,500,000.00-100.00
Operating Transfers In 22,004,517- 16,165,687.17- 5,838,829.69- 22,004,516.86-.14- 100.00
30,268,134-21,149,185.86-7,622,688.37-28,771,874.23-1,496,259.77-95.06Total Available Resources
NPDES Permit 1,579,000 211,839.66 177,084.08 388,923.74 1,190,076.26 24.63
Drainage Master Plan 500,000 241,540.66 241,540.66 258,459.34 48.31
Integrated Pest Management 150,000 150,000.00
Drainage Unallocated Projects 100,000 100,000.00
Misc Environmental Projects 640,562 25,905.80 324,541.70 350,447.50 290,114.50 54.71
Mill Creek Trunk 2,086,746 1,670,475.10 91,055.43 1,761,530.53 325,215.47 84.42
Seven Oaks Pond Imps 2,740.72 145.41 2,886.13 2,886.13-
Soos Creek Basin Improve 1,392,792 1,359,602.76 736.18 1,360,338.94 32,453.06 97.67
LID 352-3rd Avenue Storm 2,304,572 2,297,073.36 2,297,073.36 7,498.64 99.67
Lower Garrison Creek 1,825,171 1,125,469.82 11,170.65 1,136,640.47 688,530.53 62.28
Earthworks Overlays 425,000 23,804.50 78,847.90 102,652.40 322,347.60 24.15
Horseshoe Acres Pump Station 500,000 482,253.43 482,253.43 17,746.57 96.45
256th Flume 510,000 435,686.86 2,731.02 438,417.88 71,582.12 85.96
Lake Meridian Outlet 1,730,689 705,528.62 546,396.03 1,251,924.65 478,764.35 72.34
Soosette Creek/Springwood Apts 20,000 11,180.27 2,953.82 14,134.09 5,865.91 70.67
Upper Meridian Crk 234th/236th 375,000 47,301.27 373,262.08 420,563.35 45,563.35- 112.15
Upper Meridian Valley Creek 90,000 56,236.10 11,308.01 67,544.11 22,455.89 75.05
E Fork Soosette Crk/144th Clvt 65,000 65,000.00
Meridian Valley Crk Revegetate 800.00 800.00 800.00-
Misc Drainage 2003 320,456 241,585.73 78,870.27 320,456.00 100.00
Misc Drainage 2005 361,777 361,777.54 361,777.54 .54- 100.00
Misc Drainage 2006 265,000 7,979.54 257,020.46 265,000.00 100.00
Misc Drainage 2007 265,000 265,000.00 265,000.00 100.00
Misc Drainage 2008 484,608 484,608.00
Drainage Infractructure Improv 500,000 23,560.37 23,560.37 476,439.63 4.71
Kent Station - Drainage 226,831 142,758.17 142,758.17 84,072.83 62.94
Downtown ITS Improvements 158,406.09 158,406.09 158,406.09-
116th & 248th Intersection 7,072 7,072.00
Remote Telemetry Upgrade 149,456 78,651.76 14,733.27 93,385.03 56,070.97 62.48
BNSF Grade Separation 993,000 993,000.00
Military/Reith Intersection 100,000 100,000.00
272nd Extension (KK to 116th)500,942 421,042.32 421,042.32 79,899.68 84.05
Endangered Species Act Study 460,000 470,244.42 470,244.42 10,244.42- 102.23
124th Ave & SE 248th St. Imp.250,000 250,000.00
177
City of Kent 4/8/2008 9:16:21R55JC021
Sewerage FundFiscal Year: Period: 127 2Page -Projects Only
Fiscal YTD Prj to Date Variance % Prior Years Budget
2nd Avenue (Smith & Meeker)50,000 50,000.00
Event Ctr Floodplain Mitigatio 7,697.15 7,697.15 7,697.15-
LID 341-196th Corridor Mid 1,359,000 1,167,076.54 1,167,076.54 191,923.46 85.88
224th-228th Corridor 1,500,000 1,265,584.44 218,101.68 1,483,686.12 16,313.88 98.91
Russell Road Maint. Facility 1,205.23 1,205.23 1,205.23-
East Hill Operations Center 250,000 250,000.00
Hwy 99 HOV Lanes - Phase 1 2,051,200 1,807,217.68 4,731.66 1,811,949.34 239,250.66 88.34
Hwy 99 HOV Lanes - Phase 2 1,976,930 2,163,576.87 14,450.12 2,178,026.99 201,096.99- 110.17
Sanitary Sewer Master Plan 500,000 36,557.85 36,557.85 463,442.15 7.31
Unallocated Sewer Projects 200,000 200,000.00
LID 360-SE 227th Sewer 216,000 38,880.95 259,384.35 298,265.30 82,265.30- 138.09
Misc Sewer 2005 778,093 387,596.38 390,495.52 778,091.90 1.10 100.00
Misc Sewer 2007 1,483,580 24,780.50 24,780.50 1,458,799.50 1.67
Kent Station - Sewer 229,935 93,935.42 93,935.42 135,999.58 40.85
Downtown ITS Improvements 12,967.74 12,967.74 12,967.74-
Remote Telemetry Upgrade 149,456 85,143.14 14,733.22 99,876.36 49,579.64 66.83
272nd Extension (KK to 116th)86,290 13.00 518,153.10 518,166.10 431,876.10- 600.49
LID 341-196th Corridor Mid 8,976 8,737.87 8,737.87 238.13 97.35
224th-228th Corridor 129,738.11 2,828.81 132,566.92 132,566.92-
East Hill Operations Center 250,000 250,000.00
30,268,134 17,076,969.66 4,415,918.85 21,492,888.51 8,775,245.49 71.01Total Expenditures
4,072,216.20-3,206,769.52-7,278,985.72-Ending Balance
178