Keenan & Associates – License #0451271
Self-Insured Claims Administration
Confidential For Client Use Only
(Rev) 4/06/16
RENEWAL AMENDMENT No. 1
This Amendment hereby amends the Self-Insured Claims Administration Agreement (“Agreement”) dated July 1, 2016 by and between Keenan & Associates and City of Commerce (hereinafter referred to collectively as the “Parties”) as follows:
WHEREAS, the current term of the Agreement shall expire on June 30, 2019; and WHEREAS, the Parties desire to continue their relationship subject to the terms and conditions outlined in the Agreement;
NOW, THEREFORE, the Parties agree as follows:
The Agreement is hereby renewed for an additional three (3)-year term beginning on July 1, 2019 and ending on June 30, 2022 (“Renewal Term”).
Client agrees to pay Keenan, for services rendered under this Agreement, a total of $11,426 to be paid as follows:
D $36,050, payable in full on July 1, 2019, and
E $37,131, payable in full on July 1, 2020, and
F $38,245, payable in full on July 1, 2021.
G Optional renewal term 1
x $39,392, payable in full on July 1, 2022.
H Optional renewal term 2
x $40,547, payable in full on July 1, 2023.
The PRIME Fee Schedule, effective July 1, 2018 and attached hereto as Exhibit C, hereby replaces the previous Prime Fee Schedule as of the effective date of this agreement. All the remaining terms and conditions of the Agreement shall remain unchanged and in full force and effect, and shall govern the conduct of the Parties during the Renewal Term. The effective date of this Amendment is July 1, 2019. Each person signing this Amendment to the Agreement on behalf of a Party represents and warrants that he or she has the necessary authority to bind such Party and that this Amendment is binding on and enforceable against such Party.
[Signature Page Follows This Page]
DocuSign Envelope ID: F7E85C3F-327A-4A4E-9735-216A85A96CE5 Keenan & Associates – License #0451271
Self-Insured Claims Administration
Confidential For Client Use Only
(Rev) 4/06/16
City of Commerce Keenan & Associates
Signature: Signature:
By: By: Tara Schilling
Title: Title: Senior Vice President
Address: 2535 Commerce Way
Commerce, CA 90040
Address: 2355 Crenshaw Blvd., Suite
200 Torrance, CA 90505
Email: Email: [email protected]
Attention: (OD3DSSR Attention: Vanessa Pena
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-RKQ6RULD
DocuSign Envelope ID: F7E85C3F-327A-4A4E-9735-216A85A96CE5
Keenan & Associates – License #0451271
Self-Insured Claims Administration
Confidential For Client Use Only
(Rev) 4/06/16
EXHIBIT C
Fee Schedule– Effective July 1, 2018
(Subject to change upon notice)
MANAGED CARE
Early Intervention Initial Assessment / Triage .......... $50 / Hour Telephonic Case Management (TCM) ..................... $98 / Hour • PPO Channeling
• 4 PT Contact
• Initial Evaluation
• RTW Plan
• Medical Care Evaluation
• Written/Case Management Action Plan
Utilization Review .............................................. $110 / Referral Physician Advisor .............................................. $225 / Referral • Medical Necessity Determination
• Physician-to-Physician Contact
Specialty Physician Review ................................... $375 / Hour • Specialty match required
• Appeals
STOP (Pharmacy Review) ..................................... $300 / Hour • Peer-to-Peer Contact by Physician
• Management of Opioid Use
• Written Treatment Plan / Recommendations
BILL REVIEW
Minimum Processing Fee of $10 per bill
Price bills to State Fee Schedules .................. 12% of Savings • $15,000 per bill cap regardless of savings
PPO Network Access (Anthem) ...................... 24% of Savings • $15,000 per bill cap regardless of savings
• Retrospective Network Capture
• Preferred Vendor Pricing (Ancillary Services)
MPN Access ............................................... $3.50 per MPN bill • Care Concierge™ Medical Access Assistant
• Physician Based Outcome Analytics
Pharmacy Benefit Management ....................... 20% of Savings • Additional $3.00 per prescription administrative fee
Negotiations .................................................... 24% of Savings Complex Bill Review by Physician ................... 24% of Savings eBill Access .................................................. $1.20 per e-bill State Reporting Administrative Fee .................. $1.35 per bill DocuSign Envelope ID: F7E85C3F-327A-4A4E-9735-216A85A96CE5