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Agenda 03/27/2012 Item #16E13/27/2012 Item 16.E.1. EXECUTIVE SUMMARY Recommendation to approve Amendment #3 to #09 -5343 Letter of Agreement with Quest Diagnostics, Inc. to extend the Agreement through September 30, 2012 at the existing rates, terms and conditions. OBJECTIVE: To provide follow up biometric testing in support of the Wellness Based Incentives Program. CONSIDERATIONS: On January 1, 2009 the Risk Management Department implemented a behavior based wellness incentives program into the Collier County Group Health Plan. The purpose of the program is to engage employees to participate in various wellness related activities or "qualifiers" to prevent illness and to manage chronic disease. Employees are enrolled in one of three plans with progressively better benefits (Basic, Select, or Premium) based upon their completion of these qualifiers. The qualifiers include the completion of a personal wellness profile; the gathering of weight, height and waist measurements; a complete blood analysis; age and gender based screenings; and participation in diabetes management and smoking cessation programs (if applicable). The participation rate by employees has consistently exceeded 90 %. Quest Diagnostics, Inc. provides the blood analysis, biometric measurement and wellness reporting portion of the program. Once the testing is completed, the results are sent to the onsite Health Advocate and incorporated into the member's Personal Wellness Profile report. The results are shared with the employee and the employee's physician to assist the employee in improving their health status. The current agreement is set to expire on March 31, 2012. The qualifying year that the agreement serves ends September 30, 2012. Staff is recommending that the current agreement be extended at the current rates, terms and conditions through September 30, 2012 to assure that services coincide with the qualifying plan year in order to avoid a disruption of service. Further, Quest is the only provider capable of providing the required services locally at this time. The commencement date of Amendment #3 is effective April 1, 2012. A request for proposals will be released in April, 2012 for an October 1, 2012 commencement date. FISCAL IMPACT: The extension of the agreement at the current rates, terms and conditions does not add increased cost to the program. It is anticipated that approximately 200 members will utilize these services between April 1 and September 30, 2012. The estimated cost is $25,900. Funds are budgeted within Fund 517, Group Health and Life Insurance to fund the program. GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this item. LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney's Office, requires majority vote, and is legally sufficient for Board action. — CMG Packet Page -1088- 3/27/2012 Item 16.E.1. RECOMMENDATION: It is recommended that the Board of Commissioners approves Amendment #3 to the Letter of Agreement with Quest Diagnostics, Inc. and authorizes the Chairman to execute the amendment. PREPARED BY: Jeff Walker, CPCU, ARM, Director Risk Management Packet Page -1089- COLLIER COUNTY Board of County Commissioners Item Number: 16.E.1. 3/27/2012 Item 16.E.1. Item Summary: Recommendation to approve Amendment #3 to #09 -5343 Letter of Agreement with Quest Diagnostics, Inc. to extend the Agreement through September 30, 2012 at the existing rates, terms and conditions. Meeting Date: 3/27/2012 Prepared By Name: WalkerJeff Title: Director - Risk Management,Risk Management 3/6/2012 8:43:05 AM Submitted by Title: Director - Risk Management,Risk Management Name: WalkerJeff 3/6/2012 8:43:06 AM Approved By Name: WardKelsey Title: Manager - Contracts Administration,Purchasing & Ge Date: 3/9/2012 1:12:54 PM Name: MarkiewiczJoanne Title: Manager - Purchasing Acquisition,Purchasing & Gene Date: 3/9/2012 4:15:02 PM Name: WoodLyn Title: Contracts Specialist,Purchasing & General Services Date: 3/13/2012 10:14:53 AM Name: SmithKristen Title: Administrative Secretary,Risk Management Date: 3/14/2012 1:43:40 PM Packet Page -1090- 3/27/2012 Item 16.E.1. Name: GreeneColleen Title: Assistant County Attorney,County Attorney Date: 3/14/2012 2:19:48 PM Name: PriceLen Title: Administrator, Administrative Services Date: 3/14/2012 5:59:21 PM Name: GreeneColleen Title: Assistant County Attomey,County Attorney Date: 3/15/2012 11:20:15 AM Name: KlatzkowJeff Title: County Attorney Date: 3/16/2012 2:13:05 PM Name: FinnEd Title: Senior Budget Analyst, OMB Date: 3/20/2012 9:56:58 AM Name: KlatzkowJeff Title: County Attorney Date: 3/20/2012 11:21:46 AM Name: IsacksonMark Title: Director -Corp Financial and Mgmt Svs,CMO Date: 3/20/2012 12:25:31 PM Packet Page -1091- 3/27/2012 Item 16.E.1. ' : I QUEST DIAGNOSTICS INCORPORATED FORW LETTER OF AGREEMENT FOR BLUEPRINT FOR WELLNESSTM SERVICES QUEST DIAGNOSTICS INCORPORATED, ( "QUEST DIAGNOSTICS ") agrees to provide Blueprint for Wellness'*' Services to: Customer Name Collier County Government (corporate name N/A Subcontract name Customer ContactMtle Karen Eastman, Wellness Programs Mgr, OR Jeff Walker, Risk Management Director Customer Contact Information Collier County Government Street Address 3301 East Tamiami Trail, Bldg. D city Naples State, Zip FL 34112 Phone Number Karen Eastman 239 - 252 -8906 OR Jeff Walker 239 - 252 -6092 Email Address kareneastman@colliergov.net OR JeffWalker@colliergov.net Program Name /Account #(s) `INVEST IN YOUR HEALTH" Number of Participants eligible: _Based on age eligible criteria, and Total # of Participants Eligible and employees > 50 years of age timated % artici ation Ex ected % Partici ation: 80 % quested Date(s) and Location(s) ➢ List of locations for CCG is attached. Event r ➢ Primary location (same address as above, with 1,000 ate(s) to be confirmed by BFW participants would like to begin BFW events on 1/20/09 for 2 ff. weeks, then complete all locations by March 318t List each individual location and # of eligible participants at each). Note than an "Event" is considered a health fair /screening at one location or a fixed, uninterrupted period of time. Event Staffing Commitment *: ➢ Three (3) weeks before each Event * Wellness Specialist will confirm with he customer the number of * *Staffing Commitments finalized less than three (3) weeks require participants, event hours and prior approval and will be assessed additional charges as set forth in schedule event staffing three weeks Section 1 of the Terms of Service, below. prior to each event date. 2009: Health - Plan - eligible employees of CCG total - 2,200 Eligibility Criteria for Participation 2010: Age- based, Health -Plan- eligible employees of CCG 1,200 (e.g., employees only, spouses, etc.) 2011: Age- based, Health -Plan- eligible employees of CCG + eligible, active spouses 2,200 2012: Final events take place Jan - March, 2012 Services Requested Personal Laboratory Report Solution (Program modules & pricing, below 13FW LOA rev. 11/07 Packet Page -1092- 3/27/2012 Item 16.E.1. Laboratory Tests Included: Heart: Total cholesterol, HDL, calculated LDL, triglycerides, calculated cholesterol/HDL ratio (Note: no cardio -CRP as requested) Thyroid: TSH- Thyroid Stimulating Hormone, and Free T4 Kidneys: BUN, creatinine, BUN / creatinine ratio Bone: Calcium Liver: Albumin, total protein, globulin, A/G ratio, Alkaline Phosphatase, ALT, AST, total & direct bilirubin, and GGT Pancreas: Glucose Whole Body: Chloride, potassium, sodium Pancreas: Hemoglobin A1c Blood: CBC Hemogram Lungs: Cotinine blood sample) PSA (Males > or = 40) (Yes or No) NO specify if other than Males > or = 40 HRA (on -line, paper or both) HRA - Both Specimen Collection: On -site Events & Remote PSC Collection Kits (On -site Events, Remote /PS.Cs, other Medical Authority (PWN Physician Quest Diagnostics will provide medical authority via PWN - or Customer - supplied) Physician's Wellness Network. Biometric Measurement Data Height, Weight, BMI, Blood/Pressure, Waist, Hip, Waist/Hip Ratio Requested: Describe Customer requirement) Participation in BFW -PWR is a key "qualifying step" for health -plan- Participant Incentive eligible employees to increase coverage from "Basic" to "Select" or "Premium" without increasing their contribution to the health plan. Incentive Criteria BFW- Personal Wellness Report to include HRA On Line Registration Key CCG eIllness Program Participant ID? CCG Employee ID # - this change occurred 10/2/08 When spouses are added in 2011 they will use the employee ID + S Participant ID: Define unique for Spouse. Participant ID requested as it will appear in the Customer eligibility ile em to ee ID, SSN, Etc. Disclosure of Participant Data in ➢ Do not send PWR data to Meritain (health plan) at this time. ➢ CCG identified data should go to CHP- Community Health Identifiable Format (i.e., disclosure of data other than the aggregate de- Partners weekly. identified statistical report provided to ➢ CCG request that all printed BFW -PLR printed reports be made Customer): available to CHP so the CHP Health Advocates can review lab and HRA results with each participant during their one -on -one Define Customer requested Result counseling sessions. Reporting to participant or other 3`d ➢ All mailed PWRs should ship in bulk to: parties. Attn: Sandy Theobald (e.g., third party disease Community Health Partners management or wellness provider) 851 5t' Ave. North, Suite 201 * Disclosure of identifiable participant Naples, FL 34102 data requires a written directive from ➢ CCG prefers no participant results be available on -line at any he Customer containing specific time. elements, and must be received prior to any release of PHI to anyone other than the participant. 13FW LOA rev. 11/07 2 Packet Page -1093- 3/27/2012 Item 16.E.1. Identified — Aggregate ➢ Exact Reporting TBD — includes program aggregate report and orting: weekly participation reports. ne requirements for De- Identified ➢ CCG would like the standard Aggregate Report following the "egate reporting breakout and events (predicted to last through March 31, 2009, and about 1 ies to receive the reporting. month to allow some ees to visit a Quest Diagnostics PSC. After cluded in the eligibility file? , that time, additional BFW registrations should be new rogram estimated start date(s) employees. ➢ They would like to get weekly Participant participation reports showing those employees that have had BFW collected. CCG will sort by Dept. or Cost Center to determine where they need more communication to encourage participation. ➢ In subsequent years they want cohort reports that demonstrate changes over prior year, stratified by Dept. or Cost Ctr. ibility File of Participants: based. ie contact that will provide the Eligibility File to be Provided By: Aity file and target date for Alice Toppe 239 - 252 -8966 and James(Jim) Young of Collier County ery Government n eligibility file is required where J➢ Only names in the eligibility file are allowed to participate in FW scheduling and /or an HRA Blueprint for Wellness. CCG will send updated eligibility file )mponent is provided. (monthly) for the 39 months of the program. ➢ First eligibility file is due about Nov. 1, 2008. Beginning in 2011 ote: Will participation be allowed if spouses will be included. nployee and /or spouse is not cluded in the eligibility file? , Target Date for Year 2 Eligibility File: TBD rogram estimated start date(s) ➢ Events Jan 1 — Mar 31, 2009, then as needed for new ees throughout the year until Dec.31, 2009 ➢ Events in 2010 will be limited to an age -based group, followed by new employees. ➢ Events in 2011 will be limited to an age -based group and spouses, and will be followed by new employees. ➢ Events in 2012 will include employees, spouses and may be age based. ➢ Client reserves the right to adjust dates and scope of services by year with ample advance notice to BFW. rogram estimated end date(s) Program will end annually on Dec. 31St, and the complete program will end on March 31, 2012 BFW LOA rev. 11/07 3 Packet Page -1094- 3/27/2012 Item 16.E.1. BFW Proaram Module(s) and Pricing Other comments or requirements: Copies of electric invoices (as a convenience only) to: ➢ Keith Wilson: keith.wilsonO- meritain.com ➢ Victoria Krenik: victoda.krenik@medtain.com Term of the Letter of Agreement: Annually — through March 31, 2012 (39 months) (mm -dd -yy — mm- dd -yy) [ ] One Year [ ] One -time Event (check one box) X 39 Months — Jan 1, 2008 — March 31, 2012. Customer Billing Account #(s): Invoices should be sent to CCG (email preferred but not required) for Billing Arrangements: payment: If other than bill to "Customer" please ➢ Alice Toppe: 239 - 252 -8966 or alicetoppe(aD-collieraov.net detail and provide billing contact ➢ Claire Wilson: 239- 252 -6120 or clairewilsonCcD-collieraov.net Alice Toppe OR Claire Wilson Collier County Government 3301 Tamiami Trail, Bldg D Naples, FL 34112 X Monthl :39 months Other: leasespecify request) Quest Sales Representative Ran Van Horn Other Representative if an NO Fee schedule if other than current NO Other Information: I.Eiectronic Invoices Dreferred but not reauired. BLUEPRINT FOR WELLNESS SERVICE PRODUCT NAME PRICE PER EMPLOYEE PROGRAMS OR COMPONENTS (program details andspecial requirements should be noted ➢ Participant Registration and Scheduling, online and by phone All lab tests Included ➢ Physician Oversight provided throughout program ➢ BFW Specialist assigned as key contact throughout program ➢ On -Site Collection Events* ➢ Remote Collection Kits provided to employees unable to attend events ➢ Bio- Metric Measures (Height, Weight, B /P, BMI, Waist & Hip circumference) ➢ Personal Wellness Report for every participant ➢ Health Management Data Feed provided to vendors you select. ➢ Heart: Total chol, HDL, talc LDL, t0glycerides, calc chol /HDL ratio (NO CRP) ➢ Thyroid: TSH- Thyroid Stimulating Hormone, and Free T4 ➢ Kidneys: BUN, creatinine, BUN /creatinine ratio Bone: Calcium ➢ Liver: Alb, total protein, globulin, A/G ratio, Alk Phos, ALT, AST, total & direct bilirubin, and GGT ➢ Pancreas: Glucose ➢ Whole Body: Chloride, K, Na ++ ➢ Pancreas: Hemoglobin A1c ➢ Blood: CBC Hemogram ➢ Lungs: Cotinine blood sample) Waist circumference, Hip circumference, Waist/Hip Ratio $ Included TOTAL Price /Participant $129.50 Note: This price is for 2010 Program. The 3rd and 4t' year (Jan. 2011 & Jan - Mar 2012 may be subject to a price increase up to but not exceeding 4 %. SPECIAL PROGRAMS OR EVENT ARRANGEMENTS ' ' ' ' - • - (program details and special requirements should be noted) • ' BFW LOA rev. 11107 Packet Page -1095- 4 3/27/2012 Item 16.E.1. In the event Collier County Government requests additional services not set forth above, the parties shall mutually agree upon services and pricing. BLUEPRINT FOR WELLNESS CUSTOM PROGRAMS - FULLY DETAIL Send invoices to: Alice Toppe and Claire Wilson at CCG ➢ Alice Toppe: 239 - 252 -8966 or alicetoppe(dcolliergov.net ➢ Claire Wilson: 239 - 252 -6120 or clairewilson(a)-colliergov.net ➢ Addresses listed above Included BFW LOA rev. 11/07 Packet Page -1096- 3/27/2012 Item 16.E.1. Terms of Service: 1. BFW SERVICES: In accordance with the program - specific details listed above, Quest Diagnostics agrees to*""", provide the Blueprint For WellnessTm ( "BFW") Services as further set forth herein. The BFW Services provided by Quest Diagnostics are as follows: a. Registration and Scheduling of participants (if selected by Customer): offered via online access or by calling a toll -free wellness scheduling number. b. Provision of all supplies and test kits necessary to provide BFW Services. c. Collection Services to obtain /collect all specimens from participants at an "Event". Additional charges will apply when: (i) Paramedical examiner is required to collect specimens between the hours of 9:00 PM and 6:00 AM Monday- Saturday and between the hours of 6:00 PM Saturday and 6:00 AM Monday (additional charge of $30 per hour, per examiner applies). (ii) Staffing of the Event is requested less than three (3) weeks prior to the Event (additional $7 per - participant charge). (iii) Staffing is requested in advance for Events with fewer than 20 participants (a "Small Group Event"): • Home or office visit to collect specimens from one participant: $95** per visit • Small Group Events with 10 or fewer participants (based upon a 1 -2 hour event, with one examiner): $140`" • Small Group Events with 11 -19 participants (based upon a 1 -2 hour event, with one or two examiners as determined by Quest Diagnostics)): $240** • **the surcharges specified above are added in addition to BFW per - participant charges for BFW Services. If additional staffing is requested for a Small Group Event, an additional $60 per hour /per examiner charge will be assessed. • Depending on the number of Actual Participants who participate in the Small Group Event, Customer will be assessed either the Small Group surcharges listed above, or the per - participant charges for at least 20 Participants, whichever amount is lower. (iv) Paramedical examiner is required to travel more than fifty (50) miles each way to /from the Event from the ExamOne office where the paramedical examiner is based (additional $.47 /mile over 50 miles to /from Event). If an ovemight stay is required, Customer will be billed actual lodging/food expenses. d. Based upon the specific Program components selected by Customer, includes collection of biometric data, shipment of specimens to the testing laboratory, and testing of laboratory specimens. e. Release of test results to an Authorized Provider and if authorized, directly to participants. Customer will also receive a report detailing aggregate de- identified statistics. Additional or reprinted reports may be provided for an additional charge. 1. THIRD PARTY WELLNESS /DISEASE MANAGEMENT PROVIDER — COMMUNITY HEALTH PARTNERS (CHP) 2. WELL SOURCE — Wellness Provider Customer has directed Quest Diagnostics to release participant test results or other identifiable health information to third party disease management or wellness providers. Customer represents and warrants that (i) it has provided the appropriate notice to participants in its HIPAA Notice of Privacy Practices to allow such a disclosure, (ii) the provision of identifiable participant data is consistent with the Notice (iii) access to identifiable participant data will be limited to only those employees who require access to the data for the proper performance of their duties on behalf of Customer's third party disease management or wellness provider receiving the data on its behalf is acting in its capacity as a "Business Associate" of Customer. 2. PAYMENT TERMS: Customer agrees to pay Quest Diagnostics for services as set forth herein within thirty (30) days of date of invoice, and Customer agrees not to submit (or request Quest Diagnostics to submit) any claim, bill or other request for reimbursement to any insurer, Managed Care Organization, Government health program, fund, or to any other person or entity. Quest Diagnostics reserves the right to add a charge of the lesser of one and one -half percent (1 ' / %) per month, or the maximum rate the law permits, on all amounts e thirty (30) or more days past due. BFW LOA rev. 11/07 6 Packet Page -1097- 3/27/2012 Item 16.E.1. 3. MEDICAL AUTHORITY: Customer acknowledges and agrees that only a person who is authorized under applicable state /federal law to order those clinical laboratory tests included in the Blueprint For WellnessTm product ( "Testing ") shall order all Testing (such person shall be referred to as an "Authorized Provider"). a. In the event Customer provides such Authorized Provider themselves, Customer represents and warrants that the Authorized Provider meets all state/federal laws applicable to the ordering of Testing. Alternately, in the event Customer elects to have Quest Diagnostics arrange for an Authorized Provider, Quest Diagnostics shall represent and warrant that this Authorized Provider meets all state /federal laws applicable to the ordering of Testing. b. Quest Diagnostics shall report laboratory results only to such Authorized Provider, unless such Authorized Provider gives permission for Quest Diagnostics to release the lab results to such employee participants as desired. If Customer is providing such Authorized Provider, the requirement to allow release of results directly to the participant must be included in Customer's contract with such Authorized Provider. c. The Authorized Provider is responsible for contacting participants in the event of alert, critical, and significantly out -of- normal range laboratory results. d. While the Authorized Provider may set his/her own alert values, critical ranges are not modifiable. e. The Authorized Provider may be required to forward test results to the participant's personal physician. 4. NO -SHOW, MINIMUM, AND CANCELLATION CHARGES: At least three (3) weeks prior to an Event, Customer and Quest Diagnostics will finalize a Staffing Commitment ( "Staffing Commitment") which allows Quest Diagnostics to schedule staffing for the Event based upon the number of expected participants and length of the Event. At the point the Staffing Commitment is finalized, Customer will be responsible for paying no -show, minimum, and cancellation charges. a No -Show Charges: No -Show Charges will not apply if at least 90% of the Expected Participants participate in the Event ( "Actual Participation Rate "). The term "Expected Participants" means the number of participants that were expected to participate at the time the Staffing Commitment is finalized (including scheduled participants and expected walk -in participants). For all Events where the Actual Participation Rate is less than 90 %, Customer will be charged a No -Show Charge of $20 per participant until the Actual Participation Rate is equivalent to 90 %. For example: If an Event is held for 100 Expected Participants and there are 80 Actual Participants, Customer will be charged a No -Show Charge of $20 for 10 Participants. [100 Expected Participants x 90% No -Show Threshold] = 90, and [90 minimum required participants — 80 Actual Participants] x $20 = $200 No -Show Penalty. b. Minimum Event Participation and Hourly Participant Flow: Unless a Small Group Event is arranged in advance, Quest Diagnostics will only schedule and staff Events with a minimum of 20 Expected Participants and where at least 10 participants per hour can be processed by a specimen collector. For purposes of this section, "Event" means one wellness screening /health fair held at a single location. For an Event that is expected to have less than 20 Expected Participants, Customer may make arrangements in advance for Quest Diagnostics to staff for a Small Group Event. Small Group Event charges are further described in Section 1 and are assessed to Customer to equip, staff and manage the Small Group Event. C. Cancellation Charges: If an Event is cancelled after the Staffing Commitment has been finalized, Customer shall be responsible for paying $20.00 for each Expected Participant. Postponement of an Event is equivalent to a Cancellation. s. LEGISLATIVE/REGULATORY CHANGE: In the event federal or state legislative and /or regulatory changes impact Quest Diagnostics' clinical reference laboratory business, Quest Diagnostics will retain the right, upon prior written notice to Customer, to immediately amend this agreement to fully comply with any legislative or regulatory changes. All other modifications or amendments to this agreement will not be binding unless reduced to writing and signed by the parties hereto. 6. TERMINATION: This agreement will take effect on the date it is fully executed by both parties and may be renewed on an annual basis upon mutual agreement of the parties for two additional one (1) year periods. Customer will provide Quest Diagnostics with sixty (60) days advanced written notice of its intent to renew. BFW LOA rev. 11107 7 Packet Page -1098- 3/27/2012 Item 16.E.1. INDEMNIFICATION: Not to exceed the maximum extent permitted by Florida law, Quest Diagnostics shall indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attomeys' fees and paralegals' fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of Quest Diagnostics or anyone employed or utilized by the Quest Diagnostics in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. The provisions of this paragraph shall survive termination of this Agreement. This section does not pertain to any incident arising from the sole negligence of Collier County. 8. INSURANCE: Quest Diagnostics shall agree to maintain the following insurance coverage during the course of this agreement. Quest Diagnostics may utilize a program of self insurance for all or any portion of the minimum limits required to be carried. 9. ENTIRE AGREEMENT: This Agreement constitutes the entire understanding between the parties regarding the subject matter hereof and supersedes all prior understandings, arrangements and agreements relating to the subject matter hereof. 10. INDEPENDENT CONTRACTORS: It is expressly understood and agreed by the parties hereto that Quest Diagnostics and Customer will at all times be and act as independent contractors. 11. TRADEMARKS: Neither party shall use the trademark, trade name, or service mark of the other party for any purpose without the prior written consent of the other party, however, Customer authorizes the use of its name and /or logo as a participant in the Blueprint for Wellness program. BFW LOA rev. 11/07 g Packet Page -1099- TYPE LIMITS Check X Workers' Compensation Statutory Limits of Florida Statutes 440 and Federal Government Statutory Limits and Requirements X Employer's Liability X $500,000 $1,000,000 X Commercial General $500,000 per occurrence X $1,000,000 per occurrence bodily injury and Liability (Occurrence Form) bodily injury and property property damage patterned after the current damage ISO form with no limiting endorsements. X Professional Liability X $1,000,000 per occurrence $2,000,000 per occurrence Insurance $1,000,000 aggregate $2,000,000 aggregate Collier County Board of County Commissioners shall be named as the Certificate Holder. NOTE —The "Certificate Holder" should read as follows: Collier County Board of County Commissioners Naples, Florida No County Division, Department, or individual name should appear on the Certificate. No other format will be acceptable, Thirty (30) Days Cancellation Notice required on Agreements exceeding 6 months. The contract name and number shall be included on the certificate of insurance. Collier County must be named as "ADDITIONAL INSURED" on the Insurance Certificate for Commercial General Liability. 9. ENTIRE AGREEMENT: This Agreement constitutes the entire understanding between the parties regarding the subject matter hereof and supersedes all prior understandings, arrangements and agreements relating to the subject matter hereof. 10. INDEPENDENT CONTRACTORS: It is expressly understood and agreed by the parties hereto that Quest Diagnostics and Customer will at all times be and act as independent contractors. 11. TRADEMARKS: Neither party shall use the trademark, trade name, or service mark of the other party for any purpose without the prior written consent of the other party, however, Customer authorizes the use of its name and /or logo as a participant in the Blueprint for Wellness program. BFW LOA rev. 11/07 g Packet Page -1099- 3/27/2012 Item 16.E.1. IN WITNES5 , WHEREOF, Quest Diagnostics Incorporated and Collier County have each, respectively, authoriz 06 bnr% agent, hereunder set their hands and seals on the date and year first written above. vXA AFC ST:,4 f e' BOARD OF COU,ny COMMISSIONERS hFS c Witness igna Urp l' Witness Signature Approv , s to form and legal sufficiency: UC y4s .*istmTt County Attorney Sc. hL d? JrA e. L, Print Name COLLIER COMZ� By: Donna Fiala! Chairman LL By: 1:ymys a! L. is ugw N Typed /Printed Name Here with Title -J e - 14 ea cr 9 i4 N V by an WE LJ-N Er75 SlEfev ir-fi5 BFW LOA rev. 11/07 Packet Page -1100- 9 3/27/2012 Item 16.E.1. ACORD� 1 /05 / 0 CERTIFICATE OF LIABILITY INSURANCE MIDDIYYYY) L� 01 /05/2010 PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION MARSH USA INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ATTN: JANET T. NORMAN HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ' 1166 AVENUE OF THE AMERICAS ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NEW YORK, NY 10036 37986 - MAIN -09 -10 XXx INSURED QUEST DIAGNOSTICS INCORPORATED AND ITS WHOLLY OWNED SUBSIDIARIES 3 GIRALDA FARMS MADISON, NJ 07940 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Quest Diagnostics Incorporated POLICY NUMBER INSURER R Travelers Prop. Casualty Co. Of America 25674 INSURER N/A WA INSURER D: Lexington Insurance Company 19437 INSURER E 12/31/2009 J THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POIrIFS- AGGRFr;ATP I IMITC sunwu RAAV ueve eeeni oeiv ircm MV MAIM rI ARAO INSF LTR ADD' INS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MMODNYYI) POUCY EXPIRATION DATE(MWDDNrM LIMITS A BOARD OF COUNTY COMMISSIONERS GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE El OCCUR "$2,000,000 SELF INSURED 'RETENTION'" 12/31/2009 12/31/2010 EACH OCCURRENCE 2,000,000 PREMISES Ee Eors�Ix ante $ MED EXP (Any Dne person) $ PERSONAL & ADV INJURY $ GENERALAGGREGATE $ GENERAL AGGREGATES LIMIT APPLIES PER POLICY JECT LOC PRODUCTS - COMP/OP AGC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON- OVIMED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per acciderd) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ D EXCESS / UMBRELLA LIABILITY OCCUR a CLAIMS MADE DEDUCTIBLE RETENTION $ 8124555 12/31/2009 12/31/2010 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ $ B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? F N7 Mandatory in NH) Ayes, describe under PECIAL PROVISIONS below TC2JUB- 266T3523- TIL -09 (DED) TRJUB- 266T3535- TIL -09 (RETRO) '12131/2009 12/31/2009 12/31/2010 12/31/2010 X WC STAru- oTH- Lie FR .L EACH ACCIDENT $ 2,000,000 .L DISEASE - EA EMPLOYEE $ 2,000,000 .L DISEASE- POLICY LIMIT $ 2,000,000 A OTHER PROFESSIONAL LIAB. CLAIMS MADE SELF - INSURED RETENTION 12/31/2009 12/31/2010 $5,000,000 (SIR) DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS RE: BLUEPRINT FOR WELLNESS SERVICES - CONTRACT #00000105 COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS IS INCLUDED AS AN ADDITIONAL INSURED. CERTIFICATE HOLDER reMr_P1 I ATInN ©1998 -2009 ACORD CORPORATION. All Rights Reserved The A( Packet Page -1101- gistered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE COLLIER COUNTY BOARD OF COUNTY EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL COMMISSIONERS 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 3301 TAMIAMI TRAIL EAST BOARD OF COUNTY COMMISSIONERS BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND NAPLES, FL 34112 UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AoLIf T M,%:h U SA P IRnES ENTATIVE . Mada Nicholson ©1998 -2009 ACORD CORPORATION. All Rights Reserved The A( Packet Page -1101- gistered marks of ACORD 3/27/2012 Item 16.E.1. IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. Acord 25 (2009/01) Packet Page -1102- 3/27/2012 Item 16.E.1. - CERTIFICATE NUMBER NYC- 002602631 -09 PRODUCER MARSH USA, INC. AM: JANET T. NORMAN 1166 AVENUE OF THE AMERICAS, 8TH FL. P) 212/345 -5029 F) 212/345 -7616 $ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN. COMPANIES AFFORDING COVERAGE NEW YORK, NY 10036 37986 - MAIN -08 -09 XXX $ COMPANY A Quest Diagnostics Incorporated INSURED QUEST DIAGNOSTICS INCORPORATED AND ITS WHOLLY OWNED SUBSIDIARIES 3 GIRALDA FARMS MADISON, NJ 07940 COMPANY B Travelers Property Casualty Company Of America COMPANY C WA B COMPANY TOMOBILE LIABILITY ANY AUTO TC2JCAP- 266T3603- TIL -08 D Lexington Insurance Company THIS IS TO CERTIFY THAT POUCIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWATHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT NTH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDI YY) POLICY EXPIRATION DATE (MWDDIYY) UNITS A GENERALUABIUnY X COMMERCIAL GENERAL LIABILITY !1::] CLAIMS MADE F� OCCUR "$2,000,000 SELF INSURED 'RETENTION' 12/31/08 12/31/09 GENERAL AGGREGATE $ ' PRODUCTS - COMP/OP AGG $ PERSONAL & AOV INJURY $ $ OWNER'S 8 CONTRACTORS PROT $ EACH OCCURRENCE $ 2,000,000 D SHOULD ANY OF THE POLICIES DESCRIBED HERON BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE 911ILL ENDEAVOR TO MAIL A DAYS WRITTEN NOTICE TO THE QUEST DIAGNOSTICS INCORPORATED CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR RISK MANAGEMENT DEPT., 3 GIRALDA FARMS UABIUTY OF ANY HIND UPON THE INSURER AFFORDING COVERAGE. ITS AGENTS OR REPRESENTATIVES, OR THE MADISON, NJ 07940 ISSUER OF THIS CERTIFICATE." AUTHORIZED REPRESENTATIVE of Marsh USA Inc. —�- BY: Marla Nicholson v qc �.r Y; a` r, VALID AS OF:12/22/08 I. -_ ffi= Packet Page -1103 - FIRE DAMAGE (Any one fire) $ MED EXP one $ B JAU X TOMOBILE LIABILITY ANY AUTO TC2JCAP- 266T3603- TIL -08 12/31/08 12/31 /09 COMBINED SINGLE LIMIT $ 3,000,000 ALL OVIMEDAUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON-OWNED AUTOS BODILY INJURY (Per aocldent) $ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ AGGREGATE $ D EXCESS LIABILITY 2227126 12/31/08 12131/09 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ RUMBRELLA FORM X OTHER THAN UMBRELLA FORM Is B B WORKERS COMPENSATION AND EMPLOYERS'LIASIUTY TC2JUB- 266T3523 -08 (DED) TRJUB- 266T3535 -08 (RETRO) 12/31/08 12131/08 12/31/09 12/31/09 X TORY LIMITS ER EL EACH ACCIDENT $ 2,000,000 THE PROPRIETOR/ PARTNERSIEXECUiIVE INCL EL DISEASE - POLICY LIMIT $ 2,000,000 EL DISEASE -EACH EMPLOYEE $ 2,000,000 OFFICERS ARE: EXCL A OTKffk- PROFESSIONAL LIAB. SELF - INSURED RETENTION 12/31/08 12/31/09 i $5,000,000 (SIR) CLAIMS MADE D SHOULD ANY OF THE POLICIES DESCRIBED HERON BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE 911ILL ENDEAVOR TO MAIL A DAYS WRITTEN NOTICE TO THE QUEST DIAGNOSTICS INCORPORATED CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR RISK MANAGEMENT DEPT., 3 GIRALDA FARMS UABIUTY OF ANY HIND UPON THE INSURER AFFORDING COVERAGE. ITS AGENTS OR REPRESENTATIVES, OR THE MADISON, NJ 07940 ISSUER OF THIS CERTIFICATE." AUTHORIZED REPRESENTATIVE of Marsh USA Inc. —�- BY: Marla Nicholson v qc �.r Y; a` r, VALID AS OF:12/22/08 I. -_ ffi= Packet Page -1103 - 3/27/2012 Item 16.E.1. A De CERTIFICATE OF LIABILITY INSURANCE orz1/2009 ' PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION MARSH USA INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ATTN: JANET T. NORMAN HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1166 AVENUE OF THE AMERICAS ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NEW YORK NY 10036 A 37986 - MAIN -08 -09 xxx INSURERS AFFORDING COVERAGE NAIC # INSURED QUEST DIAGNOSTICS INCORPORATED AND INSURER,: Quest Diagnostics Incorporated 2,000,000 INSURER B: N/A NIA ITS WHOLLY OWNED SUBSIDIARIES 3 GIRALDA FARMS MADISON, NJ 07940 INSURER c N/A N/A INSURER D, Lexington Insurance Company 19437 MED EXP (Any one person) _ $ INSURER E $ COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NS LTR ADD' INS TYPE OF INSURANCE POLICY NUMBER POL16M EFFEcnVE DATE (MMIDDIWM POLICY EIIPIRA17ON DATE (IAMMOIn- Y) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY "$2,000,000 SELF INSURED 'RETENTION "' 12/31/2008 1213112009 EACH 2,000,000 PREMISES Ea oxunence $ CLAIMS MADE F-1 OCCUR MED EXP (Any one person) _ $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENERAL AGGREGATE LIMITAPPLIES PER POLICY PRO- JECT LOC PRODUCTS- COMP/OPA AUTOMOBILE UABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accidenq $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) BODILY INJURY $ HIREDAUTOS NON -OWNED AUTOS (Per accident) PROPERTY (Per acct �) DA $ GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ $ AUTO ONLY: AGG D EXCESS i UMBRELLA LIABILITY 2227126 12/31/2008 12/31/2009 EACH OCCURRENCE $ 5,000,000 OCCUR rx-1 CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE RETENTION E WORKERS COMPENSATION AND WC STATU- OTH- FR EMPLOYERS' LIABILITY .L EACH ACCIDENT ANY PROPRIETORIPARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? L DISEASE - EA EMPLOY $ Mandatory in N If yes, descnbe under PECIAL PROVI IONS below .L DISEASE •POLICY OMIT $ OTHER DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS RE: BLUEPRINT FOR WELLNESS SERVICES - CONTRACT#00000105 COLLIER COUNTY IS INCLUDED AS AN ADDITIONAL INSURED. CERTIFICATE HOLDER NYC - 003942183 -01 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE COLLIER COUNTY EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3301 TAMIAMI TRAIL EAST 30 DAYS WRiTrEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BOARD OF COUNTY COMMISSIONERS NAPLES, FL 34112 BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. Mada Nicholson ACORD 25 (2009101) ©1998 -2009 ACORD CORPORATION. All Rights Reserved The Al Packet Page -1104- .g(stered marks of ACORD 3/27/2012 Item 16.E.1. IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. Packet Page -1105- 3/27/2012 Item 16.E.1. AMEMDMENT NO. 3 TO THE LETTER OF AGREEMENT FOR BLUEPRINT FOR WELLNESS SERVICES BETWEEN COLLIER COUNTY GOVERNMENT AND QUEST DIAGNOSTICS INCORPORATED This AMENDMENT NO. 3 to the Letter of Agreement for Blueprint for Wellness Services ( "Amendment No.2 "), effective as of the 27`h day of March 2012 ( "Effective Date ") is entered into by and between Quest Diagnostics Incorporated ( "Quest Diagnostics ") and Collier County Government ( "Client ") and amends the existing Letter of Agreement for Blueprint for Wellness Services. L1117h 14*1113i11; WHEREAS, Quest Diagnostics and Client entered into a certain Letter of Agreement for Blueprint for Wellness Services on the 12`h day of July, 2010, as amended by a First Amendment effective on the 21" day of March, 2011 (collectively the "Agreement ") and by a Second Amendment effective on the 15` day of March, 2012, all of which incorporated herein by reference; and WHEREAS, Quest Diagnostics and Client wish to extend the term of the Agreement. NOW, THEREFORE, in consideration of the mutual promises hereinafter set forth, the receipt and sufficiency of which are hereby acknowledged, the parties hereby agree as follows: 1. The term of the Agreement shall be extended until September 30, 2012 or until the new contract is awarded, whichever comes sooner. All other terms of the Agreement, including the Attachment(s) thereto, not specifically modified by this Amendment No. 3 remain in full force and effect. QUET DIAGNOSTICS INCORPORATED By: Print Name: Steven L. Burton Title: VP- Health and Wellness Services Date: Collier County Government (Client) By: Print Name: Fred W. Coyle Title: Chairman Date: ATTEST: Dwight E. Brock, Clerk of Court By: -__- Dated: (SEAL) Approved as to form and legal sufficie r ,, Scott Teach, Deputy County Attorney Packet Page -1106-