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#17-7209 (Amendment #1 Community Health Partners) 3/8/22, 11:40 AM Detail by Entity Name DIVISION OF CORPORATIONS JlYi:i10/1 Jf 11-Ikt• 0011PJtATIOr mr(whin,!Suite of Fluridu website Department of State / Division of Corporations / Search Records / Search t y Entity Name / Detail by Entity Name Florida Not For Profit Corporation NAPLES PHYSICIAN HOSPITAL ORGANIZATION, INC. Filing Information Document Number N93000005824 FEI/EIN Number 65-0531134 Date Filed 12/30/1993 State FL Status ACTIVE Last Event CANCEL ADM DISS/REV Event Date Filed 10/31/2008 Event Effective Date NONE Principal Address 851 FIFTH AVE. N STE.201 NAPLES, FL 34102 Changed: 03/19/2004 Mailing Address 851 FIFTH AVE. N STE.201 NAPLES, FL 34102 Changed: 04/12/2012 Registered Agent Name&Address COMMUNITY HEALTH PARTNERS 851 FIFTH AVE N 201 NAPLES, FL 34102 Name Changed: 04/12/2012 Address Changed: 04/12/2012 Officer/Director Detail Name&Address Title D https://search.sunbiz.org/I nqu iry/CorporationSearch/SearchResultDetail?inqu irytype=EntityName&directionType=Initial&searchNameOrder=NAPLESP... 1/4 3/8/22, 11:40 AM Detail by Entity Name Talano, James MD 851 Fifth Ave North STE 201 NAPLES, FL 34102 Title D Lewis, John MD 851 FIFTH AVE. N STE.201 NAPLES, FL 34102 Title D Kamerman, Max MD 851 FIFTH AVE. N STE.201 NAPLES, FL 34102 Title D WOLFF, BRIAN MD 851 FIFTH AVE. N STE.201 NAPLES, FL 34102 Title Director Perez-Trepichio,Alejandro MD 851 FIFTH AVE. N STE.201 NAPLES, FL 34102 Title Director Mascotti, Kristin MD 851 FIFTH AVE. N STE.201 NAPLES, FL 34102 Title Director Dimond, Margaret 851 FIFTH AVE. N STE.201 NAPLES, FL 34102 Title Director Murphey, Bryan MD 851 FIFTH AVE. N STE.201 hops://search.sunbiz.org/Inquiry/CorporationSearch/Search ResultDetail?inqu irytype=EntityName&directionType=1 nitial&searchNameOrder=NAPLESP... 2/4 3/8/22, 11:40 AM Detail by Entity Name NAPLES, FL 34102 Title Director Leach, Gregory MD 851 FIFTH AVE. N STE.201 NAPLES, FL 34102 Title COO Jardone, Susan Kathleen 851 FIFTH AVE. N STE.201 NAPLES, FL 34102 Title D Scanlon,James, MD 851 Fifth Ave North Suite 201 Naples, FL 34102 Title D Najm Masoud, Sobia, MD 851 Fifth Ave North Suite 201 Naples, FL 34102 Title D Wyles, Rick 851 Fifth Ave North Suite 201 Naples, FL 34102 Annual Reports Report Year Filed Date 2020 06/09/2020 2021 02/04/2021 2022 03/07/2022 Document Images 03/07/2022--ANNUAL REPORT View image in PDF format 02/04/2021--ANNUAL REPORT View image in PDF format 06/09/2020--ANNUAL REPORT View image in PDF format 04/11/2019--ANNUAL REPORT View image in PDF format 03/08/2018--ANNUAL REPORT View image in PDF format 03/28/2017--ANNUAL REPORT View image in PDF format 02/05/2016--ANNUAL REPORT View image in PDF format 11/24/2015--AMENDED ANNUAL REPORT View image in PDF format 04/23/2015--ANNUAL REPORT View image in PDF format https://search.sunbiz.org/I nquiry/CorporationSearch/SearchResultDetail?inqu irytype=EntityName&directionType=Initial&searchNameOrder=NAPLESP... 3/4 3/8/22, 11:40 AM Detail by Entity Name 02/27/2014--AMENDED ANNUAL REPORT View image in PDF format 01/10/2014--ANNUAL REPORT View image in PDF format 01/25/2013--ANNUAL REPORT View image in PDF format 04/12/2012--ANNUAL REPORT View image in PDF format 01/06/2011--ANNUAL REPORT View image in PDF format 02/17/2010--ANNUAL REPORT View image in PDF format 04/28/2009--ANNUAL REPORT View image in PDF format 10/31/2008--REINSTATEMENT View image in PDF format 04/23/2007--ANNUAL REPORT View image in PDF format 03/13/2006--ANNUAL REPORT View image in PDF format 02/03/2005--ANNUAL REPORT View image in PDF format 03/19/2004--ANNUAL REPORT View image in PDF format 04/17/2003--ANNUAL REPORT View image in PDF format 03/13/2002--ANNUAL REPORT View image in PDF format 03/01/2001--ANNUAL REPORT View image in PDF format 03/27/2000--ANNUAL REPORT View image in PDF format 03/29/1999--ANNUAL REPORT View image in PDF format 02/06/1996--ANNUAL REPORT View image in PDF format 03/10/1997--ANNUAL REPORT View image in PDF format 04/22/1996--ANNUAL REPORT View image in PDF format 06/23/1995--ANNUAL REPORT View image in PDF format Fio=:da Depa-meat cf state,DIC C Cn of Corpo2fion5 https://search.sunbiz.org/I nquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrder=NAPLESP... 4/4 FIRST AMENDMENT TO AGREEMENT #17-7209 FOR MANAGED CARE & PREFERRED PROVIDER PAYOR NETWORK AGREEMENT THIS FIRST AMENDMENT, made and entered into on this \ day of Se p kcr,b e v 2022, by and between Naples Physician Hospital Organization, Inc. d/b/a Community Health Partners (the "CHP" or "Contractor") and Collier County, a political subdivision of the State of Florida, (the "County" or"Owner") (collectively, the "Parties"): WHEREAS, on September 26, 2017 (Agenda Item No. 16.E.20), the County entered into an Agreement No. #17-7209-NS "Managed Care & Preferred Provider Payor Network Agreement" (the "Agreement") with Contractor to provide the professional administration of the Collier County Group Health Plan; and WHEREAS,the Agreement is set to expire on December 31, 2022; and WHEREAS, the Parties desire to extend the Agreement for a period of three years commending on January 1, 2023 to December 31, 2025 with two additional one-year renewal terms and to add Schedule 4.7, Programs Fees setting forth the fees for services provided by CHP effective January 1, 2023. NOW, THEREFORE, in consideration of the mutual promises and covenants herein contained, it is agreed by the Parties as follows: 1. Upon execution of this First Amendment, the Agreement shall be extended from a period commencing January 1, 2023 through December 31, 2025 and may be renewed for two (2) additional one (1) year periods at the rates set forth on Schedule 4.7. unless either party gives the other notice of its intention not to renew at least ninety (90) days prior to the annual anniversary of the Effective Date. 2. The County shall pay CHP as listed on Schedule 4.7, attached hereto this First Amendment, as compensation for Managed Care Service programs CHP provides. 3. Unless modified through this First Amendment, all other terms and conditions of the agreement shall remain in full force and effect. [Signature page to follow] ****** Remainder of page intentionally left blank ****** Page 1 of 3 First Amendment to Agreement# 17-7209-NS �Q IN WITNESS WHEREOF,the Parties have executed this First Amendment on the date and year first written above by an authorized person or agent. ATTEST: Crystal <$Unzel, Clerk of the Circuit BOARD OF CO • TY COMMISSIONERS Court a4;Comptroller COLLIER COU 4 V, FLO' • 0_1.,By: By: , C— -� . . ' ,_,, ,iS ' WIL 'AM L. MCDANIEL JR.,Chairman ': ��:�•.< I rJ' g (SEAL) sira r£• .4n F. Witnesses: Naples Physician Hospital Organization, Inc. d/b/a Community Health Partners ittC,__ O BY: �St' —AC'�_cAG7U.--e, First Witness Sig attire L'sc` 0 ,, lt`Ir Act4.5� jac 6 on e - On;��4,,,,,,,TType/print witness name TType/Jrint signature and titleT Or Cyr Second Witness Z Z RDC( ( ] •' n Date (� TType/print witness ameT App rrm nd Le lity: c Iq County Attorney 0149t ih 11014140 Print Name 1 01A1\ ' \\/01?- Page 2 of 3 �1\� First Amendment to Agreement# I7 7209 NS ,0 • �,l SCHEDULE 4.7 PROGRAM FEES Effective January 1,2023 Board of County Commissioners Collier County, Florida shall pay Community Health Partners monthly the fee listed below for the Managed Care Service programs — Utilization Review Management with Large Case Management, Maternity Case Management and Disease Management. The fee shall be received by Community Health Partners by the 20th of each month. Fee to be disbursed to: Community Health Partners 851 Fifth Avenue N#201 Naples, FL 34102 Utilization Management/Case Management Fees: CHP Utilization Review Management program with Large Case Management/Care Coordination including Maternity Management 01/01/2023 — 12/31/2023 $2.84 per employee per month 01/01/2024— 12/31/2024 $2.93 per employee per month 01/01/2025— 12/31/2025 $3.02 per employee per month OPTIONAL: Two Additional 1-year terms: 01/01/2026— 12/31/2026 $3.11 per employee per month 01/01/2027— 12/31/2027 $3.20 per employee per month CHP Provider Network Access Fees: 01/01/2023— 12/31/2027 $1.50 per employee per month Two Additional 1-year renewal terms $1.50 per employee per month Page 3 of 3 First Amendment to Agreement# 17-7209-NS 0 G`r