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Agenda 02/10/2026 Iterm #16E 3 (Awarding Request for Proposal No.25-8397 to QuadMed LLC)2/10/2026 Item # 16.E.3 ID# 2026-44 Executive Summary Recommendation to approve the award of Request for Proposal No. 25-8397, Comprehensive Clinic and Wellness Services, to QuadMed, LLC, operating via its Florida registered entity Medical Care Innovation P. Corp. ("QuadMed"), at an estimated annual cost of $1,790,000. OBJECTIVE: To provide medical services to employees and dependents covered under the Collier County Group Health Plan for the purpose of promoting health, wellness, occupational health, safety, and productivity. CONSIDERATIONS: The County offers a partially self-funded Group Health Insurance Program for its employees, participating constitutional officer employees, and their eligible dependents. In 2006, the Board approved the creation of an on-site medical clinic to provide convenient, no-cost access to medical care for covered employees and dependents. Since that time, clinic services have expanded beyond acute care to include chronic condition management such as pre- diabetes and diabetes, cardiac health, and weight management, supporting improved health outcomes, early intervention, and ongoing care coordination. Up until this time, the County contracted with a separate vendor to provide biometric testing services to support members’ qualifying laboratory draws. To streamline this process, biometric testing services are being included under the proposed attached contract, further enhancing access to preventive services and reducing barriers to care. The current medical clinic agreement with Millennium Physician Group, LLC is scheduled to expire on June 30, 2026. In anticipation of the contract’s expiration, staff prepared Request for Proposal (“RFP”) No. 25-8397, Comprehensive Clinic and Wellness Services, which was posted by the Procurement Services Division on June 18, 2025. The County held a non-mandatory pre-proposal meeting on July 2, 2025. On July 11, 2025, staff extended the submittal deadline by two weeks to August 1, 2025, to promote further competition. A total of 1,178 bid packages were viewed by interested vendors, and the County received five proposals by the deadline. Of these, four were deemed responsive and responsible with minor irregularities. Pinnacle Health Specialists, Inc. was determined to be non-responsive and non- responsible for failing to meet the solicitation requirements. A selection committee met on September 18, 2025, and following its review and evaluation, shortlisted the top three ranked firms to advance to Oral Presentations: 1. Advance Medical of Naples, LLC 2. Medical Risk Solutions, LLC d/b/a My Health Onsite 3. QuadMed, LLC The selection committee reconvened on October 15, 2025, for Oral Presentations and final scoring. The final rankings resulted in a two-way tie for first place between Advance Medical of Naples, LLC and QuadMed, LLC. The County utilized the tie-breaker provision outlined in the solicitation, resulting in the following final rankings: 1. QuadMed, LLC 2. Advance Medical of Naples, LLC 3. Medical Risk Solutions, LLC dba My Health Onsite Staff recommends award of the attached agreement to QuadMed (operating through its Florida registered entity Medical Care Innovation, P. Corp., which has an initial contract term of five years, with five optional one-year renewal terms. In order to support the continued demand for these medical services by County employees and their dependents, including expanding the service to include dependents aged two and older, the clinic facility will be moving to a location approximately five miles from the Main County Campus. This location is intended to maintain reasonable accessibility for members while supporting expanded service delivery. While the vendor has identified its anticipated service location, the specific location will be finalized and communicated subject to the Board’s approval as provided in the agreement. To ensure continuity of care, uninterrupted access to medical services, and a smooth transition for members, an overlap of contracts between Millennium Physician Group, LLC and QuadMed, LLC is anticipated from March 2026 through June 2026. This overlap is intended to minimize disruption to ongoing treatment plans, chronic condition management, Page 2719 of 3707 2/10/2026 Item # 16.E.3 ID# 2026-44 and preventive services. As a result of maintaining services by two providers during this time period, a budget amendment to account 5017-121640-634999 (Other Contractual Services) may be required later in the fiscal year and, if necessary, will be presented to the Board for consideration. This item is consistent with the Collier County strategic plan objective to safeguard taxpayer money by promoting fiscal stewardship and sound budget oversight. FISCAL IMPACT: The total estimated cost to provide services as outlined in the RFP is approximately $1,790,000 per year based upon an estimated monthly enrollment of 2,323 employees. Sufficient funds have been budgeted in Fund 5017, Group Health and Life, for this purpose. GROWTH MANAGEMENT IMPACT: There is no growth management impact associated with this item. LEGAL CONSIDERATIONS: This item is approved as to form and legality and requires majority vote for Board approval. —SRT RECOMMENDATION(S): That the Board approve the award of Request for Proposal No. 25-8397, Comprehensive Clinic and Wellness Services to QuadMed, LLC, operating via its related Florida registered entity Medical Care Innovation P. Corp. and authorize the Chairman to sign the attached Agreement. PREPARED BY: Sonja Sweet, Manager - Risk, Human Resources ATTACHMENTS: 1. 25-8397 Solicitation 2. QuadMed Proposal 3. 25-8397 Final Ranking 4. 25-8397 Notice of Recommended Award 5. 25-8397 Med Clinic Agreement 02.02.26 Final VS 6. 25-9397 QuadMed COI expires 2.26.26 (GLWCELPLCL) (1) Page 2720 of 3707 Procurement Services Division COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS REQUEST FOR PROPOSAL (RFP) FOR COMPREHENSIVE CLINIC AND WELLNESS SERVICES SOLICITATION NO.: 25-8397 JAKE BOND, ASSISTANT DIVISION DIRECTOR PROCUREMENT SERVICES DIVISION 3295 TAMIAMI TRAIL EAST, BLDG C-2 NAPLES, FLORIDA 34112 TELEPHONE: (239) 252- 8987 Jake.Bond@colliercountyfl.gov (Email) Any alterations to this document made by the Vendor may be grounds for rejection of the proposal, cancellation of any subsequent award, or any other legal remedies available to the Collier County Government. Page 2721 of 3707 2 SOLICITATION PUBLIC NOTICE REQUEST FOR PROPOSAL (RFP) NUMBER: 25-8397 PROJECT TITLE: Comprehensive Clinic and Wellness Services PRE-PROPOSAL CONFERENCE: July 2, 2025, at 10:00 AM EST LOCATION: 3295 Tamiami Trail East, Bldg. C2, Conference Room A, Naples, Florida 34112 DUE DATE: July 18, 2025, at 3:00 PM EST PLACE OF RFP OPENING: PROCUREMENT SERVICES DIVISION 3295 TAMIAMI TRAIL EAST, BLDG C-2 NAPLES, FL 34112 All proposals shall be submitted online via the Collier County Procurement Services Division Online Bidding System: https://procurement.opengov.com/portal/collier-county-fl. BACKGROUND As requested by the Human Resources Division (hereinafter, the “Division or Department”), the Collier County Board of County Commissioners Procurement Services Division (hereinafter, “County”) has issued this Request for Proposal (hereinafter, “RFP”) with the intent of obtaining proposals from interested, capable, and qualified vendors to provide health center/medical clinic and wellness services to employees and dependents of the County’s health plan and to provide biometric measurement and laboratory testing services in support of the wellness-based incentive program for covered employees and their spouses, in accordance with the terms, conditions, and specifications stated or attached. The vendor, at a minimum, must achieve the requirements of the Specifications or Scope of Services stated. Historically, the County has spent approximately $850,000 annually to provide on-site clinic services to County staff and their covered dependents and has spent approximately $254,250 annually on biometric and laboratory testing services; however, this may not be indicative of future expenditures for these services. GENERAL INFORMATION Collier County, Florida, is located on southwest Florida’s Paradise Coast. The County includes the communities of Naples, Marco Island, Everglades City, and Immokalee, and is one of the largest counties east of the Mississippi River, encompassing more than 2,000 square miles. The Collier County Board of County Commissioners, comprised of five members elected in the five different districts of the County, serves as the governing body for one of six constitutional officer agencies. The other agencies include the Clerk of the Circuit Court & Comptroller, Collier County Sheriff’s Office, Property Appraiser, Supervisor of Elections, and Tax Collector. Collectively, these agencies represent Collier County Government (CCG). Of the six agencies noted above, three dedicated staff members under the Collier County Board of County Commissioners are responsible for benefit plan administration for five of the six organizations; the only agency not covered under the plan is the Collier County Sheriff’s Office. The majority of CCG employees are enrolled in the health plan, with approximately 2,400 enrolled employees/4,800 covered members. Approximately 19% of employees live in surrounding counties and travel to Collier County for work. CCG currently administers two health clinics: one at the main Collier County Government complex, located at 3299 Tamiami Trail E, Naples, FL, and one in North Naples. The North Naples location, located at 1735 SW Health Pkwy, Suite 201, Naples, FL 34109, is owned by the current vendor. In 2024, the main health clinic had 2,400 patient contacts, and the north Naples health clinic had 2,000 patient contacts. As part of its group health insurance program, CCG offers a wellness-based incentive program to its covered employees and their spouses. The program encompasses various participation incentives through which participants may qualify for the Basic cost-share level, the Select cost-share level, or the Premium cost-share level Health Plan. One of the primary qualifiers is the completion of a laboratory profile blood test, including biometric measurements (weight, height, waist circumference, calculated BMI, and blood pressure). This test is incorporated into a Personal Summary Report to measure the individual health risks of the participant. In order to continue to qualify for the Select and Premium cost-share levels, the participant must complete this screening and meet with a Health Advocate to review the report. Health Advocacy services are provided on-site by Community Health Partners (CHP). Approximately 2,500 employees qualify in even years, and approximately 1,200 spouses qualify in odd years. Page 2722 of 3707 3 CCG is seeking a vendor to operate a health clinic from a centralized off-site location within 15 miles of the Collier County Government Complex at 3299 Tamiami Trail E, Naples, FL. The proposed site must accommodate all current patient visits and biometric testing needs. Vendors may propose an additional location within the 15-mile radius; however, preference will be given to a single location. The selected vendor will be expected to collaborate closely with CHP, the County’s Wellness and Benefits staff, and its third-party administrator, Allegiance, Inc., to ensure effective service delivery. For the purposes of this RFP, "patient contacts" refer to any documented interaction between a patient and a healthcare provider involving the provision of care, support, or health-related services. This includes in-person visits, telehealth appointments, care coordination, and applicable administrative activities. Enrollment and participation numbers have been included in Exhibit C: Pricing Sheet. These numbers are not expected to vary by more than two to three percent (2-3%) annually from the estimates shown. Participation in the County’s health program has consistently been at least 90% since implementation, and this is not expected to change. TERM OF CONTRACT The contract term is intended to be for an initial five (5) year period with options of five (5) additional one (1) year renewal periods. The County reserves the right to renegotiate fees/rates at each renewal period. Prices shall remain firm for the initial term of this contract. The County Manager, or designee, may, at her discretion, extend the Agreement under all of the terms and conditions contained in this Agreement for up to one hundred eighty (180) days. The County Manager, or designee, shall give the Vendor written notice of the County's intention to extend the Agreement term not less than ten (10) days prior to the end of the Agreement term then in effect. All goods are FOB destination and must be suitably packed and prepared to secure the lowest transportation rates and to comply with all carrier regulations. Risk of loss of any goods sold hereunder shall transfer to the COUNTY at the time and place of delivery; provided that risk of loss prior to actual receipt of the goods by the COUNTY nonetheless remains with VENDOR. DETAILED SCOPE OF WORK 1. General Clinic Operations & Management The vendor is required to provide ongoing support to on-site professional staff during core operating hours, Monday to Friday, 7:00 am – 5:30 pm. Vendors will have the option to provide pricing for expanded operating hours, Monday to Friday, 7:00 am – 7:00 pm, and Saturday, 8:00 am – 12:00 pm. The Vendor will provide the following services, including but not limited to: 1.1. Maintain patient health records in compliance with State and Federal laws, including HIPAA. 1.2. Provide an electronic medical records (EMR) system for recording screenings, primary care visits, and other services. 1.3. Submit electronic billing for services to the County’s Group Health Third-Party Administrator (TPA) for recordkeeping and processing. 1.4. Ensure all clinic data, including lab and measurement results, are exported nightly to CHP in .csv or Excel format and retained in the EMR. 1.5. Maintain and replace medical equipment, IT workstations, printers, copiers, fax machines, and software applications required for clinic operations. 1.6. Conduct regular on-site visits and oversight by vendor senior management to ensure program success and client satisfaction. 1.7. Maintain open communication with CCG’s Human Resources and Wellness staff regarding workplace injury trends and service utilization. 1.8. Conduct regular meetings with CCG representatives to review operations, address service concerns, and discuss program improvements. 1.9. Ensure a smooth workflow to minimize wait times in both the waiting room and patient rooms, promoting efficiency and productivity. 1.10. Maintain a balanced schedule that keeps medical staff actively engaged while allowing flexibility for same-day sick or urgent visits. Page 2723 of 3707 4 2. Primary & Acute Care Services The vendor is required to provide the primary and acute care services, including but not limited to the following: 2.1. Offer primary care services to employees, eligible spouses, and covered dependents (16+ years old). 2.2. Conduct, coordinate, and administer basic health screenings for early detection and disease prevention. 2.3. Treat non-occupational injuries, illnesses, and episodic health conditions. 2.4. Provide urgent care for minor illnesses and injuries, including limited pharmacy services. 2.5. Administer vaccinations (flu, pneumonia, shingles, etc.) at the clinic or designated County locations. 2.6. Provide an option for telehealth services during standard operating hours. 2.7. Support coordination with CHP Health Advocates, CCG Wellness Staff, and Benefits Staff. 2.8. Incorporate limited on-site pharmacy services with an appropriate inventory of medications to address both acute episodic illnesses and chronic health conditions. This shall include maintaining and administering vaccination medications as needed. All pharmacy-related costs, including those for vaccination medications, shall be billed to the County strictly as pass-through expenses, with no added administrative fees, surcharges, or markups. 2.9. File claims for lab work and other services with CCG’s medical plan administrator so data from the clinic is incorporated into CCG’s data warehouse that is supported by Cedar Gate. 3. Health & Wellness Programs The vendor is required to provide the health and wellness programs services, including but not limited to the following: 3.1. Administer, in part or in whole as needed, the County’s: 3.1.1. Nicotine cessation program 3.1.2. Diabetes management program 3.1.3. Medically managed weight loss program 3.2. Provide counseling on health-related issues and chronic disease management. 3.3. Execute the annual biometrics testing program, including lab panels, manual blood pressure checks, and body measurements. 3.4. Conduct health education initiatives, including: 3.4.1. Preventative screenings, immunizations 3.4.2. Tobacco, alcohol, and drug education/cessation 3.4.3. Family and parenting resources 3.4.4. Workplace wellness initiatives (injury prevention, movement therapy, etc.) 3.4.5. Participate in the annual employee health fair. 3.5. Develop collaborative care plans for high-risk patients in conjunction with the Wellness, CHP, and Benefits staff. 4. Laboratory & Diagnostic Services The vendor is required to provide the laboratory and diagnostic services, including but not limited to the following: 4.1. Perform phlebotomy and biometric screenings at clinic sites and other County locations. 4.2. Provide walk-in blood pressure checks and monitoring clinics. 4.3. Offer on-site laboratory services, including: 4.3.1. Basic diagnostic testing (strep screens, pregnancy tests, monospot urine dipstick, drug screening, A1C, lipid panels, etc.) 4.3.2. Transport services for lab tests not performed on-site. 4.4. Provide X-ray capabilities on-site, off-site, or refer out to network providers. 5. Medical Oversight & Staffing 5.1. The vendor must provide adequate staffing to support all current patient interactions, biometric testing, and to fully meet the requirements outlined in the Scope of Services. The proposed staff must be available to deliver services Monday through Friday from 7:00 AM to 5:30 PM. 5.2. Below are the required medical staff positions. Additionally, the vendor is responsible for providing medical oversight and staffing for all services delivered, including but not limited to the positions listed below: 5.2.1. Physician Medical Director - to oversee clinic operations and personnel. 5.2.2. PA-C/APRN committed to: 5.2.2.1. Delivering high-quality patient care with respect and confidentiality, while actively involving the patient in their own care. 5.2.2.2. Supporting the County’s vision and mission as it pertains to wellness programs and initiatives. 5.2.2.3. Maintaining high patient satisfaction and effective communication. Page 2724 of 3707 5 5.2.2.4. Demonstrating expertise in diabetes management and medication adjustments. 5.2.2.5. Demonstrating expertise in weight management with the ability to prescribe and adjust anti-obesity medications as needed. 5.2.2.6. Coordinating specialty care services within the CHP network. 5.2.3. Medical Technician 5.2.4. Phlebotomist 5.2.5. Administrative Services 5.3. Ensure proper training and oversight of all on-site medical professionals. 5.4. Establish and maintain clinical quality assurance programs. 5.5. Train on-site staff in the use of EMR and other information systems. 6. Reporting & Compliance The vendor is required to provide reporting and compliance services, including but not limited to the following: 6.1. Submit claims and utilization data electronically to the County’s Group Health TPA. 6.2. Maintain patient records in EMR format for tracking health outcomes and program effectiveness. 6.3. Meet regularly with County representatives to analyze service utilization, strategize cost containment, and improve health outcomes. 6.4. Use biometric and lab data to assist in the development of targeted training and education programs addressing employee risk factors. 6.5. Ensure compliance with nursing practice standards, protocols, and quality assurance measures. 7. Required Biometric Testing Services The vendor is required to be able to perform or provide the following services specific to biometric testing for County employees and covered spouses. These services shall include, but not be limited to, the following: 7.1. Testing for venipuncture laboratory panel & biometric measurements. The panel of testing is a fasting test and will include the following: 7.1.1. Heart: Total Cholesterol, HDL Cholesterol, Triglycerides, LDL Cholesterol, Cholesterol/HDL ratio 7.1.2. Thyroid: TSH (Thyroid Stimulating Hormone) 7.1.3. Kidneys: Urea Nitrogen (BUN), Creatinine, eGFR, BUN/Creatinine Ratio 7.1.4. Bone: Calcium 7.1.5. Liver: Direct Bilirubin, GGT, ALT, Total Protein, albumin, Globulin, Albumin/Globulin Ratio, Total Bilirubin, Alkaline Phosphatase, AST 7.1.6. Pancreas: Glucose and Hemoglobin A1C 7.1.7. Whole Body: Sodium, Potassium, Chloride, CBC with differential: White Blood Cell Count, Red Blood Cell Count, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet Count 7.1.8. Lungs: Cotinine (blood sample) Prostate: Prostate Specific Antigen (per gender) 7.1.9. Biometric Measurements: Measured height, weight, blood pressure, waist circumference, and calculated BMI. Follow-up laboratory testing to include, but not be limited to, the following: 7.1.9.1. Serum Nicotine/Cotinine, Hemoglobin A1C, Lipid Panel 7.1.10. Combination test of Hemoglobin AIC + Lipid Panel Repeat or “challenge” testing of laboratory/biometric results, including a urine cotinine, as deemed necessary. 7.1.11. Physician oversight services, including monitoring lab values and providing outbound calls to members with medically actionable/critical values within 24 hours of the results. Actionable/critical values should be communicated to the CHP Health Advocate Office within the next business day. 7.1.11.1. The selected must be willing to discuss and modify a critical value/out-of-range communication process. 7.1.11.2. The reporting system for medically actionable labs must include a mechanism to record actionable lab values that have been addressed by the CHP Health Advocate Office. 7.1.12. Communication with critical results shall be included in both the administration and pricing of this panel. 7.2. Phlebotomy and Biometric measurement administration services shall include, but not be limited to, the following: 7.2.1. Administration oversight, scheduling, and on-site staffing by highly proficient phlebotomists. The County, through CHP, shall reserve the right to approve the on-site phlebotomy staff to assure high quality. 7.2.2. Opportunity for a vendor’s lead examiner/event coordinator to meet with CHP prior to the first on-site event and communicate regularly to assure optimal staffing. Page 2725 of 3707 6 7.2.3. Data and specimen collection, testing, physician overview, results delivery, and weekly coordination for approximately 2,500 employees (even years) and 1,200 spouses (odd years). 7.2.4. On-site Phlebotomy and Biometric events shall be provided at multiple CCG locations: November and December (various Mondays through Fridays). January through March (various Mondays through Saturdays). 7.2.4.1. The schedule shall be determined by the vendor, CHP, and Wellness staff. 7.2.4.2. Events typically run 7-10 am EST with a one-hour breakdown time. 7.2.4.3. Events may have a minimum of 10 and a maximum of 100 participants. Walk-ins will be accommodated. An event with fewer than 10 scheduled participants will require special consideration. 7.2.4.4. The phlebotomy team must be able to process one (1) participant every five (5) minutes. 7.2.4.5. The vendor shall set up all screening supplies the day before or a minimum of two (2) hours prior to the event start time. 7.2.4.6. The vendor shall provide lab requisitions with barcodes for registered participants, and blank forms to accommodate “walk-ins” will be brought with the phlebotomy team the morning of the event. 7.2.4.7. Room setup, including screens, tables, and chairs, shall be completed by CHP. 7.2.4.8. The vendor shall be responsible for all other logistical matters, including the timing, shipping, and scheduling of materials, supplies, and equipment to scheduled locations. 7.2.5. Biometric measurements requirements: 7.2.5.1. Height and weight are recorded in US metrics (inches and pounds). 7.2.5.2. Waist measurement shall be taken at the belly button using a tape measure. 7.2.5.3. Only manual blood pressure cuffs with a variety of cuff sizes, including XS-XL, shall be used. Blood pressure may be repeated up to three (3) times after the resting position. Measurements are never to be self-reported, and members should be given the opportunity to verify measurement accuracy. 7.2.6. The vendor will accept “challenged” biometric measurements from another provider. A repeat measurement for blood pressure, height, weight, waist circumference, and/or calculated BMI will be performed by the provider and sent to the vendor to update the participant’s personal biometric data that is sent to CHP. 7.2.7. Participants identified with program-specific risk factors will require venipuncture retesting from mid-July to September 30 for a Serum Cotinine, Hemoglobin A1C, Lipid Panel, or a combination Lipid Panel – Hemoglobin A1C. The majority of participants will use the clinic for the lab drawing. Out-of-County participants will use the vendor’s national Service Center Sites for lab draws and biometric measurements. All lab result data generated will be electronically transmitted to CHP as described in the Scope of Services. 7.2.8. The vendor will have the ability to retain the original eligibility file(s) and accept additional eligibility file(s) for newly enrolled participants and those who require repeat labs. 7.3. Personal Summary Report - A sample report is attached as Exhibit “A.” 7.3.1.The vendor must be able to integrate laboratory findings into a Personal Summary Report in a format like the sample. 7.3.2.All current abnormal results must be highlighted on the Personal Summary Report. 7.3.3.The vendor must be able to upload historical laboratory values and biometric measurements from CHP. The Personal Summary Report must be able to incorporate comparative data (currently three (3) years of historical data) for the participant to measure progress. 7.3.4.The vendor must have an online portal for participants to schedule appointments and to view their current year’s Personal Summary Report and previous year’s reports. 7.3.5.The vendor will communicate to participants when the Personal Summary Report is available for viewing. 7.3.6.The vendor must be able to reset passwords for participants and provide a toll-free customer service number and/or email chat service for members. Customer support must be available Monday through Saturday, 7:00 am – 7:00 pm EST. 7.4. Enrollment, Reporting Services, and Data coordination shall include, but not be limited to, the following: 7.4.1. The vendor must be able to accept a census of eligible participants electronically. The census shall be provided to the vendor by mid-October by the County from the County’s benefits enrollment system. 7.4.2. The vendor must be able to receive weekly participant eligibility file uploads. This electronic file will have a 4-8-character participant ID assigned by the County; this will not be a Social Security number. 7.4.3. The vendor will accept a termination file and have the ability to purge terminated names monthly. 7.4.4. The vendor must ensure identification is correct for merging historical data with new results by using the following three (3) identifiers: full name, date of birth, and the participant ID assigned by the County. Page 2726 of 3707 7 7.4.5. Participants must have the ability to register online via the vendor’s hosted website or via the phone. 7.4.6. The vendor will ensure the online scheduler remains open 24 hours prior to the on-site event. 7.4.7. The scheduler will interface with the eligibility file. 7.4.8. The scheduler will not allow repeat initial labs and will not allow participants to enroll in multiple events. 7.4.9. The vendor must be able to send confirmation and reminder emails to participants of upcoming appointments with the ability to customize for the County with County messaging. 7.4.10. The vendor must produce weekly participation reports and/or ad hoc activity reports of participants who have completed lab draws (including those who attended as a walk-in), participants who are currently scheduled, and participants with no activity. 7.4.11. Lost or delayed labs shall be communicated to CHP regarding the status of processing and resolution. 7.4.12. A “No Activity Report” showing eligible participants who did not participate shall be submitted to CHP. 7.4.13. The vendor must be able to maintain an ongoing history of participant laboratory results by year. 7.4.14. The vendor must provide online administrative access to CHP and CCG Wellness staff to view scheduling and completion data. 7.4.15. The vendor must provide a nightly feed of clinical data to CHP via the Secure File Transfer Protocol (SFTP) site for documentation of individual lab screenings and reporting. The lab files from the vendor shall be .csv files. 7.4.16. The vendor must provide individualized reports via a secure pathway within 2-5 business days of results for participants. Prior to publishing the Summary Lab Report, lab errors are flagged, reviewed, and corrected by the vendor prior to the member and CHP receiving the Personal Summary Report. The lab and biometric individualized result files shall be a .pdf file with the participant ID and name of each participant. 7.4.17. CHP shall be notified of any unsuccessful or erroneous reports with each nightly clinical data feed. The vendor will enter data for specific risk factor lab value retests mid-July through September. The vendor will provide the electronic data files to CHP as stated in the Scope of Service. The vendor must provide an annual aggregate report prior to November 30th, though the deadline may be extended by the County due to extenuating circumstances. The vendor’s representative will attend an annual meeting to present aggregate report outcomes to the County’s Human Resources Division Director and other staff members. The report must encompass the findings for the year and shall incorporate participation, comparative, and cohort reports at a high level as well as at the specific test level. Comparative data shall include both comparable norms to the general population, the vendor’s population (if available), and the cohort population. The vendor must conduct a weekly conference call with CHP, Wellness, and Benefits staff to communicate program updates and resolve operational issues. 7.5. Service Center Site(s) providing phlebotomy services and biometric measurements shall include, but not be limited to, the following: 7.5.1. The vendor must be able to provide multiple walk-in Service Center Sites throughout the County for those unable to attend an on-site clinic event. 7.5.2. Service Center Site(s) must replicate all services as required at on-site clinic events. 7.5.3. Service Center Site(s) can accommodate unscheduled (walk-in) appointments. 7.5.4. State and national remote Service Center Site(s) with biometric services shall be provided for active employees and retirees residing out of state, and for out-of-county participants. 7.6. Billing The vendor shall comply with the following billing requirements: 7.6.1. The vendor must bill the County’s TPA by individual participant in order to populate the individual claim file. The vendor must supply a bulk billing; however, the bill must provide a breakdown of charges by member and member identifier, in a manner acceptable to the TPA. The vendor must be paid by the County’s TPA. 7.6.2. The billing must be on a per participant basis except for follow-up testing as outlined above. 7.6.3. Any deviation from the per participant charge must be clearly delineated in the vendor’s response. 7.6.4. The cost to retest due to errors on the part of the vendor must be borne by the vendor. 7.6.5. The vendor must assume the financial responsibility for CHP data extracts pertaining to historical personal health profile data and data formatting for importing into the CHP system. The file feed layout needs to remain the same from inception so as not to incur additional programming fees. The vendor will incur the file set-up fee. Page 2727 of 3707 8 8. Program Implementation (For all services) 8.1. The vendor must test all associated processes, such as scheduling, reporting, and data exchange, prior to the go-live date. 8.2. The vendor must meet a 90-day implementation process after the contract has been awarded unless otherwise agreed upon. 8.3. No changes to any system or process will be acceptable unless fully tested and agreed upon by CCG. 9. HIPAA (For all services) The vendor must comply with the provisions of the Health Insurance Portability and Accountability Act and shall enter into a Business Associate Arrangement with the County. 10. Ownership of Data (For all services) It must be understood by all parties that biometric and lab data accumulated as a result of the program must be considered the property of the CCG Health Plan. CHP shall be responsible for possessing and maintaining a historical record of data on behalf of the County. The vendor must provide a nightly data file to CHP containing the individual testing results by member identifier. 11. Proposal Alternatives (For all services) The County will consider alternative methods of providing the services that will enhance the services and requirements outlined in the scope of services. However, the County reserves the right to reject in whole or in part alternative proposals. 12. Organization Licensure and/or Certification Requirements The vendor must be properly licensed and duly authorized to conduct business in Collier County, Naples, Florida. The vendor is required to obtain and maintain throughout the life of the resultant contract required insurances, certificates, and/or licenses as required by any federal, state, or local agency that oversees the operation of medical clinics engaged in the activities outlined in the scope of services. REQUEST FOR PROPOSAL (RFP) PROCESS 1.1 The Proposers will submit a qualifications proposal, which will be scored based on the criteria in Evaluation Criteria for Development of Shortlist, which will be the basis for short-listing the Proposers. The Proposers will need to meet the minimum requirements outlined herein in order for their proposal to be evaluated and scored by the County. The County will then score and rank the firms and enter into negotiations with the top-ranked Proposer to establish the cost for the services needed. The County reserves the right to issue an invitation for oral presentations to obtain additional information after scoring and before the final ranking. With successful negotiations, a contract will be developed with the selected Proposer, based on the negotiated price and scope of services, and submitted for approval by the Board of County Commissioners. 1.2 The County will use a Selection Committee in the Request for Proposal selection process. 1.3 The intent of the scoring of the proposal is for respondents to indicate their interest, relevant experience, financial capability, staffing, and organizational structure. 1.4 The intent of the oral presentations, if deemed necessary, is to provide the vendors with a venue where they can conduct discussions with the Selection Committee to clarify questions and concerns before providing a final rank. 1.5 Based upon a review of these proposals, the County will rank the Proposers based on the discussion and clarifying questions on their approach and related criteria, and then negotiate in good faith an Agreement with the top-ranked Proposer. 1.6 If, in the sole judgment of the County, a contract cannot be successfully negotiated with the top-ranked Proposer, negotiations with that Proposer will be formally terminated, and negotiations shall begin with the Proposer ranked second. If a contract cannot be successfully negotiated with the Proposer ranked second, negotiations with that Proposer will be formally terminated, and negotiations shall begin with the third-ranked Proposer, and so on. The County reserves the right to negotiate any element of the proposals in the best interest of the County. Page 2728 of 3707 9 RESPONSE FORMAT AND EVALUATION CRITERIA FOR DEVELOPMENT OF SHORTLIST: For the development of a shortlist, this evaluation criterion will be utilized by the County’s Selection Committee to score each proposal. Proposers are encouraged to keep their submittals concise and to include a minimum of marketing materials. Proposals must address the following criteria: Evaluation Criteria Maximum Points 1. Cover Letter/Management Summary 0 2. Professional and Technical Capabilities 20 3. Experience and Capacity of the Firm, Including Specialized Experience of Team Members 25 4. Cost of Services to the County 30 5. Business Implementation 10 6. Certified Minority Business Enterprise 5 7. Local Vendor Preference 10 TOTAL POSSIBLE POINTS 100 Tie Breaker: In the event of a tie at final ranking, the award shall be made to the proposer with the lower volume of work previously awarded. Volume of work shall be calculated based upon total dollars paid to the proposer in the twenty-four (24) months prior to the RFP submittal deadline. Payment information will be retrieved from the County’s financial system of record. The tie-breaking procedure is only applied in the final ranking step of the selection process and is invoked by the Procurement Services Division Director or designee. In the event a tie still exists, selection will be determined based on random selection by the Procurement Services Director or designee, before at least three (3) witnesses. ------------------------------------------------------------------------------------------------------------------------------------------------------------------- Each criterion and methodology for scoring is further described below. ***Proposals must be assembled, at minimum, in the order of the Evaluation Criteria listed, or your proposal may be deemed non-responsive*** EVALUATION CRITERIA NO. 1: COVER LETTER/MANAGEMENT SUMMARY (0 Total Points Available) Provide a cover letter, signed by an authorized officer of the firm, indicating the underlying philosophy of the firm in providing the services stated herein. Include the name(s), telephone number(s), and email(s) of the authorized contact person(s) concerning the proposal. The submission of a signed proposal is the vendor's certification that the vendor will accept any award as a result of this RFP. List all proposed subcontractors who will participate on the team. EVALUATION CRITERIA NO. 2: PROFESSIONAL AND TECHNICAL CAPABILITIES (20 Total Points Available) In this criteria, include but not limited to: Please answer the questions below by placing an “X” in either the “Yes” or “No” box. Failure to follow these instructions may result in your proposal being considered non-responsive. Biometric Testing/Screening Yes No Can you provide the lab testing panel as described in the Scope of Services? Can you perform biometric measurements in accordance with current County practice/standards? Can you provide the biometric measurement services as described in the Scope of Services at both the on-site events and at walk-in Service Center sites, if applicable. Does your firm offer an alternative collection method for venipuncture and biometric measurement testing other than on-site clinics or walk-in service center sites? Can your firm integrate the lab results and biometric measurements into the Personal Summary Report? Page 2729 of 3707 10 Can your firm incorporate historical health report data from CHP into the Personal Summary Report? Can your firm comply with the data coordination, enrollment, and reporting services as outlined in the Scope of Services? Does your firm provide a Personal Summary Report in the format and electronic delivery methods as described in the Scope of Services? If yes, please provide a sample of your firm’s Personal Summary Report. Technology and Equipment Yes No Is equipment such as copiers, fax machines, and other peripherals provided as part of the clinic cost, without an additional cost to the County? Is your firm responsible for the telephonic and computer hardware and software in the health clinics managed by the organization? Please provide your responses to the following questions in Exhibit B titled “Questionnaire”. Failure to provide responses may result in your proposal being considered non-responsive. Staffing What recruiting measures will you use to recruit and retain medical and administrative staff? What criteria do you use when selecting staff in terms of education, experience, and skill? Explain the process you would use to cover staff shortages within the county’s on-site clinic(s). Biometric Testing/Screening How do you handle the data and specimens that are collected to ensure they are tested on a timely basis and that the results are accurately reported? What is your error rate? Explain your process for invalid results due to processing errors and the member’s repeat lab draw process. Please specify the maximum and minimum participants allowed for on-site events, and your ability to meet the requirements as listed in the scope of services. Explain the process for not meeting or exceeding registration numbers and the financial implications. Please describe the number and location(s) of walk-in Service Center sites that you operate in Collier County, if any. Do your Service Center sites accept participants with no scheduled appointments? If yes, explain the process. Please specify the lab company used for collection and processing, both locally and nationally. What kind of equipment do you use to measure blood pressure? What cuff sizes are offered? Explain your process for a member stating their recorded BP reading is abnormal for them. Do you have accessibility for retirees and other participants living out of the area? Specify the options your firm offers and the process. Can your firm maintain and print multiple years of historical data for comparison? Please specify the number of years your Personal Summary Report allows. Is your Personal Summary Report provided in paper and as an online version? If not, please specify. Does your firm have online scheduling capabilities for both on-site events and walk-in Service Center sites? Please describe. If available, provide your website registration link so that we can sample the registration process. Please specify your firm’s advance time limitations for appointment scheduling at a walk-in Service Center site and/or on-site clinic event. On-Site Clinic Operations Describe the process that would be undertaken to measure outcomes and the success of the overall program. Outline standard and custom reporting capabilities that are available to County management. Describe how your firm specifically evaluates the effectiveness of primary care case management. Provide all clinical indicators used to track the success of the program and the results (if any), by year since the inception of the program, including the following: • Program outcomes • Utilization measures (list) • Member satisfaction • Changes in the cost of care • Productivity/absenteeism (list indicators) Page 2730 of 3707 11 Technology and Equipment Do you provide computers to the clinic staff, and do you have your own IT team? What system will be used to keep Electronic Medical Records for clinicians and personal health records for patients? Is this system something you own, or is it outsourced to another vendor? What online access is available to County employees who are patients of the clinic(s)? Do you offer a patient portal? If yes, please describe the system and its capabilities. Invoice/Billing Describe the ability to deliver a fixed-fee billing model to the County based on Exhibit C Pricing Sheet. What is your performance guarantee with a portion of the fees at risk model? Describe your performance guarantees relative to patient satisfaction, member engagement, member risk-level reduction, and implementation timeline. EVALUATION CRITERIA NO. 3: EXPERIENCE AND CAPACITY OF THE FIRM, INCLUDING SPECIALIZED EXPERIENCE OF TEAM MEMBERS (25 Total Points Available) In this criteria, include but not limited to: • Provide information that documents your firm’s qualifications to produce the required deliverables, including abilities, capacity, skills, and financial strength, and the number of years of experience in providing the required services. • Describe the various team members’ successful experiences. a. Proposals must identify appropriate medical personnel, and a schedule of hours needed to successfully provide services, and will incorporate some or all of the following staff positions: i. Receptionist Staff ii. Medical Technician iii. PA-C/APRN iv. Phlebotomist v. Administrative Services vi. Physician Medical Director b. Please provide professional resumes for all the above-mentioned staff positions. • Description of the proposed team/staff and the role to be played by each member of the team. • Describe the approach to management and execution of work with respect to the location of various key contract team members. Demonstrate the coordination between internal and external team members and County staff involved in providing services to the County. EVALUATION CRITERIA NO. 4: COST OF SERVICES TO THE COUNTY (30 Total Points Available) Please provide your pricing in Exhibit C titled “Pricing Sheet”. Failure to provide responses may result in your proposal being considered non-responsive. • In Exhibit C, Pricing Sheet, provide the monthly cost to employ and staff the County clinic(s) and perform the biometric testing. • For biometric testing/screening: In Exhibit C, Pricing Sheet, provide the cost per participant for each of the items/tests listed in the pricing sheet. • All line items must be completed; failure to do so may result in the vendor being deemed non-responsive. • Vendors may propose an additional location within the 15-mile radius; however, preference will be given to a single location. If your firm is not proposing an additional location, you are not required to provide pricing for that section. However, please clearly mark each line as “N/A” or “No Bid.” • Any additional charges or conditions must be clearly defined in the vendor’s proposal. • All special billing charges, such as travel, minimum participation, set-up, or similar charges, which are separate from the per participant charge, must be clearly specified in the vendor’s proposal. EVALUATION CRITERIA NO. 5: BUSINESS IMPLEMENTATION (10 Total Points Available) In this criteria, include but not limited to: Page 2731 of 3707 12 • Provide your implementation transition plan if awarded the resultant contract, including the timeline from the award date to the implementation start date, with your major milestones identified. Base your plan on January 1, 2026, start date. • How do you propose transitioning the service from the current vendor to your firm? • What will be the role of CCG in the selection of staff? • Would you consider the utilization of existing staff? • How do you plan to transition existing patients? EVALUATION CRITERIA NO. 6: CERTIFIED MINORITY BUSINESS ENTERPRISE (5 Total Points Available) • Submit certification with the Florida Department of Management Services, Office of Supplier Diversity as a Certified Minority Business Enterprise. EVALUATION CRITERIA NO. 7: LOCAL VENDOR PREFERENCE (10 Total Points Available) • Local business is defined as the vendor having a current Business Tax Receipt issued by the Collier or Lee County Tax Collector prior to proposal submission to do business within Collier County, and that identifies the business with a permanent physical business address located within the limits of Collier or Lee County from which the vendor’s staff operates and performs business in an area zoned for the conduct of such business. VENDOR CHECKLIST ***Vendor should check off each of the following items as the necessary action is completed (please see Vendor Check List) *** EXHIBIT A Sample of a Wellness/Biometric Personal Summary Report. EXHIBIT B Questionnaire EXHIBIT C Pricing Sheet Page 2732 of 3707 County of Collier, FL Procurement Sandra Srnka, Executive Director 3299 Tamiami Trail, East Naples, FL 34112 [QUADMED LLC] RESPONSE DOCUMENT REPORT GEN No. 25-8397 Comprehensive Clinic and Wellness Services RESPONSE DEADLINE: August 1, 2025 at 3:00 pm Report Generated: Monday, August 4, 2025 QuadMed LLC Response CONTACT INFORMATION Company: QuadMed LLC Email: rfp@quadmedical.com Contact: Naomi Peeples Address: N61W23044 Harry's Way Sussex, WI 53089 Phone: N/A Website: www.quadmedical.com Submission Date: Jul 28, 2025 1:36 PM (Eastern Time) Page 2733 of 3707 [QUADMED LLC] RESPONSE DOCUMENT REPORT GEN No. 25-8397 Comprehensive Clinic and Wellness Services [QUADMED LLC] RESPONSE DOCUMENT REPORT undefined - Comprehensive Clinic and Wellness Services Page 2 ADDENDA CONFIRMATION Addendum #1 Confirmed Jul 25, 2025 9:27 PM by Naomi Peeples Addendum #2 Confirmed Jul 25, 2025 9:27 PM by Naomi Peeples Addendum #3 Confirmed Jul 25, 2025 9:27 PM by Naomi Peeples QUESTIONNAIRE 1. I certify that I have read, understood and agree to the terms in this solicitation, and that I am authorized to submit this r esponse on behalf of my company.* Confirmed 2. ALL DOCUMENTS REQUIRING EXECUTION SHOULD BE EITHER BY WET SIGNATURES OR VER IFIABLE ELECTRONIC SIGNATURES. FAILURE TO PROVIDE THE APPLICABLE DOCUMENTS MAY DEEM YOU NON-RESPONSIVE/NON-RESPONSIBLE. Confirmed 3. Request for Proposal (RFP) Instructions Form* Request for Proposal (RFP) Instructions have been acknowledged and accepted. Confirmed 4. Collier County Purchase Order Terms and Conditions.* Collier County Purchase Order Terms and Conditions have been acknowledged and accepted. Page 2734 of 3707 [QUADMED LLC] RESPONSE DOCUMENT REPORT GEN No. 25-8397 Comprehensive Clinic and Wellness Services [QUADMED LLC] RESPONSE DOCUMENT REPORT undefined - Comprehensive Clinic and Wellness Services Page 3 Confirmed 5. Insurance Requirements* Vendor Acknowledges Insurance Requirement and is prepared to produce the required insurance certificate(s) within five (5) days of the County's issuance of a Notice of Recommended Award. Confirmed 6. Proposal Submittal* Please submit a proposal per Evaluation Criteria outlined in Solicitation. QuadMed_Proposal_Collier_County_FL.pdf 7. County Required Forms VENDOR DECLARATION STATEMENT (FORM 1)* Form_1_Vendor_Declaration_Statement.pdf CONFLICT OF INTEREST AFFIDAVIT (FORM 2)* Form_2_Conflict_of_Interest_Certification_Affidavit.pdf IMMIGRATION AFFIDAVIT CERTIFICATION (FORM 3)* Form_3_Immigration_Affidavit_Certification.pdf LOCAL VENDOR PREFERENCE (IF APPLICABLE FORM 4) Include a copy of the business tax receipt. Form_4_Vendor_Submittal_-_Local_Vendor_Preference_Certification.pdf REFERENCE QUESTIONNAIRE (IF APPLICABLE FORM 5) Form_5_Reference_Questionnaire.pdf Page 2735 of 3707 [QUADMED LLC] RESPONSE DOCUMENT REPORT GEN No. 25-8397 Comprehensive Clinic and Wellness Services [QUADMED LLC] RESPONSE DOCUMENT REPORT undefined - Comprehensive Clinic and Wellness Services Page 4 GRANT PROVISIONS (IF APPLICABLE FORM 6) All forms must be completed Form_6_Grant_Provisions_and_Assurances_Forms_Not_Applicable.pdf PROOF OF STATUS FROM DIVISION OF CORPORATIONS - FLORIDA DEPARTMENT OF STATE (SUNBIZ)** http://dos.myflorida.com/sunbiz/ should be attached with your submittal. Divisions_of_Corporations_FL.pdf E-VERIFY - MEMORANDUM OF UNDERSTANDING* Vendor MUST be enrolled in the E-Verify - https://www.e-verify.gov/ at the time of submission of the proposal/bid. E-Verify Memorandum of Understanding or Company Profile page should be attached with your submittal. Quad_E-Verify.pdf W-9 FORM* 2025_QuadMed_W-9.pdf SIGNED ADDENDUMS (IF APPLICABLE) Addendum_1_2_3.pdf MISCELLANEOUS DOCUMENTS Exhibit_C_-_Pricing_Sheet.xlsx Page 2736 of 3707 Collier County, FL Proposal for Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 August 1, 2025 PREPARED FOR SUBMITTED BY: Lisa Ness Chief Growth Officer 503.705.4087 lness@quadmedical.com Page 2737 of 3707 Table of Contents Proposal for Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 Table of Contents Collier County, FL SECTION ACover Letter/Management Summary BProfessional and Technical Capabilities •Exhibit B: Questionnaire CExperience and Capacity of the Firm, Including Specialized Experience of Team Members DCost of Services to the County •Exhibit C: Pricing Sheet EBusiness Implementation FCertified Minority Business Enterprise GLocal Vendor Preference HVendor Checklist IExhibit A: Sample of a Wellness/Biometric Personal Summary Report •Sample 1_Biometric Screening Result Form •Sample 2_Biometric Screening Result Form JAttachments •All Reporting Samples •QuadMed Job Descriptions Page 2738 of 3707 Table of Contents Section A Cover Letter/Management Summary Page 2739 of 3707 Confidential and Proprietary • Collier County, FL Page 1 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 EVALUATION CRITERIA NO. 1: COVER LETTER/MANAGEMENT SUMMARY (0 Total Points Available) Provide a cover letter, signed by an authorized officer of the firm, indicating the underlying philosophy of the firm in providing the services stated herein. Include the name(s), telephone number(s), and email(s) of the authorized contact person(s) concerning the proposal. The submission of a signed proposal is the vendor's certification that the vendor will accept any award as a result of this RFP. List all proposed subcontractors who will participate on the team.  ABM - janitorial services  Airgas - supplies oxygen/liquid nitrogen  AMN - temporary agency staff as needed  Aramark - laundry services  Daniels Sharpsmart - biohazard removal  Iron Mountain - paper shredding services  McKesson - supply and equipment purchasing  Quest Diagnostics - lab services  Securitas - security/panic buttons  SPBS, Inc. Biomed - medical equipment calibration  UPS - mail and package delivery  FedEx - mail and package delivery  USPS - mail and package delivery QuadMed has a formal process for vendor vetting, onboarding, and contracting. All subcontractors are thoroughly vetted and chosen for the quality of their work and cost- efficiency. They are also expected to adhere to Quad’s Supplier Code of Conduct. Page 2740 of 3707 Confidential and Proprietary • Collier County, FL Page 2 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 COVER LETTER/MANAGEMENT SUMMARY July 22, 2025 Jake Bond, Assistant Division Director Procurement Services Division 3295 Tamiami Trail East, Bldg. C-2 Naples, Florida 34112 Collier County, FL — Solicitation No. 25-8397 – Comprehensive Clinic and Wellness Services Dear Mr. Bond, On behalf of QuadMed, I am pleased to submit this proposal in response to Collier County’s request for Comprehensive Clinic and Wellness services. As an authorized officer of the firm, I affirm our commitment to delivering exceptional, integrated health and wellness solutions that align with your organization’s goals and values. QuadMed was founded in 1991 by Harry V. Quadracci, who was frustrated by skyrocketing health care costs and the fragmented, insufficient care his employees received in the community. He built a health center at his Pewaukee, WI headquarters, hired a physician, and the rest is QuadMed history. For 34 years, QuadMed has been providing high-quality care to employees and dependents of companies in Wisconsin and across the United States. Collier County will experience consistent touchpoints and timely communication, clear actionable reporting and strategic consultation, and billing transparency. As your partner, QuadMed’s priority will be the County’s short- and long-term goals for the health and wellbeing of your workforce. QuadMed believes we are the strongest partner for Collier County, and we set ourselves apart in the following ways:  Public entity expertise: QuadMed is privileged to serve counties, municipalities, and school districts nationwide. Because more than 30 percent of our clients are public entities, we understand your unique needs, from strict budget adherence to engaging a distributed workforce of dedicated public servants.  Transition Experience: QuadMed is experienced in providing efficient and seamless health center transitions. We believe the biggest focus should be on avoiding disruption in care and maintaining continuity of services. To achieve this, coordination of efforts between the County and QuadMed is key. We want to fully understand both the positive and negative experiences with the previous vendor and partner with you to rebuild a renewed sense of confidence and trust. Our goal is to continue to support and foster success while addressing Page 2741 of 3707 Confidential and Proprietary • Collier County, FL Page 3 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 gaps and previous pain points with your health center. QuadMed has transitioned 70% of our health centers.  Low turnover: QuadMed has the lowest staff and account management turnover in the employer-sponsored healthcare industry. The County can be assured that there will be less disruption in operating the health center and that those key relationships between providers and patients are maintained.  Exceptional Patient Experience: QuadMed is known for our exceptional patient experience from seamless appointment scheduling, low/no wait times, same and next day appointments, longer appointment times, follow up and care navigation. Our focus is treating the whole person and ensuring an exceptional patient experience. Our NPS and Patient Satisfaction scores are consistently in the 90+ range.  Data driven: QuadMed provides best-in-class analytics and reporting on quality metrics for preventive care, wellness, and condition management. With access to the County’s medical and pharmacy claims data, we can compare health care behavior and cost for health center users versus non-users on an ongoing basis. The County can be assured you will receive timely reporting with data that allows for actionable outcomes.  Building awareness and engagement: Your QuadMed Senior Marketing Strategist will partner with the County to implement communication strategies to build awareness, familiarity, and trust under the new management of your health center. Communication strategies are tailored to your population’s needs, culture, and preferred communication channels.  Senior leadership engagement: Our CEO, Kathryn Quadracci Flores, MD, is committed to treating the County employees and their families with the same dedication and care we provide for our own Quad and QuadMed members. Because her name is on the door, she is constantly focused on ensuring the highest quality care for our patients and exceptional service to our clients.  Our own innovation lab: Because Quad is a client of QuadMed, we have the unique opportunity to continuously innovate at the health centers of our parent company. This arrangement will provide the County with innovative solutions that have been tested and proven. QuadMed would be honored to partner with Collier County and deliver the personalized care and attention their employees deserve, treating the employees as though they were our own. We look forward to continuing our discussions. Thank you for your time and consideration. In partnership, Lisa Ness, Chief Growth Officer 503.705.4087 lness@quadmedical.com Page 2742 of 3707 Table of Contents Section B Professional and Technical Capabilities •Exhibit B: Questionnaire Page 2743 of 3707 Confidential and Proprietary • Collier County, FL Page 4 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 EVALUATION CRITERIA NO. 2: PROFESSIONAL AND TECHNICAL CAPABILITIES (20 Total Points Available) In this criteria, include but not limited to: Please answer the questions below by placing an “X” in either the “Yes” or “No” box. Failure to follow these instructions may result in your proposal being considered non-responsive. Please provide your responses to the following questions in Exhibit B titled “Questionnaire”. Failure to provide responses may result in your proposal being considered non-responsive. Please refer to completed Exhibit B, Questionnaire, attached. Staffing What recruiting measures will you use to recruit and retain medical and administrative staff? QuadMed’s dedicated in-house talent acquisition specialists leverage a comprehensive sourcing strategy that includes multiple recruiting channels and our internal applicant tracking system. Over 30% of our hires originate from employee referrals. Clinical candidates undergo a thorough screening process, which includes interviews and evaluations conducted by QuadMed’s senior medical directors and operations leadership. We assess candidates for clinical expertise, credentials, certifications, and skill sets aligned with the services provided. Equally important is ensuring alignment with the County’s culture and QuadMed’s relationship-driven, whole- person care model. Page 2744 of 3707 Confidential and Proprietary • Collier County, FL Page 5 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 All candidates must complete a series of pre-employment requirements, including reference checks, drug testing, and comprehensive background checks at both state and federal levels. Employment history is verified, and a Social Security verification is conducted upon hire. QuadMed maintains a retention rate exceeding 90%. When attrition does occur, it is typically at the client’s request. We are proud to have one of the lowest turnover rates for providers and health center staff in the industry—a testament to our robust benefits, extensive training, and a collaborative, supportive work environment. What criteria do you use when selecting staff in terms of education, experience, and skill? QuadMed selects staff through a comprehensive process that emphasizes education, experience, and skill alignment. Candidates must hold relevant degrees and certifications—particularly for clinical roles, which require board certifications and licenses such as BLS, ACLS, and DOT Medical Examiner. Experience is evaluated through performance reviews and competency assessments to ensure alignment with QuadMed’s care model. Interpersonal skills like communication, compassion, and cultural competence are also key, as is alignment with the organization’s relationship-driven, whole- person care philosophy. The hiring process includes interviews, reference checks, drug testing, background checks, and Social Security verification. New hires undergo structured onboarding and continuous training to support long-term success and retention. Explain the process you would use to cover staff shortages within the county’s on-site clinic(s). Scheduled absences, such as vacations, holidays, and continuing education, are anticipated and built into the staffing model. Both scheduled and unscheduled absences are mitigated by cross-training and cross-licensing of our clinical staff. For longer-term absences or leaves, QuadMed has a national program of contingent labor, which includes our own employed pool/on-call resources, multiple agency partnerships and cross-trained staff with appropriate licensure. Having employed float backfill staff allows us to provide coverage by a QuadMed employee with the training and knowledge of our processes. Biometric Testing/Screening How do you handle the data and specimens that are collected to ensure they are tested on a timely basis and that the results are accurately reported? What is your error rate? QuadMed ensures timely and accurate handling of data and specimens through a structured, technology- enabled workflow that meets AAAHC standards and complies with manufacturer and regulatory guidelines. To maintain accuracy, all specimens are logged, tracked, verified, and reported promptly. Specimens are processed onsite or picked up by courier for delivery to national reference labs such as Quest Diagnostics. Lab orders are placed electronically through electronic health record (Epic) and transmitted via lab information system (LabDaq), which integrates with Quest to support seamless result reporting. Most routine lab results are returned within 24 hours and automatically routed to providers and patients through Epic and MyChart. Explain your process for invalid results due to processing errors and the member’s repeat lab draw process. If a lab result is deemed invalid due to a processing error—such as specimen degradation, labeling discrepancies, or equipment malfunction—QuadMed initiates a structured correction protocol. The electronic health record (Epic) is updated to include documentation explaining the issue, and the ordering provider is notified. If a repeat draw is necessary, the patient is promptly informed, and a new Page 2745 of 3707 Confidential and Proprietary • Collier County, FL Page 6 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 collection is scheduled. These repeat labs are prioritized, and specimens are urgently logged, tracked, and processed. Results are reviewed by the ordering provider and shared with the patient via MyChart or direct communication, ensuring both transparency and continuity of care. Please specify the maximum and minimum participants allowed for on-site events, and your ability to meet the requirements as listed in the scope of services. Explain the process for not meeting or exceeding registration numbers and the financial implications. The QuadMed biometrics pricing includes a maximum of 62 annual events with up to 24 appointments per event hour. Walk-in participants are welcome in addition to those who schedule an appointment in advance. Based on our efficiencies, QuadMed could help Collier County cut biometric costs by at least 20%. Please describe the number and location(s) of walk-in Service Center sites that you operate in Collier County, if any. Do your Service Center sites accept participants with no scheduled appointments? If yes, explain the process. Please specify the lab company used for collection and processing, both locally and nationally. At this time, QuadMed does not have an active health center in Collier County. Yes. Open access scheduling gives patients the flexibility to schedule same-day appointments. Walk- in patients presenting with an acute need are promptly triaged and taken to an exam room for evaluation by the provider. When patients with non-acute needs present as a walk-in at the health center, we accommodate them if possible or offer them the next available appointment. Open access scheduling optimizes the use of provider and staff time and also allows us to better serve our patients. Across our book of business, approximately 30 percent of all QuadMed appointments are same day. QuadMed uses Quest Diagnostics as its contracted national reference lab services vendor. What kind of equipment do you use to measure blood pressure? What cuff sizes are offered? Explain your process for a member stating their recorded BP reading is abnormal for them. QuadMed exam rooms are equipped with integrated wall-mounted monitors, staff should use the appropriate cuff size—Small, Medium, or Large, with Pediatric and Leg/Thigh options available when needed—to take and document blood pressure readings. The measurement should be recorded in the electronic health record, including the cuff size used and any relevant context. If the reading differs significantly from the member’s usual range, notify the provider for further evaluation or follow-up. When a member reports that a recorded blood pressure (BP) reading is abnormal for them, QuadMed follows a structured process to ensure the concern is addressed appropriately. If the reading was taken outside the health center—such as at home or by another provider—staff can document it in Epic using the “Outside Blood Pressure” workflow, noting the source and relevant context. If the reading was taken in-clinic and appears inconsistent with the patient’s typical range, the care team may recheck the BP, review the patient’s history, and assess for contributing factors. Providers use clinical judgment to determine whether follow-up is needed, which may include additional monitoring, lifestyle counseling, or adjustments to the care plan. This process ensures that patient-reported concerns are validated and integrated into their ongoing care. Do you have accessibility for retirees and other participants living out of the area? Specify the options your firm offers and the process. Yes. Page 2746 of 3707 Confidential and Proprietary • Collier County, FL Page 7 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 Virtual Care: QuadMed offers virtual visits (telephone or video) by health center staff during health center hours of operation for any County members who live anywhere in the state in which the health center is located. This includes primary and acute care, behavioral health counseling, wellness coaching, nutrition counseling, diabetic education and more. This service is included in our standard pricing. Some of the health care needs we can address virtually include:  Primary Care  Acute Care  Chronic Condition Management  Behavioral Health  Prescription Refills For after-hours, QuadMed provides an after-hours nurse access line. Services provided after-hours are typically for primary and acute health-related issues. Records from these after-hours' visits are securely transmitted to QuadMed so that they can be added to the patient’s chart within our EMR to ensure continuity of care. QuadMed’s team coordinates any necessary follow up to eliminate gaps in care. This after-hours support is included in our standard pricing. QuadMed Everywhere nationwide virtual primary care (Pricing is not included): For employers with employees working in multiple states, we offer QuadMed Everywhere, our nationwide virtual primary care program. The program is staffed by a team of dedicated QuadMed physicians and advanced practice providers who are licensed in all 50 states and practice the same QuadMed whole-person, relationship- based care model as their clinic colleagues. Employees can establish a relationship with a consistent provider who can manage their care on an ongoing basis, exactly as they would in a bricks-and-mortar clinic. This program promotes health equity among all our clients' employees. Our virtual primary care providers use the same Epic EMR as the onsite clinics, so client employees everywhere will enjoy the same benefits, including the MyChart patient portal. The care model, patient experience and services offered are similar to the onsite clinics, with extended visit times, close patient/provider relationships, and care for acute, preventive and chronic needs. QuadMed Everywhere will grow with our client as they expand their nationwide footprint. Can your firm maintain and print multiple years of historical data for comparison? Please specify the number of years your Personal Summary Report allows. We can provide a cohort report at the end of the program if we have conducted screenings for three or more years. Additionally, if two years of data are available, we can offer a year-over-year comparison upon request. Is your Personal Summary Report provided in paper and as an online version? If not, please specify. Yes. QuadMed’s After Visit Summary (AVS) is available in both paper and online formats. Patients receive a printed AVS at the conclusion of their visit, which includes follow-up instructions, appointment details, and key health information. Simultaneously, this summary is accessible through MyChart, allowing patients to review their visit details, schedule follow-ups, and manage their care digitally at their convenience. Patient education is also included in the AVS, ensuring individuals leave each visit with clear, personalized guidance to support their ongoing health and wellness goals. Page 2747 of 3707 Confidential and Proprietary • Collier County, FL Page 8 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 Does your firm have online scheduling capabilities for both on-site events and walk-in Service Center sites? Please describe. If available, provide your website registration link so that we can sample the registration process. Yes. Scheduling appointments (booking, changing, or canceling) is easy through the MyChart patient portal, an essential tool in our Epic electronic medical record system. Additionally, patients can schedule appointments and leave messages for their provider through the Call Center from 7 a.m. to 7 p.m. CST, Monday through Friday. Patients can also visit the health center in person to schedule an appointment. When requesting an appointment, patients will be asked to share the reason(s) for their visit to ensure the proper appointment duration is booked to meet their needs. Patients can choose the visit type they prefer – in-person, video, or telephone. Open-access scheduling gives patients the flexibility to schedule same-day appointments. Walk-in patients presenting with an acute need are promptly triaged and taken to an exam room for evaluation by the provider. When patients with non-acute needs present as a walk-in at the health center, we accommodate them if possible or offer them the next available appointment. Open access scheduling optimizes use of provider and staff time and allows us to better serve our patients. Across our book of business, approximately 30 percent of all QuadMed appointments are same day. Please specify your firm’s advance time limitations for appointment scheduling at a walk-in Service Center site and/or on-site clinic event. Open access scheduling gives patients the flexibility to schedule same-day appointments. Walk-in patients presenting with an acute need are promptly triaged and taken to an exam room for evaluation by the provider. When patients with non-acute needs present as a walk-in at the health center, we accommodate them if possible or offer them the next available appointment. Open access scheduling optimizes use of provider and staff time and also allows us to better serve our patients. Across our book of business, approximately 30 percent of all QuadMed appointments are same day. On-Site Clinic Operations Describe the process that would be undertaken to measure outcomes and the success of the overall program. QuadMed measures program outcomes and overall success through a comprehensive, data-driven approach that integrates clinical, operational, financial, and experiential metrics. The process begins with establishing performance guarantees tailored to each client’s population and goals. Clinical outcomes: QuadMed tracks, monitors and reports clinical quality metrics through our Epic EMR, which provides sophisticated data aggregation and analytics. QuadMed’s clinical quality and informatics teams use multiple sources of information to create metrics and monitor outcomes, including nationally recognized screening benchmarks for preventive care, health screenings and chronic condition management. QuadMed aligns goals and metrics with each client’s unique member demographics, health risks and business priorities. Patient satisfaction: Following a visit, the patient receives a link to the satisfaction survey in English and Spanish via text or email. Our secure third-party vendor administers the survey and generates confidential, aggregated data. These metrics drive process and service improvement opportunities. Changes in cost of care: With access to the County's medical and pharmacy claims data, we can demonstrate the total cost of care savings for your population. We compare health status and cost of care for QuadMed health center users versus non-users. Experience shows that on a risk-adjusted basis, Page 2748 of 3707 Confidential and Proprietary • Collier County, FL Page 9 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 health center users may have a higher risk profile than non-users, yet their ER and urgent care utilization, inpatient days, and lost workdays are significantly less – translating into cost savings. Health center utilization: Your QuadMed Senior Marketing Strategist will provide reports on the success of specific marketing and health education campaigns to drive awareness, utilization and engagement. Outline standard and custom reporting capabilities that are available to County management. QuadMed’s standard reporting package includes a comprehensive set of operational, quality, and financial metrics. Collier County's dedicated client support team will provide monthly, mid-year and annual actionable performance reports. Monthly reports include health and wellness center utilization, provider utilization, visit numbers and patient satisfaction. Mid-Year reports include the monthly metrics plus measures on clinical quality, patient engagement, financial performance, and operational performance. Because QuadMed’s reporting is so extensive, our clients rarely need custom or ad hoc reports. Should Collier County have a specific data need that is not covered in the standard reporting, we can provide custom reports as needed. Complex requests may require an additional fee to cover staff time for developing the report. Please refer to All Reporting Samples.pdf, attached. Describe how your firm specifically evaluates the effectiveness of primary care case management. QuadMed believes our whole-person care model—designed to slow the pace of care through longer appointment times—enables patients and providers to build meaningful, trusting relationships. This approach allows time for education, coaching, and coordinated care, which we’ve found leads to measurable benefits for both employees and employers. QuadMed uses operational data, claims data and engagement strategy data to regularly analyze trends and match recommended services to the population’s needs to help patients and the client attain their goals. We believe this approach helps us respond quickly to changing needs and understand what will motivate this population to increase utilization or otherwise decrease health care spend. Because Quad is both our parent company and our client, we have a built-in innovation lab where we explore different services, technology and programs before we introduce them to our clients. Provide all clinical indicators used to track the success of the program and the results (if any), by year since the inception of the program, including the following: • Program outcomes • Utilization measures (list) • Member satisfaction • Changes in the cost of care • Productivity/absenteeism (list indicators) Program outcomes: QuadMed monitors and reports clinical quality metrics through our Epic EMR system, which enables advanced data aggregation and analytics. Our clinical quality and informatics teams leverage multiple data sources—including nationally recognized benchmarks—to track outcomes in preventive care, health screenings, and chronic condition management. We tailor goals and metrics to align with each client’s unique member demographics, health risks, and business priorities. Within Epic, we track a wide range of metrics to evaluate patient engagement and health outcomes. Example datapoints include: Clinical Quality Indicators  Preventive care metrics for: o Breast Cancer Page 2749 of 3707 Confidential and Proprietary • Collier County, FL Page 10 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 o Cervical Cancer o Colorectal Cancer o Lung Cancer  Chronic condition control rates: o Blood Pressure o Hemoglobin A1c  Quality metrics for: o Diabetes o Hypertension o Obesity o Asthma  Depression screening and monitoring  Immunization status  Chronic condition management  Biometrics  Patient risk scores Operational and Engagement Metrics  Provider utilization  Schedule utilization  No-show and late cancellation rates  MyChart activation rates  Patient utilization and engagement levels Utilization measures (list): The QuadMed Senior Marketing Strategist will provide reports on the success of specific marketing and health education campaigns to drive awareness, utilization and engagement. Member Satisfaction: Following a visit, the patient receives a link to the satisfaction survey in English and Spanish via text or email. Our secure third-party vendor administers the survey and generates confidential, aggregated data. These metrics drive process and service improvement opportunities. Changes in the cost of care: With access to the County’s medical and pharmacy claims data, we can demonstrate total cost of care savings for your population. By comparing health status and cost metrics between QuadMed health center users and non-users, we consistently observe that—even when users have a higher risk profile on a risk-adjusted basis—they experience significantly lower emergency room and urgent care visits, fewer inpatient days, and reduced lost workdays. These improvements translate into measurable cost savings. When medical and prescription claims data is available, we can track health plan savings for members actively engaged with clinical services. Indicators of cost efficiency include: Page 2750 of 3707 Confidential and Proprietary • Collier County, FL Page 11 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397  Reduced ER and urgent care utilization  Improved prescription adherence  Fewer specialty referrals  Lower inpatient hospitalization rates Productivity/absenteeism (list indicators): Rather than measuring absenteeism, we use a productivity savings formula that quantifies the value of quicker access to care through onsite or near-site health centers. This model captures time saved from reduced travel and wait times, multiplied by the employee’s average hourly wage, to calculate productivity gains. These savings are incorporated into our financial performance reporting and are shared in our mid-year reports to demonstrate the broader impact of accessible, efficient care. Technology and Equipment Do you provide computers to the clinic staff, and do you have your own IT team? Yes, QuadMed provides computers to health center staff and maintains its own dedicated IT team to support health center operations. QuadMed is responsible for supplying and supporting all computer and server infrastructure within the health centers it manages. This includes telephonic and computer hardware and software, which are provided without markup as pass-through expenses to clients. Additionally, QuadMed’s IT team ensures compliance with internal policies and provides ongoing support through a structured helpdesk system. What system will be used to keep Electronic Medical Records for clinicians and personal health records for patients? Is this system something you own, or is it outsourced to another vendor? QuadMed partners with Epic, the gold standard electronic medical record (EMR) platform. Epic offers the greatest level of interoperability, allowing QuadMed to connect more easily with other community providers to ensure seamless and cost-effective care delivery across the continuum, which minimizes gaps in care and provides better outcomes for patients. QuadMed has earned a 9-gold star rating from Epic, which demonstrates the organization's rigor in operationalizing Epic updates and functionality to maximize its impact on provider support, patient care, and reporting. What online access is available to County employees who are patients of the clinic(s)? MyChart Patient Portal: MyChart, the industry-leading patient portal, enhances the patient experience through online and mobile applications that make access easy and convenient. Appointment scheduling is seamless and allows the patient to select the type of visit they prefer: in-person, video or phone. With Epic’s Native Video Client, virtual visits are launched with the simple click of a button. Additionally, MyChart supports patient-provider communication within a highly secure, confidential platform. Patients are more engaged in their health care when they have easy access to key portions of their records, such as test results, after-visit summaries, medications, immunization histories, allergies, health issues and health maintenance reminders. In addition, MyChart allows you to securely message your providers, making it easy to ask questions or follow up on care. You can also request prescription refills, complete necessary forms online, and access a comprehensive health education library filled with trusted resources to support your wellness journey. Everything is designed to be convenient, secure, and accessible—so you can manage your health on your schedule. Page 2751 of 3707 Confidential and Proprietary • Collier County, FL Page 12 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 Do you offer a patient portal? If yes, please describe the system and its capabilities. Yes. QuadMed uses Epic’s MyChart, the industry-leading patient portal that enhances the patient experience through online and mobile applications for easy, convenient access. Appointment scheduling is seamless and allows the patient to select the type of visit they prefer: in-person, video or phone. With Epic’s Native Video Client, virtual visits are launched with the simple click of a button. Additionally, MyChart supports patient-provider communication within a highly secure, confidential platform. Patients are more engaged in their health care when they have easy access to key portions of their records, such as test results, after-visit summaries, medications, immunization histories, allergies, health issues and health maintenance reminders. The MyChart app is a free download available for Apple or Android devices. Invoice/Billing Describe the ability to deliver a fixed-fee billing model to the County based on Exhibit C Pricing Sheet. Yes. The County will receive an invoice each month for the total annual fee divided by 12 to produce a monthly cost, plus that month’s pass-through expenses. What is your performance guarantee with a portion of the fees at risk model? Describe your performance guarantees relative to patient satisfaction, member engagement, member risk-level reduction, and implementation timeline. QuadMed will collaborate with Collier County to define mutually agreed-upon performance guarantees and metrics that align with our shared goals for both transition and ongoing operations. Throughout the transition, the QuadMed team will stay in close contact to ensure that schedules and budgets are maintained. Any concerns or risks of delay are brought up at regular transition team meetings and addressed to mitigate that risk and maintain the schedule. QuadMed’s transition team will keep the County well informed of our progress. After the transition is complete, the QuadMed client success team will maintain regular communications with the County and provide monthly and mi-year report outs with data and metrics in support of these performance guarantees. This process ensures we are tracking and measuring our progress toward the identified guarantee metrics. Transition/Implementation guarantees Adherence to Schedule: This metric ensures that all the steps necessary to begin seeing patients on Day 1 are completed in a timely manner. A performance guarantee on this metric could include hiring and/or training staff, ensuring necessary equipment is in place and in good working order, completing technology integrations, transferring medical records, or sending initial marketing communications to introduce the clinics’ new management and staff members to drive interest and engagement. Adherence to Budget: Being able to work within a reasonable budget is essential in any circumstance but even more so when building new relationships. QuadMed has an exceptional record of creating accurate transition budgets and managing within them. Ongoing Performance Guarantees Health Outcomes: Our population health-focused approach addresses the top cost drivers by measuring the compliance of cancer screenings and chronic condition management. The care teams work diligently to ensure patients obtain recommended preventive and monitoring exams to reduce or avoid costlier and more complicated disease states. Page 2752 of 3707 Confidential and Proprietary • Collier County, FL Page 13 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 Engagement: Increased utilization of the clinics results in enhanced engagement and supports patients in taking an active role in their own health, driving a higher ROI. Patient Experience: This metric is at the core of all we do at QuadMed. If a patient is able to see their provider when they need to, has their questions addressed, and feels as though they are the most important person in the room, they are much more likely to follow medical guidance on small issues as well as large. Exceptional patient experience also creates an environment to promote other healthy behaviors and lifestyle adjustments. Cost Reduction: QuadMed is committed to partnering with the County to manage costs effectively while ensuring we have the tools to deliver excellent care and increase utilization. Our client operations team approaches fiscal management with a focus on establishing a budget that aligns with the County's financial parameters and managing to that budget effectively. QuadMed will put 100% of our management fees at risk for performance guarantees. Page 2753 of 3707 Table of Contents Section C Experience and Capacity of the Firm, Including Specialized Experience of Team Members Page 2754 of 3707 Confidential and Proprietary • Collier County, FL Page 14 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 VALUATION CRITERIA NO. 3: EXPERIENCE AND CAPACITY OF THE FIRM, INCLUDING SPECIALIZED EXPERIENCE OF TEAM MEMBERS (25 Total Points Available) In this criteria, include but not limited to:  Provide information that documents your firm’s qualifications to produce the required deliverables, including abilities, capacity, skills, and financial strength, and the number of years of experience in providing the required services. QuadMed has delivered on-site, near-site, and shared-site health center services to both public and private employers for over 34 years. As a wholly owned subsidiary of Quad/Graphics, Inc. (NYSE: QUAD), a controlled public company with majority voting control held by the Quadracci family, QuadMed brings the stability and backing of a trusted parent organization. The company has successfully staffed and operated health and wellness centers of varying sizes and possesses the full range of resources necessary to provide Collier County with all requested services and materials within the required timeframe. QuadMed holds multi-site accreditation from the Accreditation Association for Ambulatory Health Care (AAAHC), and many of its primary care practice sites have also earned Patient-Centered Medical Home Certification. Employers across the country rely on QuadMed to enhance member health, manage healthcare costs, foster a culture of wellness, mitigate health and safety risks, and deliver exceptional care. With a 98% patient satisfaction rate and an average client tenure exceeding seven years, QuadMed also boasts industry-leading provider retention—averaging 7.3 years for physicians and 5.5 years for mid-level providers. Managing worksite health centers is QuadMed’s sole focus, and its expertise spans a wide range of industries, including municipalities. Beyond clinical care, QuadMed equips clients with essential management tools and infrastructure, including the Epic electronic medical record system and MyChart patient portal, ensuring transparency and operational efficiency. As the only onsite service provider in the industry to achieve Epic Gold Stars Level 9 status, QuadMed demonstrates its commitment to leveraging best-in-class technology to support coordinated, efficient, and high- quality care. Through ongoing investment and innovation, QuadMed continues to evolve its whole- person care model to meet the dynamic needs of its clients.  Describe the various team members’ successful experiences. QuadMed’s account management team comprises three levels of continuous involvement: Health Center Manager, Operations Manager, and the Director of Operations. Health Center Manager: o Associate degree in business, healthcare administration, nursing or closely related field. o Bachelor's degree in business, healthcare administration, nursing or closely related field preferred. Page 2755 of 3707 Confidential and Proprietary • Collier County, FL Page 15 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 o At least three (3) years of leadership experience (with direct reports) in a healthcare setting. o Familiarity with practice management software and electronic medical records strongly preferred. o Current CPR (BLS) certification or must be obtained within 60 days of hire. o Current and valid license in the state of the position or compact state license for those with a nursing degree. Operations Manager: o Bachelor's degree in business, Management, Healthcare Administration, Nursing or related field (or experience in lieu of education) o A clinical degree (LPN, RN, BSN, APP) preferred but not required o Minimum five (5) years clinic/practice management experience o Account management preferred o Business and client relations with a solid foundation of business acumen to help drive solutions for health plan initiative preferred We will make these critical staff assignments only after gaining a better understanding of the County’s culture, population needs, and preferences. More information about the individuals who will fill these roles will be provided later in the process. Rest assured, they will be highly qualified, a good fit for your culture and demographics, and acutely responsive to the County’s every need. Director of Operations, Kristin McLallen, located in Florida: Kristin brings over 20 years of health care operations leadership experience to QuadMed including 9 years with Premise Health as a Director and Senior Director of Operations. She previously worked for two medical centers and held positions as a Practice Administrator and Site Manager. Kristin was responsible for managing multiple health centers delivering a full spectrum of services including primary care, occupational health, behavioral health, physical therapy, pharmacy and more. She also implemented new site expansions for major corporate clients and led strategic initiatives to drive client retention. a. Proposals must identify appropriate medical personnel, and a schedule of hours needed to successfully provide services, and will incorporate some or all of the following staff positions: i. Receptionist Staff (see Medical Assistant) o Medical Assistants are cross-trained in both reception and phlebotomy to enhance efficiency and ensure broader coverage. ii. Medical Technician (see Medical Assistant) iii. PA-C/APRN (see Advanced Practice Providers/Nurse Practitioners) Page 2756 of 3707 Confidential and Proprietary • Collier County, FL Page 16 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 iv. Phlebotomist (see Medical Assistant) o Medical Assistants are cross-trained in both reception and phlebotomy to enhance efficiency and ensure broader coverage. v. Administrative Services (see Medical Assistant) vi. Physician Medical Director (see Oversight Physician) Minimum Qualifications Oversight Physician  MD or DO degree from an accredited school of Medicine or Osteopathy, and completion of a family practice or internal medicine/pediatrics residency program  Board certification or eligibility  Active and unrestricted state license and current DEA registration  Minimum of three years of experience  Current CPR (BLS) certification or must be obtained within 60 days of hire Advanced Practice Providers/Nurse Practitioners  Completion of Master's degree level physician assistant program from accredited college/university  Active and unrestricted applicable licensure and current national board certification  3+ years of primary care experience preferred  NPI & DEA (if applicable)  Current CPR (BLS) certification or must be obtained within 60 days of hire Medical Assistant  Graduate of accredited medical assistant program  Current BLS and/or CPR certification or must be obtained within 60 days of hire  Minimum of one year of experience as a medical assistant  Phlebotomy and lab experience  Experience working in a medical facility and/or front office b. Please provide professional resumes for all the above-mentioned staff positions. Please see QuadMed Job Descriptions.pdf, attached. Page 2757 of 3707 Confidential and Proprietary • Collier County, FL Page 17 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397  Description of the proposed team/staff and the role to be played by each member of the team. QuadMed’s account management team comprises three levels of continuous involvement: Health Center Manager, Operations Manager, and the Director of Operations. Health Center Manager: Oversees daily operations, ensures clinical quality, and leads the onsite team. Operations Manager: Serves as the primary day-to-day contact, responsible for executing strategies, monitoring performance, and maintaining open communication. This role includes quarterly onsite visits and 24/7 availability for client needs. We will make these critical staff assignments only after gaining a better understanding of the County’s culture, population needs, and preferences. Director of Operations, Kristin McLallen, located in Florida: Provides strategic oversight, drives long-term planning, and ensures alignment with client objectives. This role also supports the Operations Manager and engages in high-level reporting and consultation.  Describe the approach to management and execution of work with respect to the location of various key contract team members. Demonstrate the coordination between internal and external team members and County staff involved in providing services to the County. The health center manager is responsible for overseeing and directly managing all health center staff. This role includes handling day-to-day operations, ensuring the delivery of quality clinical services in collaboration with the senior medical director, and providing leadership and oversight to the health center team. The operations manager, the County’s primary day-to-day contact, is responsible for the overall operations of your health center, the client relationship, and management support. Working closely with the County, your operations manager will develop, execute, and track strategies to ensure optimal performance of your health center. The operations manager will visit your health center a minimum of four times per year and more often as needed. You can reach your operations manager during business hours and after hours, including weekends. The operations manager reports to Kristin McLallen, director of operations. Kristin drives the creation of healthcare strategy and ensures projects and strategic initiatives are delivered successfully in a timely manner. In addition, QuadMed's senior leadership team will be closely involved in ensuring the health center fulfills the County's business and population health objectives. Senior leadership engagement sets us apart and is a core value in how we do business. Dedicated executive sponsors will be assigned to the County and contact information for QuadMed’s entire senior leadership team will be provided. Our CEO is actively engaged in the day-to-day operations of our company and routinely visits our health centers across the country. The senior and executive leadership teams participate in report-out meetings, as well as regular client leadership meetings, to allow for engagement and support at all levels of clinical and operational management. Page 2758 of 3707 Table of Contents Section D Cost of Services to the County •Exhibit C: Pricing Sheet Page 2759 of 3707 Confidential and Proprietary • Collier County, FL Page 18 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 EVALUATION CRITERIA NO. 4: COST OF SERVICES TO THE COUNTY (30 Total Points Available) Please provide your pricing in Exhibit C titled “Pricing Sheet”. Failure to provide responses may result in your proposal being considered non-responsive.  In Exhibit C, Pricing Sheet, provide the monthly cost to employ and staff the County clinic(s) and perform the biometric testing. Please refer to Exhibit C, Pricing Sheet, attached.  For biometric testing/screening: In Exhibit C, Pricing Sheet, provide the cost per participant for each of the items/tests listed in the pricing sheet. Please refer to Exhibit C, Pricing Sheet, attached.  All line items must be completed; failure to do so may result in the vendor being deemed non- responsive. Confirmed.  Vendors may propose an additional location within the 15-mile radius; however, preference will be given to a single location. If your firm is not proposing an additional location, you are not required to provide pricing for that section. However, please clearly mark each line as “N/A” or “No Bid.” Confirmed.  Any additional charges or conditions must be clearly defined in the vendor’s proposal. Confirmed.  All special billing charges, such as travel, minimum participation, set-up, or similar charges, which are separate from the per participant charge, must be clearly specified in the vendor’s proposal. Confirmed. Page 2760 of 3707 Enrollee Spouse Dependents 16 years of age and over Dependents 15 years of age and under Main Site Clinic Location Regular Hours Expanded Operating Hours Staffing and Management (Monthly) Monday - Friday, 7:00 am - 5:30 pm Monday - Friday, 7:00 am - 7:00 pm Saturday, 8:00 am - 12:00 pm Staffing Cost (state as PEPM)20.17$ 21.00$ Office, Medical Supplies, and Insurance (state as PEPM)11.80$ 11.80$ Management Fee (state as a PEPM)9.50$ 9.89$ Biometrics (state as PEPM)7.75$ 7.75$ Total Cost 49.22$ 50.44$ Additional Site Location, if applicable Regular Hours Expanded Operating Hours Staffing and Management (Monthly) Monday - Friday, 7:00 am - 5:30 pm Monday - Friday, 7:00 am - 7:00 pm Saturday, 8:00 am - 12:00 pm Staffing Cost (state as PEPM)-$ -$ Office, Medical Supplies, and Insurance (state as PEPM)-$ -$ Management Fee (state as a PEPM)-$ -$ Total Cost -$ -$ Biometric and Laboratory Screening Services Cost Per Participant Heart: Total Cholesterol, HDL Cholesterol, Triglycerides, LDL Cholesterol, Cholesterol/HDL ratio 6.20$ Thyroid: TSH (Thyroid Stimulating Hormone)3.50$ Kidneys: Urea Nitrogen (BUN), Creatinine, eGFR, BUN/Creatinine Ratio 2.10$ Bone: Calcium 2.04$ Liver: Direct Bilirubin, GGT, ALT, Total Protein, Albumin, Globulin, Albumin/Globulin Ratio, Total Bilirubin, Alkaline Phosphatase, AST 4.69$ Pancreas: Glucose and Hemoglobin A1C 6.84$ Whole Body: Sodium, Potassium, Chloride, CBC with differential: White Blood Cell Count, Red Blood Cell Count, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet Count 4.58$ Lungs: Cotinine (blood sample)42.00$ Prostate: Prostate Specific Antigen (per gender)5.00$ Biometric Measurements: Measured height, weight, blood pressure, waist circumference, and calculated BMI See Above Personal Summary Report Included Total Cost 76.95$ Follow Up Laboratory Testing Services- Cost Per Test Cost Per Participant Serum Nicotine/Cotinine 42.00$ Hemoglobin AIC 4.80$ Lipid Panel 6.20$ Combination test of Hemoglobin AIC + Lipid Panel 11.00$ Total Cost 64.00$ Implementation Fee 15,000.00$ Total Cost 15,000.00$ Exhibit C Pricing Sheet for Solicitation NO.: 25-8397: Comprehensive Clinic and Wellness Services Estimated Eligible Health Plan Enrollment 2323 1008 789 680 Page 2761 of 3707 Table of Contents Section E Business Implementation Page 2762 of 3707 Confidential and Proprietary • Collier County, FL Page 19 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 EVALUATION CRITERIA NO. 5: BUSINESS IMPLEMENTATION (10 Total Points Available) In this criteria, include but not limited to:  Provide your implementation transition plan if awarded the resultant contract, including the timeline from the award date to the implementation start date, with your major milestones identified. Base your plan on January 1, 2026, start date. While 120 days is our standard implementation timeline, we can meet a 90-day schedule if staffing resources remain in place. Page 2763 of 3707 Confidential and Proprietary • Collier County, FL Page 20 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 Location Strategy Overview for Collier County Health Center QuadMed has identified four potential locations for the Collier County health center. Each site was selected based on strategic criteria including accessibility, population density, and proximity to high- need areas. These options provide flexibility in aligning with the County’s operational goals and community health priorities, and will support the delivery of high-quality, integrated care to employees. QuadMed will conduct in-person site visits for each of the four proposed health center locations to assess their suitability and readiness. Based on preliminary evaluations, we anticipate the need to negotiate at least a basic refresh to align the spaces with clinical and operational requirements. In some cases, more extensive modifications may be necessary, including the installation of cabinetry, sinks, shut-off valves, access controls, and other essential infrastructure to ensure compliance with healthcare standards and support optimal functionality. As with any real estate, property availability is subject to change. While these sites have been identified as potential options, they may or may not be available at the time of final agreement. QuadMed will continuously evaluate the market and update location options as new opportunities arise. Page 2764 of 3707 Confidential and Proprietary • Collier County, FL Page 21 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 OPTION A: 671 Goodlette Frank Road – Suite #200 (2,545 SF) near-immediate occupancy. $24/SF + $10.53 CAM = $7,323.00/month OPTION B: 4081 Tamiami Trail North, Suite #C203 Naples, FL (2,714 SF) $25/SF= $5,654.00/month + utilities & property expenses Page 2765 of 3707 Confidential and Proprietary • Collier County, FL Page 22 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 OPTION C: 5500 Bryson Dr, Naples, FL - Suite #301 & #303 (3,000 SF) $31/SF = $7,750/month + utilities & property expenses OPTION D: 3555 Kraft Road – Suite #120, Naple, FL (3,057 SF) $32.00/SF + $12.00/SF CAM = $11,209/month Page 2766 of 3707 Confidential and Proprietary • Collier County, FL Page 23 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397  How do you propose transitioning the service from the current vendor to your firm? QuadMed is experienced in providing efficient and seamless health center transitions. We believe the biggest focus should be on avoiding disruption in care and maintaining continuity of services. To achieve this, coordination of efforts between the County and QuadMed is key. We want to fully understand both the positive and negative experiences with the previous vendor and partner with you to rebuild a renewed sense of confidence and trust. Our goal is to continue to support and foster success while addressing gaps and previous pain points with your health center. QuadMed has transitioned 70% of our health centers. To facilitate a smooth transition, the County will have a dedicated multidisciplinary transition team led by a QuadMed senior project manager. The team will include the operations director, operations manager, health clinic manager and senior marketing strategist who will support the County on an ongoing basis. Additionally, subject matter experts from various disciplines, including information services, clinical quality, training, recruiting, lab and more will join as needed. We follow a time-tested implementation process to ensure all critical milestones are met. Upon award of the contract, the QuadMed team will schedule a kick-off meeting with the County to determine transition timelines and meeting cadence, develop strategic plans and objectives, and determine performance metrics. We encourage a variety of information-gathering efforts, such as focus groups and online surveys, for QuadMed to learn about the County's culture and population.  What will be the role of CCG in the selection of staff? Transitioning the County's health center will require some support from County staff, but the additional administrative burden is expected to be minimal. Key areas of support include reviewing and approving communication materials, coordinating with various County departments, assisting with organizing and promoting onsite events, collaborating on data sharing and integration, and providing ongoing communication and feedback through quarterly review meetings. Overall, the total estimated staff time required is approximately 10-15 hours per month, with additional time for specific events and data integration tasks. This support will help maintain the clinic's effectiveness and alignment with the County’s objectives.  Would you consider the utilization of existing staff? Yes. QuadMed will collaborate with the County to staff your health center, retaining your existing staff when possible. The level of involvement typically varies based on the role being filled. For key positions like the health provider, we encourage the County to have a “meet and greet” with the final candidate to ensure a good fit before QuadMed makes an offer.  How do you plan to transition existing patients? QuadMed utilizes the industry-standard Continuity of Care Document Architecture (C-CDA) format to securely exchange patient data between organizations and healthcare providers. This format is required for all electronic health record (EHR) systems, including Athena, ensuring compatibility and consistency. Early in the transition process, QuadMed will collaborate with the County’s current healthcare vendor to establish and process C-CDA files for any patient medical records that need to be transferred. The success of this data exchange depends on the technical capabilities of the Page 2767 of 3707 Confidential and Proprietary • Collier County, FL Page 24 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 existing vendor’s EHR system. If necessary, patients may also request that their records be transferred directly to QuadMed. While C-CDA does not represent a complete medical chart, it includes all essential information needed for continuity of care—such as demographics, progress notes, medical history, problem lists, medications, allergies, and immunizations. In addition to C-CDA-based data exchange, QuadMed can access patient information from non-Epic healthcare organizations through Epic’s Care Everywhere platform and the Carequality network, further enhancing interoperability and care coordination. Page 2768 of 3707 Table of Contents Section F Certified Minority Business Enterprise Page 2769 of 3707 Confidential and Proprietary • Collier County, FL Page 25 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 EVALUATION CRITERIA NO. 6: CERTIFIED MINORITY BUSINESS ENTERPRISE (5 Total Points Available) Submit certification with the Florida Department of Management Services, Office of Supplier Diversity as a Certified Minority Business Enterprise. QuadMed is not currently certified as a Minority Business Enterprise (MBE) with the Florida Department of Management Services, Office of Supplier Diversity. As a wholly owned subsidiary of Quad/Graphics, Inc., a publicly traded company (NYSE: QUAD), QuadMed does not meet the ownership structure requirements necessary for MBE certification under Florida’s program guidelines. However, QuadMed is committed to supporting supplier diversity and is open to partnering with certified MBE subcontractors to meet or exceed participation goals outlined in the RFP. We welcome the opportunity to collaborate with local or state-certified minority-owned businesses to deliver high-quality, community-aligned healthcare services. Page 2770 of 3707 Table of Contents Section G Local Vendor Preference Page 2771 of 3707 Confidential and Proprietary • Collier County, FL Page 26 of 26 Collier County, FL Comprehensive Clinic and Wellness Services Solicitation No.: 25-8397 EVALUATION CRITERIA NO. 7: LOCAL VENDOR PREFERENCE (10 Total Points Available) Local business is defined as the vendor having a current Business Tax Receipt issued by the Collier or Lee County Tax Collector prior to proposal submission to do business within Collier County, and that identifies the business with a permanent physical business address located within the limits of Collier or Lee County from which the vendor’s staff operates and performs business in an area zoned for the conduct of such business. While QuadMed does not currently maintain a local vendor presence in Collier or Lee County, Florida, we have developed a proven implementation and operational model that ensures seamless service delivery regardless of geographic location. QuadMed maintains a robust national recruiting infrastructure that enables us to source and retain high-quality clinical and administrative staff from the local area. We prioritize hiring local talent to ensure cultural alignment and community familiarity, and we offer relocation support when necessary to fill specialized roles. Our remote support capabilities are anchored by a centralized operations team, a 24/7 IT help desk, and a dedicated client services group that ensures real-time responsiveness and accountability. We also leverage our Epic-based electronic medical record system and MyChart patient portal to provide continuity of care, data transparency, and operational oversight from any location. Page 2772 of 3707 Table of Contents Section H Vendor Checklist Page 2773 of 3707 Page 2774 of 3707 Table of Contents Section I Exhibit A: Sample of a Wellness/Biometric Personal Summary Report •Sample 1_Biometric Screening Result Form •Sample 2_Biometric Screening Result Form Page 2775 of 3707 BIOMETRIC HEALTH SCREENING If your values fall out of optimal ranges, please consult your primary care provider to review your results. Instructions: Please complete the information in this box. The results from your screening will be recorded below. Participant Name (Please print – First/Last LEGAL name)Status: Employee Spouse Screening Location: Today’s Date: / / Preferred Email: Date of Birth: / /Gender: F M Daytime Phone Number: Tobacco User? Yes No Are you fasting today? Yes No *If you are not fasting, your results could be elevated. SCREENER MRN # ©2025 QuadMed, LLC. All rights reserved. | HAMPTON065 | Rev. 05.25 RESULTS HEIGHT (in inches) WEIGHT (in pounds) SCREENING YOUR RESULTS LOW RISK MODERATE RISK HIGH RISK Keep up the good work! Consider taking action to improve. Talk to your primary care provider and take action as soon as possible. WAIST CIRCUMFERENCE (MEN)< 31.5 31.5 - 39.5 > 39.5 WAIST CIRCUMFERENCE (WOMEN)< 29.5 29.5 - 34.5 > 34.5 BLOOD PRESSURE Left Right Normal Systolic: Less than 120 Diastolic: Less than 80 Prehypertension Systolic: 120-139 Diastolic: 80-89 BLOOD PRESSURE 2 Left Right TOTAL CHOLESTEROL < 200 200-230 > 230 HDL CHOLESTEROL > 60 40-60 < 40 TRIGLYCERIDES*< 150 150-199 > 199 LDL CHOLESTEROL*< 100 100-160 > 160 A1C 4.2-5.6 5.7-6.4 ≥ 6.5 and and or Hypertension Stage 1 Systolic: 140-159 Diastolic: 90-99 or Hypertension Stage 2 Systolic: 160+ Diastolic: 100+ and/or Hypertensive Crisis (Emergency Care Needed) Systolic: 180+ Diastolic: 120+ Page 2776 of 3707 ©2025 QuadMed, LLC. All rights reserved. | HAMPTON065 | Rev. 05.25 WHAT DO MY TEST RESULTS MEAN? WAIST CIRCUMFERENCE Waist circumference is a measurement of the distance around the waist, usually just above the belly button. Waist circumference is an indicator of increased health risk for hypertension, type 2 diabetes, high cholesterol, and heart disease. BLOOD PRESSURE Blood pressure is the force of blood pushing against blood vessel walls. Systolic blood pressure is the higher or top number and measures the pressure exerted against artery walls when the heart pumps. Diastolic blood pressure is the lower or bottom number and measures the pressure exerted against the artery walls when the heart is relaxing between beats. Elevated blood pressure greatly increases your risk for heart attack, stroke, kidney disease and heart failure. TOTAL CHOLESTEROL Cholesterol is a waxy substance found in every cell of the body, and is used to make hormones and bile acids, which help to digest food. Cholesterol is carried in the blood by particles called lipoproteins. Your body manufactures all the cholesterol it needs from animal products in your diet. HDL (HIGH DENSITY LIPOPROTEIN) The HDL particle carries artery-clogging cholesterol away from blood vessel walls. A high level of HDL helps to reduce your risk of heart disease, while a low level increases your risk. TRIGLYCERIDES Triglycerides are a major form of fat found in food and in the body. Levels can rise greatly after eating a fatty meal. Being overweight, having diabetes, or consuming sugar, simple carbohydrates, animal fat or excess alcohol can raise levels. Those over 500 should be addressed by a health care provider. LDL (LOW DENSITY LIPOPROTEIN) The LDL particle delivers cholesterol to blood vessel walls where it can deposit and form artery-clogging plaque. Elevated LDL is strongly linked to an increased risk of heart disease, which is the number one cause of death in the United States. If you’re age 40 – 75 with LDL 130 or greater your health care provider may recommend medication to lower your risk for heart attack or stroke based on other risk factors, such as smoking, diabetes, high blood pressure, low HDL, gender or family history of early heart disease. A1C A1C is the average blood sugar levels over the past 3 months (90 days). It is used to diagnose and assess control for diabetes, but it can also indicate pre-diabetes, a condition that can progress to Type 2 diabetes if left untreated. High A1C requires prompt treatment and should not be ignored. If you are in the moderate or high-risk range for A1C, be sure to speak with your provider. HOW CAN I IMPROVE MY RESULTS? WAIST CIRCUMFERENCE Lose excess weight and increase physical activity. Increasing physical activity and limiting fat intake will help to burn excess calories and rid the body of fat stored in the abdomen and throughout the rest of the body. Resistance training specifically helps to build lean muscle mass, which can help to decrease the percentage of body weight that is made up of fat. HIGH BLOOD PRESSURE Lose excess weight and increase physical activity. Cut back on sources of saturated fat and cholesterol – namely, animal foods to include whole milk, cheese, butter, eggs, processed and red meat (bacon, sausage, hot dogs). Limit foods that contain partially hydrogenated oil and trans-fat, such as fried foods and snack items like chips and pastries. Choose fat-free or low-fat dairy products, and increase fiber-rich foods like fruits, vegetables, legumes (black, kidney, red, and pinto beans, split peas, lentils), and cereals such as oatmeal and bran flakes. LOW HDL CHOLESTEROL Lose excess weight and increase your activity level, quit smoking, and include heart-healthy monounsaturated fats. Food sources of these fats include nuts and nut butters (peanut, almond, or cashew butter), olive oil, canola oil, and avocados. ELEVATED TRIGLYCERIDES Lose excess weight and increase physical activity. Limit sources of saturated fat (see above recommendations for high cholesterol), and cut back on added sugars like those found in desserts and sweets. Decrease your intake of alcoholic beverages, regular sodas, lemonade, fruit juices, and fruit “drinks.” Aim to eat omega-3 fatty acids from fish twice per week; good sources include salmon, halibut, tuna, mackerel and sardines. Ask your doctor about taking a fish oil supplement if you do not eat fish. Page 2777 of 3707 BIOMETRIC HEALTH SCREENING If your values fall out of optimal ranges, please consult your primary care provider to review your results. Instructions: Please complete the information in this box. The results from your screening will be recorded below. Participant Name (Please print – First/Last LEGAL name)Status: Employee Spouse Screening Location: Today’s Date: / / Preferred Email: Date of Birth: / /Gender: F M Daytime Phone Number: Tobacco User? Yes No Are you fasting today? Yes No *If you are not fasting, your results could be elevated. SCREENER MRN # ©2025 QuadMed, LLC. All rights reserved. | HAMPTON065 | Rev. 05.25 RESULTS HEIGHT (in inches) WEIGHT (in pounds) SCREENING YOUR RESULTS LOW RISK MODERATE RISK HIGH RISK Keep up the good work! Consider taking action to improve. Talk to your primary care provider and take action as soon as possible. WAIST CIRCUMFERENCE (MEN)< 31.5 31.5 - 39.5 > 39.5 WAIST CIRCUMFERENCE (WOMEN)< 29.5 29.5 - 34.5 > 34.5 BLOOD PRESSURE Left Right Normal Systolic: Less than 120 Diastolic: Less than 80 Prehypertension Systolic: 120-139 Diastolic: 80-89 BLOOD PRESSURE 2 Left Right TOTAL CHOLESTEROL < 200 200-230 > 230 HDL CHOLESTEROL > 60 40-60 < 40 TRIGLYCERIDES*< 150 150-199 > 199 LDL CHOLESTEROL*< 100 100-160 > 160 A1C 4.2-5.6 5.7-6.4 ≥ 6.5 and and or Hypertension Stage 1 Systolic: 140-159 Diastolic: 90-99 or Hypertension Stage 2 Systolic: 160+ Diastolic: 100+ and/or Hypertensive Crisis (Emergency Care Needed) Systolic: 180+ Diastolic: 120+ Page 2778 of 3707 ©2025 QuadMed LLC. All rights reserved. | QUADWELL029 | Rev. 06.25 If your values fall out of optimal ranges, please consult your primary care provider to review your results. BIOMETRIC HEALTH SCREENING Please complete the information in this box. Participant Name (Please print clearly - LEGAL First and Last name)Status: Employee Spouse Employee Number: Today’s Date: / /Date of Birth: / /Screening Location: Preferred Email:Daytime Phone: Tobacco User? Yes No Are you fasting today? Yes No *If you are non-fasting, your results could be impacted. MM DD YY MM DD YY RESULTS HEIGHT (in inches) WEIGHT (in pounds) SCREENING YOUR RESULTS LOW RISK MODERATE RISK HIGH RISK Keep up the good work! Consider taking action to improve. Talk to your primary care provider and take action as soon as possible. BMI 18.5 - 24.9 25 - 29.9 <18.5 or > 29.9 BLOOD PRESSURE Left Right Normal Systolic: Less than 120 Diastolic: Less than 80 Prehypertension Systolic: 120-139 Diastolic: 80-89BLOOD PRESSURE 2 Left Right TOTAL CHOLESTEROL < 200 200-230 > 230 HDL CHOLESTEROL > 60 40-60 < 40 TRIGLYCERIDES*< 150 150-199 > 199 LDL CHOLESTEROL*< 100 100-160 > 160 A1C 4.2-5.6 5.7-6.4 ≥ 6.5 NICOTINE TEST Positive for cotinine Negative for cotinine and and or Hypertension Stage 1 Systolic: 140-159 Diastolic: 90-99 or Hypertension Stage 2 Systolic: 160+ Diastolic: 100+ and/or Hypertensive Crisis (Emergency Care Needed) Systolic: 180+ Diastolic: 120+ Page 2779 of 3707 ©2025 QuadMed LLC. All rights reserved. | QUADWELL231 | Rev. 05.25 WHAT DO MY TEST RESULTS MEAN? BODY MASS INDEX (BMI) Body mass index is a ratio of height to weight, measured in kilograms per meter squared. A higher-than-average BMI statistically increases your health risks compared to individuals with acceptable levels. BLOOD PRESSURE Blood pressure is the force of blood pushing against blood vessel walls. The higher number measures pressure when the heart is pumping and the lower number measures pressure between beats. Elevated blood pressure greatly increases your risk for heart attack, stroke and kidney and heart disease. High blood pressure requires prompt treatment and should not be ignored. If you are in the moderate or high-risk range for blood pressure, be sure to speak with your provider. TOTAL CHOLESTEROL Cholesterol is a waxy substance that circulates in the blood. Your body manufactures all the cholesterol it needs. Excess cholesterol, or plaque, can build up on artery walls and cause health problems including heart disease. Diet and genetic factors can both affect total cholesterol levels. HDL (HIGH DENSITY LIPOPROTEIN) HDL helps to remove artery-clogging cholesterol from your body. A high level of HDL reduces the risk of heart disease, while a low level may increase the risk. TRIGLYCERIDES Triglycerides are a form of fat that provide energy for your body. High levels of triglycerides, especially in people who are overweight or have diabetes, can increase the risk of heart disease. LDL (LOW DENSITY LIPOPROTEIN) LDL delivers cholesterol to blood vessel walls where it can form artery-clogging plaque. Elevated LDL is linked to an increased risk of heart disease, especially for those ages 45 to 70. If you are in that age range and your LDL is 70 or above, be sure to speak with your provider. A1C A1C is the average blood sugar levels over the past 3 months (90 days). It is used to diagnose and assess control for diabetes, but it can also indicate pre-diabetes, a condition that can progress to Type 2 diabetes if left untreated. High A1C requires prompt treatment and should not be ignored. If you are in the moderate or high-risk range for A1C, be sure to speak with your provider. MY RANGES ARE HIGHER — WHAT SHOULD I DO? If you fall in the moderate (yellow) or high-risk (red) ranges, especially in the categories of blood pressure or A1C, QuadMed recommends that you schedule an appointment with your health care provider as soon as possible. High blood pressure greatly increases risk for stroke and heart disease, and high A1C suggests pre-diabetes or diabetes. Elevated ranges in blood pressure and A1C require prompt treatment and should not be ignored. Your provider can suggest lifestyle changes you can make, and in some cases, prescribe medication to better control your measurements. VIEW YOUR RESULTS ONLINE Access your results through your QuadMed MyChart account! If you don’t already have a QuadMed MyChart account, creating an ac- count is easy, just follow the steps below: STEP 1 — Visit myquadmed.com/quad and click the MYCHART SIGN UP button in the top right corner. STEP 2 — Fill out all the information to identify yourself and click SUBMIT. STEP 3 — Check your email for a message from patientsupport@quadmedical.com and click the button in the email. STEP 4 — Confirm your identity and click NEXT. Once your account is set up, you’ll have access to your biometric and other test results and will be able to schedule and change appointments, request prescription refills and more! Page 2780 of 3707 ©2025 QuadMed LLC. All rights reserved. | QUADWELL029 | Rev. 06.25 If your values fall out of optimal ranges, please consult your primary care provider to review your results. BIOMETRIC HEALTH SCREENING Please complete the information in this box. Participant Name (Please print clearly - LEGAL First and Last name)Status: Employee Spouse Employee Number: Today’s Date: / /Date of Birth: / /Screening Location: Preferred Email:Daytime Phone: Tobacco User? Yes No Are you fasting today? Yes No *If you are non-fasting, your results could be impacted. MM DD YY MM DD YY RESULTS HEIGHT (in inches) WEIGHT (in pounds) SCREENING YOUR RESULTS LOW RISK MODERATE RISK HIGH RISK Keep up the good work! Consider taking action to improve. Talk to your primary care provider and take action as soon as possible. BMI 18.5 - 24.9 25 - 29.9 <18.5 or > 29.9 BLOOD PRESSURE Left Right Normal Systolic: Less than 120 Diastolic: Less than 80 Prehypertension Systolic: 120-139 Diastolic: 80-89BLOOD PRESSURE 2 Left Right TOTAL CHOLESTEROL < 200 200-230 > 230 HDL CHOLESTEROL > 60 40-60 < 40 TRIGLYCERIDES*< 150 150-199 > 199 LDL CHOLESTEROL*< 100 100-160 > 160 A1C 4.2-5.6 5.7-6.4 ≥ 6.5 NICOTINE TEST Positive for cotinine Negative for cotinine and and or Hypertension Stage 1 Systolic: 140-159 Diastolic: 90-99 or Hypertension Stage 2 Systolic: 160+ Diastolic: 100+ and/or Hypertensive Crisis (Emergency Care Needed) Systolic: 180+ Diastolic: 120+ Page 2781 of 3707 Table of Contents Section J Attachments Page 2782 of 3707 Table of Contents Attachment 1 All Reporting Samples Page 2783 of 3707 SAMPLE Performance Report JULY 2024 SUPPORT TEAM PRIMARY CONTACT: Page 2784 of 3707 EXECUTIVE SUMMARY UTILIZATION PROVIDER SCHEDULE NO SHOWS MYCHART* 0%50%100% 8,463 SURVEYS SENT 1,961 RESPONSES PROVIDER SATISFACTION*▬ TOTAL PARTICIPATION* PARTICIPATION CURRENT ELIGIBLE POPULATION 10,073 ▼ *Total Participation is based on 12-month rolling data. PATIENTS NEW 130 UNIQUE 3,134 PCP 5,783 89 ▲ 3,212 ▼ 6,227 ▼ KEY TAKEAWAYS: ▲▲▼ 96% JUL-2024 JUL-2023 61%68%9%85% ▼ *MyChart metric equals total users year to date.*All Satisfaction metrics represent year to date. 59% ▲ July 2024 ©2024 QuadMed,LLC.All rights reserved Metrics reflect data for reporting month unless otherwise noted.Arrows indicate year-over-year change. Page 2785 of 3707 TOTAL VISITS 0 500 1,000 1,500 2,000 Jul 23 Aug 23 Sep 23 Oct 23 Nov 23 Dec 23 Jan 24 Feb 24 Mar 24 Apr 24 May Jun 24 Jul 24 24 1,679 1,924 1,591 1,783 1,755 1,684 1,889 1,772 1,679 1,685 1,661 1,505 1,559 164 202 234 244 275 253 313 301 295 284 280 219 255 In-Person Virtual PROVIDER VISIT BY TYPE 13-MONTHS ROLLING Apr 24 May 24 Jun 24 Jul 24 6,703 6,0925,892 6,413 6,092 TOTAL VISITS BY RELATIONSHIP YEAR OVER YEAR JUL-2023 ▼ -2.50% VISIT TREND TOTAL VISITS YEAR OVER YEAR JUL-2024 EMPLOYEE SPOUSE DEPENDENT VISIT TREND 0K 1K 2K 3K Apr 24 May 24 Jun 24 Jul 24 3,748 3,264 3,2183,532 1,623 1,205 1,203 1,4491,439 1,090 1,568 1,187 JUL 2024 JUL 2023 DIFFERENCE 3,264 3,449 -5.36% 1,449 1,605 -9.72% 1,203 1,113 8.09% July 2024 6,248 ©2024 QuadMed,LLC.All rights reserved Page 2786 of 3707 TOTAL PRIMARY SERVICE LINE VISITS 600 400 200 0 1,400 1,200 1,000 800 Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul 23 23 23 23 23 24 24 24 24 24 24 24 474 573 1,404 1,066 840 403 293 291 270 237 236 234 Nurse Visits Previous Year Visits 0 500 1,000 1,500 Aug Sep 23 23 Oct Nov Dec 23 23 23 Jan Feb Mar Apr May Jun Jul 24 24 24 24 24 24 24 1,474 1,410 1,645 1,728 1,566 1,483 1,282 1,228 1,197 1,153 1,090 1,084 Lab Visits Previous Year Visits 0 50 100 150 200 Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul 23 23 23 23 23 24 24 24 24 24 24 24 183 144 177 154 153 174 169 163 159 180 162 184 Radiology Visits Previous Year Visits NURSE VISITS LAB VISITS July 2024 RADIOLOGY VISITS 0 200 400 600 800 1,000 Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul 23 23 23 23 23 24 24 24 24 24 24 24 919 871 978 832 768 931 842 791 887 815 796 808 Previous Year Visits PHYSICAL THERAPY VISITS Physical Therapy Visits ©2024 QuadMed,LLC.All rights reserved Page 2787 of 3707 TOTAL ADDITIONAL SERVICE LINE VISITS 0 200 400 600 800 Aug Sep 23 23 Oct Nov Dec 23 23 23 Jan Feb Mar Apr May 24 24 24 24 24 Jun Jul 24 24 388 487 725 542 185 233 222 242 265 256 217 228 Wellness Visits Previous Year Visits 0 50 100 150 200 250 Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul 23 23 23 23 23 24 24 24 24 24 24 24 222 137 194 213 164 262 220 186 235 194 159 171 Vision Visits Previous Year Visits 0 100 200 300 400 Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul 23 23 23 23 23 24 24 24 24 24 24 24 296 289 387 352 326 398 374 347 353 351 318 337 Previous Year Visits BEHAVIORAL HEALTH VISITS Behavioral Health Visits 0 50 100 150 200 250 Aug Sep 23 23 Oct Nov Dec 23 23 23 Jan Feb Mar Apr May 24 24 24 24 24 Jun Jul 24 24 230 191 209 247 210 234 248 259 235 214 192 Condition Management Visits Previous Year Visits 268 WELLNESS VISITS CONDITION MANAGEMENT VISITS VISION VISITS July 2024 ©2024 QuadMed,LLC.All rights reserved Page 2788 of 3707 0 20 30 40 50 Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul 23 23 23 23 23 24 24 24 24 24 24 24 27 16 21 20 11 14 18 23 20 13 12 10 7 SUBSTANCE USE DISORDER VISITS Substance Use Disorder Visits Previous Year Visits TOTAL ADDITIONAL SERVICE LINE VISITS 0 200 400 600 800 1,000 Aug Sep 23 23 Oct Nov Dec 23 23 23 Jan Feb Mar Apr May Jun Jul 24 24 24 24 24 24 24 971 781 939 927 760 956 931 906 980 930 857 891 Dental Visits Previous Year Visits DENTAL VISITS July 2024 140 120 100 80 60 40 20 0 Aug Sep 23 23 Oct Nov Dec 23 23 23 Jan Feb Mar Apr May 24 24 24 24 24 Jun Jul 24 24 95 79 100 76 62 84 92 90 109 108 107 EMPLOYEE ASSISTANCE PROGRAM VISITS Employee Assistance Program Visits Previous Year Visits 142 ©2024 QuadMed,LLC.All rights reserved Page 2789 of 3707 Behavioral Health Counts the number of visits based on behavioral health appointment types.Each visit represents a unique user and the defined CPT codes per day.For example,if a patient had multiple visits in 1 day,this metric would only count them once. Condition Management Visits Counts the number of visits based on provider specialty of “CCM”or “Chronic Condition Management.”Each visit represents a unique user and the defined provider specialty per day.For example,if a patient had multiple condition management visits in 1 day,this metric would only count them once. Lab Visits Counts the number of visits based on lab CPT codes.Each visit represents a unique user and the defined CPT codes per day.For example,if a patient had multiple lab codes in 1 day,this metric would only count them once. Nurse Visits Counts the number of nurse visits with a CPT code of 99211 or with the servicing provider name containing the word “nurse.”Each visit represents a unique user and the defined metric per day.For example,if a patient had multiple nurse visits in 1 day,this metric would only count them once. Participation –Current Eligible Population Counts the number of employees,spouses and dependents eligible to use the health center within the current month based on the eligibility file.This metric does not apply a specific mile radius to the eligible population. Patients -New A new patient is defined as a patient that has not had a visit with any resource in the last 3 years. Patients -PCP Reflects the number of patients who have elected a QuadMed provider as their primary care provider (PCP). Patients -Unique Reflects the number of unique patients with completed visits.A patient with multiple visits would be represented once in the unique patient count. Physical Therapy Visits Counts the number of visits based on physical therapy CPT codes.Each visit represents a unique user and the defined CPT codes per day.For example,if a patient had multiple physical therapy codes in 1 day,this metric would only count them once. Provider Satisfaction Represents the percentage of patients that responded “Excellent”or “Very Good”to the overall quality of care question compared to the number of people who responded to the survey. Provider Virtual Visit Counts the number of virtual visits (video or telephonic)based on provider CPT codes.Each visit represents a unique user and the defined CPT codes per day. For example,if a patient had multiple provider CPT codes in 1 day,this metric would only count them once. Provider Visit Counts the number of visits based on provider CPT codes.Each visit represents a unique user and the defined CPT codes per day.For example,if a patient had multiple provider CPT codes in 1 day,this metric would only count them once. METRIC DEFINITIONS July 2024 ©2024 QuadMed,LLC.All rights reserved Page 2790 of 3707 Radiology Visits Counts the number of visits based on radiology CPT codes.Each visit represents a unique user and the defined CPT codes per day.For example,if a patient had multiple radiology codes in 1 day,this metric would only count them once. Total Participation Percentage of eligible members who visited the health center (any service line)at least once within a rolling 12-month period.This metric applies a specific mile radius to the eligible population. Total Visits Represents total visits to the health center,including all service lines and all clinic locations.For clients with VPC,those visits would be included in the total visits. Total Visits by Relationship Represents all visits to the health center (any service line)by relationship.For example,if 1 employee had 3 physical therapy visits in the month,it would show 3 visits in the employee section. Unique Members This metric counts the number of unique members who visited each health center and is location specific.For example,if a member had a visit at multiple health center locations,they would be counted as a unique member at each location.This metric only applies to clients with sharing arrangements. Unique Visits This metric counts the number of unique visits to each health center location.Each visit represents a unique user and a unique visit per day.For example,if a member had multiple visits in a day,this metric would only count them once.This metric only applies to clients with sharing arrangements. Utilization -MyChart Percentage of health center users that have activated their MyChart account based on the total eligible population. Utilization -No Shows Counts the percentage of patient no shows and late cancel appointments. The no shows on asynchronous care page are specific to all provider encounters.On the utilization page,the no show rate includes all primary care visits conducted by a PA/NP/MD which means that if a provider completed a "nurse visit"it would be represented on the asynchronous care page. Utilization -Provider Reflects the number of hours a provider used for patient care compared to their total available hours.This metric excludes no-shows and time allocated for other functions such as administrative time,training,lunch,vacation,etc. Utilization -Schedule Reflects the number of hours a provider used for patient care compared to their total available hours.This metric does not exclude no-shows. Vision Visit Counts the number of vision visits completed in the health center.Each visit represents a unique user per day. Wellness Visits Counts the number of visits based on wellness CPT codes.The wellness visits include fitness,registered nutrition,and wellness coaching visits.Each visit METRIC DEFINITIONS July 2024 ©2024 QuadMed,LLC.All rights reserved Page 2791 of 3707 HEALTH CENTER Mid-Year Performance Report SAMPLE REPORT SUPPORT TEAM PRIMARY CONTACT: Page 2792 of 3707 2©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: GEO-ELIGIBLE PARTICIPATION 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. ELIGIBILITY TREND 1,259 1,584 1,665 10% 20% 30% 40% ATTRIBUTION RATE PATIENTS W/DECLARED PCP STATUS QM PCP Non-QM PCP NO PCP 31%39%41% 0% 65% PARTICIPATION* BY PATIENT TYPE TOTAL PARTICIPATION* PATIENTS/TOTAL ELIGIBLE Employee Spouse Dependent61%UNIQUE PATIENTS 27% 12% 4,062 *Total Participation is based on 12-month rolling data. *Participation is based on 12-month rolling data. 1,317 1,311 1,206 1,242 1,228 1,253 1,289 1,285 1,302 1,292 1,295 1,308 1,302 1,200 1,250 1,300 Jun 23 Jul 23 Aug 23 Sep 23 Oct 23 Nov 23 Dec 23 Jan 24 Feb 24 Mar 24 Apr 24 May 24 Jun 24 Page 2793 of 3707 ©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: GEO-ELIGIBLE PARTICIPATION - PATIENT DEMOGRAPHICS Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. 1/1/2024 to 6/30/2024 3 46%54%44% ELIGIBLE EMPLOYEES 54%46%54%44% TOTAL PATIENTS 48%52% GENDER 10% 20% 30% 40% 50% 0%1.0%3.0% 26.0% 43.0% 12.0% 1.0% 38.0% 12.0%8.0% RACE/ETHNICITY AGE BANDS Patients 2-19 Patients 20-29 Patients 30-39 Patients 40-49 Patients 50-59 Patients 60+ 512 1089 577 512 1089 577 512 1089 577 512 1089 577 512 1089 577 512 1089 577 AllMaleFemale Am e r i c a n I n d i a n o r N a t i v e A l a s k a n A s i a n B l a c k o r A f r i c a n Am e r i c a n H i s p a n ic / L a t i n o Mu l ti r a ci a l N a t i v e H a w a i ia n o r P a c i f c I s l a n d e r Wh i t e O t h e r D e c l i n e d t o a n s w e r Page 2794 of 3707 ©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024 4 TOTAL VISITS - ALL SERVICE LINES TOTAL VISIT TREND ROLLING THREE YEARSTOTAL VISITS YEAR OVER YEAR 1,445 1,231 CURRENT YTD PREVIOUS YTD VISITS BY SERVICE LINE* MYCHART ACTIVITY APPOINTMENTS SCHEDULED ONLINEACTIVE PATIENTS 81%26% Provider Nurse Lab Physical Therapy Radiology Wellness Behavioral Health Condition Management Dental Vision 22% 7% 13% 3% 3% 23% 5% 5% 8% 11%*Occupational Health and Virtual Primary Care visits are included in provider, nurse and lab service lines. 14.9% 1,311 1,308 1,301 1,206 1,242 1,228 1,253 1,289 1,285 1,317 1,302 1,292 1,200 1,250 1,300 Q2 2021 Q3 2021 Q4 2021 Q1 2022 Q2 2022 Q3 2022 Q4 2022 Q1 2023 Q2 2023 Q32023 Q4 2023 Q1 2024 Q2 2024 1,295 Page 2795 of 3707 ©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024 5 TOTAL VISITS - NEW & REPEAT TOTAL VISITS BY REPEAT PATIENTS # OF VISITS ELIGIBLE EMPLOYEES TOTAL PATIENTS 1 422 549 2 261 317 3 155 169 4 81 95 5 53 57 6+76 88 ELIGIBLE EMPLOYEES 40.3% 24.9% 14.8% 7.7% 5.1%3.1% TOTAL PATIENTS 43.1% 24.9% 13.3% 7.5% 4.5%3.0% 1 42 53 6+ Number of Visits 32 52 47 35 33 26 52 44 37 24 35 42 306Occ Health Office Visit 83Office Visit 71Physical Visit 61Virtual Visit 39Occ Health Lab Visit Previous Year Visits Jul 23 Aug 23 Sep 23 Oct 23 Nov 23 Dec 23 Jan 24 Feb 24 Mar 24 Apr 24 May 24 Jun 240 25 50 75 NEW PATIENT VISIT TREND ROLLING 12-MONTH NEW PATIENTS BY APPOINTMENT TYPE Page 2796 of 3707 PROVIDER VISITS ©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024 6 TOP FIVE PRIMARY DIAGNOSES 1,078General Adult Medical Exam 376Vaccination 279Acute Upper Respritory Infection 193Acute Pharyngitis (Sore Throat) 139Routine Child Health Exam AVERAGE MINUTES IN WAITING ROOM AVERAGE DAYS TO RESPOND TO MYCHART MESSAGES WAIT TIMES 4.2 0.56 VISIT TREND ROLLING THREE YEARS 589 500 TOTAL VISITS PREVIOUS YEAR VISITS VISIT ACTIVITY* *Includes in-person and virtual encounters 14.9% 1,317 1,311 1,206 1,242 1,228 1,253 1,289 1,285 1,302 1,292 1,295 1,308 1,302 1,200 1,250 1,300 Jun 23 Jul 23 Aug 23 Sep 23 Oct 23 Nov 23 Dec 23 Jan 24 Feb 24 Mar 24 Apr 24 May 24 Jun 24 Page 2797 of 3707 ©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024 7 PROVIDER VISITS UNIQUE PATIENT TREND ROLLING THREE YEARSUNIQUE PATIENTS YEAR OVER YEAR PROVIDER SATISFACTION 145 122 CURRENT YTD QUALITY OF CARE LIKELIHOOD TO RECOMMEND PREVIOUS YTD 150 SURVEYS SENT 12 RESPONSES 0%20%40%60%80%100% 92% 0%20%40%60%80%100% 97% 14.9% 1,311 1,308 1,301 1,206 1,242 1,228 1,253 1,289 1,285 1,317 1,302 1,292 1,200 1,250 1,300 1,295 Q2 2021 Q3 2021 Q4 2021 Q1 2022 Q2 2022 Q3 2022 Q4 2022 Q1 2023 Q2 2023 Q32023 Q4 2023 Q1 2024 Q2 2024 Page 2798 of 3707 8©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024PROVIDER VISITS - UTILIZATION Q2 2024 Q1 2024 Q4 2023 Q3 2023 70% SCHEDULE NO SHOWS 9% UTILIZATION ASYNCHRONOUS CARE PROVIDER 85% 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 Virtual Visits CommunicationsRx RefllsIn-person Visits 531 6,573 6,291 7,049 7,8952,225 1,987 1,173 1,3801,034 1,401 1,569 2,219 4,311 4,555 5,102 Page 2799 of 3707 ©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024 9 PROVIDER VISITS - VIRTUAL IN-PERSON/VIRTUAL VISIT TREND ROLLING THREE YEARS 330 1,295 1,295 1,295 1,295 1,295 1,295 1,295 1,295 1,295 1,295 1,295 1,295 92 92 92 92 92 92 92 92 92 92 92 0 300 600 450 150 Q2-2021 Q4-2021 Q1-2022 Q2-2022 Q3-2022 Q4-2022 Q1-2023 Q2-2023 Q3-2023 Q4-2023 Q1-2024 Q2-2024 In-Person Virtual TOP FIVE PRIMARY DIAGNOSES 128Acute Upper Respritory Infection 43Acute Pharyngitis (Sore Throat) 30Cough 58Covid-19 52Acute Sinusitis TOTAL VIRTUAL VISITS VISIT TYPES IN-PERSON VS. VIRTUAL 20%40%60%80% In-Person Virtual 63% 37% 0% 371 129 589 500 TOTAL VISITS PREVIOUS YEAR VISITS 14.9% Page 2800 of 3707 10©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: PROVIDER SCHEDULING EXPERIENCE Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. 1/1/2024 to 6/30/2024 APPOINTMENT STATUSBREAKDOWN LEAD TIMES FOR NEW PATIENTS LEAD TIMES FOR ESTABLISHED PATIENTS 3%9.7% 9%13.0% 74% 20.0% 6% 30.2%27.0% Same day 2-7 days 8-14 days 15-30 days >30 days82% COMMUNITY AVERAGE 92% SCHEDULED≤ 14 DAYS 9% 70% SCHEDULED≤ 7 DAYS 11% NEW PATIENT VISITS* 515 19% Completed Canceled (> 24 hours) Late Cancel (< 24 hours) No Show Page 2801 of 3707 REFERRALS 11©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024 352 767 156 IMAGING REFERRALS 24%24% 38% 20%20%24% 17%17%18% 9%9%9% 38%38% 11% TOTAL REFERRALS INTERNAL & EXTERNAL REFERRAL STATUS 72%9%6% IN PROCESS CANCELLED COMPLETED X-ray CT Ultrasound MRI Mammogram 145 122 CURRENT YTD PREVIOUS YTD +14.9% INTERNAL REFERRALS TOP 5 BY SERVICE LINE EXTERNAL REFERRALS TOP 5 BY SPECIALTY Behavioral Health Condition Management Pharmacy MTM Physical Therapy Wellness Otolaryngology (ENT) Gastroenterology Cardiology Dermatology Orthopedics Page 2802 of 3707 E -CONSULTS 12©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024 E -CONSULTS OVERVIEW 278 E-CONSULTSSUBMITTED $117,465 ESTIMATED COST SAVINGS 95% PATIENT SATISFACTION RATING 62% E-CONSULTS THAT AVOIDED A FACE -TO-FACE REFERRAL 37 Hematology 28 Endocrinology 20Cardiology 19Dermatology 17Infectious disease 16Urology 14Radiology 12Hepatology 10Neurology 9Psychiatry TOP 10 SPECIALTY REFERRALS OTHER HIGHLIGHTS 90% INFLUENCED CARE PLANS 69 DAYS PATIENTS WILL RECEIVE CARE SOONER 18% RESULTED IN A NEW DIAGNOSIS 290 PATIENT HOURS SAVED BY REDUCED OFFICE VISITS Page 2803 of 3707 13©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024 NUMBER OF PRESCRIPTIONS RANK BY THERAPEUTIC CLASS CURRENT PREVIOUS CURRENT PREVIOUS Central Nervous System Agents 10,423 9,529 20.3%20.8% Cardiovascular Agents 8,771 8,294 17.1%18.1% Hormones & Synthetic Subst.6,263 5,031 12.2%11.0% Unknown Therapeutic Class 6,106 5,639 11.9%12.3% Anti-Infective Agents 3,979 3,193 7.8%7.0% Autonomic Drugs 3,297 3,027 6.4%6.6% Gastrointestinal Drugs 2,820 2,477 5.5%5.4% Allergy Immunotherapy & Antihistamines 1,955 1,718 3.8%3.7% Respiratory Agents 1,510 1,161 2.9%2.5% Others 6,125 5,766 12.0%12.6% TOTALS 51,249 45,835 100.0%100.0% PHARMACY - PRESCRIBED Rx TOP 10 PRESCRIPTIONS BRAND VS. GENERIC 90.3% 9.7% GENERIC BRAND BY DRUG NAME CURRENT PREVIOUS CURRENT PREVIOUS Atorvastatin Calcium 1,134 1,080 2.5%2.7% Amlodipine Besylate 1,100 1,009 2.4%2.5% Metformin Hcl 1,003 955 2.2%2.4% Albuterol Sulfate 946 801 2.1%2.0% Lisinopril 939 929 2.1%2.3% Vitamin D 912 660 2.0%1.6% Omeprazole 891 864 2.0%2.1% Levocetirizine Dihydrochloride 872 816 1.9%2.0% Escitalopram 758 584 1.7%1.5% Others 36,588 32,498 81.0%80.8% TOTALS 45,143 40,196 100.0%100.0% 51,249 45,835 CURRENT PERIOD PREVIOUS PERIOD TOTAL PRESCRIPTIONS 11.6% Page 2804 of 3707 14©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024 NUMBER OF PRESCRIPTIONS RANK DRUG NAME CURRENT PREVIOUS CURRENT PREVIOUS Lisinopril 182 137 6.5%5.0% Sertraline HCL 143 122 5.1%4.4% Metformin HCL 128 74 4.6%2.7% Albuterol Sulfate 94 60 3.4%2.2% Montelukast Sodium 94 126 3.4%4.6% Levothyroxine Sodium 86 103 3.1%3.7% Atorvastatin Calcium 78 101 2.8%3.7% Sildenafl Citrate 77 77 2.7%2.8% Losartan Potassium 72 54 2.6%2.0% Cyclobenzaprine HCL 70 43 2.5%1.6% Others 6,125 1,852 63.5%67.4% TOTALS 2,802 2,749 100.0%100.0% PHARMACY - PRE-PACKAGED MEDICATIONS TOP 10 MOST UTILIZEDTOTAL MEDICATIONS DISPENSED 2,802 2,749 CURRENT PERIOD PREVIOUS PERIOD 2.3% Page 2805 of 3707 CHRONIC CONDITIONS 15©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024 CHRONIC CONDITIONS BY PCP PATIENTS* CONDITION EMPLOYEE SPOUSE DEPENDENT TOTAL % OF PCP POPULATION Obesity 122 28 6 156 14.4% Hyperlipidemia 125 30 -155 14.3% Hypertension 119 28 1 148 13.7% Asthma 37 7 9 53 4.9% Depression 33 7 7 48 4.4% Diabetes 28 15 -43 4.0% COPD 14 6 -20 1.8% Anxiety 14 2 1 17 1.6% Low Back Pain 13 3 -16 1.5% Thyroid Disorder 8 2 -10 0.5% *Patients may be represented in multiple conditions. Page 2806 of 3707 CLINICAL QUALITY & CANCER SCREENINGS 16©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Data is for PCP patients only. CERVICAL CANCER COLON CANCER BREAST CANCER 80.1%69.8%78.5% of patients had a PAP smear in the appropriate timeframe of patients have had either a colonoscopy or fecal testing in the appropriate timeframe of patients have had a mammogram in the appropriate timeframe n=2,447 n=4,226 n=1,555 HYPERTENSION 76.0% of hypertensive patients have a blood pressure lower than 140/90 n=2,397 AHA GOAL: 70% HEDIS GOAL: 74% DIABETES 79.7% of diabetic patients have an A1c in control (less than 8.0) n=817 HEDIS GOAL: 65% HEDIS GOAL: 62%HEDIS GOAL: 72% DEPRESSION 66.0% of patients with depression have received depression monitoring during the recommended timeframe n=817 HEDIS GOAL: 59% The goals presented above have been carefully selected with the aim of achieving a higher standard of care using our QuadMed onsite model. While some modifications have been made to align with our model, the core intention of achieving a higher standard of care remains. Page 2807 of 3707 17©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024CLINICAL QUALITY - 3-YEAR PCP COHORT DEPRESSION SEVERITY n=1,168 DIABETES: HGB A1c VALUES n=540 100% 80% 60% 40% 20% 100% 80% 60% 40% 20% 2021-22 2022-23 2023-24 2021-22 2022-23 2023-24 59.6% 77.6% 63.3% 79.2%66.4%81.3% 16.0% 11.9%20.6% 10.5% 15.1% 12.3%18.6%15.9% 8.5%6.1%6.1% 14.8% 12.6% Mild DepressionRemission In ControlModerate Depression 8-8.9Severe Depression ≥9 3.8%3.0%2.9% Page 2808 of 3707 18©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024CLINICAL QUALITY - 3-YEAR PCP COHORT HYPERTENSION n=1,308 2023-24 2022-23 2021-22 In Control <139/89 Stage 1 - Hypertension140-159/90-99 Stage 2 - Hypertension>160-179/100-119 Hypertensive Urgency/Crisis >180/120 100%80%60%40%20%0% 19.7% 55.3%27.6%16.3%0.8% 50.1%32.0%16.3%1.6% 52.8%36.6%10.6% Page 2809 of 3707 BIOMETRICS 19©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024 SCREENING MEASURES BREAKDOWN PATIENTS BY NUMBER OF HIGH RISK CATEGORIES SCREENING MEASURE PATIENTS SCREENED % HIGH RISK % CHANGE % OF PATIENT BY RISK CATEGORY Blood pressure 779 12.2% 3.8% BMI 750 37.7% 1.2% Blood sugar/glucose 536 9.1% 0.3% Hemoglobin A1c 438 11.0% 2.6% Total Cholesterol 465 10.8% 0.1% Nicotine Use 622 16.7% 3.3% 56.9%30.9%12.2% 32.1%30.1%37.7% 38.8%52.1%9.1% 24.7%64.4%11.0% 28.8%60.4%10.8% 76.8%16.7% NUMBER OF RISK CATEGORIES 0 1 2 3 4+ # OF PATIENTS 401 284 74 22 9 % OF PATIENTS 50.8%35.9%9.4%2.8%1.1% Low Risk Moderate Risk High Risk Page 2810 of 3707 FLU & VACCINES 20©2024 QuadMed, LLC. All rights reserved. Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. KEY TAKEAWAYS: 1/1/2024 to 6/30/2024 Influenza, Quadrivalent (flu) Tdap - Adacel, Boostrix (tetanus) Covid Pfzer Bivalent 12+ (covid) Zoster, Recumbiant (shingles) MMR sub-Q (Measles/Mumps/Rubella) 1.9%2.3%0.9%0.7%1.3% 0 400 200 600 800 TOP 5 VACCINATIONS ADMINISTERED FLU VACCINES BY AGE GROUP 866 624 440 317 217 # RECIEVED FLU VACCINE % RECIEVED FLU VACCINE Patients 2-19 382 13% Patients 20-29 854 26% Patients 30-39 989 34% Patients 40-49 1,206 41% Patients 50-59 1,563 56% Patients 60+1,701 67% Page 2811 of 3707 SAMPLE Service Line Reports Page 2812 of 3707 1©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year over year change. OCCUPATIONAL HEALTH: OVERVIEW TOTAL VISIT TREND 1,206 1,242 1,228 1,253 1,289 1,285 1,317 1,302 1,292 1,311 1,295 1,308 1,200 1,250 1,300 TOTAL VISITS BREAKDOWN VISITS BY PROVIDER TYPE Non-ProviderProvider Current Year Previous Year Physical Therapy 371 326129 TOTAL VISITS 1,445 1,231 CURRENT YTD PREVIOUS YTD 14.9% NEW PATIENTS = 672 DOT Exam Exit Exam Fit for Duty Pre-employment/ Post-offer Exam Occupational Injury Medical Surveillance OH Lab Visit OH Nurse Visit/Vaccines Travel Medicine 216192 187 58 145133 203 318 260220 272 8779 1571391412 55 Q2 2021 Q3 2021 Q4 2021 Q1 2022 Q2 2022 Q3 2022 Q4 2022 Q1 2023 Q2 2023 Q32023 Q4 2023 Q1 2024 Q2 2024 Page 2813 of 3707 2©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. OCCUPATIONAL HEALTH: PATIENT DEMOGRAPHICS 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year over year change. 10% 20% 30% 40% 50% 0%1.0%3.0% 26.0% 43.0% 12.0%16.0% <1 year 1-5 years 5-10 years 10-20 years 20-30 years 30+ years 51%46% 3%LEGAL SEX TENURE AGE BANDS Patients 16-19 Patients 20-29 Patients 30-39 Patients 40-49 Patients 50-59 Patients 60+ 512 62 577 512 62 577 512 62 577 512 62 577 512 62 577 512 62 577 OtherMaleFemale OtherMaleFemale Page 2814 of 3707 3©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year over year change. OCCUPATIONAL HEALTH: WORK-RELATED ILLNESS/INJURY OCCUPATIONAL INJURY VISIT TYPES PROVIDER OCCUPATIONAL ILLNESS/INJURY VISIT 22%66%18%12% FIRST AID TREATMENT ONLY EMPLOYEE PLACED ON RESTRICTIONS EMPLOYEE TAKEN OFF WORKTREATMENT BEYOND OSHA FIRST AID Occ injury/illness management INITIAL First Aid Nurse Visit Occ injury/illness management FOLLOW UP Emergency Response Occ injury/illness management VIRTUAL INITIAL Occ Health Lab Visit POST ACCIDENT Occ injury/illness management VIRTUAL FOLLOW UP Work-related Physical therapy INITIAL Work-related Physical therapy FOLLOW UP 43 108 194 54 97 172 65 237 195 ILLNESS/ INJURY EXAMS 1,076 Page 2815 of 3707 4©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year over year change. OCCUPATIONAL HEALTH: WORK-RELATED ILLNESS/INJURY VISITS BY BODY PART TOP 10 VISITS BY MECHANISM OF INJURY 193Mechanism 4 139Mechanism 5 376Mechanism 2 1,078Mechanism 1 279Mechanism 3 193Mechanism 9 139Mechanism 10 376Mechanism 7 1,078Mechanism 6 279Mechanism 8 BODY PART RIGHT LEFT TOTAL A. Head --15 B. Face --32 C. Neck --26 D. Shoulder 46 52 98 E. Back --16 F. Upper Arm 16 21 35 G. Lower Arm 13 11 24 H. Elbow 61 41 102 I. Wrist 152 60 212 J. Hand 56 33 89 K. Hip 32 21 53 L. Upper Leg 28 30 58 M. Lower Leg 25 17 42 N. Knee 98 69 167 O. Ankle 53 27 81 P. Foot 48 44 92 A C D B F E H G J II K L M N P O Page 2816 of 3707 5©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year over year change. TOP 10 DIAGNOSES 193Acute Pharyngitis (Sore Throat) 139Routine Child Health Exam 376Vaccination 1,078General Adult Medical Exam 279Acute Upper Respritory Infection 193Acute Pharyngitis (Sore Throat) 139Routine Child Health Exam 376Vaccination 1,078General Adult Medical Exam 279Acute Upper Respritory Infection OCCUPATIONAL HEALTH: WORK-RELATED ILLNESS/INJURY INTERNAL REFERRALS 70Behavioral Health 56Condition Management 7Pharmacy/MTM 116Physical Therapy 162Otolaryngology (ENT) 136Gastroenterology 117Cardiology 96Dermatology 79Orthopedics 25Radiology 84Wellness EXTERNAL REFERRALS TOP 5 BY SPECIALTY TOTAL: 767 TOTAL: 352 Page 2817 of 3707 6©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year over year change. OCCUPATIONAL HEALTH: SURVEILLANCE AND SAFETY TOTAL SURVEILLANCE SERVICES BY TYPE SAFETY INITIATIVES ACTIVITY JUL 23 AUG 23 SEP 23 OCT 23 NOV 23 DEC 23 AED Checks 136 118 74 218 113 117 Lunch and Learns 5422 5448 3714 3032 1526 1736 Safety Huddles 1660 1482 1416 1834 1325 1493 Safety Walks 2432 2265 2140 2320 2165 2289 Other (see below) Hearing Surveillance BASELINE Hearing Surveillance ANNUAL Respiratory Surveillance Vision INITIAL Vision FOLLOW UP 237 120 178 185 123 TOTAL: 843 Page 2818 of 3707 7©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year over year change. OCCUPATIONAL HEALTH: LABS DRUG SCREEN AND BAT DOT NON-DOT Post-offer/ Pre-employment Reasonable Suspicion Post-Accident Random Follow Up Return to Work NON-NEGATIVE RESULTS = 638 1,295 948 865 1,167 1,426 1,236 1,203 586 912 1,213 842 1,320 Page 2819 of 3707 1©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. PHYSICAL THERAPY 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year over year change. CURRENT YTD CURRENT YTD PREVIOUS YTD PREVIOUS YTD 1,295 1,295 1,308 1,308 1,200 1,200 Q2 2021 Q3 2021 Q4 2021 Q1 2022 Q2 2022 Q3 2022 Q4 2022 Q1 2023 Q2 2023 Q32023 Q4 2023 Q1 2024 Q2 2024 Q2 2021 Q3 2021 Q4 2021 Q1 2022 Q2 2022 Q3 2022 Q4 2022 Q1 2023 Q2 2023 Q32023 Q4 2023 Q1 2024 Q2 2024 1,301 1,301 TOTAL VISITS YEAR OVER YEAR 1,445 1,231 14.9%1,206 1,206 1,242 1,242 1,228 1,228 1,253 1,253 1,289 1,289 1,285 1,285 1,317 1,317 1,302 1,302 1,292 1,292 1,311 1,311 1,250 1,250 1,300 1,300 TOTAL VISIT TREND ROLLING THREE YEARS 623 567 14.9% UNIQUE PATIENTS YEAR OVER YEAR UNIQUE PATIENT TREND ROLLING THREE YEARS Page 2820 of 3707 2©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. PHYSICAL THERAPY 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year over year change. TOP FIVE PRIMARY DIAGNOSES 1,078Lower Back 376Neck 279Right Shoulder 193Knee 139Left Shoulder VISITS BY RELATIONSHIP VISITS PER PATIENT EPISODE Employee Spouse Dependent 61% 27% 12% 70% SCHEDULE NO SHOWS 9% UTILIZATION PROVIDER 85% CURRENT AVERAGE YTD PREVIOUS AVERAGE YTD COMMUNITY AVERAGE 6.8 7.0 9 -1214.9% Page 2821 of 3707 ©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. PHYSICAL THERAPY 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year over year change. 3 LEAD TIMES FOR NEW PATIENTS 21 days COMMUNITY AVERAGE 92% SCHEDULED ≤ 14 DAYS 9% 70% SCHEDULED ≤ 7 DAYS 11% NEW PATIENT APPPOINTMENTS 515 19% PROVIDER SATISFACTION QUALITY OF CARE 0%20%40%60%80%100% 92% 150 SURVEYS SENT 22 RESPONSES LIKELIHOOD TO RECOMMEND PATIENT COMMENTS 0%20%40%60%80%100% 92% Page 2822 of 3707 1©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. WELLNESS SERVICES: OVERVIEW Coaching Program planning/execution Building culture of health Outreach Fitness WELLNESS TEAM TIME ALLOCATION 38% 27% 15% 9% 11% PATIENT/MEMBER COMMENTS “Working with my coach has improved my overall health. I’m so glad my employer offers such a wide variety of wellness services.” Page 2823 of 3707 2©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. WELLNESS SERVICES TOTAL WELLNESS TEAM VISITS YEAR OVER YEAR 1,445 1,231 CURRENT YTD PREVIOUS YTD 14.9%1,206 1,242 1,228 1,253 1,289 1,285 1,317 1,302 1,292 1,311 1,295 1,308 1,200 1,250 1,300 1,301 TOTAL VISIT TREND ROLLING THREE YEARS UNIQUE PATIENTS YEAR OVER YEAR 1,445 1,231 CURRENT YTD PREVIOUS YTD 14.9%1,206 1,242 1,228 1,253 1,289 1,285 1,317 1,302 1,292 1,311 1,295 1,308 1,200 1,250 1,300 1,301 UNIQUE PATIENT TREND ROLLING THREE YEARS Q2 2021 Q3 2021 Q4 2021 Q1 2022 Q2 2022 Q3 2022 Q4 2022 Q1 2023 Q2 2023 Q32023 Q4 2023 Q1 2024 Q2 2024 Q2 2021 Q3 2021 Q4 2021 Q1 2022 Q2 2022 Q3 2022 Q4 2022 Q1 2023 Q2 2023 Q32023 Q4 2023 Q1 2024 Q2 2024 Page 2824 of 3707 3©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. WELLNESS SERVICES 60%80%100% Virtual VISIT TYPES IN-PERSON VS. VIRTUAL In-Person 26% 74% VISITS BY SERVICE 0%20%40% SUSTAINED ENGAGEMENT BY REPEAT WELLNESS PATIENTS # OF VISITS TOTAL MEMBERS % OF REPEAT USERS 1 422 38% 2 261 24% 3 155 16% 4 81 12% 5 53 8% 6+76 2% TOP FIVE REASONS FOR WELLNESS COACHING VISITS Weight management Tobacco cessation Stress management 193Modifications for blood pressure 139Modifications for cholesterol 376 1,078 279 1259 1584 658 Wellness Coaching Nutrition Fitness Page 2825 of 3707 4©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. WELLNESS SERVICES 70%SCHEDULE NO SHOWS 9% UTILIZATION PROVIDER 85% PROVIDER SATISFACTION QUALITY OF CARE LIKELIHOOD TO RECOMMEND150 SURVEYS SENT 12 RESPONSES 0%20%40%60%80%100% 92% 0%20%40%60%80%100% 97% Page 2826 of 3707 5©2024 QuadMed, LLC. All rights reserved. 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. WELLNESS SERVICES: PROGRAMS The Wellness team would add important observations here. PROGRAMS ACTIVITY Quarter 1 Quarter 2 Quarter 3 Quarter 4 TOTAL Program/Activity #1 136 118 74 218 113 Program/Activity #2 5422 5448 3714 3032 1526 Program/Activity #3 1660 1482 1416 1834 1325 Program/Activity #4 Program/Activity #5 Program/Activity #6 Program/Activity #7 2432 2265 2140 2320 2165 ADDRESS YOUR STRESS Presented by Find Balance. Live Well. TOTAL PARTICIPATION KEY TAKEAWAYS: 1,445 1,231 CURRENT YTD PREVIOUS YTD 14.9% Page 2827 of 3707 6©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. WELLNESS SERVICES: CULTURE OF HEALTH ACTIVITIES & EVENTS PERSONS ENGAGED NOTES BRG Attendance New Hire Orientation Gate Event Item #4 Item #5 Item #6 Item #7 HIGHLIGHTS Noteable features, outcomes and/or patient comments Sample Comment:“The class was fantastic, I have already recommended to several of my co-workers.” Page 2828 of 3707 7©2024 QuadMed, LLC. All rights reserved. KEY TAKEAWAYS: The Operations team would add important observations here. 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. WELLNESS SERVICES: OUTREACH 1,681 621 HIGH-RISK CANDIDATES IDENTIFIED TOTAL CANDIDATES REACHED HIGH-RISK OUTREACH OUTREACH MODALITIES RESULTING ACTIONS 1,681 2024 2023 Email MyChart Letter(s) Phone Newsletters 168 212 568 581 139 122 128 511 523 146 100 200 300 400 500 600 23%13%SCHEDULED A WELLNESS VISIT ENROLLED IN A PROGRAM Page 2829 of 3707 8©2024 QuadMed, LLC. All rights reserved. 1/1/2024 to 6/30/2024 Metrics reflect data for reporting period unless otherwise noted. Arrows indicate year-over-year change. WELLNESS SERVICES: PATIENT SUCCESS “Patient quote here” CHALLENGE • Bullet #1 • Bullet #1 • Bullet #1 SOLUTION • Bullet #1 • Bullet #1 • Bullet #1 ACHIEVEMENTS • Bullet #1 • Bullet #1 • Bullet #1 Page 2830 of 3707 Table of Contents Attachment 2 QuadMed Job Descriptions Page 2831 of 3707 QuadMedical.com JOB TITLE: PHYSICIAN Business Area: Medical Workweek: M-F Location: Varies REPORTING RELATIONSHIPS Reports To: Medical Director Collaborates With: Health Center Team, Corporate Support Teams Direct Reports: 0 Total Number of Employees Responsible For: 0 GENERAL PURPOSE OF JOB This physician will focus on prevention and wellness, as well as evaluating, treating, and educating patients in a health center setting. Under the supervision of a physician medical director, performs professional medical work including the history taking, examination, diagnosis and treatment of patients according to statutory limitations. Examines and diagnoses patients and develops treatment plans. Performs testing, referral to specialists as needed, writes prescriptions, and performs administrative procedures within the scope of expertise, protocols, and available equipment. As a QuadMed representative, and in partnership with the Client (employer sponsor), the physician may present and speak to the client as a QuadMed leader at the clinical level. KEY RESPONSIBILITIES  Provides comprehensive patient care through interviewing, examining and treating employees and their dependents in order to meet their health and wellness needs  Prescribes appropriate medical treatment and medications for patients and orders studies, tests and ancillary care services as required  Records history and physical findings, and formulates plans and prognosis, based on patient’s condition, with documentation in the electronic medical record  Provides occupational medical care to patients depending on the needs of the client  Provides medical treatment of work-related illnesses and injuries, conducts injury causation analysis, and provides other occupational health related medical services as needed  Provides onsite services and consultation to employers as needed.  Communicates with employer(s) on return-to-work status.  Functions as a liaison between employer’s management and safety team, and the onsite primary care medical provider. Page 2832 of 3707 QuadMedical.com  Knowledge of a variety of pharmacological agents used in patient treatment, the desired effects, side effects, and complications of their use as well as the accurate administration of the pharmacologic agent.  Educates patients and/or families about preventive care, wellness, medical issues, and use of prescribed medical treatments and/or medications  Performs physical examinations and preventive health measures within prescribed guidelines  Orders, interprets, and evaluates diagnostic tests to identify and assess patient’s clinical problems and health care needs  Demonstrates knowledge of growth and development, and pathophysiology of disease processes, specific to age groups served  Follows all established rules and guidelines of evidence-based care and best clinical practice  Regularly reviews chronic medical conditions that require ongoing medical attention  Educates patients on wellness, prevention and early detection by providing materials and resources to the patients and families  Works in an independent and interdependent relationship with members of the medical staff, which allows for consultation, collaboration, or referral.  Refers to appropriate specialists both inside and outside the health center in a medically appropriate and efficient manner  Practices in a collaborative fashion consistent with the concept of a patient centered medical home, consulting and partnering with other team members as needed regarding patient care, assessment, and education issues  Refers patients to and utilizes unique employer-provided benefits and resources to maximize health outcomes  Demonstrates exceptional and effective collaborative partnership and communication style with both patients and staff  Actively engages in leadership and compliance  Participates in quality improvement, continuing education, and other patient care programs established by the health center requirements for QuadMed.  Advocates for clinical quality improvement in the health center  Assists in the resolution of complaints, requests and inquiries from patients, QuadMed, and clients  Maintains privacy and confidentiality of all patient information according to federal and state guidelines and regulations  Effectively communicates with patients through technology to include email, video, telephonic, and text while complying with QuadMed policy and practices  Demonstrates the ability to remain calm and effective in emergency situations and establish a leadership role in an emergency  Demonstrates professional conduct within the health center and acts as a role model and professional leader for all health center employees. Page 2833 of 3707 QuadMedical.com JOB REQUIREMENTS Education:  MD or DO degree from an accredited School of Medicine or Osteopathy and completion of appropriate residency Experience:  Prefer three years occupational health or ambulatory primary care practice experience; if less than three years agrees to mentoring, and coaching, from another provider if assigned  Working with pediatric patients may be preferred based on the client preferences and demographics  Effective verbal and written communication skills including proficiency in electronic communication  Experience with an EMR preferred  Bilingual English-Spanish preferred depending on client demographics Certificates, Licenses, Registrations:  Active Board certification or eligibility  Active and unrestricted applicable licensure, with current DEA registration  Current CPR (BLS) certification or must be obtained within 60 days of hire Knowledge, Skills & Abilities:  Proven ability to work successfully with diverse populations and demonstrated commitment to promote and enhance diversity and inclusion PHYSICAL DEMANDS Manual Dexterity: Work requires accuracy and moderate speed Physical Effort: Work requires considerable variety of steady active physical exertion with some and/or continuous standing or walking Working Conditions: May include exposure to conditions requiring the use of personal protective equipment Hazards: Exposure to hazards that may result in short-term work-related absences. Exposure to blood-borne pathogens and hazardous materials Page 2834 of 3707 QuadMedical.com JOB TITLE: NURSE PRACTITIONER Business Area: Operations Workweek: M-F Location: Varies REPORTING RELATIONSHIPS Reports To: Health Center Manager Collaborates With: Medical directors, medical assistants, ancillary staff Direct Reports: 0 Total Number of Employees Responsible For: 0 GENERAL PURPOSE OF JOB This position will focus on prevention, wellness, and maintenance of health in partnership with patients. This will be accomplished by evaluating, treating, and educating patients in a health center setting. Under the collaboration of a physician, performs professional medical work in the examination, diagnosis and treatment of patients according to statutory limitations. Examines and diagnoses patients and develops treatment plans. Performs testing, refers to physicians as needed, writes prescriptions, and performs administrative procedures within their scope and licensure of expertise, protocols, and available equipment. KEY RESPONSIBILITIES  Provides comprehensive clinical patient care through interviewing, examining and treating associates and their dependents in order to meet their health and wellness needs. Prescribes appropriate medical treatment and clinical medications for patients and orders studies, tests and ancillary care services as required.  Records physical findings, and formulates plan and prognosis, based on patient’s condition, with documentation in the medical record  Knowledge of a variety of pharmacological agents used in patient treatment, the desired effects, side effects, and complications of their use as well as the accurate administration of the pharmacologic agent  Educates patients and/or families about preventive care, wellness, medical issues, and use of prescribed medical treatments and/or medications  Performs physical examinations and preventive health measures within evidence based and best practice guidelines  Orders, interprets, and evaluates diagnostic tests to identify and assess patients’ clinical problems and health care needs  Demonstrates knowledge of growth and development, and pathophysiology of disease processes, specific to age groups served  Follows all established rules and guidelines of evidence-based care and best clinical practice Page 2835 of 3707 QuadMedical.com  Regularly reviews chronic medical conditions that require ongoing medical attention by accessing available registry tools  Educates patients on wellness, prevention and early detection by providing materials and resources to the patients and families  Works in an independent and interdependent relationship with members of the medical staff, which allows for consultation, partnership, or referral  May refer patients to a physician for consultation or to specialized health resources for treatment  Refers to appropriate specialists outside the health center in a medically appropriate and efficient manner  Practices in a collaborative fashion consistent with the concept of a patient centered medical home, consulting with the oversight physician as needed regarding patient care, assessment, and education issues  Refers patients to and utilizes unique employer-provided benefits and resources to maximize health outcomes  Demonstrates exceptional and effective collaborative partnership and communication style with both patients and staff  Participates in quality improvement, continuing education, and other patient care programs established by the health center requirements for QuadMed  Assists in the resolution of complaints, requests, and inquiries from patients, QuadMed, and clients  Maintains confidentiality of all patient and organization information and follows federal and state regulations and organization policies regarding protection of patient information.  Effectively communicates with patients through technology to include email, video, telephonic, and text while complying with QuadMed policy and practices  Demonstrates knowledge of current and emerging trends in technologies, techniques, issues and approaches in area of expertise  Demonstrates the ability to maintain quality, safety, and infection control standards  Demonstrates the ability to remain calm and effective in emergency situations and establish a leadership role in an emergency JOB REQUIREMENTS Education:  Completed master's degree level Nurse Practitioner program from an accredited college/university Experience:  Minimum three (3) years Primary Care practice experience  Ability to work independently  Working with an electronic medical record (EMR)  Experience working with pediatric patients (required in some locations)  Certain clients and health centers may require travel  Certain clients and health centers may require phlebotomy Page 2836 of 3707 QuadMedical.com Certificates, Licenses, Registrations:  Active and unrestricted applicable licensure  Current CPR (BLS) certification or must be obtained within 60 days of hire  NPI & DEA  Current National Board Certification Knowledge, Skills & Abilities:  Bilingual Spanish a plus in some locations  Must have working knowledge of practical nursing theories and policies  An understanding of the patient care procedures, medical protocols, and testing procedures necessary to support occupational health  Communicate effectively both orally and in writing  Requires organizational and decision-making abilities  Requires excellent assessment skills  Computer skills required (electronic medical record experience preferred)  Proven ability to work successfully with diverse populations and demonstrated commitment to promote and enhance diversity and inclusion PHYSICAL DEMANDS Manual Dexterity: Work requires accuracy and moderate speed Physical Effort: Work requires considerable variety of fairly steady active physical exertion with some and/or continuous standing or walking Working Conditions: May include exposure to conditions requiring the use of personal protective equipment Hazards: Exposure to hazards that may result in short-term work-related absences. Exposure to blood- borne pathogens and hazardous materials Page 2837 of 3707 QuadMedical.com JOB TITLE: MEDICAL ASSISTANT Business Area: Medical Workweek: M-F Location: Varies REPORTING RELATIONSHIPS Reports To: Health Center Manager Collaborates With: Nursing staff, providers Direct Reports: 0 Total Number of Employees Responsible For: 0 GENERAL PURPOSE OF JOB: The Medical Assistant will be a highly motivated, quality-conscious health care worker interested in working in an environment where one-on-one time with patients and positive outcomes are the ultimate measurement of success. KEY RESPONSIBILITIES:  Measures and records vital signs (weight, height, blood pressure, etc.)  Ensures accurate and timely documentation into the EMR; i.e.- patient interviews and histories, vital signs, treatments, test results.  Assists medical staff with patient examinations  Uses CPR skills when necessary  Maintains supplies, equipment, stocks, and sterilizes instruments  Provides patients with instructions and other information regarding preparations for the service and necessary registration.  Maintains confidentiality of all patient and organization information and follows federal and state regulations and organization policies regarding protection of patient information.  Participates in development activities and maintains affiliations with medical assistant associations, as applicable.  Commitment to concepts of preventive health care programs and team-based approach to health care delivery  Front office duties including but not limited to reception, patient check-in/check-out, payment collection, and electronic scheduling.  Performs other duties as assigned  Certain clients and health centers may require travel  Where permitted, and as directed: o May perform routine screening tests o Draws patient blood samples as directed and prepares samples for ordered laboratory analysis, and collection of other ordered lab specimens. Page 2838 of 3707 QuadMedical.com o Prepares and administers ordered injectable medications and immunizations o Changes dressings, applies bandages, removes sutures and performs other first aid procedures o Assists patients with the scheduling of internal/external referrals JOB REQUIREMENTS: Education:  High school diploma or equivalent  Graduate of accredited school of medical assisting, or combination of equivalent education and experience. Experience:  Minimum One (1) year experience as a Medical Assistant  Phlebotomy and lab experience  Experience working front office  Experience working in a Primary Care setting  Bilingual in Spanish a plus  Experience working in a medical facility and/or front office preferred Certificates, Licenses, Registrations:  Current CPR (BLS) certification or must be obtained within 60 days of hire  Medical Assistant certification through AAMA, AMT, NHA or NCCT. Certification through another accredited association will need review/approval.  Skill certification through NIOSH or CAOHC Knowledge, Skills & Abilities:  Commitment to preventive health care programs and team approach to care delivery  Excellent interpersonal and communication skills (oral/written)  Proven ability to work successfully with diverse populations and demonstrated commitment to promote and enhance diversity and inclusion PHYSICAL DEMANDS  Manual Dexterity: Work requires accuracy and moderate speed  Physical Effort: Work requires considerable variety of steady active physical exertion with some and/or continuous standing or walking  Working Conditions: May include exposure to conditions requiring the use of personal protective equipment  Hazards: Exposure to hazards that may result in short-term work-related absences. Exposure to blood-borne pathogens and hazardous materials Page 2839 of 3707 Page 2840 of 3707 Page 2841 of 3707 Page 2842 of 3707 Page 2843 of 3707 Page 2844 of 3707 Page 2845 of 3707 Page 2846 of 3707 Rev. 1 2025 Procurement Services Division Form 5 Reference Questionnaire (USE ONE FORM FOR EACH REQUIRED REFERENCE) Solicitation: 25-8397: Comprehensive Clinic and Wellness Services Reference Questionnaire for: Quad/Med LLC Bernalillo County, NM (Name of Individuals Requesting Reference Information) Name:Christopher Bois Company:Bernalillo County (Evaluator completing reference questionnaire) (Evaluator’s Company completing reference) Email:cbois@bernco.gov FAX: Telephone:505-355-1919 Collier County has implemented a process that collects reference information on firms and their key personnel to be used in the selection of firms to perform this project. The Name of the Company listed in the Subject above has listed you as a client for which they have previously performed work. Please complete the survey. Please rate each criteria to the best of your knowledge on a scale of 1 to 10, with 10 representing that you were very satisifed (and would hire the firm/individual again) and 1 representing that you were very unsatisfied (and would never hire the firm/indivdiual again). If you do not have sufficient knowledge of past performance in a particular area, leave it blank and the item or form will be scored “0.” Project Description: Onsite Primary Care Clinic Completion Date: Opened 7/1/2021 Project Budget: Project Number of Days: Item Criteria Score (must be completed) 1 Ability to manage the project costs (minimize change orders to scope). 10 2 Ability to maintain project schedule (complete on-time or early). 8 – most delays were due to COVID issues 3 Quality of work. 10 4 Quality of consultative advice provided on the project. 10 5 Professionalism and ability to manage personnel. 10 6 Project administration (completed documents, final invoice, final product turnover; invoices; manuals or going forward documentation, etc.) 10 7 Ability to verbally communicate and document information clearly and succinctly. 10 8 Abiltity to manage risks and unexpected project circumstances. 9 – again, COVID caused some issues that we could not foresee 9 Ability to follow contract documents, policies, procedures, rules, regulations, etc. 10 10 Overall comfort level with hiring the company in the future (customer satisfaction). 10 TOTAL SCORE OF ALL ITEMS 97 Page 2847 of 3707 Page 2848 of 3707 Page 2849 of 3707 Page 2850 of 3707 Page 2851 of 3707 Page 2852 of 3707 Page 2853 of 3707 Page 2854 of 3707 Page 2855 of 3707 Page 2856 of 3707 Page 2857 of 3707 Page 2858 of 3707 Page 2859 of 3707 Page 2860 of 3707 Page 2861 of 3707 Page 2862 of 3707 Page 2863 of 3707 Page 2864 of 3707 Page 2865 of 3707 Page 2866 of 3707 Page 2867 of 3707 Page 2868 of 3707 Page 2869 of 3707 Page 2870 of 3707 Page 2871 of 3707 Page 2872 of 3707 Page 2873 of 3707 Page 2874 of 3707 Page 2875 of 3707 Page 2876 of 3707 Page 2877 of 3707 RFP #: 25-8397Title: Comprehensive Clinic and Wellness ServicesName of FirmKenneth KovenskyAmy LybergChristiane Rice Sonja Sweet TotalSelection CommitteeFinal Rank Tie BreakerQuad/Med, LLC212 16 1.0000 1Advance Medical of Naples, LLC121 26 1.0000 2Medical Risk Solutions, LLC d/b/a My Health Onsite333 312 3.0000 3Procurement Professional Olivia Puga 10/15/2025Selection CommitteeFinal Ranking SheetPage 1 of 1Page 2878 of 3707 Procurement Services Division Notice of Recommended Award Solicitation: 25-8397 Title: Comprehensive Clinic and Wellness Services Due Date and Time: August 1, 2025 at 3:00pm EST Proposers: Company Name City County State Final Ranking Responsive/Responsible QuadMed, LLC Sussex Waukesha WI 1 Yes/Yes Advance Medical of Naples, LLC Naples Collier FL 2 Yes/Yes Medical Risk Solutions, LLC dba My Health Onsite Ocoee Orange FL 3 Yes/Yes Collier Health Services, Inc. Immokalee Collier FL Not Ranked Yes/Yes Pinnacle Health Specialists, LLC Naples Collier FL Not Ranked No/No Utilized Local Vendor Preference (Points Assigned): Yes No Recommended Proposer For Award: On June 18, 2025, the Procurement Services Division released Request for Proposal (“RFP”) No. 25-8397, “Comprehensive Clinic and Wellness Services”, to three thousand two hundred thirteen (3,213) vendors. On July 2, 2025, a non-mandatory proposal meeting was held offering prospective proposers an opportunity to participate. On July 11, 2025, the submittal deadline was extended for two (2) weeks to August 1, 2025. One thousand one hundred seventy-eight (1,178) bid packages were viewed and five (5) submittals were received by the August 1, 2025, deadline. Four (4) proposals were found to be responsive and responsible with minor irregularities. Pinnacle Health Specialists, Inc., was found to be non-responsive and non-responsible for not meeting the requirements of the solicitation. The Selection Committee convened on September 18, 2025, as described in the solicitation documents. After reviewing the proposals and deliberation, the Committee scored the proposals, shortlisted and elected to move to Oral Presentations with the top three (3) Proposers as listed below: Advance Medical of Naples, LLC Medical Risk Solutions, LLC dba My Health Onsite QuadMed, LLC On October 15, 2025, the Selection Committee reconvened for Oral Presentations and Final Ranking. The Proposers were final ranked and there was a two (2) way tie for first (1st) place, between Advance Medical of Naples, LLC and QuadMed, LLC. Page 2879 of 3707 Pursuant to the tie breaker procedure outlined in the solicitation document, the tie was resolved and ranked as follows: QuadMed, LLC – Ranked as 1 Advance Medical of Naples, LLC. – Ranked as 2 Medical Risk Solutions, LLC dba My Health Onsite – Ranked as 3 Staff is recommending award to the top-ranked firm QuadMed, LLC. Contract Driven Purchase Order Driven Required Signatures Project Manager: Procurement Strategist: Procurement Services Director: __________________________________ _________________ Sandra Srnka Date Page 2880 of 3707 Page 2881 of 3707 Page 2882 of 3707 Page 2883 of 3707 Page 2884 of 3707 Page 2885 of 3707 Page 2886 of 3707 Page 2887 of 3707 Page 2888 of 3707 Page 2889 of 3707 Page 2890 of 3707 Page 2891 of 3707 Page 2892 of 3707 Page 2893 of 3707 Page 2894 of 3707 Page 2895 of 3707 Page 2896 of 3707 Page 2897 of 3707 Page 2898 of 3707 Page 2899 of 3707 Page 2900 of 3707 Page 2901 of 3707 Page 2902 of 3707 Page 2903 of 3707 Page 2904 of 3707 Page 2905 of 3707 Page 2906 of 3707 Page 2907 of 3707 Page 2908 of 3707 Page 2909 of 3707 Page 2910 of 3707 Page 2911 of 3707 Page 2912 of 3707 Page 2913 of 3707 Page 2914 of 3707 Page 2915 of 3707 Page 2916 of 3707 Page 2917 of 3707 Page 2918 of 3707 Page 2919 of 3707 Page 2920 of 3707 Page 2921 of 3707 Page 2922 of 3707 Page 2923 of 3707 Page 2924 of 3707 INSURANCE REQUIREMENTS COVERSHEET Project Name Vendor Name Solicitation/Contract No. Attachments Risk Approved Insurance Requirements Risk Approved Insurance Certificate(s) Comments Attachments Approved by Risk Management Division Approval: Page 2925 of 3707 INSURANCE AND BONDING REQUIREMENTS Insurance / Bond Type Required Limits 1. Worker’s Compensation Statutory Limits of Florida Statutes, Chapter 440 and all Federal Government Statutory Limits and Requirements Evidence of Workers’ Compensation coverage or a Certificate of Exemption issued by the State of Florida is required. Entities that are formed as Sole Proprietorships shall not be required to provide a proof of exemption. An application for exemption can be obtained online at https://apps.fldfs.com/bocexempt/ 2. Employer’s Liability $_500,000____ single limit per occurrence 3. Commercial General Liability (Occurrence Form) patterned after the current ISO form Bodily Injury and Property Damage $_1,000,000___single limit per occurrence, $2,000,000 aggregate for Bodily Injury Liability and Property Damage Liability. The General Aggregate Limit shall be endorsed to apply per project. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. 4. Indemnification To the maximum extent permitted by Florida law, the Contractor/Vendor shall defend, 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 attorneys’ fees and paralegals’ fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the Contractor/ Vendor or anyone employed or utilized by the Contractor/Vendor in the performance of this Agreement. 5. Automobile Liability $_________ Each Occurrence; Bodily Injury & Property Damage, Owned/Non-owned/Hired; Automobile Included 6. Other insurance as noted: Watercraft $ __________ Per Occurrence United States Longshoreman's and Harborworker's Act coverage shall be maintained where applicable to the completion of the work. $ __________ Per Occurrence Maritime Coverage (Jones Act) shall be maintained where applicable to the completion of the work. $ __________ Per Occurrence Aircraft Liability coverage shall be carried in limits of not less than $5,000,000 each occurrence if applicable to the completion of the Services under this Agreement. $ __________ Per Occurrence Pollution $ __________ Per Occurrence Professional Liability / Medical Malpractice $ 1,000,000_ Per claim & in the aggregate Project Professional Liability $__________ Per Occurrence Valuable Papers Insurance $__________ Per Occurrence Cyber Liability $1,000,000 Per Occurrence Technology Errors & Omissions $__________ Per Occurrence 7. Bid bond Shall be submitted with proposal response in the form of certified funds, cashiers’ check or an irrevocable letter of credit, a cash bond posted with the County Clerk, or proposal bond in a sum equal to 5% of the cost proposal. All checks shall be made payable to the Collier County Board of County Commissioners on a bank or trust company located in the State of Florida and insured by the Federal Deposit Insurance Page 2926 of 3707 Corporation. 8. Performance and Payment Bonds For projects in excess of $200,000, bonds shall be submitted with the executed contract by Proposers receiving award, and written for 100% of the Contract award amount, the cost borne by the Proposer receiving an award. The Performance and Payment Bonds shall be underwritten by a surety authorized to do business in the State of Florida and otherwise acceptable to Owner; provided, however, the surety shall be rated as “A-“ or better as to general policy holders rating and Class V or higher rating as to financial size category and the amount required shall not exceed 5% of the reported policy holders’ surplus, all as reported in the most current Best Key Rating Guide, published by A.M. Best Company, Inc. of 75 Fulton Street, New York, New York 10038. 9. Vendor shall ensure that all subcontractors comply with the same insurance requirements that he is required to meet. The same Vendor shall provide County with certificates of insurance meeting the required insurance provisions. 10. Collier County must be named as "ADDITIONAL INSURED" on the Insurance Certificate for Commercial General Liability where required. This insurance shall be primary and non-contributory with respect to any other insurance maintained by, or available for the benefit of, the Additional Insured and the Vendor’s policy shall be endorsed accordingly. 11. The Certificate Holder shall be named as Collier County Board of County Commissioners, OR, Board of County Commissioners in Collier County, OR Collier County Government, OR Collier County. The Certificates of Insurance must state the Contract Number, or Project Number, or specific Project description, or must read: For any and all work performed on behalf of Collier County. 12. On all certificates, the Certificate Holder must read: Collier County Board of County Commissioners, 3295 Tamiami Trail East, Naples, FL 34112 13. Thirty (30) Days Cancellation Notice required. 14. Collier County shall procure and maintain Builders Risk Insurance on all construction projects where it is deemed necessary. Such coverage shall be endorsed to cover the interests of Collier County as well as the Contractor. Premiums shall be billed to the project and the Contractor shall not include Builders Risk premiums in its project proposal or project billings. All questions regarding Builder’s Risk Insurance will be addressed by the Collier County Risk Management Division. GG – 5/2/25 ___________________________________________________________________________________________________________ Vendor’s Insurance Acceptance By submission of the bid Vendor accepts and understands the insurance requirements of these specifications and that the evidence of insurability may be required within five (5) days of the award of this solicitation. The insurance submitted must provide coverage for a minimum of six (6) months from the date of award. Page 2927 of 3707 Holder Identifier : 7777777707070700077763616065553330762606557214556607542037772416310073640577146321120734045571267471007526013776214556077660713706745100736221757005671007764615536054570077727252025773110777777707000707007 6666666606060600062606466204446200620002426226022206222006060240000060222060622620000602222606004222006222206060040220062222240620420220622200604000240206220064222642260066646062240664440666666606000606006Certificate No :570114106194CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1/21/2026 IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. 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). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. PRODUCER Aon Risk Services Central, Inc. Green Bay WI Office 1175 Lombardi Avenue Suite 350 Green Bay WI 54304 USA PHONE (A/C. No. Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (920) 437-7123 19445National Union Fire Ins Co of PittsburghINSURER A: 19399AIU Insurance CompanyINSURER B: INSURER C: INSURER D: INSURER E: INSURER F: FAX (A/C. No.):(920) 431-6352 CONTACT NAME: INSURED Quad Med, LLC N61 W23044 Harry's Way Sussex WI 53089 USA COVERAGES CERTIFICATE NUMBER:570114106194 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.Limits shown are as requested POLICY EXP (MM/DD/YYYY) POLICY EFF (MM/DD/YYYY) SUBR WVD INSR LTR ADDL INSD POLICY NUMBER TYPE OF INSURANCE LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X GEN'L AGGREGATE LIMIT APPLIES PER: $1,000,000 $1,000,000 $5,000 $1,000,000 $2,000,000 $2,000,000 A 06/30/2025 06/30/20269911774 PRO- JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE (Per accident) BODILY INJURY (Per accident) COMBINED SINGLE LIMIT (Ea accident) EXCESS LIAB OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED UMBRELLA LIAB RETENTION E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $1,000,000 X OTH- ER PER STATUTEB06/30/2025 06/30/2026 AOS 020396151 X 06/30/2025 06/30/2026 $1,000,000 Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED?N / AN WI WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $1,000,000 020396149 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Named Insured Includes: Medical Care Innovation, PC RE: Contract # 25-8397; Collier County is included as an additional insureds on a primary, non-contributory basis under GL as per contract. A 30 day notice of cancellation is afforded to the certificate holder. CANCELLATIONCERTIFICATE HOLDER AUTHORIZED REPRESENTATIVECollier County Board of County Commissioners 3295 Tamiami Trail East Naples, FL 34112 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. B AIG Specialty Insurance Company 26883 Cyber - Primary 011439386 04/01/2025 04/01/2026 Limit of Liability $1,000,000 Claims Made SIR applies per policy terms & conditions C Page 2928 of 3707 Holder Identifier : 7777777707070700077763616065553330742537666016655407742115772534110072671464347110000760624557276574007526237136432330075066335320363320714005753667031007340255110276130077727252025773110777777707000707007 6666666606060600062606466204446200620000604226000206220024040260002060002242622620220622002404026202206220024260042000062220042422400220622000624226020006220026040222420066646062240664440666666606000606006Certificate No :570104108697CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 01/21/2026 IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. 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). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. PRODUCER Aon Risk Services Central, Inc. Green Bay WI Office 1175 Lombardi Avenue Suite 350 Green Bay WI 54304 USA PHONE (A/C. No. Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (920) 437-7123 Columbia Casualty CompanyINSURER A: INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: FAX (A/C. No.):(920) 431-6352 CONTACT NAME: INSURED Quad/Med, LLC N61 W23044 Harry's Way Sussex WI 53089 USA COVERAGES CERTIFICATE NUMBER:570104108697 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.Limits shown are as requested POLICY EXP (MM/DD/YYYY) POLICY EFF (MM/DD/YYYY) SUBR WVD INSR LTR ADDL INSD POLICY NUMBER TYPE OF INSURANCE LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG GEN'L AGGREGATE LIMIT APPLIES PER: PRO- JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE (Per accident) BODILY INJURY (Per accident) COMBINED SINGLE LIMIT (Ea accident) EXCESS LIAB OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED UMBRELLA LIAB RETENTION E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT OTH- ER PER STATUTE Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED?N / A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below Each ClaimHMA 8018435393 02/26/2025 02/26/2026 Claims-Made $5,000,000Aggregate Limit Physicians ProfessionalA $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Named Insured Includes: Medical Care Innovation, PC RE: Contract # 25-8397; A 30 day notice of cancellation is afforded to the certificate holder. CANCELLATIONCERTIFICATE HOLDER AUTHORIZED REPRESENTATIVECollier County Board of County Commissioners 3295 Tamiami Trail East Naples, FL 34112 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 31127 Page 2929 of 3707