The URL can be used to link to this page

Home My WebLink About2014-143 HR - Magellan Behavior Health Inc for Employee Assistance Program $15,456 AMENDMENT TO MAGELLAN BEHAVIORAL HEALTH, INC AGREEMENT This Amendment entered into this the#day of 2014 to the the Magellan Behavioral Health, Inc. Agreement, last being signed on October 5, 2010, and an amendment signed on January 3, 2013 betweein Orange County, a body politic and corporate, a political subdivision of the State of North Carolina, (hereinafter referred to as the "County") and Magellan Behavioral Health, Inc., a corporation designated as and hereinafter referred to as "Magellan." WITNESSETH: NOW THEREFORE, for and in consideration for the mutual covenants and agreements made herein, the parties agree to amend the Original Agreement as follows: Paragraph 1. This Agreement shall be renewed for a term of 12 months extending from January 1, 2014 through December 31, 2014. Paragraph 2. ADDENDUM C, of the Amendment to Magellan Behavioral Health, Inc Agreement shall be deleted and replaced with attached Addendum C, Fee Schedule. Except for the changes stated herein, the Original Agreement shall remain in full force and effect to the extent it is not inconsistent with this Amendment. In the event that there is a conflict between the Original Agreement and this Amendment, this Amendment shall control. IN WITNESS WHEREOF, Orange County and Magellan have signed this Amendment, effective as of the day first written above. ORANG O MAGELLAN BEHAVIORAL HEALTH,INC By: By: ichael Talbert, Interim County Manager Karen Frie man, Vice President This instrument has been approved as to technical content. Cheryl You im Hut Resources Director This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act. tit 'W .4, )U"/ Clarence G. Grier, Asst. County Manager/CFO jt orm and legality o re, Staff ttorney ADDENDUM C FEE SCHEDULE BASE FEES PEPM RATE UNITED STATES: N In-person E AP Services-Choose session model $1.54 ❑ 1-3 session ❑ 1-6 session ❑ 1-4 session ❑ 1-8 session ® 1-5 session ❑ 1-10 session Telephonic EAP Services N Legal Consultation&Financial Consultation Servicesl $0.05 Work/Life Servicesi Nurse advice Line Services' New Parent Support Servicest Employee Concern Line' Other: INTERNATIONAL: E AP Services-Insert session model ❑ 1- sessions Telephonic EAP Services WorkLife Referral Servicest Legal&Financial Referral Services' Other,Describe: SUPPLEMENTAL FEES United States _Additional In-person Sessions $ 90.00 per In-person Session _Additional Service Flours $ 230.00 per provider hour Mandatory Referrals2 $1600.00 per case CISAI Cancellation Fee $ 250.00 per scheduled hour International Describe: Describe: Communication Materials Brochures with 2 Wallet Cards $ 0.40 per unit—Estimate Posters $ 1.60 per unit—Estimate Services may only be selected if EAP services are purchased. '-Charge applies only if Sponsor selects the Telephonic EAP Service model and an Employee is referred for EAP services under a"last chance agreement"or similar arrangement. ACC> CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/17/2014 9/23/2013 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must 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). PRODUCER LOckton Co1Tlpanies,LLC NE CONTACT 1185 Avenue of the Americas,Suite 2010 PHONE FAX New York 10036 E-MAILo Ex A/C No 646-572-7300 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Lexin ton Insurance Com arl 19437 INSURED MAGELLAN HEALTH SERVICES,INC. INSURER B:Lib Mutual Fir Insurance man 23035 1345009 55 NOD ROAD INSURER C:Ube=Insurance Co oration 42404 AVON CT 06001 INSURER 0: INSURER E: INSURER F: COVERAGES MAGHE01 CERTIFICATE NUMBER: 11461505 REVISION NUMBER: XXXXXXX 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. INSR TYPE OF INSURANCE ADD SUBR POLICY EFF POLICY EXP LIMITS LTR IN D POLICY NUMBER MM/DDIYYYY MM/DD/YYYY GENERAL LIABILITY H RR A N N 7055341 6/17/2013 6/17/2014 DAMAGE TO RENTED X MMERCIAL GENE BILITY PREMISES(Ea occurrence) $ 50,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1 X POLICY PECOT- LOC $ $ AUTOMOBILE LIABILITY N N AS2-651-004219-1 13 10/1/2013 10/1/2014 (Ea accident) $ 1,000,000 IX ANY AUTO BODILY INJURY(Per person) $ XX} {XXX ALL OWNED SCHEDULED BODILY INJURY Per accident } XXJG XX AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ XrXXXXXX HIRED AUTOS AUTOS $ XXXXXXX COMP.$1,00 X COLL.$1,00 A UMBRELLA LIAB OCCUR N N 7055342 6/17/2013 6/17/2014 EACH OCCURRENCE $ 10,000,000 X EXCESS LIAB x CLAIMS-MADE AGGREGATE $ 10,000,000 DED I I RETENTION$ $ x XXXXXX WORKERS COMPENSATION C AND EMPLOYERS'LIABILITY YIN N WC7-651-004219-103 10/1/2013 1011/2014 X TORY LIMIT ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ 1 000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A MANAGECARE LIAB. N N 079331689 6/17/2013 6/17/2014 $10,000,000 per Med Incident A CLAIMS MADE SIR applies per policy $10,000,000 Aggregate A terms&conditions DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) EVIDENCE OF COVERAGE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11461505 AUTHORIZED REPRESENTATIVE MAGELLAN HEALTH SERVICES,INC. 55 NOD ROAD AVON CT 06001 ' � a ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 81988-2010 ACORD CORPORATION.All rights reserved