Asserta Health Inc 10/18/2018 - Laserfiche WebLink

CITY ADMINISTRATIVE SERVICE AGREEMENT This Administrative Service Agreement(this"Agreement")is made as of January 1,2019(the"Effective Date"),by and between City of Everett Health Plan,an employer health plan("Health Plan"),and Asserta Health, Inc.,a Delaware corporation("Asserts"). Recitals: Whereas,Health Plan has created and administers a health plan for its employees;and Whereas, it is Health Plan's desire that Asserta act as the Program Administrator of its Direct Payment program to facilitate payment for Covered Services;and Asserta is willing to act in such capacity,subject to the terms and conditions hereof Now, therefore, in consideration of the mutual promises set forth herein, and other good and valuable consideration,the receipt and sufficiency of which are hereby acknowledged,the parties hereto agree as.follows: Definitions (a) "Allowed Amount" means maximum amount on which payment is based for Covered Services based on a the Health Plan's plan documents. (b) "Cash Price" means the price negotiated by Asserta constituting payment in full at the time of service for a Covered Service. (c) "Concierge Services"means the suite of Member support and cash payment services to be provided by Asserta. (d) "Covered Services" means the medical or health-related services a Member is eligible to obtain based on the terms of the Health Plan in which the Member participates. (e) "medEcash"means Asserta's proprietary payment platform,including both a mobile application and purchasing card that allows Asserts to stage funds from Members and Health Plan to enable cash payment for services. (f) "Member"means a person,including a dependent of a member,who is eligible for health care benefits for which the Health Plan has made arrangement to provide. (g) "Providers" mean, as the case may be, health professionals, hospitals, ambulatory surgical centers and other healthcare providers. (h) "Reference Price" means the calculated price for a specific service stated as a percentage of Medicare that is utilized for measuring savings. (i) "Shared Savings" means an incentive program in which Health Plan shares a portion of the savings created by medEcash payment with the Member as an inducement to use the Concierge Services. (j) "TPA"means third party administrator that administers employer sponsored health and benefit plans. 1. Term. The term of this Agreement shall be one(1)year,beginning on the Effective Date(the"Initial Term"). This Agreement shall automatically renew for additional one(1)year term(each,a"Renewal Term,"and together with the Initial Term,the"Term"),unless either party provides the other party written notice of its intent not to renew this Agreement at least sixty(60)days prior to the expiration of the applicable Term. 2. Services Provided by Asserta. Asserta shall perform the Concierge services described below in this Section 2 (the "Services") for and on behalf of the Health Plan. The Services shall be performed in a commercially reasonable, professional and workmanlike and competent manner in accordance with industry standards. In performing the Services on behalf of the Health Plan,Asserta shall have those powers expressly granted and set - 1 -