HomeMy WebLinkAboutCC RESO 15,857RESOLUTION NO. 15,857
RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY
AUTHORIZING THE CITY MANAGER TO EXECUTE AN AGREEMENT WITH
OCCUPATIONAL HEALTH SERVICES, INC. TO PROVIDE
AN EMPLOYEE ASSISTANCE PROGRAM,
AND AUTHORIZING A TRANSFER
OF FUNDS TO MEET NECESSARY
BUDGET REQUIREMENTS
WHEREAS, the City of National City has published a request for proposals to
provide an Employee Assistance Program for employees in the bargaining unit
represented by the National City Police Officers' Association; and
WHEREAS, based upon review of all proposals to perform such services, it was
determined that Occupational Health Services, Inc., is the most suitable bidder to
provide this service.
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of
National City hereby awards a contract for an Employee Assistance Program to:
OCCUPATIONAL HEALTH SERVICES, INC.
BE IT FURTHER RESOLVED that the City Manager is hereby authorized to
execute on behalf of the City, an agreement between Occupational Health Services,
Inc., and the City of National City to perform this service consistent with the
request for proposals published by the City. A copy of the agreement is attached as
Exhibit "A".
BE IT FURTHER RESOLVED by the City Council of 'the City of National City
that it hereby authorizes and directs the following transfer of funds be made in order
to meet necessary budget requirements:
AMOUNT: $3,800
FROM: 001-2411
Unappropriated Reserves
TO: 001-411-000-299
Police Operations -Contract Services
PASSED AND ADOPTED this 17th day of January, 1989.
ATTEST:
0'Lt,
Lori Anne Peoples, City 'Clerk
APPROVED AS TO FORM:
George H. Eiser, III - City Attorney
tieWaters,
at rge H. Waters,rs, Mayor
City of National City
Office of the City Manager
1243 National City Blvd., National City, CA 92050-4397 (619) 336-4240
Tom G. McCabe —City Manager
January 19, 1989
Ms. Mary Austin
Contract Administrator
Occupational Health Services, Inc.
187 Fortieth Street Way
Oakland, CA 94611
Dear Ms. Austin,
On January 17, 1989 the City Council authorized the City Manager
to execute an agreement with Occupational Health Services, Inc.
to provide an Employee Assistance Program.
En los=d for your files is an original signed agreement.
Bolint
As ist- City Manager
GJB:ld
Enclos es
xc: Personnel Director (w/signed agreement)
AGREEMENT FOR EMPLOYEE
ASSISTANCE PROGRAM SERVICES
This Agreement, dated this 9th day of January, 1989 by and
between the City of National City (hereinafter referred to as
"Sponsor") and Occupational Health Services, Inc., a California
corporation (hereinafter referred to as "Contractor").
RECITALS
Contractor operates an Employee Assistance Program that
provides counseling services to individuals with various personal,
medical -behavioral problems and is licensed as a specialized health
care service plan under the Knox -Keene Health Care Service Plan Act
of 1975.
Sponsor wishes to make the Program available to Subscribers
and their dependents.
Now, therefore, the parties mutually agree as follows:
I. DEFINITIONS
For purposes of this agreement and any other document
executed or provided in connection with this Agreement, the
following terms shall have the meanings given them in this Section
unless the context requires otherwise:
A. Employee Assistance Program (hereinafter referred to
as the "Program"): An organized procedure for the provision of
assistance and counseling to persons experiencing personal,
medical -behavioral problems related to family conflict, drug or
alcohol abuse, stress, marital discord, finances, and other matters,
and for the provision of training, consultation and other management
services relating to the effective utilization of the Program by
Sponsors.
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B. Employee Assistance Program Services (hereinafter
referred to as "Program Services"): All procedures or activities
that utilize psychological principles and methods for the
assessment, understanding, prevention, diagnosis, referral,
treatment and/or case management of personal, medical -behavioral
problems in adults, children, couples and families. Such procedures
or activities may include individual or group counseling, marriage,
divorce, and family counseling, behavior therapy, psychotherapy,
financial and credit counseling, legal counseling, stress reduction
services, career counseling, parenting skill training, conflict
resolution, grief and loss counseling, biofeedback training,
hypnotherapy, and pregnancy counseling, as utilized by a
professional for the purpose of assisting persons to cope with
and/or resolve their personal, medical -behavioral problems, that are
provided pursuant to this Agreement.
C. Provider: Any licensed or certified psychologist,
psychiatrist, clinical social worker, marriage, family and child
counselor, alcohol and drug counselor or other professional
(attorneys, financial counselors, childcare coordinators, etc.) who
is qualified and appropriately licensed to deliver program services
to persons in need thereof.
D. Panel Provider: Any Provider who has an agreement
with Contractor to deliver Program Services to Enrollees.
E. Non -Panel Provider: Any Provider who does not have
an agreement on file with Contractor to deliver Program Services to
Enrollees.
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F. Subscriber: An individual in one of the following
classifications: animal control officer, police dispatcher matron,
police officer, sergeant or lieutenant of the National City Police
Department shall be eligible for participation in the Program.
G. Enrollee: An individual who is enrolled in the
Contractor's EAP plan, either as a subscriber or the dependent of a
subscriber, and is a recipient of services from the plan as defined
herein.
H. Dependent: The lawful spouse and unmarried depen-
dent children of an individual eligible for participation in the
Program pursuant to an agreement between Sponsor and Contractor who
are either 18 years of age or less, or 22 years of age or less if
full-time students or qualified as a dependent for federal income
tax purposes, or over the age of 19 and are incapable of
self-sustaining employment by reason of mental retardation or
physical handicap. The term "children" as used herein includes
step -children, adopted children, foster children, and natural
children, provided such children are dependent upon the eligible
individual for support and maintenance. Children of an eligible
individual are not considered dependents if they are in the military
service.
I. Individual Private Session: A fifty (50) minute
counseling session with a Panel Provider for one or more Enrollees
from one Family Unit.
J. Group Counseling Session: A counseling session with a
Panel Provider for Enrollees from two or more Family Units.
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K. Family Unit: An eligible individual, together with
that individual's dependents, if any.
L. Grievance Committee: A committee of persons charged
with conducting the professional review functions described in
Section II. of this Agreement.
M. Evidence of Coverage: The document issued to an
Enrollee setting forth his or her eligibility for participation in
the Program.
N. Sponsor: A person or entity which has an Agreement
for Employee Assistance Program Services with Contractor and which
makes payment to Contractor so that individuals with a specified
relationship to Sponsor are eligible to receive Program Services and
that such person or entity can participate in the Program.
II. PRINCIPAL BENEFITS AND COVERAGE
A. General. Contractor shall provide to Enrollees the
benefits described in Sections IV (D) and (E) of this Agreement.
B. Choice of Providers. The choice of the Panel Provider
who will provide Program Services to an Enrollee shall be made by
Contractor. However, an Enrollee's choice of Panel Provider, due to
dissatisfaction or other reasonable cause, shall be honored by
Contractor when arranging for the provision of Program Services
except under unusual and compelling circumstances. In any event,
Contractor is obligated to make Program Services available only
through Panel Providers.
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C. Utilization of Program Services. To obtain Program
Services, an Enrollee should call toll free (800) 227-1060 or (415)
653-4357 directly, or contact his Sponsor for a referral to
Contractor. Service hours are:
Emergency services: 24 hours per day, 7 days per week
Non -emergency services: 6:00 A.M. - 10:00 P.M.,
7 days per week
If an enrollee is away from home but still in the United
States, he or she may utilize plan services in the event of an
emergency by calling the plan and being referred to a Panel Provider
in his or her vicinity.
D. Disputes and Complaints. In the event any dispute
arises under this Agreement, an Enrollee who is a party to such
dispute should contact Contractor at the address or phone numbers
listed below. Each Enrollee shall receive a questionnaire/
complaint form which should be completed and sent promptly to
Contractor at the address immediately below.
E. Organization & Responsibility
1. The OHS Grievance Committee shall be comprised of
two Vice Presidents of Contractor and the Chairperson. It shall be
the responsibility of the Grievance Committee to provide supervision
over, and to review grievances not resolved by, the Clinical
Director. The Chairperson of the Grievance Committee shall be
appointed by the OHS Plan Board of Directors and shall report to an
officer of the Plan. The Chairperson shall have primary
responsibility for the maintenance of the grievance procedures, for
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the review of their operations and for the utilization of any
emergent patterns of grievances in the formulation of policy changes
and procedural improvements in the Plan's administration.
F. Filing Grievances
1. Enrollees may file a complaint about the OHS Plan
or a provider by appearing in person or writing or calling OHS at:
Office of the General Counsel
Occupational Health Services, Inc.
187 - 40th Street Way
Oakland, CA 94611
(415) 655-0535
(800) 227-1060
Contractor will mail a consumer satisfaction survey to all Enrollees
who utilized the service. This will be used as a routine method to
identify strengths and weaknesses of Program Services. In addition,
copies of Enrollee complaint forms shall be sent to the Enrollee on
request, or when a complaint is indicated through return of the
client questionaire. Completed forms should be submitted to the
above address. Assistance will be provided by a representative of
Contractor to anyone attempting to file a grievance in person or by
telephone.
G. Plan Response to Grievances
1. Within fifteen (15) days of receiving a complaint,
Contractor will contact the Enrollee to acknowledge receipt of the
complaint. This contact will be made to solicit details of the
complaint from the Enrollee and conduct an investigation.
2. Within thirty (30) days, the complainant shall be
notified of the disposition of the- complaint by the Clinical
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Director.
3. If the complaint cannot be resolved by the Clinical
Director, or the complainant requests a review of the disposition of
the Clinical Director, the complaint shall be reviewed by the
Contractor's Grievance Committee. The complainant shall be given an
opportunity to present additional information to the Contractor's
Grievance Committee for the purpose of such review. The
Complaintant shall be notified of the decision of the Grievance
Committee within thirty (30) days of the request for review.
4. Any disputes not settled by the foregoing procedure
shall be subject to arbitration.
H. Records of Grievances
1. A written record shall be made of each
complaint received in person, by mail, or by telephone, including
the date, the name of the person recording the complaint, and the
resolution. When a complaint is received, information about it
will be entered into the Grievance Log, including date of complaint,
client name and number, provider name, and nature of the complaint.
The Clinical Director will note on the log the date the complainant
is contacted, the final resolution of the case and when final
contact with the complainant is made. If the complaint could not be
resolved, a notation to that effect will be made on the log and the
complaint will be reviewed by the Grievance Committee.
2. Periodically, a review shall be made by
Contractor's Grievance Committee of the types and numbers of
grievances being received. A summary of such review shall be
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reported to Contractor's Board of Directors and its Public Policy
Committee in connection with their consideration and formation of
Contractor's policy. Contractor's Grievance Committee shall include
in its periodic reports recommended corrective actions to be taken
in light of the pattern of grievances received.
I. Effectiveness of Coverage. Coverage for services
under this agreement becomes effective for an Enrollee immediately
after (1) this Agreement is executed by Contractor and Sponsor and
(2) Subscriber has the relationship with Sponsor that makes him or
her eligible for Program Services as set forth in Section I. (F.) of
this agreement.
III. LIMITATIONS, EXCEPTIONS AND EXCLUSIONS
A (1). Choice of Physicians and Providers. Enrollees must
obtain Program services only from Panel Providers if Contractor is
to pay for such Services.
A (2). Liability of Subscriber or Enrollee for Payment.
If an Enrollee chooses to receive Program Services from a Provider
who is not a Panel Provider, Contractor has no obligation or
responsibility to compensate or reimburse such Non -Panel Provider or
the Enrollee for any services rendered to such Enrollee, and
Enrollee has the responsibility for paying such Non -Panel Provider.
Therefore, Contractor will not pay Non -Panel Providers for services
rendered to Enrollees, and Enrollees may be liable to the Non -Panel
Provider for the cost of services.
B. Costs to Enrollees for Additional Sessions. If an
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Enrollee elects to receive counseling sessions in addition to the
sessions per contract period specified in Section IV (D) of this
Agreement, the Enrollee is responsible for paying the costs of such
sessions. Contractor has no obligation to pay for such additional
sessions.
C. Charges to Enrollees for Broken Appointments. An
Enrollee will be deemed to have received one of the counseling
sessions Contractor is obligated to provide pursuant to this
Agreement if any appointment made by such Enrollee with a Panel
Provider was not kept, except in those cases where: (a) the Panel
Provider is notified at least 24 hours in advance of the appointment
that it will not be kept; or (b) the appointment is missed because
of an emergency or circumstances beyond the control of the Enrollee
and the Enrollee is unable to give the Provider 24 hours advance
notice of cancellation.
D. Exclusions. Contractor has no obligation under this
Agreement to provide any of the following services:
1. Treatment for mental retardation. An Enrollee
shall be considered mentally retarded if he or she is determined by
a qualified professional to have an IQ of 70 or below as measured by
the Weschler scales.
2. Treatment for autistic children. An Enrollee
shall be considered Autistic if a qualified professional (clinical
psychologist or psychiatrist) diagnoses him or her as having an
autistic disorder as defined by latest edition of the Diagnostic and
Statistical Manual of the American Psychiatric Association.
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3. Inpatient counseling. This category includes
any counseling while Enrollee is admitted as a patient in a general
acute care or acute psychiatric hospital or other licensed health
facility.
4. Physical or medical treatment for medical,
organic, endocrine, metabolic or other physiological disorders. This
category includes, but is not limited to:
a. Pick's Disease
b. Down's Syndrome
c. Parkinson's Disease
d. Epilepsy
e. Huntington's Chorea
f. Brain Tumor
g. Alzheimer's Disease
However, Contractor will provide services to Enrollees for emotional
or psychological problems caused by or related to these conditions.
5. Involuntary requirements to undergo counsel-
ing based upon orders of any California or Federal Judicial Officer
or other governmental official mandating that an Enrollee undergo
counseling for any reason whatsoever.
6. Treatment for any condition that is compens-
able under Workers' Compensation or obtained through or required by
any governmental agency.
IV. CONTRACTOR'S SERVICES
Contractor will provide the following services during the
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term of this Agreement at Contractor's designated office locations
or mutually agreed upon facilities and/or locations:
A. Provision of management consultation to Sponsor
relative to the development and integration of organizational
policies and procedures necessary for effective implementation of
Contractor's Program.
B. Orientation of Sponsor's Enrollees to the Program by
means of written materials, briefing and training session, and
audio-visual presentations pertaining to the purpose, scope, nature
and use of the Program.
C. Training of Sponsor's supervisory and management staff
to develop the knowledge and skills necessary to utilize effectively
the resources of the Program in the exercise of their personnel
management responsibilities.
D. Provision of direct one-to-one counseling by licensed
professional staff intended to identify and evaluate personal,
medical -behavioral problems and to assess and address alternatives
for the resolution of such problems as may exist from time to time
among Sponsor's Subscribers and/or their dependents. Contractor
shall provide a maximum of three (3) Individual Private Sessions or
Group Counseling Sessions per family unit who have sought Program
Services without referral by a supervisor of Sponsor per contract
period. Fees for any counseling sessions exceeding three (3) will
become the financial responsibility of the Enrollee unless otherwise
arranged for by the Sponsor. Contractor will, however, provide any
number of counseling sessions while this Agreement is in effect to
identify and evaluate personal, medical -behavioral problems and to
assess and address alternatives for the resolution of such problems
of Sponsor's Enrollees' who have been referred to Contractor by a
supervisor of Sponsor as evidencing performance problems in their
work or occupation.
E. Provision to Enrollees of referrals to professional
community resources for treatment and/or assistance outside of the
scope of this Agreement as may be appropriate. Payment of the fees
for such treatment or assistance shall not be the responsibility of
Contractor.
F. Provision of ongoing consultation to Sponsor's
supervisors and management personnel in matters pertaining to
specific personnel actions.
G. Provision of monthly statistical evaluations for the
first six months of program implementation and quarterly
statistical evaluation thereafter to the Sponsor of Enrollee
utilization of Contractor's Program.
V. CONFIDENTIALITY
A. Records, including any information whether recorded
or not, pertaining to the indentity, diagnosis or treatment of any
employee or employee's family dependent which are maintained in
connection with the performance of this contract shall be
confidential and disclosed only in accordance with all applicable
state and federal laws and regulations, including those relating to
the confidentiality of medical records, patient consents to release
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information, the pyschotherapist-patient privilege, and drug and
alcohol program records.
B. Contractor agrees to operate a system of records on
individuals in accordance with the Privacy Act of 1974, as amended.
VI. COMPENSATION BY SPONSOR
A. Sponsor shall pay Contractor the sum of Three Thousand
Eight Hundred Dollars and 00/100 ($3,800.00) for any one contract
period in consideration for Contractor's provision of the Program.
This sum shall be paid in four installments, quarterly in advance
and each installment becomes payable upon receipt by Sponsor of an
invoice from contractor. Remittances to Contractor shall be made
payable to Occupational Health Services, Inc., and sent to
Contractor's offices located at 187 - 40th Street Way, Oakland,
California 94611. The level of compensation is related to the
number of Subscribers reported by the Sponsor as of the effective
date of this Agreement. This number will be reviewed on a quarterly
basis, with increases and/or decreases in the number of Subscribers
reported. Compensation levels may be adjusted based upon a per
capita rate or a formula that is mutually agreeable to the
Contractor and the Sponsor.
B. No individual Enrollee shall be obligated in any way
to pay for Program Services rendered by Contractor in accordance
with the terms of this Agreement, including the payment of
deductibles, copayments, or co-insurance. By statute, every
contract between Contractor and a Panel Provider shall provide that
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in the event Contractor fails to pay the Provider, an Enrollee shall
not be liable to the Provider for any sums owed by Contractor.
VII. INDEMNIFICATION AND INSURANCE
A. The Contractor shall, at his own expense, take out and
keep in force during the period of this contract, including any
extensions thereof:
1) A public liability insurance policy to protect the
Contractor, his officers, agents, and employees against any
liability to the public arising out of or relating to any activities
to be performed under this contract, or resulting from injury to, or
death of, any person occurring in or about said work, in an amount
of not less than $1,000,000 to satisfy the claim of one person, and
in the amount of not less than $1,000,000 against the claims of two
or more persons resulting from any one occurrence or accident.
2) A property damage or other insurance policy to
protect the Contractor, his officers, agents and employees against
any liability arising out of or relating to any activities to be
performed under this contract, in the amount of not less than
$500,000.
3) A worker's compensation insurance policy, covering
all Contractor's employees and volunteers, as will protect it from
claims under Workmen's Compensation Insurance Acts.
4) A professional liability policy covering errors and
omissions in a sum not less than $1,000,000. The Contractor may not
disclaim responsibility or avoid liability for the acts or omissions
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of his subcontractors or other professional consultants, and may
require professional liability insurance coverage from them in such
amount as the Contractor may deem appropriate for the work being
undertaken by subcontractors.
5) Automobile insurance covering all bodily injury and
property liability incurred during the performance of this
agreement, with minimum limits of $1,000,000 combined single limit
per occurrence. Such automobile insurance shall include both owned
and non -owned vehicles.
Each of said policies (except the worker's compensation policy)
shall name the City and its officers, agents and employees as
additional insured, and shall constitute primary insurance as to
City and its officers, agents, and employees so that any other
policies
insurance
the terms
insurance
held by City shall not contribute to any loss under said
within the limits of coverage provided by Contractor under
of this agreement.
Said policies shall obligate the
carriers to notify the City in writing not less than ten
(10) days prior to the cancellation thereof, or any other change
affecting the coverage of the policies including, but not limited
to, any erosion in aggregate coverage. Said policies shall be
written on an occurrence basis and shall not be written on a claims
made basis. The Contractor shall provide the City a certificate of
insurance demonstrating the required coverage and stating that the
policies are not written on a claims -made basis for execution of
this contract. If Contractor does not maintain all of the required
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insurance policies in full force and effect, City may elect to treat
the failure to maintain the requested insurance as a breach of this
contract and terminate the contract as provided herein.
B. Contractor agrees to hold harmless, to indemnify, and
at its own expense, cost, and risk, to defend the City, its
officers, agents and employees from every loss, claim, action or
liability which arises from or relates to Contractor's performance
of services under this contract.
VIII. TERM AND RENEWAL
A. The term of this Agreement shall be for one(1) year(s)
beginning on January 1, 1989 and ending on December 31, 1989.
B. This Agreement shall be automatically renewed for
additional one (1) year terms, unless either party serves written
notice of termination to the other more than thirty (30) days prior
to the expiration of the first or any subsequent term. This
Agreement may be renewed on the same terms and conditions as it
presently contains, provided that the compensation specified in
Section VI may, by mutual agreement be increased. Notwithstanding
the provisions of this section, the parties may negotiate new and
different terms or conditions, or a different level of compensation,
in light of legislative or regulatory changes that require
Contractor to change such terms or conditions or to offer additional
benefits not covered by this Agreement. Such changes shall be
effective on the anniversary date of this Agreement unless otherwise
mandated by law.
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C. Unless otherwise specified in Section VIII (A.), any
individual term of one (1) year's duration shall be considered a
"contract period" as that term is used in this Agreement.
D. Individual Continuation of Benefits. An individual
Subscriber does not have the right to renew his or her eligibility
for Program Services once his or her relationship (employment or
otherwise) to Sponsor is terminated. An Enrollee's right to
receive Program Services is determined solely by the Subscriber's
Sponsor and Contractor.
IX. SPONSOR OBLIGATIONS
A. Sponsor shall provide its Enrollees with information
about the Program and their eligibility for participation in the
Program, and shall distribute to all employees or associated
individuals copies of Contractor's Enrollee information forms
including Contractor's Evidence of Coverage and Disclosure Form.
The Evidence of Coverage and Disclosure Form is a summary only; this
Agreement should be consulted to determine the governing contractual
provisions.
B. In the event Contractor sends notice of suspension or
cancellation for any reason to Sponsor, Sponsor shall mail promptly
to each employee or associated individual a legible, true copy of
such notice and shall promptly provide Contractor with proof of
such mailing and the date thereof.
X. ELIGIBILITY
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A. Contractor may suspend or cancel the eligibility of
Enrollees for Program Services based upon Sponsor's repeated
failure to reimburse Contractor within 45 days of receipt of Invoice
and/or for a contribution delinquent in excess of 90 days. The
eligibility of an Enrollee for Program Services under this Agreement
shall cease on the sixtieth (60th) day after the date of any invoice
sent by Contractor to Sponsor if that invoice is unpaid by Sponsor
as of that date and Sponsor has received notice of suspension or
cancellation of this Agreement from Contractor in accordance with
Sections XI and/or XII. If Sponsor has not received notice of
suspension or cancellation by the sixtieth day, the eligibility of
an Enrollee shall cease on the date that Sponsor receives
notification of suspension or cancellation in accordance with
Sections XI and/or XII.
B. Termination of Benefits. The eligibility of an
Subscriber for Program Services shall terminate on the last day he
or she bears the relationship to Sponsor specified in Section I.
(F.). Dependents shall remain eligible for Program Services until
the eligibility of the Subscriber related to them ceases or until
loss of dependency status, whichever occurs first. Eligibility
shall, in any event, terminate immediately upon termination of this
Agreement, except as otherwise provided herein. Contractor may
terminate the eligibility of any Enrollee for fraud or deception in
the use of the services provided by it or for knowingly permitting
such fraud or deception by another.
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XI. CANCELLATION
Either party may terminate this agreement by giving thirty
(30) days notice to the other party in writing of the intention to
do so, and the reason therefor. This agreement may not be
terminated by Contractor due to the enrollee's health status or
requirements for covered services.
A. Contractor may terminate all further benefits, and be
released from all further obligations hereunder effective as of the
30th day following written notice of such cancellation to Sponsor.
B. Contractor will make payment to Panel Providers for
services authorized by Contractor prior to cancellation, and
provided thereafter in accordance with this Agreement, but in no
event for services provided beyond thirty (30) days after the
cancellation.
C. In the event of cancellation by the Contractor (except
in the case of fraud or deception in the use of services or
facilities of Contractor or knowingly permitting such fraud or
deception by another), Contractor shall, within thirty (30) days,
return to Sponsor the pro -rated portion, if any, of the money paid
to Contractor which corresponds to any unexpired period for which
payment has been received, less any amount due Contractor.
D. If any person believes that this Agreement has been
cancelled or an Enrollee has been denied Program Services because of
an Enrollee's health status or requirements for health services,
he/she may request a review by the Commissioner of Corporations of
the State of California under Section 1365(b) of the California
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Health and Safety Code.
XII. SUSPENSION
Suspension of this Agreement may only be effected in
accordance with the following provisions:
A. Contractor may suspend this Agreement, terminate all
further benefits, and be released from all further obligations
hereunder effective as of the date Contractor gives written notice
of such suspension to Sponsor upon the occurrence of the following
event:
1. In the event that Sponsor has repeatedly
failed to reimburse Contractor within 45 days of receipt of Invoice
and/or for a contribution delinquent in excess of 90 days as set
forth in Section X(A), and provided that Sponsor has been duly
notified and billed by Contractor, and at least fifteen (15) days
have elapsed since the date of notification.
However, Contractor must send a notice of suspension of
this Agreement only after Sponsor's payment has been delinquent for
sixty (60) days for suspension to be effective.
B. Contractor will make payment to Panel Providers for
services authorized by Contractor prior to suspension, and provided
thereafter in accordance with this Agreement, but in no event for
services provided beyond thirty (30) days after the suspension.
C. Acceptance by Contractor of the proper Sponsor
contribution after suspension of this Agreement shall reinstate the
Agreement as though it had never been suspended unless Contractor
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shall with five (5) business days of receipt of such payment refund
the payment so made.
XIII. GENERAL PROVISIONS
A. All notices referred to in this Agreement shall be
deemed as having been properly made upon deposit of any such notice
in the United Stated mail, postage prepaid, certified mail with
return receipt requested, addressed to Contractor at its address
specified in Section VI(A) above or to the Sponsor at the address
last appearing on Contractor's books. For purposes of this
agreement, all such notices shall be deemed received by Contractor
or Sponsor two (2) days after they have been properly made.
B. This Agreement contains the entire understanding of
the parties relating to the subject matter contained herein and
supersedes all prior and collateral contracts, understandings, and
negotiations of the parties, whether oral or written. Each party
acknowledges that no representations, inducements, promises or
agreements, oral or written, with reference to the subject matter
hereof have been made other than as expressly set forth herein.
C. Neither party may assign or delegate this Agreement
without the express written consent of the other.
D. This Agreement shall be governed by the laws of the
State of California. Contractor's Program is subject to the
requirements of Chapter 2.2 Division 2 of the California Health and
Safety Code and to Subchapter 5.5 of Chapter 3 of Title 10 of the
California Administrative Code. Any provision required to be in
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this Agreement by either of the above shall bind Contractor whether
or not any such provision appears in this Agreement.
IN WITNESS THEREOF, the parties hereto have executed this
Agreement as of the day and year first herein above set forth.
OCCUP AL HE'A TH SERVIC'ES, INC.
By: I '� .LA
Title: Vic -President
SPONSOR:
By:
Title:
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