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Home My Public Portal AboutBlueValue Solutions - Florida BlueBlueValue Solutions AGREEMENT This is an Agreement (hereinafter "Agreement") between Blue Cross Blue Shield of Florida, Inc. d/b/a Florida Blue and Health Options, Inc., (hereinafter jointly referred to as "Florida Blue"), located at 4800 Deerwood Campus Parkway, Jacksonville, Florida 32246 and City of Crestview (hereinafter "the Group") located at PO BOX 1209, Crestview, FL 32536-1209. WHEREAS, the Group and Florida Blue have contracted to provide one or more group health insurance and/or HMO products (hereinafter jointly referred to as GHP "the Group Health Plan") to the Group's employees and their covered dependents (hereinafter "Group Member(s)"); and WHEREAS, Florida Blue and the Group have agreed to work together to improve the health and wellness of the Group Members enrolled in the Group Health Plan; and WHEREAS, the Group and Florida Blue reasonably believe that improvement of the Metrics noted in this Agreement will result in measurable claims cost reductions and/or improved health outcomes. Therefore, Group and Florida Blue have agreed to certain renewal rating actions based upon achieving the wellness and health improvement activities Metrics identified in this Agreement. WHEREAS, each of the parties to this Agreement seeks to set forth in writing the terms and conditions of their Agreement. NOW THEREFORE, for good and valuable consideration, the parties agree to these terms and conditions: I. TERM The initial term of this Agreement shall begin on 4/1/2022, (hereinafter "the effective date) and shall end on 9/30/2024, (hereinafter "the Termination Date"), unless otherwise terminated in accordance with the provisions of this Agreement. II. BENEFIT PLAN Florida Blue will pay benefits to all eligible Group Members in accordance with the provisions of the GHP. III. PREMIUM PAYMENTS The Premium Rates for the GHP are payable in advance to Florida Blue at the address set forth above and subject to the standard terms and conditions of the Group Master Policy. Renewal Premiums will be adjusted as set forth in Section IV, below, based upon participation in and achievement of the goals set forth in the BlueValue Solutions program (the "Program"). IV. BlueValue Solutions Program a. Florida Blue and Group Agree to the following Program terms. 1. Baseline. Florida Blue and Group have established a baseline regarding certain health promotion and wellness activities as noted in the Chart below (the `Baseline"). Each metric's program goals (expressed as percentages) to achieve Program Points are Specifically identified on Exhibit A. These Goals may be adjusted annually upon review and mutual agreement between the parties by executing a new Exhibit A. 2. Metrics Descriptions. The Metrics have the following meanings and the Baseline percentage and Goals percentages are determined in accordance with the descriptions indicated on Exhibit A. 3. Points Earned. Total points for all Metrics identified in Exhibit A that Group may earn over the Measurement Period are identified in Exhibit A and agreed to value of points with respect to the renewal premium rate increase for the applicable anniversary date noted in Exhibit A. 4. Measurement Period. The measurement period for determining the points earned for the Program will begin on the date of execution of this Agreement and run until the date that is 90 days before the Group's renewal date specified in Exhibit A (the "Measurement Period End Date"). Upon mutual Agreement, the Goals may be adjusted once during the Measurement Period by Executing a new Exhibit A. After the measurement period has expired, Florida Blue will determine, in its sole reasonable discretion, based upon data then in its possession the percentage increase from the Baseline and the number of Program Points achieved based upon the Goal level achieved by Metric (e.g. Minimum, Target, Maximum). 5. General Terms and Conditions. The Group must comply with all of the following terms in order to be eligible for award of Program Points: a. The Agreement must be fully executed (signed) by both parties within 14 days of presenting the Agreement to the group for review and signature. b. No material modifications of the membership of the group, group health plan benefits or any other premium risk factor as solely determined by Florida Blue; c. Group's meeting with a Florida Blue Value Consultant ("Value Consultant") within 45 days of signing this Agreement to develop a Health Improvement Plan ("HIP"); d. Group's meeting, at least quarterly, with Value Consultant to review HIP, evaluate performance to plan, and revise HIP if necessary, to achieve Goals; e. Group's remaining, at all times, covered by the Group Health Plan; and, f. Group remaining up to date on payment of then current premiums. V. TERM AND TERMINATION This Agreement shall automatically terminate at the earliest of the following dates (the "Termination Date"): a. Termination of the underlying Group Health Plan by either the Group or Florida Blue pursuant to its terms; b. The Termination Date specified in section I, above; c. After any Program Points earned have been applied to the Applicable Anniversary Date premiums; d. After the GHP appoints a new Agent of Record and Florida Blue determines, in it's sole discretion to terminate and sends notice of termination of this Agreement; or, e. at any time upon mutual agreement between the parties. VI. RENEWAL This Agreement shall not automatically renew/extend after the termination date. Any future participation in the Program must be done by mutual agreement and execution of a new written contract. VII. INCONSISTENCIES If the provisions of this Agreement are, in any way, inconsistent with the provisions of the Benefit Contract(s), then the provisions of the Benefit Contract(s) shall prevail, and the other provisions shall be deemed modified but only to the extent necessary to implement the intent of the parties expressed herein. VHI. SURVIVAL The rights and obligations of the parties, as set forth herein, shall survive the termination of this Agreement to the extent necessary to effectuate the intent of the parties as expressed herein. IX. WAIVER OF BREACH The failure by either party, at any time, to enforce or to require the strict adherence to any provision of this Agreement shall not be deemed to be a waiver of such provision or any other provision of this Agreement. X. GOVERNING LAW This Agreement and the rights of the parties hereunder, shall be construed according to the laws of the State of Florida. XI. SEVERABILITY In the event any provision of this Agreement is deemed to be invalid or unenforceable, all other provisions shall remain in full force and effect. XH. AMENDMENT This Agreement may be amended at any time upon mutual, written agreement of both parties, except that Florida Blue may make changes necessary to comply with State and Federal laws upon 60 days' notice to the Group. XIII. ENTIRE AGREEMENT This Agreement, including its Exhibits, the application(s) for coverage, and the Benefit Contract(s) constitute the entire Agreement between the Group and Florida Blue. Any prior agreements, promises, or representations, either oral or written, relating to the subject matter of this Agreement, and not expressly set forth in this Agreement, are of no force or effect. XIV. NOTICES Any notice, required or permitted under this Agreement, shall be deemed given if hand delivered or if mailed by United States mail, an overnight mail service (e.g., Federal Express), postage prepaid, or by email to the applicable address as set forth above or to such other address as a party may designate, in writing, to the other party. Such notice shall be deemed effective as of the date so deposited or delivered. BLUE CROSS & BLUE SHIELD OF FLORIDA, INC. d/b/a FLORIDA BLUE & HEALTH OPTIONS, INC. By: ((___ _ Name: Joseph C Gregor Title: Vice President Date: 4/20/2022 CITY OF CRESTVIEW By: Name: Printed Title: Date: Exhibit A To BlueValue Solutions Agreement Baseline, Goals, Metrics and Maximum Points For City of Crestview (the "Group") Effective Date of this Exhibit — 4/1/2022 Baseline Metrics and Goals - Metric PHA and Biometric Screening Adult Wellness Exam Care Pathway Completion II. Metrics and Metric Descriptions — Metric PHA and Biometric Screening Adult Wellness Exam Care Pathway Completion Goal Baseline Minimum Target Maximum 43% 50% 60% 75% 34% 50% 60% 75% 97% 50% 60% 75% Program 1 2 3 Points Earned by Goal per Metric Metric Description Percentage of eligible enrolled employees participating in both the Personal Health Assessment and the Biometric Screening for blood pressure, blood glucose and total cholesterol, HDL and ratio. Percentage of eligible members 18+ receiving an exam conducted in a physician's office which consists of age/gender appropriate exam for the purpose of understanding health status and areas of risk. This is not a "sick" visit. Percentage of employees and dependents that complete their Care Pathway Plan Goals r Exhibit A To BlueValue Solutions Agreement Continued III. Points and Maximum applicable rate increase cap Points Maximum applicable rate increase cap 0 No maximum 1 No maximum 2 5% 3 4.5% 4 4% 5 _ 3.5% 6 13% 7 2% 8 1% 9 Rate hold IV. Measurement Period. The Measurement Period is 4/1/2022 through 3/31/2023 with runout through 6/30/2023. V. Applicable Anniversary Date. The Applicable Anniversary Date for the earned rate increase cap is the contract term beginning on 10/1/2023. VI. Year 1 Rate Cap. In recognition of the Group's agreement to participate in this Program, Florida Blue will not increase rates on the group by more than 5% at their next anniversary date on 10/1/2022. Agreed to by: Florida Blue Title: Vice President Crestview