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HomeMy WebLinkAboutC19-359 Correctional Healthcare CompaniesFIFTH AMENDMENT TO THE AGREEMENT FOR INMATE HEALTH CARE SERVICES AT EAGLE COUNTY, COLORADO (Effective January 1, 2019) This Fifth Amendment, effective January 1, 2019 (this "Amendment"), to the Agreement for Inmate Health Care Services, dated January 1, 2012, as amended (the "Agreement") is by and between Correctional Healthcare Companies, LLC ("CHC") and the County of Eagle, Colorado ("County"). WHEREAS, the Agreement automatically renews on January 1st of each year pursuant to Section 9.0; and WHEREAS, the Parties agree to increase compensation for each successive year pursuant to Section 9.0.1; and WHEREAS, the Parties agree to a salary increase adjustment of 0.950 FTE ofHSA; and WHEREAS, in accordance with Section 11.15, the Parties desire to amend the Agreement to memorialize such changes. NOW, THEREFORE, in consideration of the mutual covenants herein contained and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties agree as follows: 1. RECITALS. The Parties hereto incorporate the foregoing recitals as a material portion of this Amendment. 2. AMENDMENT TO SECTION 8.0 OF THE AGREEMENT. The Agreement shall be amended by deleting Section 8.0 in its entirety and inserting the following language in lieu thereof: 8.0 ANNUAL AMOUNT/MONTHLY PAYMENTS. The base annual amount to be paid by the County to CHC under this Agreement is $365,698.92 for a period of 12 months. Each monthly installment shall equal $30,474.91, pro-rated for any partial months and subject to any reconciliations as set forth below. Each monthly installment is to be paid to CHC on or before the 1st day of the month of service. 3. SEVERABILITY. If any terms or provisions of this Amendment or the application thereof to any person or circumstance shall to any extent be invalid or unenforceable, the remainder of this Amendment or the application of such term or provision to person or circumstances other than those as to which it is held invalid or unenforceable shall not be affected thereby and each term and provision of this Amendment shall be valid and enforceable to the fullest extent permitted by law. Page I of2 DocuSign Envelope ID: C206B79F-A136-4EF2-8C09-9DABF32F1D81 4. DEFINITIONS. Capitalized terms used but not defined herein shall have the meaning ascribed to them under the Agreement. 5. REMAINING PROVISIONS. The remaining provisions of the Agreement not amended by this Amendment shall remain in full force and effect. IN WITNESS WHEREOF, the Parties have caused this Amendment to be executed in their names or their official acts by their respective representatives, each of whom is duly authorized to execute the same. AGREED TO AND ACCEPTED AS STATED ABOVE: County of Eagle, Colorado Correctional Healthcare Companies, LLC By: ________ _ Name: ---------- Title: Title: President, Local Government Page 2 of2 DocuSign Envelope ID: C206B79F-A136-4EF2-8C09-9DABF32F1D81 Jeanne McQueeney Commissioner SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 2,000,000 ES1866 (Master) Manashi Mukherjee ATL-004878091-09 X AGGREGATESIR: $2M of Marsh USA Inc. N SIR: $2M 8 12/15/2018MEDICAL PROF LIABILITY 6,000,000 2,000,000 A X 08/08/2019 3,000,000 12/15/2018 1,000,000 Eagle County, its associated or affiliated entities, its successors and assigns, elected officials, employees, agents and volunteers are Additional Insureds under the commercial general liability policy of insurance. X 885 E. Chambers Ave. PO Box 359 Eagle County Detention Center Eagle, CO 81613 X A 102698814-upl-GP-18-20 PER MEDICAL INCIDENT 5,000 (CLAIMS MADE) INCLUDED 10179 100,000 03/15/2020 1801 West End Avenue, Suite 1400 Marsh USA, Inc. Nashville, TN 37203 1283 Murfreesboro Road, Suite 500 Wellpath Holdings, Inc. Nashville, TN 37217 ES1866 (Master) Jail Administrator 03/15/2020 ProAssurance Specialty Insurance Company DocuSign Envelope ID: C206B79F-A136-4EF2-8C09-9DABF32F1D81 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: Correctional Healthcare Holding Company, LLC� Wellpath Management, Inc� CHC Pharmacy Services, LLC � California Forensic Management Group, Inc.� Correctional Healthcare Companies, LLC� Wellpath, LLC� League Medical Concepts, LLC� Jessamine Healthcare, Inc.� Correct Care Holdings, LLC� 2 Healthcare Professionals, LLC � 2 Wellpath Group Holdings, LLC� CCS-CMGC Holdings, Inc.� Nashville CCS-CMGC Intermediate Holdings2, Inc. � CCS-CMGC Parent Holdings, LP � Wellpath Holdings, Inc� CCS-CMGC Intermediate Holdings, Inc.� �� �� � ADDITIONAL NAMED INSUREDS INCLUDE:� Certificate of Liability Insurance Correct Care, LLC� 102698814 Wellpath Recovery Solutions of Alaska, Inc.� Correct Care Solutions Group Holdings, LLC � Correctional Mental Health Services, LLC � CFMG Holdings Corp.� CHC Companies, LLC � Correctional Medical Group Companies, Inc. � Correct Care Solutions, LLC� Southwest Correctional Medical Group, Inc. � �� Conmed Healthcare Management, LLC� League Medical Concepts, LP� Wellpath Recovery Solutions, LLC� Correct Care of South Carolina, LLC� Marsh USA, Inc.� 1283 Murfreesboro Road, Suite 500� Wellpath Holdings, Inc.� Nashville, TN 37217 Health Cost Solutions, LLC� Physicians Network Association, Inc� Correct Care Australia Pty, Ltd (Australia)� Conmed, LLC � 25 Wellpath CFMG, inc.� DocuSign Envelope ID: C206B79F-A136-4EF2-8C09-9DABF32F1D81 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 10/13/2019 Manashi Mukherjee X ATL-004857354-09 1,000,000 WC5252135-04 (WI) 16535 of Marsh USA Inc. N X10/13/2018 3 10/13/2019BAP5252136-04 A X Zurich American Insurance Company 1,000,000 X 08/15/2019 Eagle County, its associated or affiliated entities, its successors and assigns, elected officials, employees, agents and volunteers are Additional Insureds under the automobile liability policy of insurance. 10/13/2018 885 E. Chambers Ave. PO Box 359 Eagle County Detention Center Eagle, CO 81613 102698814--AW-18-19 10/13/2019 2,000,000 A 40142 1,000,000 WC5252134-04 (AOS) 1801 West End Avenue, Suite 1400 Marsh USA, Inc. Nashville, TN 37203 1283 Murfreesboro Road, Suite 500 Wellpath Holdings, Inc. Nashville, TN 37217 10/13/2018 Jail Administrator B American Zurich Insurance Company DocuSign Envelope ID: C206B79F-A136-4EF2-8C09-9DABF32F1D81 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: Jessamine Healthcare, Inc.� Wellpath Management, Inc� Conmed, LLC � Southwest Correctional Medical Group, Inc. � Southwest Correctional Medical Group, PLLC� Correctional Healthcare Holding Company, LLC� Colorado Correctional Medical Group, PLLC� Wellpath Recovery Solutions, LLC� Correct Care of South Carolina, LLC� Southeast Correctional Medical Group, PLLC� Northwest Correctional Medical Group, PLLC� 3 Southeast Correctional Medical Group, PLLC� CHC Companies, LLC � California Forensic Medical Group, Inc� Old Empire Dental, PC� 2 Wellpath Group Holdings, LLC� CCS-CMGC Holdings, Inc.� Nashville CCS-CMGC Intermediate Holdings2, Inc. � CCS-CMGC Parent Holdings, LP � Wellpath Holdings, Inc� CCS-CMGC Intermediate Holdings, Inc.� �� �� � ADDITIONAL NAMED INSUREDS INCLUDE:� Certificate of Liability Insurance Correct Care Solutions, LLC� 102698814 CHC Pharmacy Services, LLC � Correct Care Solutions Group Holdings, LLC � League Medical Concepts, LP� CFMG Holdings Corp.� Conmed Healthcare Management, LLC� Correctional Medical Group Companies, Inc. � Northwest Correctional Medical Group, PLLC� California Forensic Medical Group, Inc.� Physicians Network Association, Inc� Correct Care Australia Pty, Ltd (Australia)� Correct Care, LLC� Wellpath, LLC� Colorado Correctional medical Group, PLLC� Healthcare Professionals, LLC � Health Cost Solutions, LLC� Massachusetts Correction Healthcare Services, PC� Marsh USA, Inc.� Correctional Healthcare Companies, LLC� California CCS, PC� 1283 Murfreesboro Road, Suite 500� Wellpath Holdings, Inc.� Nashville, TN 37217 Southwest Correctional Medical Group, PLLC� Correctional Mental Health Services, LLC � Correct Care Holdings, LLC� League Medical Concepts, LLC� 25 Wellpath Recovery Solutions of Alaska, Inc.� Wellpath CFMG, inc.� DocuSign Envelope ID: C206B79F-A136-4EF2-8C09-9DABF32F1D81 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: Zurich American Insurance Company � Workers Compensation - Statutory � � WC0165670-02 - Old Empire Psychology, PC �� WC0165664-02 - California CCS, PC � 33 � � Nashville Old Empire Psychology, PC� Midwest Center, PC� New Garden Healthcare, PC� Great Peak Healthcare Services, PC� Grand Prairie Health Services, PC� Great Peak Dental, PC � New York Correct Care Solutions Medical Services, PC� CCS Kastre Nevada Medical, PC� Certificate of Liability Insurance WC0125678-02 - Massachusetts Correction Healthcare Services, PC � 102698814 ********************************************************************� � 1/1/19 - 1/1/20 � WC0165570-02 - Grand Prairie Health Services, New York Correct Care Solutions Medical Services, CCS Kastre NV Medical Services � Employers Liability - 1M/1M/1M � WC0165660-02 - Great Peak Healthcare Services, PC� WC0165668-02 - New Garden Healthcare PC, Emerald Healthcare Services � Marsh USA, Inc.� 1283 Murfreesboro Road, Suite 500� Wellpath Holdings, Inc.� Nashville, TN 37217 WC0165568-02 - Midwest Center, PC � WC0165573-02 - Old Empire Dental, Great Peak Dental � 25 ADDITIONAL WORKERS COMPENSATION POLICIES:� DocuSign Envelope ID: C206B79F-A136-4EF2-8C09-9DABF32F1D81