HomeMy WebLinkAboutMINUTES - 08161988 - 1.5 To: 1 BOARD OF SUPERVISORS
FROM: Mark Finucane , Health Services Director
By : Elizabeth A. Spooner , Contracts AdministratorContra
Costa
DATE: August 4, 1988 County
Approval of Revised Contra Costa Health Plan Service
SUBJECT: Agreement Formats
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
I . RECOMMENDED ACTION :
Approve revisions to group and individual Costa Health Plan
Service Agreement formats and authorize the Executive Director
of Contra Costa Health Plan to use the new formats with current
and new group and private individual enrollees .
II,. FINANCIAL IMPACT :
The format revisions redefine and clarify the descriptions of
certain benefit exclusions and limitations in the service
contracts . The revisions neither reduce coverage nor increase
coverage . Current practice conforms to the Medicare regula-
tions , therefore , there is no financial impact .
j III . REASONS-FOR RECOMMENDATIONS/BACKGROUND :
The Health Plan Service Agreement is the document that contains
the most detailed description of the Contra Costa Health Plan
service package . Approval of these revisions to the Health Plan
Service Agreements will add or change language which describes
the benefits , as well as the exclusions and limitations included
in the service package .
The revisions and changes are as follows :
1 . Alternative Therapies (Acupuncture , Biofeedback and
Hypnotherapy) are specified and defined .
2 . Alcohol and Drug Abuse benefits are redefined and clarified.
3 . Mental Health services are redefined and clarified .
4 . Optical coverage is defined for all groups .
5 . Definition of therapy coverage has been clarified.
The above revisions apply to both the Individual and Group
Health Plan Service Agreements . The Department is asking for
Board of Supervisor ' s approval of these new formats since the
CONTINUED ON ATTACHMENT: _X YES SIGNATURE' rP� / /
J 2VZ,�
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDA 1 N OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S):
ACTION OF BOARD ON AQUAPPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
1 HEREBY CERTIFY THAT THIS IS A TRUE
X_ UNANIMOUS (ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN
AYES:_ NOES*.--------- AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
cc: Health Services (Contracts) ATTESTED _._____AUG 161988 _ . _......__.___.__
Risk Management PHIL BATCHELOR, CLERK OF THE BOARD OF
Auditor-Controller SUPERVISORS AND COUNTY ADMINISTRATOR
Contractor
E3Y ,DEPUTY
M382/7-83 -----
CCHP Format Revision
( #29-701-4 )
Board Order
Page 2
Board of Supervisors has delegated to the Executive Director of
the Contra Costa Health Plan the authority (with Board
ratification) to execute Individual and Group Service
Agreements .
These formats have been approved as to legal form by the County
Counsel .
GM