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HomeMy WebLinkAboutMINUTES - 12201994 - 1.68 TO BOARD OF SUPERVISORS FROM . Allen Little, Fire Chief H. George o " ra By. Michaelg Chief of Administrative Services r+ Costa DATE:: December 6, 1994 C""' "J SUBJECT: Employee Assistance (EAP) Contract for the Contra Costa County Fire Protection District SPECIFIC REQUEST(S) OR RECOMMENDATION(S ) & BACKGROUND AND JUSTIFICATION RECOMMENDATION• Authorize Chair, Board of Supervisors, to execute a contract with Occupational Health Services Corporation for the period September 1, 1994, to August 31, 1995, for the provision of an Employee Assistance Program to the employees of the Contra Costa County Fire Protection District and four (4) other Fire Districts in this County. FINANCIAL IMPACT; The total annual cost of providing the program from September 1, 1994, to August 31, 1995, is $26, 317.20, apportioned among the five (5) Fire Districts participating in the program as shown below: Fire Protection District Cost Contra Costa County $ 21,294. 00 Moraga 1,419. 60 Orinda 1,965. 60 Kensington 491.40 Rodeo-Hercules 1, 146. 60 $ 26,317.20 The contract amounts are included in the various Fire District budgets for FY 1994-95. BACKGROUND/REASONS FOR RECOMMENDATION: Through a contract with Occupational Health Services Corporation, the Contra Costa County Fire Protection District has provided an Employee Assistance Program (EAP) for its employees and their dependents. The EAP services include a maximum of seven (7) individual private or group counselling sessions per employee (includes dependents) per contract year and "critical incident" debriefing sessions for emergency response personnel following emotionally traumatic incidents encountered on the job. There is 24-hour toll-free access to the program and it offers confidential and professional counselling sessions on a variety of human problems. CONTINUED ON ATTACHMENT: _ YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE 5): /9 ACTION OF BOARD ON 1 x and APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS A/ UNANIMOUS (ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT' ABSTAIN: OF SUPERVISORS r)N TIE_ DATE SHOWN. Contact: ATTESTED ®Ee --— - -- CC: County Administrator PHIL BATCHELOR. CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR BY ,DEPUTY \17Q7 .r. �. (0 � The Contra Costa County Fire Protection District initially contracted for the EAP services for only its employees for the period September 1, 1988, through August 31, 1989. The Orinda Fire Protection District subsequently requested to be added to the Contra Costa County Fire Protection District's contract to cover its employees at a cost substantially less than what would have been charged had Orinda entered into a separate contract with Occupational Health Services Corporation. Orinda was added to the Contra Costa County Fire Protection District's contract effective December 1, 1988. Similarly, West County Fire Protection District was added effective January 1, 1990; the Riverview and Kensington Fire Protection Districts effective March 1, 1990; Moraga Fire Protection District July 1, 1990; and Rodeo-Hercules Fire Protection District September 1, 1990. This new contract reflects the reorganization in the Fire Service which occurred on 7-1-94 when the Oakley, Pinole, Riverview and West County Fire Protection Districts were dissolved and their territory was annexed to the Contra Costa County Fire Protection District. Since the contract amount exceeds the $25, 000 threshold, the contract needs to be executed by the Chair of the Board of Supervisors. Contra Costa County Number Standard Form 1/88 SHORT FORM SERVICE CONTRACT Fund/Org # 2020/7126 + Account # 2310 1. Contract Identification. Other # Department: Contra Costa County Fire Protection District Subject: Employee Assistance Program 2. Parties. The County of Contra Costa, California (County), for its Department named above, and the following named Contractor mutually agree and promise as follows: Contractor: Occupational Health Services Capacity: Corporation Taxpayer ID # 95-276?isn Address: �'4_�e-t�-d$ 25 E. Sir Francis Drake Blvd. -1ak��-s-6t---9 - Larkspur, CA 94939 3. Term. The effective date of this Contract is 9/1/94 and it terminates ._ 8/31/95 unless sooner terminated as provided herein. 4. Termination. This Contract may be terminated by the County, at its sole discretion, upon five-day advance written notice thereof to the Contractor, or cancelled immediately by written mutual consent. 5. Payment Limit. County's total payments to Contractor under this Contract shall not exceed $26,317.20 6. County's Obligations. In consideration of Contractor's provision of services as described below, and subject to the payment limit expressed herein, County shall pay Contractor, upon Contractor's submission of a properly documented demand for payment (County Demand Form D- 15) which shall be submitted not later than 30 days from the end of the month in which the contract services were rendered, and upon approval of such demand by the head of the County Department for which this Contract is made or his designee, as follows: [Check one alternative only] ( ) hour; or [x] a. FEE RATE: $2,193.10 per service unit: ( ) session, as defined below; or (x) calendar mont-h (day, week or month) NOT TO EXCEED a total of 12 service unit(s). [ ] b. Payment in full after approval by the Department. [x] c. As set forth in the attached Payment Provisions. 7. Contractor's Obligations. Contractor shall provide the following described services: a. Employee Assistance Program Services as described in Attachment #1. Services shall be rendered in compliance with Knox-Keene Health Care Service Plan Act of 1975, Attachment #2. 8. Compliance with Law. Contractor shall be subject to and comply with all Federal, _State and local laws and regulations applicable with respect to its performance under this Contract, including but not limited to, licensing, employment and purchasing practices; and wages, hours and conditions of employment, including nondiscrimination. 9. Nondiscriminatory Services. Contractor agrees that all goods and services under this Contract shall be available to all qualified persons regardless of age, sex, race, religion, color, national origin, or ethnic background, or handicap, and that none shall be used, in whole or in part, for religious worship or instruction. 10. Independent Contractor Status. This Contract is by and between two independent contractors and is not intended to and shall not be construed to create the relationship between the parties of agent, servant, employee, partnership, joint venture, or association. -1- Contra Costa County SHORT FOR14 SERVICE CONTRACT Number 11. Disputes. Disagreements between the County and Contractor concerning the meaning, requirements, or performance of this Contract shall be subject to final determination in writing by the head of the County Department for which this Contract is made or his designee or in accordance with the applicable procedures (if any) required by the State or Federal Government. 12. Access to Books and Records of Contractor, Subcontractor. Pursuant to Section 1861(v)(1) of the Social Security Act, and any regulations promulgated thereunder, Contractor shall, upon written request and until the expiration of four years after the furnishing of services pursuant to this Contract, make available to the Secretary of Health and Human Services, the Comptroller General , the County, or any of their duly authorized representatives, this Contract and books, documents, and records of Contractor that are necessary to certify the nature and extent of all costs and charges hereunder. Further, if Contractor carries out any of the duties of this Contract through a subcontract, with a value or cost of $10,000 or more over a twelve-month period, such subcontract shall contain a clause to the effect that upon written request and until the expiration of four years after the furnishing of services pursuant to such subcontract, the subcontractor shall make available, to the Secretary, the Comptroller General , the County, or any of their duly authorized .representatives, the subcontract and books, documents, and records of the subcontractor that are necessary to verify the nature and extent of all costs and charges hereunder. This special condition is in addition to any and all other terms regarding the maintenance or retention of records under this Contract and is binding on the heirs, successors, assigns and representatives of Contractor. 13. Reporting Requirements. Pursuant to Government Code Sect ion 7550, Contractor shall include in all documents or written reports completed and submitted to County in accordance with this Contract, a separate section listing the numbers and dollar amounts of all contracts and subcontracts relating to the preparation of each such document or written report. This section shall apply only if the payment limit under this Contract exceeds $5,000. 14. Indemnification. The Contractor shall defend, indemnify, save, and hold harmless the County and its officers and employees from any and all claims, costs and liability for any damages, sickness, death, or injury to person(s) or property, including without limitation all consequential damages, from any cause whatsoever arising directly or indirectly from or connected with the operations or services of the Contractor or its agents, servants, employees or subcontractors hereunder, save and except claims or litigation arising through the sole negligence or sole willful misconduct of the County or its officers or employees. Contractor will reimburse the County for any expenditures, including reasonable attorneys' fees, the County may make by reason of the matters that are the subject of this indemnification, and if requested by the County will defend any claims or litigation to which this indemnification provision applies at the sole cost and expense of the Contractor. 15. Legal Authority. This Contract is entered into under and subject to the following legal authorities: California Government Code Sections 26227 and 31000. 16. Siqnatures. These signatures attest the parties' agreement hereto: COu F O=NIA CALIFORNIA CONTRACTOR B Designee By Approved: County Administrator Designate official capacity By O�L 4 (2.... -) Designee Recommmended\by Department By ` kf,�ie— Designee [Form approved by County Counsel] -2- Note to Contractor: For corporations (profit or nonprofit), the contract must be signed by two officers. Signature A oust be that of the president or vice-president and Signature B nest be that of the secretary or assistant secretary (Civil Code Section 1190.1 and Corporations Code Section 313). PAYMENT PROVISIONS a. Provides coverage for employees of the Contra Costa County, Moraga, Orinda, Kensington and Rodeo-Hercules Fire Protection Districts. b. Payment limit of $26,317.20 is apportioned as follows: $21, 294. 00 to the Contra Costa County Fire Protection District $ 1,419. 60 to the Moraga Fire Protection District $ 1,965. 60 to the Orinda Fire Protection District $ 491. 40 to the Kensington Fire Protection District $ 1, 146.60 to the Rodeo-Hercules Fire Protection District C. FEE RATE: $ 1,774.50 per calendar month for the Contra Costa County Fire Protection District. $ 118.30 per calendar month for the Moraga Fire Protection District $ 163 .80 per calendar month for the Orinda Fire Protection District $ 40.95 per calendar month for the Kensington Fire Protection District $ 95. 55 per calendar month for Rodeo-Hercules Fire Protection District MHG(TBROWN.EAP ATTACHMENT 11 SERVICES PROVIDED Occupational Health Services Corporation (herein referred to as Contractor) agrees to furnish personnel and services to the Contra Costa Fire Protection District (herein referred as Sponsor) an "Employee Assistance Program" for employees. I. Contractor agrees to provide the following services during the term of this Agreement at Contractor's designated office locations or mutually agreed upon facilities and/or locations: A. Provision of direct one-to-one counseling by licensed professional staff. Areas of counseling include, but are not limited to, alcohol recovery services, drug abuse treatment, marital and family counseling, legal consultation, child care arrangement services, elder care counseling, individual psychological counseling, specialized children's service, psychiatric consultation, psychological assessment, stress reduction services, career counseling, step-parenting services, conflict resolution counseling, grief counseling, hypnotherapy, pregnancy counseling, treatment of phobias, educational counseling, neuropsychological screening and treatment of sexual dysfunction. Telephone legal services shall be rendered by licensed attorneys. Telephone financial and credit counseling, child care and elder care arrangement services shall be provided by qualified contractor staff. B. Contractor shall provide a maximum of seven (7) Individual Private Sessions or Group Counseling Sessions per Family Unit who has sought Progran Services without referral by a supervisor of Sponsor per contract period. Fees for any counseling sessions exceeding seven (7) will become the financial responsibility of the Subscriber or Dependent 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 Subscribers' who have been referred to Contractor by a supervisor of Sponsor as evidencing performance problems in their work or occupation. C. Twenty-four hour toll-free telephone access to the Program for eligible employees and dependents. For psychological emergencies, Contractor shall have clinicians on call at all times. D. One "critical incident" debriefing session for each - 1 - affected individual or group to assist in the prevention of post-traumatic stress response when a firefighter as been exposed to emotionally traumatic situations on the job. E. Provision of high quality program materials including: 1. employee brochures 2 . Posters 3 . Periodic mailers 4 . Newsletter articles 5. Booklet on "Selecting Quality Childcare" .6. Educational pamphlets F. 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. G. 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. H. 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. I. 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. K. Provision of wellness seminars at a mutually agreed upon fee, if requested by the Sponsor. L. Provision of quarterly statistical evaluation to Sponsor of Enrollee utilization of Contractor's Program. 2 - ATTACHMENT #2 COMBINED EVIDENCE OF COVERAGE AND DISCLOSURE FORM FOR EMPLOYEE ASSISTANCE PLAN PROVIDED BY OCCUPATIONAL HEALTH SERVICES IMPORTANT PROVISIONS THIS COMBINED EVIDENCE OF COVERAGE AND DISCLOSURE FORM ("EVIDENCE OF COVERAGE") CONSTITUTES ONLY A SUMMARY OF THIS PLAN. THE GROUP AGREEMENT BETWEEN OCCUPATIONAL HEALTH' SERVICES ("OHS") , AND THE EMPLOYER THAT HAS SPONSORED YOUR PARTICIPATION IN THIS PLAN ("EMPLOYER") MUST BE CONSULTED TO DETERMINE THE EXACT TERMS AND CONDITIONS OF COVERAGE. YOU MAY REQUEST TO SEE THE GROUP AGREEMENT FROM EMPLOYER. Not all words and terms used in this Evidence of Coverage have their usual meanings and some have meanings that limit their application. Please refer to the "Definitions" Section to understand the meanings of these words and terms. By enrolling or accepting services under this plan, Members are obligated to understand and abide by all terms, conditions and provisions of the Group Agreement and this Evidence of Coverage. If this Evidence of Coverage has been issued to an existing OHS group, then it replaces the former Evidence of Coverage, effective upon the date set forth in the Group Agreement. Read this Evidence of Coverage as benefits may have changed from those stated within the Evidence of Coverage for the previous period of coverage. This Evidence of Coverage, the Group Agreement and benefits of this plan are subject to amendment in accordance with the provisions of the Group Agreement without the consent or concurrence of Members. The services described in this Evidence of Coverage are Covered Services only if and to the extent they (1) are provided by Participating Providers, and (2) have obtained Prior Authorization of coverage and referral by OHS. This plan will not pay charges for services and supplies provided by non-Participating Providers. Members are obligated to inform OHS as to any change in residence and any circumstance which may affect entitlement to coverage or eligibility under this plan. Members must also immediately disclose to OHS whether they have filed a workers' compensation claim, or were injured by a third party. Health, legal and certain other types of professionals are required under law to treat their client's problems confidentially. Common exceptions to confidentiality include mandatory reporting of child abuse, elder abuse, persons dangerous to themselves or others. OHS will preserve the confidentiality of patient-related records in its possession in accordance with the requirements of applicable federal - 1 - and state laws. OHS will only release patient-related records in accordance with applicable federal and state laws. 2 INTRODUCTION Recognizing that personal problems can adversely impact one's effectiveness at work, Employer has contracted with OHS to provide its Employees and their enrolled Family Members coverage under this plan for counseling and treatment for certain marital and family problems, alcoholism and drug dependency, financial and credit concerns, emotional problems, stress, childcare, eldercare, interpersonal conflicts, situational life problems, federal tax problems, and legal problems. All of us encounter some of these problems at some time in our lives. These problems not only affect our mood and behavior, they frequently affect others close to us. Employer encourages its Employees and their enrolled Family Members to use this plan. The specific benefits of this plan are set forth in the section entitled "Covered Services" below and in the attached Benefits Schedule. There is no claim form submission requirement for Covered Services. Claims for Covered Services are submitted directly by the Participating Providers and are processed by OHS or an agent or independent contractor of OHS. You are required to take an active part in ensuring the success of your plan. Read this Evidence of Coverage as it will help you understand your responsibilities and benefits as a Member. If you have any questions regarding this plan, please contact OHS at (800) 227 -1060. HOW TO USE THIS PLAN For counseling services to be covered under of this plan, you must obtain Prior Authorization of coverage and a referral from OHS. This means that you must contact OHS at (800) 227-1060 to request that the service be approved for coverage before it is rendered and to receive the name and telephone number of the Participating Provider selected by OHS to assist you with your problems. Members may call OHS 24 hours a day, 365 days a year. Prior Authorization of coverage will be denied if the requested services are not Medically/Psychologically Necessary or otherwise not covered under this plan. PARTICIPATING PROVIDERS PLEASE READ THE FOLLOWING INFORMATION SO YOU WILL KNOW FROM WHICH PROVIDERS SERVICES MAY BE OBTAINED IN ORDER TO BE COVERED UNDER THIS PLAN. Members may not self refer to any non-Participating Provider or Participating Provider. Instead, OHS will refer the Member to a Participating Provider selected by OHS who will assist the Member - 3 - with his or her problems (in most cases, this referral takes place after OHS consults with the Member's attending Participating Provider, if any) . If after seeing the Participating Provider a Member is dissatisfied with the provider, OHS will provide a referral to its selection of another Participating Provider. In order to be covered under this plan, all Covered Services must be authorized by OHS, provided by Participating Providers, and all referrals to Participating Providers must be arranged by OHS. Participating Providers include psychiatrists, psychologists, clinical social workers, marriage, family and child counselors, alcohol and drug counselors, tax professionals, legal professionals, financial professionals, and childcare/eldercare coordinators. OHS' roster of Participating Providers is subject to change as new providers contract with OHS and some Participating Provider contracts are terminated. This plan does not and cannot guarantee the initial or continued availability of any particular Participating Provider. COVERED SERVICES THIS SECTION DESCRIBES THE SERVICES THAT THIS PLAN COVERS. SEE THE ATTACHED BENEFITS SCHEDULE FOR A DESCRIPTION OF CERTAIN BENEFIT LIMITATIONS. SEE ALSO THE "EXCLUSIONS AND LIMITATIONS" SECTION FOR A DESCRIPTION OF BENEFIT LIMITATIONS AND SERVICES AND SUPPLIES THAT ARE NOT COVERED UNDER THIS PLAN. o Counseling for marriage, family and relationship problems. The American family and the stresses upon it have changed dramatically in the last few decades. A great number of marriages end in dissolution. Single-parent and dual-career families are commonplace. Today's relationships have conflicts and stresses that were unknown to many of us during our upbringing. This plan covers the services of a Participating Counselor to help a family analyze and resolve the stresses that can lead to disharmony and breakup. o Counseling for alcohol and drug abuse. There are no innocent bystanders in the life of an alcohol or drug-dependent individual. Friends, coworkers, supervisors and family members are all involved and affected to some degree. This plan covers the services of a Participating Substance Abuse Counselor to assist a Member in resolving chemical dependency problems by assessing the problem, intervening, breaking denial, arranging for appropriate treatment, and motivating the individual to sustain sobriety and lifelong recovery. o Counseling for emotional, personal and stress-related concerns. This plan covers the services of a Participating Mental Health Counselor to help resolve a broad range of emotional, personal and stress-related concerns, from everyday stresses and worries to mood - 4 - swings, depression, anxiety reactions and phobias. o Counseling for financial and credit problems. In a "buy now, pay later" world, it's easy to suddenly find oneself in financial trouble. This plan covers the services of a Participating Financial Counselor to help get the Member's finances back under control, analyze spending habits and patterns, develop a realistic, personalized budget, and to educate the Member on available credit rights and options. o Counseling for childcare matters. Childcare problems can produce frustration, concern and guilt. They can interfere with a parent's routine, causing missed time from work and canceled plans. This plan covers the services of a Participating Counselor to help a Member assess the Member's childcare needs and to identify and evaluate appropriate childcare options. o Counseling for eldercare matters. Getting the help required to care for an aging relative can be a difficult and confusing process for concerned family members. This plan covers the services of a Participating Counselor to help a Member explore and utilize available resources to resolve problems with elder living arrangements, nutrition, health care, legal rights, and Social Security, Medicare and Medicaid benefits. o Counseling for legal problems. In the past, only the most privileged had routine access to legal advice. Today, legal counsel is frequently a necessity for the average citizen. This plan covers the services of a Participating Legal Counselor to provide legal consultation to Members with legal questions in areas of family law, consumer issues, landlord-tenant disputes, personal injury, .contracts and criminal matters. o Counseling for federal tax problems. Few events in life cause as much worry and preoccupation as dealing with the Internal Revenue Service under potentially adverse circumstances. To Members who are faced with federal tax problems, this plan covers the services of a Participating Tax Counselor to provide tax consultation for: o Unpaid federal taxes, penalties and interest. o IRS audits. o Unfiled, past-due federal tax returns. o Any other problem with the IRS that you or your family members have unsuccessfully attempted to resolve. o Counseling for pre-retirement planning. Whatever retirement means to you, be it a time to get away from it all or a chance to develop personal interests, how those years are spent will depend on what is done to prepare for them. This plan covers the services of a Participating Retirement Counselors to provide information on topics - 5 - relevant to persons of any age who are planning for retirement. Members will be provided information about the range of situations that they are likely to encounter in retirement, and they will be given guidance on how to plan ahead for quality retirement. o Counseling for organizing life's affairs. In our complex lives, paperwork can become overwhelming, and leaving a legacy of disorganized records and vital documents can be a time-consuming and emotional burden to surviving loved ones. To simplify life, to prepare for emergencies, and to ease the burden on family members who may need to make important decisions in your absence, this plan covers the services of a Participating Counselor to address these needs. The counselor will teach you how to create an organized legacy. This benefit can also be used for Members who need to arrange "final details" for a friend or family member, or for Members who need suggestions and support about getting life back together after the loss of a loved one. Extended Benefits This plan provides extended benefits for a Member who is totally disabled on the date his or her coverage under this plan ceases because either OHS or Employer discontinues the Group Agreement for all Employees. The extended benefits are subject to all terms and conditions of the Group Agreement, exclusions and limitations set forth in this Evidence of Coverage, and the following conditions: o For the purposes of this benefit, the Member is considered totally disabled when confined in a hospital, or, when because of injury or illness, an Employee is prevented from engaging in any occupation for compensation or profit, or, in the case of a Family Member, is prevented from performing substantially all regular and customary activities usual for a person of his or her age and family status. o Covered Services shall be furnished solely in connection with the condition which has caused total disability and for no other condition, illness or injury. Extended benefits shall be provided only when the Member is under treatment of a Participating Provider, and when written certification of the disability and the cause thereof has been furnished to OHS within 30 days from the date coverage is terminated. Proof that total disability continues must be furnished at least every 30 days during the period of extended benefits. o Extended benefits shall be provided for the shortest of the following periods: (1) Until total disability ceases; (2) For a maximum period of 12 consecutive months; (3) Until coverage without limitation as to the disabling condition is available to the Member under any replacement plan; or (4) the Member moves out of 6 - California or any other pertinent terminating event occurs, as specified in the Group Agreement or this Evidence of Coverage. EXCLUSIONS AND LIMITATIONS COVERED SERVICES ARE SUBJECT TO THE CONDITIONS, EXCLUSIONS AND LIMITATIONS SET FORTH IN THE AGREEMENT, ELSEWHERE IN THIS EVIDENCE OF COVERAGE, THE BENEFITS SCHEDULE, AND THE FOLLOWING (NOTE: FACILITY AND ALL OTHER CHARGES RELATED TO, OR AS A FOLLOW-UP TO SERVICES AND SUPPLIES THAT ARE SPECIFIED AS EXCLUDED OR BEYOND THE LIMITATIONS SET FORTH IN THIS EVIDENCE OF COVERAGE ARE LIKEWISE EXCLUDED) : 1. General exclusions and limitations. This plan does not cover: o investment advice (nor does OHS loan money or pay bills) ; o legal representation in court, preparation of legal documents, or advice in the areas of labor law, taxes, patents or immigration; o tax representation or preparation services; or o services of a Participating Provider that are not authorized by OHS, or that are beyond the maximum number of Sessions covered under this plan as set forth in the attached Benefits Schedule. o Psychoanalysis and treatment for Chronic mental health conditions is excluded. o Inpatient treatment of any kind. o Medical transportation. o Treatment that OHS determines to be for medical, organic, endocrine, metabolic, or physiological disorders. o Services and supplies determined by OHS to be for for the treatment of mental retardation, autism, congenital mental abnormalities, developmental and learning disorders, functional nervous disorders or chronic deficiencies of mental ability. 2. Non-Medically/Psychologically Necessary services and supplies are excluded. 3 . Services and supplies rendered by non-Participating Providers are excluded. 4 . Prior Authorization. Any services and supplies provided without Prior Authorization of coverage are excluded. If the Member fails to obtain Prior Authorization, OHS will not overturn the resulting denial on the basis of whether the service or supply would have been covered had the Member requested Prior Authorization. All communications by OHS granting Prior Authorization of coverage are conditioned upon the Member's eligibility for coverage at the time the Covered Services are received. If subsequent to OHS' communication of Prior Authorization OHS discovers that the Member was not eligible for coverage, OHS will deny coverage accordingly. - 7 - 5. Medications, medical supplies and medical equipment are excluded. 6. Workers' Compensation, insurance and third party liability recoveries. Services and supplies that are otherwise covered under this plan are excluded to the extent that a Member realizes a recovery from any source, including settlements and recoveries derived from workers' compensation, a liable third party, or from other insurance coverage (e.g. , homeowners' insurance, underinsured and uninsured motorists insurance) . Coverage for any condition caused by another person's negligence or intentional act or omission is excluded. This plan will, however, advance the benefits of this plan, subject to an automatic lien against the recovery for the usual, customary and reasonable value. 7. Fitness for duty opinions are excluded. 8. Medical records. Charges associated with copying or transferring medical records are excluded. 9. Mid-year plan changes. Benefits under this plan that are subject to annual benefit limitations, will not be increased, even when a Member becomes covered under two separate OHS plan contracts during the same annual period. 10. Coordination of benefits. This plan does not coordinate benefits with any other plan that may be maintained by a Member. 11. Ongoing treatment for substance abuse disorders. 12 . Ongoing treatment for psychiatric conditions of patients requiring psychotropic medications. 13 . Ongoing treatment for any psychiatric or mental disorder listed in the DSM-III-R. 14. Psychological or educational assessment and testing. UTILIZATION REVIEW This plan includes prior, concurrent and retrospective review of certain proposed courses of treatment to determine whether the proposed treatment is Medically/Psychologically Necessary and the services are covered under this plan. The determination of the reviewer or professional review organization is not a substitute for the independent judgment of the treating physician as to the course of treatment. Utilization review decisions that are not consistent with a treating physician's determination do not preclude treatment but do determine OHS' coverage for such treatment. 8 - ELIGIBILITY PROVISIONS The Group Agreement specifies the eligibility prerequisites and terms and conditions of eligibility under this plan. COMMENCEMENT OF COVERAGE The Group Agreement specifies the time and the conditions under which coverage shall start. BENEFIT CHANGES OHS will notify Employer at least 30 days in advance of any changes in benefits. TERMINATION PROVISIONS THE FOLLOWING DESCRIBES SOME OF THE USUAL TERMINATION PROVISIONS, BUT YOU SHOULD ASK EMPLOYER IF THERE ARE ANY DIFFERENT PROVISIONS IN THE GROUP AGREEMENT. Employer can terminate this plan: o By giving 60 days' written notice of termination to OHS prior to the annual renewal date of this plan. OHS can terminate a Member's coverage in any of the following events: o If prepayment fees are not paid according to the Agreement, termination will be effective on midnight of the last day of the month for which prepayment fees were last received by OHS. o If a Subscriber ceases to be eligible according to the provisions listed in the Group Agreement, coverage will be terminated for the Subscriber and any enrolled Family Members effective on midnight of the last day of the month in which loss of eligibility occurred. o If a Family Member ceases to be eligible according to the provisions listed in the Group Agreement, coverage will be terminated only for that person effective on midnight of. the last day of the month in which loss of eligibility occurred. o On midnight of the last day of the month in which a Member no longer works or maintains a permanent residence within California, coverage will be terminated for the Subscriber and any enrolled Family Members effective on midnight of the last day of the month in which such event occurred. o If, in the determination of OHS, a Member refuses to establish and maintain relationships with a Participating Provider to assure continuity of care and appropriate use of Covered Services, termination will be effective after 15 days' notice from OHS. o If, in the determination of OHS, a Member's behavior is 9 - disruptive, unruly, abusive or uncooperative to the extent that the ability of OHS or the Member's attending Participating Provider to manage the care of the Member is significantly impaired, or if the Member threatens the life or well-being of an employee of OHS or a Participating Provider, termination will be effective after 15 days' notice from OHS. o If a Subscriber makes a material false statement as to his or her health status or that of any of his or her Family Members, or obtains or attempts to obtain Covered Services by means of deception or false, misleading or fraudulent information, acts or omissions, OHS may terminate coverage immediately upon notice. If a Member's coverage is terminated under this plan by OHS and the Member has reason to believe that the termination was based upon the Member's health status or requirements for health care services, the Member may request a review of the termination by the California Commissioner of Corporations. Upon notice of termination of the Group Agreement by either OHS or Employer, Employer is responsible for providing notice of same to each Subscriber. MEMBER'S LIABILITY FOR PAYMENT When a Member receives Covered Services from a Participating Provider, the Member is responsible for payment for non-Covered Services or benefits in excess of specified limitations. If OHS does not pay a Participating Provider for Covered Services, you will not be liable to the provider for any sums owed by OHS. If you receive services and supplies from a non-Participating Provider, you will be responsible for payment. CONTINUATION OF GROUP COVERAGE In accordance with the Consolidated Omnibus Budget Reconciliation Act ("COBRA") , a Member who loses coverage under this plan is entitled under certain conditions to elect to continue group coverage if Employer is not exempted under COBRA. Generally, COBRA requires all employers of 20 or more employees to offer to continue group health coverage for up to 18 months to employees and their Dependents who lose coverage due to termination of employment (except for gross misconduct) or reduction in hours worked, and for up to 36 months to Dependents who lose coverage due to the death of the Employee, divorce or legal separation from the Employee or to children who no longer qualify as covered Dependents. "Extended" coverage of up to 29 months is available to certain COBRA beneficiaries who are disabled at the time of their qualifying event and entitled to Social Security disability benefits. Continuation of group coverage rights under COBRA continue until either the exhaustion of the previously mentioned maximum continuation periods - 10 - or a "terminating event" occurs (e.g. , termination of all group plans provided by Employer, failure of the Member to pay monthly prepayment fees when due, the Member is or becomes covered under any other group plan without limitation as to the totally disabling condition, or the Member is or becomes entitled to Medicare coverage) . Benefits of the continuation plan are identical to this group plan. The cost of the coverage will be 102% of the applicable group rate (including any portion previously paid by Employer) during the period of basic COBRA coverage and 150% of the applicable group rate during the period of "extended" coverage (i.e. , 19th through 29th month) . UNDER COBRA, ALL NOTIFICATION AND OTHER COMPLIANCE RESPONSIBILITIES ARE THE SOLE OBLIGATION OF EMPLOYER. Please consult Employer with your questions regarding continuation of group coverage. Employees should receive notice from Employer's plan administrator of their eligibility for group continuation coverage if a qualifying event occurs. This notice should be sent the Employee's Family Members in the event of the Employee's death. Failure of a Subscriber or affected Family Member to notify Employer within 60 days of a divorce, legal separation or a Dependent child's loss of eligibility will result in loss of eligibility for group continuation coverage. Employer must notify OHS of the occurrence and related date of any qualifying event within 30 days of the incidence thereof. If the Member fails to provide such notice, then the Member shall not be entitled to elect continuation coverage under this plan. COBRA coverage will begin at the time group coverage ends if the Member applies and pays the required prepayment fees within 60 days after receiving notice of eligibility for continuation coverage or the date of loss of coverage, whichever is later. Electing Members will be billed for coverage on a monthly basis. Payment is due on the first day of each coverage month. Coverage will be canceled on midnight of the last day for which payment was last made if prepayment fees are not received within 30 days of the due date. GRIEVANCE PROCEDURES General As a condition of enrollment and a contractual term of the Group Agreement and this Evidence of Coverage, Members are required to submit all grievances through OHS' internal grievance procedures. OHS' internal grievance procedures are required to be completed before the Member may file for arbitration, as specified below, for final and binding resolution of the grievance. (Note: For the purposes of these procedures, "grievances" , "appeals" and "complaints" are not distinguished) . - 11 - How to File a Grievance If after discussion with OHS a Member is dissatisfied with the result of OHS' initial determination regarding a claim, request for Prior Authorization of coverage or problem of any other nature related to this plan, the Member may appeal in writing to OHS within 30 calendar days of the date of OHS' notice of its determination. Any further appeal of OHS' response to a first or second step appeal must also be in writing and submitted to OHS within 30 calendar days of the date of OHS' notice of its determination as to the prior step. If the Member is still dissatisfied with OHS' determination, and the Member wishes to further appeal, a petition for arbitration must be filed with the arbitrator (as described below) within 30 calendar days of the date of OHS' notice of its final determination. APPEALS RECEIVED MORE THAN 30 CALENDAR DAYS AFTER THE DATE OF ANY OHS DETERMINATION WILL NOT BE CONSIDERED AND NO FURTHER INTERNAL OR EXTERNAL RESOLUTION IS AVAILABLE. Members are encouraged to call OHS at (800) 227-1060 to discuss the grievance but all appeals must be made in writing and mailed to OHS at 125 East Sir Francis Drake Boulevard, Suite 300, Larkspur, California, 94939-1860, Attention: Director of Quality Management. If you require assistance, OHS will assist you in writing the complaint. Written appeals must be made and signed by the affected Member (unless incapacitated or a minor) and include any additional information that the Member wishes OHS to consider and an itemized statement as to the amount in dispute. OHS will respond with its determination within 30 calendar days following its receipt of an appeal, unless the Member is notified that additional time is required. Details of Procedures for Grievance Resolution o First Step - Internal Review Problems with eligibility, commencement of coverage, re-enrollment, access to providers, delivery of care, cost of care, Medical/Psychological Necessity, Covered Services or any other matter should be directed in writing by the Member to OHS. In the case of a grievance concerning a Participating Provider, OHS will, upon receipt of a written grievance, conduct an investigation of the matter and implement appropriate disciplinary or corrective action if it determines that action is necessary. However, the findings of, and any actions resulting from, such peer review will not be disclosed to the grievant as they are privileged and protected from disclosure under law. No further steps of internal appeal are available for provider related grievances. - 12 - o Second Step - Internal Review If you do not agree with OHS' determination made on a first step appeal, you may request in writing that your case be reconsidered. o Third Step - Internal Grievance Committee Hearing The final internal level of appeal available to you for resolution of a grievance is a hearing by OHS' Grievance Committee. Although the make-up of the Committee is subject to change at OHS' discretion, it is currently comprised of three administrative personnel of OHS. Hearings are usually scheduled within 30 days of written request. OHS will assist you in scheduling the hearing. This step is only available for disputes where the amount in controversy equals or exceeds $1, 000. Disputes under this amount may only be finally decided by arbitration as set forth below. Members are allowed to appear with, and have information offered by third parties, including attorneys, but not insurance brokers or persons having a conflict of interest with OHS. However, unless incapacitated or a minor, the affected Member must appear in person and be principally responsible for the presentation of their grievance and for direct response to questions by the Committee. The hearing is conducted as an informal administrative hearing -- formal rules of evidence and discovery which are common to legal hearings do not apply. In some cases, OHS may require the hearing to be conducted by telephonic conference. Written requests for a hearing must be made directly by the affected Member (unless the Member is incapacitated or is a minor) . Written requests by the treating physician or other Participating Provider will not be considered unless signed also by the Member. The written request should include all information that the Member wishes OHS and the Committee to consider. Information submitted after the hearing will not be considered in the review process. The written request must also contain an itemized statement as to the amount of money in dispute. If the Member does not attend the scheduled hearing, the Committee will decide the question on the basis of the information presented at that time. Requests for rescheduling of a scheduled hearing date will ordinarily only be considered if made at least ten days prior to the scheduled hearing date. o Final Step - Neutral, Binding Arbitration If the Member does not agree with OHS' final determination, the Member may, within 30 days of OHS' notice of its final determination, file a petition for neutral, binding arbitration in accordance with the California Arbitration Act (California Code of Civil Procedure Section 1280, et seq. ) . - 13 - Arbitration is the final process for the resolution of any dispute arising out of or relating to this Evidence of Coverage or the Agreement, whether involving a claim in tort, contract or otherwise, involving Subscribers, Family Members (whether a minor or an adult) , the heirs-at-law or personal representatives of a Subscriber or Family Member, and OHS (including any of its agents or employees) . Members must settle all such disputes by neutral, binding arbitration according to the terms and conditions set forth here. By enrolling in this plan, Members waive their constitutional right (or any other such right) to a trial before a jury or judge regarding such disputes, and any other right they may have to have such disputes resolved in any manner other than as set forth here. Judgment upon the award rendered by the arbitrator(s) may be entered in any court having proper jurisdiction. The decision of the arbitrator shall be final and binding. Each party is responsible for their own attorney fees and for an equal share of the costs of arbitration. The power of the arbitrator shall be limited to the determination of the interpretation of the terms of the Group Agreement and the Evidence of Coverage only and the arbitrator expressly does not have the power to grant any other relief or award or determine any change, modification, alteration, addition or subtraction from any contractual provisions. Section 1281.2 (c) of the California Code of Civil Procedure which allows a court to order any case to trial if the case involves a party not privy (i.e. , bound by contract) to this provision, is expressly waived. How to Initiate Arbitration Proceedings OHS is available to instruct Members how to initiate arbitration proceedings. Generally, these arbitration proceedings are initiated by the Member: (1) filing a petition in the Superior Court in the county where the Agreement is to be performed (usually, the county where the Member resides) or was made requesting that arbitration be ordered, and (2) serving a copy of the petition and a written notice of the time and place of the hearing thereof and any other papers upon which the petition is based upon OHS' agent for service of process at its principal place of business. Medical, Legal and Behavioral Health Malpractice Disputes Any dispute alleging medical, legal and behavioral health malpractice, that is as to whether any services or supplies covered under this Evidence of Coverage were unnecessary or unauthorized by the Member or were improperly, negligently or incompetently rendered, will be determined by submission to arbitration as provided by California law, and not by a lawsuit or resort to court process except to the extent California law provides for judicial review of arbitration proceedings. ANY SUCH LEGAL ACTIONS SHALL NOT - 14 - INCLUDE OHS AND SHALL INCLUDE ONLY THE PROVIDER SUBJECT TO THE ALLEGATION. BY ENROLLING IN THIS PLAN, MEMBERS WAIVE THEIR RIGHT TO BRING ANY LEGAL ACTION AGAINST OHS, OR TO JOIN OHS AS A PARTY IN ANY LEGAL ACTION, REGARDING SUCH DISPUTES. INDEPENDENT CONTRACTOR RELATIONSHIP ALTHOUGH OHS IS SUBJECT TO THE REQUIREMENTS OF THE KNOX-KEENE HEALTH CARE SERVICE PLAN ACT REGARDING, AMONG OTHER THINGS, ITS MONITORING OF THE QUALITY OF CARE RENDERED BY PARTICIPATING PROVIDERS, THE RELATIONSHIP BETWEEN OHS AND PARTICIPATING PROVIDERS IS THAT OF AN INDEPENDENT CONTRACTOR RELATIONSHIP. EXCEPT FOR CERTAIN COUNSELORS PROVIDING CHILDCARE, ELDERCARE AND FINANCIAL COUNSELING WHO ARE EMPLOYED BY OHS, PARTICIPATING PROVIDERS ARE NOT AGENTS OR EMPLOYEES OF OHS, NOR IS OHS AND ITS EMPLOYEES AND AGENTS AN EMPLOYEE OR AGENT OF ANY PARTICIPATING PROVIDER. OHS AND PARTICIPATING PROVIDERS ARE NOT AUTHORIZED TO REPRESENT THE OTHER FOR ANY PURPOSES, NOR ARE THEY NOR ANY OF THEIR RESPECTIVE OFFICERS, AGENTS OR EMPLOYEES TO BE CONSTRUED TO BE THE OFFICER, AGENT OR EMPLOYEE OF THE OTHER. PARTICIPATING PROVIDERS MAINTAIN THE PROVIDER-PATIENT RELATIONSHIP WITH MEMBERS AND ARE SOLELY RESPONSIBLE TO MEMBERS FOR ALL OF THE SERVICES THEY PROVIDE TO MEMBERS. IN NO EVENT SHALL OHS BE LIABLE FOR THE NEGLIGENCE, WRONGFUL ACTS OR OMISSIONS OF PARTICIPATING PROVIDERS. EMPLOYER IS NOT THE AGENT OR REPRESENTATIVE OF OHS NOR IS OHS LIABLE FOR ANY ACTS OR OMISSIONS OF EMPLOYER, ITS AGENTS OR EMPLOYEES. OHS AND EMPLOYER ARE INDEPENDENT CONTRACTORS IN RELATION TO ONE ANOTHER AND NO JOINT VENTURE, PARTNERSHIP, EMPLOYMENT, AGENCY OR OTHER RELATIONSHIP IS CREATED BY THE AGREEMENT. NEITHER OHS NOR EMPLOYER ARE LIABLE FOR ANY ACT, NEGLIGENCE OR OMISSION OF THE OTHER, NOR EACH OTHER'S AGENTS OR EMPLOYEES. NEITHER OHS NOR EMPLOYER IS AUTHORIZED TO REPRESENT THE OTHER FOR ANY PURPOSES. NONE OF THE PARTIES TO THE AGREEMENT NOR ANY OF THEIR RESPECTIVE OFFICERS, AGENTS OR EMPLOYEES SHALL BE CONSTRUED TO BE THE OFFICER, AGENT OR EMPLOYEE OF ANY OTHER PARTY. PUBLIC POLICY OHS permits Members to participate in establishing its public policy through its Public Policy Committee, the findings and recommendations of which are regularly reported to OHS' governing Board of Directors. A minimum of 51% of the seats on the Committee are dedicated to enrollees of OHS (which can include enrollees enrolled in other plans with OHS) . For the purposes of this paragraph, "public policy" means acts performed by OHS and its employees to assure the comfort, dignity and convenience of Members who rely on Participating Providers to provide Covered Services. RIGHT TO RECEIVE AND RELEASE INFORMATION - 15 - As a condition of enrollment in this plan and a condition precedent to the provision of benefits under this plan, OHS, its agents, independent contractors and Participating Providers shall be entitled to release to, or obtain from, any person, organization or government agency, any information and records, including patient records of Members, which OHS requires or is obligated to provide pursuant to legal process, federal, state or local law in the administration of this plan. REGULATION OHS is subject to the requirements of the California Knox-Keene Health Care Service Plan Act and its implementing regulations. Any provisions required to be in this Evidence of Coverage or in the Group Agreement by either of these sources of law shall bind OHS whether or not provided in this Evidence of Coverage or the Group Agreement. NON-ASSIGNABILITY OF BENEFITS The coverage and benefits of this plan may not be assigned without the prior written consent of OHS, which consent may be withheld for any reason. OHS reserves the right to make payment of benefits, at its sole discretion, directly to the attending provider or to the Member. DEFINITIONS (Note: All defined terms are capitalized within this Evidence of Coverage) Agreement: Includes the Group Agreement between OHS and Employer, this Evidence of Coverage, the Group Application, the Notice of Acceptance, the Member's enrollment form, and any addenda, endorsements or amendments thereto. Chronic: Designating a mental health condition which OHS determines to show little or slow positive change, or reasonable prognosis for positive change. Covered Service: A counseling service that is authorized for coverage by OHS and specified as being covered in this Evidence of Coverage. Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised ("DSM") : A listing of diagnostic categories and criteria which provides guidelines for making diagnoses of mental and substance abuse disorders. The DSM is a widely accepted basis for describing the presence and type of these disorders. A DSM 16 - diagnosis of mental or substance abuse disorder is a minimum requirement for the demonstration of Medical/Psychological Necessity. The diagnosis must be contained in the most recent edition of the DSM. Dependent: Those individuals in a Subscriber's Family Unit who meet the criteria of the definition of dependent as used in the Internal Revenue Code and Regulations of the United States, subject to any Employer prerequisites to the contrary described in the Group Agreement. Employee: An individual whose employment or affiliation status with Employer meets the eligibility prerequisites set forth in the Group Agreement. Family Member: Any individual of a Subscriber's Family Unit who meets all applicable eligibility requirements and Employer prerequisites specified within the Group Agreement. Family Unit: A unit comprised of a Subscriber and each person whose eligibility for Covered Services is based upon such person's relationship with, or dependency upon, such Subscriber. Medically/Psychologically Necessary: Covered Services which are necessary and appropriate for treatment of a Member's symptoms and behaviors that demonstrate the presence of a mental or substance abuse disorder as described in the DSM. The terms "necessary" and "appropriate" as used in this paragraph are determined according to professionally recognized standards of practice. Attending Participating Providers are exclusively responsible for making all medical determinations and treatment decisions. However, payment for Covered Services rendered will be conditioned on OHS' subsequent review and determination as to consistency with these standards and OHS' medical policies. The fact that a Participating Provider may prescribe, order, recommend or approve a service, supply or admission does not, in itself, make it Medically/Psychologically Necessary or make the charge an allowable Covered Service even though it is not specifically listed as an exclusion or limitation. Member: An Employee, Dependent, Subscriber or Family Member who meets all applicable eligibility requirements specified within the Agreement, is enrolled under this plan and for whom the required prepayment fees have been received and accepted by OHS. Participating Provider: A physician, psychiatrist, psychologist, clinical social worker, marriage, family and child counselor, alcohol and drug counselor, tax professional, legal professional, financial professional, childcare coordinator, or other type of health care provider, having a written agreement with OHS, or an independent practice association or medical group which contracts - 17 - with OHS, to provide Covered Services to Members. Certain counselors providing childcare, eldercare and financial counseling are employed by OHS. Prior Authorization: Approval for coverage from OHS prior to the Member obtaining Covered Services. Requests for Prior Authorization will be denied if not Medically/Psychologically Necessary, if in conflict with OHS' medical policies, or otherwise not covered under this plan. Session: Any in-person or telephone consultation with a Participating Provider for Covered Services under this plan. Subscriber: An Employee enrolled under this plan who is responsible for payment of Copayments and any applicable prepayment fees to OHS and whose employment or other status, except family dependency, is the basis for eligibility under this plan. - 18 - BENEFITS SCHEDULE FOR EMPLOYEE ASSISTANCE PLAN This Benefits Schedule summarizes the benefit limitations requirements of this plan. Benefit limitations. A maximum of 7 sessions are covered under this plan per family unit per contract period. OHS will count one of your Sessions used if you fail to cancel an appointment at least 24 hours in advance, unless the appointment is missed because of an emergency that prevents you from giving such notice of cancellation. 19 -