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HomeMy WebLinkAboutResolutions - 2017.12.07 - 23197MISCELLANEOUS RESOLUTION #17327
December 7, 2017
BY: Commissioner Christine Long, Chairperson, General Government Committee
IN RE: BOARD OF COMMISSIONERS — AUTHORIZATION TO PROCEED WITH THE NATIONAL
ASSOCIATION OF COUNTIES LIVE HEALTHY DISCOUNT PRESCRIPTION DRUG, DENTAL AND
HEALTH PROGRAM CONTRACT
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS recognizing that the rising cost of prescription drugs coupled with the growing population of the
uninsured has created a crisis for many citizens in our country, the Board of Commissioners have established
discount health program partnerships; and
WHEREAS these partnerships have the benefit of providing substantial reductions in health care costs for
residents. These discounts include: the retail price of many commonly prescribed drugs; dental procedures;
vision care; hearing aids, diabetes products and more; and
WHEREAS these discounts are available to all Oakland County residents, regardless of age, income, or
existing health coverage; and
WHEREAS participation in these discount prescription drug programs come at no cost to Oakland County or
its residents; and
WHEREAS the Board of Commissioners entered into a discount prescription drug program with the National
Association of Counties/CVS/Caremark from 2006 to 2012 and has since partnered with Coast2Coast Rx; and
WHEREAS the Board of Commissioners began providing a discount dental program through a partnership
with Benefit Control Methods, Inc. in 2007 (which changed its name to name National Benefit Consulting, Inc.
or NBC, Inc.); and
WHEREAS as the qualified vendor for the Board of Commissioners' discount dental program, BCM provided
an annual subscription-based savings program with a projected overall savings of 30%-40% below the usual
and customary cost of dental care; and
WHEREAS in late 2016, BCM/NBC, Inc. informed the Board of Commissioners they were being purchased by
another firm and could no longer honor the discounts in the subscription savings plan, thus suspending the
Oakland County Discount Dental Program; and
WHEREAS due to the lack of an ongoing discount dental program, the Board of Commissioners requested of
the Health Department a thorough review of all available discount programs and provide a recommendation
for the best comprehensive solution to improve Oakland County residents' access to health care services; and
WHEREAS concluding their review, the Health Department has made a strong recommendation to the Board
of Commissioners identifying the NACo Live Healthy Program as the best choice to provide a comprehensive
solution for prescription discounts, dental health access and other health care benefits.
NOW THEREFORE BE IT RESOLVED that the Board of Commissioners authorizes Oakland County's
Corporation Counsel and Purchasing Division to negotiate and draft a contract with the National Association of
Counties/CaremarkPCS Health LLC for their Healthy Living Program, including the prescription, dental and
health programs.
BE IT FURTHER RESOLVED, upon completion of aforementioned contract, the Board of Commissioners
authorizes staff to notify Coast2Coast Rx of its intention to terminate the current contract.
BE IT FURTHER RESOLVED that the Oakland County Board of Commissioners authorizes the Board
Chairperson, or his designee, to execute the Agreements and any related documents between Oakland
County and the National Association of Counties/CaremarkPCS Health LLC.
Chairperson, on behalf of the General Government Committee, I move the adoption of the foregoing
resolution.
Commissioner Christine Long, Dialet #7
Chairperson, General Governm* Oommittee
GENERAL GOVERNMENT COMMITTEE VOTE:
Motion carried unanimously on a roll call vote.
Motion for direct referral to the Finance Committee carried on a voice vote.
Live Healthy U.S. Counties
Sign up your county today
Join the NACo Live Healthy 'Program. It's easy. Complete this registration form,
save it to your desktop and then attach in an email addressed to membership@naco.org
Or mail this form to:
Linda Langston, Director of Strategic Relations
National Association of Counties
660 N. Capitol St., NW Ste. 400, Washington, DC 20001
After you register, we'll send you customized materials to promote Live Healthy in your county.
County Name:
Main County Contact:
Title:
Street Address:
City: State: Zip:
Phone:
Email:
County Website
Number of County Residents:
Please check which NACo Live Healthy discounts your county would like to offer its residents:
(Counties must participate in the prescription part of the program in order to add another program):
111 Prescription—already enrolled L Health El Dental
111 Prescription
111 By checking this box you are confirming that the NACo Live Healthy programs checked above
are approved by the County's elected board.
Spanish materials required? EYes 111No
One more thing...
We will need your county's logo/seal to customize your Live Healthy materials. Then you'll be able to
share this exclusive discount program with your residents. A jpg file of your county logo is necessary
to complete your registration.
Send an email with the jpg file as an attachment to NACoRx@caremark.com . Indicate the county
name and logo attached in the subject line. The email should also include:
• A contact/name and street address for the delivery of member ID cards and display materials if it
differs from the address on the registration form. (Please note we cannot deliver to P.O. boxes.)
• A description of how the county name should appear/read on the member ID card.
For questions, call 888-407-NACo (6226), or email us at membership@naco.org
NATIONAL NAG)
ASSOCIATION
Ef COMM ES
CAREMARKPCS HEALTH, L.L.C.
AMENDED AND RESTATED MANAGED PHARMACY BENEFIT SERVICES AGREEMENT
CONSUMER CARD PROGRAM
T1118 AMENDED AND RESTATED AOREEMENT (the "Agreement") Is effective beginning January I, 2012
(the "Erfeative Date") among National Aasociation of Counties ("Costumer"), counties that are members of the National
Association of Counties ("MeMber County") and CaremarkPCS Health, L,L.C,, ("Caremark"), for the purpose of
delineating the terms and conditions under which Caremark will provide certain managed pharmacy benefit services to
Member County and Customer. This Agreement amends the existing Member County Agreements consistent with the
terms thereof, Customer agrees that It will require each Member County added after the Effective Date to execute an
Individual agreement with Caremark in the tom attached hereto as Exhibit B (the "Member County Agreement") prior
to Caremark's providing Services to such Member County. Caremark will not provide Services to Member County prior
to the receipt of the Member County's execution of the Member County Agreement,
I, STATEMENT OF SERVICES / OBLIGATIONS.
1.1 Services. Caremark will provide Member County the services as set forth in this Section 1, and the
services described in any attachment, addendum or amendment hereto (collectively the "Servicea"). Caremark may
make changes to the Services from time to time so long as such changes do not materially alter any of the provisions of
this Agreement.
. 1.2 Participating Pharmacies. Caremark has created a network of Participating Pharmacies, which will
perform pharmacy services for Participants.
1.3 Pharmacy Help Desk and Voice Response Unit. Ceremark will provide Participating Pharmacies
with help desk assistance and access to Caremark's voles response unit during Caremark's hours of operation.
1.4 Claims Preeeseing.
Submissioa of Clainis, Caremark will adjudicate Claims submitted by Participating Pharmacies to
Caremark in aecordtmee with the Participating Pharmacy's agreement with Caremark and the Consumer Card
Program.
b. Collection at Point or Sale. Customer and Member County acknowledge thal Participating
Pharmacies will collect from the Participant one hundred percent (100%) of the applicable prescription price,
discounted at the rates set forth on Exhibit A as applicable, plus a transaction fee from the Participant,
1,5 customer Service. Caremark will make available to Customer, Member County and Participants a
toll free number during those hours or operation maintained by Caremerk. Staff will be available to answer questions
on the Consumer Card Program and Consumer Card Program guidelines,
1.6 Identification Cards. Caremark will, at its owe cost, produce identification cards for Participants,
which contain Member County's and Customer's lago(s), identification cards will be available to any individual the
Member County or Customer deem appropriate. Caremark will -work with Member County on the distribution method
for ideotificatien cards; provided, however if Member County requests that Caremark mall the identification cards to
Participants, postage and handling charges will apply. The Participant shall be responsible for paying for any
prescriptions obtained while using the identification card,
L7 Clinical Services and Drug IftlilzatIon Review ("DUR").
a. Clinical Services, Caremark may provide to Member County its member compliance programs and
other programs designed to ensure proper drug utilization end encourage the use of cost-effective medications,
These programs may include mailings to Participants with active prescriptions for targeted drag products or
drug classes or to let Participants know that they may qualify for participation in a clinical trial program. Such
mailings may include Participant and drug specific information and/or general educational material.
Participants, by notifying Caremark, may epnout of such programs.
b. OUR Services. Caremark will provide its automated concurrent DUR Services for Claims. The
information generated in connection with DUR Services is intended as an economical supplement to, and not
as a substitute for, the knowledge, expertise, skill, and Judgment of physicians, pharmacists, or other health
care providers in providing patient care. Providers are individually responsible for acting or not acting upon
information generated and transmitted through the DUE. Services, and for performing services in each
jurisdictina consistent with the scope of their licenses. Notwithstanding anything set forth in this Agreement,
Caremark will have no obligation to acquire Information concerning any Participant beyond the infomaatien
that is included lit Caremark's eligibility records or the Claims submitted by Participating Pharmacies in
connection with the Consumer Card Program.
LS Formulary Services, Caremark will administer an open formulary for the Member County and will
provide certain Services that are designed to provide useful clinical information to physicians (the "Formulary
-Stryker). Caremark may make changes to the Fonnuisry Service,' described in this Agreement from time to time, and
will notify Member County and Cuslotner of any material changes to any formulary management programs. In all
eases, the proscribing physician shall have final authority over the drug that Is prescribed to the Participant.
a, Customer's Authorization. Customer authorizes Caremark to contract as a group
purchasing organization for Customer with pharmaceutical companies for Rebates. Customer acknowledges
that whether and to what extent pharmaceutical companies are willing to provide Rebates to Customer may
depend upon a variety of factors, including the content of any drug list adopted by Customer, the plan's design
features and participating In Caremark'e drug list management programs, as well as Caremark receiving
sufficient information regarding each Claim that is submitted to pharmaceutical companies for Rebates.
b. Disclosure of Manufacturer Fees. In accordance with Section 1,11(a) of this Agreement,
Caremark or its affiliates may hold contracts with certain pharmaceutical companies relating to producis
covered under this Agreement. The parties agree that Caremark shall retain one hundred percent (l 00%) of the
Rebates as reasonable compensation for in services under this Agreement. In connection with such contracts,
Caremark or its affiliates may have a financiel relationship with such pharmaceutical companies and may
receive and retain fees or other compensation from pharmaceutical companies for services rendered and
property provided to pharmaceutical companies, including, without limitation, administrative fees that range
between one percent (1%) and four percent (41%) of the Wholesale Acquisition Cost ("WAC") of the products
dispensed across Caremark's book of business. In addition, Caremark or its affiliates may receive concurrent
or retrospective discounts or Rebates from pharmaceutical companies which are attributable to or based on
products purchased by Caremark affiliated dispensing pharmacies. The term "Rebates" as used Its this
Agreement does not include the fees, compensation, and concurrent or retrospective discounts associated with
the purchase price of products described in this Section 1.3, which belong exclusively to Caremark or its
affiliates,
e. Partieip ant Authorizations and Diseloeures, Customer and Member County shall comply
with all Laws applicable tn It as a sponsor of the Services or as otherwise consistent with its obligations under
this Agreement,
d. Additional Participant Discounts. Caremark may provide a progmm that will provide
Participants with additional manufacturer discounts on certain drugs at the point of sale, From time to time,
Caremark may revise the list of drugs that have additional participant discounts. The current list of drugs on
which Participants may receive additional discounts is available upon request. Caremark will timely notify
Member County and Customer of any revisions to this list of drugs.
1.9 Management Reports. Caremark will provide Member County and Customer with Caremark's
standard management reports in connection with the Services, which reports may change from time to time at
Carenaark's discretiou. Member County and Customer may elect to receive a reasonable number of the standard
management reports made available by Caremark.
1.10 Mail Service Program, Caremark may provide to Member County mail order pharmacy services
through its mail order pharmacy facilities. For the duration of this Agreement, Member county agrees that it will offer
only Caremark mail order pharmacy services for its Participants covered under this Agreement, as further described
below.
Caremark shell fill prescriptions for Participants and shall mail such drugs or medications to such Participants subjeet to
the following terms and conditions:
a. Distribution of Information. Caremark shall provide Participants with its standard
Informational material explaining the mail service and the forma necessary fat Participants to utilize mall
service. Partieipants will have toll-free telephone access to a pharmacist and CUStOrner SendCa representative.
Access to a pharmacist will be available 24 bears per day, seven days per week.
b. Delivery and Dispensing. Caremark shall dispense through its mail service pharmacy new
or refill prescription orders upon receipt from a Participant of (i) a valid prescription order or a completed refill
order form and (ii) the applicable payment. Caremark shall Cause the filled prescriptions to be mailed to each
Partlyipant via common carrier at the address appearing on the face of the prescription so long as such
addresses are in the United States. Caremark shall not be liabk to Member County, Customer or Participant
for any delay in delivery resulting from circumstances beyond Caremark's control as set forth in Section 6.2.
Caremark's mail order pharmacies May dispense drugs evert if the prescription is not accompanied by the
correct amount however, Member County and Customer acknowledge and agree that Caremark may refuse to
fill any prescription that is either not accompanied by the correct amount and/or for any Participant who has an
unpaid balance with Conti-lark,
1.11 Preferred Drug Programme. Caremark and the retail Participating Rheniumles will work together to
encourage the use of Preferred Drugs by (i) Identifying appropriate opportunities for converting a prescription from a
non-Preferred Drug to a Preferred Drug, amid (ii) contacting the Participant and the prescriber to request that the
prescription be changed to the Preferred Drug. A Preferred Dreg is one on the Performance Drug List, which has been
developed by Caremark as a clinically appropriate and economically advantageous subset of the Caremark Fornaultuy,
us revised by Caremark from time to time.
1,12 Specialty Pharmacy. Caremark's specialty pharmacy service will be provided by a Caremark
specialty pharmacy entity or its affiliate ("Caremark 5peelaltyllx"), and offers a distribution channel for certain
pharmaceutical products that are generally bloteciumlogical in nature, are given by injection, or otherwise require
special handling ("Specialty Medications"),
Caremark SpeolaityRx shall provide proscription fttlfillment and distribution of Specialty Medications and supplies,
pharmaceutical care management services, as well as the types of Service that Member County receives under this
Agreement, including but not limited to customer services, utilization and clinical management, integrated reporting and
Claims processing ('SpecieltyRx Services").
Caremark Speolaltylex may receive prescription from Participants through an affiliated Caremark mail facility or
directly via the U.S. Mail or commercial carrier al the address specified by Caremark from time to time and may also
receive prescriptions from physicians by fax or by US. Mailicennuerelisi carrier. In accordance with the Consumer
Card Program, Caremark Spacialtylix shall dispense Covered Items in accordance with those prescriptions and mail the
Covered Items to Participants at the designated address, so long as such address is located within the Ileited States,
Caremark Specialtylket may not dispense drugs to Participants who fail to submit the correct payment with their
prescription.
Caremark Specialtyllx pharmaceutical care management services include but may not be limited to; (1) patient profiling
focusing on the appropriateness of Specialty Medication therapy and care and the prevention of drug-drug interactions;
(2) patient education materials; and (3) disease management and compliance programs with respect to Specialty
Medications. As part of these services, Participants will be asked to participate in various surveys.
3
Caremark will provide Member County and Customer with a list of the Specialty Medications and their corresponding
rates (which may vary from Network Rates) upon request. Routine supplies (needles, syringes, aleohol Swabs) in a
sufficient quantity will be included at eta additional expense.
2. FEES AND PAYMENT,
a. Fees. The parties agree that, In lieu of billing Member County a "per Claim" fee for Services,
Caremark shall retain 100% of the Rebates 43 reasonable compensation for the Services, Customer and Member
County understand and agree that neither they nor any Participant will share in the Rebate monies collected from
Manufacturers by Caremark.
b, Remedies. Additional services may be mutually agreed-upou by the parties, and the associated fees
fer such services, if any. will be Identified in Exhibit A as reasonable compensation, In the event any such fees apply
and Member County or Customer fails to pay Caremark by the due date any amount owing, Caremark, after making a
reasonable effort to eollect and upon notice to such Member County or Customer may, in addition to its remedies under
this Agreement, at Law Of in equity, do any or all of the following: (1) suspend performance of any or all of Ceremark's
obligations under or In connection with this Agreement with respect to such Member County or Customer, including
Caremark's obligation to process Claims or (ii) set off against any amounts payable to such Member County or
Customer by any amounts due Caremark from such Member County or Customer,
c. Pricing Changes. Alter the Initial Term of this Agreement, as set forth in Section 7,a, Caremark may
change the fees applicable to the Consumer Card Program. Caremark will give Customer sixty days' written notice of
any chrome, and such change will take effect on the first day of the month following the sixty-day notice period.
Customer may object to an increase in fees by providing written notice to Caremark at least thirty days before the
expiration of the sixty-day notice period. If the parties cannot agree on an appropriate fee, this Agreement will
terminate at the end of the sixty-day notice period, If Customer does not timely object, Customer will have no right to
terminate this Agreement based on the pricing change.
3. CUSTOMER AND MEMBER COUNTY OBLIGATIONS.
a. Marketing Materials. The parties agree to use only those marketing brochures and other advertising
materials pertaining to Customer's Consumer Card Program (In any medium, including, but not limited to, written
communications, verbal communications and Web based marketing) that have been approved by the other. Member
County and Customer further agree that they will communicate such requirements to RS clients or groups and will
ensure that ouch clients or groups comply with the requirements of this Section 3.a, Caremark may terminate this
Agreement immediately in the event Member County or Customer fails to comply with the provisions of this Section
3,a,
Caremark will provide Its standard marketing brochures, advertising materials and mail order forms, as applicable, to
Member County at no cost. Caremark will work with and support each Member County in marketing the Consumer
Curd Program at no cost. If the cost associated with providing such materials is determined by Caremark to be
unreasonable or excessive, Member County shall pay for the costs of the materials at a rate to be mutually weed to by
the parties in writing, If Member County elects to use customized brochures or advertising materials (it any medium,
Including but not limited to written cOmmunications, verbal communications and web based marketing), Member
County will (I) obtain Caremark's approval on such forms, and (IL) pay a reasonable charge, as established by Caremark,
for such materials If created or provided by Caremark,
3,2 Support of Consumer Card Program. Customer will recommend and support the Consumer Card
Program in accordance with the terms of this Agreement,
4. USE OF AND ACCESS TO INFORMATION.
a. Use or _midge tilled Data. Claims, as well as eligibility information which is deldentified in
accordance with HIPAA and other applicable law, and which is not Identifiable on a Customer or Plan Participant basis,
may be used, disclosed, reproduced, adapted or sold by Caremark. Such deidentified data may be provided to nationally
recognized data Integration firms to support appropriate administration of Caremark's drug management programs.
This beitohmarking data enables Caremark to compare against other drug population sets and improve programs and
Services for clients,
b. Right to Audit Rebates. Customer, at 1(3 Sole expense, may audit a reinonabite sample of records
directly related to Customer's Rebates once in each twelve-month period (following sixty (60) days written notice to
Caremark), Such records shalt be limited to information necessary for validating the accuracy of the Rebate amounts
distributed to Member County by Caremark. The parties agree that att independent third-party auditor agreeablIti to
Customer and Caremark shall conduct such audit, and that such rum will sign a Caremark confidentiality agreement
ensuring that all details and terms of all Manufacturer Rebate contracts with Caremark (except the total aggregate
amount due to Customer) will be treated as crinfidential to Caremark and will not be revealed in any manner or form by
or to any person or entity. Furthermore, such audit shall be conducted at Curemarki a office where such records are
located, during normal business hours, without undue interference with business activities, and in accordance With
reasonable audit procedures.
5, CONFIDENTIALITY AND INTELLECTTJA.L PROPERTY,
a. Confidential and Proprietary Information. in connection with this Agreement, each party may
disclose to the other party certain proprietary or confidential technical and beeineas information, databases, trade
secrets, and innovations belonging to the disclosing party ("Confidential Information"), the value of which might be
lest if the proprietary nature or confidentiality of such Confidential Information is not maintained. For the purposes of
this Seotion, the contents of this Agreement and of any eichthits, amendments, or addenda attached hereto are deemed
Confidential Information. Furthermore, any work, compilation, processes or inventions developed by Caremark,
Member County or Customer, or their respective agents, employees or contractors, is deemed Confidential Information
of such party under this Agreement. Notwithstanding the foregoing, Confidential Information may be disclosed by
Member County in response to a request made pursuant to the Member County's applicable state Public Records Law,
Insofar as disclosure is required by that Law. Member County shall provide Caremark with (i) notice of its intent to
disclose Confidential Information and (ii) an opportunity for Caremark to object to suck disclosure in accordance with
Law.
b. Non-Disclosure of Confidential Information. The parties will not (except to the extent expressly
authorized by this Agreement) disclose Confidential Information of any other to anyone outside of Caremark, Member
County or Customer, nor will they copy or reproduce any Confidential Information of another unless expressly
authorized to do so by such party in writing. Each party will disclose Centidentiel Infermation of another only to its
employees who have a need to know the Confidential information in order to accomplish the purpose of this Agreement
and who (i) have been informed of the confidential and proprietary nature of the Confidential 'reformation, and (ii) have
agreed not to disclose it to others. In order to preserve and protect the confidential or proprietary nature of any
Confidential information and to prevent it from falling into the public domain or into the possession of persons not
bound to maintain its confidentiality, each party will handle the Cenfidentiel Information Of any Other party with the
same degree of care that it applies with respect to its own information that it considers as confidential and proprietary,
but in no event with less than reasonable care.
a. Exceptions and Permitted Disclosures. The receiving party of Confidential Information will not be
liable for any disclosure or use of Confidential Information which is publicly available or later becomes publicly
available other than through a breach of this Agreement, or if the Confidential Information is shown by written
domumentation to be known to the receiving party on the date of execution of this Agreement, having been received
From a source (other than a party to this Agreement) that had the right to disclose the Confidential Information,
d. Subpoena. Confidential Information may be disclosed pursuant to a bona fide subpoena if the party
receiving the bona fide subpoena has given the other party prompt written notice of receipt of the subpoena so that the
other party can object or otherwise intervene as it deems proper.
e. Return or Destruction of Information. All Confidential Information will remain the property of the
disclosing party, and the receiving party will room all written or tangible materials, and all copies thereof, upon request
of the disclosing patty. If and to the extent feasible, upon termination of this Agreement. Caremark will destroy or will
return to Member County or Customer all PHI obtained pursuant to this Agreement and shall retain no copies thereof:
provided however, that if such return or destruction is not reasonably feasible, the provisions of Section 4 of this
Agreement shall continue to apply to such infonnetion after the termination hereof.
f. Proprietary to Caremark. Member County and Customer acknowledge that the Formulary 15
proprlottuy to Caremark, Further, all Caremark databases, as well as the software, hard coding, and logic used to
generate the compilations of information contained In Caremark's Claims adjudication system and in all other databases
developed by Caremark or its designees in connection with performing Services Including identifiers assigned by
Caremark, and the format of all reports, printouts, and copies there from, and any prior and future versions thereof by
any name, are the property of Caremark and are protected by copyright which shall be owned by Caremark.
g, Tradenames; Trademarks; and Service Marks. None of the parties herete may use any
tradenames, trademarks or service marks of another, or any word or Symbol likely to be confused with such tradenames,
trademarks or service marks, unless authorized in writing or as expressly permitted by this Agreement.
h. Remedies, Any unauthorized disclosure or use of Confidential Information would cause Caremark,
Member County or Customer inunecliate and irreparable injury or loss that cannot be adequately compensated with
money damages. Accordingly, if any party hereto talk; to comply with this Section 5, the other(s) will be entitled to
specific performance Including Immediate issuance of a temporary restraining order or preliminary injunction enforcing
this Agreement, and to judgment for damages (Including reasonable attorneys fees) caused by the breath, and to any
other remedies provided by Law,
6. LIMITATION OF LIABILITY; COMPLIANCE WITH LAW.
a. Warranty. This Agreement is not a contract for the sale of goods. Caremark will perfon the
Services in a good and workmanlike manner in accordance with the customs, practices, and standards of providers
skilled in the industry. EXCEPT AS WARRANTED IN THIS SECTION 6.e, CAREMARK DISCLAIMS ALL
EXPRESS AND ALL IMPLIED WARRANTIES OP ANY KIND, INCLUDING THE SUITABILITY FOR ANY
PARTICULAR PURPOSE OF THE DATA GENERATED THROUGH THE CAREMARK SYSTEM. CAREMARK
RELIES ON FIRST DATABANK, MEDI-SPAN, OR. INDUSTRY COMPARABLE DATABASES IN PROVIDING
CUSTOMER, MEMBER COUNTY AND PARTICIPANTS WITH DRUG UTILIZATION REVIEW SERVICES.
CAREMARK HAS UTILIZED DUE DILIGENCE IN COLLECTING AND REPORTING THE INFORMATION
CONTAINED IN THE DATABASES AND HAS OBTAINED SUCH INFORMATION FROM SOURCES
BELIEVED TO BE RELIABLE. CAREMA.RK, HOWEVER, DOES NOT WARRANT THE ACCURACY OF
REPORTS, ALERTS, CODES, PRICES, OR OTHER DATA CONTAINED IN THE DATABASES. THE CLINICAL
INFORMATION CONTAINED IN THE DATABASES AND THE FORMULARY IS INTENDED AS A
SUPPLEMENT TO, AND NOT A SUBSTITUTE FOR, THE KNOWLEDGE, EXPERTISE, SKILL, AND
JUDGMENT OF PHYSICIANS, PHARMACISTS, OR OTHER HEALTH-CARE PROFESSIONALS INVOLVED IN
PARTICIPANT'S CARE. THE ABSENCE OF A WARNING FOR A GIVEN DRUG OR DRUG COMBINATION
SHALL NOT BE CONSTRUED TO INDICATE THAT THE DRUG OR DRUG COMBINATION IS SAFE,
APPROPRIATE OR EFFECTIVE FOR. ANY PARTICIPANT. CAREMARK DOES NOT WARRANT THAT ITS
SERVICES WILL BE UNINTERRUPTED OR ERROR FREE,
b, Force Majeure. Except for the payment obilgationa set tbrth in Section 2 of this Agreement, the
parties are excused from performance under this Agreement to the extent that a party is prevented from performing any
obligation, in whole or in part, as a result of causes beyond its reasonable control, including, acts of God, war, civil
disturbance, court order, governmental intervention, Change in Law, nonperformance by the other party or any third
party, failures or fluctuations in electrical power, heat, light, air conditioning, or telecommunications equipment. Any
nonperformance under this Section 6.b will not constitute a default or a ground for termination of this Agreement.'
c. Indemnity. To the extent permitted by applicable Law applicable to Customer and each Member County, Customer and Member County shall indemnify and hold harmless Caremark and its officers, directors,
employees, agents, successors. and assigns ("Carentark Indeninitees") for, from and against any damages, costs, or
attorney's fees, actually Incurred by Caremark or a Caremark Indemnitee, as the result of a third party claim that
Customer or Member county, Its officers, directors, employees, agents, successors, or assigns acted with negligence,
and/or in violation of applicable standards of care, provided that the Caremark Indemnitce has acted ig a manner that is consistent with this Agreement, the Consumer Card Program and applicable standards of care, The
foregoing indemnification shall not apply and shall not be enforceable to the extent any applicable Law prohibits a
Member County front providing such indemnification. To the etent permitted by applicable Law, Caremark shall
indemnify and heed heartless Member County, Customer and their officers, directors, employees, agents, successors,
and assigns (collectively "Customer Indemnitees") for, from and against any damages, costs, or attorney's fees, actually
incurred by any Customer Indemnitee, as the 10411 of a third party claim that Caremark, its officers, directors,
employees, agents, successors, or assigns acted with negligence, willfully, and/or in violation of applicable standards of
care, provided that the Customer kidemnitee bas acted in a manner that is consistent with this Agreement, the Consumer
Card Program and applicable standards of care. However, nothing in this Agreement is to be construed as a waiver of
governmental immunity as offered by the court or state law.
d, Compliance with Law. Customer and Member County will comply with all Laws applicable to its
prescription drug benefit plan, including without limitation insurance licensing, antitrust, comurner protection, and any
other Laws that may apply. Caremark has no responsibility to advise Member County or Customer about the
applicability of or compliance with any applicable Law Including, without Uniltatlon, HIPAA, the Employee Retirement
Income Security Act, or the Americans with Disabilities Act.
Caremark will comply with all Laws applicable to it and to the Services it provides under this Agreement. Member
County and Customer have no responsibility to advise Caremark regarding its compliance with any applicable Lew,
Effective as of September 8, 2005, each party certifies that it shah not violate the federal anti-kickback statute, set forth
at 42 U.S.C. § 1320a-7b(b) ("Anti-Kickback Statute"), or the federal "Stark Law," sot forth at 42 § Deena
("Stark Law"), with respect to the performance of its obligations under this Agreement, Further, Caremark shall ensure
that individuals meeting the definition of "Covered Persons" (es such term is defined in the Corporate integrity
Agreement between the Office of Inspector General of the Dem:Mont of Health and Human Services and
AdvancePCS) shall comply with Caremark's Compliance Program, including training related to the Anti-Kickback
Statute and the Stark Law, In addition, Caremarles Code of Conduct and policies and procedures on the Aral.Kickback
Statute and Stark Law may be accessed at llatmeheeeemememereemeatozgamadeadMa l.
e, Change In Law, The parties will attempt to equitably adjust the terms of this Agreement to take into account any Change in Law or any material change in drug industry practice that materially alters the rigbts or
obligations of either party under this Agreement. If the parties are unable ta agree upon an equitable adjustment within
sixty days after either party notifies the other of such a Change in Law or material change in drug industry practice, this
Agreement will automatically terminate.
f. Limitations. In no event shall either party be liable to the other party, nor shall Caremark be liable to
any Participant for any indirect, speeial, or consequential damages or lost profits, arising out of or related to
performance of this Agreement or a breech of lie Agreement, even if advised of the possibility of such damages or lest
profits.
Caremark (end its affiliates, directors, employees, agents, successors or assigns) will not be liable for any claim which is
asserted by Member County or Customer more than ninety days after Member County or Customer is or reasonably
should have been aware of such claim, and will in no event be liable for any claim which is asserted more than twelve
months after the event resulting in damages or loss.
Caremark does not direct or exeroise any control over the professional judgment exercised by any pharmacist bt
dispensing prescriptions or otherwise providing pharmaceutical related services at a Participating Pharmacy. Participating Pharmacies are independent contractors, not subcontractors or agents of Caremark, and Cucuta* shall
have no liability to Member County or Customer for a claim arising out of any act or emission or any Participating Pharmacy or Its agents or employees.
Caremark shall be entitled to rely on First Data Bank, Moil-Span or any other nationally available reporting service of
pharmaceutical prices selected by Caremark to determine Ana for purposes of establishing the pricing provided to
Customer under this Agreement. Customer acknowledges that Caremark does not establish AM), and Caremark shall have no liability to Customer arising from the use of First DataBank, Medi-Span or any other nationally available reporting service, Customer acknowledges that if the reporting source for determining Customer's AWP should not
continue to support AWP, Customer shell cooperate with Caremark to negotiate the pricing hereunder to maintain the
parties' respective economic position under this Agreement as of the Effective Date,
7, TERM AND TERMINATION OF AGREEMENT.
a. Term. This Agreement is for all Initial term of five years from the Effective Date, through December
31, 2016 (the "Initial Term"), and will automatically continue in effect for successive one year tem thereafter, subject
to the remaining provisions of this Section.
b. Termination. This Agreement may be terminated as follows:
a. By any party, with or without cause, at the end of the initial Term or any renewal term, by
giving written notice to the others at least 60 days prior to the end of such initial Term or renewal term;
b. Automatically, if the parties are unable to agree on an equitable adjustment under Section 6.e
of this Agreement;
e. By any party if another materially defaults in its performance of this Agreement and such
default continues without cum for a period of sixty days after the terminating party provides written notice to
the defaulting party specifying the nature of the default;
d. By any party, at its option, If any court, or governroental or regulatory agency tulles to
another party an order or finding of impairment or insolvency, or an order to cease and desist frOM writing
business. The party receiving notice of an order Or finding must provide the others written notice within two
business days ofrecelpt;
e. By any petty if another patty; (1) makes an assignment for the benefit of creditors: (ii) has a
petition fled (whether voluntary or involuntary) under Title 11 of the 'United States Code, or any other similar
statute now or hereafter in effect; (iii) has a receiver, custodian, conservator, or trustee appointed with respect
to all or a substantial part of its property; or (Iv) has a proceeding commenced against It which substantially
impairs performance hereunder; or
f. By Caremark, immediately on written notice to Member County or Customer, if (1) either
fulls to comply with the provisions of Section 3.4 of this Agreement, or (ii) Caremark determines, in its sole
discretion that Member County or Customer's program may not folly comply with all applicable LAW&
73 Effect of Termination and Survival.
Sections 4, 5 and 6 of this Agreement, and obligations arising under this Agreement prior to the
effective date of any termination, will survive termination,
S. NOTICES.
All notices under this Agreement must be in writing, delivered in person, sent by certified mail, delivered by air courier,
or transmitted by facsimile and confirmed in writing (by air courier or certified mail) to a party at the facsimile number
and address shown In this Agreement. A party may notify the other party of any changes in the Listed address or
facsimile number in accordance with the provisions of this Section. All notices are effective upon receipt.
Notices to Caremark must be addressed as follows:
Vice President, Client Contract Services
Caremark Inc.
2211 Sandell Road, NST9
Northbrook, U. 60062
Fax No.; 847-559-4302
With a copy to;
Managing Counsel, Client and Account Services
Caremark inc.
2211 Sanders Road, NITI9
Northbrook, IL 60062
Fax No.; 847-559-4179
Notices to Customer must be addressed as follows:
National Association of Counties
25 Massachusetts Avenue, NW
Suite 14$00
Washington, DC 20001
Attre Mr. Andrew Ooldschmidt, Director, Membership Marketing
Fax No.: (202) 393-2630
9. MISCELLANEOUS,
a, entire Agreement; Interpretation; Amendment; Counterparts. This Agreement (including
exhibits, schedules, attachments, or any addendum to this Agreement) eonslitutes the eetire understanding and
obligation or the parties wins respect to the Services and supersedes any prior agreements, writings, or understandings, whether oral or written. The headings in this Agreement are used only for convenience of reference and do not affect
the meaning or interpretation of any provialoe. The parties may amend this Agreement only through a properly executed writing authorized by both parties. This Agreement may be executed in several counterparts, all of which
taken together constitute a single agreement between the patties.
b. Binding Effect; Assignment. This Agreement is binding on the parties end their respective
successors and permitted assigns. None of the parties may assign this Agreement, in whole or In part, without the prior
written consent of the others (which vonsent will not be unreasonably withheld); except that Caremark may assign this
Agreement, in whole or in part, to 'my entity that controls, is controlled by, or is under common control with Caremark.
C. Independent Contractor; Third Parties. The parties to this Agreement are independent contractors,
and have no other tog& relationship under or in connection with this Agreement. No term or provision of this
Agreement is for the benefit of any person who is not a petty hereto (including, without limitanoe, any Participant or
broker), and no such party will have any right or cause of action hereunder.
d. Waivers. My failure by a party to comply with any covenant, agreement, or condition herein or in
any other agreements or instruments executed and delivered hereunder may be waived in writing by the party in whose
favor such obligation or condition rims; except that failure to insist upon strict compliance with any such covenant, agreement, or condition will not operate as a waiver of; or estoppel with respect to, any subsequent or other failure.
e. Severability. In the event any term or provision of this Agreement is declared to be invalid or illegal
for any reason, title Agreement will remain in full force and effect and will be interpreted as though such invalid or
illegal provision were not a part of this Agreement. The remaining provisions will be construed to preserve the intent
and purpose of this Agreement and the parties will negotiate in good faith to modify any invalidated provisions to
preserve each party's anticipated benefits.
f. Enforcement Cots. If any party hereto institate5 an action or proceeding to entbree any ,rights arising under this Agreement, the party prevailing in such action or proceeding will be paid all reasonable attorneys'
fees and costs to enforce such rights by the other party, such fees and costs to be set by the court, not by a jury, and to be inoluded in the judgment entered in such proceeding.
g. Authority. Each party represents and warrants that it has the necessary power and authority to enter into this Agreement and to consummate the transactions contemplated by this Agreement,
h. Exclusivity. Member County end Customer hereby grant Caremark during die term of this
Agreement, and any renewals hereo4 the exclusive right to provide a Consumer Card Program to Member County and
Customer, This exclusive right is solely applicable to participants designated by Member County as eligible for the
Member County's discount consumer card program and shall not affect any other benefits or programs provided to
Participants by Member County. Member Comity and Customer further agree that, during the term of this Agreement
and any renewals hereof, it will not negotiate, contreet, or agree with any thug manufacturer for the purpose of
obtaining Rebates or other discounts related to Participants under this Agreement. Member County and Customer also
agree to cancel any existing agreements or contracts with any drug manufacturers related to such drug Rebates or
discounts as of the Effective Date of this Agreement. In the event of a breach of this Section by Member County or
Customer, Caremark may terminate this Agreement. By entering into this Agreement, Customer does not endorse, and
Caremark will not represent Customer's endorsement of any other programs or services which Caremark may offer to a
Member County or Participant.
I. Drug Classilleution and Pricing. Caremark shall use the indicators of Medi.Span Master Drug
Database (Medi-Span), and their associated files, as updated regularly by Medi-Span, or another nationally available
reporting service of pbaneaceutical drug information in determirthig the classification of drugs (e.g. legend vs. over the
counter, brand vs. generic, single-source vs, multi-source) for purposes of this Agreement.
J. Customer-Specific Programming. Upon request by the Customer for services or changes to
Services that require customized programming or systems work, Caremark will estimate the time end cost for
completion of such work. if Customer authorizes Caremark to perform such work, It will pay Caremark the cost of
performing such work at the established programming rate,
Pricing Assumptions. in addition to any pricing assumptions set forth in any pricing implementation or
similar document that is executed by Customer;
(a) Upon thirty (30) days prior written notice to Customer, Caremark may modify or amend the financial
provisions in this Agreement in a manner which accounts for the impact of the events identified below. Such
notice will include Carernark's explanation of the manner in which the modification accounts for the impact of
the event:
1. Any government imposed or industry wide change that would impede Caremark's ability to
provide the pricing described in this Agreement, including any prohibition or restriction on the ability
to receive Rebates or discounts for pharmaceutical products; or
2. A change in any of the pricing assumptions set forth in this Agreement, including, Exhibit A.
(b) Frining Benchmarks, The parties acknowledge that the pricing indices historically used by Caremark
are the basis fot the financial offer of this Agreement and are outside the control of the parties, in the event
First DataBank, Medl-Span or other nationally available AWP reporting source discontinues the reporting of
AWP or changes the manner in which AWP is calculated prior to the Effective Date, or during the Term, then
Caremark reserves the right to modify the pricing terms of this Agreement, to be effective as of the Effective
Date or such later effective data of such discontinuation or change, so as to maintain the parties' relative
economic positions as existed immediately before the effective date of such discontinuation in reporting or
change in the calculation of AWP, as measured across all products on an aggregate basis, Such modifications
may include, without limitation, the adjustment of AWP. to the methodology relied on by such reporting source
prior to such modification of AWF' methodology, the adjustment of the AWP discount, or the utilization of
alternate pricing benchmarks.
10. DEMITIONS. The following terms and phrases, when capitalized, have the meanings set forth below.
a. "AWP" means the "average wholesale price" for a standard package size of a prescription drug from
the most current pricing information provided to Caremark by First Datatiank(10, Medi-Span Prescription Pricing Guide
(with supplements), or following notice to Client, any ether nationally available reporting service of pharmaceutical
prices as utilized by Caremark es a pricing source for prescription drug pricing, The standard package size applicable to
a mail service pharmucy shall mean one hundred (100) units (Le., pills, tablets, capsules, etc.), Unless only a smaller
package size is available from the manufacturer, or the actual package size dispensed for liquids and topical treatments.
The standard package size applicable to a Participating Pharmacy shall be the acted package size dispensed from a
Participating Pharmacy as reported by such Participating Pharmacy to Caremark,
10
b. "Change in Law" means any (1) change in or adoption of any Law, (ii) change in the judicial or
administrative interpretation of any Law, or (iii) change in the enforcement of any Law, occurring after the date
Customer is implemented or the Effective Date, whichever Is earlier.
e. "Claim(s)" mean those claims processed through the Caremark on-line claims adjudication system or
otherwise transmitted or processed in accordance with the terms of this Agreement in connection with the Consumer
Card Program.
d, "Covered items" mean the prescription drug benefits for which Participants are eligible pursuant to
Member County's drug benefit plan.
c. "Law" means any federal, state, local or other constitution, charter, act, statute, law, ordinance, code,
rule, regulation, order, specified standrds or objective criteria contained in any applicable permit or approval, or other
legislative or administrative action of the United States of America, or any state or any agency, department, authority,
political subdivision or other Inatounentality thereof or a decree or judgment or order of a court,
f. "Manufacturer" means a pharmaceutical company that has contracted with Caremark (or its affiliate
or agent) to offer discounts for pharmaceutical products in connection with Caremark's Formulary Services.
g. "Maximum Allowable Cost (MAC)" means the unit price that has been established by Caremark for
a multi-source drug (Le,, a drug with more than two sources) included on the MAC drug list applicable to Customer,
which list may be amended from time to time by Caremark in maintaining its generic pricing program. Customer
acknowledges that the MAC list applicable to Client is not the same as the MAC list published by the Centers for
Medicare and Medicaid Services (formerly known as the Health Care Financing Administration, or "HCFA MAC'). A
copy of such MAC drug list shall be provided to Customer prior to execution of this Agreement and thereafter upon
Customer's reasonable request.
h, "Participant" means an individual designated by Member County as eligible for Covered Items
under the terms of the Consumer Card Program.
I. "Partielplating Pharmacy" means a pharmacy that has agreed to provide certain pharmacy serviees
to Participants in accordance with the terms of its agreement with Caremark. A list of Participating Pharmacies can be
accessed via Caremark's Internet viebsite, which is subject to change trona time to time.
j, "Rebate(s)" means, for any period, all rebates, reimbursements, or other discounts received under a
pharmaceutical manufacturer's discount program with respect to pharrnaeeutical products dispensed to a Participant
under the Consumer Card Program for such period.
it
nyi_AMSAAD.
`UndA mitAm -tt
Date:
By;
Titte:
Date;
IN WITNESS WHEREOF, the parties have caused this Agreement to be executed by their respective duly authorized
officers or agents as of the data first above written,
NATIONAL ASSOCIATION OF COUNTIES CARENIARKPCS HEALTH, LIR,
12
Date:
CAREMARIKPCS HEALTH, L.L.C,
SECOND AMENDMENT TO
MANAGED PHARMACY BENEFIT SERVICES AGREEMENT
CONSUMER CARD PROGRAM
THIS SECOND AMENDMENT TO AMENDED AND RESTATED AGREEMENT (the "Amendment") is
effective beginning November l, 2014 (the 'Effective Date") among National Association of Counties ("Customer"),
counties that are members of the National Association of Counties ('llimber County") and CaremarkPCS Health,
L.L.C., ("Caremark"), for the purpose of delineating the terms and conditions under which Caremark will provide certain
managed pharmacy benefit services to Member County and Customer.
WHEREAS, the parties entered into the Agreement for the provision of Consumer Card Program services by Caremark to
Customer with respect to Customer's Consumer Card plan; and
WHEREAS, the parties desire to amend the Agreement to describe and clarify certain services to be provided by
Caremark;
NOW, THEREFORE, for good and valuable consideration the parties agree to amend the Agreement as follows;
I, The tom of the Agreement, as amended, shall continue for a successive two (2) year term beginning on November 1,
2016 and expiring on December 31, 2018, subject to remaining provisions of Section 7 of the Agreement.
IN WITNESS WHEREOF, the parties have caused this Agreement to be executed by their respective duly authorized
offices or agents as of the date first above written,
NATIONAL ASSOCIATION OF COUNTIES
Date c,if 1q
CAREMARKPCS HEALTH, ',LC,
THIRD AMENDMENT TO THE AMENDED AND RESTATED
MANAGED PHARMACY BENEFIT SERVICES AGREEMENT
CONSUMER CARD PROGRAM
THIS THIRD AMENDMENT TO THE AMENDED AND RESTATED MANAGED PHARMACY
BENEFIT SERVICES AGREEMENT CONSUMER CARD PROGRAM (the "Third Amendment") is
effective January 1, 2017 (the "Effective Date") among National Association of Counties ("Customer"),
counties that are members of the National Association of Counties ("Member County") and
CaremarkPCS Health, L.L.C. ("Caremark" or "CVS/earemark"), for the purpose of delineating the
terms and conditions under which CVS/caremark will provide certain managed pharmacy benefit services
to Member County and Customer.
WHEREAS, the parties entered into an Amended and Restated Managed Pharmacy Benefit Services
Agreement, effective January 1, 2012 ("Agreement"), for the provision of Consumer Card Program
services by CVSkaremark to Customer with respect to Customer's Consumer Card Program; and
WHEREAS, the parties desire to amend the Agreement to describe and clarify certain Services to be
provided by CVS/earemark;
NOW, THEREFORE, for good and valuable consideration, the parties agree to amend the Agreement as
follows:
The term of the Agreement, as amended, shall continue for a successive four (4) year term
beginning on January I, 2017 and expiring on December 31, 2020, subject to remaining provisions of
Section 7 of the Agreement,
2. Section 8 (Notices) of the Agreement is hereby amended by deleting the Address for National
Association of Counties and replacing with the following:
Notices to Customer must be addressed as follows:
National Association of Counties
Attn: Ms. Linda Langston, Director of Strategic Relations
660 North Capitol Street, NW, Suite 400
Washington, DC 20001
Fax No, (202) 393-2630
3. Section 4(a) (Use of and Access to Information) of the Agreement is hereby deleted in its entirety
and replaced with the following:
4(a) Use of Health Information and Compliance with Data Privacy Laws.
In providing the Services under this Amendment, CVS/caremark and its employees
and agents will have access to certain personally identifiable information
concerning the Participants ("Personal Data"). For purposes of this Amendment,
Personal Data means any data or information which may be used to contact, locate
or identify an individual, including, but not limited to, the person's name, address,
phone numbers, email address, IP address, passwords, account numbers, medical
NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL,
PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARKPCS HEALTH, L.L.C.
record numbers, biometric identifiers, financial or healthcare information, social
security number, driver license number, or any other unique identifying number,
characteristic, or code. Personal Data includes "Protected Health Information" as
defined in the BIPAA Rules.
CVS/caremark will maintain and enforce physical, technical and administrative
safety and security procedures and processes for any Personal Data that it creates,
receives, maintains, stores, transmits, shares, uses, discloses, or to which it has
access, in connection with the subject matter of this Amendment consistent with
industry standards and applicable international, federal, state and local data privacy
and security laws ("Data Privacy Laws"). The Data Privacy Laws include, but are
not limited to, the Health Insurance Portability and Accountability Act of 1996, as
amended ("H1PAA"); the Health Information Technology for Economic and
Clinical Health Act, as amended ("HITECH"); regulations related to privacy,
security, enforcement and breach notification promulgated thereunder, including
without limitation, the Standards for Privacy of Individually Identifiable Health
Information, Security Standards for the Protection of Electronic Protected Health
Information, Breach Notification Rule, and the Enforcement Rule (collectively, the
"HIPAA Rules") and the data security breach notification laws of the various states
of the United States.
Claims, as well as eligibility information which is deidentified in accordance with
EILPAA and other applicable law, and which is not identifiable on a Customer or
Plan Participant basis, may be used, disclosed, reproduced, adapted or sold by
CVS/caremark. Such deidentified data may be provided to nationally recognized
data integration firms to support appropriate administration of CVS/caremark's
drug management programs. This benchmarking data enables CVS/caremark to
compare against other drug population sets and improve programs and Services for
clients. Upon the parties' mutual agreement, CVS/caremark shall provide such
deidentified aggregated benchmarking data to Customer in a format which allows
Customer to understand profiles of average users of Customer's Consumer Card
Program per Member County,
4. Exhibit 13 (Managed Pharmacy Benefit Services Agreement for Member County), attached to the
Agreement is hereby deleted in its entirety and replaced with the attached Exhibit B.
5. Except as specifically amended by this Third Amendment, the Agreement shall remain
unchanged and in fall force and effect, In the event of any conflict between the Agreement and this Third
Amendment, this Amendment shall control.
NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL,
PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARICPCS HEALTH, L.L.C.
IN WITNESS WIIEREOF, the parties have caused this Third Amendment to be executed by their
respective duly authorized officers or agents as of the date first above written.
NATIONAL ASSOCIATION OF COUNTIES
By:
Title: i-ye cuivei b(crker
Date: roor)
Title: ikoll7
It Date: ID - ri
NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL,
PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARKPCS HEALTH, L.L.C.
EXHIBIT A
EXHIBIT A
National Association of Counties
Effeetiva January 1, 2011
Subject to the terms and conditions of this Agreement, Program Participants utilizing the Program shall receive from the
Partieipating Phamiacies the discounts set forth below. Customer Specific Programming or additional services not
Identified herein will be quoted upon Customer request,
Program Participants will recciva an average 22% discount on their prescription drug transactions when
prescriptions are purchased at a Participating retail pharmacy, a Caremark Mail or a Caremark Specialtyax pharmacy as
compared to the pharmacy's aggregate usual and customary price (the cash paying customer price), Program
Participants will not pay more for a proscription drug transaction by using the Program. There will be prescription drag
transactions under Ws program that will be priced at the pharmacy's usual and customary price when that price is equal
to or more favorable to their contractual discount rate with Caremark.
Prices may vary in certain areas for reasons such as local legal requirements, geographic location, specialized
manufacturer processes, limited availability, extraordinary; shipping requirements or other factors beyond Caremark's
control. Participating Pharmacies shall collect from the Program Participant all applicable taxes for covered items, and
Caremark is not liable for the payment of applicable taxes. Caremark does not guarantee Participant savings ., the
estimate set forth above is based upon anticipated pharmacy network performance. All claims may be aggregated for
purposes of determining the actual average discount rate. Actual discount rates may vary by drug, Participating
Pharmacy, Caremark Mail Pharmacy and Caremark SpecialtyRx Pharmacy. Certain retail, mail, and Specialty claims
may be excluded from these rates, including but not limited to Claims for select Injectable drugs and select oral drugs
that are bio-technical in nature, compound drugs, end those requiring special handling.
EXHIBIT B
EXHIBIT B
CAREMARKPCS HEALTH, L.L.C.
NATIONAL ASSOCIATION OF COUNTIES
MANAGED PHARMACY BENEFIT SERVICES AGREEMENT
FOR MEMBER COUNTY
This Managed Pharmacy Benefit Services Agreement for Member County effective
(the "Effective Date") is entered into by and between CaremarkPCS Health, L.L.C. ("Caremark" or
"CVS/caremark") and ("Member County"). Reference is
hereby made to the Amended and Restated Managed Pharmacy Benefit Services Agreement Consumer
Card Program dated as of January 1, 2012 (the "Agreement") among National Association of Counties
("Customer"), Member County, and CVS/caremark under which Customer has engaged CVS/caremark
to provide services to prescription drug plans for Customer and its Member Counties ("Services").
MEMBER COUNTY does hereby agree to be bound by, and to assume and perform, each and all of the
terms, covenants and conditions of the Agreement as Member County (as defined in the Agreement) in
the same manner and to the same extent as if it were a party thereto. Member County acknowledges and
agrees that Customer and CVS/earemark may amend all or any portion of the Agreement, and Member
County hereby agrees to be bound by any such amendment, except with respect to Term. The Term of
Services for Member County shall begin on the Effective Date above and, so long as the Agreement is in
effect, shall continue for a period of three (3) years ("Initial Member County Term"), unless written
notice of termination is received by CVS/caremark no later than thirty (30) days after the Effective Date.
If notice of termination is received within thirty (30) days of the Effective Date, termination will take
effect thirty (30) days after receipt of notice. The Term of Service shall thereafter automatically renew,
so long as the Agreement is in effect, for successive one (1)-year terms, unless Member County notifies
CVS/caremark and Customer of Member County's intent not to renew at least sixty (60) days prior to the
end of the Initial Member County Term, or any renewal Term.
Customer shall give Member County reasonable notice prior to the effective date of any non-Term
amendment between Customer and CVS/caremark. If such non-Term amendment is adverse to Member
County or its Participants, Member County may, within ninety (90) days of receiving such notice from
Customer, terminate its participation in the Agreement by giving prior written notice to Customer and
CVS/caremark.
Customer and CVS/caremark, by their signatures hereto, accept and agree to Member County's
participation with the Agreement under the terms and conditions of the Agreement. By signing this
Managed Pharmacy Benefit Services Agreement for Member County, Member County acknowledges and
agrees that the terms of the Agreement have been completely read, fully understood and voluntarily
accepted and further agrees to be bound thereby.
NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL,
PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARKPCS HEALTH, L.L.C.
NATIONAL ASSOCIATION OF COUNTIES CAREMARKPCS HEALTH, L.L.C.
By:
By:
Matt Chase
Title: Executive Director
Date:
Title:
Date:
MEMBER COUNTY:
County Name
By:
Title:
Date:
28979646_11i.DOC
NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL,
PROPRIETARY AND CONSTITUTES TRADE SECRETS OF CAREMARICPCS HEALTH, L.L.C.
EIDER !
With respect to County's participation in the Consumer Card Program, the Parties
intend and agree to revise the terms of the Agreement as follows:
1 The following Is added as a new Section lac of the Agreement:
Marketing Reimbursement Fee. As consideration for the Consumer Card Program information
that Merriber'County provides to County residents, Caremark shall pay to Member County a Marketing
Reimbursement Pee of one dollar ($1.00) for each retail Claim processed by Caremark during the term of
this Agreement on which a transaction fee is collected by the Participating Pharmacy. If the Member
County Agreement is signed by all parties between the first and fifteenth days of the month, then the
effective date for the Member County to begin receiving Marketing Reimbursement Fees is the first day
of the month following the signing date. If the Member County Agreement is signed by all parties
between the sixteenth and last days of any month, then the effective date for the Member County to begin
receiving Marketing Reimbursement Fees is no later than the first day of the second month following the
signing date. In either instance, the first Marketing Reimbursement Fee payment to Member County is
due and payable no later than 60 days following the end of the first calendar quarter following the
effective date. Marketing Reimbursement Fee cheeks shall be accompanied by a summary report
prepared by Caremark setting forth the calculation of the Marketing Reimbursement Fees. It is the
intention of the Parties that this fee shall constitute and shall be treated by Member County as a fair
market value payment for specified marketing services.
Accepted and Agreed:
MEMBER COUNTY:
(County Name]
By:
Title:
Date:
commissioner Thomas Middleton, tistrict #4
Chairperson, Finance Committee
FISCAL NOTE (MISC . #17327) December 7, 2017
BY: Commissioner Thomas Middiewn, Chairperson, Finance Committee
IN RE: BOARD OF COMMISSIONERS — AUTHORIZATION TO PROCEED WITH THE NATIONAL
ASSOCIATION OF COUNTIES LIVE HEALTHY DISCOUNT PRESCRIPTION DRUG, DENTAL AND
HEALTH PROGRAM CONTRACT
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has reviewed the above referenced resolution
and finds:
1. The resolution authorizes Oakland County's Corporation Counsel and Purchasing Division to
negotiate and draft a contract, with the National Association of Counties (NACo)/CaremarkPCS
Health LLC, for their Healthy Living Program, including the prescription, dental and health
programs.
2. This change is primarily a result of the previous vendor, National Benefit Counseling, Inc.,(NBC
Inc.), formerly known as Benefit Control Methods (BCM), being purchased by another firm and no
longer being able to honor the discounts in the subscription savings plan, thus suspending the
Oakland County Discount Dental Program.
3. Due to a lack of a discount dental plan, the Board of Commissioner requested the Oakland County
Health Department to review all available discount programs. After a thorough review, it was
recommended that NACo Live Healthy Program offered the best comprehensive solution to
improve Oakland County residents' access to health care services.
4, Upon completion of the contract, the Board of Commissioners authorizes staff to notify Oakland
County's current discount prescription drug program partner, Coast2Coast Rx, of its intention to
terminate the current contract.
5. A budget amendment is not required at this time.
FINANCE COMMITTEE VOTE:
Motion carried unanimously on a roll call vote.
Resolution #17327 December 7, 2017
Moved by KowaII supported by Jackson the resolutions (with fiscal notes attached) on the amended Consent
Agenda be adopted (with accompanying reports being accepted).
AYES: Dwyer, Fleming, Gershenson, Gingell, Hoffman, Jackson, KowaII, Long, McGillivray,
Middleton, Quarles, Tietz, VVelpert, Woodward, Zack, Berman, Crawford. (17)
NAYS: None. (0)
A sufficient majority having voted in favor, the resolutions (with fiscal notes attached) on the amended Consent
Agenda were adopted (with accompanying reports being accepted).
7')
( I )
GERALD D. POISSON
CHIEF DEPUTY COUNTY EXECUTIVE
ACTING PURSUANT TO MCL 45559/47)
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I. Lisa Brown, Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true and
accurate copy of a resolution adopted by the Oakland County Board of Commissioners on December 7, 2017,
with the original record thereof now remaining in my office.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of the County of Oakland at Pontiac,
Michigan this 71" day of December, 2017.
Lisa Brown, Oakland County