TCMA Addendum #04/Changes Ex C & DPIGGYBACK AGREEMENT ADDENDUM NO. 4
BETWEEN
THE CITY OF OKEECHOBEE AND
TREASURE COAST MEDICAL ASSOCIATES, INC.
WHEREAS, the City of Okeechobee, Florida, (CITY) desires to procure healthcare
services with and through medical professionals duly licensed and qualified to provide
such services and to manage and operate an employee health center; arid,
WHEREAS, Okeechobee County has entered into a contract (Initial Agreement) with
Treasure Coast Medical Associates (TCMA) on or about September 29, 2017; and,
WHEREAS, CITY originally entered into an Agreement with TCMA on or about October
3, 2017, (Piggyback Agreement) has extended the Piggyback Agreement thereafter
through various addendums (the Addendum).
WHEREAS, Certain City employees presently do not to participate in the group health
insurance plan through the group health insurance provided through the City due to cost
issues.
WHEREAS, This Addendum may enable certain City employees and their eligible
dependents to participate in the medical services with TCMA.
WHEREAS, As described in the Addendum, the fees would be through payroll
deduction, or if retired, fees must be paid prior to the 25th of the month, for benefits to be
paid for the following month. For those employees not participating in employee health
insurance the city will pay the monthly fee.
NOW, THEREFORE, in consideration of the promises and mutual covenants contained
herein and for other good and valuable considerations, the receipt and sufficiency of
which are hereby mutually acknowledged, the parties agree as follows:
1. Recitals. The above recitals are true and correct and are incorporated into this
CITY Piggyback Agreement ("Agreement") by reference.
2. Terms and Conditions. This Addendum No. 4 shall, except as otherwise stated
herein, be subject to the terms and conditions of the Okeechobee County Initial
Agreement , which is attached and incorporated herein as "Exhibit A", and the
October 3, 2017 piggyback agreement, which is attached and incorporated
herein as "Exhibit B".
3. Extensions. This agreement may be extended, from time to time, utilizing an
addendum to this agreement.
4. Termination. The parties adopt and incorporate the provisions of Article III,
Section 3 of the Initial Agreement into this Agreement as the method of
termination.
5. Public Records. Pursuant to Florida Statutes § 119.0701, to the extent TCMA is
performing services on behalf of the CITY, has noticed and set forth in Exhibit B.
Incorporated herein by reference are Exhibit C and Exhibit D which incorporates the
following: Reimbursable Operating Expenses by participants and the Monthly
Administration Fee.
All IN WITNESS WHEREOF, the CITY and TCMA have made and executed this
Addendum No. 4 to the Piggyback Agreement
AS TO THE CITY: AS TO THE PROVIDER
idt/;" /1/'
Dowling R. Watford, Jr., Mayor Dr
President, T
ATTEST:
Lane Garniotea, City Clerk
REVIEWED FOR LEGAL SUFFICIENCY:
WITNESSES:
Signature
John J. Fumero, City Attorney Signature
EXHIBIT C
REIMBURSABLE OPERATING EXPENSES
The only operating expenses that will be invoiced are the costs incurred for labs ordered,
medications dispensed, X-ray over reads, and any other tests, equipment, or external contracted
services which are agreed upon by the constituency for whom the tests, equipment, or contracted
services are required. These pass-through expenses will only be for employees, dependents, and
retirees that are on the City's medical plan.
For the patients that are not on City of Okeechobee's medical insurance plan, the patient and not
the City of Okeechobee will need to pay for these services.
Medication: A prescription will be sent to the pharmacy of their choosing.
Vaccinations: The patient will need to pay the self -pay price for any vaccinations needed
that TCMAi keeps in stock.
Labs: The patient will be given a requisition form to have their labs drawn at an outside
laboratory.
X -Ray Over Reads: The patient will need to pay $8.50 per view for any X -Rays
performed in office. This fee will need to be paid before the X -Ray is performed. If the fee for
the over reads increases by TCMAi's vendor, this expense will be reflected in the charge for the
patient.
Durable Medical Equipment: DME is not covered in this contract. Any DME needed
will be paid for by the patient and not the City of Okeechobee.
EXHIBIT D
MONTHLY ADMINISTRATION FEE
The participants authorized to utilize the clinic include both employees, their dependents and
retirees on City of Okeechobee's medical plan and employees and their dependents that are not
on City of Okeechobee's medical plan. The participants that are on the City's medical plan will
have the administration fee paid for by the City of Okeechobee. The participants that are not on
the City's medical plan will pay the City of Okeechobee for the administration fee and in return
the City of Okeechobee will pay Okeechobee Medical Providers, Inc. for their administration fee
for those not on the City's medical plan.
The monthly administration fee will be billed as follows:
If there are at least 800 total participants, the administration fee= $40.00 per person
If there are less than 800 total participants, the administration fee= $56.00 per person
Two monthly rosters will be sent to TCMAi at least 5 days before the start of the month with a
breakdown of eligible employees for the clinic. One roster will have all participants that are on
the City of Okeechobee's medical plan. A second roster will have all participants that are not on
the City's of Okeechobee medical plan.