Agreement for Employee Assistance Program Services with Cigna Behavioral Health, Inc. 0247 9V67
COVER SHEET TO
AGREEMENT FOR EMPLOYEE ASSISTANCE PROGRAM SERVICES
Employer's Name City of Miami Beach ("Employer")
Employer's Address 1700 Convention Center Drive, Fourth Floor,Miami Beach, FL 33139
Employer's Contact Person Sonia Bridges
Cigna Behavioral Health, Inc.'s Name Cigna Behavioral Health, Inc. ("Cigna Behavioral")
Cigna Behavioral Health, Inc.'s Address 11095 Viking Drive, Suite 350, Eden Prairie,MN 55344
Cigna Behavioral Health,Inc.'s Contact Person Karen Cierzan,President
Agreement Effective Date January 1,2017
Effective Date of Amendment Effective by Cover Sheet N/A
Fee for Service $1.80 per employee per month
Number of Employer Account Service Hours 24 per 1000 employees
Number of Visits Available Per Assessed Problem For Clinica
Services Five(5)
Other
The rest of this page intentionally left blank
10222015 1
IN WITNESS WHEREOF the parties hereto have caused this Cover Sheet to be executed as of the
Effective Date shown on this Cover Sheet.
CITY OF MIAMI B" r C ' ' CIGNA BEHAVIORAL HEALTH,INC.
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10222015 2
AGREEMENT FOR EMPLOYEE ASSISTANCE PROGRAM SERVICES
Agreement made as of the date set forth as the Effective Date on the Cover Sheet to this Agreement
between Cigna Behavioral and the Employer identified on the Cover Sheet to this Agreement as
Employer.
WITNESSETH:
WHEREAS, Employer wishes to provide an Employee Assistance Program ("EAP") which includes
Clinical Services as described herein to its employees,their dependents, and members of their households
("Participants") who do not reside in California or Nevada. The Clinical Services' components of the
EAP provided to Participants who reside in California or Nevada are covered under the short-term
counseling policies issued to Employer by Cigna Health and Life Insurance Company, a Cigna
Behavioral affiliate ("CHLIC") and not by the terms of this Agreement. All other EAP services for such
Participants are covered under the terms of this Agreement; and
WHEREAS, Cigna Behavioral has established and administers an EAP and has agreed to provide its EAP
services to Employer for Participants.
NOW, THEREFORE, in consideration of the mutual promises set forth herein, Employer and Cigna
Behavioral agree as follows:
I. Responsibilities of Cigna Behavioral
EAP-Services
1.1. Clinical Service: For mental health, alcoholism or drug abuse service ("Clinical Service"), Cigna
Behavioral shall provide assessment, referral and/or short-term problem resolution sessions, up to the
maximum number of visits per assessed problem as set forth on the then effective Cover Sheet, per
contract year.
1.2. Work/Life Support Services: For family care, legal/financial information, Healthy Rewards
(telephonic), and Promotional Communications which includes but is not limited to, Frequently Asked
Questions, Article Library, initial registration, online eligibility check, self-assessment tool and Provider
Directory and Search vehicle, Cigna Behavioral shall provide assessment and referral services as
requested by Participant or Employer. Legal assessment and referral services are not available to
Participants if the issue is related to a potential cause of action against Employer. Online behavioral
health services ("Online Services"), shall be provided pursuant to the terms of Exhibit 1 of this
Agreement. Any additional services ("Menu Options") purchased by Employer are attached hereto as
Exhibit 3 of this Agreement.
1.3. Services shall be provided by Cigna Behavioral through its employees and/or independent
contractors. Cigna Behavioral employees and/or contractors shall look solely to Cigna Behavioral for
payment for assessment, referral and/or short-term problem resolution services provided pursuant to this
Agreement. Participants may access services from Cigna Behavioral through a toll-free telephone
number maintained by Cigna Behavioral twenty-four(24)hours a day, seven(7)days a week.
1.4. Participant calls to the Cigna Behavioral toll-free number shall be handled by a personal advocate
who shall refer the Participant to an appropriate resource.
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A. For Clinical Services, Cigna Behavioral shall offer an appointment within two(2)business
days with a local counselor. In a Clinical Services' emergency, trained clinicians shall be
available at Cigna Behavioral to telephonically address the situation and to make a referral
to a local counselor or crisis intervention center for assessment, referral and/or short-term
problem resolution.
B. For Work/Life Support Services, Cigna Behavioral may refer Participant to contracted
specialty firms or to local resources for assessment and referral. Participants shall be
responsible for costs of services provided pursuant to a referral. Contracted specialty
firms may offer Participant a discount rate. Work/Life Support legal services and/or
financial services shall include, at no charge to Participants, an initial thirty (30) minute
consultation.
1.5. For Clinical Services, Cigna Behavioral shall maintain a nationwide network of local mental
health and substance abuse counselors who shall assess the problem, provide short-term problem
resolution and/or guide the Participant to appropriate local treatment resources.
1.6. Fees for Clinical Services other than assessment, referral and short-term problem resolution
services within the maximum number of visits per assessed problem as shown on the Cover Sheet shall
be the Participant's responsibility. Cigna Behavioral shall not represent to the Participant that Cigna
Behavioral's identification of or referral to treatment resources constitutes coverage under the provisions
of Participant's medical coverage plan.
1.7. Cigna Behavioral shall provide Account Services as set forth in Exhibit 2.
1.8. Communication materials related to EAP services shall be available electronically.
1.9. Cigna Behavioral shall provide reports concerning utilization of EAP services by Participants on a
quarterly basis to Employer. Individually identifiable Participant information shall be the property of
Cigna Behavioral. Without the appropriate written consent of the Participant, Cigna Behavioral shall
provide no information to Employer or any third party that includes any Participant specific identifiable
information.
1.10. Cigna Behavioral and Employer agree not to use for any purposes other than the performance of
this Agreement, and further agree not to disclose to others, any confidential or proprietary technical or
business information of the other party obtained in connection with the performance of any services
rendered, without the prior written consent of the other party. Each party shall treat and shall require its
employees to treat as strictly confidential all such technical and business information it has learned in the
course of this Agreement, and in discussions and proposals leading up to this Agreement. The provisions
of this section shall survive the termination of this Agreement. Cigna Behavioral shall maintain as
confidential all patient identifiable information received in the course of performing services under this
Agreement, and shall not use or disclose such information except as may be permitted or required under
applicable state and federal law.
1.11. Cigna Behavioral shall provide management consultations to supervisors who request assistance
for work related problems of employees. Cigna Behavioral shall provide assistance with mandatory
referrals for employees who are required, under continuation of employment, drug free workplace or
other workplace policies, to receive an assessment under the EAP. However, Cigna Behavioral shall not
nor shall any of its network of providers provide advice and/or make a determination regarding an
employee's (a) ability to safely perform the functions of his/her job, (b) ability to return to work after a
medical disability, involuntary suspension from duties or administrative leave of absence, and/or (c)
potential for workplace violence. No individually identifiable employee information concerning the
employee's treatment shall be provided without the employee's written consent on a form approved by
Cigna Behavioral.
10222015 4
II. Responsibilities of Employer
2.1. Employer shall distribute to employees the communication materials described in paragraph 1.8
above, at Employer's expense and shall cooperate with Cigna Behavioral in other reasonable efforts to
otherwise communicate with Participants concerning the services available to them pursuant to this
Agreement.
2.2. Employer shall inform Cigna Behavioral of Employer's management policies and procedures that
guide supervisors in handling employees with performance concerns in order for Cigna Behavioral to
provide the training set forth in Exhibit 2. Cigna Behavioral assumes no responsibility for the legal
appropriateness of such policies and procedures.
2.3. Employer shall compensate Cigna Behavioral for services provided under this Agreement in the
amount shown on the then effective Cover Sheet. Employer agrees to pay Cigna Behavioral on the first
day of each covered month. Payments by Employer shall be sent to Cigna Behavioral at the address set
forth on the then effective Cover Sheet to this Agreement. Retroactive adjustments to the amount of the
per employee per month fees paid to Cigna Behavioral shall be limited to twelve(12)months prior to the
date the Employer notifies Cigna Behavioral of such a retroactive adjustment.
2.4. The amount set forth on the then effective Cover Sheet shall not include any state premium, sales,
use tax, or similar tax (including penalties or interest thereon) assessed on the basis of the services
provided by Cigna Behavioral pursuant to this Agreement.
2.5. Cigna Behavioral shall have the right to revise Cigna Behavioral's fees and/or the number of
hours available to Employer as Employer Account Services (i) twenty-four (24) months from the
effective date of this Agreement, (ii) at any time thereafter, but no more frequently than once every
twelve (12)months after the initial twenty-four(24) month term,by giving Employer not less than thirty
(30) days'prior written notice, and (iii)when the number of employees varies by more than 10%from the
number included on the first Cigna Behavioral billing for the initial twenty-four (24) month term and
each subsequent twelve(12)month period of the Agreement.
2.6. Employer agrees that, annually, at least ninety (90) days prior to the anniversary date of the
Effective Date of this Agreement, Employer shall furnish to Cigna Behavioral the number of employees
who are Participants by state of residence.
III. Miscellaneous Provisions
3.1. All notices required or permitted to be given under this Agreement shall be in writing and
addressed to the address and contact person set forth on the then effective Cover Sheet to this Agreement
and mailed through the United States mail or nationally recognized courier service. Notices shall be
effective upon receipt by the party to which they are addressed.
3.2. No amendment of any of the provisions of this Agreement shall be binding on either party unless
in writing and signed by the duly authorized representatives of both parties. Amendments to items
contained on the then effective Cover Sheet shall be effected by the execution of a revised Cover Sheet
showing the effective date of the revised Cover Sheet and signed by both parties.
3.3. This Agreement is nonassignable without the written consent of the other party, except that Cigna
Behavioral may assign the Agreement to a Cigna affiliate. Any attempted assignment without such
consent shall be void.
3.4. No failure by either party at any time or for any period of time to insist upon full performance by
the other party shall be deemed a waiver of any duty owed by the other party to the non-objecting party.
3.5. Employer hereby delegates to Cigna Behavioral the authority, responsibility, and discretion to
determine all questions of eligibility and status under the EAP, to interpret and construe the provisions of
10222015 5
the EAP as necessary to reach factually supported conclusions and to make a full and fair review of each
claim for EAP benefits which have been denied by Cigna Behavioral pursuant to the requirements of the
Employee Retirement Income Security Act of 1974, as amended ("ERISA"). Cigna Behavioral assumes
no responsibility for Employer's ERISA plan except as set forth in this section.
3.6. This Agreement contains the entire agreement between Employer and Cigna Behavioral with
respect to the services provided hereunder, and supersedes any and all prior discussions or agreements,
written or oral, with respect thereto.
3.7 Intentionally Deleted.
3.8. This Agreement shall remain in effect from the Effective Date until terminated as follows:
A. by Cigna Behavioral upon Employer's failure to pay Cigna Behavioral as provided in
Section 2.3 within thirty(30)days of a written request from Cigna Behavioral;
B. or by either party with ninety(90)days' prior written notice to the other party.
3.9. This Agreement shall be governed by, and shall be construed in accordance with all applicable
federal laws, including ERISA, and the laws of the state of Florida. The exclusive venue for any
litigation arising out of this agreement shall be Miami-Dade County, Florida, if in state court, and the
U.S. District Court, Southern District of Florida,if in federal court.
3.10. The terms of Exhibit 4,Privacy Addendum, shall be incorporated herein.
3.11 Florida Public Records Law
A. Cigna Behavioral shall comply with Florida Public Records law under Chapter 119, Florida
Statutes, as may be amended from time to time. Records made or received in connection with
this Agreement are public records under Florida law, as defined in Section 119.011(12),
Florida Statutes.
B. Pursuant to Section 119.0701 of the Florida Statutes, if the Cigna Behavioral meets the
definition of"Contractor"as defined in Section 119.0701(1)(a), Cigna Behavioral shall:
a. Keep and maintain public records required by the Employer to perform the service;
b. Upon request from the Employer's custodian of public records, provide the Employer
with a copy of the requested records or allow the records to be inspected or copied
within a reasonable time at a cost that does not exceed the cost provided in Chapter
119,Florida Statutes or as otherwise provided by law;
c. Ensure that public records that are exempt or confidential and exempt from public
records disclosure requirements are not disclosed, except as authorized by law, for the
duration of the contract term and following completion of the Agreement if Cigna
Behavioral does not transfer the records to the Employer;
d. Upon completion of the Agreement, transfer, at no cost to the Employer, all public
records in possession of Cigna Behavioral or keep and maintain public records
required by the Employer to perform the service. If Cigna Behavioral transfers all
public records to the Employer upon completion of the Agreement, Cigna Behavioral
shall destroy any duplicate public records that are exempt or confidential and exempt
from public records disclosure requirements, unless otherwise required to be
maintained by Cigna Behavioral by law. If Cigna Behavioral keeps and maintains
public records upon completion of the Agreement, Cigna Behavioral shall meet all
applicable requirements for retaining public records. All public records stored
electronically must be provided to the Employer, upon request from the Employer's
custodian of public records, in a format that is compatible with the information
technology systems of the Employer.
10222015 6
C. REQUEST FOR RECORDS;NONCOMPLIANCE.
a. A request to inspect or copy public records relating to the Employer's contract for
services must be made directly to the Employer. If the Employer does not possess the
requested records, the Employer shall immediately notify Cigna Behavioral of the
request, and Cigna Behavioral must provide the public records to the Employer or allow
the records to be inspected or copied within a reasonable time.
b. Cigna Behavioral's failure to comply with the Employer's request for public records
shall constitute a breach of this Agreement, and the Employer, at its sole discretion,
may: (1) unilaterally terminate the Agreement; (2) avail itself of the remedies set forth
under the Agreement; and/or (3) avail itself of any available remedies at law or in
equity.
c. A Contractor who fails to provide the public records to the Employer within a
reasonable time may be subject to penalties under s. 119.10.
D. CIVIL ACTION.
a. If a civil action is filed against a Contractor to compel production of public records
relating to the Employer's contract for services, the court shall assess and award
against Cigna Behavioral the reasonable costs of enforcement, including reasonable
attorney fees,if:
(i) The court determines that Cigna Behavioral unlawfully refused to comply with
the public records request within a reasonable time; and
(ii)At least 8 business days before filing the action, the plaintiff provided written
notice of the public records request, including a statement that Cigna
Behavioral has not complied with the request, to the Employer and to Cigna
Behavioral.
b. A notice complies with subparagraph (1)(b) if it is sent to the Employer's custodian of
public records and to Cigna Behavioral at Cigna Behavioral's address listed on its
contract with the Employer or to Cigna Behavioral's registered agent. Such notices
must be sent by common carrier delivery service or by registered, Global Express
Guaranteed, or certified mail, with postage or shipping paid by the sender and with
evidence of delivery,which may be in an electronic format.
c. A Contractor who complies with a public records request within 8 business days after
the notice is sent is not liable for the reasonable costs of enforcement.
E. IF CIGNA BEHAVIORAL HAS QUESTIONS REGARDING THE APPLICATION OF
CHAPTER 119, FLORIDA STATUTES, TO CIGNA BEHAVIORAL'S DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS AGREEMENT, CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT:
CITY OF MIAMI BEACH
ATTENTION: RAFAEL E.GRANADO, CITY CLERK
1700 CONVENTION CENTER DRIVE
MIAMI BEACH, FLORIDA 33139
E-MAIL: RAFAELGRANADO a,MIAMIBEACHFL.GOV
PHONE: 305-673-7411
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IV. Liability and Indemnity
4.1 Cigna Behavioral shall be liable to and indemnify the Employer for any loss, cost or expense
(including court costs and reasonable attorneys' fees) for which Employer may become liable in
consequence of any negligent acts or omissions of Cigna Behavioral or its employees, agents, or
representatives; or fraud, embezzlement,willful misconduct, or intentional disregard by Cigna Behavioral
or its employees, agents, or representatives. The foregoing shall not include indemnification for: (1)the
negligent acts or omissions of Participating Providers, as by contract, Cigna Behavioral requires
Participating Providers to maintain adequate amounts of professional liability insurance, and Participating
Providers remain responsible for their own professional conduct; or(2) any negligent acts or omissions of
Employer or its employees, agents, or representatives; or fraud, embezzlement, willful misconduct or
intentional disregard by Employer or its employees, agents, or representatives.
V. Insurance
5.1 As a subsidiary of Cigna Corporation, Cigna Behavioral is covered under Cigna Corporation's
master insurance program, which provides insurance coverage in amounts that meet or exceed
Employer's requirements, which are described in the attached Exhibit 5, Miami Beach Professional
Services.Upon Employer's request, Cigna Behavioral will provide evidence of insurance coverages.
VI. Audit
6.1 Annual audits of Cigna Behavioral may be conducted by an independent third party on behalf of
the Employer, at no additional cost to Employer; provided that the scope of the audit is limited to
financial information or information related to Employer's fiduciary responsibilities, and provided that all
security documents, non-disclosure agreements and authorizations are completed in advance of the audit.
Cigna Behavioral must receive such audit request no less than sixty (60) days prior to the proposed audit
date.
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EXHIBIT 1
ONLINE SERVICES
General Terms Applicable To All Users
Cigna Behavioral provides online services ("Online Services") as a supplement to other health and
wellness services furnished under this Agreement.
This Online Services attachment("Attachment") states the terms and conditions that govern the use of the
Online Services. The information contained in the Online Services is for informational purposes only
and is not to be used for medical diagnosis or treatment.
Agreement; Online Services
By Employer using the Online Services or notifying Participants of the availability of the Online Services,
Employer agrees to the terms and conditions of this Attachment. If at any time Employer becomes
dissatisfied with the Online Services, Employer will discontinue its use and notify Participants that the
Online Services are no longer available to them.
The Online Services are provided through Cigna Behavioral and/or third-party websites ("Site" or
"Sites"). Cigna Behavioral grants to Employer and Participants, for personal, noncommercial purposes
only, a nonexclusive, limited and revocable right to access and use the Online Services. Employer and
Participants may not use the Online Services for any other purpose, including external commercial
purposes,such as co-branding, framing or linking. Employer and Participants may not copy,reproduce or
distribute any material from the Online Services. By way of example and not limitation, Employer shall
not copy materials from the Online Services and use them as handouts during employee and/or manager
training programs unless the materials are specifically marked as available for such use.
Employer and Participants will not take any action inconsistent with the copyright and trademark
ownership rights of the Online Services content owners and any other providers of the Online Services.
Computer Equipment
Employer and Participants are responsible for obtaining, installing, maintaining and operating all
equipment and software necessary to access the Online Services, in accordance with such requirements as
may be provided by the equipment and software manufacturers. Cigna Behavioral is not responsible for
any errors or problems that arise from the malfunction or failure of such equipment or software.
Browser Access and Internet Services
Employer and Participants are responsible for obtaining Internet services via an Internet service provider
in order to access the Online Services. Likewise, Employer and Participants are responsible for any and
all fees imposed by such Internet service provider and any associated communications service provider
charges.
Passwords
Cigna Behavioral may at its option change the parameters for the password used to access the Online
Services ("Password") without prior notice to Employer or Participants. This may result in Employer or
Participants being required to change their password the next time the Online Services are accessed.
10222015 9
Employer agrees to, and shall require Participants to, protect and keep confidential its User ID, Password,
or other means of accessing its account for the Online Services.
New Features
The content of the Online Services may, from time to time and at Cigna Behavioral's sole discretion,
include new features or modify or delete existing features to the Online Services.
Limitation of Liability;No Warranties
EXCEPT AS SPECIFICALLY SET FORTH HEREIN OR WHERE THE LAW REQUIRES A
DIFFERENT STANDARD, CIGNA BEHAVIORAL SHALL NOT BE RESPONSIBLE FOR ANY
LOSS, DAMAGE OR INJURY OR FOR ANY I) DIRECT, II) INDIRECT, OR III) PUNITIVE
DAMAGES ARISING FROM OR RELATED TO THE FAILURE OF ELECTRONIC OR
MECHANICAL EQUIPMENT OR COMMUNICATION LINES; FAILURE OR UNAVAILABILITY
OF INTERNET SERVICE; CONFIGURATION PROBLEMS OR INCOMPATIBILITY OF
COMPUTER HARDWARE OR SOFTWARE; THIRD PARTY CONTENT, INFORMATION OR
PRODUCTS; OR ANY OTHER PROBLEMS DUE TO CAUSES BEYOND CIGNA BEHAVIORAL'S
CONTROL. CUSTOMER ACKNOWLEDGES THAT CIGNA BEHAVIORAL MAKES NO
WARRANTY THAT THE ONLINE SERVICES WILL BE UNINTERRUPTED, TIMELY, SECURE
OR ERROR-FREE UNLESS OTHERWISE STATED ON THE SITE OR IN ANY APPLICABLE
AGREEMENT. CIGNA BEHAVIORAL DOES NOT WARRANT OR MAKE ANY
REPRESENTATIONS REGARDING THE USEFULNESS OF OR THE EXPECTED RESULTS OF
THE MATERIAL CONTAINED ON THE SITE. TO THE FULLEST EXTENT PERMITTED BY
LAW, CIGNA BEHAVIORAL DISCLAIMS ALL REPRESENTATIONS, WARRANTIES AND
CONDITIONS OF ANY KIND (EXPRESS, IMPLIED, STATUTORY OR OTHERWISE),
INCLUDING BUT NOT LIMITED TO THE WARRANTIES OF MERCHANTABILITY AND
FITNESS FOR A PARTICULAR PURPOSE, TITLE AND NON-INFRINGEMENT OF
PROPRIETARY RIGHTS, AS TO THE ONLINE SERVICES AND ALL INFORMATION,
PRODUCTS AND OTHER CONTENT (INCLUDING THIRD PARTY INFORMATION, PRODUCTS
AND CONTENT) INCLUDED IN OR ACCESSIBLE FROM THE SITES. NO LICENSE TO YOU IS
IMPLIED IN THESE DISCLAIMERS.
Termination
Cigna Behavioral may terminate, suspend or limit Employer and/or Participants' access privileges to the
Online Services, in whole or part, at any time for any reason without prior notice,unless otherwise stated
in an agreement with respect to the Online Services.
Site links
The Sites may contain links to other third party web sites. Cigna Behavioral is not responsible for, nor
does it control, the content, products, or services provided by linked sites. Employer's and Participants'
access, use and reliance upon such content, products or services at such third party websites is at their
own risk.
Digital Millennium Copyright Act
Cigna Behavioral reserves the right, but not the obligation, to terminate Employer's and/or Participants'
access to the Online Services if it determines in its sole discretion that such individuals are involved in
infringing activity, including alleged acts of first-time or repeat infringement, regardless of whether the
material or activity is ultimately determined to be infringing. Cigna Behavioral and its service providers
accommodate and do not interfere with standard technical measures used by copyright owners to protect
materials. Cigna Behavioral has implemented procedures for receiving written notification of claimed
10222015 10
infringements and for processing such claims in accordance with the Digital Millennium Copyright Act.
Cigna Behavioral's designated agent to receive notification of claimed infringement is:
Jonathan Witte
1601 Chestnut Street—Two Liberty
Philadelphia, PA 19192
215.761.1964
Any notice from Employer or a Participant regarding any infringement of copyright or of other
proprietary rights must include the following information:
A. A signature of a person authorized to act on behalf of(i) the owner of an exclusive right that is
allegedly infringed or(ii)the person defamed.
B. Identification of the copyrighted work claimed to have been infringed, or, if multiple copyrighted
works at a single online site are covered by a single notification, a representative list of such works
at that site.
C. Identification of the material that is claimed to be infringing, or to be the subject of infringing
activity, including information reasonably sufficient to permit us to locate the material.
D. Information reasonably sufficient to permit us to contact you, such as your address, telephone
number, and/or electronic mail address.
E. A statement that Employer or the Participant (as applicable) has a good faith belief that use of the
material in the manner complained of is not authorized by the copyright or other proprietary right
owner,its agent, or the law.
If Employer or Participants choose to access the Online Services from outside the United States, they do
so on their own initiative and are responsible for compliance with U.S. and local laws, if and to the extent
that local laws are applicable. Software is subject to United States export controls. No software may be
downloaded or otherwise exported or re-exported (i) into (or to a national resident of) Cuba, Iraq, Libya,
North Korea, Iran, Syria, or any other country to which the U.S. has embargoed goods, or (ii) to anyone
on the U.S. Treasury Department list of Specially Designated Nationals or the U.S. Commerce
Department's Table of Deny Orders. Employer represents and warrants that it is not located in, under the
control of, or a national resident of any such country or on any such list. Employer agrees to comply with
U.S. export control laws and that it will not transfer any software or other content from the Online
Services to a foreign national or foreign country in violation of those laws.
Minors and the Children's Online Privacy Protection Act
Except as expressly stated upon initial access to a Site or section of such Site, the Site does not direct
content to Minors and does not intend to collect personal information from Minors and therefore is not
subject to the Child Online Privacy Protection Act.
If a Participant allows a minor child, or a child for whom a Participant is a legal guardian (a "Minor"), to
access and use the Site, such Participant will be solely responsible for: (i) the online conduct of such
Minor; (ii)monitoring such Minor's access to and use of the Site; and (iii)the consequences of any use.
Viruses,Worms,Use of Files
Cigna Behavioral cannot and does not guarantee or warrant that files available for downloading from the
Site are free of viruses, worms, Trojan horses or other code that has contaminating or destructive
properties. Cigna Behavioral does not make any express or implied warranties, representations or
endorsements whatsoever (including without limitation warranties of title, noninfringement or fitness for
a particular purpose) with respect to the files available for downloading from the Site. In no event will
Cigna Behavioral be liable to Employer, Participants, or anyone else for any decision made or action
taken in reliance on results obtained from use of files downloaded from the Site. These files may be
10222015 11
downloaded and/or reprinted for personal use only. Permission to reprint or electronically reproduce any
document or graphic in whole or in part for any reason except for personal use is expressly prohibited,
unless prior written consent is obtained from the appropriate Cigna Behavioral copyright holder.
Message Boards and Chat Rooms
It is a condition of Participants' use of Message Boards or Chat Rooms that Participants do not: (i)post or
transmit any unlawful, threatening, abusive, libelous, defamatory, racial, obscene, vulgar, pornographic,
profane or indecent information of any kind, including without limitation any transmissions constituting
or encouraging conduct that would constitute a criminal offense, give rise to civil liability or otherwise
violate any local, state, national or international law; (ii) post or transmit comments containing harassing
or offensive language, using sexual references, sexual nicknames, racial slurs or rude or deliberately
offensive comments or engage in disruptive activity online, including excessive use of scripts, sound
waves, scrolling(repeating the same message over and over), or use viruses,worms or Trojan horses; (iii)
post or transmit any information, software or other material which violates or infringes the rights of
others, including material which is an invasion of privacy or publicity rights or which is protected by
copyright, trademark or other proprietary right, or derivative works without first obtaining permission
from the owner; (iv) post or transmit any information, software or other material which contains a virus,
worm, Trojan horse or other code that has contaminating or destructive properties; (v) post any
information, software, or other material for commercial purposes; (vi) solicit other users to join or
contribute money to any online service or other organization, advocate or attempt to get users to join in
legal or illegal schemes; (vii) impersonate any person or entity or falsely represent their professional or
other affiliation with any person or entity; or (viii) use the Site to collect personally identifiable
information in violation of the Privacy Statement accompanying the Site.Cigna Behavioral, at its sole and
absolute discretion, shall determine whether any information transmitted or received violates this
provision. Cigna Behavioral reserves the right to prohibit Participants from use of Message Boards or
Chat Rooms if they violate this provision.
Employer understands that Cigna Behavioral has no obligation to monitor Message Boards or Chat
Rooms. Cigna Behavioral reserves the right at all times to disclose any information regarding the
Message Boards or Chat Rooms, or to remove any information or materials, in whole or in part, that in
Cigna Behavioral's sole and absolute discretion, are objectionable. Employer acknowledges that Cigna
Behavioral reserves the right to monitor any and all information transmitted or received through the Sites,
which may be examined, recorded, copied, and used in accordance with the Privacy Statement
accompanying the Site. Use of the Sites constitutes consent to such activity by Cigna Behavioral.
When using the Sites Participants should not compromise their personal safety. Participants should not
provide their name, phone number, social security number or any other personally identifying information
to people they do not know. Participants should not continue any conversation online that makes them
feel uncomfortable.
Calculations and Investment Decisions
Financial calculators and calculations are provided for illustrative purposes only. Participants are
responsible for verifying the accuracy and suitability of all assumptions and calculations. Participants
should seek the advice of licensed and/or competent individuals before making any investment or
financial planning decisions. Participants should not rely solely on financial calculators\calculations or
financial or retirement information found on the Sites.
10222015 12
EXHIBIT 2
EMPLOYER ACCOUNT SERVICES
Employer is entitled to utilize, for the delivery of the Employer Account Services listed below, the
number of hours set forth on the then effective Cover Sheet to this Agreement in each twelve month
period from the Effective Date of this Agreement. Pro-rata adjustments in this number of hours may be
computed pursuant to Section 2.5 of this Agreement.
* Employee Orientation Sessions
* Management/Supervisory Training Sessions
* Educational/Wellness Seminars
* Critical Incident Response Services
* Other Employer Account Services - Employer Account Services requested by Employer
for which Cigna Behavioral notifies Employer that those services shall be counted against
Employer Account Services' hours, including but not limited to, executive briefings,
reduction in workforce counseling, and Employer's on-site EAP promotional activities
conducted by Cigna Behavioral EAP managers or Cigna Behavioral contracted EAP
affiliates.
Delivery of these Employer Account Services shall be as agreed upon by the parties. In the event
Employer does not utilize or only partially utilizes these Employer Account Services' hours during the
twelve (12) month period to which they relate, Employer shall not be entitled to any refund or account
credit, or to carry those hours forward. If Employer cancels its request for these services or reduces the
number of hours initially requested after an independent provider has been secured by Cigna Behavioral,
Cigna Behavioral shall deduct that number of hours the provider had been secured from Employer
Account Services' hours.
Additional Employer Account Services' hours may be purchased by Employer from Cigna Behavioral at
Cigna Behavioral's fee-for-service rates in effect at the time of the request for such Employer Account
Services. Delivery of these additional Employer Account Services' hours shall be as agreed upon by the
parties.
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10222015 13
EXHIBIT 3
MENU OPTIONS****
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****Only those additional Menu Options purchased by Employer will be listed on this page.
10222015 14
EXHIBIT 4
PRIVACY ADDENDUM
GENERAL PROVISIONS
Section 1. Effect. Effective as of the Effective Date, the terms and provisions of this Addendum are incorporated in
and shall supersede any conflicting or inconsistent terms and provisions of the Agreement for Employee Assistance
Program Services to which this Addendum is attached, including all exhibits or other attachments thereto and all
documents incorporated therein by reference(the"Agreement"),except for any provisions of the Agreement which are
more stringent regarding the use or disclosure of PHI by Cigna Behavioral than this Addendum. Any such more
stringent provisions in the Agreement shall prevail over this Addendum. This Addendum sets out terms and provisions
relating to the use and disclosure of protected health information without written authorization from the individual.
Section 2. Amendment to Comply with Law. Cigna Behavioral,Employer(also referred to as"Plan Sponsor")and
the Group Health Plan that is the subject of the Agreement (also referred to as "the Plan") agree to amend this
Addendum to the extent necessary to allow either the Plan or Cigna Behavioral to comply with the HIPAA Privacy
Rule, the HIPAA Standards for Electronic Transactions (45 CFR Parts 160 and 162),the HIPAA Security Standards
(45 CFR Parts 160 and 164, Subpart C), the Health Information Technology for Economic and Clinical Health
("HITECH")Act, which was included in the American Recovery and Reinvestment Act ("ARRA") (P.L. 111-5) and
their implementing regulations promulgated or to be promulgated by the Secretary,and other applicable regulations or
statutes.
Section 3. Relationship of Parties. The parties intend that Cigna Behavioral is an independent contractor and not an
agent of the Plan.
II. OBLIGATIONS OF CIGNA BEHAVIORAL
Section 1. Use and Disclosure of Protected Health Information. Except as otherwise provided in this Addendum,
Cigna Behavioral may use or disclose Protected Health Information ("PHI") to perform functions, activities or
services for,or on behalf of,the Plan as specified in the Agreement,provided that such use or disclosure would not
violate the HIPAA Privacy&Security Rules if done by the Plan. To the extent Cigna Behavioral is to carry out one
or more of the Plan's obligations under Subpart E of 45 CFR Part 164, Cigna Behavioral agrees to comply with the
requirements of Subpart E that apply to the Plan in the performance of such obligations. Cigna Behavioral may use
and disclose Protected Health Information:
(i) for the proper management and administration of Cigna Behavioral,or to carry out the legal responsibilities
of Cigna Behavioral;
(ii) for the proper management and administration of Cigna Behavioral, provided that disclosures are: (a)
required by law or (b) Cigna Behavioral obtains reasonable assurances from the person to whom the
information is disclosed that it will remain confidential and used or further disclosed only as required by law
or for the purpose for which it is disclosed to the person, and the person notifies Cigna Behavioral of any
instances of which it is aware in which the confidentiality of the information has been breached;or
(iii) to provide Data Aggregation services relating to the health care operations of the Plan or to de-identify PHI.
Once information is de-identified,this Addendum shall not apply.
(iv) as required by law.
Section 2. Disclosure of Protected Health Information to Group Health Plan Sponsor. The Group Health Plan
acknowledges and agrees that the Privacy Rules allow the Group Health Plan to permit Cigna Behavioral to disclose
or provide access to PHI,other than Summary Health Information,to the Plan Sponsor only after the Plan Sponsor has
amended its plan documents to provide for the permitted and required uses and disclosures of PHI and to require the
Plan Sponsor to provide a certification to the Plan that certain required provisions have been incorporated into the
Plan documents before the Plan may disclose, either directly or through a business associate, such as Cigna
Behavioral,any PHI to the Plan Sponsor. The Group Health Plan hereby warrants and represents that no PHI will be
provided to the Plan Sponsor nor to any of its employees,agents or other persons under its control. Therefore no such
Plan document amendments have been made nor any such certification received from the Plan Sponsor.
Section 3. Other Information to Plan Sponsor or Plan. Upon the written request of Plan or Plan Sponsor, Cigna
Behavioral will provide certain other information including,but not limited to,information about Cigna Behavioral's
10222015 15
arrangements with health care providers("Other Information")to Plan Sponsor's designated employee. Plan Sponsor
acknowledges that in receiving Other Information under these provisions,it acts in its capacity as Plan Administrator,
as that term is defined by the Employee Retirement Income Security Act of 1974,as amended. Except with respect to
any information that is subject to disclosure pursuant to Florida Public Records Laws including, without limitation,
Chapter 119,Florida Statutes,Other Information will be kept confidential and will be used by Plan Sponsor solely for
the purpose of satisfying its fiduciary responsibilities with respect to administration of the Plan, and will be handled
and maintained in accordance with all fiduciary obligations owed to participants in the Plan.
*Notwithstanding anything to the contrary in this Section 3, Cigna Behavioral acknowledges that Employer is a
municipal corporation,organized and existing under the laws of the State of Florida and,as such,is subject to Chapter
119,Florida Statutes, and related statutes known as the"Public Records Laws". Other Information may be subject to
disclosure pursuant to Florida Public Records laws,including,without limitation,Chapter 119,Florida Statutes.
Section 4. Security Standards. Cigna Behavioral shall use appropriate safeguards and comply with Subpart C of 45
CFR Part 164 with respect to Electronic PHI to prevent use or disclosure of PHI other than as provided for by the
Agreement.
Section 5. Reporting of Violations. Cigna Behavioral shall report to the Group Health Plan any use or disclosure of
the Protected Health Information not provided for by this Addendum of which it becomes aware.
Section 6. Disclosures to and Agreements by Third Parties.
(a) In accordance with 45 CFR §164.502(e)(1)(ii) and 164.308(b)(2), Cigna Behavioral agrees to ensure that any
subcontractors that create, receive, maintain, or transmit PHI on behalf of Cigna Behavioral agree to substantially
similar restrictions,conditions,and requirements that apply to Cigna Behavioral with respect to such information.
(b) Upon Group Health Plan's or Employer's written request, Cigna Behavioral will provide Protected Health
Information and/or Other Information to certain designated third-parties who assist in administering the Plan and are
authorized by the Group Health Plan to receive such information("Designated Third Parties") solely for the purpose
of assisting in the carrying out of Plan administration functions. Such parties may include, but are not limited to,
third-party administrators, consultants, brokers, auditors, successor administrators or insurers, and stop-loss carriers.
Group Health Plan shall enter into and maintain an agreement with each agent and subcontractor or other third party to
which it directs Cigna Behavioral to disclose PHI under which such agent,subcontractor or other third party is legally
bound by substantially similar restrictions with respect to Protected Health Information that apply to Cigna Behavioral
pursuant to this Addendum.
(c) It is acknowledged and agreed that the Privacy Rules require the Group Health Plan to maintain policies and
procedures to ensure that any PHI that it uses, requests or discloses be no more than the minimum necessary to
accomplish the intended purpose. The Group Health Plan hereby warrants and represents that any requests that it
makes for PHI to be disclosed to it or to any third parties will be for no more than the minimum amount necessary for
the intended purpose.
(d) Any other provision of this Addendum notwithstanding, Cigna Behavioral may decline to disclose to any third
party any information which the Agreement provides may not be disclosed to the Employer.
Section 7. Access to Information.
(a) Request made to the Plan. When an individual requests access to PHI contained in a designated record set and
such request is made directly to the Plan or Employer, the Plan shall so notify Cigna Behavioral within two (2)
business days of receipt of such request. Cigna Behavioral shall make such PHI available directly to the Participant
within the time required in 45 C.F.R.Section 164.524.
(b) Request made to Cigna Behavioral. If a Participant directs a request for access to PHI contained in such
designated record set to Cigna Behavioral, Cigna Behavioral will provide the PHI to the individual within the time
required in 45 C.F.R.Section 164.524.
10222015 16
(c) Responsibility for denials and responding to requests. In the case of either subsection (a) or (b) above, the
Plan delegates to Cigna Behavioral the duty to determine, on behalf of the Plan, whether to deny access to PHI
requested and the duty to provide any required notices and review.
(d) It is understood and agreed that in all activities performed pursuant to this section, Cigna Behavioral acts as a
delegate of,and on behalf of,the Plan and/or Employer. When responding to an individual's request for access,it may
inform such individual of that fact and that there may be other PHI about that individual created or maintained by the
Plan and/or its other business associates and not included in Cigna Behavioral's response. Cigna Behavioral shall not
be responsible for performing any of the duties described herein with respect to any such other PHI.
Section 8. Availability of Protected Health Information for Amendment.
(a) Handling of Requests by Cigna Behavioral. When an individual requests amendment of PHI contained in a
designated record set and created or received by Cigna Behavioral or its subcontractors, and such request is made
directly to the Plan or Employer, within two (2) working days of its request, the Plan shall forward such request to
Cigna Behavioral for handling except that the Plan shall retain and handle all requests to the extent that they pertain to
individually identifiable health information(i.e. enrollment information) originated by the Plan, Plan Sponsor, or its
other business associates. Cigna Behavioral shall respond to such forwarded requests as well as to any such requests
that it receives directly as required by Section 164.526 except that Cigna Behavioral shall forward to the Plan for
handling any requests for amendment of PHI originated by the Plan,Plan Sponsor or its other business associates.
(b) Responsibility for denial of request. With respect to those requests handled by Cigna Behavioral under
subparagraph(a)above,the Plan delegates to Cigna Behavioral the duty to determine,on behalf of the Plan,whether
to deny a request for amendment of any PHI and the duty to provide any required notices and review as well as,in the
case of its determination to grant such a request,the duty to make any amendments in accordance with the terms of
the Privacy Rules. In all other instances,the Plan retains all responsibility for handling such requests,including any
denials,in accordance with the Privacy Rules.
(c) Amendments by the Plan. Whenever Cigna Behavioral is notified by the Plan that the Plan has agreed to make
an amendment pursuant to such a request which it handles hereunder, Cigna Behavioral shall incorporate any such
amendments in accordance with Section 164.526.
(d) It is understood and agreed that in all activities performed pursuant to this section, Cigna Behavioral acts as a
delegate of,and on behalf of, the Plan and/or Employer. When responding to requests for amendment of PHI,Cigna
Behavioral may inform such individual of that fact and that there may be other PHI about that individual created or
maintained by the Plan and/or its other business associates and not included in Cigna Behavioral's response. Cigna
Behavioral shall not be responsible for performing any of the duties described herein with respect to any such other
PHI.
(e) Modifications to Individual Rights and Accounting of Disclosures. Effective on and after February 17, 2010,
or the date specifically provided in the HITECH Act provisions or regulations issued by the Secretary pursuant to such
provisions, Cigna Behavioral shall comply with,and shall assist the Plan in complying with,the modifications to the
individual rights under the HIPAA Privacy Rule; specifically modifications to: requested restrictions on certain
disclosures of health information, under 45 CFR § 164.522(a)(1)(i)(A); access to certain information in electronic
format if the Plan or Cigna Behavioral uses or maintains an electronic health record with respect to an Individual's
Protected Health Information, under 45 CFR § 164.524; and accounting of certain Protected Health Information
disclosures if the Plan or Cigna Behavioral uses or maintains an electronic health record with respect to Protected
Health Information,under 45 CFR§ 164.528. Cigna Behavioral shall provide an accounting of disclosures of PHI to
an Individual who requests such accounting in the manner and time required in 45 CFR 164.528.
Section 9. Accounting of Disclosures
(a) Request made to the Plan. When an individual requests an accounting of disclosures pursuant to Section
164.528, and such request is made directly to the Plan or Employer,the Plan shall so notify Cigna Behavioral within
two(2)business days of receipt of such request.
(b)Request made to Cigna Behavioral. If a Participant directs a request for accounting to Cigna Behavioral,Cigna
Behavioral will provide the accounting to the participant within the time required in 45 CFR Section 164.528.
10222015 17
(c) It is understood and agreed that in all activities performed pursuant to this section, Cigna Behavioral acts as a
delegate of, and on behalf of, the Plan and/or Employer. When responding to requests for an accounting of
disclosures,Cigna Behavioral may inform such individual of that fact and that there may be other disclosures of PHI
about that individual made by the Plan and/or its other business associates and not included in Cigna Behavioral's
response. Cigna Behavioral shall not be responsible for performing any of the duties described herein with respect to
any such other PHI or disclosures.
Section 10. Other Requests. Cigna Behavioral shall handle Participant requests made to it for privacy protection for
PHI pursuant to the requirements of the Privacy Rules at Section 164.522.
Section 11. Processes and Procedures. In carrying out its duties set forth in Sections II,7,8,9 and 10 above,Cigna
Behavioral may establish procedures and processes for requests from individuals as permitted by the Privacy Rules,
including the requirement that requests be made in writing and the creation of a form for use by individuals in making
such requests. As appropriate,Cigna Behavioral shall utilize the same or similar procedures regarding requests from
individuals for access to PHI that it applies to its own health care plan administration business.
Section 12. Availability of Books and Records. Cigna Behavioral hereby agrees to make its internal practices,
books and records relating to the use and disclosure of Protected Health Information available to the Secretary for
purposes of determining the Group Health Plan's compliance with the Privacy Rules.
Section 13. Protection of Electronic PHI. With respect to Electronic Protected Health Information,no later than the
compliance date for the Security Standards and at all times thereafter Cigna Behavioral shall:
(a) Implement administrative, physical, and technical safeguards that reasonably and appropriately protect the
confidentiality, integrity, and availability of the Electronic Protected Health Information that Cigna Behavioral
creates,receives,maintains,or transmits on behalf of the Plan as required by the Security Standards;
(b) Ensure that any agent, including a subcontractor, to whom Cigna Behavioral provides Electronic PHI agrees to
implement reasonable and appropriate safeguards to protect such information;and
(c) Report to the Plan any Security Incident of which it becomes aware.
Section 14. Receiving Remuneration in Exchange for Protected Health Information Prohibited. Cigna
Behavioral shall not directly or indirectly receive remuneration in exchange for any Protected Health Information of
an Individual, unless an authorization is obtained from the Individual, in accordance with 45 CFR § 164.508, that
specifies whether Protected Health Information can be exchanged for remuneration by the entity receiving Protected
Health Information of that Individual,unless otherwise permitted under the HIPAA Privacy Rule.
Section 15. Limited Data Set or Minimum Necessary Standard and Determination. Cigna Behavioral shall limit
the use,disclosure,or request of Individuals'Protected Health Information,to the extent practicable,to the minimum
necessary amount of Individuals' Protected Health Information to accomplish the intended purpose of such use,
disclosure, or request and to perform its obligations under the underlying Agreement and this Addendum. Cigna
Behavioral shall determine what constitutes the minimum necessary to accomplish the intended purpose of such
disclosure. Cigna Behavioral's obligations under this provision shall be subject to modification to comply with
guidance issued by the Secretary.
Section 16. Security Breach Notification. Cigna Behavioral will notify the Plan of a Breach (including privacy
related incidents that might,upon further investigation,be deemed to be a Breach)without unreasonable delay and,in
any event,within ten business days after Cigna Behavioral's discovery of same. This notification will include, to the
extent known:
(a)the names of the individuals whose PHI was involved in the Breach;
(b)the circumstances surrounding the Breach;
(c)the date of the Breach and the date of its discovery;
10222015 18
(d)the information Breached;
(e)any steps the impacted individuals should take to protect themselves;
(f)the steps Cigna Behavioral is taking to investigate the Breach,mitigate losses,and protect against future Breaches;
and,
(g)a contact person who can provide additional information about the Breach.
For purposes of discovery and reporting of Breaches, Cigna Behavioral is not the agent of the Plan or the Employer
(as "agent" is defined under common law). Cigna Behavioral will investigate Breaches, assess their impact under
applicable state and federal law,including HITECH, and will make a recommendation to the Plan regarding whether
notification is required pursuant to 45 CFR §164.404-408 and/or applicable state breach notification laws. With the
Plan's prior approval, Cigna Behavioral will issue notices to such individuals, state and federal agencies—including
the Department of Health and Human Services, and/or the media as the Plan is required to notify pursuant to, and in
accordance with the requirements of,applicable law(including 45 CFR§164.404-408). Cigna Behavioral will pay the
costs of issuing notices required by law and other remediation and mitigation which,in Cigna Behavioral's discretion,
are appropriate and necessary to address the Breach. Cigna Behavioral will not be required to issue notifications that
are not mandated by applicable law. Cigna Behavioral shall provide the Plan with information necessary for the Plan
to fulfill its obligation to report Breaches affecting fewer than 500 Individuals to the Secretary as required by 45 CFR
§164.408(c).
HI. TERMINATION OF AGREEMENT WITH CIGNA BEHAVIORAL
Section 1. Termination Upon Breach of Provisions Applicable to Protected Health Information. Any other
provision of this Agreement notwithstanding,this Agreement may be terminated by the Group Health Plan upon prior
written notice to Cigna Behavioral in the event that Cigna Behavioral materially breaches any obligation of this
Addendum and fails to cure the breach within such reasonable time as the Plan may provide for in such notice;
provided that in the event that termination of this Agreement is not feasible,in the Group Health Plan's sole discretion,
Cigna Behavioral hereby acknowledges that the Group Health Plan shall have the right to report the breach to the
Secretary.
If Cigna Behavioral knows of a pattern of activity or practice of the Plan that constitutes a material breach or violation
of the Plan's duties and obligations under this Addendum,Cigna Behavioral shall provide a reasonable period of time,
as agreed upon by the parties,for the Plan to cure the material breach or violation.Provided,however,that,if the Plan
does not cure the material breach or violation within such agreed upon time period,Cigna Behavioral shall terminate
the Agreement,if feasible,at the end of such period.However,if neither termination of the Agreement nor cure are
feasible,Cigna Behavioral shall report the violation to the Secretary.
Section 2. Use of Protected Health Information upon Termination.The parties hereto agree that it is not feasible
for Cigna Behavioral to return or destroy PHI at termination of this Agreement, therefore, the provisions of this
Addendum shall survive termination of this Agreement and Cigna Behavioral shall limit any further uses and
disclosures of such PHI to the purpose or purposes which make the return or destruction of such PHI infeasible.
IV. DEFINITIONS FOR USE IN THIS ADDENDUM
Definitions. Certain capitalized terms used in this Addendum are defined in Article IV. Terms used in this
Addendum shall have the meanings ascribed to them by the Health Insurance Portability and Accountability Act
("HIPAA") and the Health Information Technology for Economic and Clinical Health ("HITECH") Act and their
respective implementing regulations and guidance.If the meaning of any term defined herein is changed by regulatory
or legislative amendment, then this Agreement will be modified automatically to correspond to the amended
definition. All capitalized terms used herein that are not otherwise defined have the meanings described in the HIPAA
Privacy and Security Rules and the HITECH Act. A reference in this Addendum to a section in the HIPAA Privacy •
Rule,HIPAA Security Rule, or the HITECH Act means the section as in effect or as amended or a successor section
thereto,and for which compliance is required.
"Breach" shall mean the unauthorized acquisition, access, use, or disclosure of Unsecured Protected Health
10222015 19
Information ("PHP") which compromises the security or privacy of such information, except where an authorized
person to whom such information is disclosed would not reasonably have been able to retain such information. A
Breach does not include any unintentional acquisition, access, or use of PHI by an employee or individual acting
under the authority of Cigna Behavioral if such acquisition, access, or use was made in good faith and within the
course and scope of the employment or other professional relationship of such employee or individual with Cigna
Behavioral;and such information is not further acquired,accessed,used,or disclosed by any person.
"Business Associate"means Cigna Behavioral Health,Inc.
"Covered Entity"means Plan.
"Data Aggregation" shall mean the combining of Protected Health Information by Cigna Behavioral with the
Individually Identifiable Health Information created or received by Cigna Behavioral in its capacity as a business
associate of another covered entity, to permit data analyses that relate to the health care operations of the Group
Health Plan and the other covered entity.
"Designated Record Set" shall mean the, payment, claims adjudication, and case or medical management record
systems maintained by or for the Group Health Plan,or used, in whole or in part,by or for the Group Health Plan to
make decisions about individuals. As used herein the term "Record" means any item, collection, or grouping of
information that includes Protected Health Information and is maintained, collected,used, or disseminated by or for
the Group Health Plan.
•
•
"Electronic Protected Health Information"shall mean PHI that is transmitted by or maintained in electronic media
as that term is defined in 45 CFR 160.103
"Plan"or"Group Health Plan"shall mean the Group Health Plan(as defined in the Employee Retirement Income
Security Act of 1974,as amended,(ERISA)at 29 U.S.C.§1191b(a))maintained by the Plan Sponsor that is identified
in this Agreement as the health Plan for or on behalf of which Cigna Behavioral is obligated to perform any function
or activity involving the use or disclosure of Protected Health Information pursuant to this Agreement.
"Individually Identifiable Health Information" shall mean information that is a subset of health information,
including demographic information collected from an individual,and:
(i) is created or received by a health care provider, health plan,health care clearinghouse (as those terms
are defined in the Privacy Standards),or employer;and
(ii) relates to the past, present, or future physical or mental health or condition of an individual; the
provision of health care to an individual; or the past, present or future payment for the provision of
health care to an individual; and (a) identifies the individual, or (b) with respect to which there is a
reasonable basis to believe the information can be used to identify the individual.
"Limited Data Set" shall have the same meaning as the term"limited data set"as set forth in as defined in 45 CFR
164.514(e)(2).
"Privacy Standards"shall mean the Standards for Privacy of Individually Identifiable Health Information,45 C.F.R.
Part 160 and Part 164,subparts A and E.
"Protected Health Information" or "PHI" shall mean Individually Identifiable Health Information transmitted or
maintained in any form or medium that Cigna Behavioral creates or receives from or on behalf of the Group Health
Plan in the course of fulfilling its obligations under this Agreement. "Protected Health Information" shall not include
(i)education records covered by the Family Educational Rights and Privacy Act, as amended,20 U.S.C. §1232g,and
(ii)records described in 20 U.S.C.§1232g(a)(4)(B)(iv).
"Secretary"shall mean the Secretary of the United States Department of Health and Human Services.
"Security Incident"shall have the same meaning as the term"security incident"as set forth in 45 CFR 164.304.
10222015 20
"Summary Health Information" shall mean information, that may be Individually Identifiable Information, and(i)
that summarizes the claims history, claims expenses, or type of claims experienced by individuals covered by the
Group Health Plan; and (ii) from which the information described at 45 C.F.R. §164.514(b)(2)(i) has been deleted,
except that the geographic information described in 45 C.F.R. §164.514(b)(2)(i)(B) need only be aggregated to the
level of a five-digit zip code.
"Unsecured Protected Health Information"shall mean PHI that is not secured through the use of a technology or
methodology specified by the Secretary in accordance with the requirements of Section 13401(h)(1)of the HITECH
Act.
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10222015 21
EXHIBIT 5
MIAMI BEACH PROFESSIONAL SERVICES
Before beginning any work, and throughout the term of the contract(including renewal periods), the
Provider shall indicate that insurance coverage has been obtained which meets the requirements as
outlined below:
A. Worker's Compensation for all employees of the provider as required by Florida Statute
440, and Employer's Liability Insurance in an amount not less than$1,000,000.
B. Commercial General Liability on a comprehensive basis in an amount not less than
$1,000,000 combined single limit per occurrence, for bodily injury and property damage.
City of Miami Beach shall be shown as an additional insured, on a blanket basis only, with respect
to this coverage.
C. Automobile Liability Insurance covering all owned,non-owned and hired vehicles used in
connection with the work, in an amount not less than$1,000,000 combined single limit per
occurrence for bodily injury and property damage.
D. Professional Liability Insurance in an amount not less than$1,000,000.
With the exception of Professional Liability Insurance, the insurance coverage required above must
include a waiver of subrogation in favor of the City. A blanket waiver of subrogation endorsement shall
be deemed acceptable.
The insurance coverage required shall include those classifications, as listed in standard liability
insurance manuals, which most nearly reflect the operations of the provider. All insurance policies
required above shall be issued by companies authorized to do business under the laws of the State of
Florida, with the following qualifications:
The company must be rated no less than "B+" as to management, and no less than "Class
VI" as to financial strength,by the latest edition of Best's Insurance Guide,published by
A.M. Best Company, Oldwick,New Jersey, or its equivalent, subject to the approval of the
City Risk Management Division.
CERTIFICATE HOLDER MUST READ:
CITY OF MIAMI BEACH
1700 CONVENTION CENTER DRIVE
3' FLOOR
MIAMI BEACH, FL 33139
Compliance with the foregoing requirements shall not relieve the vendor of his liability and obligation
under this section or under any other section of this agreement.
10222015 22
Enclosed with this package please find two (2) originals of an Agreement for Employee
Assistance Program attached to the letter from Karen Cierzan. If you are in agreement
with the terms of this Agreements as written, please sign the documents on as the
example indicates below and as follows: (a) the space under your company name. Please
see example below regarding where to sign.
Return all originals to your Cigna Account Manager listed on the above referenced letter.
The Account Manager will obtain the necessary signature from the appropriate Cigna
Behavioral Health representative and will return one fully executed original of each to
you for your files.
Thank you.
'" •g � ' 'J+�';� `£ f°,j
EMPLOYER CIGNA BEHAVIORAL HEALTH,INC.
By: ` P =r i By:
Name: Name:
Title: Title:
Date: Date:
WITH RESPECT TO THE PRIVACY
ADDENDUM(EXHIBIT F)ONLY:
*GROUP HEALTH PLAN(PLAN SPONSOR'S PLAN)
By: RECEIVED
Name:
Title: 2011 MAR 114 PM 12` 01
Date: