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Agreement with EyeMed Vision Care, LLC 1 ICI DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Z 0 2 2- 32 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-525B7161CC3F O/ L2_/2-2 C2E eYe FEE FOR SERVICE AL)MINISTP/V1-; ,t AGREEMENT A wno4y own W subsiAdyd EyeMaO Vision Cara City of Miami Beach This Agreement is entered into by end between EyeMed Vision Core,LLC("EyeMed")and First American Administrators, Inc.("FAA"),with their principal place of business at 4000 Luxotiica Place,Mason,OH 45040 and City of Miami Beach with Its principal place of business at 1700 Convention Center Drive, Miami Beach, Florida 33139. as Employer and Plan Administrator("Employer') RECITALS Employer provides benefits for its employees and their qualified dependents and now intends to offer vision benefits to such Participants(as defined herein); Employer has elected to pay for These vision benefits by self-funding vision benefits under its Plan (the "Plan') and contracting out claims administration and Vision Network administration services; Employer wishes to engage the services of EyeMed and FAA to provide a vision benefit, claims administration,and Vision Network administration to assist employer in their responsibilities as Employer for self-funded vision benefits; EyeMed makes its Vision Network of Participating Providers available to Employer's Members who have vision care coverage; FAA, a wholly owned subsidiary of EyeMed and a duly licensed third-party administrator in required states,provides certain administrative services available to Employer's Members who have vision care coverage. NOW,THEREFORE,in accordance with the terms and conditions contained herein,the parties agree as follows: I. EFFECTIVE DATE,TERM AND RENEWAL A. Effective Date This Agreement is effective October 1.2022("Effective Date")and shall continue until September 30,2024. For purposes of this Agreement:(I)all references to"Business Days"shall mean a day when EyeMed and/or FAA and Employer are open for business,excluding Saturday and Sunday;and(ii)any references to a particular time of the day shall be considered Eastern Time. B. Term The Agreement shall commence on the Effective Date for a term of forty-eight(48)months or until the Agreement is otherwise terminated in accordance with Section XII. C. Renewal The agreement may be renewed for one(1)additional two-year period to be exercised at the City Manager's sole option and discretion,by providing Consultant with written notice of same no less than thirty(30)days prior to the expiration of the initial term. D. Definitions Capitalized terms and otherwise defined terms within the section are defined on Exhibit A. II. RESPONSIBILITIES OF EYEMED A. Services EyeMed shall provide the following: 10-1999-EyeMed/FAA—EMPLOYER I NON-ERISA AGREEMENT/PROPRIETARY Page t DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-52587161CC3F 1. Vision Benefit EyeMed shall make available to Members the Vision Benefit as set forth on Exhibit B at Participating Provider locations. EyeMed shall also provide additional services,including but not limited to,responding to questions from Members,Providers and Employer regarding Vision Benefits. 2. Enrollment Information for Participants EyeMed shall maintain Participant enrollment records based on and in reliance upon data furnished to it by Employer or its agent. 3. Identification Cards/Member Materials EyeMed shall design, produce and distribute identification cards. In addition, upon request, EyeMed shall make available open enrollment materials and other communication materials. EyeMed agrees to review and advise concerning the description of Vision Benefits within Plan documents,including materials intended for distnbution to Participants. 4 Customer Service EyeMed shall train and maintain adequate levels of staff as determined by EyeMed and provide a loll-free telephone number to respond to inquiries from Employer's administrative staff, Members and Participating Providers concerning the Vision Benefit. 5. Web Access EyeMed will maintain web access to the Vision Benefit and Member's eligibility information. 6. Usage Reporting EyeMed shall provide standard usage reports annually, as defined by EyeMed, at no charge. All other requested reports shall be produced upon the mutual agreement of the parties, including but not limited to any associated cost(s)for such report(s). 7. Reporting Assistance for Employer EyeMed shall provide to Employer reports regarding the financial and claims experience of the Plan.and other information the Employer reasonably requires that assists Employer in its compliance with income tax, or other disclosure requirements. B. Provider Network Services and Provider Locator Service 1 ParticleAi q Provider Network EyeMed shall provide a Vision Network of ophthalmologists, optometrists, opticians, and retail optical locations that are contracted with EyeMed to deliver services consisting of vision exams. materials, and contact lenses, at negotiated prices ("Participating Providers"). Any additions or deletions to the Vision Network shall be in EyeMed's sole discretion;provided, however, that EyeMed will make reasonable efforts to provide Employer with reasonable advance notice of significant changes in the Vision Network,which would materially affect the nature or extent of services provided to Members. EyeMed shall reimburse the Participating Provider at the rate contracted between EyeMed and the Participating Provider,which may be an amount different than what is set forth on Exhibit B. 2. Participating Provider Independent Contractor EyeMed does not employ Participating Providers and such providers are not EyeMed's agents,partners or subcontractors. Participating Providers participate in the Vision Network only as independent contractors Participating Providers are solely responsible for exercising professional judgment related to a Participant's care. 3. Participating Provider Locator EyeMed shall maintain a Participating Provider locator service that the Member may access through a toll-free telephone number,the EyeMed website or the mobile app. 4. c_redentialing EyeMed shall credential,contract with,and re-credential each ophthalmologist and optometrist in accordance with EyeMed's credentialing procedures, which meet NCQA standards. EyeMed may contract with a NCQA accredited credentials verification organization of its choice to perform verifications of the credentials. 10.1999-EyeMed/FAA—EMPLOYER I NON-ERISA AGREEMENT 1 PROPRIETARY 1-'ayie 2 DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-525B7161CC3F 5. Nondiscrimination EyeMeds Participating Providers Agreement requires Participating Providers to make its services available to Members on the same basis as those services are provided to all other patients,and that Participating Provider shall not discriminate on the basis of age,sex,race,religion,or color. 6. Balance Billing EyeMed's Participating Provider Agreement requires providers to not balance bill Members for Vision Benefits; provided, however, a Participating Provider shall collect from Members any copayment or coinsurance amounts for which Members are financially obligated under the Plan and any amounts for non-covered servce(s) C. Claims Processing Services 1. Claims Submission FM shall process in-network and out-of-network claims for Vision Benefits. In-network claims will be submitted directly to FAA by the Participating Provider. Out-of-network claims must initially be paid by the Member in full; the Member must submit the out-of-network claim(or information) directly to FM on the appropriate claim form to obtain the appropriate reimbursement as set forth on Exhibit B. EyeMed shall make the out-of-network claim form available to Members through a toll-free telephone number or on the EyeMed website. 2 Claims Delegation Employer delegates to FM the discretionary authority to determine the validity of claims and appeals under the Plan. 3. Claims Processing Services FAA shall: (a)determine the amount of Vision Benefits payable, if any, for each claim;(b)notify the Member its decision concerning the claim;(c)disburse payments to the Participating Provider(per the Participating Provider Agreement)or the Member(per the out-of-network information on Exhibit B),as applicable. 4. Claims Review Services FAA shall provide for a review of denied claims upon request by the Member FAA shall notify the Member of its decision upon completion of the review. 5. Run-Out Claims Services After the termination of this Agreement, FAA shall continue to provide claims processing services and daims review services, but only for those claims incurred prior to the date of termination of the Agreement. FAA shall provide such services for a period of twelve (12) calendar months (the "Run-Out Period') following termination. During the Run-Out Period, FAA will continue to invoice the Employer for the claims cost and will additionally invoice the Employer for an administrative fee equal to 6%of the claims cost, Employer will be responsible for payment of such invoices. Invoicing and payment procedures applicable during the term of this Agreement shall continue to be applicable during the Run-Out Period. This clause shall survive the termination of this Agreement. III. RESPONSIBILITIES OF EMPLOYER A. Responsibility for the Plan 1. Plan Administrator Employer is the Plan Administrator of the Plan. Employer may name another entity or individual as Plan Administrator, provided that such Plan Administrator is not EyeMed or FAA and is neither EyeMed nor FAA employee. EyeMed and FAA expressly decline to accept responsibility for being Plan Administrator. 2. Final Authority'or the Plan Employer retains all final authority and responsibility for the Plan and its operations. Both parties shall be responsible for compliance with any and all applicable laws and regulations. 3. Plan Amendment and Certification from Employer Employer represents and warrants that: (a) its Plan documents have been amended, in accordance with 45 CFR §164.504(f), so as to allow Employer to receive Protected Heath Information;(b)the Employer has received a certification from the Plan in accordance with 45 CFR§164.504(f)(2Xii),and will provide a copy of such certification to EyeMed prior to the Effective Date; (c)the Plan document amendments permit Employer to receive detailed invoices from FAA; and (d) 10-1999-EyeMed/FAA—EMPLOYER/NON-ERISA AGREEMENT I PROPRIETARY Page 3 DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-525B7161CC3F Employer has determined, through its own policies and procedures, that the detailed invoice from FAA contains the minimum information necessary for Employer to carry out its payment and health care operations B. Enrollment Services 1. Participant Enrollment Information Employer will determine Participant's eligibility in the Plan and provide EyeMed with data sufficient to enable EyeMed to maintain accurate Participant enrollment records. In the event benefits under the Plan are made available to an individual who is no longer eligible to receive such benefits resulting from Employer's failure to timely notify FM of the ineligibility of such individual,Employer shall be liable to FM for the payment of all benefits provided to such individual. 2. Membership File. Employer will provide EyeMed/FAA with electronic Member enrollment via the EyeMed Group Portal identifying those individuals that the Employer determines is eligible to receive Vision Benefits under the Plan Employer will update Member enrollment additions,changes or deletions via the EyeMed Group Portal as such information becomes available Employer represents and warrants that, to the best of its ability, the electronic Member enrollment will be accurate, and that EyeMec/FAA may rely on such information to authorize services for such enrolled Members. IV. INVOICING ARRANGEMENTS A. Invoice for Vision Benefits FAA shall invoice Employer on a monthly basis for eligible dams processed and paid during the previous month("Claims Invoice"). In addition, FAA shall invoice Employer on a monthly basis administration fee as set forth on Exhibit B ("Admire strative Invoice"). The monthly Administrative Invoice shall be determined by multiplying the number of Members identified by Employer's electronic Member enrollment by the applicable rate set forth on Exhibit B. For purposes of the Administrative Invoice,FM will count the Members who are active and eligible for the applicable billing month as of the 2151 day of each month prior to the billing month in which the invoice is issued to Employer For example,FAA will determine the active and eligible Members for the July invoice as of June 21�'. B. Payment of Invoice Employer shall pay the entire amount of both the Claims Invoice and Administrative Invoice (excluding only 'Disputed Amounts", as defined below)within thirty(45)calendar days from the date of each invoice. If any non-Disputed Amount owed by Employer to EyeMed/FAA is not paid within sixty(60)calendar days of the date of such invoice,EyeMed/FAA may apply interest equal to one and one-half percent (1.5%) per month. In addition, if any Disputed Amount agreed or determined to be owed by Employer to EyeMed/FAA is not paid within fifteen(15) business days from the date of such agreement or determination, EyeMed/FAA may apply interest equal to one and one-half percent (1.5%) per month. Payment shall be considered credited to the account of Employer when received by EyeMed/FAA. As used herein, "Disputed Amounts" shall mean invoice amounts that are subject to a bona fide dispute raised by Employer in a writing received by EyeMed/FAA within fifteen(15)calendar days of the date of an invoice therefore and with respect to which the parties are making reasonable,diligent and good faith efforts to resolve. V. RECORDS MAINTENANCE AND AUDIT A. Records Maintenance EyeMed owns and shall keep all books and records necessary to reflect accurately the business it transacts with respect to Employer and to determine the respective rights of the parties under this Agreement. Such books and records shall be kept at the principal place of business of EyeMed or at such other location as EyeMed determines in its sole discretion. All records will be maintained for a period of at least seven(7)years after the date they are first prepared or for such longer penod as may be required by law. B. Audit During the term of the Agreement, and at any time within twelve (12) months following Its termination, Employer or a mutually agreeable entity or a regulatory authority with jurisdiction over Employer may audit or inspect the records of EyeMed and/or FAA to determine whether EyeMed and/or FM is fulfilling the terms of this Agreement. Employer must advise EyeMed and/or FAA at least sixty(60)calendar days in advance of Employer's intent to audit.The place,time,type, duration, and frequency of all audits must be agreed to in writing by EyeMed and/or FAA in advance of the audit, which approval shall not be unreasonably withheld. 1. All audits shall be on a regular business day,during normal business hours and conducted in such manner as to avoid, to the extent reasonably possible, interference with the normal business functions of EyeMed and/or FAA. Employer shall be solely responsible for all costs of the audit,except for any EyeMed and/or FAA employee time and office space. In addition, Employer shall have the right to review applicable files, records or other information 10.1999-EyeMed/FAA--EMPLOYER/NON-ERISA AGREEMENT I PROPRIETARY Page 4 DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-525B7161CC3F maintained by EyeMed and/or FAA related to Employer, excluding any information, including but not limited to, reports that EyeMed considers proprietary. 2. All audits shall be limited to information relating to the calendar year in which the audit is conducted and/or the immediately preceding calendar year With respect to EyeMed's and/or FAA's transaction processing services, the audit scope and methodology shall be consistent with generally acceptable auditing standards, including a statistically valid random sample or other acceptable audit technique as approved in writing 3. Employer will provide EyeMed and/or FAA with a copy of any audit reports VI. INDEMNIFICATION A. EyeMed and/or FAA Indemnification to Employer EyeMed and/or FM will indemnify,defend and hold Employer harmless from and against any loss,cost,damage,expense or other liability,including,without limitation,reasonable costs and reasonable attorney fees("Costs')incurred in connection wAllza_hy third party claims, suits, investigations or enforcement actions, including claims of infringement of any intellectual pio -_`y rights("Claims')which may be asserted against, imposed upon or incurred by Employer and arising as a result of ) fyeMed's and/or FAA's negligent acts or omissions or willful misconduct, or(ii) EyeMed's and/or FAA's breach of its Obligations under this Agreement. EyeMed and/or FAA shall not be liable to Employer for any third-party claims, suits, investigations or enforcement actions,arising directly or indirectly from the acts or omissions of a Participating Provider. B. Notification of Claim The party seeking indemnification shall notify the indemnifying party in writing within thirty(30)calendar days of receipt of any Claim for which indemnification may be sought hereunder and shall tender the defense of such claim to the indemnifying party thereafter Failure to so notify the incemnifying party shall not be deemed a waiver of the right to seek indemnification unless the actions of the indemnifying party have been prejudiced by the failure of the other party to provide notice within the required time period. C. Survival This clause shall survive the termination of this Agreement. VII. INSURANCE A. Commercial General Liability Insurance EyeMed and FAA shall maintain Commercial General Liability Insurance.including coverage(or contractual liability,public liability, property damage, products-completed operations, cross liability and severability of interest claims, personal injury and advertising injury,with limits of at least: $3,000,000 per occurrence $3,000,000 general aggregate B. Workers'Compensation Insurance EyeMed and FAA shall maintain Workers' Compensation Insurance with benefits afforded under the laws of any state in which the services are to be performed and Employer's Liability insurance with limits of at(east: $1,000,000 for Bodily Injury-each accident $1,000,000 for Bodily Injury by disease policy limits $1,000,000 for Bodily Injury by disease each employee In states where Workers'Compensation Insurance is a monopolistic state-run system, EyeMed and FAA shall maintain Stop Gap Employer's Liability insurance with limits not less than One Million Dollars($1,000,000)each accident or disease. C. Business Automobile Insurance EyeMed and FM shall maintain Business Automobile Insurance with limits of at least One Million Dollars($1,000,C00)each accident for bodily injury and property damage.extending to all owned,hired and non-owned vehicles D. Commercial Crime Insurance EyeMed and FM shall maintain Commercial Crime Insurance with a limit of riot less than Three Million Dollars ($3,000,000). The policy shall provide Employee Theft, Premises, Transit, Depositor's Forgery and Computer Theft and Funds Transfer coverages. The Commercial Crime policy shall include a third-party customer property coverage endorsement with limits of at least One Million Dollars($1,000,000). 10.1999-EyeMedlFAA---EMPLOYER I NON-ERISA AGREEMENT/PROPRIETARY I'.,cit•-' DocuSign Envelope ID:1BDEODEi-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-52587161CC3F E. Managed Care Error and Omissions Insurance EyeMed and FAA shall maintain Managed Care Organization Errors and Omissions Insurance with a policy limit of not Less than Three Million Dollars($3,000,000)each claim and in the aggregate. F. Policies of Insurance--Financial Rating All policies of insurance required of EyeMed and FAA herein shall be issued by insurance companies having and maintaining a Financial Strength Rating of"A minus"or better and a Financial Size Category of"VII"or better in the A.M. Best Key Rating Guide for Property and Casualty Insurance Companies,except that,in the case of Workers'Compensation insurance,EyeMed and FAA may procure insurance from the stated fund of the state where services are to be provided. G. Cyber Liability Policy Cyber Liability(System Damage and Business interruption; Privacy Breach Notification Costs,and Data Breach Regulatory Investigations) with limits of $10,000,000 in the aggregate. Such insurance shall cover damages it is obligated to pay Customer or any third party,which are associated with any Security Breach or loss of Personal Data.Costs to be covered by this insurance policy shall include withoit limitation: (a) costs to notify individuals whose Personal Data was lost or compromised;(b)costs to provide credit monitoring services or identity theft nsurance to individuals whose Personal Data was lost or compromised;(c)costs associated with third party claims arising from the Security Breach or loss of Personal Data,including litigation costs;and(d)regulatory fines and penalties. H. Proof of Insurance Upon Employer's written request,certificates of insurance shall be delivered to Employer upon execution of the Agreement. All policies of insurance will endeavor to provide for at least thirty(30)days prior written notice to Employer of the cancellation or substantial modification thereof. Alt policies required of EyeMed and FAA herein shall be endorsed to read that such policies are primary policies and any insurance carried by Employer shall be noncontributing with such policies. VIII. LICENSE TO USE NAME AND TRADEMARKS A. Employer's Use of EyeMed's Name Employer may use the EyeMed name, as provided by EyeMed (the "Licensed Marks") solely in connection with communicating the Vision Benefit to its Members and shall not use the Licensed Marks or any other trademarks, services marks or trade names of EyeMed(the'Trademarks")for any other purpose. Employer shall not use EyeMed's logo without prior written consent or inconsistent with the attached General Terms of Use for EyeMed Service Marks and Logos related to websile linking. Employer shall not question,contest or challenge EyeMed's rights in and to the Trademarks,nor seek to register the same. Employer expressly recognizes and acknowledges that the use of the Licensed Marks shall not confer upon Employer any proprietary rights to such marks. Upon termination of this Agreement,Employer shall immediately stop using the Licensed Marks. B. EyeMed's Use of Employer's Name EyeMed may use Employer's name and logo(s)as provided by Employer(the"Licensed Marks")solely in connection with communicating the Vision Benefit and shal not use the Licensed Marks or any other trademarks, service marks or trade names of Employer("Trademarks")for any other purpose. EyeMed shall not question, contest or challenge Employer's rights in and to the Trademarks, nor seek to register the same. EyeMed expressly recognizes and acknowledges that the Licensed Marks shall not confer upon EyeMed any proprietary rights to such marks. Upon termination of this Agreement, EyeMed shall immediately stop using the Licensed Marks. C. Remedies The parties expressly agree and understand that the remedy al law for any breach by it of the terms of this section would be inadequate and the damages flowing from such breach are not readily susceptible to being measured in monetary terms. Accordingly,it is acknowledged by each party that upon its breach of any provision of this section,the non-breaching party shall be entitled to seek immediate injunctive relief and may seek to obtain a temporary order restraining any threatened or further breach without the necessity of proof of actual damage. Nothing contained herein shall be deemed to limit the non- breaching party's remedy at law or in equity for any breach by the breaching party of the provisions of this section which may be pursued or availed of by the non-breaching party. IX. WEBSITE LINKING BY COMPANY EyeMed is the owner or operator of a web site located at www.eyemed.corn(the"EyeMed Site) Employer is the owner or operator of a website(the"Employer Site"). EyeMed and Employer desire to allow users of the Employer Site to link to the EyeMed Site landing on EyeMed's home page. In the event Employer establishes a hyperink from Employer's Site to EyeMed's Site the parties hereby agree to the terms and conditions as set forth in the attached General Terms of Use for EyeMed's Service Marks and I ogos,Exhibit C 10-1999-EyeMed/FAA—EMPLOYER/NON-ERISA AGREEMENT/PROPRIE CARY Faye fi DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-525B7161CC3F X. PROTECTION OF CONFIDENTIAL INFORMATION Employer and EyeMed shall not disclose to any other person, firm or corporation, or use for its own benefit except as provided herein, the terms of this Agreement, or any information that it receives from the other party that is marked either "Confidential" or "Proprietary" or "Stnctly Private" or "Internal Data," or that is any unmarked information in the form of financia, information or trade secrets (collectively referred to as "Confidential Information"), without the express written authorization of the other party. Both paries shall take all necessary steps to protect the other party's trade secrets and confidential business information and records. As permitted by law, upon the termination of this Agreement, both parties agree to return any and all materials containing such Confidential Information,plus any and all copies,written or machine made,in whatever medium,that it may have,within ten(10)days of a request from the other party. Confidential Information shall not include information that: A. Was,at the time of receipt,otherwise known to the recipient without restrictions as to use or disclosure; B. Was in the public domain at the time of disclosure or thereafter enters into the public domain through no breach of this Agreement by the recipient; C. Becomes known to the recipient from a source other than the disclosing party,which source has no duty of confdentiality with respect to the information; D. Is independently developed by the recipient without reliance on or access to any of the disclosing party's Confidential Information;or E. Is required to be disclosed by a government agency or bureau,by a court of law or equity with competent jurisdiction over the recipient or by a recognized body engaged in professional self-regulation(such as national accounting or auditing associations),provided that the recipient will first have provided the disclosing party with prompt written notice of such required disclosure and will take reasonable steps to allow the disclosing party to seek a protective order with respect to the Confidential Information required to be disclosed. The recipient will promptly cooperate with and assist the disclosing party,at the disclosing party's expense,in connection with obtaining such protective order. F. Is subject to disclosure pursuant to Florida Public Records law,as may be amended from time to time. XI. BUSINESS ASSOCIATE AGREEMENT/HIPAA PRIVACY In order:o comply with the Administrative Simplification Provisions of the Health Insurance Portability and Accountability Act of 1996 IP.L. 104-191),42 U.S.C.Section 1320d,et,seq.,and regulations promulgated thereunder,as amended from time to time(statute and regulations hereafter collectively referred to as "HIPAA"), the parties hereby agree to the terms and conditiors described in the attached Business Associate Agreement, Exhibit D. Terms used, but not otherwise defined, shall have the same meaning as those terms in HIPAA. XII. TERMINATION A. Voluntary Termination This Agreement may be terminated, without cause: (i)by mutual written agreement of the parties; or(ii)by either party providing one hundred eighty(180)days prior written notice to the other party at any lime during the term of the Agreement or any renewal term B. Termination for Cause or Default Either party may terminate this Agreement if the other party is in material breach of this Agreement and fails to cure such breach within thirty(30)calendar days after receiving written notice reasonably detailing such breach. In the event that the breach is not cured within the thirty(30)day cure period,this Agreement shall terminate in accordance with the initial notice of breach. Additionally,either party shall be deemed to have materially breached this Agreement upon the occurrence of any of the following events,which list is not intended to be inclusive of what constitutes a material breach: 1. Either party shall become insolvent or otherwise admit in writing its inability to pay its debts when they become due, becomes bankrupt, seeks protection under any law for the protection of insolvents, or have a receiver or conservator appointed under any law pertaining to such party's insolvency. 2. Either party fails to remit any amounts due(excluding Disputed Amounts)under this Agreement within thirty(30)calendar days of the date such amount is due and payable, 3. Either party shall knowingly commit a material violation of the laws or regulations of any state where this Agreement is performed. 10-1999-EyeMed/FAA—EMPLOYER/NON-ERISA AGREEMENT/PROPRIETARY Page DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-52587161CC3F 4. Any misrepresentation or falsification of any information supplied by Employer or EyeMed for consideration by the other, except that EyeMed will not be responsible for any misrepresentation or falsification of information provided to it by a Participating Provider. 5. EyeMed or Employer ceases to engage in all business activities. 6. EyeMed substantially fails to perform its obligations under this Agreement, including but not limited to maintaining an adequate Vision Network of Participating Providers, maintaining a Participating Provider locator service for Members to be able to locate Participating Providers,and maintaining sufficient customer service representatives to answer Member and Participating Provider calls. 7. FAA is in default of its payment obligations to any Participating Provider or Members with respect to the services rendered under this Agreement to the Member and fails to cure such default within ten(10)business days of written notice from Employer, so long as FAA does not dispute in good faith the amount that is owed to the Participating Provider or Member. If FAA disputes in good faith that any money is owed or the amount which is awed, FAA is not in default under this Agreement. XIII. GENERAL PROVISIONS A. Requirements Imposed by Law Each party agrees to adhere to legal requirements imposed by federal,state or other law as of the date such law becomes effective and applicable to this Agreement. B. Independent Contractor In the performance of the work,duties and obligations of the parties pursuant to this Agreement,each of the parties shall at all times be acting and performing as an independent contractor,and nothing in this Agreement shall be construed or deemed to create a relationship of employer and employee or partner or principal and agent. C. Governing Law This Agreement shall be governed by and construed in accordance with federal law,and to the extent not preempted,by the laws of the State of Florida. D. Entire Contract This Agreement together with all attachments contains all the terms and conditions agreed upon by the parties, and supersedes all other agreements,express or implied regarding the subject matter. E. Waiver The waiver of any party of any breach of this Agreement shall not be construed as a continuing waiver or a waiver of any other breach of this Agreement. F. Attorney Fees If EyeMed or Employer find it necessary to enforce any part of this Agreement through legal proceedings,resulting in final judgment by a court of competent jurisdiction,Employer and EyeMed agree that each party shall pay all of their own costs and attorneys'fees incurred for such purpose. G. Severability In the event that any clause, term,or condition of this Agreement shall be held invalid or contrary to law, this Agreement shall remain in full force and effect as to all other clauses,terms,and conditions. H. Force Majeure No party to this Agreement shall be liable for failure to perform any duty or obligation that such party may have under this Agreement where such failure has been caused by an act of God,fire,flood,strike,unavoidable accident,war or any cause outside the reasonable control of the party who had the duty to perform. I. Heading The section headings used herein are for reference and convenience only and shall not enter into the interpretation hereof 10-1999-EyeModIFAA—EMPLOYER/NON-ERISA AGREEMENT I PROPRIETARY Page a DocuSign Envelope ID. 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-52587181CC3F J. Counterparts This Agreement may be executed in several counterparts,each of which shall be deemed an original,but all of which shall constitute one Agreement. K. Assignment This Agreement may not be assigned by a party,in whole or in part,without the prior written consent of the other,except that a party may.without the consent of the other,assign this Agreement to an affiliate. L. Successor/Survival All terms of this Agreement shall be binding upon,inure to the benefit of,and be enforceable by the parties hereto and their respective successors and assigns.All rights and obligations of the parties arising out of this Agreement prior to termination which by their nature are designed or intended to continue shall survive the termination of this Agreement M. Amendments This Agreement may be amended from time to time by mutual agreement between Employer and EyeMed, which amendment shalt be in writing signed by the parties Notwithstanding any provision contained herein to the contrary.each party shall have the right,for the purpose of complying with the provisions of any law or lawful order of a court or regulatory authority,to amend this Agreement including any Exhibits hereto,to increase,reduce or eliminate any of the Vision Benefits provided under this Agreement. If the parties cannot agree to an amendment, notwithstanding arty provision of this Agreement to the contrary. Employer or EyeMed may terminate this Agreement as of the end of any month by the giving of ninety(90)days prior written notice. N. No Third-Party Beneficiaries. Nothing express or implied in this Agreement is intended or shall be construed to confer upon or give any person,other than Employer and EyeMed,any right or remedies under or by reason of this Agreement. O. Notice All notices,requests and demands under this Agreement shall be in writing. They shall be deemed to have been given upon delivery if(i)delivered in person,(ii)mailed by certified mail,postage pre-paid and return receipt requested,or Oil)deposited with an overnight delivery service by a nationally recognized overnight courier service. Notice shall be effective upon receipt and shall be directed to the individuals below and at the address in the first paragraph. If to Employer: Sonia T.Waithour,IPMA-SCP Division Director,Rick Management&Benefits Human Resources Department If to EyeMed or FAA Mr.Lukas Ruedter President CC: EyeMed Legal P. Inspector General Audit Rights 1. Pursuant to Section 2-256 of the Code of the City of Miami Beach,the Employer has established the Office of the Inspector General which may,on a random basis,perform reviews,audits inspections and investigations on all Employer contracts,throughout the duration of said contracts. This random audit is separate and distinct from any other audit performed by or on behalf of the Employer. 2. The Office of the Inspector General is authorized to investigate Employer affairs and empowered to review past, present and proposed Employer programs,accounts,records,contracts and transactions.In addition,the Inspector General has the power to subpoena witnesses, administer oaths, require the production of witnesses and monitor Employer protects and programs.Monitoring of an existing Employer project or program may include a report concerning whether the project is on time, within budget and in conformance with the contract documents and applicable law.The Inspector General shall have the power to audit,investigate,monitor,oversee,inspect and review operations,activities,performance and procurement process including but not limited to project design,bid specifications,(bid/proposal)submittals,activities of EyeMed,its officers,agents and employees, lobbyists, Employer staff and elected officials to ensure compliance with the contract documents and to detect fraud and corruption. Pursuant to Section 2-378 of the City Code, the Employer is allocating a percentage of its overall annual contract expenditures to fund the activities and operations of the Office of Inspector General. 3 Upon ten (10) days written notice to EyeMed, EyeMed shall make all requested records and documents available to the Inspector General for inspection and copying. The Inspector General is empowered to retain the services of independent private sector auditors to audit,investigate,monitor,oversee,inspect and review operations activities,performance and procurement process including but not limited to project design, bid specifications, (bid/proposal)submittals, activities of 10.1999-EyeMed/FAA—EMPLOYER/NON-ERISA AGREEMENT I PROPRIETARY DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-525B7161CC3F EyeMed its officers, agents and employees, lobbyists, City staff and elected officials to ensure compliance with the contract documents and to detect fraud and corruption. 4. The Inspector General shall have the right to inspect and copy all documents and records in EyeMed's possession,custody or control which in the Inspector General's sole judgment,pertain to performance of the contract,including, but not limited to original estimate files, change order estimate files, worksheets, proposals and agreements from and with successful subcontractors and suppliers, all project-related correspondence, memoranda, instructions, financial documents, construction documents, (bid/proposal) and contract documents, back-change documents, all documents and records which involve cash,trade or volume discounts,insurance proceeds,rebates,or dividends received,payroll and personnel records and supporting documentation for the aforesaid documents and records. 5. EyeMed shall make available at its office,at all reasonable times, the records,materials,and other evidence regarding the acquisition(bid preparation)and performance of this Agreement,for examination,audit,or reproductior•until three (3) years after final payment under this Agreement or for any longer period required by statute or by other clauses of this Agreement.In addition: i. If this Agreement is completely or partially terminated,EyeMed shall make available records relating to the work terminated until three(3)years after any resulting final termination settlement;and ii. EyeMed shall make available records relating to appeals or to litigation or the settlement of claims arising under or relating to this Agreement until such appeals,litigation,or claims are finally resolved. 6. The provisions in this section shall apply to EyeMed, its officers, agents, employees, subcontractors and suppliers. EyeMed shall incorporate the provisions in this section in all subcontracts and all other agreements executed by EyeMed in connection with the performance of this Agreement. 7. Nothing in this section shall impair any independent right to the Employer to conduct audits or investigative activities.The provisions of this section are neither intended nor shall they be construed to impose any liability on the Employer by EyeMed or third parties. Q. E-Verify 1. To the extent that EyeMed provides labor,supplies,or services under this Agreement, EyeMed shall comply with Section 448.095, Florida Statutes, "Employment Eligibility"("E-Verify Statute"), as may be amended from time to time. Pursuant to the E-Verity Statute,commencing on January 1, 2021,EyeMed shall register with and use the E-Veriy system to verify the work authorization status of all newly hired employees during the Term of the Agreement. Additionally,EyeMed shall expressly require any subcontractor performing work or providing services pursuant to the Agreement to likewise utilize the U.S. Department of Homeland Security's E-Veiny system to verify the employment eligibility of all new employees hired by the subcontractor during the contract Term. If EyeMed enters into a contract with an approved subcontractor,the subcontractor must provide EyeMed with an affidavit stating that the subcontractor does not employ, contract with, or subcontract with an unauthorized alien. EyeMed shall maintain a copy of such affidavit for the duration of the contract or such other extended period as may be required under this Agreement. 2. TERMINATION RIGHTS. a. It the Employer has a good faith belief that EyeMed has knowingly violated Section 448.09(1),Florida Statutes,which prohibits any person from knowingly employing,hiring,recruiting,or referring an alien who is not duly authorized to work by the immigration laws or the Attorney General of the United States,the Employer shall terminate this Agreement with EyeMed for cause,and the Employer shall thereafter have or owe no further obligation or liability to EyeMed. b. If the Employer has a good faith belief That a subcontractor has knowingly violated the foregoing Subsection 1,but EyeMed otherwise complied with such subsection,the Employer will promptly notify EyeMed and order EyeMed to immediately terminate the contract with the subcontractor. EyeMed's failure to terminate the contract with the subcontractor shall be an event of default under this Agreement,entitling the Employer to terminate this Agreement for cause. e. A contract terminated under the foregoing Subsection(2)(a)or(2xb)is not in breach of contract and may not be considered as such. d. The Employer or EyeMed or a subcontractor may fife an action with the Circuit or County Court to challenge a termination under the foregoing Subsection(2Xa)or(2xb)no later than 20 calendar days after the dale on which the contract was terminated. e. If Employer terminates the Agreement with EyeMed under the foregoing Subsection(2xb), EyeMed may not be awarded a public contract for at least 1 year after the date of termination of this Agreement. f. EyeMed is liable for any additional costs incurred by the Employer as a result of the termination of this Agreement under this Section Q. R. EyeMed's Compliance With Florida Public Records Law 1. EyeMed shall comply with Florida Public Records law under Chapter 119.Florida Statutes,as may be amended from time to time. 2. The term'public records"shall have the meaning set forth in Section 119.011(12).which means all documents, papers,letters,maps,books,tapes,photographs,films,sound recordings.data processing software,or other material,regardless of the physical form.characteristics,or means of transmission,made or received pursuant to law or ordinance or in connection with the transaction of official business of the City 3. Pursuant to Section 119.0701 of the Florida Statutes,if EyeMed meets the definition of'Contractor'as defined in Section 119.0101(1)(a),EyeMed 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 10-1999-EyeMed/FAA—EMPLOYER/NON-ERISA AGREEMENT 1 PROPRIETARY DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID AE3FA6F3-48C3-4F97-A7A4-525B7161CC3F 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 EyeMed does not transfer the records to the Employer. d. Upon crimple:on of the Agreement, transfer, at no cost to the Employer, all public records in possession of EyeMed or keep and maintain public records required by the Employer to perform the service.If EyeMed transfers all public records to the Employer upon completion of the Agreement. EyeMed Shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements.If EyeMed keeps and maintains public records upon completion of the Agreement, EyeMed shall meet all applicable requirements for retaining public records All records stored electronically must be provided to the Employer,upon request front the Employer's custodian of public records,in a format that is compatible with the information technology systems of the Employer. 4 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 EyeMed of the request,and EyeMed must provide the records to the Employer or allow the records to be inspected or copied within a reasonable time, n. EyeMed's failure to comply with the Employer's request for 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.EyeMed who fails to provide the public records to the Employer within a reasonable time may be subject In penalties under s. 5. CIVIL ACTION. a. If a civil action is filed against EyeMed to compel production of public records relating to the Employers contract for services,the court shall assess and award against EyeMed the reasonable costs of enforcement,including reasonable attorneys'fees,if: 1 The court determines that EyeMed unlawfully refused to comply with the public records request within a reasonable lime;and 2. At least 8 business days before filing the action,the plaintiff provided written notice of the public records request,Including a statement that EyeMed has not complied with the request,to the Employer and to EyeMed b. A notice complies with subparagraph(aX2)If it is sent to the Employer's custodian of pt,blic records and to EyeMed at EyeMed's address listed on its contract with the Employer or to EyeMed's registered agent.Such notices must be sent by common carrier delivery service or by registered. Global Express Guaranteed,or certified mall, with postage or shipping paid by the sender and with evidence of delivery,which may be in an electronic format. c. if EyeMed comphes with a public records request within 8 business days after the notice is sent is not liable for the reasonable costs of enforcement 6. IF EYEMED HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONSULTANT'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@MIAMIBEACHFL.GOV PHONE: 305-673-7411 10-1999-EyeMedlFAA—EMPLOYER/NON-ERISA AGREEMENT/PROPRIETARY Page 11 DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 IN WITNESS WHEREOF.the undersigned have executed this Agreement. EyeMMeedVision Care,t_I.,C First American Administrators,Inc. By: `-" ✓� By ‘a2 Name: Jason Rome Name: Jason Rome Title: Senior Vice President Title: Senior Vice President Date: October 4,2022 Date- October 4,2022 1 City of Miami oh By. G+/� Name: A T.HMIs Title- City Manager Date: 412 I Z2—_ Attes)ad-DocuSigned by: BY. \---F.1388.0aggRi4C Name: Rafael E.Granado Title: City Clerk 10/14/2022 I 3:15 EDT Date: APPROVED AS TO FORM&LANGUAGE FOR UTION au�v E 2 2 fey Attorney r r Date 10-1999-EyeMedIFAA--EMPLOYLR/NON-EKISA AGRF F MF.NI ;f'ROF'I IE TARY Page 12 DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-525B7161CC3F EXHIBIT A -DEFINITIONS DEFINITIONS The following terms used in this Agreement shall have the meaning as set forti hereafter A. "Agreement"shall mean the Fee for Service Agreement between EyeMed and/or FAA and Employer B. "Business Days"shall mean a day when EyeMed and/or FAA and Employer are open for business,excluding Saturday and Sunday. C. "HIPAA"shall mean Health Insurance Portability and Accountability Act of 1996. D. "Members"shall mean the Participant and eligible dependents who have health benefits under the Plan. E. "PHI"shall mean Protected Health Information. F. "Participants"shall mean the individual who has an employment arrangement,contractual arrangement,or affiliation with Employer. G. Participating Provider" shall mean the ophthalmologists, optometrists, opticians, and retail optical locations who are contracted with EyeMed to deliver services consisting of vision exams,materials,and contact lenses,at negotiated prices. H. "Plan"shall mean the plan established by the employer or other entity for self-funding vision benefits. "Plan Administrator"shall mean the employer named in the plan document as responsible for day-to-day operations. Also known as the Employer. J. "Employer"shall mean the entity that sponsors the vision plan. K. "Vision Benefit"shall mean the vision benefit as set forth on Exhibit B available to Members from Participating Providers. L. 'Vision Network"shall mean the collection of Participating Providers; the specific network as identified on Exhibit B. 10-1999- EyeMed/FAA—EMPLOYER/NON-ERISA AGREEMENT/PROPRIETARY Page 13 DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign E.nvalnpe ID AE3FA6F3-48(;3-4F97-A7A4-525B71&1CC31= EXHIBIT B—BENEFIT SCHEDULE—PAGE 1 eye City of Miami Beach meaVISION CARE IN-NETWORK OUT-OF-NETWORK SERVICES MEMBER COST MEMBERBERREIMBURSEMENT EXAM SERVICES Exam a/Pt US Crowder& SU cob", UPtoWit Exam $0 copay Up to 528 PropocodBonefilc Fa end Follow-up Stenderd $0 repay contact lens ft and Iwo toaow'upvisits Up to$40 F4led Follow-up Premium SO copes 10%off relad once Then apply$40 allowance Up to S40 Option Eye360 FRAME Exam a Materials Any available frame el PLUS Providers $u curray,lot!,al bats nee over Sinel allowance up to S/5 Select Network Frame S0 copay:20%off balance over$150 allowance Up to$75 ASO CONTACT LENSES Employee Paid (Contact Lens allowance includes materials only) Funded Benefits Contacts-Conventional S0 copay.15%off balance over S150 allowance Up to$120 Contacts-Disposable S0 copay:100%of balance over$150 allowance Up to$120 Contacts-MedicaNy Necessary $0 copay paid-in-kill Up to$200 ri,(41O11Cy STANDARD PLASTIC LENSES Single Vision $10 coney Up to$18 Bifocal $10 copay Up to$32 Examination Trifocal $10 copay Up to$56 Once every plan year Lenticular $10 copay Up to$56 Lenses lin lieu of con(actst Progressive-Standard $10 copay Up to S77 Once every plan year Progressive-Premium $10 copay.20%off retail price less S120 allowance Up to$77 Contacts fin Ileu of tensest LENS OPTIONS Once every plan year Anti Reflective Coaling-Standard SO copay Up to$32 • a e Pdycarbonale-Standard $0 copay Up to S28 Once every plan year Scratch Coating-Standard Plastic SO copay Up to S11 Tint•Sold and Grittier l $0 copay Uplo$11 1 n r r,;, UV Treatment SO copay Up to$11 Contract Tarn'. 48 months Rate Guarantee 48 months MONTHLY RATES Per Subscriber Per.Mohth.. ,.. .-50:52. . _ Monthly Rate is subject to adjustment even during a rate guarantee period in the event of any of the following events.changes In benefits.employee contributions.the number of eligible employees,or the imposition of any new taxes,fees or assessments by Federal or Stele regulatory agencies.The Plan reserves the right to make changes to the products available on each her All prodders are not required to carry all brands on all tiers For current fisting of brands by tier,call 866.939.3633. PLAN DETAILS Quote for group sitused In the Stale of FL and will be valid until the 10/012022 implementation dale.Date Ducted 05/05/2022.Rates are valid only when the quoted plan is the sole stand-alone vision plan offered by the group. ELAN EXCLUSIONS/LIMITATIONS No benefits will be paid for services or materials connected with or charges arising from:medical or surgical treatment,services or supplies for the Treatment of the eye eyes or supporting structures.Refraction.when not provided as pen of a Comprehensive Eye Examination.services provided as a result of any Workers' Compensation law,or similar legislation.or required by any governmental agency or program whether federal.slate or subdivisions(hereof.orthoptic or vision training, subnormal vision aids and any associated supplemental testing:Anlseikonic lenses:any Vision Examination or any corrective Vision Materials required by a Policyholder as a condition of employment,safely eyewear solutions.cleaning products or frame cases,non-prescription sunglasses.piano(non-prescription)lenses plan(non-presMption)contact lenses:two pair of glasses In lieu of bifocals,electronic vision devices:services rendered alter the date an Insured Person ceases to be covered under the Policy.except when Vision Materials ordered before coverage ended are delivered.and the services rendered loth*Inswed Person are within Si days wan the date of such order,or lost or braken lenses.frames.glasses.or contact lenses that are rexaced before the next Benefit Frequency when Vision Materials would next become available.Fees charged by a Provider for services ether than a covered benefit and any local.state or Federal taxes must be paid in full by the Insured Person to the Prodder.Such fees.taxes or materials are not covered under the Policy Allowances provide no remaining balance for future use within the same Benefit Frequency.Some provisions.benefits.exclusions or limitations listed herein may vary by state. By signing below,the Group agrees to receive all documents and correspondence electronically and that the Group can access the Internet or the email address provided The Group understands that the Group may revoke this authorization or request specific paper documents without revoking this authorization by contacting EyeMed by melt email.or telephone If City of Miami Beech has chosen this benefit design.attach this document to the group application and sign here Signature Date P201603 TC-0 0.00039611-QL-0000067022 10-1999-EyeMetl/FAA—EMPLOYER/NON-EIRISA AGREEMENT,PROPRIETARY f'age 14 DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-525B7161CC3F EXHIBIT B-BENEFIT SCHEDULE-PAGE 2 City of Miami Beach Saving our members some extra green Vo'a'v:committed to firer r.cr morcy in out ro rrrbors'pockets rya rs wily we offer o. 'r•iters additional discounts above the proposed plan benefits ADDITIONAL DISCOUNTS V16tON CARE IN•NETWORI( u,h r 'h n,r.�„� SERVICES MEMBER COST DISCOUNTED EXAM SERVICES 40% off ntldifinnnr tuns or glosses revs a 1 h% Itatmat imaging Up to$39 discount on conventional lenses once DISCOUNTED LENS OPTIONS funded benefit Is used-an industry exclusive Pholochramlc-Non-Glass 20%off retail price 20% off any arm riot covered by the plan OTHER ADD-ON SERVICES AND MATERIALS 20%off retail price including non-prescription sunglasses Lasik Laser d PRK front US Laser Network 15%off retail price a 5%off promotional price Hearing Care Through Amplifon Hearing Health Care Network.members receive up 10 64%off hearing aids. an extended warranty, and free batteries DISCOUNT DETAIL. Member receives a 20%discount on items not covered by the plan at EyeMed In-Network locations,Discount does not apply to EyeMed Provider's professional services. or contact lenses.Plan discounts cannot be combined with any other discounts or promotional offers.In certain states members may be required to pay the full retail rate and not the negataled discount rate with certain participating providers.Please see EyeMed's online provider locator to determine which participating providers have agreed to the discaueted rate Discounts on vista"waterier,may Trot be applicable locertem m,nufeclwers'products The Plan reserves the right to mate changes to the products on each tier and the member out-of-pocket costs.Fixed pricing is reflective of brands at the listed product levet.NI providers are not required to carry all brands al ail levels.Service and amounts listed above are subject to change at any time 10.1999-EyeMedlFAA—EMPLOYER f NON•ERISA AGREEMENT PROPRIETARY Page 15 DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-52587161CC3F EXHIBIT C-GENERAL TERMS OF USE FOR EYEMED TRADEMARKS, SERVICE MARKS AND LOGOS These general terms of use("General Terms")are for Employer intending to use the EyeMed trademark or service marks (the'Marks"),or logos(the"Logos-)(collectively,the"Portfolio')to provide information regarding EyeMed Vision Care,LLC "(EyeMed")or EyeMed vision benefits plan,or for network providers wishing to use the Portfolio to confirm that they accept EyeMed plan members(collectively the"Purposes"). The Marks,Logos or Portfolio is attached hereto as Attachment 1. EyeMed's Portfolio is therefore extremely valuable because it symbolizes the standards of excellence and consistent quality asso08ted with EyeMed vision plans By using any element of the Portfolio,in whole or in part,Employer' 1 agrees to adhere to(i)the Usage Guidelines as set forth on Attachment 2,and(it)the Logo Principles as set forth on Attachment 3; 2. agree not to use, or to cease using, any EyeMed service mark, trademark or logo other than the marks, trademarks and logos provided as part of this agreement 3. agree to enter into a non-exclusive, non-transferable. royalty-free license for the limited right to use the Portfolio solely for the Purposes under these General Terms and according to the guidelines provided with the Marks. Logos or Portfolio,which may be unilaterally modified from time to time by EyeMed, 4. acknowledge that EyeMed,its aftdrates or their licensors are the sole owners of the Portfolio; 5 acknowledge that the goodwill derived from using any element of the Portfolio inures exclusively to the benefit of and belongs to EyeMed,its affiliates or their licensors,as applicable. 6 agree not to(i)interfere with such ownership rights in the Portfolio,inciuding challenging the use,registration of,or any application to register any element of the Portfolio(alone or in combination with other elements),anywhere in the world,(ii)apply for registration of any element of the Portfolio(atone or in combination with other elements)(n) do any act that could invalidate the registration of any element of the Portfolio,and(iv)harm,misuse,or bring into disrepute any element of the Portfolio, 7 acknowledge that, except for the limited right to use the Portfolio as expressly permitted under these General Terms,no other rights of any kind are granted hereunder,by implication or otherwise, 8 agree to include in all the uses of the Portfolio the following statement 'EyeMed Vision Care is a registered trademark of EyeMed Vision Care,LLC.' at least once in the document in which the Portfolio is included. 9. agree to submit appropriate samples of the use of the Marks and Logos upon request by EyeMed,for EyeMed's inspection and review;and 10 acknowledge that the limited rights granted under these General Terms can be terminated at any time without cause by EyeMed. 10-1999-EyeMed/FAA—EMPLOYER/NON-ERISA AGREEMENT I PROPRIETARY Page 16 DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-525B7161CC3F ATTACHMENT 1-CAMERA READY LOGO Color yr, m e al Grayscale � eve Q I 1 1 Ly 1 1J C.) CKl. frl ea 10-1999-EyeMed/FAA—EMPLOYER/NON•ER1SA AGREEMENT I PROPRIETARY Page 1 DocuSign Envelope ID:1BDE0DE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID.AE3FA6F3-48C3-4F97-A7A4-52587161CC3F ATTACHMENT 2-USAGE GUIDELINES A. Authorized Usage 1. Generic Names: You must set any element of the Marks apart from the service it is associated with by always using the generic name of the service along with the Marks(e.g. correct. "we offer EyeMed Vision Can!'vision wellness plans"incorrect:"we offer EyeMed Vision Care'5"). 2 Appropriate Trademark Symbols: You must use appropriate symbols for any Marks (e.g.. correct: EyeMed Vision Carew,EyeMedsM;incorrect:EyeMed Vision Care or EyeMed Vision Care'""). 3. Distinguishing the Marks:You must set any Marks or Logos apart from the text it is surrounded by.For the Marks you may not use underlining, italic type,or bold type for the name(e.g. incorrect: EyeMed Vision Care, EyeMed Vision Care*,EyeMed Vision Care.). 4. Displaying the Logos: See the attached Attachment B for additional requirements, including. color, clear space around the logo,sizing,format,spelling and examples of incorrect usage 5. Advertising: Use of the Portfolio is permitted in all forms of print advertising. Any element of the Portfolio may only be used once in each copy. It can be placed anywhere in the copy,but should never exceed 10%of the size of the ad The marks may be used in your office window.A window decal will be prcvided to you by EyeMed 6 Link to EyeMed Website: If expressly authorized in willing by EyeMed, you may place a text link to the EyeMed website(wow eyemed.com),so long as the link a is proceeded by appropriate wording such as"This way to eyemed corn" b delivers users to the EyeMed webpage at www.eyemed.com, c. provides users with 'point and click" feature clearly indicating the link will lead to the EyeMed homepage at ww v eyemed.com, d does not suggest or imply any affiliation,endorsement or sponsorship of the linking site by EyeMed;and e. delivers the EyeMed content in its own browser. B. Unauthorized Usage 1. Company,Product,Service and Domain Name: You may not use or register,in whole or in part,any element of the Portfolio or any potentially confusing variation thereof, as or as part of a company name, trade name, product name, service name,or domain name.You may not place your company name,trademark,service mark,or product name,or that of a third-party,next to,or combine them with any element of the portfolio 2. Variations, Takeoffs or Abbreviations: You cannot use any variation, phonetic equivalent, foreign language equivalent,takeoff,or abbreviation of any element of the Portfolio for any purpose 3. Disparaging Manner:You may not use any element of the Portfolio in a disparaging manner. 4. Endorsement or Sponsorship: You may not use any element of the Portfolio in a manner that would imply an unwarranted affiliation with or endorsement,sponsorship,or support of your own services or any non-EyeMed services. 5. Merchandise Items: You may not manufacture, sell or give-away merchandise items, including but not limited to T- shirts and mugs,bearing any element of the Portfolio unless expressly au;horized in writing by EyeMed 6. Advertising: You may not use the Portfolio in television,radio or billboard advertising. 7. EyeMed's Trade Dress:You may not imitate the distinctive website design or trade-dress belonging to EyeMed 8. Protected Slogans and Tagilnes:You may not use or imitate any EyeMed slogan or taglrne 10-1999•EyeMed/FAA—EMPLOYER I NON-ERISA AGREEMENT 1 PROPRIETARY Page 18 DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-525B7161CC3F ATTACHMENT 3-LOGO PRINCIPLES Nice to see you Our logo principles Aprl 2013 eye th,44 eri Logo Wfmwy f699 eye DC-VS caned around ownhg the deo of the eye.both n amphos'zing the word and referencing the eye shape, the logotype oolances cr sp prec s'on w th a fr endly att tilde It may even w nk of med got 1 from t me to tine ornery ThS aloryxl grew.and woe W90 es the greolesl represenloton of our Mprv1 pursonO.ty ontl mould Oa used os our pnmwy Klentny on 96%or our motermis Groycww USedd on oro stole-pr.nteo opptnot.ons Groyscae ye • . _ 1 4' 10-1999-EyeMedVFAA--EMPLOYER f NON-ERISA AGREEMENT I PROPRIETARY Page 19 DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-525B7161CC3F • Logo clear spore The EyeMed logo should • I I l always appear as clearly and ! _ - consistently as pass ble Ith - shoir d never compete w t - - other graph c elements or any sort of v sual c k ittel dear space I i l l I Maumee site „ I Minimum See eye LOmm Brand name EyeMed is written as one word. The way we treat a k brond name"EyeMed'when I's written or set n copy s,ust as hnportont os the way we treat Use an n t al cop tol for both the"E'•and••M' the logo Keep EyeMed the same weight os other text ea.µ i.154 hlnv�t Use all lowercase-eyemed Use all uppercase-EYEMED Make EyeMed bolder than other text wnen do.use EyeMeo vts:om Core' Use a hyphen Eye-Med Use talic zed letters EyeMed W liet model the VN1 10-1999-EyeMed/FAA—EMPLOYER 1 NON-ERISA AGREEMENT?PROPRIETARY Page 20 DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-52587161 CC3F Logo-sizing Sz ng and plot ng our logo cons stently across l ke common cot ons helps convey our profess ono' cons dered approach Hoof do take the logotype? Whore eo i pow tho loge'+ • Mwta(or.IgN to tN*Op? What Ma londs[ope formate, eye Mad .r t Logo eVeWe Ike or rt logo ust the wuy t eve 2 eve 7 t Altrrtry t plat ny d ► €1 1 Mac! me, 777��C1C1C1{{{}`(((.rr}7`f}tt}} way that makes t ale _I •`•�t only dim nShes lS value and makes us look:inprofessonol. so is really best not to mess w th t %%or.aol too. _ eve e Hey Y „ ..�x Da net De net Do not l 1 Do not Do not ( Do not no Oe t Met 10.1999•EyeMerl/FAA—EMPLOYER I NON-ERISA AGREEMENT/PROPRIETARY Page 21 DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-525B7161CC3F EXHIBIT 0—BUSINESS ASSOCIATE AGREEMENT Definitions A. In General. Terms used, but not otherwise defined, in this Agreement shall have the same rieaning as those terms in 45 CFR§§160.103 and 164.501. B. Specific Definitions 1. "Applicable Law"shall mean any of the following items,including any amendments:o any such item as such may become effective: a. the Health Insurance Portability and Accountability Act of 1996('HIPAA"); b. the federal regulations regarding privacy and promulgated with respect to HIPAA, found at Title 45 CFR Parts 160 and 164(the"Privacy Rule"); c. the federal regulations regarding electronic data interchange and promulgated with respect to HIPAA,found at Title 45 CFR Parts 160 and 162(the"Transaction Rule'); d the federal regulations regarding security and promulgated with respect to HIPAA, found at Title 45 CFR Parts 160 and 164(the"Security Rule"):and e. the Health Information Technology for Economic and Clinical Health Act("HITECH'). 2. "Business Associate" shall mean EyeMed Vision Care, LLC ("EyeMed") and First American Administrators("FAA"),on behalf of themselves and their affiliates 3. 'Covered Entity"shall mean the City of Miami Beach,on behalf of itself or on behalf of its group health plans,as applicable. 4. "ePHI"means electronic protected health information within the meaning of 45 CFR§160.103, limited to the information created, received, maintained, or transmitted by Business Associate from or on behalf of Covered Entity. 5. "HIPAA Breach"shall have the same meaning as the term"breach"in 45 CFR§164 402. 6. "Protected Health Information"or'PHI" shall have the same meaning as the term "protected health information" in 45 CFR § 160.103, limited to the information created, received, maintained,or transmitted by Business Associate from or on behalf of Covered Entity. 7. "Service Agreement" shall mean the Fee for Service Agreement or other agreement for the provision of services by Business Associate that is between Covered Entity and/or Employer and Business Associate. 8. "Unsecured PHI" shall have the same meaning as the term "unsecured protected health information"in 45 CFR§ 164.402, limited to the information created, received, maintained, or transmitted by Business Associate from or on behalf of Covered Entity. II. Rights and Obligations of Business Associate A. General Obligations 1. Compliance with Privacy Rule. a. Business Associate shall not use or further disclose PHI other than as permitted or required by HIPAA,the Privacy Rule,and this Agreement. b. Business Associate shall use appropriate safeguards to prevent use or disclosure of the PHI other than as provided for by this Agreement. c. Business Associate shall report to Covered Entity any use or disclosure of PHI,known to Business Associate,that is not permitted by this Agreement. 10.1999-EyeMedIFAA—EMPLOYER/NON-ERHSA AGREEMENT I PROPRIETARY PAW IZ DocuSign Envelope ID: 1 BDEODEI-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-525B7161CC3F 2. Compliance with Security Rule. a. Business Associate shall implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality,integrity,and availability of ePHI. b. Business Associate shall report to Covered Entity any Security Incident of which Business Associate becomes aware. Notwithstanding the foregoing, Unsuccessful Security Incidents(as defined below)for which no additional notice to Covered Entity shall be required. `Unsuccessful Security Incidents"shall include, but not be limited to, pings and other broadcast attacks on Business Associate's firewall, port scans, unsuccessful log-on attempts,denials of service and any combination of the above,so long as no such incident results in unauthorized access,use or disclosure of PHI. 3. Compliance with HITECH. a. Business Associate shall comply with the breach notification requirements provided in Section II.A.4 of the Agreement below. b. Business Associate shall not receive remuneration, either directly or indirectly, in exchange for PHI, except as may be permitted by HITECH § 13405(d) and the Privacy Rule. c. Business Associate shall comply with those portions of the Privacy Rule made applicable to Business Associate by HITECH. d. Business Associate shall comply with those portions of the Security Rule made applicable to Business Associate by HITECH. 4. Breach Notification. a. Notice to Covered Entity. Business Associate shall notify Covered Entity without unreasonable delay and within thirty (30) calendar days of Business Associate's discovery of a HIPAA Breach of Unsecured PHI. The notice to Covered Entity shall include the identity of each Individual whose Unsecured PHI was involved in the HIPAA Breach,a brief description of the HIPAA Breach and any mitigation efforts To the extent that Business Associate does not know the identities of all affected Individuals when it is required to notify Covered Entity, Business Associate shall provide such additional information as soon as administratively practicable after such information becomes available. For purposes of this paragraph, a HIPAA Breach shall be treated as discovered as of the 9rst day on which the HIPAA Breach is known or should reasonably have been known to Business Associate(including any person, other than the one committing the HIPAA Breach, which is an employee, officer, or other agent of Business Associate). b. Notice to Individuals. Business Associate will provide written notice of the HIPAA Breach of Unsecured PHI,on behalf of Covered Entity, without unreasonable delay but no later than sixty (60)calendar days following the date the HIPAA Breach of Unsecured PHI is discovered or such ater date as is authorized under 45 CFR § 164.412 to each Individual whose Unsecured PHI has been,or is reasonably believed by Business Associate to have been,accessed, used,or disclosed as a result of the HIPAA Breach. For purposes of this paragraph,a HIPAA Breach shall be treated as discovered as of the first day on which the HIPAA Breach is known or should reasonably have been known to Business Associate(including any person,other than the one committing the HIPAA Breach, which is an employee,officer,or other agent of Business Associate). The content,form,and delivery of such written notice shall comply in all respects with 45 CFR§164.404(c)-(d). Business Associate and Covered Entity shall cooperate in all respects regarding the drafting and the content of the notice. To that end,before sending any notice to any Individual, Business Associate shall first provide a draft of the notice to Covered Entity. Covered Entity shall have five (5) business days (plus any reasonable extensions)to provide comments on Business Associate's draft of the notice. 10-1999-EyeMed/FAA—EMPLOYER I NON-ERISA AGREEMENT I PROPRIETARY Page 2:t DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3.4F97-A7A4-525B7161CC3F c. Notice to Media. Business Associate will provide written notice of the HIPAA Br of Unsecured PHI, on behalf of Covered Entity, to the media to the exte0t.regetrailif under 45 CFR§164.406. Business Associate and Covered Entity shall clapataleati all respects regarding the drafting and the content of the notice. To that EVrid,before sending any notice to the Secretary, Business Associate shall first provide a draft of the notice to Covered Entity. Covered Entity shall have five(5)business days(plus any reasonable extensions)to provide comments on Business Associate's draft of the notice. d. Notice to Secretary. Business Associate will provide written notice of the HIPAA Breach of Unsecured PHI,on behalf of Covered Entity,to the Secretary to the extent required under 45 CFR § 164.408. Business Associate and Covered Entity shall cooperate in all respects regarding the drafting and the content of the notice. To that end,before sending any notice to the Secretary,Business Associate shall first provide a draft of the notice to Covered Entity. Covered Entity shall have five business days (plus any reasonable extensions)to provide comments on Business Associate's draft of the notice. If the HIPAA Breach of Unsecured PHI involves loss than five hundred (500) individuals, Business Associate will maintain a log or other documentation of the HIPAA Breach of Unsecured PHI which contains such information as would be requred to be included if the log were maintained by Covered Entity pursuant to 45 CFR§164 408,and provide such log to Covered Entity within five(5)business days of Covered Entity's written request. 5. Subcontractors and Agents. Business Associate shall ensure that any agent, including a subcontractor,to whom it provides PHI agrees in writing to the same restrictions and conditions that apply through this Agreement to Business Associate with respect to such PHI. 6. Access to Books and Records by Secretary. Business Associate shall make its internal practices, books, and records relating to the use, disclosure, and security of PHI available to the Secretary for purposes of the Secretary determining Covered Entity's compliance with HIPAA. Business Associate shall make its internal practices,books,and records relating to the use, disclosure, and security of PHI available to the Secretary for purposes of the Secretary determining Business Associate's compliance with HIPAA. 7. Mitigation. Business Associate shall mitigate,to the extent practicable, any harmful effect that is known to Business Associate of(a)a use or disclosure of PHI by Business Associate in violation of the requirements of this Agreement,or(b)a Security Incident. B. Obligations Relating to Individual Rights 1. Restrictions on Disclosures. Upon request by an Individual, Covered Entity shall determine whether an Individual shall be granted a restriction on disclosure of the PHI pursuant to 45 CFR §164.522. Covered Entity will not agree to any such restriction,if such restriction would affect Business Associate's use or disclosure of PHI,without the prior consent of Business Associate, provided,however,that Business Associate's consent is not required for requests that must be granted under HITECH§ 13405(a). Covered Entity will communicate any grant of a request. made consistent with the foregoing,to Business Associate. Business Associate will restrict its disclosures of the Individual's PHI in the same manner as would be required for Covered Entity. If Business Associate receives an Individual's request for restrictions,Business Associate shall forward such request to Covered Entity within five(5)business days. 2 Access to PHI. Upon request by an Individual, Covered Entity shall determine whether an Individual is entitled to access his or her PHI pursuant to 45 CFR§164,524. If Covered Entity determines that an Individual is entitled to such access,and that such PHI is under the control of Business Associate, Covered Entity will communicate the decision to Business Associate. Business Associate shall provide access to the PHI in the same manner as would be required for Covered Entity. If Business Associate receives an Individual's request to access his or her PHI, Business Associate shall forward such request to Covered Entity within five(5)business days. 10.1999-EyeMed/FAA—EMPLOYER/NON•ERISA AGREEMEN i 1 PROPRIETARY PNe 21 DocuSign Envelope ID:1BDE0DE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-52587161CC3F 3. Amendment of PHI. Upon request by an Individual, Covered Entity shall determine whether any Individual is entitled to amend his or her PHI pursuant to 45 CFR§ 164.526. If Covered Entity determines that an Individual is entitled to such an amendment,and that such PHI is both in a designated record set and under the control of Business Associate, Covered Entity will communicate the decision to Business Associate. Business Associate shall provide an opportunity to amend the PHI in the same manner as would be required for Covered Entity. If Business Associate receives an Individual's request to amend his or her PHI, Business Associate sha I forward such request to Covered Entity within five(5)business days. 4. Accounting of Disclosures. Upon request by an Individual, Covered Entity shall determine whether any individual is entitled to an accounting pursuant to 45 CFR§ 164.528. If Covered Entity determines that an Individual is entitled to an accounting, Covered Entity will communicate the decision to Business Associate. Business Associate will provide information to Covered Entity that will enable Covered Entity to meet its accounting obligations. If Business Associate receives an Individuals request for an accounting,Business Associate shall forward such request to Covered Entity within five(5)business days. C. Permitted Uses and Disclosures by Business Associate Except as otherwise limited in this Agreement or by Applicable Law,Business Associate may: 1. Use or disclose PHI to perform functions, activities, or services for or on behalf of Covered Entity, as specified in the Service Agreement between the Parties and in this Agreement, provided that such use or disclosure(i)is consistent with Covered Entity's Notice of Privacy Practices and(ii)would not violate HIPAA or the Privacy Rule if done by Covered Entity; 2. Use PHI for the proper management and administration of Business Associate or to carry out the legal responsibilities of Business Associate; 3. Disclose PHI for the proper management and administration of Business Associate.provided that (i) Business Associate 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 was disclosed to the person, and the person notifies Business Associate of any instances of which it is aware in which the confidentiality of the information has been breached or(ii)the disclosures are Required By Law;and 4. Use PHI to provide Data Aggregation services to Covered Entity as permitted by 42 CFR § 164.504(e)(2Xi)(B). III. Rights and Obligations of Covered Entity A. Privacy Practices and Restrictions 1. Upon request, Covered Entity shall provide Business Associate with the notice of privacy practices that Covered Entity produces in accordance with 45 CFR § 164.520. If Covered Entity subsequently revises the notice,Covered Entity shall provide a copy of the revised notice to Business Associate. 2. Covered Entity shall notify Business Associate of any restriction to the use or disclosure of PHI that Covered Entity has agreed to in accordance with 45 CFR§164.522. Covered Entity shall provide Business Associate with any changes in,or revocation of,permission by an Individual to use or disclose PHI,if such changes affect Business Associate's permitted or required uses and disclosures B. Permissible Requests by Covered Entity Covered Entity shall not request Business Associate to use or disclose PHI in any manner that would not be permissible under the Privacy Rule if done by Covered Entity. IV Term and Termination A. Term. The term of this Agreement shall begin on the later of the Effective Date defined above or the effective date of the Services Agreement and shall end upon the termination of the Services Agreement or upon termination for cause as set forth in the following Section IV.B,whichever is earlier. 10-1999• EyeMed/FAA—EMPLOYER/NON-ERISA AGREEMENT?PROPRIETARY Pttcle Z) DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 DocuSign Envelope ID:AE3FA6F3-48C3-4F97-A7A4-52587161CC3F B. Termination for Cause. Upon any Party's knowledge of a material breach of this Agreement by another Party,the nonbreaching Party shall have the following rights: 1. If the breach is curable,the nonbreaching Party may provide an opportunity for the other Party to cure the breach or end the violation Alternatively, or if the other Party fails to cure the breach or end the violation, the nonbreaching Party may terminate this Agreement and the Services Agreement. 2. If the breach is not curable,the nonbreaching Party may immediately terminate this Agreement and the Services Agreement. 3. If termination is not feasible,the nonbreaching Party may report the problem to the Secretary C. Effect of Termination. 1. Except as provided in the following paragraph, upon termination of this Agreement, for any reason, Business Associate shall return or destroy all PHI within its possession or control,and all PHI that is in the possession or control of Business Associate's subcontractors or agents. Business Associate shall retain no copies of the PHI. 2, If Business Associate determines that returning or destroying the PHI is infeasible, Business Associate shall provide to Covered Entity notification of the conditions that make return or destruction infeasible. Business Associate shall extend the protections of this Agreement to such PHI and limit further uses and disclosures of such PHI to those purposes that make the return or destruction infeasible,for so long as Business Associate maintains such PHI. V Miscellaneous A. Electronic Health Records. The Parties agree that Business Associate shall not maintain any"electronic health record"or'personal health record,"as those terms are defined in HITECH, for or on behalf of Covered Entity. As such,Business Associate has no obligation to document disclosures that are exempt from the accounting requirement under 45 CFR§ 164.528(1Xi}(ix), and Covered Entity agrees not to include Business Associate on any list Covered Entity produces pursuant to HITECH§13405(eX3). B. Regulatory References. A reference in this Agreement to a section in any Applicable Law means the section in effect or as amended,and for which compliance is required. C. Amendment. The Parties agree to take such action as is necessary to amend this Agreement from time to time as is necessary for Covered Entity to comply with the requirements of Applicable Law All amendments to this Agreement,except those occurring by operation of law,shall be in writing and signed by both Parties. D. Interpretation. Any ambiguity in this Agreement shall be resolved in favor of a meaning that permits Covered Entity to comply with Applicable Law. E. Effect on Agreement. Except as specifically required to implement the purposes of this Agreement,or to the extent inconsistent with this Agreement, all other terms of the underlying Services Agreement shaH remain in force and effect. 10-1999-EyeMed/FAA--EMPLOYER f NON-ERISA AGREEMENT I PROPRIETARY Pacts 26 DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 ATTACHMENT A RESOLUTION &COMMISSION AWARD MEMO DocuSign Envelope ID 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 RESOLUTION NO. 2022-32179 A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE RECOMMENDATION OF THE CITY MANAGER, PURSUANT TO REQUEST FOR PROPOSALS (RFP) NO. 2022-320-WG FOR VISION INSURANCE BENEFITS PLAN; AUTHORIZING THE ADMINISTRATION TO NEGOTIATE WITH EYEMED VISION CARE, LLC, THE TOP-RANKED PROPOSER; AND, IF THE ADMINISTRATION IS UNABLE TO SUCCESFULLY NEGOTIATE TERMS WITH EYEMED VISION CARE, LLC, AUTHORIZING THE ADMINISTRATION TO NEGOTIATE WITH NATIONAL VISION ADMINISTRATORS, LLC, THE SECOND-RANKED PROPOSER; AND, IF THE ADMINISTRATION IS UNABLE TO SUCCESSFULLY NEGOTIATE TERMS WITH NATIONAL VISION ADMINISTRATORS, LLC, AUTHORIZING THE ADMINISTRATION TO NEGOTIATE WITH METROPOLITAN LIFE INSURANCE COMPANY, THE THIRD-RANKED PROPOSER; AND FURTHER AUTHORIZING THE CITY MANAGER AND CITY CLERK TO EXECUTE AN AGREEMENT UPON CONCLUSION OF SUCCESSFUL NEGOTIATIONS BY THE ADMINISTRATION. WHEREAS, On April 6, 2022, the Mayor and City Commission approved the issuance of RFP 2022-320-WG Vision Insurance Benefits Plan; and WHEREAS, on May 9, 2022, the City received proposals from the following three (3) firms: EyeMed Vision Care, LLC; Metropolitan Life Insurance Company; and National Vision Administrators, LLC; and WHEREAS, on May 26, 2022, the Evaluation Committee appointed by the City Manager and comprised of Marvin Adams, Employee Benefits Manager, Human Resources Department; Krystal Dobbins, Financial Analyst III, Finance Department; Kenneth Ingersoll, Compensation Manager, Human Resources Department; and Marcela Rubio, Assistant Director, Housing & Community Services, convened to consider the proposals received; and WHEREAS, the Committee was provided an overview of the project, information relative to the City's Cone of Silence Ordinance, the Government Sunshine Law, and general information on the scope of services and a copy of each proposal; and WHEREAS, the Committee was instructed to score and rank each proposal pursuant to the evaluation criteria established in the RFP; and WHEREAS, the evaluation process resulted in the proposers being ranked by the Evaluation Committee in the following order: 1st EyeMed Vision Care, LLC 2nd National Vision Administrators, LLC 3rd Metropolitan Life Insurance Company WHEREAS, after reviewing all of the submissions and the Evaluation Committee process, the City manager concurs with the Evaluation Committee and finds EyeMed Vision Care, LLC, the top-ranked firm, to be the best-qualified firm to provide a vision insurance benefits plan. DocuSign Envelope ID 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 WHEREAS, EyeMed Vision Care, LLC has provided excellent vision insurance benefits to the City as the incumbent firm for twelve years and is proposing to continue to do so; and WHEREAS, EyeMed offered the most competitive pricing and a diverse eyecare network of providers and optical retailers; and WHEREAS, the second-ranked and third-ranked firms, National Vision Administrators, LLC and Metropolitan Life Insurance Company, respectively, are well-qualified and should be considered, in order of rank, if negotiations with EyeMed Vision Care, LLC are not successful; and NOW,.THEREFORE, BE IT DULY RESOLVED BY THE MAYOR AND_CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, that the Mayor and City Commission hereby accept the recommendation of the City Manager, pursuant to request for proposals (RFP) No. 2022- 320-wg for vision insurance benefits plan; authorize the Administration to negotiate with EyeMed Vision Care, LLC, the top-ranked proposer; and, if the Administration is unable to successfully negotiate terms with EyeMed Vision Care, LLC, authorize the Administration to negotiate with National Vision Administrators, LLC, the second-ranked proposer; and, if the Administration is unable to successfully negotiate terms with National Vision Administrators, LLC, authorize the Administration to negotiate with Metropolitan Life Insurance Company,. the third-ranked proposer; :and further authorize the City Manager and City Clerk to execute an agreement upon conclusion of successful negotiations by the Administration. PASSED AND ADOPTED this a d day of J'' - 2022. ATTEST: : JUN 2 3 202�� 72 ,‘::22,,,,,_______ RAFAEL E. GRANA O, CITY:CLERK _ �?Mi'8 ,AN GELBER, MAYOR . =INEORP DRA1ED1 i ;�h_: 'a CH' 6' APPROVED AS TO FORM&LANGUAGE & FOR EXECUTION r----3 ----- 6_—)p_q_z__ City Attorney M' Date DocuSign Envelope ID 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 Competitive Bid Reports-C2 E MIAMI BEACH COMMISSION MEMORANDUM TO: Honorable Mayor and Members of the City Commission FROM: Alina T. Hudak, City Manager DATE: June 22, 2022 SUBJECT:A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE CITY OF MIAMI BEACH, FLORIDA, ACCEPTING THE RECOMMENDATION OF THE CITY MANAGER, PURSUANT TO REQUEST FOR PROPOSALS (RFP) NO. 2022-320-WG FOR VISION INSURANCE BENEFITS PLAN; AUTHORIZING THE ADMINISTRATION TO NEGOTIATE WITH EYEMED VISION CARE, LLC, THE TOP-RANKED PROPOSER; AND, IF THE ADMINISTRATION IS UNABLE TO SUCCESSFULLY NEGOTIATE TERMS WITH EYEMED VISION CARE, LLC, AUTHORIZING THE ADMINISTRATION TO NEGOTIATE WITH NATIONAL VISION ADMINISTRATORS, LLC, THE SECOND-RANKED PROPOSER; AND, IF THE ADMINISTRATION IS UNABLE TO SUCCESSFULLY NEGOTIATE TERMS WITH NATIONAL VISION ADMINISTRATORS, LLC,AUTHORIZING THE ADMINISTRATION TO NEGOTIATE WITH METROPOLITAN LIFE INSURANCE COMPANY, THE THIRD-RANKED PROPOSER; AND FURTHER AUTHORIZING THE CITY MANAGER AND CITY CLERK TO EXECUTE AN AGREEMENT UPON CONCLUSION OF SUCCESSFUL NEGOTIATIONS BY THE ADMINISTRATION. RECOMMENDATION It is recommended that the Mayor and City Commission approve the Resolution authorizing the Administration to negotiate with EyeMed Vision Care, LLC, the top-ranked proposer. If the Administration is unsuccessful in negotiating with EyeMed Vision Care, LLC, the Resolution authorizes the Administration to negotiate with National Vision Administrators, LLC, the second- ranked proposer, and Metropolitan Life Insurance Company, the third-ranked proposer, in order of rank. The Resolution also authorizes the City Manager and City Clerk to execute an Agreement upon the conclusion of successful negotiations by the Administration and the City Attorney's Office. BACKGROUND/HISTORY On July 15, 2009, the Mayor and City Commission approved Resolution 2009-27138, which authorized an agreement with EyeMed Vision Care for the City's group vision plan for employees, retirees and dependents, pursuant to a request for proposals issued by the Citys insurance consultant at that time— Gallagher Benefits Services. The contract for the vision plan currently expires September 2020. Page 48 of 1232 DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Subscribers (e.g., employees, retirees or dependents) pay a monthly premium and the City pays approximately $12,000 annually over the last three years for administrative services. The City also pays the claims. The City currently has approximately 1548 subscribers enrolled in vision insurance program. The RFP required that any proposed plan shall offer a vision network of credentialed ophthalmologists, optometrists, opticians, and retail optical centers that are geographically accessible to participants. Plan services shall at a minimum provide the following: • annual vision exams; • eyeglass exams, contact lens exams,frames, and lenses; • eye surgery or treatment for eye diseases. ANALYSIS On April 6, 2022, the Mayor and City Commission approved the issuance of RFP 2022-320- WG Vision Insurance Benefits Plan. The Procurement Department issued bid notices to approximately 6,700 companies utilizing the City's e-procurement system, with 42 prospective bidders accessing the solicitation. RFP responses were due and received on May 9, 2022. The City received proposals from the following three (3) firms: EyeMed Vision Care, LLC, Metropolitan Life Insurance Company, and National Vision Administrators, LLC. On May 26, 2022, the Evaluation Committee appointed by the City Manager convened to consider the proposals received. The Committee was comprised of Marvin Adams, Employee Benefits Manager, Human Resources Department; Krystal Dobbins, Financial Analyst III, Finance Department; Kenneth Ingersoll, Compensation Manager, Human Resources Department;and Marcela Rubio,Assistant Director, Housing &Community Services. The Committee was provided an overview of the project, and information relative to the City's Cone of Silence Ordinance and the Government Sunshine Law. The Committee was also provided with general information on the scope of services and a copy of each proposal. The Committee was instructed to score and rank each proposal pursuant to the evaluation criteria established in the RFP. The evaluation process resulted in the proposers being ranked by the Evaluation Committee in the following order(See Attachment A): 1st EyeMed Vision Care, LLC 2nd National Vision Administrators, LLC 3rd Metropolitan Life Insurance Company Following is a summary of the top three ranked firms. EyeMed Vision Care. LLC EyeMed has provided vision care benefits to the City for the last twelve years. The firm focus is on providing a vision network local to our employees, with benefits that take employee dollars further. The firm have an extensive nationwide network with the right mix of independent, national, and regional retail providers. The firm have over 30 years of vision care industry experience, translating into innovative products and stress-free Administration. Samples of relevant experience providing similar services to other public sector agencies Page 49 of 1232 DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-61 9DEB4B6A43 include the City of Lakeland, FL., and the Town of West Palm Beach, FL. National Vision Advisors. LLC (NVA) Now in its 43rd year of operation, NVA provides comprehensive vision benefit management services to clients of all types throughout the United States and Puerto Rico. NVA has worked to lower vision care costs while ensuring members receive quality care and choice through their nationwide network of eye care professionals. NVA's National Eye Care Professional Network includes over 99,000 provider location combinations including optometrists, ophthalmologists, and opticians in private practitioner offices and optical retailers. Samples of relevant experience providing similar services to public sector agencies include the City of Savanah, GA., and the City of Largo, FL. Metropolitan Life Insurance Company(MetLife) MetLife has been providing group vision benefits since 1983. The firm offers a broad range of benefits designed to meet employer and employees' needs. In addition, MetLife provides flexible coverage options and proven experience in building the right plans simple, cost- effective way. MetLife serves more than 50,000 US Group customers and 41 M US employees and dependents. Samples of relevant experience providing similar services to public sector agencies include the City of Tampa, FL.,and the City of Grand Prairie, TX. SUPPORTING SURVEY DATA Not Applicable FINANCIAL INFORMATION The City is self-insured. Subscribers (e.g., employee, retiree or dependent)pay a monthly premium of $0.52 per month and the City pays approximately $12,000 annually over the last three years for administrative services. The City also pays the claims. The City currently has approximately 1548 subscribers enrolled in vision insurance program. Claims have averaged approximately$185,000 overa the last four(4)years. In its proposal to the RFP, Eyemed offered to maintain its existing price of$0.52 per subscriber per month and improved its frame allowances as compared to the current contract. National Vision Administrators, L.L.C. proposed a per member per month price of $.55. The proposal submitted by Metropolitan Life Insurance Company was based on a fully insured plan with a guaranteed premium of $216,957.00 to the City plus a per employee per month rate of $7.25 for the employee only, or employee plus one dependent at a rate of $14.04 or employee plus family at a rate of$24.27. Amount(s)/Account(s): Admin Fees: 560-1793-000303-13-413-592-00-00-00- Claims: 560-1793-000433-13-420-592-00-00-00- CONCLUSION After reviewing all of the submissions and the Evaluation Committee process, I concur with the Evaluation Committee and find EyeMed Vision Care, LLC, the top-ranked firm, to be the best- qualified firm to provide a vision insurance benefits plan. EyeMed Vision Care, LLC has Page 50 of 1232 DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 provided excellent vision insurance benefits to the City as the incumbent firm for twelve years and is proposing to continue to do so. EyeMed offered the most competitive pricing and a diverse eyecare network of providers and optical retailers. The second-ranked and third-ranked firms, National Vision Administrators, LLC and Metropolitan Life Insurance Company, respectively, are well-qualified and should be considered, in order of rank, if negotiations with EyeMed Vision Care, LLC are not successful. For the reasons stated herein, I recommend that the Mayor and City Commission approve the Resolution authorizing the Administration to enter into negotiations with EyeMed Vision Care, LLC, as the top-ranked proposer; and, if unsuccessful, authorizing the Administration to enter into negotiations with National Vision Administrators, L.L.C., as the second-ranked proposer; and, if unsuccessful, authorizing the Administration to enter into negotiations with Metropolitan Life Insurance Company, as the third-ranked proposer. Further, the Resolution authorizes the City Manager and City Clerk to execute an Agreement upon conclusion of successful negotiations by the Administration and the City Attorneys Office. Is this a "Residents Right Does this item utilize G.O. to Know" item, pursuant to Bond Funds? City Code Section 2-14? No No Legislative Tracking Human Resources/Procurement ATTACHMENTS:_ Description ❑ Attachment A ❑ Resolution Page 51 of 1232 DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 RFP G VISiOn Insurance Benefits Plan Marvin Adorns 3 KryS I Dobblm Kannath Ingersoll Mprca4 Rubio � b a 2 Totals Qualitative Quantitative Subtotal Qualitative Quantitative Subtotal Qualitative Queriltative Subtotal Qualitative Quenlnetive Subtotal Everted Vision Care LLC 93 0 93 1 94 0 94 1 96 0 96 1 97 - 0 97 1 4 1 Metropoilan Life Insurance COMM 70 0 70 3 87 0 87 2 86 0 86 3 94 0 94 2 10 3 National Vision Administrators.L.L.C. 83 _ 0 83 2 87 _ 0 87 2 91 0 91 2 92 0 92 3_ 9 2 w • • Page 52 of 1232 DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 ATTACHMENT B ADDENDUM AND RFP SOLICITATION DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 M I A M I B E AC H PROCUREMENT DEPARTMENT 1755 Meridian Avenue,3rd Floor Miami Beach,Florida 33139 www.miamibeachfl.gov ADDENDUM NO. 1 REQUEST FOR PROPOSALS NO. 2022-320-WG VISION INSURANCE BENEFIT PLAN April 29,2022 This Addendum to the above-referenced RFP is issued in response to questions from prospective proposers, or other clarifications and revisions issued by the City. The RFP is amended in the following particulars only (deletions are shown by strikethrough and additions are underlined). I. ATTACHMENT(S): Attachment A: Employee Census File—Excel Format Attachment B: Eyemed Utilization Report through March 2022 Attachment C: Claim Lag Report II. REVISION: Section 0400 Proposal Evaluation— Paragraph 4, Cost Proposal Evaluation has been revised as follows: fa la: Sample Obiective Formula for Celt Example Maximu►r♦ Vendor Allowable-Poif s Tetat_pojats Vendor Cost Awarded Proposal noted-above,) Round-to Vender-A $100.00 20 29 VendorB $15049 20 - 1-3 Vendor C $200410 20 1-0 III. RESPONSES TO QUESTIONS RECEIVED: Q1. I wanted to touch base with you and see if the census data was available in excel format? Al. Please refer to Attachment A. Q2. Are any commissions needed to be paid to Gallagher Benefits Services? A2. Gallagher Bassett Services is no longer our consultant; it is Foundations Risk Partners. There is no commission for this benefit program. Q3. Are any fees for platform or ben admin needed?Any credits? A3. No. 1 ADDENDUM NO.1 REQUEST FOR PROPOSALS NO 2022-320-WG VISION INSURANCE BENEFIT PLAN DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 M I /\tv'\ I B EACH PROCUREMENT DEPARTMENT 1755 Meridian Avenue,3rd Floor Miami Beach,Florida 33139 www.miamibeachfl.gov Q4. What are the total eligible lives? A4. Please refer to Attachment B Utilization Report attached. Q5. Are premium equivalent rates available? A5.Vision premiums are included in the City of Miami Beach's health rates. Q6. Are monthly lives available that coincide with the claims data provided? A6. Please see the response to question 4 above. Q7. Is more recent claims data available into 2022? A7. Please refer to Attachment C Claim Lag Reports attached. Q8. How long has the group been with Eye Med? A8. The City of Miami Beach has been with EyeMed since January 1, 2010. Q9. Can the City provide Claims Experience provided monthly for the past three years.? A9. Please see the response to question 7 above. Q10. In what manner would you like the Dun & Bradstreet report delivered? The RFP states the Supplier Qualification report must be submitted by Dun & Bradstreet directly to the City. Is it acceptable for Dun & Bradstreet to email the report to the City's point of contact for the bid? A10. When requested by the City, the specified report must be provided directly to WilliamGarviso(c�miamibeachfl.gov from Dun and Brad Street within 3 days from receipt. Q11. Is there a detailed claim report available? All. Please see the response to question 7 above. 2 ADDENDUM NO.1 REQUEST FOR PROPOSALS NO 2022-320-WG VISION INSURANCE BENEFIT PLAN DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 M I A M I BE \ F-1 PROCUREMENT DEPARTMENT 1755 Meridian Avenue,3m Floor Miami Beach,Florida 33139 www.miamibeachfl.gov Q12. Can the city provide a working link for the Dun and Bradstreet SQR noted in Section 4 — Financial Capacity? Al2. Please refer to https://service.dnb.comlhome?TAB ID=TAB 02. When requested by the City,the specified report must be provided directly to WilliamGarviso a(�,miamibeachfl.gov from Dun and Brad Street within 3 days from receipt. Any questions regarding this Addendum should be submitted in writing to the Procurement Management Department to the attention of the individual named below, with a copy to the City Clerk's Office at RafaelGranado@miamibeachfl.gov Contact: Telephone: Email: William Garviso 305-673-7000 ext. 7490 WilliamGarviso@miamibeachfl.gov Proposers are reminded to acknowledge receipt of this addendum as part of your RFP submission. Potential proposers that have elected not to submit a response to the RFP are requested to complete and return the"Notice to Prospective Bidders"questionnaire with the reason(s)for not submitting a proposal. 5 rely le enis (Pro urement Director ADDENDUM NO.1 i REQUEST FOR PROPOSALS NO 2022-320-WG VISION INSURANCE BENEFIT PLAN DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 MIAMI BEACH Request for Proposals (RFP) No. 2022-320-WG Vision Insurance Benefit Plan TABLE OF CONTENTS SOLICITATION SECTIONS: 0100 INSTRUCTIONS TO PROPOSERS 0200 GENERAL CONDITIONS 0300 PROPOSAL SUBMITTAL INSTRUCTIONS & FORMAT 0400 PROPOSAL EVALUATION APPENDICES: APPENDIX A MINIMUM REQUIREMENTS & SPECIFICATIONS APPENDIX B INSURANCE REQUIREMENTS EXHIBIT A EMPLOYEE CENSUS FILE/ CURRENT BENEFIT SUMMARY/ CLAIMS REPORTS DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 AAIAMI BEACH SECTION 0100 INSTRUCTIONS TO PROPOSERS 1. GENERAL. This Request for Proposals (RFP) is issued by the City of Miami Beach, Florida (the "City"), as the means for prospective Proposers to submit their qualifications, proposed scopes of work and revenue proposals (the "proposal") to the City for the City's consideration as an option in achieving the required scope of services and requirements as noted herein. All documents released in connection with this solicitation, including all appendixes and addenda, whether included herein or released under separate cover, comprise the solicitation, and are complementary to one another and together establish the complete terms, conditions and obligations of the Proposers and, subsequently, the successful Proposer(s) (the"contractor[s]") if this RFP results in an award. The City utilizes Periscope S2G (formally known as BidSync) (www.periscopeholdinqs.com or www.bidsync.com)for automatic notification of competitive solicitation opportunities and document fulfillment, including the issuance of any addendum to this RFP. Any prospective Proposer who has received this RFP by any means other than through Periscope S2G must register immediately with Periscope S2G to assure it receives any addendum issued to this RFP. Failure to receive an addendum may result in disqualification of proposal submitted. 2. PURPOSE. The City offers as a part of its health benefits program Vision insurance through EyeMed for its benefit eligible employees, retirees, and their dependents. The City of Miami Beach is requesting proposals for a group vision insurance plan administrator. The plan is currently self-funded, and the monthly premium equivalent rate is paid entirely by the employee. The City currently has —1548 subscribers enrolled in vision insurance. An employee census file, current benefit summary, and claims reports are included with this packet(refer to Exhibit A). Proposed plans shall offer a vision network of credentialed Ophthalmologists, Optometrists, Opticians, and retail optical centers for benefit eligible employees, retirees and their dependents that are geographically accessible to participants. Plan services shall at a minimum provide the following: • A vision network of credentialed Ophthalmologists, Optometrists, Opticians, and retail optical centers that are geographically accessible to participants; • Annual vision exams; • eyeglass exams, contact lens exams, frames and lenses; • eye surgery or treatment for eye diseases. 2.1. Background. On July 15, 2009, the Mayor and City Commission approved Resolution 2009-27138 which authorized an agreement with EyeMed Vision Care for the City's group vision plan (employees and retirees), pursuant to a request for proposals issued by the City's consultant at that time—Gallagher Benefits Services. 3.ANTICIPATED RFP TIMETABLE. The tentative schedule for this solicitation is as follows: RFP Issued April 11, 2022 Pre-Proposal Meeting Not Applicable Deadline for Receipt of Questions April 29, 2022, at 5:00 pm ET Responses Due May 9, 2022, at 3:00 pm ET Join on your computer or mobile app Click here to join the meeting Or call in (audio only) +1 786-636-1480 United States, Miami Phone Conference ID: 214 995 783# Evaluation Committee Review TBD Tentative Commission Approval TBD Contract Negotiations Following Commission Approval DocuSign Envelope ID 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 MIAMI BEACH 4. PROCUREMENT CONTACT. Any questions or clarifications concerning this solicitation shall be submitted to the Procurement Contact noted below: Procurement Contact Telephone Email: William Garviso, CPPB, CPP 305 673-7490 WilliamGarviso• miamibeachfl.•ov additionally, the City Clerk is to be co•ied on all communications via e-mail at: RafaelGranado• miamibeachfl •ov; or via facsimile: 786-394-4188. The Bid title/number shall be referenced on all correspondence. All questions or requests for clarification must be received no later than ten (10) calendar days prior to the date proposals are due as scheduled in Section 0200-3. All responses to questions/clarifications will be sent to all prospective Proposers in the form of an addendum. 5. PRE-PROPOSAL MEETING OR SITE VISIT(S). Not Applicable 6. PRE-PROPOSAL INTERPRETATIONS. Oral information or responses to questions received by prospective Proposers are not binding on the City and will be without legal effect, including any information received at pre- submittal meeting or site visit(s). The City by means of Addenda will issue interpretations or written addenda clarifications considered necessary by the City in response to questions. Only questions answered by written addenda will be binding and may supersede terms noted in this solicitation. Addendum will be released through Periscope S2G. Any prospective proposer who has received this RFP by any means other than through Periscope S2G must register immediately with Periscope S2G to assure it receives any addendum issued to this RFP. Failure to receive an addendum may result in disqualification of proposal. Written questions should be received no later than the date outlined in the Anticipated RFP Timetable section. 7. CONE OF SILENCE. This RFP is subject to, and all proposers are expected to be or become familiar with, the City's Cone of Silence Requirements, as codified in Section 2-486 of the City Code. Proposers shall be solely responsible for ensuring that all applicable provisions of the City's Cone of Silence are complied with, and shall be subject to any and all sanctions, as prescribed therein, including rendering their response voidable, in the event of such non-compliance. Communications regarding this solicitation are to be submitted in writing to the Procurement Contact named herein with a copy to the City Clerk at rafaelgranado@miamibeachfl.gov 8. ADDITIONAL INFORMATION OR CLARIFICATION. After proposal submittal, the City reserves the right to require additional information from Proposers (or Proposer team members or sub-consultants) to determine: qualifications (including, but not limited to, litigation history, regulatory action, or additional references); and financial capability (including, but not limited to, annual reviewed/audited financial statements with the auditors notes for each of their last two complete fiscal years). 9. PROPOSER'S RESPONSIBILITY. Before submitting a response, each Proposer shall be solely responsible for making any and all investigations, evaluations, and examinations, as it deems necessary, to ascertain all conditions and requirements affecting the full performance of the contract. Ignorance of such conditions and requirements, and/or failure to make such evaluations, investigations, and examinations, will not relieve the Proposer from any obligation to comply with every detail and with all provisions and requirements of the contract, and will not be accepted as a basis for any subsequent claim whatsoever for any monetary consideration on the part of the Proposer. 10. DETERMINATION OF AWARD. The City Manager may appoint an evaluation committee to assist in the evaluation of proposals received. The evaluation committee is advisory only to the city manager. The city manager may consider the information provided by the evaluation committee process and/or may utilize other information deemed relevant. The City Manager's recommendation need not be consistent with the information provided by the evaluation committee process and takes into consideration Miami Beach City Code Section 2-369, including the following considerations: (1) The ability, capacity and skill of the Proposer to perform the contract. DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 MIAMI BEACH (2) Whether the Proposer can perform the contract within the time specified, without delay or interference. (3) The character, integrity, reputation,judgment, experience and efficiency of the Proposer. (4) The quality of performance of previous contracts. (5) The previous and existing compliance by the Proposer with laws and ordinances relating to the contract. The City Manager may recommend to the City Commission the Proposer(s) s/he deems to be in the best interest of the City or may recommend rejection of all proposals. The City Commission shall consider the City Manager's recommendation and may approve such recommendation. The City Commission may also, at its option, reject the City Manager's recommendation and select another Proposal or Proposals which it deems to be in the best interest of the City, or it may also reject all Proposals. 11. NEGOTIATIONS. Following selection, the City reserves the right to enter into further negotiations with the selected Proposer. Notwithstanding the preceding, the City is in no way obligated to enter into a contract with the selected Proposer in the event the parties are unable to negotiate a contract. It is also understood and acknowledged by Proposers that no property, contract or legal rights of any kind shall be created at any time until and unless an Agreement has been agreed to; approved by the City; and executed by the parties. 12. E-VERIFY. As a contractor you are obligated to comply with the provisions of Section 448.095, Fla. Stat., "Employment Eligibility." Therefore, you shall utilize the U.S. Department of Homeland Security's E-Verify system to verify the employment eligibility of all new employees hired by the Contractor during the term of the Contract and shall expressly require any subcontractors performing work or providing services pursuant to the Contract to likewise utilize the U.S. Department of Homeland Security's E-Verify system to verify the employment eligibility of all new employees hired by the subcontractor during the Contract term. 13. PERISCOPE S2G (FORMERLY BIDSYNC). The Procurement Department utilizes Periscope S2G, Supplier-to- Government electronic bidding (e-Bid) platform. If you would like to be notified of available competitive solicitations released by the City you must register and complete your vendor qualifications through Periscope S2G, Supplier-to- Government www.bidsync.com/Miami-Beach. Registration is easy and will only take a few minutes. For detailed instructions on how to register, complete vendor qualifications and submit electronic bids visit https://www.miamibeachfl.qov/city-hall/procurement/for-approval-how-to-become-a-vendor/. Should you have any questions regarding this system or registration, please visit the above link or contact Periscope S2G, Supplier-to-Government at supportbidsync.com or 800.990.9339, option 1, option 1. 14. HOW TO MANAGE OR CREATE A VENDOR PROFILE ON VENDOR SELF SERVICE (VSS). In addition to registering with Periscope S2G, the City encourages vendors to register with our online Vendor Self- Service web page, allowing City vendors to easily update contacts, attachments (W-9), and commodity information. The Vendor Self-Service (VSS) webpage (https://selfservice.miamibeachfl.gov/vss/Vendors/default.aspx) will also provide you with purchase orders and payment information. Should you have any questions and/or comments, do not hesitate to submit them to vendorsupport a(�miamibeachfl.gov 15. SUPPLIER DIVERSITY. In an effort to increase the number and diversity of supplier options in the procurement of goods and services, the City has established a registry of LGBT-owned businesses, as certified by the National LGBT Chamber of Commerce (NGLCC) and small and disadvantaged businesses, as certified by Miami-Dade County. See authorizing resolutions here. If your company is certified as an LGBT-owned business by NGLCC, or as a small or disadvantaged business by Miami-Dade County, click on the link below to be added to the City's supplier registry (Vendor Self-Service) and bid DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 MIAMI BEACH system (Periscope S2G, Supplier-to-Government). These are two different systems and it is important that you register for both. Click to see acceptable certification and to register: https://www.miamibeachfl.gov/city-hall/procurementlhow-to- become-a-vendor/. Balance of Page Intentionally Left Blank DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 SECTION 0200 GENERAL CONDITIONS TERMS & CONDITIONS —SERVICES. By virtue of submitting a proposal in response to this solicitation, proposer agrees to be bound by and in compliance with the Terms and Conditions for Services (version dated April 13, 2020), incorporated herein, which may be found at the following link: https://www.miamibeachfl.gov/city-hall/procurement/standard-terms-and-conditions/ DocuSign Envelope ID. 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 SECTION 0300 PROPOSAL SUBMITTAL INSTRUCTIONS AND FORMAT 1. ELECTRONIC RESPONSES (ONLY). Proposals must be submitted electronically through Periscope S2G (formerly BidSync) on or before the date and time indicated. Hard copy proposals or proposals received through email or facsimile are not acceptable and will be rejected. A proposer may submit a modified proposal to replace all or any portion of a previously submitted proposal until the deadline for proposal submittals. The City will only consider the latest version of the bid. Electronic proposal submissions may require the uploading of attachments. All documents should be attached as separate files in accordance with the instructions included in Section 4, below. Attachments containing embedded documents or proprietary file extensions are prohibited. It is the Bidder's responsibility to assure that its bid, including all attachments, is uploaded successfully. Only proposal submittals received, and time stamped by Periscope S2G (formerly BidSync) prior to the proposal submittal deadline shall be accepted as timely submitted. Late bids cannot be submitted and will not be accepted. Bidders are cautioned to allow sufficient time for the submittal of bids and uploading of attachments. Any technical issues must be submitted to Periscope S2G (formerly BidSync) by contacting (800) 990-9339 (toll free) or S2Gperiscopeholdinqs.com. The City cannot assist with technical issues regarding submittals and will in no way be responsible for delays caused by any technical or other issue. It is the sole responsibility of each Bidder to ensure its proposal is successfully submitted in BidSync prior to the deadline for proposal submittals. 2. NON-RESPONSIVENESS. Failure to submit the following requirements shall result in a determination of non- responsiveness. Non-responsive proposals will not be considered. 1. Bid Submittal Questionnaire 2. Failure to comply with Minimum Eligibility Requirement(See Appendix A, Section Al). 3. Financial Proposal (Tab 4). 3. OMITTED OR ADDITIONAL INFORMATION. Failure to complete and submit the Bid Submittal Questionnaire (submitted electronically) and the Cost Proposal with the bid and by the deadline for submittals shall render a proposal non-responsive. Non-Responsive proposals will not be considered. With the exception of the Bid Submittal Questionnaire (completed and submitted electronically) and the Cost Proposal, the City reserves the right to seek any omitted information/documentation or any additional information from Proposer or other source(s), including but not limited to: any firm or principal information, applicable licensure, resumes of relevant individuals, client information, financial information, or any information the City deems necessary to evaluate the capacity of the Proposer to perform in accordance with contract requirements. Failure to submit any omitted or additional information in accordance with the City's request shall result in proposal being deemed non- responsive. 4. ELECTRONIC PROPOSAL FORMAT. In order to maintain comparability, facilitate the review process and assist the Evaluation Committee in the review of proposals, it is strongly recommended that proposals be organized and tabbed in accordance with the tabs, and sections as specified below. The electronic submittal should be tabbed as enumerated below and contain a table of contents with page references. The electronic proposal shall be submitted through the "Line Items" attachment tab in Periscope S2G, Cover Letter& Minimum Qualifications Requirements 1.1 Cover Letter and Table of Contents. The cover letter must indicate Proposer and Proposer Primary Contact for the purposes of this solicitation. 1.2 Minimum Qualifications Requirements. Submit verifiable information documenting compliance with the DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 minimum qualifications requirements established in Appendix A, Minimum Requirements and Specifications. TAB 2 Experience&Qualifications 2.1 Qualifications of Proposing Firm. Submit detailed information regarding the relevant experience and proven track record of the firm and/or its principals in providing the scope of services similar as identified in this solicitation, including experience in providing similar scope of services to public sector agencies. For each project that the Proposer submits as evidence of similar experience for the firm and/or any principal, the following is required: project description, agency name, agency contact, contact telephone &email, and year(s)and term of engagement. For each project, identify whether the experience is for the firm or for a principal (include name of principal). 2.2 Qualifications of Proposer Team. Provide an organizational chart of all personnel and consultants to be used for this project if awarded, the role that each team member will play in providing the services detailed herein and each team members' qualifications. A resume of each individual, including education, experience, and any other pertinent information, shall be included for each Proposal team member to be assigned to this contract. TAB 3 Approach and Methodology Submit detailed information on how Proposer plans to accomplish the required scope of services, including detailed information, as applicable, which addresses, but need not be limited to: • include a schedule of benefits and any applicable discounts,costs,copays, etc. • vision network of credentialed ophthalmologists, optometrists, opticians, and retail optical centers that are geographically accessible to participants; • explain how the proposer will efficiently and accurately communicate with City personnel and the benefits consultant; • explain proposer's approach to customer service and how it retains representatives with knowledge on specific details of the vision plan, claims, and the network of providers; • explain how the proposer will resolve any member issues(preferably within three(3)working days); • explain the process for receiving enrollment from the City via electronic enrollment; • explain how the proposer will provide monthly billing reports with access to pull billing and other coverage information online securely; • explain the proposer's appeals procedure process for any member with dissatisfaction with a claim denial; • explain how the proposer will efficiently process claims including verification of enrollment, determination of benefit coverage, application of appropriate provider reimbursement, creation and mailing of EOBs for all claims, timely payment, storage of all claims information; • explain how the proposer will monitor and report plan financials, utilization, network performance, etc. • explain the process for enrollment of active members during open enrollment with an effective date of October 1st and give terminated members the ability to continue coverage via COBRA. TAB 4 Cost Proposal 1. Submit proposed per employee per month (PEPM)fee. Balance of Page Intentionally Left Blank SECTION 0400 PROPOSAL EVALUATION DocuSign Envelope ID: 1 BDEODEI-3EAF-450E-8374-619DEB4B6A43 1. EVALUATION OF PROPOSALS. All responsive proposals will be evaluated in accordance with this section. If more than one proposal is received, the City Manager may appoint an Evaluation Committee to consider and provide feedback on the qualitative factors of each proposal. In the event that only one responsive proposal is received, the City Manager, after determination that the sole responsive proposal materially meets the requirements of the RFP, may, without an evaluation committee, recommend to the City Commission that the Administration enter into negotiations. In the evaluation of proposals, Proposers may be requested to make additional written submissions of a clarifying nature or oral presentations to the Evaluation Committee. Failure to provide the requested information within the time prescribed may result in the disqualification of proposal. 2. QUALITATIVE FACTORS (QUALIFICATIONS, APPROACH AND COST). The Evaluation Committee shall only consider qualitative factors. The Evaluation Committee shall not consider quantitative factors (e.g. veterans preference, etc.) in its review of proposals. The Evaluation Committee's role is solely in an advisory capacity to the City Manager. The results of the Evaluation Committee process do not constitute an award recommendation. The City Manager may utilize, but is not bound by, the results of the Evaluation Committee process, as well as consider any feedback or information provided by staff, consultants or any other third-party, as well as consideration of the quantitative factors, in developing an award recommendation to be presented to the City Commission for consideration. In its review of proposals received, the Evaluation Committee may review and score all proposals, with or without conducting interview sessions, in accordance with the following criteria. The Procurement Department will assign points for Veteran's Preference, pursuant to Section 2-374 of the City Code, as applicable. Qualitative Criteria Maximum Points (Points Assigned by Evaluation Committee) Experience &Qualifications 35 Approach & Methodology 30 Cost Proposal 35 TOTAL AVAILABLE POINTS for Qualitative Criteria 100 Quantitative Criteria Maximum Points (Points Assigned by Procurement Department) Veteran's Preference Points 5 TOTAL AVAILABLE POINTS for Qualitative and 105 Quantitative Balance of Page Intentionally Left Blank DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 3.QUANTITATIVE FACTORS. Quantitative factors shall not be considered by the Evaluation Committee. Quantitative factors will be considered by the City Manager in preparing a recommendation to the City Commission. In considering quantitative factors, the City Manager may also consider any feedback or information provided by staff, consultants or any other third-party in developing an award recommendation in accordance with Sub-section 5 below 4.Cost Proposal Evaluation. The cost proposal points shall be developed in accordance with the following formula: Sample Objective Formula for Cost Example Maximum Formula for Calculating Points Vendor Allowable Points (lowest cost I cost of proposal being Vendor Cost evaluated X maximum allowable Total Points (Points noted are for illustrative Awarded Proposal purposes only.Actual points are points=awarded points) noted above.) Round to Vendor A $100.00 20 $100 I$100 X 20=20 20 Vendor B $150.00 20 $100 I$150 X 20=13 13 Vendor C $200.00 20 $100 I$200 X 20=10 10 EVALUATION COMMITTEE RANKING FOR QUALITATIVE AND QUANTITATIVE FACTORS. The sum of qualitative and quantitative scores will be converted to rankings in accordance with the example below. Bidder A Bidder B Bidder C Qualitative Points 82 76 80 Committee Quantitative Points 22 15 12 Member 1 Total 104 91 92 Rank 1 3 2 Qualitative Points 79 85 72 Committee Quantitative Points _ 22 15 Member 2 Total 101 100 Rank 1 2 •3 Qualitative Points 80 74 66 Committee Quantitative Points 22 15 12 Member 2 Total 102 89 78 Rank 1 2 3 Low Aggregate Score 3 7 8 Final Ranking* 1 2 3 5. DETERMINATION OF AWARD. The City Manager shall consider qualitative and quantitative factors, in accordance with Sub-section 2 and 3 above, to recommend the proposer(s) he deems to be in the best interest of the City or may recommend rejection of all proposals. The City Manager's recommendation need not be consistent with the information provided by the evaluation committee process and takes into consideration Miami Beach City Code Section 2-369, including the following considerations: (1) The ability, capacity and skill of the Proposer to perform the contract. (2) Whether the Proposer can perform the contract within the time specified, without delay or interference. (3) The character, integrity, reputation, judgment, experience and efficiency of the Proposer. (4) The quality of performance of previous contracts. (5) The previous and existing compliance by the Proposer with laws and ordinances relating to the contract. The City Manager may recommend to the City Commission the Proposer(s) s/he deems to be in the best interest of the City or may recommend rejection of all proposals. The City Commission shall consider the City Manager's recommendation and may approve such recommendation. The City Commission may also, at its option, reject the City Manager's recommendation and select another Proposal or Proposals which it deems to be in the best interest of the City, or it may also reject all Proposals. DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 APPENDIX A M I AM I E AC H Minimum Requirements & Scope of Work RFP 2022-320-WG Vision Insurance Benefit Plan PROCUREMENT DEPARTMENT 1755 Meridian Avenue, 3rd Floor Miami Beach, Florida 33139 DocuSign Envelope ID. 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 Al. Minimum Eligibility Requirements. The Minimum Eligibility Requirements for this solicitation are listed below. Bidder shall submit the required submittal(s) documenting compliance with each minimum requirement. Proposers that fail to comply with minimum requirements shall be deemed non-responsive and shall not have its bid considered. 1. The Company must be licensed in the State of Florida to provide insurance services. A2. Scope of Work. Vision Insurance Benefit Plan providers shall provide vision insurance coverage for benefit eligible employees, retirees and their dependents including, but not be limited to, the following services: - A vision network of credentialed Ophthalmologists, Optometrists, Opticians, and retail optical centers that are geographically accessible to participants. - Discounts on products and services including, but not limited to annual vision exams, eyeglass exams, contact lens exams, frames and lenses. - Efficient, accurate, and timely response to City personnel and their benefits consultant. A toll-free number shal be provided for member support. Customer Service representatives should be knowledgeable on specific details of the vision plan, claims, and the network of providers. Any member issues should be resolved withing three (3) working days. - Receipt of enrollment from the City via electronic enrollment. - Provide participants with a vision card which will identify the member as eligible for vision services and discounts. Mail vision cards to the participant's home address withing ten (10) business days of receiving enrollment information. - Provide monthly billing reports with access to pull billing and other coverage information online securely. - Offer a clear appeals procedure process for any member with dissatisfaction with a claim denial. - Perform all claims processing functions including verification of enrollment; determination of benefit coverage; application of appropriate provider reimbursement; creation and mailing of EOBs for all claims; timely payment; storage of all claims information. - Produce claims reports to monitor plan financials, utilization, network performance, etc. - Enroll active members during open enrollment with an effective date of October 1st and give terminated members the ability to continue coverage via COBRA. A3. Special Conditions 1. TERM OF CONTRACT. The term of the Agreement resulting from this RFP shall be for an initial term of two (2) years. 2. OPTION TO RENEW. The City, through its City Manager, will have the option to extend for one (1) additional two-year period at the City's sole discretion. The successful contractor shall maintain, for the entirety of any renewal period, the same cost, terms, and conditions included within the originally awarded contract. Continuation of the contract beyond the initial period, and any option subsequently exercised, is a City prerogative, and not a right of the successful contractor. 3. ADDITIONAL SERVICES. Services not specifically identified in this request may be added to, or deleted from, any resultant contract upon successful negotiations and mutual consent of the contracting parties, and approval by the City Manager. DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 APPENDIX B iv,„ Am , E Acog Insurance Requirements RFP 2022-320-WG Vision Insurance Benefit Plan PROCUREMENT DEPARTMENT 1755 Meridian Avenue, 3rd Floor Miami Beach, Florida 33139 DocuSign Envelope ID:1 BDE0DE1-3EAF-450E-8374-619DEB4B6A43 MIAMI BEACH INSURANCE REQUIREMENTS The vendor shall maintain the below required insurance in effect prior to awarding the contract and for the duration of the contract. The maintenance of proper insurance coverage is a material element of the contract and failure to maintain or renew coverage may be treated as a material breach of the contract, which could result in withholding of payments or termination of the contract. A. Workers' Compensation Insurance for all employees of the Contractor as required by Florida Statute Chapter 440 and Employer Liability Insurance with a limit of no less than $1,000,000 per accident for bodily injury or disease. Should the Contractor be exempt from this Statute, the Contractor and each employee shall hold the City harmless from any injury incurred during performance of the Contract. The exempt contractor shall also submit (i) a written statement detailing the number of employees and that they are not required to carry Workers' Compensation insurance and do not anticipate hiring any additional employees during the term of this contract or(ii) a copy of a Certificate of Exemption. B. Commercial General Liability Insurance on an occurrence basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence, and$2,000,000 general aggregate. C. Automobile Liability Insurance covering any automobile, if vendor has no owned automobiles, then coverage for hired and non-owned automobiles, with limit no less than $1,000,000 combined per accident for bodily injury and property damage. D. Professional Liability(Errors & Omissions) Insurance appropriate to the Consultant's profession, with limit no less than $1,000,000. Additional Insured -City of Miami Beach must be included by endorsement as an additional insured with respect to all liability policies(except Professional Liability and Workers' Compensation) arising out of work or operations performed on behalf of the contractor including materials, parts, or equipment furnished in connection with such work or operations and automobiles owned, leased, hired or borrowed in the form of an endorsement to the contractor's insurance. Notice of Cancellation - Each insurance policy required above shall provide that coverage shall not be cancelled, except with notice to the City of Miami Beach do EXIGIS Insurance Compliance Services. Waiver of Subrogation—Vendor agrees to obtain any endorsement that may be necessary to affect the waiver of subrogation on the coverages required. However,this provision applies regardless of whether the City has received a waiver of subrogation endorsement from the insurer. Acceptability of Insurers— Insurance must be placed with insurers with a current A.M. Best rating of A:VII or higher. If not rated, exceptions may be made for members of the Florida Insurance Funds (i.e. FWCIGA, FAJUA). Carriers may also be considered if they are licensed and authorized to do insurance business in the State of Florida. Verification of Coverage—Contractor shall furnish the City with original certificates and amendatory endorsements, or copies of the applicable insurance language, effecting coverage required by this contract. All certificates and endorsements are to be received and approved by the City before work commences. However, failure to obtain the required documents prior to the work beginning shall not waive the Contractor's obligation to provide them. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements, required by these specifications, at any time. DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 CERTIFICATE HOLDER MUST READ: CITY OF MIAMI BEACH c/o EXIGIS Insurance Compliance Services P.O. Box 4668—ECM#35050 New York, NY 10163-4668 Kindly submit all certificates of insurance,endorsements,exemption letters to our servicing agent,EXIGIS, at: Certificates-miamibeach anriskworks.com Special Risks or Circumstances - The City of Miami Beach reserves the right to modify these requirements, including limits, based on the nature of the risk, prior experience, insurer,coverage,or other special circumstances. 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. DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 ATTACHMENT C SUNBIZ& PROPOSAL RESPONSE TO RFP DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 DIVISION OF CORPORATIONS DIMON of r,,,..+"""j.,r.r•�-r` an*id lune of Fl rich wolAnte Department of State / Division of Corporations / Search Records / Search by FEI/EIN Number/ Detail by FEI/EIN Number Foreign Limited Liability Company EYEMED VISION CARE LLC Filing Information Document Number M01000001774 FEI/EIN Number 31-1656473 Date Filed 08/07/2001 State DE Status ACTIVE Ad Prin�inal dress 4000 LUXOTTICA PL MASON, OH 45040-8114 Changed:04/10/2012 Mailing Address PO BOX 8509,ATTN: TAX DEPT MASON, OH 45040 Changed: 04/10/2012 Registered Agent Name&Address NRAI SERVICES, INC 1200 South Pine Island Road Plantation, FL 33324 Name Changed:05/12/2008 Address Changed: 02/11/2011 Authorized Person(s)Detail Name&Address Title CFO FLAMINI, EMILIA 12 HARBOR PARK DRIVE PORT WASHINGTON, NY 11050 Title MEMB DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Luxottica of America Inc. 4000 LUXOTTICA PL MASON,OH 45040-8114 Title President RUECKER, LUKAS 4000 LUXOTTICA PL MASON, OH 45040-8114 Title VP Holley, Cathy 4000 LUXOTTICA PL MASON, OH 45040-8114 Annual Reports Report Year Filed Date 2020 02/12/2020 2021 03/26/2021 2022 04/16/2022 Document Images 04/16/2022—ANNUAL REPORT View image in PDF format 03/26/2021—ANNUAL REPORT View image in PDF format 02/12/2020—ANNUAL REPORT View image in PDF format 04/16/2019—ANNUAL REPORT View image in PDF format 04/28/2018—ANNUAL REPORT View image in PDF format 04/17/2017—ANNUAL REPORT View image in PDF format 04/26/2016—ANNUAL REPORT View image in PDF format 04/30/2015—ANNUAL REPORT View image in PDF format 04/29/2014—ANNUAL REPORT View image in PDF format 04/10/2013—ANNUAL REPORT View image in PDF format 04/10/2012—ANNUAL REPORT View image in PDF format 04/19/2011—ANNUAL REPORT View image in PDF format 04/05/2010—ANNUAL REPORT View image in PDF format 04/29/2009—ANNUAL REPORT View image in PDF format 05/12/2008—Reg Agent Change View image in PDF format 04/25/2008—ANNUAL REPORT View image in PDF format 04/26/2007—ANNUAL REPORT View image in PDF format 05/25/2006-ANNUAL REPORT View image in PDF format 05/04/2005—ANNUAL REPORT View image in PDF format 05/05/2004—ANNUAL REPORT View image in PDF format 05/02/2003—ANNUAL REPORT View image in PDF format 05/12/2002—ANNUAL REPORT View image in PDF format 08/07/2001—Foreign Limited View image in PDF format DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 BID SUBMITTAL QUESTIONN SEC.HON 1 - t31t) CER f IFICATION i= his document is a REQUIRED FORM that must be submitted fully Solicitation No: Solicitation Title: 2022-320-WG Vision Insurance Benefit Plan BIDDERS NAME.EyeMed Vision Care,LLC NO.OF YEARS IN BUSINESS:34 NO.OF YEARS IN BUSINESS LO OTHER NAME(S)BIDDER HAS OPERATED UNDER IN THE LAST 10 YEARS:Not applicable BIDDER PRIMARY ADDRESS(HEADQUARTERS):4000 Luxotlica Plate CITY:Mason STATE:OH ZIP CODE:46040 TELEPHONE NO.:613.766.6000 TOLL FREE NO.:Not applicable FAX NO.:Not applicable BIDDER LOCAL ADDRESS:4000 Luxottica Place CITY Mason STATE:OH ZIP CODE:45040 PRIMARY ACCOUNT REPRESENTATIVE FOR THIS ENGAGEMENT Teresa Moyers ACCOUNT REP TELEPHONE NO.:513.765.4011 ACCOUNT REP TOLL FREE NO. Not applicable ACCOUNT REP EMAIL.tmoyers@eyemed.com DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 FEDERAL TAX IDENTIFICATION NO. 31-1656473 By virtue of submitting a bid, bidder agrees: a)to complete and unconditional acceptance of the terms ar all specifications, attachments, exhibits and appendices and the contents of any Addenda released specifications, terms and conditions contained herein or Addenda; c)that the bidder has not divulged, di has not colluded with any other bidder or party to any other bid; d) that bidder acknowledges that all in defined by the State of Florida Sunshine and Public Records Laws; e) the bidder agrees if this bid is document for the purpose of establishing a formal contractual relationship between the bidder and the requirements to which the bid pertains; and f)that all responses, data and information contained in the b The individual named below affirms that s/he: is a principal of the applicant duly authorized to e) document(s) are complete, true, and correct to the best of his/her knowledge and belief. Name of Bidder's Authorized Representative: ' Title of Bidder's Authorized Matthew MacDonald Representative: Senior Vice President, Operations DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 SECTION 2 - ACKNOWLEDGEMENT OF ADDENDUM After issuance of solicitation, the City may release one or more addendum to the solic to bidders or alter solicitation requirements. The City will strive to reach every bidder procurement system. However, bidders are solely responsible for assuring they have to solicitation. This Acknowledgement of Addendum section certifies that the bidder h pursuant to this solicitation. Failure to obtain and acknowledge receipt of all addenda rr Enter Initial to Enter Initial to Ente Confirm Confirm Confii Receipt Receipt Addendum 1 Addendum 6 Addendum 2 Addendum 7 Addendum 3 Addendum 8 Addendum 4 Addendum 9 Addendum 5 Addendum 10 If additional confirmation of addendum is required, submit ur SECTION 3 - CONFLICT OF INTEREST All bidders must disclose the name(s) of any officer, director, agent, or immediate far who is also an employee of the City of Miami Beach. Further, all bidders must disch either directly or indirectly, an interest of ten (10%) percent or more in the bidder entity YES Q NO If yes, please disclose the name(s): FIRST AND LA' 1 2 3 4 5 6 SECTION 4- FINANCIAL CAPACITY DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 When requested by the City, each bidder shall arrange for Dun & Bradstreet to submit the City. No proposal will be considered without receipt, by the City, of the SQR d preparation of the SQR shall be the responsibility of the bidder. The bidder shall reques https://supplierportal.dnb.com/webapp/wcs/stores/servlet/SupplierPortal?storeld Bidders are responsible for the accuracy of the information contained in its SQI review the information contained in its SQR for accuracy prior to submittal solicitation process. For assistance with any portion of the SQR submittal proce: At time of request, bidder shall request that Dun & Bradstreet submit its Supplier Qual three (3) days of request. SECTION 5 - MORATORIUM ON TRAVEL TO AND THE PURCHASE OF GO( Pursuant to Resolution 2016-29375, the City of Miami Beach, Florida, prohibits official the purchase of goods or services sourced in Mississippi. Bidder shall agree that no Beach to Mississippi, nor shall any product or services it provides to the City be source By virtue of submitting bid, bidder agrees it is and shall remain in full compliance with R https://www.miamibeachfl.gov/wp-content/uploads/2017/11/2016-29375-Resolution-Ver North-Carolina-Mississippi-1.pdf DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 SECTION 6 - REFERENCES AND PAST PERFOF Project No. 2022-320-WG Project Title Vision Insurance Benefit Plan Bidder shall submit at least three (3) references for whom the bidder has complete referenced in solicitation. Reference No.1 Firm Name: City of Lakeland Contact Individual Name and Title: Joyce Dias, Risk Manager Address: 228 S. Massachusetts Ave., Lakeland, FL 33801-5012 Telephone: 863.834.6000 Contact's Email: joyce.dias@lakelandgov.net Narrative on Scope of Services Provided: Currently administer vision benefit services to employees of the City of Lakeland,Florida. Reference No.2 Firm Name: JPOFFHIT Contact Individual Name and Title: Steve Zona, President Address: 625 Stockton St., Jacksonville, FL 32204 Telephone: 904.759.7416 Contact's Email: szona@jpoffhit.org Narrative on Scope of Services Provided: Currently administer vision benefit services to JPOFFITT, a health insurance trust m Florida. DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Reference No.3 Contact Individual Name and Title: Jennifer Chripczuk, Benefits Manager Address: 401 Clematis St., West Palm Beach, FL 33401-5319 Telephone: 561.822.1200 Contact's Email: jchripczuk@wpb.org Narrative on Scope of Services Provided: Currently administer vision benefit services to the employees of West Palm Beach, Florida DocuSign Envelope ID. 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Additional Reference Firm Name: City of Philadelphia Contact Individual Name and Title: Marsha Greene-Jones, Deputy Director Address: 9800 Ashton St., Philadelphia, PA 19102 Telephone: 215.686.2325 Contact's Email: marsha.greene-jones@phila.gov Narrative on Scope of Services Provided: Currently administer vision benefit services to the employees of the City of Philadelphia. SECTION 7 - STANDARD TERMS AND CON The Standard Terms and Conditions are available at https://www.miamibeachfl.gov/city virtue of submitting a bid, bidder attests that they have read and understand the applici: in the solicitation. Project No. 2022-320-WG Project Title Vision Insurance Benefit Plan SECTION 8 - VENDOR CAMPAIGN CONTRIB Bidders are expected to be or become familiar with, the City's Campaign Finance Refoi 490 of the City Code https://library.municode.( nodeld=SPAGEORCH2ADARTVI ISTCODIVSCAFIRE Bidders shall be solely responsible for ensuring that all applicable provisions of the Cit) with, and shall be subject to any and all sanctions, as prescribed therein, including dis, such non-compliance. Are there any individuals or entities (including your sub-consultants) with a controllinc campaign either directly or indirectly, of a candidate who has been elected to the offic Miami Beach. YES ri NO DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 If yes, list name (first and last name) of individuals, occupation, amount and date: First and Last Nara: 3ntributor Occup. ), 1 2 3 4 5 6 7 8 9 DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 SECTION 9 — SUSPENSION, DEBARMENT, OR CONTRA Has bidder ever been debarred, suspended or other legal violation, or had a contract c sector agency? YES NO If answer to above is "YES," bidder shall submit a statement detailing the reasons that SECTION 10 - EQUAL BENEFITS FOR EMPLOYEES V AND EMPLOYEES WITH DOMESTIC PART When awarding competitively solicited contracts valued at over $100,000 whose contractor payrolls during 20 or more calendar work weeks, the Equal Benefits for Domestic Partners Orc business with the City of Miami Beach, who are awarded a contract pursuant to competitive bid domestic partners, as they provide to employees with spouses. The Ordinance applies to all limits of the City of Miami Beach, Florida; and the Contractor's employees located in the United who are directly performing work on the contract within the City of Miami Beach. Does bidder provide or offer access to any benefits to employees with spouses or to spouses c YES Does bidder provide or offer access to any benefits to employees with (same or opposite employees? YES Please check all benefits that apply to your answers above and list in the `other" section any benefits are provided to employees because they have a spouse or domestic partner, such directly to the spouse or domestic partner, such as medical insurance. Bidder Provides for Bidder Provides fc BENEFIT Employees with Employees with Spouses Domestic Partner Health X X Sick Leave X X Family Medical Leave X X Bereavement Leave X X DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 If Bidders cannot offer a benefit to domestic partners because of reasons outside your control willing to offer domestic partner coverage) you may be eligible for Reasonable Measures corn pay a cash equivalent and submit a completed Reasonable Measures Application with all ne Application will be reviewed for consideration by the City Manager, or his designee. Approval final. Further information on the Equal Benefits requirement is available at http://www.miamib€ ordinance-and-procedures/ DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 SECTION 11 - BYRD ANTI-LOBBYING AMENDMENT CEF APPENDIX A, 44 C.F.R. PART 18—CERTIFICATION REGAR[ Certification for Contracts, Grants, Loans, and Cooperati The undersigned Contractor certifies, to the best of his or her knowledge, that: 1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the unders influence an officer or employee of an agency, a Member of Congress, an officer or emplc Congress in connection with the awarding of any Federal contract, the making of any Federal into of any cooperative agreement, and the extension, continuation, renewal, amendment, or cooperative agreement. 2. If any funds other than Federal appropriated funds have been paid or will be paid to any officer or employee of any agency, a Member of Congress, an officer or employee of Con€ connection with this Federal contract, grant, loan, or cooperative agreement, the undersig "Disclosure Form to Report Lobbying," in accordance with its instructions. 3. The undersigned shall require that the language of this certification be included in the awa subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) accordingly. This certification is a material representation of fact upon which reliance was placed when this this certification is a prerequisite for making or entering into this transaction imposed by 31, U Act of 1995). Any person who fails to file the required certification shall be subject to a civil $100,000 for each such failure. The undersigned Contractor certifies or affirms the truthfulness and accuracy of each stat addition, the Contractor understands and agrees that the provisions of 31 U.S.C. § 3801 et seq., By virtue of submitting bid, bidder certifies or affirms its compliance with the Byrd Anti-Lobbying, Name of Bidder's Authorized Representative: Title of Bidder 's Authorized Matthew MacDonald Representative: Senior Vice President, Operations DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 SECTION 12 —SUSPENSION AND DEBARMENT CE The Contractor acknowledges that: (1) This Contract is a covered transaction for purposes of 2 C.F.R. pt. 180 and 2 C.F.R. pt. 3000. of the Contractor, its principals (defined at 2 C.F.R. § 180.995), or its affiliates (defined at 2 180.940) or disqualified (defined at 2 C.F.R. § 180.935). (2) The Contractor must comply with 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpar these regulations in any lower tier covered transaction it enters into. (3) This certification is a material representation of fact relied upon by the City. If it is later dE C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C, in addition to remedies available to th remedies, including but not limited to suspension and/or debarment. (4) The Contractor agrees to comply with the requirements of 2 C.F.R. pt. 180, subpart C and 2 throughout the period of any contract that may arise from this offer. The Contractor further ag in its lower tier covered transactions." By virtue of submitting bid, bidder certifies or affirms its compliance with the Suspension and D( Name of Bidder's Authorized Representative: Title of Bidder's Authorized Matthew MacDonald Representative: Senior Vice President, Operations SECTION 13 - SMAU. AND DISADVANTAGED BUSINE4 Pursuant to Resolution 2020-31519, the City is tracking the Small and Disadvantaged BusinessE certified as Small or Disadvantaged Business by Miami-Dade County. Does bidder possess Small or Disadvantaged Business certification by Miami-Dade County? 0 YES p SECTION 14 - LGBT BUSINESS ENTERPRISE CER Pursuant to Resolution 2020-31342, the City is tracking the utilization of LGBT owned firms thz by the National Gay and Lesbian Chamber of Commerce (NGLCC). DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 Does bidder possess LGBT Business Enterprise Certification by the NGLCC? 0 YES p SECTION 15 — CONE OF SILENCE Pursuant to Section 2-486 of the City Code, all procurement solicitations once advertised and to the City Commission by the City Manager are under the "Cone of Silence.' at hops://library.municode.com/fl/miami beach/codes/code of ordinances?nodeld=SPAGEO Any communication or inquiry in reference to this solicitation with any City employee or Cii communications with the Procurement Director, or his/her administrative staff responsible solicitation providing said communication is limited to matters of process or procedure regar solicitation are to be submitted in writing to the Procurement Contact nam at rafaelgranado@miamibeachfl.gov . Vendor attests that they have read, understand, and are in compliance with the Cone of Siler Code? p YES 0 DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 SECTION 16—CODE OF BUSINESS ETH Pursuant to City Resolution No.2000-37879, the Bidder shall adopt a Code of Business Ethics Division with its response or within three (3) days upon receipt of request. The Code shall, a applicable governmental rules and regulations including, among others, the conflict of interes Beach and Miami Dade County. Bidder shall submit firm's Code of Business Ethics within three (3) of request by the City. In lie indicate that it will adopt, as required in the ordinance, the City of Miami Beach Code of Et hall/procurement/procurement-related-ordinance-and-procedures/ Bidder adopts the City of Miami Beach Code of Business Ethics? YES Bidder will submit firm's Code of Business Ethics within three (3) days of request by the City? p YES SECTION 17 — DRUG FREE WORKPLACE CERTI The Drug Free Workplace Certification is available at: https://www.miamibeachfl.gov/wp-content/uploads/2019/04/DRUG-FREE-WORKPLACE-CERTI By virtue of submitting bid, bidder certifies or affirms it has adopted policies, practices and stan Certification. SECTION 18 — LOBBYIST REGISTRATION REQU This solicitation is subject to, and all bidders are expected to be or become familiar with, all Cit ensuring that all City lobbyist laws are complied with, and shall be subject to any and all limitation, disqualification of their responses, in the event of such non-compliance. By virtue of submitting bid, bidder certifies or affirms that they have read and understand the at SECTION 19 — NON-DISCRIMINATIO1 The Non-Discrimination ordinance is available at: https://library.municode.com/fl/miami beach/codes/code of ordinances?nodeld=SPAGEOR By virtue of submitting bid, bidder agrees it is and shall remain in full compliance with Section 2 DocuSign Envelope ID 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 SECTION 20 — FAIR CHANCE REQUIREM The Fair Chance Ordinance No. 2016-4012 is available at: https://library.municode.com/fl/miami beach/codes/code of ordinances?nodeld=SPAGEOR By virtue of submitting bid, bidder certifies that it has adopted policies, practices and standar( Bidder agrees to provide the City with supporting documentation evidencing its compliance up the representations made herein shall constitute a material breach of contract, and shall entit the agreement, in addition to any damages that may be available at law and in equity. SECTION 21 — PUBLIC ENTITY CRIME Please refer to Section 287.133(2)(a), Florida Statutes, available at: https://www.flsenate.gov/Laws/Statutes/2012/287.133 By virtue of submitting bid, bidder agrees with the requirements of Section 287.133, Florid convicted vendor list. DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 SECTION 22 — VETERAN BUSINESS ENTERPRISES Pursuant to City of Miami Beach Ordinance No. 2011-3748, https://library.municol nodeld=SPAGEOR CH2AD ARTVIPR DIV3COPR 52-374PRPRPRVECOGOCOSE the City shall givE which is a small business concern owned and controlled by a veteran(s) or which is a service within five percent (5%) of the lowest and best bidder, by providing such bidder an opportuni the lowest responsive bid amount. Whenever, as a result of the foregoing preference, the adt small business concern owned and controlled by a veteran(s) or a service-disabled veteran la to an ITB, RFP, RFQ, ITN or oral or written request for quotation, and such bids are responsi' quality and service, then the award shall be made to the service-disabled veteran business enti Is the bidder a service-disabled veteran business enterprise certified by the State of Florida? YES Is the bidder a service-disabled veteran business enterprise certified by the United States Fed YES ! DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Table of Contents TAB 1 1.2 Minimum Qualifications Requirements Exhibit A. FAA Good Standing - Florida Exhibit B. EyeMed Good Standing - Florida TAB 2 2.1 Qualifications of Proposing Firm 2.2 Qualifications of Proposing Team Exhibit C.Organization Chart Exhibit D. Resumes TAB 3 3.1 Approach and Methodology Exhibit E. EOB Sample Exhibit F. Know Before You Go Overview Exhibit G. Eye360 Overview Exhibit H. Pop-Up Clinic Overview Exhibit I. Mobile App Overview TAB 4 4.1 Cost Proposal Cover Page 4.2 Cost Proposal eye 1 I Confidential.proprietary,trade secret meM DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 eve Med 4000 Luxottica Place May 9, 2022 Cincinnati, OH 45040 RE:Solicitation 2022-320-WG eyemed.com On behalf of EyeMed Vision Care, LLC, please accept the attached proposal for your self-insured vision benefit. EyeMed makes this proposal along with its wholly-owned subsidiary, First American Administrators, Inc. ("FAA"). FAA is a licensed Third-Party Administrator in all states that require licensing. To be clear. EyeMed and FAA are presenting a joint bid. and both entities will be parties to the vision benefits contract. Due to the licenses held by EyeMed and FAA. respectively. EyeMed cannot agree to be the sole contracting party. We would like to thank you for the opportunity to continue providing vision care benefits for City of Miami Beach.Over the course of our 12-year relationship, we have focused on providing the vision network where your employees are, with benefits that take your employees'dollars further, with an easy and transparent experience for all - because we still want them to see life to the fullest. Enclosed you will find all of the amazing new ways we will complement your goals in vision care. DARE TO SEE BEYOND THE STATUS QUO Throughout our proposal, we demonstrate how we'll continue to exceed expectations by evolving our benefits and giving clients and members more of what's best, not more of the same, including: • Over 30 years of vision care industry expertise,translating into innovative products and stress-free administration • A large, nationwide network loaded with the right mix of independent, national and regional retail providers- no wonder 97%of your employees visit an in-network provider today • Benefits that redefine expectations -our members know what's best for them, so we'll keep giving them options that meet their eye care needs, style and lifestyle - without restriction • And above all else, an experience made easy with member communications,online tools and award-winning resources We're excited to share all the ideas we have for your vision benefits,and we're committed to continuing to provide exceptional value and service to you and your employees. If you have any questions, please feel free to contact me at any time. Sincerely, Teresa Moyers Senior Account Manager EyeMed Vision Care, LLC p 513.765.4011 I e tmoyers@eyemed.com SEEING LIFE TO THE FULLEST DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Nice to see you again, eve City of V iami Beach Mea -. f 1"11111111714. • . 1 � • r ` We've been your preferred vision partner since 2010,and we thank you for giving us the opportunity to get to know you and your employees.From the very beginning,we've been committed to bringing you innovative ideas and solutions that make vision benefits a breeze.In fact,over the past year.we've delivered a vision benefit program that resulted in savings of over $363,000 for your members.' We're thrilled with what we've achieved together so far,and we're looking forward to continuing to share our vision of how benefits should be.In our proposal for City of Miami Beach,we're offering you the same great benefit plan for your employees,or you have the option of choosing the Eye360 benefit plan that includes$0 copays as well as an additional$50 frame allowance at PLUS Providers in our Select network And with 12 years with City of Miami Beach,we know your employees appreciate our approach to vision care-proven by your more than 97%in-network utilization.'Staying with EyeMed will ensure your employees continue to get more of what's best,not just more of the same. Challenging the status quo Our proposal continues to provide your employees with the vision benefits they appreciate today along with these highlights: • 4-year rate guarantee to keep costs consistent • NEW! Option to include Eye360 with$0 copay eye exams and an extra$50 frame allowance at PLUS Providers • NEW! Pop-up clinics • Performance guarantees with fees at risk The vision network where your employees are 97%OF CITY OF MIAMI BEACH MEMBERS UTILIZE AN IN-NETWORK PROVIDER TODAY' We know that City of Miami Beach members enjoy having access to the right mix of independent and retail providers.And with us,it's easy for your employees to continue using their benefits when and where they want.Staying with EyeMed ensures your members will experience minimal disruption and can continue to visit the providers they prefer. • 25,400 locations with 120,000 independent and retail provider access points nationwide including popular national chains like LensCrafters and Pearle Vision,plus and regional favorites near you like For Eyes Optical and South Beach Vision • Anticipated provider disruption of up to 49%when switching to another industry carrier2 • Online in-network options including LensCrafters.com,TargetOptical.com,Ray-Ban.com.Glasses.com and ContactsDirect.com-with seamless benefit integration • Over 500 locations in your top employee metro area,Miami/Fort Lauderdale/West Palm Beach-49%more than our largest competitor network3 • 100%urban/suburban employee access to 2 providers in 10 miles and 98%rural employee access to 1 provider in 20 miles3 INDEPENDENT LENSCRAFTERS PRC PEARLE� ®OPTICAL •)VIDER NETWORK r VISION r ;. 1 DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 Benefits that take your emoloyees' dollars further LAST YEAR,CITY OF MIAMI BEACH MEMBERS SAVED AN AVERAGE OF NEARLY 74%VERSUS RETAIL' Eye360 from EyeMed combines vision wellness with extra ways to save.With Eye360,employees will receive a$0 copay eye exam plus an extra$50 toward their frame at any of our Select PLUS Providers.With a growing number of locations to choose from nationwide,98%of your employees live within 20 miles or less of at least one Select PLUS Provider.And,we make it easy.No brand restrictions,promo codes or coupons required. 41110 Rti• 40%off unlimited additional Ability to use both contact Valuable discounts and complete pairs of lens and frame allowances special offers featured on Eye360 with enhanced prescription glasses in the same benefit year our Member Portal and benefits at PLUS Providers Mobile App Plus,with EyeMed,your employees will continue to enjoy: • Up to 64%off hearing aids,an extended warranty and free batteries through Amplifon • 15%off retail or 5%off the promotional price of LASIK • 20%off any item not covered by the benefit,including non-prescription sunglasses While making the experience easy and transparent for all 97%OF EYEMED CLIENTS AGREE WE'RE EASY TO DO BUSINESS WITH4 It's our vision of a carefree benefits experience.That's why you'll continue to have access to solutions like online tools, personalized member communications and more.Just another way we're making life easier for members-and easier for you,too. eEASY FOR MEMBERS 16 EASY FOR YOU • Flexible communications including open enrollment • I'll remain your everyday contact leading all day-to-day materials,benefit summaries and Welcome Packets internal deliverables,consulting on vision trends. for new employees facilitating client communications and more • Special offers on our Member Portal and mobile app with • We'll maintain our annual business reviews to touch discounts from manufacturers and providers base,assess your current offering and make • Enhanced Provider Search with the ability to book adjustments if any changes are needed appointments online at participating locations • We can provide a variety of communication toolkits • Know Before You Go tool that estimates member out- with downloadable member materials of-pocket costs(if any)ahead of time • EyeSiteOnWellness.com with access to educational • Award-winning call center with live-agent coverage 7 collateral and articles including a customizable wellness days a week-ranked among America's best call calendar centers for the past 12 yearss • You'll continue to have access to our client portal, • Mobile app for members with on-the-go access to benefit EyeManage,for downloading reports,member data information,facial recognition and 1-touch ID and invoices • Optional personalized text alerts with benefit • HITRUST CSF Certified with data security based on reminders,special offers,quick tips and more industry best practices and resources including end-to-end encryption and two-factor authentication We know your time is valuable,and we thank you for taking the time to get to know us over the last 12 years.And just like you do today,you can count on us to continue providing your employees with a vision benefit they can truly find value in.If you have any questions,please feel free to contact me. Teresa Moyers Senior Account Manager p 513.765.4011 I e tmoyersOeyemed.com 1 City of Miami Beach Utilization Report, 2021 2 Internal analysis of Netminder competitor data, Winter 2020 3 EyeMed Select Network, January 2020 4 EyeMed Client Satisfaction Survey conducted by Walker, 2021 5 Awarded by BenchmarkPortal as "Certified Center of Excellence"2009-2021 Corifidential,prupr: tart',ti ache ,e_rat i 2 DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 EyeMed Response to Minimum Qualifications Requirements 1.2. Minimum Qualifications Requirements.Submit verifiable information documenting compliance with the minimum qualifications requirements established in Appendix A, Minimum Requirements and Specifications. Al. Minimum Eligibility Requirements.The company must be licensed in the State of Florida to provide insurance services. Confirmed. We've attached Exhibit A - Florida Certificate of Authority- FAA and Exhibit B - Florida Certificate of Good Standing - EyeMed. A2.Scope of Work.Vision Insurance Benefit Plan providers shall provide vision insurance coverage for benefit eligible employees, retirees and their dependents including, but not be limited to,the following services: -A vision network of credentialed Ophthalmologists, Optometrists, Opticians, and retail optical centers that are geographically accessible to participants. - Discounts on products and services including, but not limited to annual vision exams, eyeglass exams, contact lens exams,frames and lenses. - Efficient, accurate, and timely response to City personnel and their benefits consultant.A toll-free number shall be provided for member support. Customer Service representatives should be knowledgeable on specific details of the vision plan, claims, and the network of providers. Any member issues should be resolved withing three(3)working days. - Receipt of enrollment from the City via electronic enrollment. - Provide participants with a vision card which will identify the member as eligible for vision services and discounts. Mail vision cards to the participant's home address withing ten(10) business days of receiving enrollment information. - Provide monthly billing reports with access to pull billing and other coverage information online securely. -Offer a clear appeals procedure process for any member with dissatisfaction with a claim denial. - Perform all claims processing functions including verification of enrollment; determination of benefit coverage; application of appropriate provider reimbursement; creation and mailing of EOBs for all claims;timely payment; storage of all claims information. - Produce claims reports to monitor plan financials,utilization, network performance,etc. - Enroll active members during open enrollment with an effective date of October 1st and give terminated members the ability to continue coverage via COBRA At EyeMed, we continue to challenge the status quo to provide you and your employees with more of what's best, not more of the same, including: The vision network where employees are • Diverse network options with the right mix of independent providers, plus popular national and regional retail providers like LensCrafters, Pearle Vision,Target Optical, and more • 25,400 locations across the country including 1,442 locations in your top metro areas, nearly 7% more than our biggest competitor' • Several options for members to use their in-network benefits online to purchase glasses or contacts: LensCrafters.com,TargetOptical.com, Ray-Ban.com, Glasses.com and ContactsDirect.com DocuSign Envelope ID 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Benefits that take your employees'dollars further • Eye360 for$0 copay eye exams plus an additional $50 frame benefit at any of our PLUS Providers in the Select network • The ability to use both contact lens and frame allowances in the same benefit year-a$150 additional value • Extra savings like 40%off complete, unlimited additional pairs of glasses(the largest additional pairs discount in the industry), plus unique members-only discounts and deals always available through the Special Offers page on our Member Portal While making the experience easy and transparent for all • Customized Welcome Packet distributed to newly enrolled employees with all the information they need to start using their benefits,including 2 ID cards • Optional text alerts for members to help them stay on top of the vision benefit • Enhanced Provider Search tool available online or via our mobile app to help members find the right provider and the ability to book appointments online • Know Before You Go tool that estimates out-of-pocket costs(if any)by service and product so there are no surprises when members visit their provider • Award-winning member support that's ranked among America's best call centers for 12 consecutive years2 • Mobile app with the ability to pull up the ID card, locate a provider,get turn-by-turn directions, set exam and contact reminders and even save the member's prescription As the fastest-growing vision benefits company in the country,3 its no surprise that more and more companies are choosing EyeMed for the results we see-with us,typically more employees enroll,more employees visit in-network providers and more employees use their benefits.4 1 Internal analysis of Netminder competitor data. Winter 2020 2 Awarded by BenchmarkPortal as Certified Center of Excellence"2009-2021 3 Internal analysis of EyeMed membership data compared to data from leading vision benefit companies, as reported in publicly available information.2O19. 4 EyeMed analysis of new business that transferred over from a prior benefits company, 2017 A3.Special Conditions 1. Term of Contract.The term of the Agreement resulting from this RFP shall be for an initial term of two(2)years. We're offering City of Miami Beach a 48-month contract term. 2. Option to Renew.The City,through its City Manager,will have the option to extend for one(1) additional two-year period at the City's sole discretion.The successful contractor shall maintain, for the entirety of any renewal period,the same cost,terms and conditions included within the originally awarded contract. Continuation of the contract beyond the initial period,any option subsequently exercised,is a City prerogative,and not a right of the successful contractor. As stated previously. EyeMed is offering City of Miami Beach a renewal that includes a 48-month contract term. 3. Additional Services.Services not specifically identified in this request may be added to,or deleted from,any resultant contract upon successful negotiations and mutual consent of the contracting parties,and approval by the City Manager. Confirmed. DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 Exhibits Summary A. FAA Good Standing - Florida B. EyeMed Good Standing - Florida C. Organization Chart D. Resumes-Account Management E. EOB Sample F. Know Before You Go Overview G. Eye360 Overview H. Pop-Up Clinic Overview I. Mobile App Overview eve 1 I Confidentiol.proprietary trade secret mea DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Clarifications anc Deviations Summary RE:Solicitation 2022-320-WG We support you every step of the way to make sure you and your employees get the most from your vision plan. And even though we offer the following deviations,you should know that they are very minimal and in no way affect our ability to administer your benefits: Specification EyeMed Response Section A2 Scope of Work. Our network offers the right mix of independent A vision network of credentialed Ophthalmologists, providers,plus the most desired national and regional Optometrists,Opticians,and retail optical centers retail providers, ensuring your employees have the that are geographically accessible to participants. choice and convenience they expect. But we don't just stop with great access. Our network continues to redefine expectations.And here's how: More choice: 120.000 qualified provider access points at over 25.000 locations throughout the country 7,700 providers in Florida and over 500 locations in your top CBSA A network made up of 74%independent and 26% retail Providing your employees with 100%urban/suburban access to 2 provider access points within 10 miles and 98%rural access to 1 provider access point within 20 miles The right choices: The right mix of independent and retail providers- including popular national chains and regional favorites. No wonder 98%of EyeMed members choose to visit an in-network provider' In-network national retail favorites like LensCrafters, Pearle Vision and Target Optical Longer evening and weekend hours2- letting members go where they want,when they want And an experience that changes the game: Providers who are individually-certified and offer advanced technology(cutting-edge exam and fit technologies) Relationships with retail providers that deliver unique experiences for our members like our open enrollment captain's program and onsite pop-up vision clinics Online, in-network options-allowing members to use their benefits to purchase contacts and prescription glasses from their computer,tablet or smart phone eve 1 I Confidentrot proprietors/ trope secret mea DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Specification EyeMed Response There are many reasons that people like us,but one thing is clear:a strong network delivers results.That's why nearly 98%of our members choose to stay in- network to use their benefitsl-which far exceeds other carriers.With options they really want and deserve,more members are getting the full value of their benefits and seeing the saving they expect from their vision benefit. It's just one of the reasons that we're America's fastest growing vision benefits company.3 1 EyeMed book of business data,2021 2 EyeMed analysis of EyeMed and competitor network provider evening and weekend hours 3 Internal analysis of EyeMed membership data compared to data from leading vision benefit companies as reported in publicly available information,2019. Section A2 Scope of Work We're committed to keeping money in our members' Discounts on products and services including, but not pockets.That's why we offer our members additional limited to annual vision exams,eyeglass exams, discounts above the proposed benefits,such as: contact lens exams,frames and lenses. • 40%off unlimited additional complete pairs of prescription glasses at any location,any time throughout the benefit year- largest and most flexible in the industry • Up to 34%off popular lens options not covered by the benefit • Up to 30%savings on a standard fit and follow-up on qualifying networks • 15%off retail or 5%off the promotional price of LASIK from LCA Vision or for even greater savings, members receive$800 off at over 60 LasikPlus, TLC and LVI locations nationwide • 20%off any remaining balance over the frame allowance • 15%off any balance over the conventional contact lens allowance • 20%off any item not covered by the benefit. including non-prescription sunglasses • Up to 64%off hearing aids,an extended warranty and free batteries through Amplifon To help your employees get even more out of their vision benefit,we have a Special Offers page on our Member Portal at eyemed.com where members can easily find discounts on frames,contacts,eye exams and more directly from manufacturers and providers. Some can even be combined with your vision benefit. eve 2 I Confidential,proprietary trade secret me DocuSign Envelope ID 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Specification EyeMed Response Offers change periodically,but here's a sampling of the current specials: • LensCrafters: Extra$50 off a complete pair purchase • Target Optical:$25 off everyday low prices • Contactsdirect.com:Save 10% • Glasses.com:Get up to$50 off any pair of designer sunglasses • LasikPlus:$800 off LASIK Section A2 Scope of Work Whether you give us a call or send an email,your Efficient,accurate,and timely response to City personnel and their benefits consultant.A toll-free National Account Manager,Teresa Moyers,will be number shall be provided for member support. ready to respond within 1 business day or sooner. Customer Service representatives should be In our Customer Care Center our representatives knowledgeable on specific details of the vision plan, undergo extensive training to make sure that they're claims,and the network of providers.Any member ready to quickly and accurately answer calls. By using issues should be resolved withing three(3)working an issue-based program.our representatives are only days. able to answer calls at their current skill level,leaving tenured representatives for more complex inquires. This means your calls go to the best person suited to answer your question every time- no waiting or being transferred. In addition,our performance guarantees that include administrative fees at risk(item#5 in our proposal) includes 98%complaint resolution completed within 30 days. Section A2 Scope of Work You can continue to send us electronic eligibility data Receipt of enrollment from the City via electronic enrollment on a weekly basis.Weekly"add,change.and delete" files are preferred. If you choose to send weekly"add. change,and delete"files,we recommend a full-file update at least monthly to make sure we collect up- to-date information on all members. We're able to accept eligibility in the following formats: • 834x12 file format • EyeMed proprietary fixed length record format. • Most TPA&proprietary file formats can be supported You can transmit eligibility to us via SFTP- using SSH encryption. Section A2 Scope of Work Newly-enrolled employees will receive our full color. Provide participants with a vision card which will customized Welcome Packet with ID cards and other identify the member as eligible for vision helpful features: eve 3 I Confidential.proprietary trade secret M V a DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Specification EyeMed Response services and discounts. Mail vision cards to the • A description of your benefit participant's home address withing ten(10) • A personalized list of providers who are located business days of receiving enrollment information. close to the employee's home • Customer Care Center and website information • Details on how to access the benefit • Member ID cards If you choose the Eye360 option,all of your enrolled employees will receive our Welcome Packet that includes member ID cards after we receive clean eligibility data from you. Members also have easy"on the go" access to their ID card on our website and mobile app.And while members have ranked our Welcome Packet and ID card as the most valuable source of benefit information,we don't require the card to access network services.With member name and date of birth,our doctors can verify eligibility and provide services. Section A2 Scope of Work An electronic version of your monthly administrative Provide monthly billing reports with access to pull fee invoice will continue to be produced based on all billing and other coverage information online securely. active members within our system at the time of billing,as well as an invoice for claims incurred during the month.All payments are due at the beginning of each month.We provide 90-day retroactive adjustments on each administrative invoice for any membership updates not captured in time for the invoice.You can always view up to 13 months of your invoices through our website. Invoices are prepared on the 21st of each month, 1 month in advance,and will be available on EyeManage near the end of the month. Section A2 Scope of Work Members with complaints or inquiries should initially Offer a clear appeals procedure process for any contact our Customer Care Center where our team is member with dissatisfaction with a claim denial. available 7 days a week to answer their questions. Our representatives are thoroughly trained in issue resolution for every type of call.And,what's even better is that 99%of the time inquiries are resolved during this first call. But on rare occasions,they can't be.So our representatives can assist in documenting a complaint to our Quality Assurance department. Within 3 Business days, members will receive written confirmation of receipt. For complaints dealing with clinical care,our Medical Director reviews and researches the issue.A resolution,acknowledged in writing,will be reached within 30 calendar days or less. eve 4 I Confidential,proprietary.trade secret i i DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 Specification EyeMed Response If the member elects to appeal the decision.1 of 2 groups will hear the appeal.The Peer Review Sub- committee will hear appeals centered on quality of clinical care while the Claim Appeal Sub-committee will hear appeals centered on claim denial. Last year, EyeMed received only 2,871 formal complaints from over 23.4 million claims-equating to less than 0.01%. Section A2 Scope of Work In-Network Perform all claims processing functions including Network claims are always submitted by our verification of enrollment; determination of benefit providers,so its simple and convenient for members coverage;application of appropriate provider to use their benefits. Here's what happens during the reimbursement;creation and mailing of EOBs for all claims process: claims;timely payment;storage of all claims information • Provider verifies eligibility and then submits the claim. • The claim passes through our automated claims system to make sure all benefits are applied correctly. • The claim goes through our billing system and we disperse payment to the provider. Out of Network Most of our members choose to visit an in-network provider,but if a member wants to see an out-of- network provider,they can easily submit the claim for reimbursement: • Members log into the Member Web after receiving service and submit the claim for reimbursement online and include a photo of their itemized receipt from the provider.Additional options include downloading an out-of-network claim form from our website or requesting one through our Customer Care Center and mailing it in. • The claim is adjudicated through our automated claims system to make sure all benefits are applied correctly. • The claim goes through our payments system and we mail them a reimbursement check. In addition, members also have the option to quickly and easily submit out-of-network claims via our online portal.The member need only fill out a quick form at eyemed.com,upload a photo of their receipt and submit the claim. eye 5 I Confidential.oropnetary,trade secret Mea DocuSign Envelope ID 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Specification EyeMed Response Meanwhile,we produce EOBs weekly and post them on our website within 7 days of production.All EOBs are based on the claims processed from the prior week. Our EOBs include the provider's reimbursement,the member's out-of-pocket charges and copayment amounts. It's easy to read and understand, but if a member has any questions.they can call our Customer Care Center and we'll be happy to talk them through it.Want to take a look at what members see after they receive services? Section A2 Scope of Work Working with us for the past 12 years,you know that Produce claims reports to monitor plan financials, our reporting package gives you a detailed view of utilization, network performance,etc. your vision benefits. In fact,your latest utilization report shows that more than 97%1 of your members utilize their in-network benefit-which means you're getting great value.We're happy to continue sending your utilization report on an annual basis,so that you can understand your plan's performance.including trends with usage,preferences,and more. Take a look at what your reporting package will continue to include: • Utilization: illustrates enrollment trends and provides exam and material utilization statistics • Network Utilization:explains member provider preferences,including usage among independents and retailers,as well as frame utilization by price point and network • Benefit Utilization:illustrates the benefit savings on exams,contacts,frames and lenses and provides utilization stats based on member age groupings • Member Experience: measures member savings on exams,contacts,frames,lenses and lens options • Performance Statistics:outlines our ability to meet and exceed our agreed upon performance standards in both client and member services In addition,you'll continue to receive the following reports within 2 business days each time data is loaded: • Eligibility Detail:provides a snapshot of the employees added,received and termed eye 6 I Confidential proprietary,trade secret Med DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Specification EyeMed Response • Eligibility Exceptions:details the exception records not loaded, along with the reason, helping to quickly address and correct the issue • Termination Report: lists all terming members or members missing from the full eligibility file • Group Summary Report: shows how many subscribers and dependents that were loaded by Group ID as well as any members not loaded due to invalidity 1 City of Miami Beach Utilization Report, 2022 Section A2 Scope of Work For your active members who will be newly enrolled, our most popular method for submitting membership Enroll active members during open enrollment with an is through electronic data file. Once you select us,you effective date of October 1st and (or your TPA)collect your membership data, all give terminated members the ability to continue securely,and send us a full list of all participating coverage via COBRA. employees. In addition, we've got you covered for open enrollment support. Benefit summaries,optional enrollment forms and representation at employee meetings with at least 500 people onsite means we're looking out for you. For your terminated members, EyeMed will work with your COBRA Administrator to offer benefits to your former plan members who elect to continue coverage under applicable state or federal continuation of coverage laws. eve 7 I Confidential.proprietary.trade secret M V a DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 eve Network Analysis EyeMed Vision Care Select Network Created for... City of Miami Beach April 22, 2022 Created with the Quest Analytics Suite Copyright© 2003-22 Quest Analytics, LLC. DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-6190EB4B6A43 Network Analysis 2 Contents Report Contents All Employees 3 Map View:Employee Map All Providers 4 Map View:Select Provider Map Urban/Suburban - 2 Providers within 10 Miles Access Summary By City 6 Access Analysis: EMS/US-2 Providers within 10 Miles Access Detail By Zip Code 7 Access Analysis: EMS/US-2 Providers within 10 Miles Rural - 1 Provider within 20 Miles Access Summary By City 9 Access Analysis: EMS/R- 1 Provider within 20 Miles Access Detail By Zip Code 10 Access Analysis:EMS/R-1 Provider within 20 Miles DocuSign Envelope ID 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Network Analysis 3 All Employees Employee Map �`•_ ` 160 —i --- i : le r l • �� lam , lsj i • ♦ ,f i r __ �'- ••• • - '2. : '� 4 ,i r n+ � " - x f Y .) @ 2022 Quest Analytics,LLC. April 22,2022 DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Network Analysis 4 All Providers • Select Provider Map fiT r . . 11 .` Ie. ' }` /�f V� 5'2222_finest Analylics,LL0,. April 22,2022 DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 Urban/Suburban - 2 Providers within 10 Miles DocuSign Envelope ID:1BDE0DE1-3EAF-450E-8374-619DEB4B6A43 Network Analysis - Employees With and Without Access 6 Access Summary By City Employees With and Without Access Employee Group 1,441 employees 1,441 (100.0%) employees with access 0 (0.0%) employees without access Provider Group (120,090 total access points) Key Geographic Areas Employee With Access' Without Access' Counts' Average Distance City # # % # % # 1 2 3 Miami, FL 721 721 100.0 0 0.0 407 1.1 1.4 1.7 Miami Beach, FL 186 186 100.0 0 0.0 21 0.8 0.8 0.8 Hollywood, FL 165 165 100.0 0 0.0 115 0.9 1.1 1.3 Hialeah, FL 114 114 100.0 0 0.0 94 0.8 0.9 1.1 Fort Lauderdale, FL 74 74 100.0 0 0.0 225 1.1 1.3 1.5 Miami Gardens, FL 30 30 100.0 0 0.0 1 1.1 2.0 2.1 Opa Locka, FL 25 25 100.0 0 0.0 4 1.8 2.3 2.3 Hallandale, FL 15 15 100.0 0 0.0 0 1.8 2.0 2.0 d Homestead, FL 15 15 100.0 0 0.0 26 2.6 2.6 2.6 u North Miami Beach, FL 11 11 100.0 0 0.0 3 0.7 1.1 1.3 4 Pompano Beach, FL 11 11 100.0 0 0.0 102 1.0 1.4 1.6 6 Pembroke Pines, FL 10 10 100.0 0 0.0 3 1.0 1.3 1.3 3 Boynton Beach, FL 6 6 100.0 0 0.0 69 0.9 1.1 1.2 Boca Raton, FL 4 4 100.0 0 0.0 87 1.7 1.9 2.0 Coral Springs, FL 3 3 100.0 0 0.0 23 0.9 0.9 1.0 Delray Beach, FL 3 3 100.0 0 0.0 46 0.7 0.8 0.9 Cape Coral, FL 2 2 100.0 0 0.0 87 1.9 2.6 2.6 Dania, FL 2 2 100.0 0 0.0 11 0.7 0.7 0.7 Key Biscayne, FL 2 2 100.0 0 0.0 2 0.1 0.2 6.3 Orlando, FL 2 2 100.0 0 0.0 404 2.0 2.4 2.6 Palm Ba FL 2 2 100.0 0 0.0 4 2.4 2.9 3.3 No data that meets the criteria 0 2022 Guest Analyfics.LLC. April 22,2022 Provider Group Areas Without Access Bottom 21 Cities in the market,sorted by the EyeMed Select Providers number of employees without access Access Analysis EMS/US-2 Providers within 10 Miles Areas With Access 1 The Access Standard is defined as Employee Group Top 21 Cities in the market,sorted by the number (Urban/Suburban Employees)employees Urban/Suburban Employees of employees with access accessing: Too many lines to display DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Network Analysis - Employees Without Access 7 Access Detail By Zip Code Employees Without Access : Zip Employee Without Access' Average Distance • ':t y *; < Code # # % 1 2 3 No data that meets the criteria ©2022 Quest Analytics,LLC. April 22,2022 EyeMed Select Providers 2(EyeMed Select Providers) providers in 10 miles Access Analysis EMS/US-2 Providers within 10 Miles EMS/US-2 Providers within 10 Miles 'The Access Standard is defined as (Urban/Suburban Employees)employees Employee/Provider Groups accessing: Urban/Suburban Employees DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Rural - 1 Provider within 20 Miles DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Network Analysis - Employees With and Without Access 9 Access Summary By City II Employees With and Without Access Fmployee Group. 98 employees 96 (98.0%) employees with access - 2 (2.0%) employees without access "Provider Group (120,090 total access points) fKey Geographic Areas Employee With Access' Without Access' Counts' Average Distance City # # a # oh, # 1 2 3 Miami, FL 20 20 100.0 0 0.0 407 2.9 3.5 3.5 Homestead, FL 5 5 100.0 0 0.0 26 2.4 2.4 2.4 Fort Pierce, FL 2 2 100.0 0 0.0 12 4.7 4.7 6.2 Melbourne, FL 2 2 100.0 0 0.0 105 0.7 1.0 1.1 Ocala, FL 2 2 100.0 0 0.0 113 7.5 7.5 7.5 Palm City, FL 2 2 100.0 0 0.0 2 1.7 1.7 3.2 Palm Coast, FL 2 2 100.0 0 0.0 24 0.9 1.1 1.1 Summerfield, FL 2 2 100.0 0 0.0 0 5.6 5.6 5.6 in Tallahassee, FL 2 2 100.0 0 0.0 134 6.2 6.6 6.6 'u Troy,AL 2 2 100.0 0 0.0 12 2.9 2.9 2.9 Apopka, FL 1 1 100.0 0 0.0 30 4.6 4.6 4.6 Arcadia, FL 1 1 100.0 0 0.0 9 1.7 1.7 1.7 Baldwin, GA 1 1 100.0 0 0.0 1 3.8 6.4 6.4 Beverly Hills, FL 1 1 100.0 0 0.0 0 7.7 8.5 9.2 Brooksville, FL 1 1 100.0 0 0.0 22 10.1 10.4 10.4 Browns Summit, NC 1 1 100.0 0 0.0 0 7.8 7.8 7.8 Clermont, FL 1 1 100.0 0 0.0 63 2.9 2.9 4.3 Cumming, GA 1 1 100.0 0 0.0 60 5.6 6.7 6.7 Davenport, FL 1 1 100.0 0 0.0 6 4.2 4.2 4.2 Defuniak Springs, FL 1 1 100.0 0 0.0 5 8.2 8.2 8.2 Deland FL 1 1 100.0 0 0.0 10 2.9 2.9 2.9 Aspen, CO 1 0 0.0 1 100.0 0 24.5 32.5 37.9 Astor, FL 1 0 0.0 1 100.0 0 20.3 20.3 20.3 to i ID v o 0 2022 0uest Analy,ics,LLC. April 22,2022 Provider Group Areas Without Access EyeMed Select Providers Bottom 21 Cities in the market,sorted by the Access Analysis number of employees without access EMS/R- 1 Provider within 20 Miles Areas With Access Top21 Cities in the market,sorted bythe number `The Access Standard is defined as(Rural Employee Group Employees)employees accessing: Rural Employees of employees with access 1(EyeMed Select Providers)provider in 20 miles Too many limo to dhpYT DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Network Analysis - Employees Without Access 10 Access Detail By Zip Code Aspen, CO 81611 1 1 100.0 24.5 32.5 37.9 Astor, FL 32102 1 1 100.0 20.3 20.3 20.3 Grand Totals 2 2 100.0 22.4 26.4 29.1 ©2022 Quest Analytics LLC. April 22,2022 EyeMed Select Providers Access Analysis EMS/R-1 Provider within 20 Miles EMS/R-1 Provider within 20 Miles 'The Access Standard is defined as(Rural Employees)employees accessing: Employee/Provider Groups 1(EyeMed Select Providers) provider in 20 miles Rural Employees DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 eN{e City of Miami Beach-10/1/2022-ASO fried Reporting Guarantee Reporting01/2022 09/30/2025 Administrative Services Only(ASO)Quote: Fees At Risk: 20%of Adair Results Reported: Quarterly Fees Measured and Paid: Annually Performance uarantee Pe ormance 'esults 4—Definition alcuration Amo 41111 At Risk Based on daily audit of a statistically EyeMed will process clean and valid significant sample of all claims. Claim Processing Processing Accuracy claims with at least 99%accuracy Calculation:(Total#of accurate claims 1.82% sampled/Total#of claims sampled) EyeMed will pay the correct amount on Based on daily audit of a statistically significant sample of all claims. Claim Processing Financial Accuracy clean and valid claims with at least Calculation:(Total$correctly paid in 1.82% 99.5%accuracy sample/Total$in sample) Claim Turnaround Time- 99%of Clean and Valid Claims Measurement:Claim Received Date to Claim Processing Paid processed and paid within 10 business Claim Paid Date(This includes both In- 1.82% days Network and Out-of-Network claims) 100%of Welcome Packets will be Measured from the date the Membership distributed within 10 business days of file is loaded by EyeMed to the date Implementation and On- Member ID Cards loading clean membership data file Welcome Packets are distributed 1.82% Going Administration (excludes packets requiring (Membership files after 4:00pm ET will translation). count as the next business day) 98%of electronic eligibility files will be Measured from the date the eligibility file is received by EyeMed to the date Implementation and On- Eligibility Updating processed within two(2)business days eligibility files are loaded to EyeMed's 1.82% Going Administration of receipt of clean data delivered via system(Files after 4:OOpm ET will count SFTP as the next business day) The Abandonment Rate represents the% of all callers who hang up prior to being answered(calls abandoned within 8 Member Services Call Abandonment Rate No more than 2.5%of calls received seconds or less are excluded from 1.82% calculation).Calculation equals all abandoned calls divided by the total numbers of calls received. The Average Speed of Answer equals the average length of time a caller waits in Member Services Average Speed of Answer Will not exceed 25 seconds queue prior to being answered. 1.82% Calculation equals total calls and their avg time on hold-inclusive of all calls. 98%of all written complaints will be acknowledged in writing within 3 Complaints/Appeals/ Provider Relations Grievance Resolution business days of mail/fax receipt by Self Explanatory 1.82% the EyeMed Quality Assurance Department. Complaints/Appeals/ Provider Relations Grievance Resolution 98%complaint resolution in 30 days Self Explanatory 1.82% Surveys Member Survey(National 95%member satisfaction 95%(top 3 box) 1.82% y Results) Standard Utilization Producing standard Utilization Utilization Reporting Reporting Package Reporting Package within 30 days of Self Explanatory 1.82% the end of the reporting period f, Performance guarantee results are based on our total book of business and payments,if any,are assessed and paid on an annual basis.Results are reported quarterly and are issued on standard calendar quarters. City of Miami Beach Administrative Services Only(ASO)-05-03-2022 1 DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 State of Florida Department of State I certify from the records of this office that FIRST AMERICAN ADMINISTRATORS, INC. is an Arizona corporation authorized to transact business in the State of Florida, qualified on May 26, 1998. The document number of this corporation is F98000002974. I further certify that said corporation has paid all fees due this office through December 31, 2021, that its most recent annual report/uniform business report was filed on March 26, 2021, and that its status is active. I further certify that said corporation has not filed a Certificate of Withdrawal. Given under my hand and the Great Seal of the State of Florida at Tallahassee, the Capital, this the Eighth day of March, 2022 • Cam" coi, Secretary of State Tracking Number:9469991306CU To authenticate this certificate,visit the following site,enter this number,and then follow the instructions displayed. https://se rvices.su n biz.o rg/Filings/C a rtificateOf Statu s/CertificateAuth enticatio n DocuSign Envelope ID: IBDEODEI-3EAF-450E-8374-619DEB4B6A43 State of Florida Department of State I certify from the records of this office that EYEMED VISION CARE LLC is a Delaware limited liability company authorized to transact business in the State of Florida, qualified on August 7, 2001. The document number of this limited liability company is MO1000001774. I further certify that said limited liability company has paid all fees due this office through December 31, 2021, that its most recent annual report was filed on March 26, 2021, and that its status is active. I further certify that said limited liability company has not filed a Certificate of Withdrawal. Given under my hand and the Great Seal of the State of Florida at Tallahassee, the Capital, this the Eighth day of March, 2022 crl' .. Y- ...9i,,,, 44 ...,..„..„„ ,r.,.,,,.., ..... ;,. .„.,,,. .,.....___• _ . . _,..„...„..,4 '`.'* '.4,. _ ...t4•17-7 --T,i'.. ..--:.!... fitatillW ii . v,i Secretary of State Tracking Number:4630971124CU To authenticate this certificate,visit the following site,enter this number,and then follow the instructions displayed. https://services.su nbiz.org/Filings/CertificateOfstatus/CertificateAuthentication DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 EyeMed Response to Experience and Qualifications Tab 2 - Experience&Qualifications 2.1 Qualifications of Proposing Firm.Submit detailed information regarding the relevant experience and proven track record of the firm and/or its principals in providing the scope of services similar as identified in this solicitation,including experience in providing similar scope of services to public sector agencies. For each project that the Proposer submits as evidence of similar experience for the firm and/or any principal,the following is required:project description, agency name,agency contact,contact telephone 6 email,and year(s)and term of engagement. For each projects,identify whether the experience is for the firm or for a principal(include name of principal). Project Description We already know you and your industry well,plus we've been providing vision benefit programs since 1988. Our expertise and flexibility support complex business structures,including many diverse populations across the country.With more than 200 of your peers and more than 1.5 million of their employees,we've become quite familiar with your industry,and our experience counts.We're America's fastest growing vision benefits company' with more than 30 years of experience,plus we're challenging the status quo.We give you the vision network where employees are and benefits that take your employees'dollars further while making the experience easy and transparent for all. Check out our qualifications: • The right mix of independent providers,the most desired national and regional retail providers and online in- network options give members the choice and convenience they expect • Flexible benefit options that align with what your members want,all with freedom of choice • Multiple ways for members to access their benefits-from our mobile app to eyemed.com,even locating providers and booking appointments online • An award-winning call center that's available 102 hours per week-an average of about 15 hours per day • A secure,fully integrated system that allows us to quickly and accurately verify eligibility, process claims and support members • Dedicated implementation and service teams that create a simplified,hassle-free experience that you can appreciate What this means is we provide our clients and their employees with more of what's best,not more of the same. In fact,our experience has made us very familiar with your industry,and we've served additional clients like you, such as the following: Agency Names 1. City of Lakeland 228 S Massachusetts Ave Lakeland, FL 33801-5012 Contact:Joyce Dias Risk Manager 863.834.6000 joyce.dias@lakelandgov.net Client since 2019 DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 2.JPOFFHIT 625 Stockton St Jacksonville, FL 32204 Contact:Steve Zona President 904.759.7416 szonaOjpoffhit.org Client since:2020 3.City of West Palm Beach 401 Clematis St West Palm Beach, FL 33401-5319 Contact:Jennifer Chripczuk Benefits Manager 561.822.1200 jchripczukowpb.org Client since:2016 4.City of Philadelphia 9800 Ashton St. Philadelphia, PA 19102 Contact: Marsha Greene-Jones Deputy Director 215.686.2325 marsha.greene Jones@phila.gov Client since 2016 1 Internal analysis of EyeMed membership data compared to data from leading vision benefit companies, as reported in publicly available information, 2019. DocuSign Envelope ID:1BDEODEI-3EAF-450E-8374-619DEB4B6A43 EyeMed Response to Experience and Qualifications 2.2 Qualifications of Proposer Team.Provide an organizational chart of all personnel and consultants to be used for this project if awarded,the role that each team member will play in providing the services detailed herein and each team member's qualifications.A resume of each individual,including education,experience and any other pertinent information,shall be included for each Proposal team member to be assigned to this contract. We support our clients every step of the way to make sure that they each get the most from their vision benefit.The Account Management team dedicated to your account has been purposefully assembled with individuals whose client experience is similar in industry,size and complexity to yours. As our client,you can expect a hassle-free administration of benefits, because we'll lead you through each phase of our program and remain dedicated to your account throughout our partnership. Say hello to your EyeMed team: Teresa Moyers-Senior Account Manager • Day-to-day contact • Execution of key deliverables • Eligibility, billing and reporting inquiries • Benefit performance and consultation • Contract renewal Erin Putman -Account Management Director • Executive-level oversight • Escalated inquiries • Overall benefit satisfaction Operations Service Department • Project manager and system logic expert • Operations partner for projects and issue resolution • Contact for file changes and issues Account Coordinator Team • Member eligibility questions and urgent updates • Member claims questions • EyeManage password resets • Copies of invoices and rosters To give you a broader view of our support teams, we've attached an organizational chart as Exhibit C. Plus,you can find more details of each team member's background in our Resumes that are included as Exhibit D. DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 Nice to see � a ain , City of Miami Beach you • 98% Client Retention Easy for employees means easier for you, too. • 99% Client Satisfaction Let us prove it, with: • Over 99% Implementation Satisfaction Lukas Ruecker PRESIDENT Matt MacDonald Jason Rome Sr. VP, Operations Chief Commercial Officer Chad Prittie Natasha D'Sa Brendan Edwards National VP, Acct VP, Sales VP, Operations Management Liz Carozza Shawn Gillum Erin Putman Brian Boose Director, Ops Sr. Director, Director of Account Regional VP, Services Operations Management Sales Evette Levine Teresa Moyers Operations Service Sr. Manager Senior Account Thomas Koebel Brian Birge Department Implementation Manager Sales Director Sales Manager The VIlages, FL Hollywood, FL Implementation Manager eve MG d DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Chad Prittie eye NATIONAL VICE PRESIDENT.EYEMED VISION CARE mea BACKGROUND Highly experienced team leader with more than 24 years of experience in the employee benefits field,13 of which have been with EyeMed Successfully leads the sales and account management teams to effectively represent constituent needs within the larger organization Dedicated to exceeding client satisfaction by building solid partnerships in order to determine and develop the most efficient way to solve client needs EXPERIENCE EyeMed Vision Care I National Vice President of Account Management Lead commercial account management focused on retention,strategy development and account Responsible for small,medium and national account segments,which includes groups between 10-30,000 members Provides Executive-level oversight to clients and prospects EyeMed Vision Care I Regional Vice President Responsible for leading a team of Sales and Account Managers in the Mid-west Region of the country Responsible for sales to prospects with 10-20,000 employees and account management for clients with eligible employees between 2.000-20,000 Consults with sales team to make sure we are meeting the strategic needs of our prospects Mentors and assists team to provide quick solutions and client/member satisfaction Provides Executive-level oversight to clients and prospects The Kroger Company I Manager of Corporate Benefits Responsible for health management programs,financial performance,labor relations,and vendor relationships Successfully led the development of a healthcare strategy with a strong emphasis on consumerism and health management Served as a consultant to the labor relations team on numerous health and welfare union contracts EDUCATION MBA Entrepreneurship concentration, University of Louisville BS Business/Environmental Science.Minor in Psychology. Taylor University 4000 LUXOTTICA PLACE MASON. OHIO 45040 0 866-945-4985 chod.prittieoeyemed.com DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 Ra Erin Putman eve mea �. P DIRECTOR,ACCOUNT MANAGEMENT EYEMED VISION CARE r* B A C K G R O U N D Seasoned business director with more than two decades'experience in client services and communications(17 years of industry experience).13 of which have been with EyeMed; particularly specialized in health insurance.Fortune 500 communications and project leadership. EXPERIENCE EyeMed Vision Care I Director,Account Management Manages and develops commercial account management team Serves as executive point of escalation for client and broker inquiries Assists with strategic development of retention planning Oversees commercial book of national accounts including fortune 1,000 companies EyeMed Vision Care I Director.Strategic Partners Managed new and existing business development opportunities for strategic health partners with special focus on government programs Retained and grew partners'books of business through strategic planning,sales and service consultation,training and contract execution EyeMed Vision Care I National Account Manager Managed national client groups with 2.000-19.999 employees Acted as vision plan consultant,recommending services and plan enhancements based on employee utilization and industry trends EyeMed Vision Care I Sales Support Manager Project managed key client initiatives including implementation deliverables,contract negotiations,sales training and messaging for strategic health and dental partners Served as internal liaison for account management.legal,compliance,provider relations, marketing,operations,finance and internal brands EDUCATION Masters of Arts in English Composition and Rhetoric Bachelor of Arts in English Literature. Wright State University 4000 LUXOTTICA PLACE MASON. OHIO 45040 0 513.765.3837 erin.putmanOeyemed.corn DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 Teresa Moyers ev SR. NATIONAL ACCOUNT MANAGER meci 411164 EYEMED VISION CARE BACKGROUND Highly experienced Account Manager with more than 40 years of experience.16 of which have been with EyeMed Dedicated to building and maintaining client relationships through proactive account management and effective consultation Successful in partnering with cross-functional teams to achieve goal-oriented results EXPERIENCE EyeMed Vision Care I Sr.National Account Manager Responsible for national client groups with 2,000-19,999 employees Delivers a high level of client and member satisfaction Facilitate and track resolution for all administrative inquiries and client requests Acts as a vision plan consultant,recommending services and plan enhancements based on employee utilization and industry trends Conducts business and strategy reviews Anthem Blue Cross&Blue Shield I Manager Account Services Responsible for client groups 5,000-20.000 Proactively manage protocol to include client visits as defined by group size Managed day to day contact with internal departments,including call center,claims.network and finance Responsible for on-going training of internal departments:claims,call center EDUCATION Associates Degrees in Business and Marketing. University of Cincinnati Certified Health Consultant Designation-CHC The Health Insurance Association of American-HIAA Designation 4000 LUXOTTICA PLACE MASON. OHIO 45040 0 877-384-3115 teresa.moyersOeyemed.com DocuSign Envelope ID 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 EyeMed Response to Approach and Methodology Tab 3 -Approach and Methodology 3.1 Submit detailed information on how Proposer plans to accomplish the required scope of services, including detailed information, as applicable,which addresses, but need not be limited to: • Include a schedule of benefits and any applicable discounts,costs,copays, etc. Benefit and cost details,including copays,discounts.etc.,are outlined in our Cost Proposal, attached in Tab 4. • Vision network of credentialed ophthalmologists, optometrists,opticians and retail optical centers that are geographically accessible to participants Selecting EyeMed ensures your members will continue to reap the benefits of a network offering the right mix of independent providers, plus the most desired national and regional retail providers.This means that members will experience zero disruption while still utilizing the network they've come to know-in fact, more than 97%of your members currently utilize an in-network provider.But as you know,we don't just stop with great access.Our network continues to redefine expectations: Our Select Network is made up of more than 25,400 locations nationwide.That includes more than 500 locations in your top employee metro area,Miami/Fort Lauderdale/West Palm Beach-over 16%more than our biggest competitor* Internal analysis of Netminder competitor data, Winter 2020. • Explain how the proposer will efficiently and accurately communicate with City personnel and the benefits consultant. Whether you give us a call or send an email,your National Account Manager,Teresa Moyers,will continue to respond within 1 business day or sooner.You'll also continue to receive Annual Business Reviews and other updates as you have all along. Your satisfaction and peace of mind are important to us so we built an account management strategy that allows you to appreciate a stress-free benefit administration experience. From the point of sale to ongoing service,we'll be with you every step of the way. Whether you like to do-it-yourself or leave it all to us,our team-based approach will allow for you to get quick answers.Assigned based on service expertise,access to clients and internal resources,and lead by a professional,experienced account manager,we're all working hard so you don't have to. • Explain proposer's approach to customer service and how it retains representatives with knowledge on specific details of the vision plan,claims and the network of providers. Our Customer Care Center provides service to over 68 million members and consistently meets and exceeds stringent performance levels such as an average speed of answer of less than 25 seconds and an impressive 99.6%first call resolution rate. All representatives are 100%dedicated to answering EyeMed questions only-unlike competitors who also administer dental or medical through the same call center.What's more,our automated system allows us to route calls based on need level so that complex or escalated issues are forwarded to more experienced representatives. eve 1 I Confidential.proprietary.trade secret -Solicitation 2022-320-WG med DocuSign Envelope ID 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 To make sure that our representatives are ready to quickly and accurately answer calls,they undergo extensive training. By using an issue-based program,our representatives are only able to answer calls at their current skill level,leaving tenured representatives for more complex inquires.This means your calls go to the best person suited to answer your question every time- no waiting or being transferred. Below is an overview of our issue-based training: Member • Call Types: Eligibility status, ID cards, benefit information,provider locator,claim status,out-of-network reimbursements • Training: HIPAA compliance,classroom instruction, hands on training,small group sessions,mentoring, call monitoring,3 assessment tests and 3 quality observations Provider • Call Types: Eligibility status,claims status,other claims inquiries • Training: Member experience,classroom instruction,2 assessment tests and 3 quality observations Provider Relations • Call Types:Provider relations and complex inquiries • Training: Member and provider experience,classroom instruction and mentoring Hours of Training • Member:88 hours of classroom • Provider:80 hours of classroom • Provider Relations:16 hours of classroom Methods and Materials • Training is delivered with a variety of methods including classroom and e-leaming. • Online knowledge base website is used throughout training and on-going basis. • Classroom training includes PowerPoint,hands-on exercises,worksheets, interactive e-learning courses and quizzes to test their knowledge. • Explain how the proposer will resolve any member issues(preferably within(3)working days) Each of our representatives is empowered to resolve issues over the phone. And that's just one reason we average a 99.6%first call resolution rate.' By using a skill-based routing system,we're able to make sure each call received is answered by an individual who has the knowledge and skills to resolve the caller's question. If you have a question,give us a call -we'll take care of the rest. On rare occasions,our representatives can assist in documenting a complaint to our Quality Assurance department. Within 3 Business days, members will receive written confirmation of receipt. For complaints dealing with clinical care,our Medical Director reviews and researches the issue.A resolution,acknowledged in writing. will be reached within 30 calendar days or less. •EyeMed Book of Business, 2020 • Explain the process for receiving enrollment from the City via electronic enrollment. You can continue to send us electronic eligibility data on a weekly basis.Weekly"add,change,and delete"files are preferred. If you choose to send weekly"add,change,and delete"files,we recommend a full-file update at least monthly to make sure we collect up-to-date information on all members. eve 2 I Confidential, proprietary.trade secret -Solicitation 2022-320-WG Mea DocuSign Envelope ID: 1BDEODEI-3EAF-450E-8374-619DEB4B6A43 We're able to accept eligibility in the following formats: • 834x12 file format • EyeMed proprietary fixed length record format. • Most TPA&proprietary file formats can be supported You can transmit eligibility to us via SFTP-using SSH encryption. Plus,your benefit administrator can continue to make eligibility changes through EyeManage. Through this innovative tool.you'll continue to have access to valuable updates including: • Real-time enrollment reports, plus a centralized reporting hub • Smart Search-an advanced search tool • Improved workflow for Member Management functionality • Streamlined billing and payment options • Enhanced Administrator Management section • Simplified password reset&ID requests • Expanded user Resource Center with EyeManage specific training pieces and member materials • Explain how the proper will provide monthly billing reports with access to pull billing and other coverage information online securely. An electronic version of your monthly administrative fee invoice will continue to be produced based on all active members within our system at the time of billing,as well as an invoice for claims incurred during the month.All payments are due at the beginning of each month.We provide 90-day retroactive adjustments on each administrative invoice for any membership updates not captured in time for the invoice.You can always view up to 13 months of your invoices through our website. Invoices are prepared on the 21st of each month,1 month in advance,and will be available on EyeManage near the end of the month. • Explain the proposer's appeals procedure process for any member with dissatisfaction with a claim denial. We're always sorry to hear that a member has a complaint, but even more so,we are always confident that we can take care of it Members with complaints or inquiries should initially contact our Customer Care Center where our team is available 7 days a week to answer their questions.Our representatives are thoroughly trained in issue resolution for every type of call.And,what's even better is that 99%of the time inquiries are resolved during this first call. But on rare occasions,they can't be.So, as previously stated,our representatives can assist in documenting a complaint to our Quality Assurance department.Within 3 Business days, members will receive written confirmation of receipt. For complaints dealing with clinical care,our Medical Director reviews and researches the issue.A resolution,acknowledged in writing,will be reached within 30 calendar days or less. If the Member elects to appeal the decision,one of two groups will hear the appeal.The Peer to Peer subcommittee will hear appeals centered on quality of clinical care while the Claim Appeal subcommittee will hear appeals centered on claim denial. Last year, EyeMed received only 2,871 formal complaints from over 23.4 million claims-equating to less than 0.01%. eve 3 I Confidential.proprietary trade secret -Solicitation 2022-320-WG fried DocuSign Envelope ID 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 • Explain how the proposer will efficiently process claims including verification of enrollment determination of benefit coverage, application of appropriate provider reimbursement,creation and mailing of EOBs for all claims,timely payment, storage of all claims information. In-Network Network claims are always submitted by our providers,so it's simple and convenient for members to use their benefits. Here's what happens during the claims process: • Provider verifies eligibility and then submits the claim. • The claim passes through our automated claims system to make sure all benefits are applied correctly. • The claim goes through our billing system and we disperse payment to the provider. Out of Network Most of our members choose to visit an in-network provider, but if a member wants to see an out-of-network provider,they can easily submit the claim for reimbursement: • Members log into the Member Web after receiving service and submit the claim for reimbursement online and include a photo of their itemized receipt from the provider.Additional options include downloading an out-of- network claim form from our website or requesting one through our Customer Care Center and moiling it in. • The claim is adjudicated through our automated claims system to make sure all benefits are applied correctly. • The claim goes through our payments system and we mail them a reimbursement check. In addition, members also have the option to quickly and easily submit out-of-network claims via our online portal.The member need only fill out a quick form at eyemed.com,upload a photo of their receipt and submit the claim. Meanwhile,we produce EOBs weekly and post them on our website within 7 days of production.All EOBs are based on the claims processed from the prior week. Our EOBs include the provider's reimbursement,the member's out-of-pocket charges and copayment amounts. It's easy to read and understand, but if a member has any questions,they can call our Customer Care Center and we'll be happy to talk them through it.Want to take a look at what members see after they receive services? Check out Exhibit E for a sample EOB. • Explain how the proposer will monitor and report plan financials,utilization, network performance, etc. Working with us for the past 12 years.you know that our reporting package gives you a detailed view of your vision benefits. In fact,your latest utilization report shows that 97.4%1 of your members utilize their benefit in- network-which means you're getting great value.We're happy to continue sending your utilization report on an annual basis.so that you can understand your plan's performance,including trends with usage,preferences,and more. Take a look at what your reporting package will continue to include: • Utilization: illustrates enrollment trends and provides exam and material utilization statistics • Network Utilization:explains member provider preferences, including usage among independents and retailers. as well as frame utilization by price point and network • Benefit Utilization:illustrates the benefit savings on exams,contacts,frames and lenses and provides utilization stats based on member age groupings • Member Experience: measures member savings on exams,contacts,frames,lenses and lens options eve 4 I Confidential,proprietary,trade secret -Solicitation 2022-320-WG Med DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 • Performance Statistics:outlines our ability to meet and exceed our agreed upon performance standards in both client and member services In addition, you'll continue to receive the following reports within 2 business days each time data is loaded: • Eligibility Detail: provides a snapshot of the employees added, received and termed • Eligibility Exceptions: details the exception records not loaded,along with the reason, helping to quickly address and correct the issue • Termination Report: lists all terming members or members missing from the full eligibility file • Group Summary Report: shows how many subscribers and dependents that were loaded by Group ID as well as any members not loaded due to invalidity 1 City of Miami Beach Utilization Report, 2022 • Explain the process for enrollment of active members during open enrollment with an effective date of October 1 and give terminated members the ability to continue coverage via COBRA. Our most popular method for submitting membership is through electronic data file.Once you decide to renew with us, you (or your TPA)collect your membership data, all securely, and send us a full list of all newly enrolled employees. In addition, we've got you covered for open enrollment support. Benefit summaries,optional enrollment forms and representation at employee meetings with at least 500 people onsite means we're looking out for you. For your terminated members, EyeMed will work with your COBRA Administrator to offer benefits to your former plan members who elect to continue coverage under applicable state or federal continuation of coverage laws. eve 5 I Confidential,proprietary,trade secret -Solicitation 2022-320-WG MG a DocuSign Envelope ID:18DEODEI-3EAF-450E-8374-619DEB4B6A43 eve �4 Me °k EXPLANATION OF BENEFITS EyeMed Vision Care *** THIS IS NOT A BILL *** Administered by: First American Administrators. Inc. Page 1 of 10 4000 Luxottica Place Mason, OH 45040 Subscriber: CARL COMBINED Group Name: XYZ COMPANY PLAN Date Printed: 09/22/2020 COMBINED, CARL 000 MAIN ST ANYTOWN, ZZ 99999 Claim ID: 13597425960 Member ID: 9876543210 Provider ID: NC5051 Claim Activity for CARL COMBINED (Subscriber) Date of Service: 08/22/20 Claim Information: Annual Benefit Limit(s) Exam: No remaining benefits for the frequency period in which this service was obtained Frame: No remaining benefits for the frequency period in which this service was obtained Lens: No remaining benefits for the frequency period in which this service was obtained Contacts: No remaining benefits for the frequency period in which this service was obtained DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 Claim ID: 75216983040 Member ID: 7654321098 Provider ID: OH5051 Claim Activity for CAROL COMBINED (Subscriber) Date of Service: 08/22/20 Claim Information: Annual Benefit Limit(s) Exam: No remaining benefits for the frequency period in which this service was obtained Frame: No remaining benefits for the frequency period in which this service was obtained Lens: No remaining benefits for the frequency period in which this service was obtained Contacts: No remaining benefits for the frequency period in which this service was obtained Claim ID: 75216983041 Member ID: 7654321098 Provider ID: OH5051 Claim Activity for CAROL COMBINED (Subscriber) Date of Service: 08/22/20 Claim Information: Annual Benefit Limit(s) Exam: No remaining benefits for the frequency period in which this service was obtained Frame: No remaining benefits for the frequency period in which this service was obtained Lens: No remaining benefits for the frequency period in which this service was obtained Contacts: No remaining benefits for the frequency period in which this service was obtained Remarks: (Code/Description) PSR=The charge exceeds the allowable rate for the service EyeMed Vision Care is providing you with this explanation of benefits as a service to our members. If you have questions regarding benefit application, please contact us via the internet at www.eyemedvisioncare.com, or by calling 1-866-539-3633. Access TTY Services by dialing 711. DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 EYEMED VISION CARE OFFERS it Great savings on eye examinations, contact lenses, lens options, and accessories. Your choice of ophthalmologists, optometrists, opticians, and chain retail locations throughout the country. Many providers are open evenings and weekends to accommodate busy lifestyles. Choice of frames available at provider locations. Customer Service Representatives available to answer your questions 7 days a week, including evenings. Questions about EyeMed Vision Care?Visit our website at www.eyemedvisioncare.com DocuSign Envelope ID 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 YOUR RIGHT TO REVIEW THE PLAN'S DETERMINATION If you are not satisfied with this coverage decision, you may request a review (appeal) of this decision. To obtain a review, you or your authorized representative should submit your request in writing to: EyeMed Vision Care Attn: Quality Assurance 4000 Luxottica Place Mason, OH 45040 Fax: 1-513-492-3259 Your request for a review of this decision must be submitted within 180 days of the date of this Notice. A copy of the specific rule, guideline, or protocol relied upon in the decision will be provided free of charge upon request by you or your authorized representative. You may also review the documents relevant to your claim. If your plan is governed by ERISA, you may have the right to bring legal action under section 502(a) of ERISA if you do not agree with the final determination on review. You and your plan may have other alternative dispute resolution options, such as mediation. One way to find out what may be available is to contact your local U.S. Department of Labor office and your state insurance regulatory agency. GLOSSARY OF TERMS Claim ID: The number used to track the service you have received. Submitted Charge: Charges submitted by the provider for services rendered. (Your benefit plus discount plus what you owe totals the submitted charge.) Allowed: The maximum amount your plan will pay for a covered service. If your provider charges more than the allowed amount, you may have to pay the difference. Benefit (What We Will Pay): The amount of money paid to or on behalf of the policyholder. (Your allowed less the discount totals the benefit.) Deductible: The amount paid out of pocket by the policy holder before the insurance provider pays any expenses. Discount: Discount of submitted charges negotiated by the payor. Coinsurance: Your share of the costs of a covered service. calculated as a percent of the allowed amount for the service. Copay: A fixed amount you pay for a covered service. Total Member Responsibility: What you owe. (Your copay, plus coinsurance, plus deductible, and any services that your plan does not cover.) DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 a' NOTICE OF NON-DISCRIMINATION AND ACCESSIBILITY REQUIREMENTS Your plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.Your plan does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. For people with disabilities, we offer free aids and services, such as sign language interpreters, Braille, large print, audio, and accessible electronic formats. If you request information in an accessible format, you won't be disadvantaged by any additional time necessary to provide it. This means you will get extra time to take any action if there's a delay in fulfilling your request. For people whose primary language is not English, we offer language assistance services through interpreters and other written languages. If you believe that your plan has failed to provide these services or discriminated on the basis of race, color, national origin, age, disability, or sex,you can file a compliant, also known as a grievance, by emailing eyemedOAC©eyemed.com or calling 1-866-939-3633. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf Or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697(TDD) Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html. TRANSLATION SERVICES For free translation services, please call 888-249-5194. Access TTY services by dialing 711. SPANISH:Su plan cumple con las leyes de derechos CHINESE: 1 mt inatot 'Jrio fsnil,T© ,At• civiles federales aplicables y no discrimina por C .§i(3 A'Ist Il 1. ET�T7i° raza,color, pals de origen,discapacidad o sexo. ; Q: r V11rp5, ii .14tan Ret o a; I ATENCION: Si usted habla espar ol, hay servicios de 888-249-5194 $;MART- 0PQ $R .'($#77 Ng traduccion gratuitos disponibles. Para solicitor los ol1711c, servicios de traduccion, Ilame al 888-249-5194; marque al 711 para acceder a los servicios de TTY. KOREAN:L �I�F9l z �nN o�O�otL°M a' z zToF�i°I o,LaiT , LF OI,oh0ll,��of z"II e 7J si-oi xIz z gxl d LI CI. VIETNAMESE:Goi boo hiem cua quyvi tuan thu luat Tol: o11 AjHl z olo-6Fz phap ve cac quyen clan so'hien hanh cua Lien bang va MdLIEL.c=9 A1d1^^—z g2AIz1°1 888-249-5194 . khong phan biet del xCr vi ly do chung toc, mau da, nguon woof �Al TTY AI HI�L 711tI2 Ol a 4 o1 e LICF. goc quoc gia,tuoi tac,tinh trang khuyet tat hay gidi tinh. LUU Y: neu quy vi not Tieng Viet,se co cac dich vu dich RUSSIAN: Baw nnaH COOTBeTCTByeT Tpe6oBaHv M thuat mien phi danh cho quy vi.Doi voi cac dich vu dich p,eincTeyrou4ero 4e,gepanbHoro 3aKOHO,gaTenbCTBa thuat,vui long goi so 888-249-5194. De tiep can dich B o611acTvv 3aLLMTbi rpaxKp,aHCKvlx npaB VI He cop,epx<vT vu TTY,vui long quay so 711. npV13HaKOB,Q,VICKpVVMvHaL4VVV1 Ha OCHOBaHVIV1 paCOBOVI npuHa,gnex<HocTVI, L4BeTa KOx<Vl, HaL41/10HanbHOCTVI, TAGALOG—FILIPINO:Sumusunod ang iyong piano Bo3pacTa, orpaHviLieHvisi 03144ecKvx vim yMCTBeHHbIX sa naaangkop na mga karapatang sibil ng Pederal BO3MO)KHOCTei vim nova. at hindi nagtatangi batay sa lahi, kulay, bansang BHVIMAHVIE! ECnvl Bbi rOBO viTe Ha pyccKOM 513biKe, pinagmulan, edad, kapansanan,o kasarian. TO MO)KeTe BOCn0nb3OBaTbCA Hawei 6ecnnaTHOv1 ATENSYON: Kung nagsasalita ka ng Tagalog, cnyx<6o0 5,13biKOBOv1 nop,p,epxKKvl.Ycnyrvl nepeaop,a magagamit mo ang libreng serbisyo ng tulong sa wika. MO)KHO 3aKa3aTb no Tene#Hy 888-249-5194 vim Para sa mga serbisyong pagsasalin pakitawagan ang Tenerai/Iny(Homed 711). 888-249-5194. I-access ang mga serbisyo ng TTY sa pamamagitan ng pag-dial sa 711. DocuSign Envelope ID: 1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 4.J1).1.0.J19 a+i_cJl :ARABIC CAMBODIAN:nt[,tiThitifinintffints muoji6Kigncul0 y°9. JI J��I 91 v9J1 91 c91�1 ( iLJI I..^ ll ia,o�cgW/!9 fi.3tnn§i'Lla 331Gfiglr.ps Wht7fi3ifitiliwi'qntsjtri3MSftflfiSS .L)-.,:7.11 91 1-91— 191 v it 91 (1tlfifiJt3ji iw1intllJlnCilnfUlfi3§. H1u1 Clnliln tjtnstSVjwi al;L�any uLav ,4?}32-11 u> i L:;iS 131 :d1 >L 1tilcOt ititn31nH n�n nS(if1w (1f1Slt2i)iF1111n43tSniLt31rtfl iG �,1n.1>LIc J9 - .`Jl>I O 9 t31S (l3GSiarl i 1 fiiL31t3tfifSlnFfunLi fiit36ifi.fntS1tlu8 o3lg$11 uLo Li u1s.jLeaAl,SliCA19 .888-249-5194 )JI _ � 888-249-51941 GCLitLUtfi.ifinti TTY Iw1tLiGGiCli2711`I .711(.3.6 .11 L,l.c. FRENCH:Votre plan respecte les lois federates FRENCH CREOLE:Plan w Ian respekte Iwa Federal sou dwa sivil epi Ii pa fe diskriminasyon sou baz applicables relatives aux droits civils et ne fait aucune ras, koule, orijin nasyonal, laj, andikap,oswa seks. discrimination fondee sur la race, la couleur de peau, ATANSYON:si w pale kreyal ayisyen, genyen sevis I'origine nationale, Page, I'incapacite ou le sexe. tradiksyon gratis ki disponib you ou. Pou sevis ATTENTION :si vows parlez francais, un service de tradiksyon tanpri rele 888-249-5194.Jwenn akse traduction vous est propose gratuitement. Si vous avez ak sevis TTY pandan w ap konpoze 711. besoin dune traduction, appelez le 888-249-5194. Accedez aux services ATS en composant le 711. POLISH:Twoj plan jest zgodny z obowicizujcicymi federalnymi przepisami dotyczgcymi prow obywatelskich PORTUGUESE:0 seu piano esta em conformidade i nie powoduje dyskryminacji ze wzglQdu no rasQ,kolor corn as leis federais de direitos civis e nao comete skory, narodowosc,wiek, niepe+nosprawnosc lub pied. discriminatao contra rasa,cor,origem nacional, UWAGA:dla osob mowigcych wjQzyku polskim dostgpne idade,deficiencia ou sexo. sq bezp+atne uslugi tlumaczenia.W sprawie uslug ATENCAO: Se voce fala portugues brasileiro, ha tlumaczenia prosimy o kontakt telefoniczny pod numerem servi4os gratuitos de traducao disponiveis para voce. 888-249-5194.W celu uzyskania dostepu do uslug TTY Para servicos de traducao,contate 888-249-5194. (trybu telefonu tekstowego) nalezy wybrac numer 711. Acesse servicos TTY discando 711. ITALIAN: II tuo piano e conforme alle leggi Federali sui GERMAN:Ihr Plan entspricht den geltenden diritti civili vigenti e non fa discriminazioni sulla base bundesstaatlichen Grundrechten and enthalt keine di razza,colore, nazionalita, eta,disabilita,o di sesso. Diskrimierungen aufgrund von Rasse, Hautfarbe, ATTENZIONE:se parli italiano, sono disponibili servizi di nationaler Herkunft,Alter oder Geschlecht. assistenza linguistica gratuiti. Per i servizi di assistenza ACHTUNG: Wenn Sie Deutsch sprechen,stehen Ihnen linguistica gratuita chiamare it numero 888-249-5194. kostenlose Unterstutzungsleistungen in lhrer Sprache Per accedere ai servizi TTY comporre i1 numero 711. zur Verfugung. Siehe Kontaktdaten welter oben. JAPANESE: t a)75' I, s9r-!alosrO Jl) � �ss9> 199)I Lo:,aoUy:FARSI 81), Am, Ea>> ,. 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L11-1.tutu: °2ll ci4 3,ionicii 4llcll E91, cll cl-il}11Z-1 ct zt cuE 21c1R+ll HMONG:Koj pawg kws muab key saib xyuas kho mob ua G4c-lob f9. x.t jgt1;tic lZ41 ti Sul& l 888-249-5194 u2'tc-. rows li Tsoom Fwv cov key cal lij choj hais txog pej xeem 821.711 Stzlei 82`l=t TTY 2tcu 4i z+152i2i sit. coy cai thiab tsis ntxub ntxaug leej twg los ntawm lub hauv paus haiv neeg,cev nqaij daim tawv,lub teb chaws yug, J91 d.cg!L1a.0 L„9L99^?9,^ ^LS yT:URDU hnub nyoog,key xiam oob qhab, los sis poj niam txiv neej. _L)-C �1a y iL,;,CIS u,,;�L, 5)9 ,) .0 99 ;),J,,,; TSHWJ XEEB:yog koj hais Lus Hmoob, muaj key pab ul ,.> 5 y J ul,93 0±1 9,9>>I yl}SI txhais lus pub dawb rau koj.Txhawm rau thov coy key >'888-249-5194 0}S o1y J c.Lo.,.>�S .o�y_ �l.:.a� pab cuam txhais lus,thov hu rau 888-249-5194. Nkag ,�Ji>L,;L,J) TTY Lg.)711_L),,}S JIS cuag coy key pab cuam txog TTY. nias 711. DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 PUNJABI:ScJA.LIT16T tadt3 biftiara q'cSA c T MARSHALLESE: Plan ko am: ej aikuij bwe en lore T3 Mir t f OHM,3dT,(PH dd' N_t3,@NU,muTuj ,,-rT ft&IT kakien ko an kien eo lolab kin jimwe ko im ejab kalijeklok Lt d f�3gd 6d1 adCr ilo aoleben wawin kein kin kwe armij in ia, kolar in kiluum, A.i1-111-?Hrt AMc]c� jd'3 3 UTF{T lidired, lemoreen eo am, iio,utamwe ko ibam,ak eman ak kora. T t ti nfhg'rc}le'�i ML1I fdd v add 888-249-5194 KEJELLA: he kwoj moron kenono kajin Majol, ewor 'F5 del 711 6'165 ado TTY T zjTu3 d$ I jerbal in ukok eo non kwe eo ejjelok wonen. Non melele ko kin jerbal in ukok in ejjelok wonen,jouj im kur tok BENGALI: 9�a 91tGm�Irll� 7 c��lcarl � 888-249-5194. Kin jerbal an TTY kur tok 711. CeIC'I bCc1 aI 'suf ,,K�cf, ��,If r21ar f a�zc 9M91-17� 7 mca�rI ll7h11J7ll�llD1l77]1l11]k '1 u't7��!] cap Ih79 Ill"h:YIDDISH \ld :rr9fR at<t T�I�lld?1�2Ir 4Cc1r,3179r"f4cII Cc'tld 1'`7IN DvT"I7 P]vl7 u'] u-1']'r]'-17D'7 11N,1071J-1 117,11'Y 1)1)11 1N1)TlJa 11H 91fdZrdT 9I1Z l dM iid\s1r11888-249-5194 .117h113'N]N 1"T,-11J071J,U1.)U17N]N1NN] 0'11 ,1JDN1 Ill"T rI�1Cd (plrl marl 1711 rIh14 u�I?Jic1 mCd TIY 9ffdCSd?9 1M.1 .u11J7W1Ja 1117�t XJl]D'TniN U31J7,J'7" l]11J1 1'h 1'IN :]]Il]DN AMHARIC: h4).E'4'td,R°`Z1 svo.e.Gs\4'1A(11 OD-1*1- I- 1Ufb DAFT 9'IN]rt 0 11 .p1JfII7N1 IN"T'11 .10D3'1]]1N1JT11J11N DC etnC9Q9 rl,U'7 f1HCF flcn9°F m-Orsve.y'1C` nx.e.012,7 flh-A- .71117'1]Nn]N 003'7 TTY pv317N1 0]v7 .888-249-5194 me,9°f19,' etODhCt AR)-hY.QC'14°:: Q9nr1113:- hallC 'S'Q95"1�h111 4+0.9° THAI:uwuuavnluquomuntanuluileou8.nswatuavuays ula PA0.4°h-16Vlrtu'ia9'1'S hflh9')fl 888-249-5194 ej :: nariun't.IDFTLA1 uazIutaant)nOciou,nnauuwumumutuand -AVID S'TTY hlsVlr� A°9'11"711(V, „ECM:: ulcltiltuo Dig n iuwrns vssatwa IUJsons1u: auusnlstipothaaenunllni OROMO:Karoorri kee akkaataa mirgoota Heerota ttdiniuIoulutarwi1ZtiaiEJloc Jim uu nistuJanlul liJsotnslU sivilii Federaalaa dhimmi-ilaallatutti hojjeta akkasumas nnu1EJtau 888-249-5194 na:tihuuSnis TTY fUscTns sanyii,halluu,biyya dhalootaa,umurii,qaama-hir'ummaa, lsuiEJtau 711 yookiin saala irratti hundaa'uun addaan hin baasu. HUBADHU:Ati [Afaan Oromoo] ni dubbatta yoo ILOCANO:Ti planom ket maiyannugot kadagiti ta'e,tajaajilliwwan hiikkaa afaanii tolaan siif ni jiru. agaplikar a sibil a linlinteg ti Pederal ken scan a Tajaajilawwan hiikkaa-afaaniif maaloo 888-249-5194 mangidumduma iti puli, kolor, naggapuan a nasion, bilbili.711 bilbiluun tajaajilawwan TTY argadhu. edad, pisikal a kasasaad,wenno sekso. ATENSION: No ti pagsasaom ket['Iacono], mabalinmo LAO: cceluduiitmeotn°�vtJurlticuin.1nnr]v°uoncioac u� nga usaren ti awan bayadna a serbisio a tulong iti q �v . es pagsasao. Para kadagiti serbisio iti panagipatarus, iiiuoucUe'2e5stiu'i un�r�rnt o tut u ue:).i lcc9unc nultL71nLIgOlglll pangngaasim to awagam ti 888-249-5194. I-access 1Jt�nvclnvt�e�ncl, �c7O, �nclt�')CUO, 8'1;, 61Dn1Julnnsu, cwcl. dagiti serbisio ti TTY babaen iti panangi-dial iti 711. �tlscl�ntJ: xlntn'uJcanwn0nana, ielt6En'nj oucweclnuwnon �tnulnv�n�DtJtaJ€�n. i'nautJannvatJwnon ALBANIAN:Planijuaj eshte ne perputhje me ligjet 888-249-5194. ti?ntriltianiu TTY Ntcl/cl€1ltnsczl 711. federate ne fuqi per to drejtat civile dhe nuk diskriminon ne !Daze to races, ngjyres,origjines kombetare, mashes, CROATIAN:Vas plan je u skladu s vazecim drzavnim aftesise se kufizuar ose gjinise. zakonima gradanskog prava te ne diskriminira no KUJDES: Nese flisni shqip, perju ka ne dispozicion osnovi rase, boje, nacionatnog podrijetla, dobi, sherbime perkthimi falas. Per sherbimet e perkthimit, invalidnosti iii spolu. telefononi ne numrin 888-249-5194. Ne sherbimet PAZNJA: Ukoliko govorite hrvatski, dostupne su vam TTY mund te keni akses duke formuar numrin 711. besptatne prevoditeljske usluge.Za prevoditeljske usluge nazovite broj 888-249-5194.Za TTY usluge UKRAINIAN:Baw nnaH BIAnoBIAaE 4VIHHOMy birajte broj 711. cPe/epanbHOMy 3aKOHOT BCTBy npO rpOMaRAHCbKI npaBa Ta He[1,0nyCKaE AvCKpV1MIHaL41l Ha OCHOBI paCV, KOnbOpy NEPALI:dLTTtcb T c'tI i4f- v1-Ic11 t2{1:0- cT WKIpVI, Hai4I0HanbHOCTI, BIKy, IHBaJ1IAHOCTI a6o CTaTI. chit-Ial+ili 1-1 U tir y��.fi3„� ��t � q YBATAI IKLLIO BVl rOBOpV1Te yKpaIHCbKOFO MOBOIO,TO BaM TT�Ti1 3TrETrt�fT � +I i 'S '�' 6e3KOWTOBHO HaAaIoTbcc nepeKna,Qai 4bKl nocnyrv.,QnSi r OTpV1MaHHSI nocnyr nepeKnagy Tene�OHyV1Te 3a HOMepOM El:FRbT d4c1ecT I f14l6tc h1 if 888-249-5194 888-249-5194. flocnyrvl TTY AocrynHl 3a HOMepoM 711. zlT chd TTY27,1711grErFii2t TTY 11I1c1 TT 1Frl DUTCH:Uw plan voldoet aan de geldende federate civiele wetgeving en discrimineert niet op grond van KAREN:,o- coS NT ,u*Aiol' oDt4:cuSmSoS coSacicoo col4c§ ras, kleur, nationaliteit, leeftijd, lichamelijke beperking 3:0-3So7smScr2Sopc&o.yic$ioc S, 6Soe:mc , Po?Snico of geslacht. q1,YaDc;S°'SOgWT. LET OP:Als u Nederlands spreekt,staan vertaaldiensten. o85.P - tyScno`ii (<-74 r° ), cr°ScoSciSon,im,lmo.DS(79:c Sw-toD' cola) kosteloos,voor u ter beschikking. Gelieve 888-249-5194 c'ii :cJ3ai s-c3�o.Scv,0S, cvunSmaSlcr o5 DSaacSS 63.3:91a5:cril:aii te bellen voor vertaaldiensten. Bel 711 om toegang te 888-249-5194 aDTS' aDo?. /.33 CID( S TTY coSaimnaaciS krijgen tot TTY-diensten. a6:4:8c1 711 mmS. DocuSign Envelope ID: 1BDEODEI-3EAF-450E-8374-619DEB4B6A43 SAMOAN:0 lou peleni e ogatusa ai ma tulafono Feterale BURMESE:043ao3a004 cvuS390S C� 9,,i3D03a661: faaletagata ma e le faailoga tagata ona o le aganuu, edo33ao48:cx?E6am8A:c1291:i 3aan:3a66p&1 CAT lanu,tupuaga faaleatunuu,matua,ma'i,po o itupa.FAAILOGA:Afai e to tautala i le Faa-Samoa,e iai se 3adooSsag � g6oSi 6 °ci",q 6?oS c383aG0)&:° tautua faaliliu e avanoa mo oe. Mo le tautua faaliliu 33Ggasj AoN c$lii faamolemole ia vili mai ile 888-249-5194. E mafai 3aa3Go:9Jcii 3amxS j aD&G ')GaYocm:rpn nrnocm€c.bc\&I ona e faaaoga le tautua ole TTY e ala i le viliina le 711. apoanocm:o*Gam&Qp: 3a04 9a3aoo(75610 n aman ROMANIAN:Planul dumneavoastra respecta o 000d8ci`d:iu c4 3aoaaS 888-249-5194 o GaT c10 711 prevederile aplicabile ale Legislatiei federale referitoare crNtg:TTY c400do r :qc a1a la drepturile civile si nu face discriminari pe bozo de rasa,culoare, nationalitate,varsta, handicap sau sex. BASSA:DE rh po gba bE rn kea nyuEE mE dye bolo-nain- ATENTIE: daca vorbiti limbo romana,va stau la gma sein kpein,ke main da bE m ke nyaun-dyi muin ma, dispozitie servicii de asistenta lingvistica,gratuit. Pentru rf1 see k5. nya bE wa juE, m» dy»-ku wa 6646E, m» bodo servicii de asistenta lingvistica apelati 888-249-5194. wa s5 k5E, m»z5 ji ka wa da nyuE, m»wa mE k3 dyis, m» Accesati serviciile TTY apeland numarul 711. wa mE m5 maa m» gaa kE. TONGAN:Ko ho'o palani 'oku tokafalo fakataha ia TO DUU N3MO DYIIN CAO: J ju ke m dyi Bas»-wadi-po-nyi mo e ngaahi lao sivile'a e Fetulolo ki he totonu 'a e ju ni,nii,a belle ny3 be bE wa ke rn bii'Bas55-wudua cee bo tangata (Federal civil rights laws) pea 'oku tapu ke pidyi. fvl dyi ma bE wa ke rn bii Bas»-wudua cee ni, nil, da faka-mavahevahe'i ha taha tupu mei ha matakali, 888-249-5194.Da TTY kua-nyu-ny5 bey nabs nia kE la 711. lanu,fonua 'o e tupu'anga, ta'u,tisi'apiliti, pe ko e fa'unga tangata (sex). SWAHILI:Mpango wako unatii sheria zinazotumika TOKANGA KI Al:Kapau'oku ke lea Faka-Tonga"oku 'i ai'a za haki za raia za Serikali na haubagui kwa misingi ya e sevesi tokoni ki he fakatonuled,pea'oku ma'u atu 'a e kabila, mbari, rangi,asili ya taifa, umri, ulemavu, au faingamalie ko ia ta'etotongi kiate koe.Kataki'o taa ki he jinsia. Mpango wako hautengi watu wala kuwatendea 888-249-5149 ke ma'u atu'a e sevesi tokoni fakatonulea. tofauti kwa sababu ya mbari, rangi,asili ya taifa, umri, Taa ki he 711 ke ma'u faingamalie ki he sevesi TTY. ulemavu au jinsia. ILANI: ikiwa unazungumza Kiswahili, kuna huduma INDONESIAN:Rencana Anda sesuai dengan za usaidizi wa lugha unazopata bila malipo.Tazama hukum hak-hak sipil Federal yang berlaku dan tidak taarifa ya mawasiliano iliyotajwa hapojuu. Kwa mendiskriminasikan berdasarkan ras,warna kulit, huduma za tafsiri,tafadhali piga simu 888-249-5194. asal kebangsaan, umur, disabilitas,atau jenis kelamin. Fikia huduma za TTY kwa kubonyeza 711. PERHATIAN:Jika Anda berbicara bahasa Indonesia, tersedia layanan bantuan bahasa secara untuk Anda. NILOTIC—DINKA:AjuEErdu/Tarldu ee mat kene athoor Untuk layanan terjemahan, hubungi 888-249-5194. de yith ke juaac de akutnhom de!bog kuka cin atekthok de Akses layanan TTY dengan menekan 711. guip,cit, pandujne bii yin thin, runku, gaapduun de NORWEGIAN:Din plan etterlever gjeldende foderale yin gulp,wElE/ka ye tik ka ye moc. borgerrettighetslover, og diskriminerer ikke pa grunnlag TAAU E YI NHOM THIN (PIIN APIETH):Te yin jam ne thuprl av etnisitet, hudfarge, nasjonal opprinnelse, alder, jiarl,anJrl kake ku»ny de wEEre thok ye ya abac tenJrl yin. funksjonshemming eller kjonn. Ne ke de wEEre thok yin thiecku ba 888-249-5194 oal. OBS: Hvis du snakker norsk,finnes det tilgjengelige Yak kake TTY ne tEEu de/guite 711 ne telepunic. kostnadsfrie sprakassistansetjenester. For sprakassistansetjenester kan du ringe 888-249-5194. IGBO:Atumatu gi na esoro iwu ikikere mmadu nke Teksttelefon er tilgjengelig ved a trykke 711. Etiti Goomenti ndi di adi, o naghi akpa oke n'isiokwu nke agburu, agba, obodo, afo, nkwaru, ma o bu okike. GREEK:To oxt&O oac EivaL oupcpwvo pE toug LoxuovtEc NRUBAMA: 0 buru na na asu Igbo, oru ntughari opoanov5LaKouc vopouc nEpi atopl.KLJv SLKaLWlaTWv asusu diiri gi n'efu. Maka pry ntughari asusu biko KaL 6Ev KGVEL 8LaKpi.OELc cpuArjc,Xpc;wpatoc, EOVLKOirliac, kpoo 888-249-5194. Nweta oru TTY site na ikpo 711. *king, avanrlpiac rj cpuAou. [IPO>OXH: Eav pLXaxE EAArlvcKa,napExovtaL bwpEav PENNSYLVANIA DUTCH:EyeMed iss willich, die Gsetze urLrlpEo1Ec pEtacppaorlc. FLa urtrlpEoiEc pEtaeppaanc, (federal civil rights)vun die Owwerichkeet zu folliche un KaN ors GTO 888-249-5194. FLa npoo(3aorl otLc duht alle Leit behandle in der seem Weg. Es macht nix unrlpEOLEc TTY, KaNEOtE 711. aus,vun wellem Schtamm ebber beikummt,aus wellem YORUBA:Eta re dogba pelu Awon Ofin eto omoniyan ti Land die Voreldre kumme Sinn,was fer en Elt ebber hot, eb ebber en Mann iss odder en Fraa,verkrippelt ijoba orile-ede ko si se atako lori eya,awo, orile-ede ti o ti iss odder net. wa,ojo ori, abarapa,tabi ako tabi abo. Wann du Deitsch (Pennsylvania German /Dutch) AKIYESI:Ti o ba ri so Yoruba, awon Ise Itumo ede, Wee schwetzscht, kannscht du mitaus Koschte ebber gricke, ti wa nile fun Q. Fun awon ise itumo ede jowo pe ass dihr heift mit die englisch Schprooch. 888-249-5194. Rayesi awon ise TTY nipa pipe 711. DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 NAVAJO:Bik'ehgo naa'ahayanigI doo nika ana'alwo'igI HAWAIIAN:Hahai kau papa hana i koho ai me na ei Waashindoondee'bila'ashdla'ii be'iina'bik'i adeest'jj'go kanawai pono kiwila pekelala a e ho'okae'ole'ia ho'i ma beehaz'aanii t'aa ate ye'osin doo die bila'ashdla'ii al•'aa ke'ano o ka lahui, ke kala o ka'ili,'aina kupa, ka pae dine'e jilinigif doo, hakagi anoolninigI doo, bila'ashdla'ii makahiki, ke kinana a i'ole ina he kane a i'ole he wahine. bikeyand joogaatigif doo, honaahai doo, haah dahaz'a, MALIU MAI: Ina'olelo'oe i ka'olelo Hawaii, ua loa'a na el doodago hastljda doo asdzanf jilinigif biniinaa kokua unuhi'olelo no ke kokua'ana mai ia'oe. No na kokua ha'at'iida doo hach'j'yaa nichj'da doo t'aa sandii nahaft'e'da. ma ka unuhi'ana, olu'olu e kahea aku i keia helu kelepona BAA AKONINIZIN: Dine bizaad bee yanifti'go, ata'hane' 'a 888-249-5194. No ka loa'a'ana o na kokua TTY,e komi bee aka i'iilyeedigll,t'aa jiik'e, nich'!'aa'at'e. Saad bee i ka helu 711. aka i'iilyeedigii kwe'e Bich'!'hodiilnih 888-249-5194. Hajeehkaigo el I I Y bee na'anishj!'hodiilnih 711jj'hoodIilnih. CHEROKEE:EyeMed osi ayelvhnv nusdv watsini dikahnowadvsdi duhv ayvwi ugvwahli ale tla kilo LA9.0 linen )naodi o )noxo$91 n o�n1 :ASSYRIAN idvgayugdasi igvhnisisgi udalesvi. 249in.1, 1 on 1± •\on,.1 9 2rni 9 4:141 916 o Hagsesda: iyuhno hyiwoniha tsalagi gawonihisdi. L i9 Ln...on ,)Yi\\ .Ada La o L..iaxia9 ode ? L�oi,Lanxia ,1=...19 1L\n..LUo '14?L.,,.i9 Lei$, BISAYAN: Nituman ang imong piano sa Federal .1001 1404 ,)\.AT r 1 .n- Non,oai 2-39-m#n_9 A ?.. 0,1:;i? civil rights nga balaod ug wala magpasulabi base kaA,in ? 1,.TnTn n 1 '1 3=list.301&,ro CO O 2 :1b0,o, sa kaliwatan, kolor, nasyon nga gigikanan, edad, �1 > 3n ? T'"TA ^^"-tr"La Cam (1\1 A) pagkabalda, o kinatawo. ? 1>ThTn A D n .888-249-5195.- iz.,b 5"\no-„ ATENSYON: kung ang imong sinultihan Cebuano, naa'y .711 lniti b. ? TTY libre nga mga serbisyo sa paghubad along kanimo. Along sa mga serbisyo sa paghubad palihog tawag sa CHUUKESE:Omw pekin insurance mei pwung ussun 888-249-5194. I-access ang TTY nga mga serbisyo met mei affat non Annukun "Federal civil rights"pwe pinaagi sa pag-dial sa 711. resap nifinifin aromas anongonong won it io,anuwen unucher, is wesetan fonuwer, ierir, mei ter, mwan „,363o0 L,bLo SL.,I,JokSoJ uok.SoUI,:KURDISH ika fefin. NENGENI: Ika ka kapasen Chuuk(Chuukese/Trukese), ,09OLDNJ ,�S.io) ,�SO,Jo a) SLoOU?)00..,oLj 9 ogoc.,}So�SoLs ka tongeni angei aninisin chiakku,ese kamo inet chok .ut5lJ )O�So)Ut, O .olaios IoLS'o '- ka mochen. Ren omw kopwe angei aninisin chiakku u).)I)9olj.> (,,J95)oLJ Asks kosemochen kopwe kokkori 888-249-5194. .,A a.3o9Jou L,,,WI) 03)ou) .ol)oL.J ,1) .JOtn) Ren aninisin TTY kopwe kokkori 711. ou 5.1.:,09.0�o9os L A09(s)l)9ioej� g, .o�j a.,09Nou.,JoJ TTY S)1J9Sio?y ou 6..3,l0, q.ot.S, 888-249-5194 BANTU-KIRUNDI: Indinganizo yawe ikurikiza oLS,711 ou 63 09,0‘,) amategeko yerekeye uburenganzira umuntu ategerezwa kugira mu gihugu yubahirizwa ku Rwego POHNPEIAN:Noumw pilahn kin idawehn koasaoned en rwa Reta zose kandi ntirangwa no kwironda lfatiye Federal me kin apwapwahli pwung in aromas oh sohte ku bwoko, kw'ibara ry'urukoba, ku gihugu c'amamuko, kin epwel saperek ohng pali en wasa me ke kohsang ie, ku myaka, k'ubumuga umuntu afise,canke ku gitsina. pooh, mehn is tohn wehi, sounpar, de ma ke ohl de lih. ICO KWITONDERA: Nimba uvuga Ikirundi, serivisi MEHN KAIR: Ma ke kin lokaiahn Pohnpei, mie palien z'uguhindura indimi, k'ubuntu,ziragutegekanirijwe. sawas en ahmw pall en lokaia ni sohte isais. Ohng Ukeneye kuronswa serivisi z'uguhindura indimi nkundira pali en sawas en lokaia, komw koahl 888-249-5149. uhamagare 888-249-5194. Kuronswa serivisi za TTY Pali en sahpis ohng me salengepon, Loma daihl 711. naho fyonda 711. TURKISH:Planiniz.yururliikteki Federal sivil haklar FULFULDE:Taskaram maada yaadi e keeri hakke neddo yasalari lie uyumludur ve irk, renk, milliyet,yak, gado toodi di lesdi nden di peerootiraay dow daliila lenyol, engellilik durumu veya cinsiyet temelinde ayrimcilik nonnde, asngol lesdi, duubi, nyakkere, malla debbo/gorko. olu§turmamaktadir. HAKKIL:To a wolwan Fulfulde woodi taskaram fassara DIKKAT:Turk4e konuguyorsan z ucretsiz tercume ngam maada.To a maran haaje taskaram fassara ngal hizmetlerinden yararlanabilirsiniz.Yukaridaki ileti�im meer nodda 888-249-5149 heba kuude TTY'yoona 711. bilgilerine bakin.Tercume hizmetleri icin lutfen 888-249-5194 numarali telefonu arayin.TTY CHOCTAW: EyeMed hvt yakni ilvppa im ai vlhpesa hizmetlerine eri§im i4in 711 numarali telefonu arayin. iyakaiya.Yohmi atoko,apela chi bvnna hokma, EyeMed hvt chim vpi inchowa,chim okloshi, cho chim afvmmi TELUGU: e9, 3641o.6 .3.)dt5ei,1)ZeTpit cSty,,e.)63 holhtina isht anokfillachi kiyo. Mikma,tek cho nakni chia �°23J 0 6.)8a'S.1.i a3°a, 60(5.), apba136, 60.1O:1.1), 3S`e.)86 hokmvt, keyokmvto chi haknip vt ataklvmma hokma e�E7 Dodo e9>;"(Sorr,Z6ge'4 i5.7'Oo'JocSa)deS). EyeMed hvt chi apelashke. Kocha chi pilachi kiyo. n�Zg. e,sZ91 L63 3e>,� e.76. L d e9 �a ANOMPA PA PISAH: Chahta makilla ish anompoli 7o6e�e�s2yd e�odaarea�eS'�cra�o� e9 0.�5 7o6e.)goo hokma, kvna hash Nahollo Anompa ya pipilla Nosh chi tosholahinla. tSol3ab 888-249-5194s sNe58oxioco. 711Z de58oS3c o Asa,TTY 7o6e)S`o toz'386 o�J.'odoPa. DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 KNOW BEFORE YOU GO OUT-OF-POCKET COST ESTIMATOR eve Size uo the Med oottom line . . , w. , imb,„,, .. _ —"I 000 t ', ..0, ,, , \ s + Many of our members don't have out-of-pocket costs beyond their copays. But for those who do, we've designed an industry-first transparency tool. It estimates what their total costs will be ahead of time—so there are fewer surprises when it's time to pay their provider. MEMBERS GET THEIR TOTAL IN 3 SIMPLE STEPS .� Our Know Before You Go out-of-pocket cost estimator is easy to �� understand and a cinch to use: %notq�otxtariou amit .t 22 ea .... 1 Members choose anticipated services ,� and products ,� ri r. Explanations of the differing types of frames, ��` �'�' ~� lenses, add-ons and contacts are included 3 They see their plan-specific out-of-pocket cost total (if any) Learn more about how we make vision benefits easy to use— Contact your EyeMed rep or visit eyemed.com S-2001-CB-51 DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 TIERED NETWORK eye With Eye36O , fried wellness Hess and savings are in sight ._ . .. .,.. ..„ ... • , ., . .. • •„...•..,..... . ...., . , .:, . ...„. .. 4, , , i ,, ai \,0071)" lir.. 't I- 1411( $ INTRODUCING EYE360 A first-generation tiered product in the vision care industry, Eye360 provides enhanced benefits when members visit a PLUS Provider—a select group of providers in the EyeMed network. Eye360 focuses on health, simplicity and savings. Best of all,the perks are built into the vision plan.That means no promo codes or paperwork required. SEEING SAVINGS Eye360 offers: With Eye360, members receive$0 copay eye exams and additional frame allowances at PLUS Providers—on top of their base plan's • $0 copay eye exams benefits.And when combined with other offers and discounts, it adds • Additional $50 frame up to truly eye-opening savings. allowance • A streamlined experience CHOICE OF PROVIDERS With PLUS Providers nationwide, including independent, retail and online options, members will find plenty of locations nearby. O VISION CARE IS HEALTHCARE �" Ail An annual eye exam not only helps uncover vision correction needs, "Mi it can sometimes be the first to detect signs of serious health conditions, Find nearby PLUS Providers such as diabetes, high blood pressure, high cholesterol'and eye on our Provider Locator diseases like glaucoma and cataracts.2 With Eye360, $0 annual Just look for the PLUS eye exams help encourage employees to be proactive with their holistic healthcare. "'20 surprising health problems an eye exam Help employees see, save and live better with Eye360— can catch'aao.org.January16.2020 2"Keep an eye on your vision health."cdc.gov, Contact your EyeMed rep or visit eyemed.com July 26,2018 S-2002-CB-246 DocuSign Envelope ID:1BDEODEI-3EAF-450E-8374-619DEB4B6A43 eve � � y Brin in eye care Med a n d eyewear r to you - , it - .. y ,„ .4, .,. . , fr. -1- --/- _ ,. y0 ,. ., .. ) _ . . - \ rto: , •-• .,„...41<4.1‹ 2 ...,rir - \ I Oh 0,. , .,,,. - :, .. li• -4.., \ - -11".--r(dr ... —.---- A" . Vision care delivered right to your door Convenience is what our Pop-up Clinic is all about;it's a fully-equipped aimmo vision clinic right in your own facility. No need for employees to leave ME_ the office. No extra commutes. No hassle finding a time that fits everyone's schedule. EMPLOYEES CAN: Eyewear can be delivered Receive an eye exam. More than a basic screening;this is a 15-20 minute to the employee's home,office comprehensive exam by a local optometrist.The technology they use can or local store-for free help identify even the slightest vision issue or early sign of some serious health conditions. Shop the latest styles. Every employee is welcome to browse the on- site frame store- even if they don't get an eye exam or aren't enrolled. They can choose from hundreds of brand name frames,sunglasses and contacts,then easily apply their benefits and discounts at checkout DU (many frames may be 100%covered by the benefit allowance). YOU SUPPLY THE SPACE. WE'LL TAKE CARE OF THE REST On-site store features • Promotional materials and appointment reminders 400+frames, including top designer brands • A link to your own microsite for scheduling eye exam appointments • Flexible days and hours • No-fuss clinic setup and removal Make eye care more convenient than ever — Contact your EyeMed rep or visit starthere.eyemed.com 5-1903-CB-336 DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 EYEMED APP eve go? on eesEmptoy the toted Now their benefits are, too. Our revamped EyeMed App brings fresh new features to help employees get the most from their EyeMed experience—anytime, anywhere. FEATURES MEMBERS LOVE PLUS NEW FEATURES TO EXPLORE: evenee �,;.,.• pp • Benefits and eligibility ,r. • Claims tracking ' 10' l • Special offers to help members save more Welcome to your • Provider Locator to find in-network eye doctors happy place. • ID card at-a-shake • Upcoming exam reminders • Contact lens replacement reminders • Wellness interactives to help members see and live their best •^�° • Facial Recognition,Touch ID and Apple Wallet for Apple users �S • Helpful FAQs 0 ARE EMPLOYEES STILL USING THE OLD APP? �' " "" Make sure to let employees know they should snag the newest version with our latest features now as technical support for the old version ends soon. Employees can download the new app from App Store or Google Play PDF-2009-C-659 DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 Tab 4 - Cost Proposal 1. Submit proposed per employee per month(PEPM)fee. We are pleased to offer the City of Miami Beach$0.52 PSPM for your renewal plan "as-is"for 48 months.The claims dollars will continue to be as previously expected. We are also excited to offer you the option to move to our new Eye360 product at your same ASO rate of$0.52 PSPM.With the Eye360 benefit enhancement(exam copay$0 and the$50 additional frame allowance at PLUS Providers),the claims dollars are estimated to increase approximately$2,800 per year. We're happy to discuss both options with you,and we appreciate your partnership. For more details, please refer to our Financial Proposal, included as Item 4.2. DocuSign Envelope ID:1BDE0DE1-3EAF-450E-8374-619DEB4B6A43 Your custom vision quote MORE OF WHAT'S BEST, NOT MORE OF THE SAME Get the most out of your vision plan with these EyeMed highlights: • Eye360 features a $0 eye exam and an additional $50 added to your frame allowance at PLUS Providers' • Ability to use the frame and contact lens allowances in the same benefit year - worth up to an extra $1502 • Separate contact lens fit & follow-up coverage (leaving the entire allowance for materials) Plus, with us, you also always get THE VISION NETWORK BENEFITS THAT REDEFINE ABOVE ALLLSE,WE EMPLOYEES WANT EXPECTATIONS MAKE BENEFITS EASY America's largest vision network The freedom to choose any Cost transparency with our Know with the right mix of providers3 ophthalmic frame, lens or contact Before You Go cost estimator lens without restrictions at any of Digital tools like online our retail providers, independent schedulin 4 Several in-network options for provider locations or online 9 , a mobile app and personalized text alerts buying eyewear online Complimentary HealthyEyes wellness program that keeps the focus on eye health with online tools, articles and videos to make the conversation around vision even easier Members-only savings on eyewear, LASIK, hearing aids and more with online options We can't wait to work with you - Contact Teresa Moyers at tmoyers@eyemedvisioncare.com with questions Not available in all states. 'This document provides highlights of one or more EyeMed plans.Frame allowances may vary by plan.Please consult your EyeMed representative for details. 'Based on the EyeMed Insight network,October 2020. At select locations. PDF-2003-X-295 DocuSign Envelope ID: EODE1-3EAF-450E-8374-619DEB466A43 M VISION CARE IN-NETWORK OUT-OF-NETWORK SERVICES MEMBER COST MEMBER REIMBURSEMENT EXAM SERVICES Exam $0 copay Up to$28 Fit and Follow-up-Standard $0 copay;contact lens fit and two follow-up visits Up to$40 Proposed Benefits Fit and Follow-up-Premium $0 copay;10%off retail price,then apply$40 allowance Up to$40 FRAME Option AS IS Frame $0 copay;20%off balance over$150 allowance Up to$75 Exam&Materials Select Network CONTACT LENSES (Contact Lens allowance includes materials only) ASO Contacts-Conventional $0 copay; 15%off balance over$150 allowance Up to$120 Employee Paid Contacts-Disposable $0 copay;100%of balance over$150 allowance Up to$120 Funded Benefits Contacts-Medically Necessary $0 copay;paid-in-full Up to$200 STANDARD PLASTIC LENSES Single Vision $10 copay Up to$18 Frequency Bifocal $10 copay Up to$32 Trifocal $10 copay Up to$56 Lenticular $10 copay Up to$56 Examination Progressive-Standard $10 copay Up to$77 Once every plan year Progressive-Premium $10 copay,20%off retail price less$120 allowance Up to$77 Lenses(in lieu of contacts) _ — LENS OPTIONS Once every plan year Anti Reflective Coating-Standard $0 copay Up to$32 Contacts(in lieu of lenses) Polycarbonate-Standard $0 copay Up to$28 Once every plan year Scratch Coating-Standard Plastic $0 copay Up to$11 Frame Tint-Solid and Gradient $0 copay Up to$11 Once every plan year UV Treatment $0 copay Up to$11 Terms Contract Term 48 months Rate Guarantee 48 months MONTHLY RATES Monthly Rate is subject to adjustment even during a rate guarantee period in the event of any of the following events:changes in benefits,employee contributions,the number of eligible employees, or the imposition of any new taxes,fees or assessments by Federal or State regulatory agencies.The Plan reserves the right to make changes to the products available on each tier.All providers are not required to carry all brands on all tiers.For current listing of brands by tier,call 866-939-3633. PLAN DETAILS Quote for group sitused in the State of FL and will be valid until the 10/01/2022 implementation date.Date Quoted 05/05/2022.Rates are valid only when the quoted plan is the sole stand-alone vision plan offered by the group. PLAN EXCLUSIONS/LIMITATIONS No benefits will be paid for services or materials connected with or charges arising from:medical or surgical treatment,services or supplies for the treatment of the eye, eyes or supporting structures;Refraction,when not provided as part of a Comprehensive Eye Examination;services provided as a result of any Workers' Compensation law,or similar legislation,or required by any governmental agency or program whether federal,state or subdivisions thereof;orthoptic or vision training, subnormal vision aids and any associated supplemental testing;Aniseikonic lenses;any Vision Examination or any corrective Vision Materials required by a Policyholder as a condition of employment;safety eyewear;solutions,cleaning products or frame cases;non-prescription sunglasses;piano(non-prescription)lenses; piano(non-prescription)contact lenses;two pair of glasses in lieu of bifocals;electronic vision devices;services rendered after the date an Insured Person ceases to be covered under the Policy,except when Vision Materials ordered before coverage ended are delivered,and the services rendered to the Insured Person are within 31 days from the date of such order;or lost or broken lenses,frames,glasses,or contact lenses that are replaced before the next Benefit Frequency when Vision Materials would next become available.Fees charged by a Provider for services other than a covered benefit and any local,state or Federal taxes must be paid in full by the Insured Person to the Provider.Such fees,taxes or materials are not covered under the Policy. Allowances provide no remaining balance for future use within the same Benefit Frequency.Some provisions,benefits,exclusions or limitations listed herein may vary by state. P201603 TC-0 0-00039611—QL-0000067021 DocuSign Envelope ID: 1BDEODE1-3EAF-450E-8374-619DEB4B6A43 • • Saving our members some extra green We're committed to keeping money in our members' pockets. That's why we offer our members additional discounts above the proposed plan benefits. ADDITIONAL DISCOUNTS VISION CARE IN-NETWORK $avings for Members SERVICES MEMBER COST DISCOUNTED EXAM SERVICES 40% off Retinal Imaging Up to$39 additional pairs of glasses and a 15% DISCOUNTED LENS OPTIONS discount on conventional lenses once funded benefit is used—an industry Photochromic-Non-Glass 20°/a off retail price exclusive OTHER ADD-ON SERVICES AND MATERIALS 20%off retail price 20% off any item not covered by the plan, including non-prescription sunglasses Lasik Lasik or PRK from US Laser Network 15%off retail price or 5%off promotional price Hearing Care Through Amplifon Hearing Health Care Network,members receive up to 64%off hearing aids, an extended warranty, and free batteries DISCOUNT DETAILS Member receives a 20%discount on items not covered by the plan at EyeMed In-Network locations.Discount does not apply to EyeMed Provider's professional services or contact lenses. Plan discounts cannot be combined with any other discounts or promotional offers. In certain states members may be required to pay the full retail rate and not the negotiated discount rate with certain participating providers. Please see the online provider locator to determine which participating providers have agreed to the discounted rate.Discounts on vision materials may not be applicable to certain manufacturers'products.The Plan reserves the right to make changes to the products on each tier and to the member out-of-pocket costs.Fixed tier pricing is reflective of brands at the listed product level.All providers are not required to carry all brands at all levels.Services and amounts listed above are subject to change at any time.Discounts are not insured benefits. DocuSign Envelope ID:1 BDEODEI-3EAF-450E-8374-619DEB4B6A43 eve City of Miami Beach meaVISION CARE IN-NETWORK OUT-OF-NETWORK SERVICES MEMBER COST MEMBER REIMBURSEMENT EXAM SERVICES Exam at PLUS Providers $0 copay Up to$28 Exam $0 copay Up to$28 Proposed Benefits Fit and Follow-up-Standard $0 copay;contact lens fit and two follow-up visits Up to$40 Fit and Follow-up-Premium $0 copay;10%off retail price,then apply$40 allowance Up to$40 Option Eye360 FRAME Exam&Materials Any available frame at PLUS Providers $0 copay;20%off balance over$200 allowance Up to$75 Select Network Frame $0 copay;20%off balance over$150 allowance Up to$75 ASO CONTACT LENSES Employee Paid (Contact Lens allowance includes materials only) Funded Benefits Contacts-Conventional $0 copay;15%off balance over$150 allowance Up to$120 Contacts-Disposable $0 copay;100%of balance over$150 allowance Up to$120 Contacts-Medically Necessary $0 copay;paid-in-full Up to$200 Frequency STANDARD PLASTIC LENSES Single Vision $10 copay Up to$18 Bifocal $10 copay Up to$32 Examination Trifocal $10 copay Up to$56 Once every plan year Lenticular $10 copay Up to$56 Lenses(in lieu of contacts Progressive-Standard $10 copay Up to$77 Once every plan year Progressive-Premium $10 copay,20%off retail price less$120 allowance Up to$77 Contacts(in lieu of lenses) LENS OPTIONS Once every plan year Anti Reflective Coating-Standard $0 copay Up to$32 Frame Polycarbonate-Standard $0 copay Up to$28 Once every plan year Scratch Coating-Standard Plastic $0 copay Up to$11 Tint-Solid and Gradient $0 copay Up to$11 Terms UV Treatment $0 copay Up to$11 Contract Term 48 months Rate Guarantee 48 months MONTHLY RATES 3 :. 4� e5a rf�"' '`V•,d t'. dye .f • Monthly Rate is subject to adjustment even during a rate guarantee period in the event of any of the following events:changes in benefits,employee contributions,the number of eligible employees, or the imposition of any new taxes, fees or assessments by Federal or State regulatory agencies. The Plan reserves the right to make changes to the products available on each tier.All providers are not required to carry all brands on all tiers.For current listing of brands by tier,call 866-939-3633. PLAN DETAILS Quote for group sitused in the State of FL and will be valid until the 10/01/2022 implementation date.Date Quoted 05/05/2022.Rates are valid only when the quoted plan is the sole stand-alone vision plan offered by the group. PLAN EXCLUSIONS/LIMITATIONS No benefits will be paid for services or materials connected with or charges arising from:medical or surgical treatment,services or supplies for the treatment of the eye, eyes or supporting structures;Refraction,when not provided as part of a Comprehensive Eye Examination;services provided as a result of any Workers' Compensation law,or similar legislation,or required by any governmental agency or program whether federal,state or subdivisions thereof;orthoptic or vision training, subnormal vision aids and any associated supplemental testing;Aniseikonic lenses;any Vision Examination or any corrective Vision Materials required by a Policyholder as a condition of employment;safety eyewear;solutions,cleaning products or frame cases;non-prescription sunglasses;piano(non-prescription)lenses; piano(non-prescription)contact lenses;two pair of glasses in lieu of bifocals;electronic vision devices;services rendered after the date an Insured Person ceases to be covered under the Policy,except when Vision Materials ordered before coverage ended are delivered,and the services rendered to the Insured Person are within 31 days from the date of such order;or lost or broken lenses,frames,glasses,or contact lenses that are replaced before the next Benefit Frequency when Vision Materials would next become available.Fees charged by a Provider for services other than a covered benefit and any local,state or Federal taxes must be paid in full by the Insured Person to the Provider.Such fees,taxes or materials are not covered under the Policy. Allowances provide no remaining balance for future use within the same Benefit Frequency.Some provisions,benefits,exclusions or limitations listed herein may vary by state. P201603 TC-0 Q-00039611—QL-0000067022 DocuSign Envelope ID:1BDE0DE1-3EAF-450E-8374-619DEB4B6A43 Saving our members some extra green We're committed to keeping money in our members' pockets. That's why we offer our members additional discounts above the proposed plan benefits. ADDITIONAL DISCOUNTS VISION CARE IN-NETWORK $avings for Members SERVICES MEMBER COST DISCOUNTED EXAM SERVICES 40% off Retinal Imaging Up to$39 additional pairs of glasses and a 15% DISCOUNTED LENS OPTIONS discount on conventional lenses once funded benefit is used—an industry Photochromic-Non-Glass 20%off retail price exclusive OTHER ADD-ON SERVICES AND MATERIALS 20%off retail price 20% off any item not covered by the plan, including non-prescription sunglasses Lasik Lasik or PRK from US Laser Network 15%off retail price or 5%off promotional price Hearing Care Through Amplifon Hearing Health Care Network,members receive up to 64%off hearing aids, an extended warranty, and free batteries DISCOUNT DETAILS Member receives a 20%discount on items not covered by the plan at EyeMed In-Network locations.Discount does not apply to EyeMed Provider's professional services or contact lenses. Plan discounts cannot be combined with any other discounts or promotional offers. In certain states members may be required to pay the full retail rate and not the negotiated discount rate with certain participating providers. Please see the online provider locator to determine which participating providers have agreed to the discounted rate.Discounts on vision materials may not be applicable to certain manufacturers'products.The Plan reserves the right to make changes to the products on each tier and to the member out-of-pocket costs.Fixed tier pricing is reflective of brands at the listed product level.All providers are not required to carry all brands at all levels.Services and amounts listed above are subject to change at any time.Discounts are not insured benefits. DocuSign Envelope ID:1 BDEODE1-3EAF-450E-8374-619DEB4B6A43 ATTACHMENT D INSURANCE REQUIREMENTS DocuSign Envelope ID:1BDEODE1-3EAF-450E-8374-619DEB4B6A43 MIAMI BEACH INSURANCE REQUIREMENTS The vendor shall maintain the below required insurance in effect prior to awarding the contract and for the duration of the contract. The maintenance of proper insurance coverage is a material element of the contract and failure to maintain or renew coverage may be treated as a material breach of the contract, which could result in withholding of payments or termination of the contract. A. Workers' Compensation Insurance for all employees of the Contractor as required by Florida Statute Chapter 440 and Employer Liability Insurance with a limit of no less than $1,000,000 per accident for bodily injury or disease. Should the Contractor be exempt from this Statute, the Contractor and each employee shall hold the City harmless from any injury incurred during performance of the Contract. The exempt contractor shall also submit (i) a written statement detailing the number of employees and that they are not required to carry Workers' Compensation insurance and do not anticipate hiring any additional employees during the term of this contract or(ii)a copy of a Certificate of Exemption. B. Commercial General Liability Insurance on an occurrence basis, including products and completed operations, property damage, bodily injury and personal & advertising injury with limits no less than $1,000,000 per occurrence, and $2,000,000 general aggregate. C. Automobile Liability Insurance covering any automobile, if vendor has no owned automobiles, then coverage for hired and non-owned automobiles, with limit no less than $1,000,000 combined per accident for bodily injury and property damage. D. Professional Liability(Errors & Omissions) Insurance appropriate to the Consultant's profession, with limit no less than $1,000,000. Additional Insured-City of Miami Beach must be included by endorsement as an additional insured with respect to all liability policies(except Professional Liability and Workers' Compensation)arising out of work or operations performed on behalf of the contractor including materials, parts, or equipment furnished in connection with such work or operations and automobiles owned, leased, hired or borrowed in the form of an endorsement to the contractor's insurance. Notice of Cancellation - Each insurance policy required above shall provide that coverage shall not be cancelled, except with notice to the City of Miami Beach c/o EXIGIS Insurance Compliance Services. Waiver of Subrogation—Vendor agrees to obtain any endorsement that may be necessary to affect the waiver of subrogation on the coverages required. However,this provision applies regardless of whether the City has received a waiver of subrogation endorsement from the insurer. Acceptability of Insurers — Insurance must be placed with insurers with a current A.M. Best rating of A:VII or higher. If not rated, exceptions may be made for members of the Florida Insurance Funds (i.e. FWCIGA, FAJUA). Carriers may also be considered if they are licensed and authorized to do insurance business in the State of Florida. Verification of Coverage—Contractor shall furnish the City with original certificates and amendatory endorsements, or copies of the applicable insurance language, effecting coverage required by this contract. All certificates and endorsements are to be received and approved by the City before work commences. However, failure to obtain the required documents prior to the work beginning shall not waive the Contractor's obligation to provide them. The City reserves the right to require complete, certified copies of all required insurance policies, including endorsements, required by these specifications, at any time. DocuSign Envelope ID:1BDE0DE1-3EAF-450E-8374-619DEB4B6A43 CERTIFICATE HOLDER MUST READ: CITY OF MIAMI BEACH do EXIGIS Insurance Compliance Services P.O. Box 4668—ECM#35050 New York, NY 10163-4668 Kindly submit all certificates of insurance,endorsements,exemption letters to our servicing agent,EXIGIS,at: Certificates-miamibeachriskworks.com Special Risks or Circumstances -The City of Miami Beach reserves the right to modify these requirements, including limits, based on the nature of the risk,prior experience, insurer,coverage,or other special circumstances. 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.