CSP027240_Amendment_1.pdf

Vision Service Plan Insurance Company CSP027240, Amendment 1 Page 1 of 5

Version 2/25

VISION PROGRAM FOR EXEMPT STATE OF OHIO EMPLOYEES REQUEST FOR PROPOSALS

CONTRACT (CSP027240)

AMENDMENT 1

This Amendment 1 to contract # CSP027240 (the “Amendment”) is between the State of Ohio, Department of Administrative Services (the “State”) and Vision Service Plan Insurance Company (the “Contractor”). This Amendment changes the terms of the Vision Program for Exempt State of Ohio Employees Request for Proposals contract (CSP027240) (the “Contract”).

WHEREAS, the State and Contractor entered into the Contract on 07/01/25; and

WHEREAS, the State and Contractor determined that an amendment is necessary to address certain revisions to the Contract.

NOW, THEREFORE, the Contract is amended as follows:

1. Part 6 – Mutually Agreed Upon Changes, Letter O. is deleted in entirety and replaced with the following

Revised Performance Guarantees which are effective 07/01/25:

Part 2, Section I (Performance Guarantees) is replaced with the mutually agreed upon performance guarantees:

This Contract includes minimum Performance Guarantees (PGs) that will be used to monitor and manage the Contractor’s performance of the Work. The Contractor may supplement the minimum PGs with additional PGs that are generally applicable to its other customers only if the additional parameters are not addressed in, or are more stringent than, the minimum PGs set forth in this Contract. Modifications to the PGs may only be made by written agreement of the State and the Contractor.

The Contractor must maintain, at a minimum, the following PGs throughout the term of the Contract.

PGs will be measured quarterly. The amount due for an unmet PG is based on the administrative fees paid for the quarter(s) where a PG is not met. The Agency requires a minimum risk of 45% of the total annual administrative fees. PGs may be modified on an annual basis, as mutually agreed upon by the Agency and the Contractor. Performance Standard Measurements are based on the Contractor’s performance on this Contract not the Contractor’s book of business.

PG # PG Performance

Standard Measurement

Percentage of fees at risk

1 Plan sponsor satisfaction with implementation (implementation - applies to first year only)- Plan sponsor will score based on its satisfaction of the implementation results.

Minimum score of 4.0 (on a 5.0 point scale).

5.0%

2 Claims financial accuracy- Calculated on a monthly basis based upon daily audit results. The term “financial error” encompasses all errors found in the audit process, regardless of whether the error caused/resulted in an overpayment or an underpayment. Any error found that results in a financial impact is recorded as a financial error. At the end of the month, financial errors are totaled and taken as a percentage of the total dollars paid for all claims audited during

Claims financial accuracy minimum of 99%

8.0%

Vision Service Plan Insurance Company CSP027240, Amendment 1 Page 2 of 5 the given month (with a 0.5% margin of error).

3 Claims processing accuracy - Calculated monthly, based on daily audit results.

The term “processing error” encompasses all errors found in the audit, regardless of whether the error caused a financial impact. At month’s end, all processing errors for the month are totaled and taken as a percentage of the total number of claims audited for the month.

Claims processing accuracy minimum of 99%

4.0%

4 Claim turnaround time 95% of all preferred provider claims processed within five business days

95% of all member claims processed within five business days

99% of all claims processed within 15 business days

3.5%

5 Average speed of answer- The average speed of answer (the amount of time a caller is waiting while on hold) is calculated by dividing the total time all calls are on hold (in seconds) by the total number of calls received. Results are reported to the tenth decimal (versus rounding to a whole number).

80% of all calls answered within 30 seconds by a live customer service representative.

1.5%

6 Call Center telephone abandonment rate- Calculated monthly by taking the total number of abandoned calls, divided by the number of calls accepted by the Call Center, which includes calls answered via the Interactive Voice Response and Automated Call Distribution systems.

Abandonment rate less than or equal to 3%. The calculation is: Abandoned Calls / Total Calls = Abandoned Call Rate.

1.0%

7 Call resolution (same day response)

Minimum of 98% Calculated as follows:

1.00 - Number of Research Inquiries/ Total Number of Calls (IVR and Customer Service Representative) = %

3.0%

Vision Service Plan Insurance Company CSP027240, Amendment 1 Page 3 of 5

Call resolution (same day response)

8 Agency satisfaction with Account Manager performance via Account Management Survey. The Contractor must score at a minimum 4 out of 5.

Contractor and Agency will mutually agree upon contents of survey upon implementation.

Agency subjective measure related to the satisfaction of the Account Manager’s performance. This PG will be an annual PG evaluation.

8.0%

9 Overpayment recovery- total number of dollars overpaid to providers that are collected in the stated time divided by total number of dollars overpaid.

A minimum of 90.00% recovered within 180 days

0.5%

10 Network turnover- level of voluntary and involuntary vision provider turnover in the State’s network in the State of Ohio.

Optometrist: <3% Ophthalmologist:

<4%.

1.5%

11 Network turnover notification

Agency must be notified of the termination of a provider group with more than 50 claims for client’s covered population during the last twelve months within 15 business days of termination and agrees to provide a monthly report of all terminations.

3.0%

12 Data enrollment files- The Contractor will process and confirm weekly enrollment information provided by the Agency within the timeframe set forth by the Agency following receipt of clean enrollment file (an enrollment file that is free from errors).

A minimum of 100.00% of files loaded within two business days or less upon receipt from the State.

4.0%

13 Web portal availability- The Contractor must ensure the web portal is available to Members 99.9% of the time (excluding scheduled down time).

The web portal is available to Members 99.9% of the time (excluding scheduled down time).

2.0%

Vision Service Plan Insurance Company CSP027240, Amendment 1 Page 4 of 5

This Amendment shall become effective as of 10/17/25 and shall remain in full force and effect for the term of the Contract. Except as modified by this Amendment, all other terms, conditions and pricing of the Contract shall remain the same and in full force and effect.

IN WITNESS WHEREOF, the parties have executed this Amendment as of the dates appearing below.

VISION SERVICE PLAN STATE OF OHIO

INSURANCE COMPANY DEPARTMENT OF ADMINISTRATIVE SERVICES

By: By:

Name: Stuart Thompson Name: Kathleen C. Madden

Title: Sr. Vice President, Deputy Counsel Title: Director

Vision Service Plan Insurance Company CSP027240, Amendment 1 Page 5 of 5

SUMMARY OF AMENDMENTS

Amendment Number

Effective Date Description

1 10/17/25

This amendment is issued to revise the Performance Guarantees as mutually agreed upon.

All other prices, terms and conditions remain unchanged.

SUMMARY OF AMENDMENTS