CSP900221_DAS070_Contract_REV.pdf

Index No.: DAS070

Eff. Date: 07/01/25

STATE OF OHIO

DEPARTMENT OF ADMINISTRATIVE SERVICES

GENERAL SERVICES DIVISION

OFFICE OF PROCUREMENT SERVICES

4200 SURFACE ROAD, COLUMBUS, OH 43228-1395

MANDATORY USE CONTRACT FOR: EMPLOYEE POPULATION HEALTH MANAGEMENT (PHM) PROGRAM

CONTRACT NUMBER: CSP900221 EFFECTIVE DATES: 07/01/20 TO 06/30/23

* Renewal through 06/30/26

The Department of Administrative Services has accepted Proposals submitted in response to Request for Proposal (RFP) No.

CSP900221 that opened on 10/09/19. The evaluation of the Proposal responses has been completed. The Offeror listed herein has been determined to be the highest ranking Offeror and has been awarded a Contract for the services listed. The respective Proposal response including, Contract Terms & Conditions, any Proposal amendment, special Contract Terms & Conditions, specifications, pricing schedules and any attachments incorporated by reference and accepted by DAS become a part of this Services Contract.

This Requirements Contract is effective beginning and ending on the dates noted above unless, prior to the expiration date, the Contract is renewed, terminated, or cancelled in accordance with the Contract Terms and Conditions.

This Requirements Contract is available to the Human Resources Division (HRD), Benefits Administration Services (BAS), of the Department of Administrative Services (DAS) as applicable.

The agency is eligible to make purchases of the contracted services in any amount and at any time as determined by the agency. The State makes no representation or guarantee that department will purchase the volume of services as advertised in the Request for Proposal.

This Requirements Contract and any Amendments thereto are available from the DAS Web site at the following address:

www.ohio.gov/procure

*Indicates mutual renewal through 06/30/26, per amendment 6.

MUTUALLY AGREED TO CLARIFICATIONS / MODIFICATIONS TO THE RFP

Final Clarifications and Negotiations – response dated 01/22/2020

Finalist Interview and Presentation – responses dated 12/12/2019

Finalist Interview Clarification – response dated 12/13/2019

Performance Guarantees – response dated 01/13/2020

Best and Final Offer – response dated 01/17/2020

Licensing and Ownership Rights – response dated 03/10/20

EFFECTIVE 07/01/24

Addition of the Next Steps Consult Program: A concierge-style engagement conversation that helps employees understand their health status by reviewing their HRA and biometric screenings results. These one-time-a-year conversations, led by a Health Guide direct members to the programs and resources available to help them achieve their goals.

If there are any discrepancies between any of the above documents, the later dated response prevails.

*PROHIBITION OF THE EXPENDITURE OF PUBLIC FUND FOR OFFSHORE SERVICES

No State Cabinet Agency, Board or Commission will enter into any contract to purchase services provided outside of the United States or that allows State data to be sent, taken, accessed, tested, maintained, backed-up, stored, or made available remotely outside (located) of the United States, unless a duly signed waiver from the State has been attained.

Notwithstanding any other terms of this Contract, the State reserves the right to recover any funds paid for services the Contractor performs outside of the United States for which it did not receive a waiver. The State does not waive any other rights and remedies provided to the State in the Contract.

Further, no State agency, board, commission, State educational institution, or pension fund will make any purchase from or investment in any Russian institution or company. Notwithstanding any other terms of this Contract, the State reserves the right to recover any funds paid to Contractor for purchases or investments in a Russian institution or company in violation of this paragraph. The provisions of this paragraph will expire when the applicable Executive Order is no longer effective.

The Contractor must complete the Contractor/Subcontractor Affirmation and Disclosure Form (https://procure.ohio.gov/pdf/EO2022-02D/04-Affirmation%20and%20Disclosure%20Form_3-4-22.pdf) affirming the Contractor understands and will meet the requirements of the above prohibition. During the performance of this Contract, if the Contractor changes the location(s) disclosed on the Affirmation and Disclosure Form, Contractor must complete and submit a revised Affirmation and Disclosure Form reflecting such changes.

*Indicates addition of the Prohibition of the Expenditure of Public Fund for Offshore Services language, per amendment 6.

https://urldefense.com/v3/__https:/nam11.safelinks.protection.outlook.com/?url=https*3A*2F*2Fprocure.ohio.gov*2Fpdf*2FEO2022-02D*2F04-Affirmation*2520and*2520Disclosure*2520Form_3-4-22.pdf&data=05*7C01*7Cpzipperer-davis*40carestar.com*7C14e64c91626c447194d508da23d1211f*7C97949c389d76437188b278d5c33b4e88*7C1*7C0*7C637861678555466720*7CUnknown*7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0*3D*7C3000*7C*7C*7C&sdata=AVuQHWdW3*2B8b9OeMhx0lgh0JB820niXbuV3e*2FFGeMSA*3D&reserved=0__;JSUlJSUlJSUlJSUlJSUlJSUlJSUlJSUlJSUl!!ADJM6pxZfkrGng!WXH1-0dh0eQMkG7ITbo6N-xRTHt1UUIXntvp-MPmhqYX6FWCzHcdDwBGZuZmv4Z1Kip5Wv5aBQfzbDnwXBqOYWM8vNRO9gR98v4$

Eff. Date: 03/29/24

PRICE SCHEDULE

Per Employee Per Month (PEPM) Per Participant Administered Per Month (PPAPM)

OAKS

ITEM NO. SET UP FEES UNIT OF MEASURE ONE TIME FEE

37744 Year One Set-up fee (must include all fees to implement) One Time Set Up $30,000.00

Single Sign-On Included in ASO Fee

ITEM NO. ADMINISTRATIVE SERVICES ONLY (ASO) FEES UNIT OF MEASURE *FEE

37745 Total Core Monthly ASO Fees PEPM $1.55 Outreach Coordinators Included in ASO Fee Travel Included in ASO Fee Dedicated Member Services Toll Free Telephone Line Included in ASO Fee Online Health Risk Assessment Included in ASO Fee Incentives Tracking Included in ASO Fee Incentive Administration Included in ASO Fee Portal/HUB Fees Included in ASO Fee Individual Based Challenges Included in ASO Fee Mobile Applications Included in ASO Fee Communications Included in ASO Fee Data Feeds Included in ASO Fee

ITEM NO. LIFESTYLE MANAGEMENT (LSM) COACHING FEES UNIT OF MEASURE *FEE

37746 Phone-Based Programs Lifestyle Management (LSM) Coaching PPAPM $47.00

37747 Medium to High Risk LSM Phone-Based Programs PPAPM $47.00

37748 Medium to High Risk LSM Computerized Cognitive Behavioral Therapy (CCBT) App (One Year of Access) Per Participant Per Year $65.00

37749 Medium to High Risk LSM Tobacco Cessation Coaching Program (Not Including Nicotine Replacement Therapy)

PPAPM $47.00

Web-Based Programs (Including Medium to High Risk) Included in ASO Fee Online Programs (Including Medium to High Risk) Included in ASO Fee *Next Steps Consult Program PPAPM $30.00

ITEM NO. ADDITIONAL LSM PROGRAM FEES UNIT OF MEASURE *FEE

38017 WellBeats Fitness Program PEPM $0.50 38018 Blue Mesa Diabetes Prevention Program Per Participant $330.00

ITEM NO. BIOMETRICS FEES UNIT OF MEASURE *FEE

37750 Onsite Per Administered $50.00 37751 Lab Per Administered $50.00

37752 Physician Form (when form is processed, not when form is requested) Per Form $10.00

38019 Additional Privacy Screen Per Screen $35.00

38020 Registration Clerk, Less Than 50 Participants ($10,000 Annual Credit) Per Hour $35.00

*Indicates administrative update and the addition of new cost item effective 07/01/24, per amendment 5.

Eff. Date: 03/29/24

PRICE SCHEDULE (CONT’D)

ITEM NO. OTHER FEES UNIT OF MEASURE *FEE

Voluntary Outcomes-Based Program Administration Included in ASO Fee

37753 Out-of-Scope Reporting Cost of Mailing, if Required

37754 Gift Card Fulfillment Gift Card Value Customized Member Portal/HUB Included in ASO Fee Team Based Challenges Included in ASO Fee Customized Mobile App Included in ASO Fee Additional Data Fees Included in ASO Fee

37755 Confirmation Statements Cost of Mailing, if Required

*Indicates administrative update, per amendment 5.

CONTRACTOR INDEX

CONTRACTOR: CONTRACT NO.: CSP900221

HR386

*Personify Health Inc.

75 Fountain St., Ste. 310 Providence, RI 02902 TERMS: Net 30

*CONTRACTOR’S CONTACT:

Carrie Monroe O’Keefe Office: (401) 680 - 1728 Email: Carrie.MonroeOKeefe@Personifyhealth.com

SUBCONTRACTORS:

Quest Diagnostics SilverCloud Health Inc.

WellBeats, Inc.

*Indicates the Contractor’s name change and the Contractor Contact Information, per Amendment 6.

mailto:Carrie.MonroeOKeefe@Personifyhealth.com

SUMMARY OF AMENDMENTS

Amendment Number

Effective Date Description

6 07/01/25

This amendment is issued to notify that as a result of mutual agreement between the State of Ohio and the Contractor, this contract is renewed for an additional 12 months, effective 07/01/25 through 06/30/26. Also, this amendment is issued to add the Prohibition of the Expenditure of Public Fund for Offshore Services language to the contract, update the Contractor Name and the Contractor Contact information.

All other prices, terms and conditions remain unchanged.

5 03/29/24

This amendment is issued to add the following cost item: Next Steps Consult Program, to be effective 07/01/24.

Additionally, this amendment is issued to add a mutually agreed upon modification, Next Steps Consult Program, and perform an administrative update.

All other prices, terms and conditions remain unchanged.

4 07/01/23

This amendment is issued to notify that as a result of mutual agreement between the State of Ohio and the Contractor, this contract is renewed for an additional 24 months, effective 07/01/23 through 06/30/25.

This amendment is also issued to update the contractor’s contact information.

All other prices, terms and conditions remain unchanged.

3 07/01/21 This amendment is issued to revise the “Data Exchange” performance guarantee, to what was agreed upon for year 1, for the remainder of the contract, effective 07/01/21.

2 11/13/20 This amendment is issued to revise the “Data Exchange” performance guarantee for year 1. The original performance guarantee will be in effect starting in year 2, 07/01/21.

1 07/01/20

This amendment is issued to add the following cost items: WellBeats Fitness Program, Blue Mesa Diabetes Prevention Program, Biometrics Registration Clerk, less than 50 participants ($10,000 annual credit), and Biometrics Additional Privacy Screens (as originally proposed). Additionally, this amendment is issued to add a mutually agreed upon modification, Licensing and Ownership Rights, add a subcontractor, WellBeats, Inc., and repaginate pages 4 and 5.

CONTRACT FOR: EMPLOYEE POPULATION HEALTH MANAGEMENT (PHM) PROGRAM