CSP900320_A3.pdf

Index No.: DAS032 Contract No.: CSP900320 Eff. Date: 7/01/25

STATE OF OHIO

DEPARTMENT OF ADMINISTRATIVE SERVICES

GENERAL SERVICES DIVISION

OFFICE OF PROCUREMENT SERVICES

4200 SURFACE ROAD, COLUMBUS, OH 43228-1395

AMENDMENT FOR CHANGE

AMENDMENT NO. 3

TO: LIMITED DISTRIBUTION - DEPARTMENT OF ADMINISTRATIVE SERVICES, HUMAN RESOURCES

DIVISION (HRD), OFFICE OF BENEFITS

FROM: KATHLEEN C. MADDEN, DIRECTOR, DEPARTMENT OF ADMINISTRATIVE SERVICES

SUBJECT: CONTRACT FOR TELEHEALTH ADMINISTRATION

Attached are pages 1 and 5 to this contract. Remove these pages from the existing contract and replace with the attached pages on the effective date.

As a result of mutual agreement between the State of Ohio and the Contractor, this amendment is issued to renew the subject contract an additional twelve months, effective 07/01/25 through 06/30/26.

Also, this amendment is to update the Contractor Contact information.

All other prices, terms and conditions remain unchanged.

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

http://www.ohio.gov/procure

Affected Contractor(s):

HR00001368

Community Insurance Co.

Dba Anthem Blue Cross and Blue Shield 6740 North High Street Worthington, OH 43085 Michael.patton@anthem.com

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: TELEHEALTH ADMINISTRATION

CONTRACT NUMBER: CSP900320 EFFECTIVE DATES: 07/01/19 TO 06/30/22

* Renewal through 06/30/26

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

CSP900020 that opened on 08/29/18. 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 Department of Administrative Services (DAS), Human Resources Division (HRD), Office of Benefits Administration 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 contract renewal through 06/30/26, per amendment 3.

CONTRACTOR INDEX

CONTRACTOR: CONTRACT NO.: CSP900320

OAKS Vendor ID: HR00001368

Community Insurance Co.

Dba Anthem Blue Cross and Blue Shield 6740 North High Street Worthington, OH 43085

CONTRACTOR'S CONTACT: Michael Patton * Telephone: 614-318-3975* Email: Michael.patton@anthem.com *

* Indicates an update to the Contractor’s Contact Information.

mailto:Michael.patton@anthem.com

SUMMARY OF AMENDMENTS

Amendment Number

Effective Date Description

3 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 twelve months, effective 07/01/25 through 06/30/26. Also, this amendment is to update the Contractor Contact information.

All other prices, terms and conditions remain unchanged.

2 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 twenty-four

(24) months, effective 07/01/23 through 06/30/25.

All other prices, terms and conditions remain unchanged.

1 07/01/22

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 twelve (12) months, effective 07/01/22 through 06/30/23. Additionally, this amendment is issued to include updated language regarding the Prohibition of the Expenditure of Public Funds for Offshore Services. All other prices, terms and conditions remain unchanged.