2010-06-07_(2).pdf - 19318.8K - BridgeportCT.gov

i t i
CIGNA HealthCare Performance Guarantee Agreement
Customer Bridgeport City BOE
Effective Date July 1 2010
Account Number s involved in Performance Guarantee s 3213172
tIIr
CIGNA
Performance Guarantee Connecticut General
reserves the right to reasonably adjust the
Payment Amount ifany
Employer s act or omission Connecticut
General will provide notice ofsuch
adjustment to Employer
to account for
Should Employer
not agree to the adjustment amount
Employer will notify Connecticut General of
its objection The Parties agree
to meet and
discuss such objections and come to mutual
agreement on resolution
4 6 Performance Reports measure results for the
entire Guarantee Period Any quarterly or
otherperiodic results shared with Employer
are for informational purposes only
52 Connecticut General may replace or modify
Performance Guarantees ifnecessitated by a
change in the way Connecticut General
systematically tracks or measures the
applicable Performance Guarantee Any
substitute Performance Guarantee will to the
extent reasonably possible attempt to reflect
the same underlying objective and
performance levlel reflected in the original
Performance Guarantee consistent with its
new measurementtracking methodology
Connecticut General shall explain the reasons
for the change ofa Performance Guarantee
and the specifics ofthe substitute
Performance Guarantee in writing at least 30
days prior to such change
4 7 No third party audit results will be used to
measure Performance Guarantees
Section 6
Aereemlmt Modification
4 8 Payment Amounts are based on the Projected
Population andor total amount of fees
expected to be paid by Employer to
Connecticut General underthe applicable
Service Agreements andor Policies Payment
Amounts are subject to change by
Connecticut General in the event thatthe
Projected Population andor total amount of
fees paid by Employer under the applicable
Service Agreements andor Policies during
the Guarantee Period changes as described in
the applicable Services Agreement
Section 5
Measurement
Methodoloev Chanees
5 1 Connecticut General shall apply its standard
methodology consistent with industry
standards to measure Performance
Guarantees Additional information about
methodology for specific Performance
Guarantees if applicable is detailed in
applicable Exhibit B Industry standard
codes including but not limited to CPT ICD
9 NDC and CDT codes that are set
by the
industry or a government agency are subject
to
update change Any such updates changes
occurring after the Effective Date will be
deemed incorporated into this Agreement
without further action required by the parties
This Agreement constitutes the entire contract
between the parties relating to the subject matter
herein and no modification or amendment hereto
shall be valid unless it is in writing and signed by
an officer ofEmploye r and by Connecticut
General s Regional Financial Officer
Section 7
Laws Governine Contract
This Agreement shall be construed in accordance
with the laws of the State ofConnecticut without
regard to conflict of law rules and both parties
consent to the venue andjurisdiction ofits courts
Section 8
Resolution ofDisputes
8 1 Any dispute ben leen the parties arising from
or relating to the performance or
interpretation ofthis Agreement
Controversy shall be resolved exclusively
pursuant to the following mandatory dispute
resolution procedures
8 1 1 Any Controversy shall first be referred for
Executive Review The disputing party
shall give the other party written notice of
the Controversy and request Executive
Review Within twenty 20 days of such
written request the receiving party shall
respond to the other in writing The notice
and the response shall each include a
OS 28 2010
2010 Performance Guarantee Page 7