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

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CIGNA HealthCare Performance Guarantee Agreement Customer Bridgeport City BOE Effective Date July 1 2010 Account Number s involved in Performance Guarantee s 3213172 RCIGNA received by Connecticut General to and including the day the Claim is processed The day thatthe Claim is receivedwill not be included in this calculation 2 Claim Qualitv 2 1 Financial Accuracy 2 2 1 1 Financial Accuracy Measurement Financial Accuracy Performance Commitment will be determined by applying Connecticut General s Standard Quality Assurance Audit Methodology to a statistically valid sample ofClaims Account Level or claims Office Level processed during the Guarantee Period Financial Accuracy represents the sum of the absolute value oftotal dollars overpaid and the total dollars underpaid subtracted from the total dollars paid divided by the total dollars paid expressed as a percent Overpayments and underpayments are determined from auditing a statistically valid sample ofclaims paid during the period 2 2 Claim Processing Accuracy Overall Accuracy 2 2 2 1 Claim Processing Accuracv Overall Accuracy Measurement Claim Processing Accuracy Overall Accuracy Performance Commitment will be determined by applying Connecticut General s Standard Quality Assurance AuditMethodology to a statistically valid sample ofClaims Account Level or claims Office Level processed during the Guarantee Period Claim Processing Accuracy Overall Accuracy represents the total number of claims processed without any errors both financial and non financial errors divided by the total claims processed expressed as a percent The calculation ofclaims paid with error is determined from auditing a statistically valid sample of claims paid during the period 23 Inquiry 23 1 Average Speed of Answer ASA 23 IIASA Measurement The ASA will be determined by measuring the sum ofthe total elapsed time between the moment when a telephone call is queued to the Call Center s and the time the call is responded to for all answered calls to the Call Center s and then dividing that number by the total number of telephone calls answered in the Call Center s during the Guarantee Period The calculation ofASA is either based on all Inquiries Account Level or on all calls received by the Call Center s that are serviced in the Special Account Queue 232 Call Abandonment Rate 23 2 1 Call Abandonnlent Rate Measurement The Call Abandonment Rate will be calculated as the total number ofcalls received during the Guarantee Period that result in the caller terminating the call after it is queued to a CSA divided by the total number oftelephone calls received by the Call Center s during the Guarantee Period expressed as a percent The calculation ofCall Abandonment Rate is based on all Inquiries Account Level or on all calls received by the Call Center s during the Guarantee Period that are serviced in the Special Account Queue 23 3 First Call Resolution 233 1 First Call Resolution Measurement An Inquiry will be considered closed on first inquiry when Connecticut General gives it a closed status on the Inquiry Tracking System s andno Inquiries involving the same matter are received during the 45 day period prior to the Inquiry or during the 45 day period following the Inquiry The First Call Resolution rate will be calculated by dividing the number of Inquiries thatwere closed on first inquiry during the Guarantee Period by the total OS 28 20 0 20 I 0 Performance Guarantee Page 14
CIGNA HealthCare Performance Guarantee Agreement Customer Bridgeport City BOE Effective Date July 1 2010 Account Number s involved in Performance Guarantee s 3213172 aCIGNA number ofInquiries received during the Guarantee Period expressed as a percent 24 Emplover Service 24 1 Automated Maintenance Eligibility Processing This Performance Guarantee shall not apply if Employer is using theEnrollment Maintenance Tool 24 1 1 Condition Precedent This Maintenance Eligibility Processing Commitment is contingent upon the submission by Employer or Employer s agent of full electronic eligibility files containing no more than two 2 percent erroneous records An erroneous record is defined as any Plan Participant record lacking any ofthe accurate information necessary to correctly administer benefits such as correct spelling ofthe Plan Participant s name applicable Social Security Number date ofbirth account number division if any branch number information to correctly identify plan and benefit structure such as benefit option code benefit structure plan code plan type network ID if the Plan uses provider networks effective date of coverage termination date HIPAA privacy informationifany member address and any other demographic data 24 12 Maintenance Eligibility Processing Measurement Maintenance Eligibility Processing will be calculated by counting the number ofBusiness Days from the Business Day that the file is received by Connecticut General to and including the Business Day the file is entered into the Connecticut General eligibility system The Business Day the file is received will not be included in this calculation Maintenance Eligibility Processing performance will be calculated by dividing the number ofeligibility files that met the performance standard during the Guarantee Period by the total number of eligibility files processed expressed as a percent 242 Maintenance ID Cards 24 2 1Maintenance ID Cards Measurement Maintenance ID Cards performance will be calculated by counting the number of Business Days jrom the Business Day that eligibility infonnation necessary to issue that card is released to the ID card vendor to and including the Business Day that the ID card is issued to the Plan Participant The Business Day the eligibility information is received by the ID card vendor will not be included in this calculation Maintenance ID Cards performance will be calculated by dividing the number of ID cards that were issued to Plan Participants within the desigpated number ofBusiness Days during the Guarantee Period by the total number ofID cards issued to Plan Participants during the Guarantee Period expressed as a percent 2 5 Account Manal ement 25 1 Account Management Measurement Connecticut Gem ral s Account Management Sales Team commits to providing services to Employer of such quality as will result in Connecticut General s achieving on the Account Management Report Card sample available upon request the designated Account Management Composite Score 2 52 Account Management Condition Precedent This commitment is contingent on Employer completing its obligations in the Evaluation ofAccount Management as follows subsection below on a quarterly basis 2 53 Evaluation ofAccount Management At the beginning ofthe Term Employer shall designate individuals on its benefits staff who will receive and complete the Account Management Report Card on a quarterly basis The Account Management Report Card will be distributed to Employer s designated staff members on a quarterly basis shall be completed signed and dated by them and all returned to Connecticut General by OS 28 2010 2010 Performance Guarantee Page 15
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AGENDA CITY COUNCIL MEETING MONDAY
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THE FOllOWING NAMED PERSONS HAVE RE
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And now they are planning on cuttin
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CITY COUNCIL MEETING Monday June 7
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102 09 Communication from Airport M
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73 09 Miscellaneous Matters Committ
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COUNCIL MEMBER BAKER MOVED TO WAIVE
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ADJOURNMENT COUNCIL MEMBER CURWEN M
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DRAFT CHARLES FEREIRA 235 CHURCH ST
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l AWARD BY STIPULATiON FOR FULL AND
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SEVENTEEN THOUSAND FIVE HUNDRED DOL
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IN VIEW OF THE FOREGOING We the und
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BILL FINCH Mayor CITY OF BRIDGEPORT
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B11L of 199r62 fO tl40 1994 02 1082
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1999 04226182 DAY DENEISE G 5 26 20
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2002 02 4924167 BANK LOCK SER vICE
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2003 02 6807922 SANTOS JEWELERS 4 2
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2004 02 6095256 SANTIAGO AUTO SALES
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2004 02 f572541 JAMES R 5AYBAltl AT
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2005 02 6097852 ESSENTIAL SERK JONE
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2005 02 7930901 TONYS TRANSPORTATIO
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2005 02 7949105 QUARLE5 VALERIA DB
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2006 02 6100179 LARRY SAMS SEAFOOD
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2006 02 7931532 WOLF JED OB OUT OF
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2006 02 7952815 JaHN J CAROLAN REAL
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2006 03 7468611 LOPEZ CLARITA 5 26
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2007 02 7932351 DOMACK RESTORATION
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2008 02 0040579 BCA CONTRACT ASSEMB
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2008 02 0042462 12 CONSl 1LTlNG OB
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2008 02 0044109 RADIATOR EXPF ESS O
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II i CITY OF BRIDGEPORT OFFICE OF P
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2010-06-07_(2).pdf - 19318.8K - BridgeportCT.gov

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