Letter Agreement dated October 1, 2010, between Administaff of Texas, Inc. and UnitedHealthcare Insurance Company

Via:

UPS Next Day Air, email and facsimile

By:

/s/ Richard G. Rawson

Its:

President

Date:

10/1/2010

 

A.

 

B.

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***

***

***

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***

1.

*** is defined to include *** for coverage in a ***  or ***, including all ***, and/or *** COBRA or state continuation coverage.

 

C.

 

1.

UnitedHealthcare and Administaff agree to reduce the claim-related performance standards set forth in Minimum Premium Administrative Services Agreement, Exhibit A, Section 4, from a maximum amount of *** to ***, and an additional *** in potential Premium Credits will be at risk for the results of an independent claim audit every ***.  The Time to Pay performance standard potential credit will be reduced from a maximum amount of *** to ***; the Financial Accuracy performance standard potential credit will be reduced from a maximum amount of *** to ***; and the Procedural Accuracy performance standard potential credit will be reduced from a maximum amount of *** to ***, all such reductions to be taken proportionally across the levels delineated within the standards.  The parties will negotiate the criteria for measuring passing or failing the audit with consultation from the UnitedHealthcare Exter nal Auditing unit.

 

2.

UnitedHealthcare and Administaff agree to reduce the phone-performance standards and customer satisfaction survey standards set forth in the Minimum Premium Administrative Services Agreement, Exhibit A, Section(s) 5 and 6, from a maximum amount of *** to ***, and an additional *** in potential Premium Credits will be at risk for the timely and accurate production of *** and *** of *** annually.  Such performance standard shall not be provided if the timely delivery of those *** is prevented by federal law or state insurance department cause delays in availability of approved ***.  Notwithstanding the above, the *** Premium Credit shall be available if such delays result in the imposition of penalties or fines to Administaff under the Patient Protection and Affordable Care Act, except where such untimeliness or inaccuracy is due to Administaff’s actions.  The Average Speed to Answ er performance standard potential credit will be reduced from a maximum amount of *** to ***; the Abandonment Rate performance standard potential credit will be reduced from a maximum amount of *** to ***; and the Customer Satisfaction Survey performance standard potential credit will be reduced from a maximum amount of *** to ***, all such reductions to be taken proportionally across the levels delineated within the standards.  Administaff will be provided with direct access to a UnitedHealthcare contracts representative to assist in developing and producing new documents based on the reasonable needs of Administaff.

 

D.

 

1.

If Administaff introduces a competing carrier, the following provisions shall apply as long as UnitedHealthcare continues to write new group policies in that market:

 

i.

Administaff agrees to *** to the competing carrier;

 

ii.

Existing Clients will be offered a choice at the time of the Client’s contract renewal between the UnitedHealthcare and competing carrier coverage options;

 

iii.

The choice between UnitedHealthcare and the competing carrier’s coverage options shall only be *** at the *** and in no event *** to the ***.

 

2.

Existing UnitedHealthcare membership will be grandfathered through at least December 31, 2012, which existing UnitedHealthcare membership shall be measured as of the time the competing carrier is introduced into the market.

 

3.

Only one competing carrier will be introduced into a limited number of markets, not to exceed *** markets through December 31, 2013.

 

4.

UnitedHealthcare will be notified at least 90 days prior to the introduction of a competing carrier into a market.

 

5.

In no event will a competing carrier be introduced in the ***, which market includes *** and *** and *** markets.  These markets will remain exclusive markets.

 

6.

A competing carrier for *** coverage will not be offered in the *** market.  The existing exclusivity provisions on *** coverage in the *** Market as set forth in the Medical Definitive Agreements shall remain in place.

 

7.

Notwithstanding any provision of Exhibit F or this Letter of Agreement to the contrary, the exclusivity provisions shall not apply to *** due to the absence of a ***, or any other county where *** following a *** where there is no ***.

 

8.

Notwithstanding any provision of Exhibit F or this Letter of Agreement to the contrary, the exclusivity provisions shall not apply to any *** business policies (*** business policies are those issued to groups with *** eligible employees).

 

E.

*** Membership

 

F.

 

G.