ConnectCare3 (CC3)

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CC3 services are an enhancement to an individual’s medical benefits and available at no additional cost to employees and their dependents covered on the consortium member’s group health plan. CC3 offers solutions to help build health literacy and reduce barriers to care while aiming to help consortium members with cost reduction strategies through their wellness solutions services. CC3 is a unique independent advocate and have no affiliation with any insurance carrier or hospital system.

Clinical Services

Patient Advocacy

• Support clinical team with provider and social service resources

Nurse Navigation

• Assist patients in understanding their diagnosis and treatment options

• Prepare questions for physician appointments.

• Identify well-credentialed physicians for second opinions.

• Provide clinical support throughout diagnosis.

Chronic Disease Management & Prevention

• Multidisciplinary team of registered nurses, registered dietitians, and certified health coaches

• Assist individuals with prediabetes, diabetes, high blood pressure, high cholesterol or obesity

• Provide the resources and support to make and sustain healthy lifestyle change needed to improve health.

Nutrition Education

• Help patients understand the connection between diet and health by providing nutritional assessments and healthy meal plans.

• Promote healthy and sustainable dietary changes to decrease risk of disease

Tobacco Cessation

• Work one-one-one with certified health coaches to achieve and maintain a tobacco-free life.

• Can be used as reasonable alternative program

Wellness Solutions

Collaboration

• CC3 will evaluate an organization’s needs and assist them in accomplishing a wide range of goals. This can be straightforward, such as developing an employee

Back to Table of Contents engagement strategy and providing ready-to-use educational tools, or as expansive as building a wellness committee and creating a three- to five-year strategic wellness plan.

Consultation

• CC3 will help employer design wellness programming suited specifically to their organization’s culture and demographics. They can provide wellness campaigns and educational resources on relevant and timely health topics. Consortium members can use these resources to support their wellness initiatives with minimal added work required for them. They can also assist employers in exploring incentives as an employee engagement tool.

Connection

• CC3 will equip consortium members with marketing materials, webinars, and other communication tools to help drive the utilization of CC3 services. They also connect consortium members with additional wellness resources from their insurance carrier, employee assistance program, or within the community that may be available at little to no cost. They can help identify the most appropriate wellness vendors, if needed, for screening services.

Termination from the Consortium Termination by Health Plan

Section 5.5 of the Shared Services Health Plan Cooperation agreement states:

A Member may be terminated by the Board of Directors for actions, conduct or reasons deemed adverse to the best interests of the Health Plan by a vote of no less than twothirds (2/3) of the Directors. If a Member is so terminated, the Member shall be provided a Notice of Involuntary Termination setting forth an effective date of termination that is no earlier than ninety (90) days from the date of the Notice of Involuntary Termination. Effective as of the date of the Notice of Involuntary Termination, the Member's designated representative serving on the Board of Directors shall be removed from the Board and shall have no further duties or responsibilities as a Board member. Irrespective of the foregoing, a Member may be terminated by the Board of Directors immediately by written notice to the Member (i) if a Member makes an assignment for the benefit of creditors; (ii) if a Member is dissolved; (iii) if a receiver or liquidator is appointed for the Member; (iv) if insolvency, bankruptcy, reorganization, or similar proceedings are instituted by or against a Member; or (v) if a member fails to make the payments provided for or contemplated herein (e.g. payments of Member Contributions) on or before the due date for such payment. The right to terminate this Agreement as to a Member under this Section 5.5 shall be in addition to any other remedies available to the Health Plan under this Agreement or otherwise, at law or in equity.

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Termination by the Consortium Member

A consortium member may terminate with proper notice. Section 5.4 of the Shared Services Health Plan Cooperation agreement states:

A. Termination Effective After Initial Term of Participation. In order for a Member to terminate its participation in the Health Plan after the Member’s Initial Term of Participation, the Member must give a Notice of Termination at least 150 days prior to the last day of the third (3rd) full Contract Year in the Member’s Initial Term of Participation.

B. Termination Effective in Subsequent Terms of Participation. In order for a Member to terminate its participation in the Health Plan in Subsequent Terms of Participation, the Member must give a Notice of Termination at least 150 days prior to the last day of any Contract Year.

C. Provision of Notice of Termination. The Notice of Termination required under this Agreement must be in writing and shall be deemed to be effective upon mailing and must be (a) deposited in the U.S. Mail, postage prepaid, certified or registered mail, return receipt requested; (b) sent by recognized overnight delivery service; or (c) delivered personally to the Chair of the Board of Directors.

Upon Termination the Consortium Member May Incur the Following Additional Costs

ASO Run-out Fees: these fees cover the cost of the ASO carrier continuing to apply discounts and the payment of claims that were incurred but not paid prior to the termination date. Refer to your administrative services agreement for specific information on the calculation of ASO run-out fees and any notice requirements. Note: consortium members may not pay run-out fees or penalties out of the SSHPT account.

Non-Covered Claim Liabilities: consortium member is responsible to pay all claims incurred but not paid during the contract period. This includes but is not limited to claims that exceeded the specific stop loss deductible or aggregate attachment point and are not reimbursed by the stop loss carrier. Refer to your stop loss agreement for further information

Additional Fees:

• Management fee

• Broker fee (if applicable)

• Stop loss run-out coverage premium fee

• Shared Consortium Expenses: o D&O o Audit o Tax Preparation o PCOR