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Contract 2025-013ADocusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 AGREEMENT No. 2025-013 EMPLOYEE HEALTHCARE AND BENEFITS CONSULTING SERVICE THIS AGREEMENT, is made and entered into this Tuesday, July 1, 2025, by and between the CITY OF CLERMONT, FLORIDA, a municipal corporation under the laws of the State of Florida whose address is: 685 W. Montrose Street, Clermont, Florida, (hereinafter referred to as "CITY"), and Hylant Group, Inc., whose address is: 811 Madison Ave., Toledo, Ohio 43604 (Notice to Attn: Legal Department), (hereinafter referred to as "CONTRACTOR"). WHEREAS, the City of Clermont issued RFQ 25-013 titled Employee Healthcare and Benefits Consulting Services; WHEREAS, CONTRACTOR submitted its response dated November 21, 2024, to RFQ 25-013; WHEREAS, CITY desired to award a contract to CONTRACTOR in accordance with the terms and conditions of RFQ 25-013 and CONTRACTOR's response thereto; WITNESSETH: That the parties hereto, for the consideration hereinafter set forth, mutually agree as follows: 1. SCOPE OF WORK The CONTRACTOR shall furnish employee healthcare and benefits consulting services as described in CITY's RFQ 25-013 and CONTRACTOR's November 21, 2024 response thereto, which are expressly incorporated herein and made a part of the Agreement Documents hereto and shall do everything required by this Agreement and the Agreement Documents. Provided, however, that nothing herein shall require CITY to purchase or acquire any items or services from CONTRACTOR. 2. THE CONTRACT SUM CITY shall pay CONTRACTOR, for the faithful performance of the Agreement as set forth in the Agreement Documents and the Unit Price Schedule an amount in accordance with the compensation schedule set forth in the Scope of Services dated February 12, 2025 attached hereto and incorporated herein. 3. PROVISION OF SERVICES AND COMPLETION OF WORK A. The CONTRACTOR shall only provide the CITY with employee healthcare and benefits consulting services upon receipt of an authorized order from the CITY and shall provide the requested items in the timeframe and as set forth in or in the specific purchase order submitted by the CITY. Nothing herein shall obligate CITY to purchase any particular amount of product from CONTRACTOR or create an exclusive purchase agreement between CITY and CONTRACTOR. CITY shall not be obligated or required to pay for 1 Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Term Agreement RFQ 25-013 Employee Healthcare and Benefits Consulting Services any items received until CITY has accepted the items in accordance with the order provided to CONTRACTOR. B. CONTRACTOR, upon receipt of a purchase order hereunder, shall as soon as reasonably practicable notify CITY if there is an issue or question related to the fulfillment of the order or whether there will be any delay in providing the items requested. Failure of CONTRACTOR to so notify CITY will preclude CONTRACTOR from seeking payment of any kind for any items that were delayed in delivery. Upon receipt of notification of the delay, CITY may, at its sole option, cancel the order and seek the items from any available source. C. It is expressly understood and agreed that the passing, approval, and/or acceptance of any services herein by CITY or by any agent or representative as in compliance with the terms of this Contract shall not operate as a waiver by the CITY of strict compliance with the terms of this Contract, and the CITY may require the CONTRACTOR replace the accepted services so as to comply with the warranties and specifications hereof. D. COMPANY expressly acknowledges that this Contract does not bind or obligate CITY to purchase any minimum quantity of product during the term hereof. 4. TERM AND TERMINATION A. This Agreement is to become effective upon execution by both parties and shall remain in effect for a period of four (4) years thereafter, unless terminated or renewed as provided for herein. B. Notwithstanding any other provision of this Agreement, CITY may, upon written notice to CONTRACTOR, terminate this Agreement: a) without cause and for CITY's convenience upon thirty (30) days written notice to CONTRACTOR; b) if CONTRACTOR is adjudged to be bankrupt; c) if CONTRACTOR makes a general assignment for the benefit of its creditors; d) CONTRACTOR fails to comply with any of the conditions of provisions of this Agreement; or e) CONTRACTOR is experiencing a labor dispute, which threatens to have a substantial, adverse impact upon the performance of this Agreement, without prejudice to any other right or remedy CITY may have under this Agreement. In the event of such termination, CITY shall be liable only for the payment of all unpaid charges, determined in accordance with the provisions of this Agreement, for work, properly performed and accepted prior to the effective date of termination. C. Upon mutual Agreement of the parties, this Agreement may be renewed for four (4) additional one-year terms. Sixty (60) days prior to completion of each extended term of this Agreement, CONTRACTOR may request and the City may consider an adjustment to price based on changes in the Producer Price Index (PPI). 2 Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Term Agreement RFQ 25-013 Employee Healthcare and Benefits Consulting Services 5. PAYMENTS In accordance with the provisions fully set forth in the Contract Documents, the CONTRACTOR shall submit an invoice to CITY upon completion of the services and delivery of products to CITY as set forth in the applicable purchase order. CITY shall make payment to the CONTRACTOR for all accepted deliveries and undisputed products delivered and services provided, within thirty (30) calendar days of receipt of the invoice. 6. DISPUTE RESOLUTION - MEDIATION A. Any claim, dispute, or other matter in question arising out of or related to this Agreement shall be subject to mediation as a condition precedent to voluntary arbitration or the institution of legal or equitable proceedings by either party. B. The CITY and CONTRACTOR shall endeavor to resolve claims, disputes, and other matters in question between them by mediation. C. The parties shall share the mediator's fee and any filing fees equally. The mediation shall be held in Clermont, Lake County, Florida unless another location is mutually agreed upon. Agreements reached in mediation shall be enforceable as settlement Agreements in any court having jurisdiction thereof. 7. INSURANCE AND INDEMNIFICATION RIDER 7.1. Worker's Compensation Insurance The CONTRACTOR shall take out and maintain during the life of this Agreement, Worker's Compensation Insurance for all its employees connected with the work of this Project and, in case any work is sublet, the CONTRACTOR shall require the subCONTRACTOR similarly to provide Worker's Compensation Insurance for all of the subCONTRACTOR employees unless such employees are covered by the protection afforded by the CONTRACTOR. Such insurance shall comply with the Florida Worker's Compensation Law. In case any class of employees engaged in hazardous work under this Agreement at the site of the Project is not protected under the Worker's Compensation statute, the CONTRACTOR shall provide adequate insurance, satisfactory to the CITY, for the protection of employees not otherwise protected. 7.2. CONTRACTOR's Commercial General Liability Insurance The CONTRACTOR shall take out and maintain during the life of this Agreement, Commercial General Liability and Business Automobile Liability Insurance as shall protect it from claims for damage for personal injury, including accidental death, as well as claims for property damages which may arise from operating under this Agreement whether such operations are by itself or by anyone directly or indirectly employed by it, and the amount of such insurance shall be as follows: A. CONTRACTOR's Commercial General Liability, $1,000,000 Each ($2,000,000 aggregate). Liability Coverages, Bodily Injury Occurrence, & Property Damage Combined Single Limit Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Term Agreement RFQ 25-013 Employee Healthcare and Benefits Consulting Services B. Automobile Liability Coverages, $1,000,000 Each, Bodily Injury & Property Damage Occurrence, Combined Single Limit 7.3. CITY's and CONTRACTOR's Protective Liability Insurance The CITY shall procure and furnish a CITY's and CONTRACTOR's Protective Liability Insurance Policy with the following minimum limits: A. Bodily Injury Liability & $1,000,000 Each ($2,000,000 aggregate) Property Damage Liability Occurrence Combined Single Limit. 7.4. Indemnification Rider A. To the fullest extent permitted by law, the CONTRACTOR shall indemnify and hold harmless the CITY and its employees from and against all claims, damages, losses and expenses, including but not limited to reasonable attorney's fees, arising out of or resulting from its performance of the Work, provided that any such claim, damage, loss or expense (1) is attributable to bodily injury, sickness, disease or death, or to injury to or destruction of tangible property (other than the Work itself) , and (2) is caused in whole or in part by any negligent act or omission of the CONTRACTOR, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, regardless of whether or not such acts are caused in part by a party indemnified hereunder. Such obligation shall not be construed to negate, abridge, or otherwise reduce any other right to obligation of indemnity which would otherwise exist as to any party or person described in this Article; however, this indemnification does not include the sole acts of negligence, damage or losses caused by the CITY and its other contractors. B. In any and all claims against the CITY or any of its agents or employees by any employee of the CONTRACTOR, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, the indemnification obligations under this Paragraph shall not be limited in any way by any limitation on the amount or type of damages, compensation or benefits payable by or for the CONTRACTOR or any subcontractor under workers' or workmen's compensation acts, disability benefit acts or other employee benefit acts. 8. NOTICES All notices shall be in writing and sent by United States mail, certified or registered, with return receipt requested and postage prepaid, or by nationally recognized overnight courier service to the address of the party set forth below. Any such notice shall be deemed given when received by the party to whom it is intended. 4 Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Term Agreement RFQ 25-013 Employee Healthcare and Benefits Consulting Services CONTRACTOR: Hylant Group, Inc. 811 Madison Ave, Toledo, Ohio 43604 Attn: Legal Department OWNER: City of Clermont 685 W. Montrose Street, Clermont, FL 34711 Attn: Rick Van Wagner, Interim City Manager Either party may change the name of the person receiving notices and the address at which notices are received by so advising the other party in writing. 9. MISCELLANEOUS 9.1. Attorneys' Fees In the event a suit or action is instituted to enforce or interpret any provision of this Agreement, the prevailing party shall be entitled to recover such sum as the Court may adjudge reasonable as attorneys' fees at trial or on any appeal, in addition to all other sums provided by law. 9.2. Waiver The waiver by the CITY of breach of any provision of this Agreement shall not be construed or operate as a waiver of any subsequent breach of such provision or of such provision itself and shall in no way affect the enforcement of any other provisions of this Agreement. 9.3. Severability If any provision of this Agreement or the application thereof to any person or circumstance is to any extent invalid or unenforceable, such provision, or part thereof, shall be deleted or modified in such a manner as to make the Agreement valid and enforceable under applicable law, the remainder of this Agreement and the application of such a provision to other persons or circumstances shall be unaffected, and this Agreement shall be valid and enforceable to the fullest extent permitted by applicable law. 9.4. Amendment Except for as otherwise provided herein, this Agreement may not be modified or amended except by an Agreement in writing signed by both parties. Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Term Agreement RFQ 25-013 Employee Healthcare and Benefits Consulting Services 9.5. Entire Ap-reement This Agreement, including the documents incorporated by reference, contains the entire understanding of the parties hereto and supersedes all prior and contemporaneous Agreements between the parties with respect to the performance of services by CONTRACTOR. 9.6. Assi _ ng ment Except in the event of a merger, consolidation, or other change of control pursuant to the sale of all or substantially all of either party's assets, this Agreement is personal to the parties hereto and may not be assigned by CONTRACTOR, in whole or in part, without the prior written consent of the CITY. 9.7. Venue The parties agree that the sole and exclusive venue for any cause of action arising out of this Agreement shall be Lake County, Florida. 9.8. Applicable Law This Agreement and any amendments hereto are executed and delivered in the State of Florida and shall be governed, interpreted, construed, and enforced in accordance with the laws of the State of Florida. 9.9. Public Records The CONTRACTOR expressly understands records associated with this project are public records and agrees to comply with Florida's Public Records law, including the following: A. Keep and maintain public records that ordinarily and necessarily would be required by the CITY in order to perform the services contemplated herein. B. Provide the public with access to public records on the same terms and conditions that the CITY would provide the records and at a cost that does not exceed the cost provided in Florida's Public Records law or as otherwise provided by law. C. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. D. Meet all requirements for retaining public records and transfer, at no cost, to the CITY all public records in possession of CONTRACTOR upon the termination of the contract and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. The CONTRACTOR shall make reasonable efforts to provide all records stored electronically to the CITY in a format compatible with the information technology systems of the CITY. E. IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, THE 11 Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Term Agreement RFQ 25-013 Employee Healthcare and Benefits Consulting Services CONTRACTOR SHALL CONTACT THE CITY'S CUSTODIAN OF PUBLIC RECORDS AT THE CITY CLERK'S OFFICE, (352) 241-7331. 10. CONTRACT DOCUMENTS The Contract Documents, as listed below are herein made fully a part of this Contract as if herein repeated. Document Precedence: A. This Agreement B. Purchase Order / Notice To Proceed C. Scope of Services dated February 12, 2025 D. All documents contained in RFQ 25-013 titled Employee Healthcare and Benefits Consulting Services and CONTRACTOR's response thereto. 7 Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Term Agreement RFQ 25-013 Employee Healthcare and Benefits Consulting Services IN WITNESS WHEREOF, the parties hereto have executed this Agreement. CITY OF CLERMONT Signed by: g: SIGNATURE Tim Murry FULL NAME Mayor TITLE ATTEST FT DocuSigned by: ��ktiQyd H¢+v� SIGNATURE Tracy Ackroyd Howe FULL NAME City Clerk TITLE 2/27/2025 DATE SIGNED 2/27/2025 DATE SIGN STAMP DS E3 Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Term Agreement RFQ 25-013 Employee Healthcare and Benefits Consulting Services HYLANT GROUP, INC. DocuSigned by: 08005507A42641D... SIGNATURE Brian Boone FULL NAME Regional CEO, Southeast TITLE 2/27/2025 DATE SIGNED Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Employee Benefits Scope of Services Prepared For: City of Clermont DATE 2/12/2025 Hylant-Orlando 1025 Greenwood Blvd Suite 285 1 Lake Mary, FL 32746 hylant.com rinrii ;— r-:—'-1- Ir). Wz1r1rlCh_r A7R Af1CC_ onrQ_ RG7'2r1FOFAr' You have many competing priorities on your plate as a company leader. Hylant clients rely on our service team to serve as an extension of their human resources team. We advocate, strategize, support and expand resources for you and your employees. accounrrMq��� C ,tv'teiti��ngfor Op#iMalR�s4/f� CLIENT or y qq 000. T edm 41 C-4CV MEM�� 0 9y 9� d+ w� Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Strategic Advice & Plan Oversight Our team makes sure the decision ma is well -executed. The process starts b,. points. Armed with input from key stakeholders, we dive into the data available and build a multi -year strategic roadmap for your employee benefits plan. From implementation to renewals and everything that happens in between, your Hylant team is here to support your needs, both proactively and reactively. We view our team as an extension of your team. The services identified throughout with ❑.i are included in Hylant's standard fee or commission service agreement. Services identified with � may require additional fees. Please refer to page 11 for applicable fee details. A customized, comprehensive strategic plan that determines objectives Strategic and benefits strategies in support of the overall corporate direction. Planning Provide detailed outlines of the actions needed to accomplish those goals. Once developed, review and refine the benefits playbook regularly. Written Service Our written service timeline details in chronological order the services that El Timeline will be provided and the timeframe in which these services will be performed over the course of the year. Benchmarking Benchmark your plan design, contribution strategy and plan costs against multiple, reliable data sources. Trends & Communicate industry trends and innovations and the relevance to your El Innovations employee benefits programs (e.g., direct contracting, chronic condition management, reference -based pricing, etc.). Carrier/TPA Work with you and your employees to maximize the resources available El Resources from the carrier/TPA partners. Carrier/Vendor Manage all market RFPs to identify the optimal carrier/vendor to meet El Management strategic objectives. This includes all lines of coverage, benefits related vendors and services. Provide claims reporting using reports available through the carrier or Claims Third -Party Administrator and PBM. This will include a Performance F*71 Reporting Report, High -Cost Claimant Analysis and other reports depending on available data. Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Strategic Advice & Plan Oversight Continued Stop Loss Audits and Recovery EJ Plan Document Review Data Analytics team audits actual stop loss payments received against expected payments by comparing stop loss reports against carrier/TPA to ensure you receive appropriate stop loss reimbursements. (Only applies to self -funded health plans) Review all benefit plan certificates and policies to ensure they properly reflect the requested benefit provisions. Cost Containment and Healthcare Analytics To manage expenses, you first must understand what factors are impacting costs. Hylant uses proprietary technology to analyze data and from there consults with company stakeholders on recommendations to contain costs for your self -funded plan. Provide access to your organization's self -funded plan data via Hylant's Data Analytics Platform with state-of-the-art analysis, which helps guide the overall benefits and population health management strategies. Provide standard monthly reports and dashboards, as well as customized reports. Q Data Analytics If you choose, you will have access to the data and relative dashboards, designed to help you take control of medical and pharmacy costs. Additional fees for EDI feeds may apply. If the annual fee agreement does not cover the cost of administration, an additional PEPM fee will apply. (Applies to self -funded health plans only, unless a fully insured health plan can get regular access to detailed claims and eligibility files) Strategic Cost Identify factors driving plan cost and recommend solutions to better F� Containment manage costs. Financial Provide financial modeling services for self -funded health plans. This Modeling includes but is not limited to plan design modeling, budget projections, IBNR estimates, stop loss optimization, etc. A comprehensive pharmacy program analysis conducted by our licensed Ph.D. pharmacy consultants, including discounts, rebates, contract Q Pharmacy provisions, utilization, plan design, formulary management, prior Management authorization requirements, step therapy, drug edits, etc. Leverage our preferred PBM agreements for your self -funded health plan, where possible. Additional fees apply for Hylant's pharmacy program, if selected. (Typically, this section only applies to self -funded health plans) Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Health & Well -Being Strategies Managing the health of your employees and benefit plan participants is in your company's best interest for a multitude of reasons. Hylant is here to help equip you with the tools and resources to build a culture of well-being. Services listed for Health & Well -Being are subject to specific criteria for inclusion. Collaboratively design customized population health management Health and Well- Being Strategic programs that support employees along the entire health spectrum. Dedicated health strategists will conduct discovery sessions that lead to Roadmap the customized strategy, then coordinate the implementation of selected vendors and programs. Ongoing Provide ongoing support and guidance to keep your population health Guidance and management efforts robust and innovative. Conduct regular stewardship Stewardship meetings to review program satisfaction and results. On -Site and Our team of health strategists will partner with clients to assist in Virtual Events coordinating virtual and onsite events as part of the overall population health strategy. Provide our proprietary nurse navigation and advocacy program for clients that implement the Hylant Data Analytics platform. This program leverages Q HealthDirect available data to assist members needing care navigation and clinical support. Program requires certain plan criteria. Additional fees apply. (Only applies to self -funded health plans) Member Education & Engagement Educating employees and plan participants on the benefits available and, once enrolled, how to effectively utilize the plans is a critical component that aids in attracting and retaining talent, as well as managing costs for your benefit plans. Hylant supports our clients in education because we have seen firsthand the positive impact knowledge has in plan outcomes and people's lives. Lead and/or participate in employee meetings, both virtually and on -site, to Benefits educate employees and their families on how to best utilize the available El Education programs and benefits. Develop and deploy an ongoing, year-round benefits Campaign education strategy tailored to your needs and priorities. Travel expenses may be passed through to the client at cost. Prepare Benefit Guides for distribution to employees. Guides are designed F71 Benefit Guides to provide plan information, decision -making tips, and to meet ERISA's required disclosures. Printing service costs may be passed through to the client at cost. Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Member Education & Engagement Continued Comprehensive benefit video library available to help you educate plan Benefit Videos participants. Links to the videos are often embedded in the Benefit Guide. Digitally available to host or deploy via URL, QR code, or embed code. Employee Navigator is Hylant's preferred enrollment technology for our Q Employee clients without an HRIS solution. Hylant will also assist with carrier Navigator connectivity through available EDI or API connections between Employee Navigator and the carriers or administrators. An additional PEPM cost may be assessed depending on our fee agreement. PerksPlus Employee discount marketplace with access to thousands of supplemental perks and cash back offers in a wide range of areas, all at no cost to you. Benefits Provides resources that make it easy for employees to understand how Education benefits work and lead a healthy lifestyle via a collection of health and well - Center being articles, materials, videos, FAQs, and more. Virtually accessible and mobile friendly. Provide tailored employee Benefit Guides, personalized Benefits Hub, online Enhanced resources, videos and tutorials for open enrollment and ongoing employee Communication © communication. Subject to certain criteria for consideration. Additional fees Materials may apply. If printing for all employees is required, printing or other associated costs may be passed through to the Client at cost. Translation Hylant works with various partners who can provide translation services Q Services including documents, videos, telephonic or in -person. Fees for translation services may be passed through to the Client at cost. Decision Hylant teams with various partners who guide employees in their plan Q Support Tools selections during open enrollment or onboarding. Decision support tools will be marketed and quoted as appropriate. Q Engagement Hylant continuously reviews and analyzes developing technology that is Apps designed to improve member engagement in benefit programs. Engagement apps will be marketed and quoted as appropriate. Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Client & Employee Advocacy We are here to alleviate some of the a burden that comes with managing ben serving as an advocate and liaison to i administrators. Whether we are suppo issue or talking with an employee abot claim situation, you can count on your to have your back. Employer Serve as an extension of your Human Resources team. Direct dial telephone ID Advocacy numbers and email addresses are provided to connect with your Hylant Team for assistance with any question or concern that may arise. Foundational Advocacy for Client Advocates support your employees and their dependents on questions or issues related to their benefit where the carrier resources have Employee programs Benefits Issues not resolved the matter. Enhanced Hylant Client Advocates support your employees and their dependents on Q Employee questions or issues related to their benefit programs. Client Advocates act as the front line to resolve member claims issues. Toll free Benefits Hotline is Advocacy and Claim Services available to employees and their covered dependents. Additional fees may apply. Once the benefits administration system/vendor is selected, Hylant's account Benefits management and enrollment/eligibility team works closely with the selected El vendor to ensure the system is functioning properly in accordance with all Administration policy specifications. This includes periodic system testing and quality control prior to open enrollment as well as for new hire enrollments. In cases where there is no benefits administration system in place or the © Enrollment & system is not integrated with the carriers via either EDI or API file feeds, the Eligibility Hylant Enrollment & Eligibility team will manage new hires, terminations and Services changes through the insurance carriers or administrators. Subject to certain criteria and requires an additional service agreement. Carrier/Vendor Serve as an advocate on behalf of each client with plan administrators, carrier El Management partners and other vendors. Hylant has extensive experience with carrier relationships and serves as your advocate for carrier accountability. Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Compliance Helping you navigate the complexities of keeping benefit plans compliant with federal and state regulations is a top priority at Hylant. You can rest easy knowing we will provide you with important legislative changes, sample required notices and disclosures, and offer ongoing education as it pertains to maintaining a compliant employee benefits program for your organization. Proprietary Perform a periodic compliance review to promote awareness and knowledge Compliance of the myriad of federal laws impacting group health and welfare plans, and to 21 Review identify potential compliance gaps to mitigate unknown liabilities associated Checklist with employer policies that are inconsistent with insurance contracts and/or the plan's governing documents. Subject to specific criteria for inclusion. ACA Forms Assist you with the required 1094/1095 forms. This includes identifying the 21 1094/1095 appropriate outsourced reporting solution, as well as working with the vendor to ensure the system is generating accurate forms. Q COBRA Hylant negotiates and arranges COBRA administrative services through our Administration preferred partnership with iSolved. Additional fees may be required. Coordinate the preparation and submission of your annual Form 5500 with Q Form 5500 your selected vendor or our preferred partnership with Wrangle. The Form 5500 vendor will also complete a Summary Annual Report (SAR). Additional fees may be required. HIPAA Privacy Assist with HIPAA compliance to include the required documents as well as El & Security guidance on how to comply with the Privacy and Security rules. Client customization of these documents is required. Plan Document Hylant will prepare a wrap document for your plan(s) written to ensure 2 / SPD (or Wrap) ERISA/DOL compliance. This includes future amendments and Summaries of Material Modifications (SMMs). Participant Hylant will provide model and/or sample notices and disclosures to be Notices & distributed to employees as required by various laws (e.g., CHIP Notice, Disclosures HIPAA Special Enrollments Rights Notice, Medicare Part D Notice, etc.) Required Hylant will submit reminders to you to file or submit various governmental El Governmental disclosures on a timely basis (e.g., Medicare Part D Disclosure to CMS, Filings and/or PCORI fees, RxDC filings, gag clause attestations, etc.). Disclosures Q Discrimination Support your efforts to complete discrimination testing as applicable under Testing IRC Sections 105 and/or 125. Hylant will identify external vendors to complete the analysis. Additional fees may be required for complex analysis. Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Compliance Continued Ongoing F*71 Compliance Education Strategic Compliance Guidance Keep you apprised of legislative developments that impact employee benefit plans. This may be done through monthly eBlasts, periodic Action Alerts, webinars, and/or our Annual Compliance Year -in -Review publication. Hylant will explain the impact that new or revised regulations or guidance will have on your organization's employee benefit plans and build the appropriate strategy for compliance with these requirements. Technology & HR Support Tools There are so many technologies and HR tools on the market that knowing where to start can be overwhelming. Let Hylant help you analyze your options using our market intelligence, resulting in optimum solutions for your business. Provide access to a personalized website offering both customized and Client Portal recommended resources to help fulfill administration, legislative compliance and communication needs. HR Navigator is your personalized, one -stop resource for all your human resources and benefits needs, brought to you by Hylant. Our online portal provides you with a comprehensive set of tools and resources that are HR Resources & easily accessible and searchable. Stay updated with industry trends, 21 Support news, and best practices, and find everything you need to manage your HR duties easily. Access member engagement campaigns, compliance resources, an interactive HR forum, a Learning Management System, toolboxes, and more. Provide HR Hotline which gives access to on -demand HR expertise and HR Hotline advice. HR professionals, available by phone or email, are ready to answer your HR-related and labor law questions. Payroll and HRIS consulting are provided at no cost through our HRIS RI HRIS & Payroll consulting team, ranging from stand-alone benefits administration systems Consulting to full spectrum HCM. Subject to certain criteria for consideration. System charges are not included. Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Leave Management Services Hylant offers consultative solutions to challenges related to leave, as well as General Leave Support Assist with general questions about leave management legislation, Questions requirements, best practices, benchmarking, etc. Discovery, Perform a discovery session to identify current leave management Market RFP and © requirements, policies and procedures, as well as to determine future Analysis goals and objectives. Additional fees apply. Vendor In conjunction with a market RFP of leave management providers, assist Selection and © with the selection of the appropriate vendor as well as coordinate the Implementation implementation of the selected service provider. Additional fees apply. Leave Policy Provide guided leave policy consultation that will help you establish the Q Consulting appropriate leave policies and procedures (best practices, benchmarking and policy creation). Additional fees apply. Global Benefits Global Benefits Deliver specialized expertise for employers facing complex international 21 Practice benefits and administration. Address various international benefit issues through collaboration and fact finding. Provide customized, locally compliant risk management programs that take into consideration the insurance and employee benefit nuances El Hylant Global specific to each country. Provide flexibility and choice to ensure an optimal Alliance local partnership, delivering the resources, support, and communication needed to fully protect your business, no matter where in the world you operate. Provide services to assist you in the initial stages of global expansion, as Q Global Benefit well as if you are expanding existing benefits offerings, or looking to Management assess your programs against current market trends and competitiveness. Additional fees apply. © Country analysis, compliance review, merger/acquisition support, plan Global Services design, vendor management, benchmarking, pooling analysis, etc. Additional fees apply Docusign Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Summary of Fees for City of Clermont Below is an outline of the total fees, in Scope of Services $70,000 per year based on The included services as identified and outlined in this Scope of Services. enrollment of 330. Additional Services Some services warrant an additional fee per the explanations provided throughout this proposal. The following additional services will be provided as indicated. Cost Containment Data Analytics Page 4 Included Cost Containment Pharmacy Management Page 4 .95 per claim with escalator if PBM is under management Health & Well -Being Health Strategist Services Page 5 Included Strategies Health & Well -Being HealthDirect Page 5 Market rate Strategies Member Education & Engagement Employee Navigator Page 6 Not needed Member Education & Enhanced Communication Page 6 Not needed Engagement Materials Client & Employee Enhanced Employee Advocacy Page 7 Not needed Advocacy and Claim Services Client & Employee Enrollment & Eligibility Page 7 Not needed Advocacy Services Client & Employee HRIS & Payroll Consulting Page 7 Not needed Advocacy Leave Management Discovery, Market RFP and Page 10 Nofneeded Services Analysis Leave Management Vendor Selection and Page 10 Not needed Services Implementation Leave Management Leave Policy Consulting Page 10 Not needed Services Global Services Global Benefits Management & Page 10 Not needed Services The following services must be quoted separately or determined as incurred: Form 5500 COBRA Admin Discrimination Printing & Translation Decision Engagement (Fees may (Non-iSolved) Testing Postage Services Support Tools Apps apply) Printing service and travel expenses may be passed through to the client at cost. CLIENT INITIALS DATE Docusiqn Envelope ID: 350ClDEO-CA7B-4DEE-A4C8-B523C3695AC3 Summary of Proposec Fees for City of Clerm Effective July 1, 2025, the Annual Fee is $70,000 based on 330 enrolled medical employees. Paid in equal Monthly installments. Adjusted based on enrolled population at annual renewal. Policies for the following lines of coverage are included in this Annual Fee: • Medical • Stop Loss • Dental • Employer -Paid Life/AD&D • Employer -Paid Long -Term Disability • EAP • Others as mutually agreed upon Following the Initial Term, the starting fee will increase by three percent (3%) each year on the anniversary of the Effective Date of this Agreement, and the Annual Fee will be calculated based on enrolled headcount in the month prior to the start of the term. Additionally, Client acknowledges and agrees that, in addition to the Annual Fee, Hylant will receive commissions on voluntary lines of coverage including but not limited to: • Vision • Employee -Paid Life/AD&D • Employee -Paid Short -Term Disability • Accident • Critical Illness • Hospital Indemnity CLIENT INITIALS DATE HYLANT CONFIDENTIALITY STATEMENT The information and concepts provided to you by Hylant Group, Inc. are strictly confidential. The information and concepts are solely for your internal evaluation, and no other use of distribution is permitted or authorized. Legal Entity: Hylant Group, Inc. DBA Hylant Insurance Agency I CA License #OD58578 Individual Producer License Information Andria Herr 10.30.2024v