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Express Scripts Programs PBM Service Agreement Copyrighted April 3, 2017 City of Dubuque Consent Items # 9. ITEM TITLE: Express Scripts Programs SUMMARY: City Manager recommending approval for the City Manager to sign the 2017 PBM Agreement Service Addendum with Express Scripts. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Approve ATTACHMENTS: Description Type Express Scripts Programs-MVM Memo City Manager Memo Staff Memo Staff Memo 2017 PBM Agreement Service Addendum Supporting Documentation THE CITY OF Dubuque DUB E i" Masterpiece on the Mississippi 2007.2012.2013 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Express Scripts Programs DATE: March 20, 2017 Express Scripts has issued two new programs as part of their Safeguard RX Initiative and is offering the programs without any additional cost to the City or impact to plan members. Personnel Manager Randy Peck recommends City Council approval for the City Manager to sign the 2017 PBM Agreement Service Addendum with Express Scripts. I concur with the recommendation and respectfully request Mayor and City Council approval. Mic ael C. Van Milligen MCVM:jh Attachment cc: Crenna Brumwell, City Attorney Cindy Steinhauser, Assistant City Manager Teri Goodmann, Assistant City Manager Randy Peck, Personnel Manager THE CITY OF Dubuque ADubE btft" 1 I-AmadcaCtty 111 1. Masterpiece on the Mississippi 2007.2012.2013 TO: Michael C. Van Milligen, City Manager FROM: Randy Peck, Personnel Manager SUBJECT: Express Scripts Programs DATE: March 13, 2017 Express Scripts has issued two new programs as part of their Safeguard RX Initiative. The new programs are Inflammatory Conditions Care Value Program and Market Advance Protection Program. I have attached an explanation of both programs. Both programs will be implemented without any additional cost to the City or impact to plan members. The estimated annual savings for these programs is as follows: I • Inflammatory Conditions Care Value Program - $6,000 • Market Events Protection Program - $4,800 I recommend that we implement the Inflammatory Conditions Care Value and Market Events Protection Programs. I request that the City Council approve a motion authorizing you to sign the 2017 PBM Agreement Service Addendum. The addendum has been reviewed by City Attorney Crenna Brumwell and she finds the terms acceptable. RP:Imh XPRESS SCRIPTS° 2017 PBM Agreement Service Addendum Date of PRIM Agreement: Client Name: City of Dubuque, Iowa ("Sponsor") Carrier: YRSA BPL/Contract: Group: Effective Date of Addendum: 05/15/2017 or best date available Sponsor hereby directs Express Scripts to Implement the selected programs on the attached Clinical Programs schedule as of the Effective Date. Sponsor agrees to pay the applicable fees In accordance with the payment provisions of the PBM Agreement. Upon execution by Sponsor, this Addendum shall replace and supersede any previously executed Clinical Programs schedule Addendum as It pertains to the programs contained herein and shall become part of and Incorporated Into the PBM Agreement between Sponsor and Express Scripts Identified above as of the Effective Date. By signing below, Sponsor agrees to the prices and terms set forth In this PBM Agreement Service Addendum. If this Form was communicated to Sponsor as an attachment to an electronic communication (i.e., email), then any response to such email from Sponsor indicating Sponsor's approval shall constitute Sponsor's electronic signature to Implement the changes set forth. AUTHORIZED SIGNATURE: TITLE: City Manager Date Signici (Signatory must have authority to legally bind Sponsor) Michael C. Van Milligen Data Class: Confidential Express Scripts CONFIDENTIAL Clinical Programs Express Scripts offers a comprehensive suite of trend and Integrated health management programs. This offering may change or be discontinued from time to time as we update our offering to meet the needs of the marketplace. _ List of drugs subject to change at the discretion of ESI. SAFEGUARD RX-Programs fY Jil Program Requirements: Exclusive Accredo,no courtesy fills for Vieklra Pak/XR and Harvonl Exclusive Madre Pak1XR and Harvonl for Genotype 1 Prefer Harvonl for all other FDA approved Genotypes PA criteria must not contain Metavir score requirements Express Scripts standard clinical criteria Express Scripts standard clinical rules Automatic updates(If applicable) Commercial $0.00 •POS discount �( ESI managed Program Requirements: Exclusive Accredo,no courtesy fills for PCSK9 Inhibitors Comprehensive prior authorization for PCSK9s Express Scripts standard clinical criteria A, , Express Scripts managed coverage reviews Express Scripts standard clinical rules(Includes PA&DQM) Automatic updates Clinical days'supply Commercial •POS discount $0.00 •PCSK9 Inhibitors$65 PMPY cost ESI managed cap Program Requirements: Exclusive Accredo,no courtesy fills for all oncology medications Oncology drug preference by indication Express Scripts standard criteria X Express Scripts managed coverage reviews Express Scripts standard clinical rules (Includes PA) Automatic updates •POS discount •Early discontlnuallon Commercial $0.00 X reimbursement ESI managed z Program Requirements: Exclusive Accredo,no courtesy fills for all Inflammatory conditions medications Inflammatory condition drug preference by Indication X X Express Scripts standard criteria Express Scripts managed coverage reviews Express Scripts standard clinical rules Automatic updates Commercial Place X by choice below: •Early discontinuation $0.00 reimbursement 1. X_NPFIBasic •$21K per 30 day prescription for up X X ESI managed to 90 day supply 2. High Performance Data Class:Confidential Express Scripts CONFIDENTIAL Program Requirements: Any of the following actions may be taken In response to a market event: Block brand Block generic X X Prefer a clinically equivalent alternative Implement a prior authorization Implement step therapy . Quantity level limits Dosage form changes Commercial $0.00 X )( ESI managed Note: 1)Criteria for modules are subject to change at the discretion of ESI. 2)ESI is not responsible for clinical program Impact due to missed file delivery dates from client's vendor(s). 3)ESI has structured the terms of this program to comply with certain exceptions and safe harbors to the Federal Antl-Kickback Statute(42 U.S.C.§1320a-7b(b)),including the discount exception(42 U.S.C.§1320a-7b(b)(3)(A)and safe harbor(42 C.F.R.§1001.952(h)). ESI will treat any reimbursement made to Sponsor hereunder as retrospective discounts on the price of the product paid by Sponsor. ESI will fully and accurately report such discounts on the payment advice submitted to Sponsor. ESI hereby informs Sponsor that it may be required by law to properly disclose and appropriately reflect(in any costs claimed or charges made)all such discounts. Further,ESI will refrain from taking any action that would impede or frustrate Sponsor in any such disclosure requirements.Sponsor may be required to provide information on the discount furnished to Sponsor to the Secretary of Health and Human Services,or any state or other governmental agency,upon request. ESI will comply with all applicable reporting and disclosure obligations. SafeGuardRx Savings Guarantee Notes: 1)If Sponsor chooses to participate in any of the SafeGuardRx programs,all the terms and conditions of that program will apply. Hepatitis Cure Value Notes: 1)Sponsor's benefit design must be set 10 exclusive Accredo for Viekira Pak/XR and Harvoni with no courtesy fills allowed at any other pharmacy. 2)Sponsor's formulary must adopt Viekira Pak/XR and Harvoni exclusively(or preferred with Express Scripts'standard step edit)for Hepatitis C genotype 1. 3)Sponsor's formulary must also prefer Harvoni for all other FDA approved Hepatitis C genotypes. 4)Sponsor's Prior Authorization criteria for Viekira Pak/XR and Harvoni must not have Metavir score requirements. 5)Claims for which Sponsor overrides the applicable PA criteria will be excluded from all components of the program. 6)The Program does not apply to patients receiving therapy for off-label indications. 7)The total value to be provided to the Sponsor,on a benefit plan by benefit plan basis,from rebates(if applicable)and the Additional Discount on Viekira Pak/XR shall not exceed 60%of the total,aggregated amount of WAC(Wholesale Acquisition Cost)attributable to the Sponsor's Viekira Pak/XR claims for the applicable year.A benefit plan will be defined based on Sponsor's level of enrollment in the program. COMMERCIAL:Click Below link(https://www.express-scripts.com/art/pdf/TC-HCV.pdf)to view the full terms and conditions of the programs. If you have difficulty accessing the terms and conditions or require a printed version,please reach out to your account team contact. HCV Commercial Division Terms and Conditions Cholesterol Care Value Notes: 1)Sponsor's benefit design will be set to exclusive Accredo for Repatha and Praluent(and any future PCSK9 inhibitors)with no courtesy fills allowed at any other pharmacy, 2)Sponsor must utilize the Express Scripts CCV Prior Authorization criteria for Repatha and Praluent(and any future PCSK9 inhibitors). 3)Express Scripts must manage Sponsor's prior authorization process, 4)Claims for which Sponsor overrides ESI's PA criteria will not be eligible to be included in the program. 5)The Program does not apply to patients receiving therapy for off-label indications. Cost Cap: 1)ESI will provide Sponsor with a PCSK9 Cost Cap per member per year, ESI will provide Sponsor with a credit,dollar for dollar,to the extent that Sponsor's actual PCSK9 spend(net of Rebates and Manufacturer Administrative Fees)exceeds the PMPY cap. ESI will determine if the PMPY cap is exceeded by comparing the cap to the result of the following equation:Sponsor's actual ingredient cost billed for PCSK9 inhibitors for the calendar year,less any Rebates and Manufacturer Administrative Fees paid divided by the average enrollment in Sponsor's Plans during the calendar year. 2)Only utilization while Sponsor and is enrolled in the Cholesterol Care Value Program will count towards the PMPY cost cap.Only utilization while the patient is covered by Sponsor will apply. 3)The PMPY Cap may be adjusted if there are significant changes to the FDA approved labels for Praluent or Repatha(or any future PCSK9 Inhibitors), ESI may adjust the PMPY cap if outcomes trials are released that materially change prescriber behavior. ESI may also adjust the cap is the number of Sponsor's members enrolled in the program drops below 1,000, 4)The PMPY cost cap Is only applicable to Praluent or Repatha claims and does not include the cost of any other therapies used by the patient,including statin therapy. 5)The total value to be paid to Sponsor under PCSK9 Cost Cap will not exceed 25%of AWP of the PCSK9 products dispensed to Sponsor's members. 6)The PMPY Cost Cap will apply only to claims dispensed after all prior authorization criteria are implemented for Sponsor's plans. If Sponsor was not enrolled in the CCV program In 2015,it will take additional time to Implement the prior authorization criteria. 7)ESI reserves the right to retain an administrative fee,not to exceed 2.75%of wholesale acquisition cost of the pharmaceutical product from the payments which are paid to Sponsor in exchange for ESI's services rendered under the programs. COMMERCIAL:Click below link(https://www.express-scripts.com/tc/TC-CCV-CD.pdf)to view the full terms and conditions of the programs. If you have difficulty accessing the terms and conditions or require a printed version,please reach out to your account team contact. Password:u'HH%2}—*Fez CCV Commercial Division Terms and Conditions Password: u'HH%2}-"Fez Data Class:Confidential17 Express Scripts CONFIDENTIAL Oncology Care Value Notes: 1)Sponsor's pharmacy network must be set to exclusive Accredo for all oncology drugs,when Accredo has access to the oncology drug,with no courtesy fills allowed at any other pharmacy. 2)Sponsors must accept applicable drug preference requirements at the indication level and formulary status updates to qualify for applicable discounts at Accredo. 3)Sponsors must accept automatic updates and/or enhancements to the program to continue to qualify for applicable discounts at Accredo. 4)Express Scripts must manage Sponsor's PA process, 5)Claims for which Sponsor overrides the applicable PA criteria will not be eligible for,or included in,any portion of the program. 6)If Sponsor participates in the program,Sponsor will be eligible for additional discounts or credits,which will be applied at the point of sale or paid out on an annual basis for all specified oncology products dispensed at Accredo. The list of products,and their associated discount rates or credit values,will be provided to Sponsor upon request and will be reflected In the invoices sent to Sponsor. The list of specified products(and their associated discounts)may be updated by ESI from time to time upon notice to Sponsor. COMMERCIAL:Click below link (https://www.express-scripts.com/art/pdf/TC-OCV.pdf)to view the full terms and conditions of the programs. If you have difficulty accessing the terms and conditions or require a printed version,please reach out to your account team contact. OCV Commercial Division Terms and Conditions Inflammatory Conditions Care Value Notes: 1)Sponsor's benefit design must be set to exclusive Accredo for Inflammatory conditions'drugs with no courtesy fills allowed at any other pharmacy. 2)Sponsor must be enrolled in Express Script's National Preferred Formulary,or a clone thereof,or utilization management programs that drives preference by indication for the applicable Inflammatory Products. 3)Claims for which Sponsor overrides the applicable PA criteria will be excluded from all components of the program Early Discontinuation: 1)Early discontinuation only applies in situations when a member has their initial and subsequent fills at Accredo 2)Sponsor will only be reimbursed up to one time per patient for each unique preferred inflammatory condition drug 3)To be eligible for the ICCV Discontinuation Credit,the ICCV Patient must start(receive their first fill)at Accredo and remain at Accredo through discontinuation of therapy. In addition,the ICCV Patient must have been continuously eligible in the prior 270 days and remained covered by Sponsor for the duration of the credit period(136 Days after first fill).(i.e.,must remain benefit eligible)and Sponsor must be able to provide 270 days of claims data evidencing that the patient has not previously filled an Inflammatory Product. 4)New to ESI clients must be able to provide verification of first fill for new clients 5)The Discontinuation Credit will only be available with respect to ICCV Patients who discontinue therapy within 136 days of their first fill of the applicable Inflammatory Product. 6)ESI will reimburse Sponsor for up to 90-day supply per patient on preferred medication should a patient discontinue therapy, 7)Sponsor will only be eligible for the Discontinuation Credit one time per unique ICCV Patient, The Discontinuation Credit will not apply when the ICCV Patient does not discontinue therapy,but merely switches from one Inflammatory Product to another. 8)No more than one(1)therapy discontinuation credit will be provided to Sponsor annually,on a per unique patient per preferred medication basis. For the avoidance of doubt, Sponsor will receive no more than one(1)therapy discontinuation credit per preferred medication for each utilizing patient,on an annual basis. However,Sponsor may receive an additional therapy discontinuation credit on the same patient,up to an annual maximum of one(1)credit per preferred medication. 9)ESI reserves the right to retain an administrative fee,not to exceed 2.75%of wholesale acquisition cost of the pharmaceutical product from the payments which are paid to Sponsor in exchange for ESI's services rendered under the programs. COMMERCIAL:Click below link(https://www.express-scripts.com/tc/TC-ICCV-CD,pdf)to view the full terms and conditions of the programs. If you have difficulty accessing the terms and conditions or require a printed version,please reach out to your account team contact. ICCV Commercial Division Terms and Conditions Market Event Protection Program Notes: 1)Sponsor acknowledges and agrees that for certain actions to be taken when preferring a specific medication,Sponsor must have dispense as written("DAW")code(s)5 and/or 9 enabled for adjudication to prevent potential member disruption. By enrolling,Sponsor agrees to enable DAW 5 and/or 9,if necessary. 2)ESI will provide Sponsor advance notice of any action taken under the Program. ESI will provide Sponsor's members advance notice of any action taken under the Program if such action has a direct member impact that will require a member to take action(e.g.if a new prescription may be required). 3)Sponsor may disenroll from the Program at any time,provided that ESI is given 30 days advance written notice. If Sponsor disenrolls from the program,any authorized action previously taken under the Program during Sponsor's enrollment will no longer apply and Sponsor will be reverted back to its state prior to enrollment in the Program. 4)Claims impacted by the Program will be adjudicated and reconciled in accordance with the pricing set forth in the PBM Agreement. Nothing herein changes the pricing guarantees under the PBM agreement. 5) The current list of market events eligible for the Program and the specific actions that Sponsor is authorizing ESI to take are set forth in the table included in the full terms and conditions of the program. Market events will be reviewed on a book of business basis. Click below link (https://www.express-scripts.com/tc/TC-ME-CD.pdf)to view the full terms and conditions of the programs. If you have difficulty accessing the terms and conditions or require a printed version,please reach out to your account team contact. ME Commercial Division Terms and Conditions Data Class:Confidential17 Exprwss Scripts CONFIDENTIAL Page 1 of 1 INFLAMMATORY CONDITIONS DIABETES MARKET EVENTS CURRENT •.ery CARE VALUE PROGRAMS"' CARE VALUE PROGRAMS" PROTECTION PROGRAM'" SOLUTIONS Inflammatory Conditions Care Value Program"" New Solutions Enrollment For seven years in a row,inflammatory conditions has been the#1 Name: driver of drug spend.In 2015,the average cost per prescription for _ this therapy class was$3,035.95 and,if left unchecked,drug spend Company Name: CITY OF DUBUQUE for this class will nearly double by 2018. Email Address: The Inflammatory Conditions Care Value Programs'will manage Enroll in our new SafeGuardRx solutions this class at the indication level,helping to increase competition and below. control costs while ensuring patients receive specialized care For questions,to change your seleclion(s),or if you need to exclusively from Accredol Specialty pharmacy. enroll after Oct.14,please contact your account team. With one click,you can enroll in the Key Benefits following: Management of treatment options by indication,rather than Inflammatory Conditions Care Value ©✓ class,increases competition and better controls costs. Program Minimizes your financial exposure if patients discontinue (Enroll by Oct.14 to start on Jan.1) preferred inflammatory medications early. Diabetes Care Value Program Provides patients and physicians with access to comprehensive (Enroll by Oct.14 to start on Mar.i) and clinically appropriate treatment options. Market Events Protection Program Offers assistance and education for patients from the Accredo (Enroll by Oct.14 to start on Jan.1) specialized care team in the Inflammatory Conditions Therapeutic Resource Centers"',where patients achieve better ENROLL outcomes and 8%higher adherence'to therapy. --- Highlights Indication-level management refines utilization by setting treatment preferences for each inflammatory condition,which enables management of drugs by condition and delivers greater cost control for plan sponsors. Early discontinuation reimbursement offers up to 82,000 per 30- day prescription for the first three fills of preferred inflammatory medications. Rigorous clinical documentation ensures the appropriate therapy option is filled and patients get the medications that they need To sign up for Our Inflammatory Conditions Care Value Program"', click the enroll button on the right side of the page. Please contact your account team to learn more. Oel,c,al a:!here„ca•s JaPr=.d as 3C'i or mor, http://My.express-scripts.com/SGR20170ptInIO14-ICCV.html 9/22/2016 Page 1 of 2 INFLAMMATORY CONDITIONS DIABETES MARKET EVENTS CURRENT VAN CARE VALUE PROGRAM'"' CARE VALUE PP.OGRAMs" PROTECTION PROGRAMS"' SOLUTIONS Market Events Protection Programs"' Each year,the pharmaceutical industry experiences unique market New Solutions Enrollment situations that dramatically increase the cost of certain medications, Name: sometimes overnight.Unforeseen market dynamics require payers to _ react rapidly or be faced with significant,and often unwarranted. Company Name: CITY OF DUBUQUE] increases in spending. Email Address: * E— The Market Events Protection Programs"'helps mitigate the impact Enroll in our new SafeGuardRx solutions of major changes by allowing us to act more immediately on your below. behalf to benefit your plan and members. For questions,to change your selection(s),or if you need to enroll after Oct,14,please contact your account team. Key Benefits With one click,YOU can enroll in the Allows quick action to protect you when potentially damaging following: market situations occur. Inflammatory Conditions Care Value [✓ Helps you keep pace with rapid changes in the healthcare Program marketplace. (Enroll by Oct.14 to start on Jan.1) Reduces financial exposure to high cost medications that do not Diabetes Care Value Program benefit members. (Enroll by Oct.14 to star)on Mar.1) Offers easy,one time enrollment process. [� • Complements solutions you might already have,such as Market Events Protection Program(Enroll by Oct.14 to sled on Jan.1) formulary and utilization management tools,and other programs ENROLL Highlights This program targets three types of market events: „ Price increases—When a drug more than doubles in price at any point in the past 12 months,has meaningful Utilization and represents a savings opportunity. Patent expirations—When patents for brand drugs expire, resulting in new generic launches and significant savings opportunities. Unwarranted price discrepancies—Oihen a therapy option is more than double the cost of an alternative,including: Different dosage forms of the same medication(e.g tablet vs Capsule). Drug manufacturers circumventing plan design by offering copay incentives on costly brand drugs Significant differences in generic pricing within the same therapy class This program will not replace any others you already have In place By partcipa!rng, y0!I eaoav us to take action on events beyond what YOU are currently protected against. To sign uo for our Iblar kat E rents Protection Program,".click the enroll button on the right side of the page Please contact your a.-Court tear^to learn more http://my.express-scripts.com/SGR20170pt1nl014-ME.html 9/22/2016 City of Dubuque Insurance Requirements for Professional Services Insurance Schedule C 1. Express Scripts, Inc. shall furnish a signed Certificate of Insurance to the City of Dubuque, Iowa for the coverage required in Exhibit I prior to commencing work and at the end of the project if the term of work is longer than 60 days. Providers presenting annual certificates shall present a Certificate at the end of each project with the final billing. Each Certificate shall be prepared on the most current ACORD form approved by the Iowa Department of Insurance or an equivalent. Each certificate shall include a statement under Description of Operations as to why issued. Eg: Project# or Project Location at or construction of 2. All policies of insurance required hereunder shall be with a carrier authorized to do business in Iowa and all carriers shall have a rating of A or better in the current A.M. Best's Rating Guide. 3. Each Certificate shall be furnished to the contracting department of the City of Dubuque. 4. Failure to provide minimum coverage shall not be deemed a waiver of these requirements by the City of Dubuque. Failure to obtain or maintain the required insurance shall be considered a material breach of this agreement. 5. Consultants shall require all subconsultants and sub-subconsultants to obtain and maintain during the performance of work insurance for the coverages described in this Insurance Schedule and shall obtain certificates of insurances from all such subconsultants and sub-subconsultants.Consultants agree that it shall be liable for the failure of a subconsultants and sub-subconsultants to obtain and maintain such coverages.The City may request a copy of such certificates from the Consultants. 6. All required endorsements to various policies shall be attached to Certificate of insurance. 7. Whenever a specific ISO form is listed, an equivalent form may be substituted subject to the provider identifying and listing in writing all deviations and exclusions that differ from the ISO form. 8. Provider shall be required to carry the minimum coverage/limits, or greater if required by law or other legal agreement, in Exhibit I. If provider's limits of liability are higher than"the required minimum limits then the provider's limits shall be this agreement's required limits. 9. Whenever an ISO form is referenced the current edition of the form must be used. Page 1 of 3 Schedule C Professional Services May 2016 City of Dubuque Insurance Requirements for Professional Services Insurance Schedule C (continued) Exhibit I A) COMMERCIAL GENERAL LIABILITY General Aggregate Limit $2,000,000 Products-Completed Operations Aggregate Limit $1,000,000 Personal and Advertising Injury Limit $1,000,000 Each Occurrence $1,000,000 Fire Damage Limit(any one occurrence) $ 50,000 Medical Payments $ 51000 a) Coverage shall be written on an occurrence, not claims made,form. The general liability coverage shall be written in accord with ISO form CG0001 or business owners form BP0002. All deviations from the standard ISO commercial general liability form CG 0001, or Business owners form BP 0002, shall be clearly identified. b) Include ISO endorsement form CG 25 04"Designated Location(s)General Aggregate Limit" or CG 25 03 "Designated Construction Project(s) General Aggregate Limit"as appropriate. c) Include endorsement indicating that coverage is primary and non-contributory. d) Include endorsement to preserve Governmental Immunity. (Sample attached). e) Include an endorsement that deletes any fellow employee exclusion. f) Include additional insured endorsement for: The City of Dubuque,including all its elected and appointed officials, all its employees and volunteers,all its boards, commissions and/or authorities and their board members, employees and volunteers. Use ISO form CG 2026. B) AUTOMOBILE LIABILITY $1,000,000(Combined Single Limit) C) WORKERS' COMPENSATION & EMPLOYERS LIABILITY Statutory benefits covering all employees injured on the job by accident or disease as prescribed by Iowa Code Chapter 85 as amended. Coverage A Statutory—State of Iowa Coverage B Employers Liability Each Accident $100,000 Each Employee-Disease $100,000 Policy Limit-Disease $500,000 Policy shall include an endorsement providing a waiver of subrogation to the City of Dubuque. Coverage B limits shall be greater if required by Umbrella Carrier. D) UMBRELLA LIABILITY $1,000,000 Umbrella liability coverage must be at least following form with the underlying policies included herein. E) PROFESSIONAL LIABILITY $1,000,000 a) Provide evidence of coverage for 5 years after completion of project. F) CYBER LIABILITY $1,000,000 Coverage for First and Third Party liability including but not limited to lost data and restoration, loss of income and cyber breach of information. Yes X No Page 2 of 3 Schedule C Professional Services May 2016 City of Dubuque Insurance Requirements for Professional Services Preservation of Governmental Immunities Endorsement 1. Nonwaiver of Governmental Immunity.The insurance carrier expressly agrees and states that the purchase of this policy and the including of the City of Dubuque, Iowa as an Additional Insured does not waive any of the defenses of governmental immunity available to the City of Dubuque, Iowa under Code of Iowa Section 670.4 as it is now exists and as it may be amended from time to time. 2. Claims Coverage.The insurance carrier further agrees that this policy of insurance shall cover only those claims not subject to the defense of governmental immunity under the Code of Iowa Section 670.4 as it now exists and as it may be amended from time to time.Those claims not subject to Code of Iowa Section 670.4 shall be covered by the terms and conditions of this insurance policy. 3. Assertion of Government Immunity,The City of Dubuque, Iowa shall be responsible for asserting any defense of governmental immunity, and may do so at any time and shall do so upon the timely written request of the insurance carrier. 4. Non-Denial of Coverage.The insurance carrier shall not deny coverage under this policy and the insurance carrier shall not deny any of the rights and benefits accruing to the City of Dubuque, Iowa under this policy for reasons of governmental immunity unless and until a court of competent jurisdiction has ruled in favor of the defense(s) of governmental immunity asserted by the City of Dubuque, Iowa. No Other Change in Policy.The above preservation of governmental immunities shall not otherwise change or alter the coverage available under the policy. SPECIMEN Page 3 of 3 Schedule C Professional Services May 2016