Express Scripts AgreementCity of Dubuque
ITEM# 17.
ITEM TITLE:
SUMMARY:
SUGGESTED DISPOSITION:
Express Scripts Agreement
City Manager recommending approval of
Agreement with Express Scripts effective
31, 2014.
Suggested Disposition: Receive and File;
ATTACHMENTS:
Description
❑ Express Scripts Agreement -MVM Memo
❑ Express Scripts Memo
❑ Express Scripts Agreement
Type
City Manager Memo
Staff Merno
Supporting Documents#ion
Copyright 2014
a new Employer Participation
January 1, 2014 to December
Approve
Masterpiece on the Mississippi
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Express Scripts Agreement
DATE: September 25, 2014
Dubuque
2007 • 2012 • 2013
In 2004 the Health Care Committee participated in a Request for Proposal process for
pharmacy benefit managers sponsored by the Iowa Employer Coalition and conducted
by Gallagher Benefit Services Inc. the City's benefit and actuarial consultant. Express
Scripts was selected as the pharmacy benefit manager for the Iowa Employer Coalition.
Gallagher Benefit Services Inc. has negotiated with Express Scripts for improved
financial terms. The estimated annual savings is $40,000, which will come primarily
from higher formulary rebates, larger discounts and lower dispensing fees.
Personnel Manager Randy Peck recommends City Council approval of a new Employer
Participation Agreement with Express Scripts effective January 1, 2014 to December31,
2014.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
Mic, al C. Van Milligen
MCVM:jh
Attachment
cc: Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Teri Goodmann, Assistant City Manager
Randy Peck, Personnel Manager
tE CITY OF
MaSterpiece on1 r *ssissippi
TO: Michael C. Van Milligen, City Mana9
FROM: Randy Peck, Personnel Manager
1)tibucitle
.111- ta
?MC 21)12 20.11
SUBJECT: Employer Participation Agreement between the City of Dubuque and
Express Scripts, Inc.
DATE: September 24, 2014
In 2004, the Health Care Committee participated in a RFP process for pharmacy benefit
managers sponsored by the Iowa Employer Coalition and conducted by Gallagher
Benefit Services Inc., our benefit and actuarial consultant. The Iowa Employer Coalition
is a coalition of other Iowa cities and counties. There was no cost to the City to
participate in the RFP process. Express Scripts was selected as the pharmacy benefit
manager for the Iowa Employer Coalition.
As a result of negotiations conducted by Gallagher Benefit Services Inc., Express
Scripts agreed to improved financial terms. The estimated annual savings is $40,000.
Projected savings will come primarily from higher formulary rebates, larger discounts
and lower dispensing fees.
The new agreement is in effect from January 1, 2014 to December 31, 2014. I have
been working with Express Scripts for approximately nine months to resolve some
language issues, particularly as it relates to the renewal provision. City Attorney Barry
Lindahl has reviewed the applicable provisions of the Employer Participation Agreement
and specifically, the renewal provision, and finds the terms acceptable. I request that
the City Council approve a motion authorizing you to sign the agreement.
RP:Imh
EMPLOYER PARTICIPATION AGREEMENT
THIS EMPLOYER PARTICIPATION AGREEMENT (the ''Employer Participation Agreement') is
made by and between City of Dubuque ("Employer') and Express Scripts, Inc., a Delaware corporation
CES|°), for the purpose of delineating the terms and conditions under which ESI will provide certain
pharmacy benefit management services to Employer under the Coalition Umbrella Agreement (as defined
be|ov) between ESI and Gallagher Benefit Services, Inc.
RECITALS:
A. Gallagher BenefServices ("GBS"), a Denver corporation, manages healthcare vendor relationships
on behalf of the Employer and ts counterparts who participate in coalition purchasing programs;
B. ESI and GBS have entered into that certain Pharmacy Benefit Management Agreement dated
�.
The parties acknowledge and intend that the Coalition UmbreHa Agreement is incorporated herein by
reference. Defined terms used herein shall have the same meaning assigned to such terms in the
Coalition Umbrella Agreement; and
D
Employer desires that ESI provide ESI Services to the Employer in accordance with he Coalition
Umbrella Agreement.
NOW, THEREFORE, in consideration of the foregoing Recita|s, which are incorporated herein by
refenanoe, and in consideration of the mutual covenants herein conhained, the parties hereto agree as
t ESI'S Obligations. ESI agrees to comply with the terms and conditions as set forth in the
Coalition Umbrella Agreement.
2. Employer Obligations. Employer acknowledges that it has read and hereby agrees to the terms
and conditions set forth in the Coalition Umbrella Agreement, which Employer acknowledges are
hereby incorporated into this Employer Participation Agreement by reference. Furtbpnnooe.
Employer agrees to the following:
a) Financial Responsibility/Payment Terms. In accordance with the Coalition Umbrella
Agreement, Employer will pay to ESI the fees due under the Coalition Umbrella
Agreement pursuant to the payment terms set forth in the Coalition Umbrella
Agreement, Employer has sole responsibility for timely payrnent of such fees, GBS may
facilitate the payment process, but Employer retains all financial responsibility for timely
payrnent of the applicabte fees.
°
b) Member Authorizations and Disclosures. When such services are requested by
Emp/oyar. Employer will obtain all Member authorizations required by law for ESI to
perform any ESI Services provided for in this Employer Participation Agreement or in
any addendum or amendment ho/eto, and for ESI to contact Members, Members'
physiciana. and Participating Pharmacies in order to promote therapeutic and generic
substitution opportunities and to perform any other ESI Services or activities
contemplated by this Employer Participation Agreement that may require such contact.
Employer shall provide ESI with Members' addresses and such other information as may
be reasonably necessary to facilitate such cornmunications.
Employer will disclose to Members any and all matters relating to the plan design that
are required by law to be disclosed including information relating to the calculation of
co -payments, coinsurance amounts, deductibles or any otheramounts that are payable
by a Member in connection with the plan desi
c) Confidentiality. Employer will hold the terms and conditions of this Employer
Participation Agreement confidential except to the extent disclosure is required under
applicable law. Employer will not share the terms of this Agreement with its consultant
or other third party without the express permission of.ESI and GBS.
3. Term and Renewal. The initial term of this Employer Participation Agreement shall commence
ten (10) days after EG|'s execution of this Agreement (the "Effective Date") and remain in effect
for one (1) year thereafter (the "Initial Term") Thereafter, this Employer Participation Agreement
shall automatically renew for successive one (1) year terms unless terminated by either party as
described in Section 4 �f this Employer Partic!pation Agreement.
4. Termination of Employer Participation Agreement, ESI and Employer may terminate this
Employer Participation Agreement as follows:
a) Non -Renewal Upon Notice. Not less than ninety (90) days prior to the end of
the Initial Term or any renewal term of this Agreement either party may notify
the other party in writing that it desires to terminate this Agreement effective as
of the end of the then current term. Notwithstanding any provision in this
egnaemnnt to the nontrary, this agreement is terminable "without cause" by
either party.
b) Breach or D fault. Either party may give the other written notice of a material,
substantial and continuing breach of this Agreement. If the breaching party
has not cured said breach within thirty (30) days from the date such notice was
sent, this Agreement may be terminated at the option of the non -breaching
party. If the amount of time commercially reasonable for the breach to be
cured is longer than thirty (3O) days, this Agreement may not be terminated by
the non -breaching party pursuant to this provision until such commercially
reasonable period of time has elapsed; pn/vided, however, that /n no event will
such period exceed sixty (60) days.
c) Non -Payment. Notwithstanding anything to the contrary herein, ESI (and its
wholly-owned subsidiaries) shall have the right to terminate this Employer
Participation Agreement or suspend performance hereunder (and the Coalition
Umbrella Agreement) and oeaae providing or authorizing the provision of
Covered Drugs to that Employer's Members upon forty-eight (48) hours written
notice if Employer fails to pay ESI or provide a deposit, if nsquired, in
accordance with the terms of this Agreement. ESI attempts collection through
written and verbal communications with Employer prior to sending the notice
described herein.
d) Move to Fully Insured Plan. In the event Employer moves to a fully insured
plan which includes both pharmacy and medical covenege. Employer may
terminate this Agreement upon ninety (90) days written notice of the move to a
fully insured plan.
e) Termination of the Coalition Umbrella Agreement, If GBS terminates the
Coalition Umbrella Agreement, Employer will also have the option to terminate
this Employer Participation Agreement as of the effective date of the date the
Coalition Umbrella Agreement terminates, In the event the Coalition Umbrella
Agreement is terminated, ESI will cease offering Coalition pricing to Employer,
and will offer different pricing (based on Employer's size, uh|izadon, market
conditions, etc.) if the Employer wishes to enter into an Agreement with ESL If
the parties cannot agree on revised pricing terms, either party may terminate
this Employer Participation Agreement upon ninety (90) days prior written
notice.
f) Ob Upon notice of termination of this Employer
Participation Agreement, the parties will mutually develop a run-off plan
providing for: (a) Employer notification to Members of the timing of any
transition to a successor pharmacy benefit manager at least thirty (30) days
prior .to the effective date of such termination.; (b) ESI provision of open Mail
Service Pharmacy refill files and standard claims data and PA files for
transition to the successor pharmacy benefit manager in accordance with then
existing industry protocol; and (c) whether Employer elects for ESI to process
Participating Pharmacy or Member Submitted Claims for prescriptions filled
during the Term but filed with ESI after the effective date of termination
("Termination Date"), Employer will continue to pay ESI in accordance with this
Employer Participation Agreement and the Coalition Umbrella Agreement for
any Fees for ESI Services provided during the term and any run-off period,
ESI will continue filing for Rebates for claims incurred prior to the Termination
Date and will pay Employer Rebates for such claims in accordance with the
Rebate payment schedule set forth in Exhibit B of the Coalition Umbrella
Agreement.
5. H|PAA. The parties agree that as relates to use and disclosure of PHI, electronic transaction
standards and security of electronic PHI under H|PAA. they are subject to the terms of a
separate Business Associate Agreement.
8. GBS Manaciernent and Consulting Fees. Employer hereby confirms that GBS is
providing management and consulting services on behalf of Employer in connection with the
pharmacy benefit management program administered pursuant to this Employer Participation
Agreement, Employer hereby directs and authorizes ESI to tsci|itaie, on behalf of Ernpoyer, the
payment of a monthly fee in an amount equal to $0.12 per each approved Prescription Drug
Claim processed by ESI for Employer during such month ("Management and Consulting Fees").
ESI agrees to facilitate the payment of the Management and Consulting Fees subject to the
(a) Employer has executed this Agreement and Employer is current in its payment
ohligations to ESI
(b) Employer hereby represents and warrants that the GBS Fees are fair and reasonable for
the actual services to be performed by GBS in connection with Employer's prescription drug
program; are commensurate with other consulting fees in the industry; and are not in violation of
any law or regulation. including ER|8A. ESI will not pay per prescription fee,u on Medicare
subsidy utilization.
(c) ESI will comply with any requesby Employer to stop GBS Fee payments, Employer shall
hold ES{ harmless in connection with any dispute between GBS and Employer regarding GES
Fees.
7, TruvenHea|th Analytics Fees. Employer hereby confirms that TruenHealth Anaiytics
("TH^ or "Auditor") provides services for the benefit of Employer. in connection with the pharmacy
benefit management program administered pursuant to this Employer Participation Agreement.
3
In addition to the GBS fee deser bed herein, Employer hereby dPiects ;3rid authorizes ESI to
facil:tate, on behalf of Employer the payment of a monthly fee to TH, in an amount eqi.al to SO 18
pro approved Prescription Drug Claim processed by ESI for Employe, during such month ESE
agrees to facilitate the payment of The TH Fees to TH subject to the following
(a) Employer has executed this Agreement and Employer is current in its payment
obligations to ESE
(b) Employer hereby represents and warrants that the TH Fees are be remitted on behalf of
Employer are fair and reasonable; are commensurate wan other TH Fees in the industry for the
actual services to be performed by Broker in connection with the Employer's prescription drug
progrini; and are not in violation of any laiN or regulation, including ERISA. ESI will rot pay per
prescription 1 H Fees on Medicare subsidy utilization.
(n) ESI will comply with any request by Employer to stop Tri Fee payments. Employer shall
hold ESE linrmless in connection with any dispute. between TH, and Employer regarding TH Fees
e. CHECK APPLICABLE BENEFIT PLAN BELOW
O 7.-?Artitti)rtAL.
O PASS
• ttiAl`atl.A,pLJs
• Es. 1-tETWOR
0. Emplo7er Information.
City of Dubuque
Attn Randy Peck
50 W, 13'1' S trivet
Dullurpie. IA 52001
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their
respective duly amhorized officers or agents as 0' the date f:rist above written
EXPRESS CRIPTS, INC. CITY OF DUBUQUE
BYC....a' ....... - _ By'
it
Sciin tlik.,(iiloy
Print Name: PresidentCornmercizl Division
Print Nanie fylieh4el C. Van Mill gen _
- i
Title' Title: City Manager
„.., ,
Da te, t -i / CI 1,0 ( 4-f Date ' '.i -i I -I ' ,
4
ATTACHMENT 1 TO CLIENTAGREEMENT
FINANCIAL DISCLOSURE TO ESI PBM CLIENTS
This disclosure provides an overview of the principal revenue sources of Express Scripts, Inc. and Medco
Health Solutions, Inc. (individually and collectively referred to herein as "ESI"), as well as ESI's affiliates. In addition
to administrative and dispensing fees paid to ESI by our clients for pharmaceutical benefit management CPBMl
services, ESI and its affiliates derive revenue from other sourcov, including arrangements with pharmaceutical
nmnuhauturem'whn|esa|edistributom. and retail pharmacies. Some of this revenue relates to utilization of
prescription drugs by members of the clients receiving PBM services. ESI may pass through certain manufacturer
payments to its clients or rnay retain those payrnents for itself, depending on lhe contract terms between ESI and the
client.
Network Pharmacies - ESI contracts for its own account with retail pharmacies to dispense prescription
drugs to client members. Rates paid by ESI to these pharmacies may differ among networks (e.g, Medicare,
Worker's Comp, open and |imited), and among pharmacies within a network, and by client arrangements, PBM
ag^aemantn8enora||yprovideLhatudiantpayE8|aningredieniuont.p|uodisponoinyfoo.hjrd/ugdmimn |fthe rate
paid by a client exceeds the rate contracted with a particular pharmacy ESI will realize a positive margin on the
applicable claim. The reverse eisa may be true, resulting in negative margin for ESI. ESI also enters into pass-
through urmngamentsvvhenethec|ientpayyES|theacfuo|in8radian<cnotanddiapensingfeeomuuntpaidhyES|io,
the particular claim when the claim is adjudicated to the pharmacy. In addition, when ESI receives payment from a
client before payment to a pharmacy. ESI retains the benefit of the use of the funds between these payments. ESI
may maintain non -client specific aggregate guarantees with pharmacies. ESI may charge pharmacies standard
transaction fees to access ESI's pharmacy claims systems and for other related administrative purposes,
Brand/Generic Classifications - Prescription drugs may be classified as either a "brand" or "generic;"
however, the reference to a drug by its chemical name does not necessarily mean that the product is recognized as a
generic for adjudicetion, pricing or copey purposes. ESI distinguishes brands and generics through a proprietary.
algorithm ("BGA") that uses certain published elements provided by First DataBank (FDB) including price indicators,
Generic Indicator, Generic Manufacturer Indicator, Generic Name Drug Indicator, Innovator, Drug Class and ANDA.
The EGA uses these data elements in ahiommhica| process to categorize the products as brand or generic. The
BGA also has processes to resolve discrepancies and prevent "flipping" between 'brand and generic status due to
price fluctuations and marketplace availability changes. The elements listed above and sources are subject to
change based on the availability of the specific fields, Updated sumrnaries of the BGA are aveilabie upon request.
Maximum Allowable. cast "MACITMaxim.um ReimbursementAmount ("MRA") - As part of the
administration of the PBM services, ESI maintains a MAC List of drug products identified as requiring pricing
management due to the number of manufacturers, utilization and/or pricing volatility. The criteria for inclusion on the
MAC List are based on whether the drug has readily available generic product(s), is generally equivalent to a brand
drug, is cleared of any nega,.tive clinical implications, and has a cost basis that will allow for pricing below brand rates.
ESI also maintains MRA price lists for drug products on the MAC List based on current price reference data provided
by MediSpan or other nationalty recognized pricing ynurce, market pricing and availability information from generic
manufacturers and on-line research of national wholesale drug company files, and client arrangements. Similar to
the 8GA, the elements listed above and sources are subject to change based on the availability of the specific fields.
Updated summaries of the MAC methodology are available upon request.
Manufacturer Formular Rebates Associated Administrative Fees, and PBM Service Fees - ESI contracts
for its own account with manufacturers to obtain formulary rebates attributable to the utilization of certain brand drugs
and supplies (arid possibly certain authorized generics marketed under a brand manufacturer's new drug apptication).
Formulary rebate amounts vary based on the volume of utilization as well as formulary position applicable to the drug
or supplies, and adherence ¢/various formulary management controls. benefit design requimmonto, claims vo|ume,
and other similar factors, and in certain instances also rnay vary based on the product's market -share. ESI often
pays an amount equal to all or a portion of the formulary rebates it receives to a client based on the client's PBM
agreement terms. ESI retains the financial benefit of the use of any funds held until payment of formulary rebate
amounts is made to the client. In addition, ESI provides administrative services to formulary rebate contracted
menuhyogrem, which ino|udo, for oxemp|o, maintenance and operation of the systems and other infrastructure
necessary for maneging and administering the PBM farrnulary rebate process and eccess to drug utilization data, as
allowed by |e*, for purposes of verifying and evaluating the rebate payments and for other purposes related to the
manufacturer's products. ESI receives administrative fees from the participating manufacturers for these services.
These administrative fees are calculated based on the price of the rebated drug or supplies along with the volume of
utilization and do not exceed the greater of (i) 4.58% of the average wholesale price, or (ii) 5.5% of the wholesale
acquisition cost of the products. In its capacity as a PEM company, ESI also may receive service fees from
manufacturers as compensation for the performance of various xemicoa, ino|udiog, for oxamp|e, formulary
compliance inibativmx, clinical services, therapy management services, education uowices, medical benefit
management services, and the | ofnon-patient identifiable claim information. These service fees are not part of
the formulary rebates or associated administrative foos,
Copies of ESIs standard formularies may be reviewed at wwexpressscripts.com/services/centsadvisors,
In addition to formulary onnoidorahona, other plan design elements are described in ESI's Plan Design Review Guide,
which may be reviewed at ‘ivww.express-scripts.com/services/clientadvisors.
E8! Subsidiary Pharmacies — ESI has several licensed pharmacy m/boid|orioo, including our specialty
pharmacies. These entities may maintain product purchase discount arrangements and/or fee�or.nnmice-
arrongnments with pharmaceutical manufacturers and wholesale distributors, These subsidiary pharmacies contract
for these arrangements on their own account in support of their various pharmacy operations. Many of these
subsidiary arrangements relate to services provided outside of PBM anangemenb, and may be entered into
irrespective of whether the particular drug is on one ofES|'s national formularies. Discounts and fee-for-service
payments received by ES|'o subsidiary pharmacies are not part of the PBM .formulary rebates o/ associated
adminisLnativafaospaidtoE3|inconnao(iunwithEO|'yPBWfbrmu|arymbatopmgrams.FmmdmetoUma.ES|ond
its affiliates also may pursue and maintain for its own account ather supply chain sourcing relationships not described
below as beneficial to maximize E0'n drug purchasing capabilities and efficiencies. and ESI or affiliates may realize
an overall positive rnargin with regard to these inhiatives.
The following provides additional information regarding examples of ESI subsidiary discount anongementS
and fee-for-service arrangements with pharmaceutical manufacturers, and Wholesale distributors:
E3|Svboidiwrv. Pharmacy Discount Arrangements ESI subsidiary pharmacies purchase prescription
drug inventohen, either from manufacturers or wholesalers, for dispensing to patients. Often, purchase
discounts off the acquisition cost of these products are made available by manufacturers and
wholesalers in the form of either up -front discounts or retrospective discounts. These purchase
dincoon\o, obtained through separate purchase contracts, are not formutary rebates paid in connection
with our PBM formulary rebate programs, Drug purchase discounts are based on a pharmacy's
inventory needs and, at times, the performance of related patient care services and other performance
requirements. VVhen a subsidiary pharmacy dispenses a product from its inventory, the purchase price
paid for the dispensed product, including applicable dispensing fees, may be greater or Iess than that
pharmacy's acquisition cost for the product net of purchase discounts. In gnnera|, our pharmacies
realize an overall positive margin between the net acquisition cunt and the amounts paid for the
dispensed drugs.
ESI Subsidiary Feo'For-Service Arrangements -- One or more of E0`a ouhsidioheo, induding, but not
limited to, its subsidiary pharmacies also may receive fee-for-service payments from manufacturers or
wholesalers in conjunction with various programs or services, including, for. example, patient assistance
programs for indigent paUonts, dispensing prescription medications to patients enrolled in clinical trio|o,
various therapy adherence and fertility programs, administering FDA compliance requirernents related to
the dmg, product reimbursement support services, and various other clinical or pharrnacy programs or
services. As a condition to having access to certain praducts, and sometimes related tocertain therapy
adherence criteria or FDA requiremonts, a pharmaceutical manufacturer may require a pharmacy to
report selected information to the manufacturer regarding the pharmacy's service levels and other
dispensing -related data with respect to patients who receive that manufacturer's product. A portion of
the discounts or other fee-for-service payments made available to our pharmacies may represent
compensation for such roporting.
Other Manufacturer Arrangements — ESI also maintains other lines of business that may involve
discount and service fee relationships with pharmaceutical manufacturers and wholesale distributors.
Examples of these businesses include a wholesale distribution buoinosa, a group purchasing
o/gunizuUon, a medical benefit management company, and United BioSource Corporation (^UBC^).
Compensation derived through these business arrangements is not part of the PBM tormulary rebates or
associated administrative fees paid to ESI in connection with ES|'s PBM formulary rebate programs.
Services related to these arrangements aro provided to manufacturers irrespective of whether a drug is
on one of EG|'s national formularies. Of particular note. UBC partners with life sciences and
pharmaceutical companies to develop, commendaUzn, and support safe, effective use and access to
pharmaceutical products. UBC maintains a team of research soientistn, biomedical exportn, research
operations professionals, technologists and clinicians who work with clients to conduct and support
n|ininal tha|o, crea(o, and validate and administer pre and post product safety and risk management
programs. UBC also works on behalf ufpharmaceutical manufacturers to provide product and disease
state education pmgramo, reimbursement assistance, and other support services to the patient public at
large, Fees paid to UBC in connection with its services are unrelated to the ESI PBM formulary,
203160
Third Party Data Sales — Consistent with any client contract limitations,, ESI or tts affiliates may sell non-
patient
aggregators, manufacturers, or other third parties on a fee-for,seryice basis, All such activities are
conducted in compliance with applicable patient and pharmacy privacy laws and client contract
restrictions.
January 1'20i3
THIS EXHIBIT FINANCIAL POLICIES. E AY PERIODICALLY UPDATE THIS EXHIBIT
AND THE FINANCIAL DISCLOSURES CONTAINED HERE TO REFLECT CHANGE NESS
PROCESSES THE CURFENT FINANCIAL DISCLOSURE IS AVMLABLE UPON REQUEST AND ACCESSBLE
ON E.XPRESS SCRIPTS.COM FOR CLIENTS & ADVISORS,
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 Lease of premises
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. Subcontractors and sub subcontractor performing work or service shall provide a Certificate of Insurance
in accord with Exhibit I.
6. API 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.
9. Whenever an ISO form is referenced the current edition of the form must be used.
Page 1 of 3 Schedule C, Professional Services October 2013,Doc
City of Dubuque Insurance Requirements for Professional Services
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A) COMMERCIAL GENERAL LIAB!LITY
General Aggregate Liniit $2p00000
ProductsCompleted Operations Aggregate Limit $1'000,000
Personal and Advertising Inlury Limit $1,000,000
Each Occurrence $1'000,000
Fire Damage lirnit (any one occurrence) $ 50'000
Medical Payments $ 5,000
a) Coverage shall be written on an occrrencenotdaimumade,fonn. All deviations trom the
standard 150 cornmercial general Iiability form CG0QU1'vrBusiness owners formBPU0O2'
shaH be clearly identified.
W lncludo ISO endorsement form CG 25 04 "Designated Location(s) General Aggregate Limit"
or CG 25 03 "Designated Construction Project (s) General Aggregate Limit" ps appropriate.
c) Include endorsement indicating that coverage is primary and non-contributory.
d) Include endorsement topreserve Govemmenta|Immunity. (Sample auachad).
e) Include an endorsernent that deletes any fellow employee exclusion.
D Include additional insured endorsement for:
The City of Dubuque, including all its elected and -appointed officials, all its employees
and volunteers, aii its boards, commissions and/or authorities and their board members,
ernployees and volunteers. Use ISO form CG 2026.
8) AUTOMOBILE LIABILITY $1,000,000(Combined Single Limit)
C) WORKERS' COMPENSATION & EMPLOYERS UABJLITY
Statutory benefits covering all employees injured on the job by accident or disease as prescribed by
|owa Code Chapter 85 as amended.
Coverage A
Coverage
Statutory—State of lowa
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 for, with the underlying policies included
herein.
E) PROFESSIONALLK\8|UTY
1,000,000
Page 2 of 3 Schedule C, Professional Services October 2013.Doc
City of Dubuque Insurance Requirements for Professional Services
Preservation ofGovernmental Immunities Endorsement
1. Nonwaiver ofGovernmental Iminsurance carrier expressTy agrees nd 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,
I. (]abms[oxeege.The|nsurancecu/rierfurtherageesthatthispo|icyofinmrmnceshaUcoveron|y
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|nnuo¢y The City of Dubuque, Iowa shaH be responsibe fer asserting any
defense of governmental immunity, and may do so at any time and shall do so upon the timely
written request ef the insurance carrier.
4,Non--Denial ofCove The insurance carrier shal 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.
NootherChange in Policy. The above preservationion of governrnental irnmunities shall not otherwise
change or alterthe coverage availabie under the policy.
SPECIMEN
Page 3 of 3 Schedule C, Professional Services October 2 ,Doc