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l�7eighborhood <br />H E A L T H <br />Yakima Neighborhood Health Services <br />12 South 8" St, PO Box 2605 <br />Yakima WA 98907-2605 <br />Phone (509) 454-4143 Fax (509) 454-3651 <br />www.ynhs.org <br />$4,175 — one-time incentive payment for meeting QHP enrollment target of 369.. The incentive <br />will be paid by HBE to YNHS (and YNHS to the sub -contractor) for the proportion of the <br />amended enrollment target met for new and renewed plans selected through the end of the OE -5 <br />Open Enrollment period as validated by the Washington Healthplanfmder system data. <br />Total Base Payment = $23,659 <br />Total Potential Incentive Payment $ 4,175 <br />Maximum Nine Month Contract Award $ 27,834 <br />C. Contractor Payment: <br />■ Sub -Contractors will receive a one-time enrollment outcome payment after the 2018 open <br />enrollment period concludes. The payment will be generated upon validation through the <br />Washington Healthplanfmder system of the QHP new and QHP renewed plans selected by <br />service area navigators during the open enrollment period. The payment will be based on the <br />proportion, up to but not exceeding 100%, of the QHP plan selection contract goal met at the <br />conclusion of the open enrollment period. <br />• Should sub -contractor enroll or re -enroll fewer than 325 QHP members (as identified by the HBE <br />data system), sub -contractor's outcome -based enrollment payment will be pro -rated to that same <br />percentage of the one-time incentive payment. <br />D. Reporting: <br />Sub -contractor agrees to continue reporting monthly outreach activities to contractor, using the format <br />provided by HBE and/or contractor, to include: Highlights of community outreach events or key <br />activities during the previous month: Outreach events conducted in report month, city/county, target <br />population; Key accomplishments; Barriers/Issues experienced during outreach effort <br />Reports are due by the 5t' of the following month. <br />The parties hereto, having read this Sub -Contract Amendment in its entirety, do agree to the terms of the <br />amendment <br />Approved (Contractor) <br />Yakima Neighborhood Health Services <br />Signature <br />Print name and title <br />Approved (Sub -Contractor) <br />Sub -Contractor Agency <br />date Signature <br />Print name and title <br />0 <br />Accredited by the Joint Commission Patient Centered Medical Home Level 3 <br />date <br />