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Total Base Payment = <br />........... <br />Neiahbor/rood <br />~HEAL' H <br />Yakima Neighborhood Health Services <br />12 South 8'h St, PO Box 2605 <br />Yakima WA 98907-2605 <br />Phone (509) 454-4143 Fax (509) 454-3651 <br />www.ynbs.org <br />Total Potential Incentive Payment <br />Maximum Twelve Month Contract Award <br />C. Contractor Payment: <br />$23 ,744 <br />$ 4,283 <br />$28,027 <br />• Sub-Contractors will receive a one-time enrollment outcome payment after the 2019 open <br />enrollment period concludes. The payment will be generated upon validation through the <br />Washington Healthplanfinder 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 357 QHP members (as identified by the <br />HBE data system), sub-contractor's outcome-based enrollment payment will be pro-rated to that <br />same 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 5 th of the following month in order for YNHS to roll up reports and submit to HBE <br />by the required monthly reporting deadline. <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 />\...,. . <br />Signature <br />A nita Mo no ian, Preside nt / CEO <br />Print name and title <br />Accredited by th e Joint Commission <br />7/1 /18 <br />date <br />Approved (Sub-Contractor) <br />Sub-Contractor Agency <br />{lit~ date <br />1Ff ~tra1 La ,tih, /nl(J,, 111 A1!tn1/l,1~t rn fir <br />Print nam~ and title <br />Patient Centered Medical Hom e l evel 3