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SHJ25-009 fully executed document
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2025-06-17 10:00 AM - Commissioners' Agenda
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SHJ25-009 fully executed document
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Last modified
9/17/2025 3:19:55 PM
Creation date
9/17/2025 3:19:18 PM
Metadata
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Template:
Meeting
Date
6/17/2025
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Fully Executed Version
Supplemental fields
Item
Request to Approve Agreement SHJ25-009 Community Health Plan of Washington - 1115 Medicaid Re-Entry Initiative
Order
16
Placement
Consent Agenda
Row ID
132242
Type
Contract
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Docusign Envelope lD: CEBC6B3C-DFA1-4BOC-AFE8-6A4A63440080 <br />2. Medicare Advantase (MA) Plans (Continued) <br />Medicare Advantage Special Needs Plans Not Included <br />offered by CHPW. <br />Network Name: CHPW SNP Network <br />n Exhibit B-2-A- Medicare Advantage Reimbursement Rates <br />fl Exhibit B-2-B - Medicare Advantage Required Provisions <br />fl Exhibit B-2-C - Medicare Advantage Value Based Payment Arrangement <br />3. CHPW Health Benefit Products <br />"Cascade C^re" Public Option Plans Not Included <br />offered by CHPW. <br />Network Name: CHPW Cascade Care Affiliate Network <br />fl Exhibit B-3-A - CHPW Health Benefit Exchange Reimbursement Rates <br />fl Exhibit B-3-B - CHPW Health Benefit Exchange Required Provisions <br />fl Exhibit B-3-C - CHPW Health Benefit Exchange Value Based Payment Arrangement <br />n Exhibit B-3-D - CHPW Health Benefit Exchange QHP Addendum for IHCP's <br />Third Partv Benefit Plans. The following Benefit Plans are offered by third party plan <br />sponsors that (i) have an obligation to administer and pay for Covered Services provided to a <br />Member enrolled in the applicable Benefit Plan, and (ii) have entered or is subject to a written <br />agreement with CHPW for provider network management services for the applicable Benefit <br />Plan, and which may be subject to this Agreement. The following Benefit Plans are designated as <br />either "Included" or "Not Included" for purposes of this Agreement, and any Benefit Plan that is <br />"Included" is accompanied by one or more Plan Exhibits, as indicated, that will control with <br />regard to services delivered to Members of that Benefit Plan. <br />For each Benefit Plan designated as "Included" below, Facility authorizes the applicable plan <br />sponsor to offer Facility's services to individuals in accordance with the provisions of the <br />"Included" Benefit Plan(s). Notwithstanding anything in the Agreement to the contrary, for Third <br />Party Benefit Plans listed as "Included" below, Facility shall accept payment as outlined in the <br />applicable Plan Exhibits. <br />4. Third-Party Health Benefit Exchanee Products <br />Affiliated o'Cascade Care" Public Option Plans <br />Public Option Plans offered by a CHPW ffiliate, including <br />Community Health Network of Washington. <br />Network Name: CHPW Cascade Care Affiliate Network <br />Not Included <br />2020 Facility Exh B - BenefitPlans Page 27 of5I Contract #5908 -662684
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