To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Contract #77-823 with Vision Service Plan
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County a Vision Care Agreement (County Contract #77-823) with Vision Service Plan, a California nonprofit corporation, in an amount not to exceed $270,000, to provide hosted vision plan management and administrative services to Contra Costa Health Plan’s Medicare Advantage Dual Eligible Special Needs Plan members for the period October 20, 2026 through December 31, 2028.
FISCAL IMPACT:
Approval of this Contract will result in contractual service expenditures of up to $270,000 over a two-year period and will be funded 100% by Contra Costa Health Plan (CCHP) Enterprise Fund II revenues.
BACKGROUND:
This Contract meets the needs of the County by delegating a California-licensed specialized health care service plan administrator for CCHP’s Medicare Advantage (MA) Dual Eligible Special Needs (D-SNP) members' vision service benefits. Vision Service Plan is a licensed California specialized health care service plan as defined by the California Knox-Keene Health Care Service Plan Act of 1975 and licensed by the California Department of Managed Health Care and the California Department of Insurance to arrange and coordinate vision services through delegated and non-delegated agreements in California. Vision Service Plan will be responsible for certain Plan functions, including but not limited to provider network development, network adequacy, credentialing, member services, claims processing, and other delegated activities as required by CCHP. Each month, CCHP will reimburse Vision Service Plan a $6.01 Per Member Per Month Capitation Payment Rate as outlined in Exhibit B of the Agreement on behalf of each Covered Person or Member for the performance of its delegated activities. The benefit of CCHP entering into this agreement is that Vision Service Plan already has the operational capability and infrastructure to assume these services, given its position as a specialized vision health care service plan and its coordination of similar services with numerous health plans in California.
This Contract is entered into under and subject to the following legal authorities: California Government Code §§ 31000. Health Services Personnel approved this Contract to ensure no conflicts with labor relations. A summary of service contract deliverables, including measurable outcomes required of the Contractor to be monitored by the department in compliance with Section III (B)(6) of County Purchasing Policy Administrative Bulletin 600.4, (AB 600.4), includes delegated activities, data submission and reporting obligations and arrangement for or administration of the contracted vision care services. Per AB 600.4, the Department has posted a continuous Request for Qualifications and maintains a current qualified list of vendors at all times.
Under this new County Contract #77-823 the parties will execute a Vision Care Agreement that includes mutual indemnification obligations of each party to defend, indemnify, and hold harmless the other party against third party claims arising under the Contract, and delegating Vision Service Plan for the management and administration of CCHP’s vision plan services concerning its MA D-SNP lines of business beginning January 1, 2027 through December 31, 2028.
CONSEQUENCE OF NEGATIVE ACTION:
If this Contract is not approved, the consequences of not delegating a vision plan manager and administrator will have a direct impact on CCHP’s ability to continue offering vision benefits to its DSNP members.