56-19 Exhibit - Agreement with Meritain Health as Third Party Administrator.pdf

Exhibit “A”

Welcome to Meritain Health Proposal for Township of West Orange Presented by Michael Atkinson Fairview Associates James Malvey Regional Vice President, Sales Richard Rispoli Aetna www.meritain.com | © 2018–2019 Meritain Health, Inc. All rights reserved. 1/3/2019

A Proposal for: Township of West Orange Table of contents Executive summary Proposed costs — Fees — Conditions 1/3/2019

Meritain Health Executive Summary Thank you for allowing Meritain Health to present our proposal for employee healthcare benefits. Your client can benefit from the full advantage of our quality, affordable healthcare solutions. Here’s how we do it. We understand clients’ needs include the benefits employees need In today’s healthcare marketplace, your clients face many challenges. Meritain Health works with you to address the following: Employee health and productivity. Every employee population has unique needs. These needs can best be met through a healthcare benefits partner that advocates for employees’ best health and well-being. The cost of employee benefits. Employee healthcare costs are rising much faster than the rest of the economy. Your clients need affordable benefits plans for short- and long-term savings. Achieving peace of mind. Partnership with a strong, stable benefits administrator provides the advantages of caring and dependable customer support, and effective benefits management. Get the help you need to address clients’ challenges At Meritain Health, an independent subsidiary of Aetna, we are Advocates for Healthier Living. A Meritain Health employee benefits plan consists of quality, affordable healthcare that is easy for employees to access and use. This, plus our self-funded expertise and advice, supports employees in healthy, productive lives. Our mission Through our partnership, Meritain Health will work hand-in-hand with you for customized healthcare solutions. Your clients’ benefit plans help create healthier members, reduced healthcare spending and bottom-line impact. The features Meritain Health offer make us one of the most unique, competitive healthcare benefits solutions in the marketplace: Our financial stability as an Aetna company is coupled with a 30-plus year track record of operational excellence. We offer our clients and members access to the Aetna Open Choice® and Choice® Point of Service (POS) II networks, as well as 270 other top provider networks. Our cost management strategies feature out-of-network and high-dollar negotiations, and have saved our clients millions. We draw upon our aggregated suite of services to build best-fit benefit solutions that include our internal wellness, medical management and pharmacy services, as well as Health Savings Account (HSA), Health

upon our aggregated suite of services to build best-fit benefit solutions that include our internal wellness, medical management and pharmacy services, as well as Health Savings Account (HSA), Health Reimbursement Arrangement (HRA) and Flexible Spending Account (FSA) administration. All plans include our high-touch support: consultative client services, dedicated implementation specialists, multi- tier support teams and nationwide service centers. Through our innovative technology platform, we deliver industry-leading performance standards and full control of plan changes. We are your Advocates for Healthier Living. By listening and understanding our clients’ needs, we offer flexible, cost- effective and easy-to-use healthcare solutions. We are dedicated to providing compassionate support and guidance to help our members be active participants in their healthcare. We look forward to a successful partnership. www.meritain.com | © 2018–2019 Meritain Health, Inc. All rights reserved. 1/3/2019

Medical Administrative Fee Options Township of West Orange Quoted Effective Date: 4/1/2019 Employees Network: Aetna Choice POS II 592 Plan Design: Proposed Benefits TPA: Meritain Health Projected Reinvested Subscribers Rebates 1 Medical Administration Fee 592 $70.50 Network Access Fee 592 Included Utilization Management (Assuming Model Precert List) 592 Included Case Management 592 Included COBRA (+2% of Collected Premiums) 592 Included Reinsurance Administration Fee 592 Included ATLAS - Arrow Reporting 592 Included SBC Preparation (See Conditions for Printing Options) 592 Included NYHCRA/HCRA Surcharge Reporting 592 Included Maternity Management 592 Included Disease Management 592 Included 24/7 Nurseline 592 Included Teladoc 592 Included Fiduciary 592 Included Set Up Fee 592 Waived Broker Fees 592 Included Total Administration Fees:

592 Waived Broker Fees 592 Included Total Administration Fees: $70.50 Utilization of Scrip World PBM Program Included PBM Coordination Fee Included Integrated OOP Deductible Included Total Administration Fees after SW Credits $70.50 Total Administration Fees (Annual): $500,832.00 1. Assumes Reinvested Rebates with Scrip World for the 20 Library Employees. The other employees will have a carve-out Rx arrangement. The above Meritain Health administration rates are guaranteed for three years and require a three year agreement. Early termination fees may apply. 1/3/2019

Optional Services Township of West Orange Per EE Per Participant Set-Up Fee Healthcare Bluebook Standard Program ("Go Green") $2.05 N/A N/A Healthcare Bluebook - SmartSelect $3.45 N/A N/A Dental Administration Fee (Including Aetna Dental Network) $2.95 N/A N/A Vision Administration Fee $0.85 N/A N/A COBRA Administration for Outside Lines of Coverage $0.75 N/A N/A COBRA Actuarial Report N/A N/A $1,500.00 Maternity Management $0.80 N/A N/A Demand Management - 24x7 Nurse Line $0.45 N/A N/A Pre-Admission and Post-Discharge Counseling $0.50 N/A N/A Teladoc (Plus $40 per Consultation, Required for HDHP Plans) $1.55 N/A N/A Teladoc State Restrictions: Idaho - Video Only, Georgia - 3 day Rx limitation. FSA Including Restricted Debit Card & AutoRollover ($75 Monthly Minimum) N/A $5.40 $525.00 Additional Banking Fees may apply Meritain Health HSA Fee - Including Debit Card, Plus one of the following: N/A $1.10 $15/Part. - Option 1 - Employer Paid N/A $2.55 See Above - Option 2 - Employee Paid from Account (Applies to Balances Under $1,000) N/A $3.90 See Above HSA Member Welcome Kits N/A Included N/A Additional Banking Fees may apply 1/3/2019

Pharmacy Meritain Health Pharmacy Management benefit administration integrated with Meritain Health medical benefit Township of West Orange MH Tier 4/1/2019 RB16-T4 Reinvested Rebates Pharmacy Benefits Retail Brand Discount 17.50% Net effective generic discount 79.00% Retail dispensing fee $1.20 Mail Brand Discount plus dispensing Fee 18.00% Net effective generic discount, plus dispensing Fee 80.00% Specialty Specialty Discount 13.50% Specialty dispensing Fee $1.20 Rebates Retail Brand $0.00 Mail Brand $0.00 Specialty Brand $0.00 Formulary: Rates are based on an open formulary and our broad national network. Additional formulary and network offerings and corresponding rates are available upon request. All Meritain Health Pharmacy Management offerings include the benefit of rebates and are delivered in various ways. Our recommended model is the Reinvested Model, which offers the greatest benefit for our clients and their members, including: (1) lowering net cost at time of purchase with reduced costs on all drugs, not just on rebate eligible drugs. (2) reducing the incentive toward higher cost brand drugs caused by rebates. (3) eliminating the volatility associated with which drugs are rebate eligible. (4) immediate realization of value without pay-out lag that is

centive toward higher cost brand drugs caused by rebates. (3) eliminating the volatility associated with which drugs are rebate eligible. (4) immediate realization of value without pay-out lag that is typical with rebates. We offer a traditional rebate model, wherein the rebates are paid out to the plan sponsor. While the traditional rebate model can yield significant savings when rebate eligible drugs are utilized, lower cost alternatives may exist that offer lower net cost to plan. For groups focused on low fixed costs, we offer a model with the benefit of rebates in the form of an admin credit. Generic discount and dispensing fee guarantees cover Multi-Source products only. The brand discount and dispensing fee guarantees apply to non-Multi-Source products. High Deductible Health Plans (HDHP) are subject to a fee of $2.00 per script. 1/3/2019