Description of NuWin Services
- NuWin provides a network of licensed physicians accessible via telephone, secure bi-directional video and email. *
*Based on state guidelines
- Coverage for Employees, including covered dependents based on elected coverage type or as agreed to.
- Membership Cards with unique identification numbers for each Employee will be delivered by email and also available in the Employee’s Portal.
- Types of Physician Consultations Offered and Available 24 hours per day, 7 days per week, and 365 days per year.
- BY PHONE: Employees have access to a special Employee only toll-free number.
i. Guaranteed within 1 hour. Requires receipt of a completed Medical Assessment and History Questionnaire to create a physician/patient relationship and for medication to be prescribed.
i. Secure email informational consultation with a physician through our secure messaging system for medical questions only. Informational only. Not for treatment and prescribing of medications.
ii Bi-Directional Video Conferencing: Secure video consultation with a physician through our secure bi- directional video conferencing system. Requires receipt of a completed Medical Assessment and History Questionnaire to create a physician/patient relationship and for medication to be prescribed. Also requires Employee to have webcam capability. In certain instances, at the physicians’ determination, a video consultation may be required to effectively diagnose and treat certain medical conditions.
- Prescription Program - Only Employees who have accurately and fully completed the Medical Assessment and History Questionnaire and established a physician/patient relationship, are eligible to receive medications when appropriate. 1.800MD physicians do not prescribe narcotic pain medications, DEA controlled substances or lifestyle drugs.
- Employee Services Toll Free Support: Employees have access to Employee only toll-free support, 24/7.
- Personal Health History and Disclosure (PHD) - Employees will have ability to store, update, maintain and transmit partial or entire medical records.
a. Health Risk Assessment Tools- Empower Employees to review lifestyle factors and health risks.
- Physician Response Times:
- Phone Consultation – Guaranteed within 1 hour.
- E-mail Consultation – Guaranteed within 3 hours.
- Video Consultation– Guaranteed within 1- hour or by scheduled appointment. Available between 7:00 AM and 7:00 PM local time.
- If response times are not met by physician, 1.800MD will waive the consultation fee if requested by Employee.
- Coordinated appointment times as established between the Physician and the Employee are not subject to the Response Time Guarantees.
- System Availability- Commercially reasonable efforts to make the Services available in full at all times.
- 1.800MD is responsible for collecting Employee consultation fees established by Client via credit card or debit card at the time of service.
- Optional Added Program Descriptions:
- Behavioral Health- Our tele-behavioral clinicians can provide assessment, diagnosis, consultation, and brief psychotherapy to address your behavioral health needs via live, interactive videoconferencing on your computer and other connected devices (e.g. smartphone).
Initial Pricing and Utilization
Per Employee Per Month (PEPM) Initial Price (the “PEPM Pricing”):
$2.99 with a minimum employer contribution of $.50 PEPM
$3.99 with no employer contribution
Right to Change Pricing.
- Excessive Usage PEPM Pricing Increase.
- After the Initial Term, NuWin reserves the right to increase Pricing due to excessive consultations (as determined below) upon 45 days prior written notice to Selected Buyer, as further described and defined below.
- Basis for Excessive Usage Pricing Increase: NuWin's pricing assumes a maximum of 20% annual utilization (per 12 months beginning on the Effective Date) measured by dividing the annual number of consults in the aggregate covered population under the Service Agreement by the annual aggregate number of covered employees in the covered population under the Service Agreement (i.e. number of members paying PEPM in the population).
- The PEPM pricing will be increased by $.30 for each 5% increment increase in annual utilization above 20%.
- For example: if after the initial period of 12 months from the effective date the annual utilization is calculated to be between 20% and 24.9%, the PEPM pricing for the $0.00 Consult Subsidized Model will be increased by $0.30 PEPM for the following month (to cover the then-current year). A similar provision will be included in all Client Agreements subsequent to the Effective Date.
- Notwithstanding the foregoing or any other provision of this Agreement to the contrary, the PEPM shall never exceed (i) $4.99 (with a minimum employer contribution of $0.50 PEPM) and (ii) $5.99 (for Direct Pay Employees).
- Each Selected Buyer will be set up as their own group and the annual utilization will be calculated by dividing the annual number of consults in the group’s aggregate covered population by the annual aggregate number of Employees in the covered population (i.e. number of members paying PEPM in the population).
- Each Direct Pay Employee that signs up independent of any Selected Buyer will be set up under a separate “CSCS Direct” group consisting of all Direct Pay Employees of all Selected Buyers, and the annual utilization will be calculated by dividing the annual number of consults in the CSCS Direct group’s aggregate population of Direct Pay Employees by the annual aggregate number of individuals in the population of Direct Pay Employees (i.e. number of members paying PEPM in the population).