Packages Services Description
The following Castlight Services are available for Customer to purchase from Castlight. The purchase of each such Service must be memorialized in an applicable Services Order Form.
Note: Items excluded from the Castlight Services are set forth at end of this document.
PACKAGES
1. CASTLIGHT CONNECT PACKAGE
The Castlight Connect package shall include the following modules/functionalities described in sections that follow below:
i. Medical
ii. Pharmacy
iii. Standard Support
iv. Up to two (2) integrations
2. CASTLIGHT CONNECT EXPRESS PACKAGE (Available based on Customer’s Administrators and Member Count)
The Castlight Connect Express package shall include the following functionalities described in sections that follow below:
i. Medical
ii. Pharmacy
iii. Standard Support
iv. Up to two (2) integrations
3. CASTLIGHT ENGAGE™ PACKAGE
The Castlight Engage package shall include the Castlight Connect Package and the following additional services:
i. Key
ii. Action
iii. Up to three (3) integrations for a total of five (5) integrations
4. CASTLIGHT ENGAGE™ EXPRESS PACKAGE (Available based on Customer’s Administrators and Member Count)
The Castlight Engage Express package shall include the Castlight Connect Express Package and the following additional services:
i. Key
ii. Action
iii. Up to three (3) integrations for a total of five (5) integrations
MODULES AND FUNCTIONALITIES
5. MEDICAL
i. User Account Management features:
- User registration using social security number or another secure, Castlight-approved identifier or process that is enabled by information contained in Customer’s eligibility file
- Ability to integrate User registration into on-line benefits enrollment portal workflow
- User password change/reset
- User e-mail address change
- User communication opt-out options
- Newly eligible User registration invitation and reminder email notices. 4-26-17 Confidential
ii. Prospective services search features:
- Provider and services search box
- Out-of-pocket estimates, based on Customer or Administrator provided plan details and applicable data feeds, for select inpatient and outpatient services/providers (list of supported inpatient and outpatient services is at the discretion of Castlight and may vary over time or by geography). If Customer’s TPA is a Blue Cross Blue Shield plan, Customer understands that Castlight’s provision of such estimates is dependent upon such TPA obtaining consent to display data from the host Blue Cross Blue Shield plan(s), as applicable, and the Blue Cross Blue Shield Association
- Sort results by out of pocket costs and distance
- Detailed provider information (e.g. provider specialty, board certification) for select providers
- Detailed explanation and educational content on pricing and/or coverage for select outpatient services
iii. Benefit Programs:
- Ability for Users to view information on benefit programs available to them (such as telehealth, onsite clinic, wellness)
- Ability for Customer to configure information on any third party benefit, service, or program (such as 401k, retirement, corporate wellness, etc.)
iv. Care Center:
- Ability for Users to establish a “Care Team” of providers and facilities, make notes about those providers, and view tips about their “Care Team”
v. Past care features:
- History of past medical services with costs (subject to applicable Administrator permissions and Castlight’s specifications)
- Periodic email notices and push notifications based on claims and eligibility information
- Out of network alerts
vi. Castlight Mobile: mobile platform providing access to certain features via mobile devices:
- Apple iPhone application
- Google Android application
- Mobile web application
viii. Insurance plan and coverage features:
- Key medical policy features
- Accumulator snapshots
viii. User Reviews:
- Ability for Users to submit User Reviews
- Access by Users to User Reviews submitted by other Users, and by Castlight’s other customers’ Users, as aggregated and displayed in de-identified form by Castlight in the Castlight Platform and modified and edited by Castlight pursuant to Castlight’s policies
ix. Online support features:
- “Ask Castlight” support feature, where applicable
- Toll-free support number, where applicable
- Periodic email notices on product updates, tips, feedback, usage, and related topics
x. Basic Reporting Services: Castlight standard reporting, as enhanced by Castlight from time to time, shall include quarterly reporting on utilization of the Castlight Service such as:
- Registration
- Engagement
- Search activity
- Spend
- Support utilization
Such reporting may include incentive reporting according to Castlight’s standard specifications. Any custom reporting will be subject to a service fee as set forth in the applicable Services Order Form.
xi. Pulse: Pulse is an analytics application specifically designed for benefits personnel to access dynamic reporting on:
- Registration
- Engagement
- Search activity
- Visits
- Mobile usage
Subject to a required minimum number of participating Users, Pulse provides twenty-four (24) hour access to data and the ability to filter such data.
xii. Engagement-Based Rewards
- Incentives for application-based action(s) undertaken by the Users
- Displays Users’ incentive balance in Rewards Center in both web and mobile applications
- Standard content on the homepage and in the Rewards webpage to encourage awareness ofEngagement-Based Rewards program
- Standard email notification of Engagement-Based Rewards program launch to registered Users
- Incentive Files: upon Customer’s written request, setting up an incentive file feed, based onCastlight’s specifications, from Castlight to Customer’s system (or Customer’s authorized third party) to support Customer’s incentive program related to Engagement-Based Rewards
xiii. Rollover of Standard Medical Plans
- Direct carry-forward of existing medical plans without changes, creation of up to the same number of medical plans similar to existing plans in regards to network, benefits, and special designations
- Update of existing medical plans with minor changes including plan name, contact information, or other descriptive text; update deductible amounts, coinsurance, or out of pocket maximum
xiv. Ongoing Engagement Support: Castlight will support with engagement activities, which may include up to or the equivalent of the following services delivered until the end of the Agreement term:
- Ability to support embedding the Castlight registration process into Customer’s benefits enrollment process
- Ongoing and targeted outreach (which may be via email) to Customer’s eligible Users on key topics related to their health care needs
- Announcements to eligible Users when new features and/or products are added Page 3 of 9v. 4-26-17 Confidential
- Automated onboarding and outreach emails to new eligible Users
- Ongoing support and updates for the Castlight online playbook for standard communications accessible 24/7
- Collecting feedback from registered Users including testimonials and product surveys/feedback
- Educational support and information offered to eligible Users before log-in to drive learning and education of the Castlight Services
- Partner with Customer to integrate Castlight Service into Customer’s overall incentive/wellness programming with dedicated incentives and rewards tied to registration of the Castlight Service and/or usage, as feasible
6. PHARMACY
- Drug information
- Estimated out-of-pocket drug pricing and pharmaceutical savings options*
- Pharmaceutical claims history
- Care guidance for specialty drugs
- Standard spotlight content to encourage awareness of Pharmacy
- Targeted outreach and message to Users on key topics related to their pharmacy needs
- Formulary messaging for non-covered drugs**
- Rollover of Customer’s pharmacy plan, including: updating formulary, network and benefit design for the same number of pharmacy plans as the existing number of pharmacy plans; updating layout, or delivery type, as applicable, due to change in population through open enrollment or post-rollover eligibility file
*Estimated out-of-pocket drug pricing and pharmaceutical savings options only available at the drug level for the Connect Express or Engage Express Package
**Formulary messaging for non-covered drugs available only with national PBMs for the Connect Express or Engage Express Package
7. ELEVATE™
- Integration/Promotion of certain Customer behavioral health programs such as EAP and teletherapy
- Targeted outreach and messaging to Users who are at-risk for behavioral healthcare
- Targeted condition-specific self-assessments with personalized care recommendations based on responses
- Access for all Users to digital self-care resources through Castlight’s third-party content provider
- Search for in-network behavioral health providers, and in-network psychiatric and substance abuse inpatient facilities*
- Behavioral health educational resources
- Condition-specific resource guidance pages
- Standard reporting and analytics
- Available on mobile and web
*Only available for carve-in behavioral health carriers for the Connect Express or Engage Express Package
8. ACTION
- Identify population segments likely to be making health or wellness decisions, based on predictive analytics including claims, social/demographic data, and search activity
- Inform Users of their available healthcare benefits and care options through timely relevant communication and outreach campaigns, utilizing email notifications, push notifications, and in-application messaging
- Promote existing healthcare and benefit programs through targeted campaigns
- Measure engagement outcomes with near real-time tracking
9. PROTECT (Available based on Customer’s TPA)
- Permits Customer to set reference prices for select eligible services and establish maximum reimbursement amounts for such selected eligible services. Customer’s TPA will adjudicate User claims against the referenced price for selected services
- Distinguishes providers whose services are priced above or below the reference price for applicable services
- Referenced-based benefit education and standard spotlight content to learn about the benefit design
- Email communication to Users informing them of recently adjudicated claims occurring above or below the reference price for the service or procedure received
- Promotional Protect digital banner
10. DENTAL (Available based on Customer’s DBM)
- Search feature for dental services
- Displays Out-of-pocket dental pricing, dental claims history and past care
- Dental educational content
- Displays dental insurance plan design and accumulators
- Standard spotlight content to encourage awareness of Dental
11. KEY (Available based on Customer’s TPA)
- Secure access, in accordance with security measures agreed to by Castlight, to the Castlight Service for Customer’s authorized third party vendors on behalf of Customer’s Users
- Provide access to vendors to User-specific accounts, including provider search, out-of-pocket pricing, past care, education, and quality information
- Reporting and analytics regarding vendor use of such functionality
- Standard email notification of program launch to registered Users
- One (1) web conference training session for third-party representatives
- Quarterly recorded updates of new features and functionality for third party representatives
- Supporting documentation (e.g. FAQs about Castlight) for third-party representatives
- Self-guided online training module and annual self-guided online training updates for third-party representatives
12. IMPLEMENTATION SERVICES
Castlight’s Implementation Services are comprised of the following:
- Eligibility Feeds: integration of a Customer-provided eligibility data file in accordance with Castlight’s specifications
- Benefits Information*: provision by Customer of all Plan information, open enrollment materials, and TPA, PBM, MBHO or DBM key contacts
- Customer Claims Feed*: setting up a data feed for Customer’s TPA, PBM, MBHO or DBM to the Castlight Platform to enable regular imports of Customer’s claims information into the Castlight Platform per Castlight’s specifications
- Provider Directory*: setting up a feed for Customer’s TPA, MBHO or DBM so that such TPA, MBHO or DBM can transmit one (1) provider directory for that TPA, MBHO or DBM and provide Castlight with all necessary information for Castlight to set up providers in the Castlight Service and identify and configure any narrow or specialty networks (provided that any narrow or specialty network deductible differential may require an additional Services Order Form)
- Incentive Files: upon Customer’s written request, setting up an incentive file feed, based on Castlight’s specifications, from Castlight to Customer’s system (or Customer’s authorized third party) to support Customer’s incentive program related to its Users’ registration and utilization of the Castlight Service
- Plans implemented*: implementation of up to five (5) plans per TPA, PBM, MBHO or DBM so long as Customer provides to Castlight accurate summary plan description(s) and promptly reviews such implemented plans
- Accumulator Set Up*: setting up an ongoing feed with the TPA, MBHO, DBM or other third parties to support display of year-to-date spending and accrual towards plan limits
- Demonstration and/or Test Account: provision of Demonstration and/or Test Accounts to Customer as agreed to in writing between the parties
*DBMs not applicable for the Connect Express or Engage Express Package
13. INTEGRATION SERVICES
i. Inbound/Outbound Single Sign-On Integration*
- Single sign-on capabilities utilizing the SAML 2.0 standard from/to the Customer’s portal into/from the Castlight Platform
- Single sign-on capabilities utilizing the SAML 2.0 standard from/to the Customer’s third party vendor into/from the Castlight Platform
ii. HealthFundIntegration**
- Integration of FSA, HSA, or HRA (as selected in the applicable Services Order Form) balance information from Customer’s third party provider of such information for display in the Castlight Service
iii. Standard Administrator-Delivered Preferred Network Integration (Narrow Network, Tiered Network, or Centers of Excellence (“COE”))
- Requires Customer’s TPA to send unique network identifiers designations as part of the standard provider directory feed, definitively identifying all providers and facilities in the network
- Provides the ability to configure the network for a set of Customer defined procedures
- If applicable, allows a benefit differential to be configured for network designated providers
- Provides the ability to sort network providers to the top of relevant search results and view network designation in the search experience
- Supports configuration of network program details in the Medical “Benefits” tab
iv. Embedded Registration Integration
- Integration into the Customer’s benefit enrollment solution, such that eligible Users can register for the Castlight Service within the benefit enrollment experience
*SSO integrations not available for the Connect Express or Engage Express Package
**Health fund integration subject to (i) Castlight entering into a valid agreement with Customer’s FSA, HSA, or HRA provider for receipt of data necessary for Castlight’s provision of the health fund integration; and (ii) Castlight’s receipt of such data in a format acceptable to Castlight.
14. STANDARD SUPPORT
Online and phone support in English and Spanish, as well as language line support for one hundred seventy (170) languages, for registered Users, Monday through Friday (excluding holidays) 8AM – 9PM Eastern Time, in the following areas: (i) technical support including password reset, bug reporting; (ii) clarification support including answering questions to increase health literacy, explanation of health benefits available to the User, and explanation of how to use Castlight Services; (iii) decision support including guiding Users on searching for outpatient providers/services using Castlight Services and how to interpret such search results; and (iv) educational services for past care. Additionally, registered Users shall be entitled to third-party support, outreach and communication as mutually agreed by Castlight and Customer.
15. PREMIUM CONCIERGE
Includes all services set forth in Standard Support, with the following additions: (i) appointment scheduling for standard office visits, lab tests, and imaging facilities; (ii) Castlight Guide facilitated program enrollment; and (iii) Castlight Guide facilitated claims appeal education and preparation. Premium Concierge Users are routed to a select team of Castlight Guides who have received additional customer service training regarding common health and benefits questions, and employer-specific benefits and programs.
16. STANDARD COMMUNICATION PACKAGE FOR CONTRACT YEAR ONE
Castlight will provide the following “Standard” launch communication services, which may include up to or the equivalent of the following services delivered prior to and during Contract Year One:
- Provide to Customer the standard Castlight playbook of content for e-mail and print marketing communications, provisioned with Customer’s logo and color palette (Customer grants Castlight license to use Customer’s name and logo on such playbook)
- Provide best practices information for using Castlight’s playbook of content
- Ability to support embedding the Castlight registration process into Customer’s benefits enrollment process
- Partner with Customer to integrate Castlight Service into Customer’s overall incentive/wellness programming with dedicated incentives and rewards tied to registration of the Castlight Service and/or usage, as feasible
- Partner with Customer to send out a dedicated communication endorsing Castlight for Customer’s leadership team to send via email or another broad channel targeting the eligible User population
- Support in the development of a best practices launch plan based on Customer’s profile andCastlight’s experience with similar customers incorporating selected key tactics to drive User acquisition and activation
- Send additional launch email announcement(s) from Castlight to all eligible Users pending whitelisting of the Castlight IP address to facilitate Castlight emails
- Support for incentive file delivery to Customer’s vendor/internal teams based on mutually agreed to specifications
- Support for other marketing activities as mutually agreed upon by the parties
- Provide training of Customer’s employees and other internal audiences as requested Partner with Customer to execute at least three (3) emails to promote registration and use of the Castlight Service using web links
- Develop launch communications for Customer to send via non-email channels (e.g. print, intranet portals) and to incorporate Castlight Services into ongoing benefits related messaging
17. UPGRADED COMMUNICATIONS PACKAGE FOR CONTRACT YEAR ONE
Castlight will provide the following “Upgraded” launch communication services, which may include up to or the equivalent of the following delivered in Contract Year One:
- Provide to Customer the standard Castlight playbook of content for e-mail and print marketing communications, provisioned with Customer’s logo and color palette (Customer grants Castlight license to use Customer’s name and logo on such playbook)
- Provide best practices information for using Castlight’s playbook of content
- Ability to support embedding the Castlight registration process into Customer’s benefits enrollment process
- Partner with Customer to integrate Castlight Service into Customer’s overall incentive/wellness programming with dedicated incentives and rewards tied to registration of the Castlight Service and/or usage, as feasible
- Partner with Customer to send out a dedicated communication endorsing Castlight for Customer’s leadership team to send via email or another broad channel targeting the eligible User population
- Support for the development of a customized, best practices launch plan based on Customer’s needs and overall calendar incorporating key, selected key and/or new tactics to drive User acquisition and activation
- Send additional launch email announcement(s) from Castlight to all eligible Users pending whitelisting of the Castlight IP address to facilitate Castlight emails
- Support for incentive file delivery to Customer’s vendor/internal teams based on mutually agreed to specification
- Support for other marketing activities mutually agreed upon by the parties
- Provide training for Customer’s employees and other internal audiences as requested
- Partner with Customer to execute at least three (3) emails to promote registration and use of the Castlight Service using web links
- Develop launch communications for Customer to send via non-email channels (e.g. print, intranet portals) and to incorporate Castlight Services into ongoing benefits related messaging Support for the creation of new channels/tactics as needed to reach Customer’s eligible User population
- Access to Castlight’s strategic communications expertise/team focused on driving engagement success
18. EXPRESS COMMUNICATION PACKAGE FOR CONTRACT YEAR ONE
Castlight will provide the following “Express” launch communication services, which may include up to or the equivalent of the following services delivered prior to and during Contract Year One:
- Provide to Customer the standard Castlight playbook of content for e-mail and print marketing communications, provisioned with Customer’s logo and color palette (Customer grants Castlight license to use Customer’s name and logo on such playbook)
- Provide best practices information for using Castlight’s playbook of content
- Ability to support embedding the Castlight registration process into Customer’s benefits enrollment process
- Partner with Customer to integrate Castlight Service into Customer’s overall incentive/wellness programming with dedicated incentives and rewards tied to registration of the Castlight Service and/or usage, as feasible
- Partner with Customer to send out a dedicated communication endorsing Castlight for Customer’s leadership team to send via email or another broad channel targeting the eligible User population
- Support in the development of a best practices launch checklist based on Customer’s profile and Castlight’s experience with similar customers incorporating selected key tactics to drive User acquisition and activation
- Provide consultative support to the Customer to advise on recommended best practices and tactics to drive engagement
19. ADDITIONAL COMMUNICATIONS SERVICES
Additional communication services may be selected at any time by Customer via an email request for the following: on-site registration drive outside of initial launch efforts as agreed upon with Customer during initial launch planning $3,000.00.
SERVICE EXCLUSIONS
Subject to change from time to time at Castlight’s sole discretion (except as specifically set forth above), the Castlight Service does not include:
- Prospective search and out of pocket cost information for Pharmacy, vision and certain inpatient and outpatient procedures or pharmacy, unless such specific capability is set forth in the applicable Services Order Form
- Additional customizations of the Castlight Service including, but not limited to, customizations to the data required to support the Castlight Service (i.e. data used to process eligibility, provider network data, or data in claims files that are not mapped to Castlight’s standard specifications), or customizations to the content display that require additional data feeds not included in Castlight’s standard implementation
- Customizations to text or other content in the Castlight Service outside of targeted messages and the configurable sections of the Your Plan page
- Customized reporting or data analytics, which includes any reporting that requires adding fields to the eligibility file outside of the two (2) included with standard reporting
- Additional customer support services (e.g. claims dispute resolution)
- Attending employee benefits fairs
- Single sign-on capabilities, unless such specific capabilities are purchased and meetCastlight’s technological requirements of SAML 2.0
- Supporting a change to or an addition of Customer’s Administrators, including but not limited to receiving data feeds from Administrators other than those providing services to Customer as of the Effective Date of the MSA
- Supporting data feeds in addition to the specified data feeds from the Administrators or as otherwise specified above (such as feeds from HSA/FSA/HRA vendors or wellness vendors)
- Delivery of outbound files other than incentive files which are in accordance withCastlight’s specifications
- Provision of the Castlight Service to persons other than Users unless otherwise agreed to by the parties in writing
- Printing and distribution of printed communications materials for Communications Services set forth above
- Any additional services associated with rollover of plans beyond the rollover services provided through implementation services above, including but not limited to Administrator changes, vendor changes, new networks, broadening of an existing COE or Protect program and/or inclusion of on-site clinic benefits. Such additional services shall be provided on a then-current Castlight professional services time and materials basis.
Provision of any of these additional services will require a separate Services Order Form, including terms and conditions and additional associated service fees to be mutually agreed to by the parties in writing.