SERVICES DESCRIPTION
Last Updated: Feb 11, 2022
The following Services are available for Customer to purchase from Castlight. The purchase of each Service must be memorialized in an applicable Services Order Form. Items excluded from the applicable Services are set forth at end of this document.
PACKAGES
1. WHOLE HEALTH NAVIGATION
The Whole Health Navigation package includes the following modules/functionalities described in the sections below:
- Universal Platform Features
- Engagement Hub Features
- Wellbeing Features
- Care Guidance Features
- Ecosystem and custom integrations as further specified in the applicable Services Order Form
- Included Services
- Castlight Care Guides (included in package, no buy-up required)
2. CARE NAVIGATION (Available based on Customer’s Administrators)
The Care Navigation package includes the following modules/functionalities described in the sections below:
- Universal Platform Features
- Engagement Hub Features
- Care Guidance Features
- Ecosystem and custom integrations as further specified in the applicable Services Order Form
- Included Services
- Castlight Care Guides (included in package, no buy up required)
3. COMPLETE DIGITAL HUB
The Complete Digital Hub package includes the following modules/functionalities described in the sections below:
- Universal Platform Features
- Engagement Hub Features
- Wellbeing Features
- Care Guidance Features
- Ecosystem and custom integrations as further specified in the applicable Services Order Form
- Included Services
4. HOLISTIC WELLBEING
The Holistic Wellbeing package includes the following modules/functionalities described in the sections below:
- Universal Platform Features
- Engagement Hub Features
- Wellbeing Features
- Ecosystem and custom integrations as further specified in the applicable Services Order Form
5. CARE GUIDANCE (Available based on Customer’s Administrators)
The Care Guidance package includes the following modules/functionalities described in the sections below:
- Universal Platform Features
- Engagement Hub Features
- Care Guidance Features
- Ecosystem and custom integrations as further specified in the applicable Services Order Form
- Included Services
MODULES AND FUNCTIONALITIES
6. UNIVERSAL PLATFORM FEATURES
- Employer Branding: A Customer-branded user experience. Customer can select logo for display within the Castlight Platform, color to control key application elements, and standard onboarding screens that can vary by User segment
- Education Content: Consumer-oriented education content on a variety of conditions and health and wellness topics
- Reporting Dashboard: Self-serviced reports for the Customer’s benefits personnel to access on a twenty-four (24) hour basis via a web based dashboard. Dashboard has ability to filter data. Certain reports require a minimum number of participating Users. Dashboard includes reporting in the following areas:
- Registration
- Returns
- Visits
- Mobile usage
- Store, incentives and Rewards Center, budget tracking*
- Program reporting: Program adoption and behavior funnel*
- Challenges reporting: Adoption & behavior reporting tailored to each Challenge type*
- Search activity*
- Product Communications: Automated communications delivered to registered and unregistered eligible Users via multiple channels that provide tips on using the Castlight Platform (via web or mobile)
*Only available for packages which include Wellbeing features
**Only available for packages which include Care Guidance features
7. ENGAGEMENT HUB FEATURES
- Benefits Tab: A list of benefit programs available to the User, including details and contact information for each
- Personalized Recommendations: Recommendations based on Castlight’s personalization engine which connects Users to the targeted benefit program, behavior, care option, content, or incentive
- Communication Suite: A centralized, easy-to-use toolkit to create and deliver communications to Users (i.e. events, messages, and surveys)
8. WELLBEING FEATURES
- Incentives: Ability to offer points for specific actions, behaviors, or outcomes in different benefits programs or within the Castlight Platform that can be redeemed for rewards in the Rewards Center
- Customers may vary incentive designs for up to four (4) segments (which may be determined by employees, adult dependents, union employees, non-union employees, location, business unit, medical plan)
- Reward Center: A marketplace for redeeming points for rewards
- Customers may vary Reward Center design by the same segments as those selected for incentives
- Store: A marketplace for purchasing third party consumer tracking devices and other health related items
- Customers may vary credit for use in the Store by the same segments as those selected for incentives
- Challenges: Immersive and time-bound experiences designed to encourage healthy behaviors and habits through a fun and engaging participant experience
- Customers may launch Challenges company-wide or by the same segments as those selected for incentives
9. CARE GUIDANCE FEATURES
- Guided 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 (available list of supported inpatient and outpatient services is at Castlight’s discretion 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 estimated out of pocket costs and distance
- Provider information (e.g. provider specialty, quality ratings, board certification) for select providers
- Explanation and educational content on pricing and/or coverage for select outpatient services
- Care Team:
- Ability for Users to establish a “Care Team” of providers and facilities, make notes about those providers, and view tips about their Care Team
- Medical Claims History 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
- Insurance plan and coverage features for all supported medical plans:
- Key medical policy features
- Accumulator snapshots
- 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
- 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
- Pharmacy (Available based on Customer’s PBM)
- Drug information
- Estimated out-of-pocket drug pricing and pharmaceutical savings options
- Pharmaceutical claims history
- Care guidance for specialty drugs
- 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
- 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
- Engagement-Based Rewards*
- Incentives for registration and/or application-based action(s) undertaken by Users
- Displays Users’ incentive balance in both web and mobile applications
- Standard content on the Homepage and on the rewards webpage to encourage awareness of Engagement-Based Rewards program
- Standard email notification of Engagement-Based Rewards program launch to registered Users
*Whole Health Navigation, Complete Digital Hub, and Holistic Wellbeing packages will receive Engagement-Based Rewards as part of Incentives (see section 9)
ECOSYSTEM INTEGRATIONS
10. TWO-WAY DATA EXCHANGE INTEGRATION
Bi-directional integration of third party partners where Castlight sends contextual User data about Users to partners and Users can observe real-time completion for progressive actions in real-time within the Castlight Platform. The resale of such third-party products must be documented in an executed Services Order Form. Programs are either “Platform Service Provider” programs or “Custom” programs:
- Platform Service Provider (“PSP”) Integrations: Based on a product-level integration between Castlight and the PSP who is part of Castlight’s partner ecosystem. PSP programs include a pre-defined set of objectives which can be used to measure User progress and award incentive points. Castlight will guide Customer through the configuration options for each Castlight PSP program.
- Custom Integrations*: Allows Customer to include vendors outside the Castlight partner ecosystem. Custom programs prescribe a specific User flow and data intake format to facilitate a consistent and straightforward integration. Customer is required to assist with facilitating data integration discussions with the vendor, receiving commitment from vendor to complete integration, and ensuring that the vendor meets its obligations in completing the integration.
*Only for packages which include Wellbeing features
11. CONSUMER PROGRAM INTEGRATION*
One-way integration of third party consumer apps, devices, and services available in the Store where Users are rewarded in real-time for completing progressive actions in the Castlight Platform.
*Only for packages which include Wellbeing features
12. EDUCATION PROGRAM INTEGRATION
Allows Customer to guide participants through a program which rewards activities completed or self-attested directly within the Castlight Platform. No external data integration is implemented.
13. 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
14. PROGRAM LINKOUT
Embedded web link within the Castlight Platform to a third party site designated by Customer
15. EMBEDDED USER INTERFACE INTEGRATION*
- Health Fund Integration**
- 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
- 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 “Benefits” tab
*Only for packages which include Care Guidance features
**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
INCLUDED SERVICES
16. CUSTOMER SUCCESS SUPPORT
Ongoing consultative support focused on strategy, engagement, and growth delivered by the Customer’s Customer Success manager
17. STANDARD USER SUPPORT
User support team providing education, guidance and assistance on using the Castlight Platform via email and in-app chat support Monday through Friday (excluding holidays) 8AM – 9PM Eastern Time
- Email support for eligible Users available in English and Spanish, as well as language support for one hundred seventy (170) languages, in the following areas: (i) provide technical support (e.g. password reset, register for the Castlight Service); (ii) offer explanation of and/or navigation of available health benefits and how to use the Castlight Service; (iii) instruct Users on how to conduct searches within the Castlight Service*; (iv) provide explanation of claims information displayed in the Castlight Service*; and (v) assist registered Users regarding incentives**
*Only available for packages with Care Guidance features
**Only available for packages with Wellbeing features
18. ENGAGEMENT STRATEGY
Provide Customers with Castlight’s launch communications and engagement strategies, and assistance in developing an engagement launch plan
- Launch Support: Provide Customer with launch plan and campaign toolkits, registration support, playbook of email and print marketing content, print and digital launch communications, leadership team communications, training for customer teams, incentive and reward program tied to registration or usage of the Castlight Platform
- Training on Communication Suite: One (1) standard recorded training on how to leverage Communication Suite
- Ongoing Engagement Support: Castlight will support Customer 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
- Automated on-boarding and outreach emails to new eligible Users
- Partner with Customer to integrate the Service into Customer’s overall incentive/wellbeing programming with dedicated incentives and rewards tied to registration of the Service and/or usage, as feasible
19. CUSTOMER ANALYTICS
Provide Customers with Castlight’s launch communications and engagement strategies, and assistance in Semi-annual and annual reviews led by Castlight’s Analytics Team to help Customer understand and showcase its population’s engagement within the Castlight Platform and cost savings
20. INCENTIVES ADMINISTRATION*
Regular reporting on reward redemptions to Customer and to Castlight’s incentive fulfillment partner
*Only available for packages with Wellbeing features
21. CASTLIGHT PLATFORM INCENTIVE REPORTING*
Upon Customer’s written request, Castlight will provide User platform activity reporting to Customer’s incentive vendor(s)
*Only applicable for packages with Care Guidance features
22. IMPLEMENTATION
Implementation support from kickoff through launch of the Castlight Platform, delivered by an implementation team
- Castlight’s implementation of the Complete Digital Hub or Whole Health Navigation packages are described in the two (2) sub-sections immediately below
- Castlight’s implementation of the Holistic Wellbeing package is comprised of the following:
- Eligibility data management: scoping, data inclusion and business rules definition, testing, file approval
- Platform configuration and testing
- Program vendor management: data transfer scoping and configuration
- Demonstration and/or Test Account: provision of Demonstration and/or Test Accounts to Customer as agreed to in writing between the parties
- Castlight’s implementation of Care Guidance or Care Navigation packages 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 (as applicable)
- Customer Claims Feed: setting up a data feed for Customer’s TPA, PBM, MBHO or DBM (as applicable) 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)
- 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 party 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
23. USER ACCOUNT MANAGEMENT
- 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
- User password change/reset
- User e-mail address change
- User communication opt out options
BUY UPS
24. PREMIUM USER SUPPORT
Telephonic in addition to in-app chat and email support as described in the Included Services section. Telephonic support is available in English and Spanish, as well as language support for one hundred seventy (170) languages, for eligible Users, Monday through Friday (excluding holidays) 8AM – 9PM Eastern Time. Additionally, registered Users shall be entitled to third party support, outreach and communication as mutually agreed by Castlight and Customer.
25. PREMIUM ENGAGEMENT STRATEGY SUPPORT
Telephonic in addition to in-app chat and email support as described in the Included Services section.
- Support from a Castlight communications strategist to help develop and execute Customer’s specific launch plan and communications
- Up to two (2) User engagement planning meetings per Contract Year to discuss communications strategies and tactics
- Communications check-in meetings from kick-off to launch and for rollout launches
- Enhanced wellness champion guidebook that is updated with each new rollout
- Custom support for Communication Suite (e.g. survey design, copy support)
26. IN-APP TRANSLATIONS*
Standard and customer specific text for supported languages. Excludes Russian and right-to-left languages (e.g. Arabic)
*Only supported for packages with Wellbeing features
27. CUSTOMER-FULFILLED REWARDS
Customer may add its own rewards (e.g. company provided items) to Reward Center. For Customer fulfilled items, Castlight will provide winner report to Customer for Customer to manage fulfillment
28. 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
29. CASTLIGHT CARE GUIDES*
Includes all services set forth in the Premium User Support section above, with up to the following additions to be included as part of the Castlight Service:
- Non-Clinical Interventions by Castlight Care Guides (for inbound contacts only):
- Answering benefits and claims related questions
- Assistance with finding high-quality providers using the Castlight Service and appointment scheduling
- Promoting programs and facilitating enrollment
- Facilitating billing issues/disputes, claims appeal
- Clinical Interventions by Castlight Clinical Care Guides (for inbound and outbound contacts)**:
- Castlight Clinical Care Guides will include clinicians who support Users’ use of the Castlight Service and educate employees regarding medications, medical conditions and finding high-quality care, coaching users to the next step in their care journey. Castlight Clinical Care Guides will have insights into the clinical profile of the inbound caller to provide personalized support to address healthcare gaps.
- Outbound outreach to clinical segments shall be mutually agreed upon between Castlight and Customer
- Castlight will partner with Customer to launch and promote Castlight Care Guides to Customer population, in conjunction with in-application promotions of Castlight Care Guide benefits on the Castlight Platform
*Castlight Care Guides are included (no buy-up required) for the Care Navigation and Whole Health Navigation packages only
**Castlight Clinical Care Guides with a clinical background do not provide telemedicine service and do not practice medicine (e.g. Castlight Clinical Care Guides will not have the ability to prescribe medications, make a diagnosis or recommend a treatment).
30. ADDITIONAL EDUCATION PROGRAMS
Additional educational programs as described in Section 13 above.
SERVICE EXCLUSIONS
Subject to change from time to time at Castlight’s sole discretion, the Services exclude:
- 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)
- Single sign on capabilities, unless such specific capabilities are purchased and meet Castlight’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 with Castlight’s specifications
- Provision of the Service to persons other than Users unless otherwise agreed to by the parties in writing
- Printing and distribution of printed communications materials for Engagement Strategy related 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 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 requires a Services Order Form, including terms and conditions and additional fees to be mutually agreed to by the parties in writing.