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DocuSign Envelope ID: 7F8DFDB2-D81A-4AOF-AF96-9B69F601FC96 <br /> Exhibit A <br /> • Eight weeks of nicotine replacement therapy (NRT), based on participation in counseling sessions: <br /> four weeks sent to the Orange County participant home address via UPS upon completion of the <br /> first telephone counseling call (45 min.) and an additional 4 weeks sent via UPS if the Orange <br /> County Health Department participant completes second counseling call. <br /> OR <br /> • Four weeks of NRT sent to Orange County participant home address via UPS upon <br /> completion of the first telephone counseling call. <br /> • An information packet which includes a quit tobacco use guide will be mailed to all participants <br /> completing the screener call. Those who complete the first counseling call and are approved for NRT <br /> will also receive simplified instructions along with the NRT kit. <br /> QuitlineNC Reports <br /> The Orange County Health Department has requested the following reports: <br /> • Monthly aggregate report on services provided, corresponding costs paid with funds from <br /> Orange County Health Department, and remaining balance of funds. Report includes # of <br /> Orange County participants served, by month and year to date, as well as demographics <br /> information, services offered, and amount and type of NRT sent to participants. <br /> Costs for Services, Protocol/Database Changes,Verification,and Outcome Evaluation <br /> Alere Wellbeing, Inc. ("Alere") is the prime vendor to QuitlineNC. Alere, while contracted with the TPCB, <br /> will provide QuitlineNC services, including up to 8 weeks of Nicotine Replacement Therapy, at State specific <br /> unit cost rates. This is a cost-sharing agreement, whereby selected services will be paid by the Orange <br /> County Health Department,while other services will be provided by the TPCB at no cost to the Orange <br /> County Health Department, as shown below: <br /> Pricing structure <br /> Nicotine Replacement Unit Costs 4 weeks 8 weeks <br /> Patches $48.00 per $48.00 $96.00 <br /> shipment <br /> Gum $30.00 per box $90.00 $150.00 <br /> Lozenges $38.00 per box $152.00 $190.00 <br /> Combination Therapy - 4 $108 per 4 weeks $108.00 $156.00 <br /> wks patches and two <br /> boxes of gum <br /> In addition, an Administrative fee equal to 5%of the total contract price will be charged for the cost of <br /> administrative services including the monthly cost and aggregate service reports. <br /> 2 <br />