In application of the provisions of Article 14, one, of the recast of the Law on Social Security of the Armed Forces, approved by Royal Legislative Decree 1/2000, of June 9, the Management of the Social Institute The Armed Forces entered into agreement with the National Institute of Social Security and the General Treasury of Social Security on 30 December 1986 and under the successive annual carry-over arrangements, in order to ensure that the members of the beneficiaries of the Special Regime of Social Security of the Armed Forces could receive the benefit of health care through the Health Network of Social Security, in accordance with the conditions in force for the General Regime.

Under the above mentioned precepts, the ISFAS, on the basis of public notice, also subscribed to certain insurance entities for the health care of holders and beneficiaries in 2010, with a view to extensions for 2011, 2012 and 2013, which was published by Resolution 4B0/38275/2009 of 10 December 2009 ("BOE" number 313, 29-12-2009), with the agreements between the Social Institute of the Armed Forces having been formalised on 27 October 2011. and the Entities that are listed in the First section of this Resolution, for which are extended for the year 2012.

For the purposes of the exercise of the powers conferred by Article 18 of the General Regulation on Social Security of the Armed Forces, approved by Royal Decree 1726/2007 of 21 December, and in order to facilitate the The choice of the holders of the ISFAS and in order that, in the event that they choose to be assigned to a Insurance Entity, they know the content and the regime of the benefit, it is agreed:

First.

Publish, as Annex I to this Resolution, the text of the Agreement extending for 2012 the Concert for the healthcare of beneficiaries of the ISFAS, which was signed on October 27, 2011 with the following Insurance Entities:

-ASISA, Insurance Interprovincial Health Care, Company Anonymous.

-Compañía Segurcaixa Adeslas, Sociedad Anonima de Seguros y Reinsurance.

Second.

Publish, as Annex II to this Resolution, the Addendum of modifications that are introduced in the wording of the Agreement for the extension of the Concert with the aforementioned Insurance Entities for the assistance health of the beneficiaries of the ISFAS for the year 2012, in order to facilitate their knowledge to the stakeholders.

Third.

To determine that, during the month of January 2012, the holders affiliated to the ISFAS who so wish may change the Attending Mode, through the appropriate application, so that, during this period, they may be assigned to any of the Insurance Entities related to the first paragraph, to avail of the Concert with the INSS and the TGSS when it is chosen to receive the assistance through the Health Network of Social Security or to be assigned to the Health Services Military, with the limitations set forth in Ministerial Order 52/2004, March 18.

The change referred to shall be requested by the holder, or duly authorized person, in the ISFAS Delegation or Subdelegation to whose scope it belongs or, in the case of Madrid, in any of the Delegated Offices, The membership document must be joined to the application for replacement. If this procedure is carried out by a person other than the holder, the representation must be credited.

The month of January of each year shall be unique for changes of Entity of an ordinary character, without prejudice to the extraordinary changes provided for in clause 1.7 of the Concerts and in the corresponding regulation specifies.

Madrid, November 2, 2011. -General Secretary of the Social Institute of the Armed Forces, Celia Abenza Rojo.

ANNEX I

Agreement between the Social Institute of the Armed Forces and various entities for which the Concional for the health care of the beneficiaries of the ISFAS, signed on December 10, 2009, is extended for the year 2012

MANIFEST

First.

That clause 7.1.2 of the Concert signed on 10 December 2009 between the ISFAS and the mentioned Entity for the healthcare of beneficiaries of the ISFAS during 2010, provides for the possibility of being extended for 2011, 2012 and 2013 by mutual agreement of the parties expressed in writing in the month of October of the previous year.

Second.

That both parties consider the extension to be appropriate for the coming year 2012 and that, to that end, the representative of the Entity declares under its responsibility that it maintains the conditions demanded for the signature of the Concert In Resolution 4B0/38234/2009 of 14 October, of the Social Institute of the Armed Forces, which called for the submission of applications by insurance entities to subscribe to the Concito with this Institute for Health Care Beneficiaries of the same period during 2010, with a forecast of extensions, published in the Bulletin State Officer " number 253, 20 October.

Third.

They also consider it appropriate to introduce into the Convention the amendments set out in Annex I, in order to achieve better coverage of the assistance needs of ISFAS affiliates.

By virtue of the above,

AGREE

First.

The concert concluded between the parties on 10 December 2009, for healthcare to the beneficiaries of the ISFAS during the years 2011, 2012 and 2013 (hereinafter the Concert), is extended in all its terms, except in As regards the amendments contained in Annex I, for the year 2012. The extension shall have effect from the zero hours of the day one January 2012 until the twenty-four hours of the day thirty-one December of that year.

Second.

In the wording of the Concerto, the modifications contained in Annex I, which are accompanied by this Agreement as an integral part of it, are introduced. In Annex II and in order to facilitate their easier access and knowledge to those concerned, the recast text in which the amendments referred to in Annex I are incorporated into the Convention shall be incorporated into the Convention, which shall apply from the date of one of the following: January 2012.

Third.

In accordance with the forecast of Base 8.1 of Resolution 4B0/38234/2009, of October 14, of the Social Institute of the Armed Forces, which calls for the submission of applications to sign a concert for the health care of beneficiaries of the same, during the years 2010, 2011, 2012 and 2013, this extension is subject to the suspension of adequate and adequate credit for the financing of the obligations arising from it.

And in sign of conformity, they sign two copies of this Agreement and of Annex I.

ANNEX II

Social Institute of the Armed Forces Concert with Insurance Entities for Health Care of holders and beneficiaries of ISFAS

Extension for 2012

ADDENDA OF MODIFICATIONS TO THE CONCERT

1. Amendments to Chapter 2. Portfolio of services

Clause 2.1.2 Services Portfolio Content.

The Podology is included, grouping it with Other Prstations.

2.1.2 Services Portfolio Content.

The Services Portfolio is the set of techniques, technologies or procedures, understanding each of the methods, activities and resources based on scientific knowledge and experimentation, through which Health benefits shall be effective.

The Services Portfolio that is the object of the Concert is structured into the following capabilities:

1) Primary Care.

2) Specialized Attention.

3) Emergency Care.

4) Palliative Care.

5) Bucodental health.

6) Healthcare transport.

7) Pharmaceutical delivery, dietetic products and other medical devices.

8) Other Benefits:

− Oxygenotherapy and other respiratory therapies.

− Orthopprostheses: diagnostic or therapeutic surgical implants.

− Preventive Programs.

− Podology.

Access to the services included in the Services Portfolio is guaranteed by the provision of the necessary care resources by levels and geographical and population areas as set out in Chapter 3 of this Article. Concert.

The entity will promote actions aimed at strengthening the coordination between primary care, specialized care and emergency services, in order to guarantee the continuity of care and the integral care of the patients.

Clause 2.3.3 Hospitalization in Interment Regime.

The amount of the daily compensatory amounts that are set out in section E) is updated relative to Hospitalization for pediatric care.

2.3.3 Hospitalization in detention.

.../...

E) Hospitalization for pediatric care.

Children under the age of 15 will be provided. In any case, the person accompanying the child shall be entitled to a bed and a companion alimony. In cases where the accompanying food pension is not provided by the centre, the Entity shall pay the holder EUR 25,89 per day.

When the companion resides in a municipality other than that of the health center and in addition the characteristics of the center do not allow its accommodation because it does not have the same or because the child is in the ICU, the Entity will pay the A compensatory amount of 49.45 euros per day. It shall not be paid when the accompanying person resides in the municipality where the hospital is located.

Clause 2.3.8 Mental Health.

The amount of the daily compensatory amount set out in paragraph B is updated for non-concerted central psychiatric income:

2.3.8 Mental Health.

.../...

B) Psychiatric hospitalization.

Hospitalization, including day care, will be prolonged for as long as the psychiatrist responsible for patient care deems it necessary and, therefore, up to hospital discharge and will cover all processes Acute as chronic. If the income is produced in a non-concerted place, no prior authorization of the Entity is required and, in this case, the same will pay to the affiliate the expenses of hospitalization with the limit of 84.07 euros per day. The refund shall be made within 10 working days of the date on which the beneficiary submits the supporting documents to the Entity.

Coverage of the social internment of patients affected by neurodegenerative dementias such as Alzheimer's and others is excluded.

However, the hospitalization of those patients who, suffering from some type of neurodegenerative dementia, requires psychiatric hospitalization due to inter-current or decompensation processes, will be attended. severe.

Clause 2.8.8 Quality of Pharmaceutical Prescription.

The indicators and objectives for the evaluation of prescription drugs are modified, adapting them to the current situation of the pharmaceutical supply:

2.8.8 Quality of the pharmaceutical prescription.

The efficient use of medicines, through the use of effective cost drugs, and the use of first-choice drugs in certain prevalent pathologies will be assessed in particular.

The assessment will be carried out by monitoring the following basic indicators for which minimum targets are set:

Percentage of drugs under the reference price system: Percentage of containers of medicinal products subject to reference price on the total packaging of dispensed medicinal products.

Use of first-choice antiulcerative drugs: Percentage of Omeprazole-dispensed DDDs, on the total Proton Pump Inhibitors.

Use of first choice hypolipemiants: Percentage of DDDs. dispensed from Simvastatin, Lovastatin, and Pravastatin on the total of Estatins dispensations.

The indicators and targets as well as the score assigned to each objective are detailed in the following table and can be modified by Resolution of the General Secretariat of the ISFAS.

Indicators

Indicator Value	Associated
prescription at reference price.	% Envases.	izq"> 10%-15%	3
% DDD Omeprazole.	70%-75%	1
	> 75%-80%	2
> 80%	3
Hipolipemants.	% DDD statins of choice.	30%-38%	1
		> 38%-40%	2
	40%	3

The cost of the tools and actions to be developed by the Entity for the achievement of the objectives of quality improvement in the pharmaceutical prescription will be financed by a monthly capitative fee, which be paid exclusively for the months in which the abovementioned basic indicators, obtained from the data of the prescriptions given to the collective assigned to the Entity, give rise to a total score equal to or greater than 4 points.

Clause 2.10.4 Podology.

This is introduced as a new clause to specify the limits of the Podology capability, which is included in the Services Portfolio.

2.10.4 Podology.

The podiological attention is included for insulin-dependent diabetic patients as well as for diagnosed patients with neuropathic foot of etiology other than diabetes.

The attention of the podiatrist requires medical prescription. The maximum number of sessions per patient and year will be six.

2. Amendments to Chapter 3. Means of the Entity.

Section 3.5 Service Catalog.

Clause 3.5.1. on general criteria is amended to ensure that the offer of services will be comparable to that which the Entity carries out for the collective of other Mutuals of Officials with which it has formalised Health Care Concerts.

3.5.1 General criteria.

The Service Catalog of the Entity contains the detailed relationship of the means of the Entity and the information necessary to enable it to be used properly by the beneficiaries. The Services Catalogues may be directed, in addition to the beneficiaries of the ISFAS, also to the collectives belonging to MUFACE and MUGEJU.

The content of the Service Catalog will be clear, complete and transparent, with all the optional and the assistance centers agreed by the Entity that have been offered for the subscription of the service. Concert.

In the Service Catalog, all the appropriate or concerted assistance means must be included that the Entity offers for the assistance of the collective of other Mutualities of officials with whom it maintains Health Care, considering all the assigned services effects for the assistance of the beneficiaries assigned to the Entity.

The Services Catalogs will not include advertising or advertising messages or information regarding other products or services of the Entity.

3. Amendments to Chapter 4. Use of non-concerted media.

Clause 4.3 Urgent Character Urgent Assistance.

The wording of clause 4.3.2 of the Concerto is amended, including certain urgent situations among the emergency cases of urgency.

4.3.2 Accident Assistance in Service Act and other special emergency situations.

It is always considered that it brings together the consideration of vital urgency and that the assistance received, if not used, has also the requirement provided for in the second paragraph of the above clause, the following special situations:

(A) The assistance specified by the holders of the ISFAS belonging to any Army or the Corps of the Civil Guard, for the purpose of injury or bodily harm suffered in the exercise of the functions of their activity or as a consequence or on the occasion of acts committed by persons integrated into organised and armed bands or groups.

B) When the beneficiary is in the public road or places and is activated, by person other than that or his family members in case he is accompanied, public health emergency teams 112, 061, etc.

C) When the activation of public health emergency equipment is performed by the state security bodies or other non-sanitary emergency structures (firefighters, etc.).

D) When the beneficiary suffers a road accident or accident of service and is treated by public health emergency teams at the place where it occurs.

E) When the beneficiary resides in a center of assisted care and the public health emergency teams are activated by the staff of the center, as long as that or his family has communicated to the center that for the medical assistance belong to the signatory Entity of this Concert.

F) When the beneficiary is a psychiatric patient, in a state of agitation, and the activation of the public health emergency device is performed by people outside the family. In the case of patients admitted as long as the patient or his family has communicated to the center that for medical assistance they belong to the undersigned Entity of this Concert.

4. Amendments to Chapter 7. Duration, economic regime and price of the Concert.

Clause 7.3 Concert Price.

The wording of clause 7.3.1 of the Concerto is amended to update the price of the Concert, as well as clause 7.3.3 relating to specific targets for meeting objectives, introducing a higher degree of graduality.

7.3.1 The composition of the population protected by this Concert has undergone significant variations, so that, in order to balance the inequalities produced, derived fundamentally from the evolution of the pyramid of the age of the ISFAS collective, during the term of this Concert, the payment is made according to the following parameters:

(a) In 2012, the ISFAS shall pay the Entity the amount of EUR 85 per month, for each protected beneficiary who was 70 or more years of age at twenty-four hours on the last day of the previous month to which the payment corresponds, according to the high and low criteria that are set out for economic purposes in clause 7.2.1.

(b) In 2012 ISFAS shall pay the Entity the amount of EUR 68.23 per month, for each protected beneficiary who is under 70 years of age and over 60 years of age at 24 hours on the last day of the month preceding the date of corresponds to the payment, according to the high and low criteria which for economic purposes are set out in clause 7.2.1.

c) Likewise, in 2012 the ISFAS will pay the Entity the amount of 57.76 euros per month, for each protected beneficiary that is under 60 years of age at the end of the month of the last day of the month preceding the one corresponding to the payment, according to the high and low criteria which for economic purposes are set out in clause 7.2.1.

The amounts will be met by concept 14.113.312E.251, within the Agency's budgetary availabilities.

7.3.3 Target-specific quotas.

.../...

b) The quota associated with objectives of improvement in the quality of the pharmaceutical prescription.

The months in which a score equal to or greater than 4 points is reached for the fulfilment of the objectives defined in clause 2.8.8 shall be paid an additional fee per person per month, the amount of which shall be in relation to the scoring that is reached, according to the following scale:

− 4 points: € 0.20 fee.

− 5 points: € 0.30 fee.

− 6 points: share of 0.35 euros.

− 7 points: € 0.45 share.

− 8 points: € 0.55 share.

− 9 points: EUR 0.60 share

− 10 points: € 0.65 fee.

The payment of the quotas associated with the achievement of objectives will be carried out monthly, but for the assessment of the achievement of objectives of the corresponding month (month n), the data obtained will be taken into account from the recipe billing for the month n-2.

5. Amendments to Annex 6. Additional primary care and emergency mode.

The fourth paragraph is amended to update the fees to be paid in 2012 for the services corresponding to this Mode.

ANNEX 6

Primary and emergency care supplementary mode

Fourth.

The price to be paid for the care services corresponding to the Primary and Emergency Care Mode (Mode C) for the year 2012 will be as follows:

(a) In 2012, the ISFAS shall pay the Entity the amount of EUR 15,42 per month, for each beneficiary under Mode C who was 70 or more years of age at 24 hours on the last day of the month preceding the date of corresponds to the payment, according to the high and low criteria which for economic purposes are set out in clause 7.2.1.

(b) In 2012, the ISFAS shall pay the Entity the amount of EUR 12.55 per month for each beneficiary assigned to the Mode C which is less than 70 years and over 60 years of age at 24 hours on the last day of the month prior to which the payment corresponds, according to the high and low criteria which for economic purposes are set out in clause 7.2.1.

c) Likewise in 2012, the ISFAS will pay the Entity the amount of 10.77 euros per month, for each beneficiary assigned to the Mode C that was less than 60 years of age at twenty-four hours on the last day of the month before corresponds to the payment, according to the high and low criteria which for economic purposes are set out in clause 7.2.1.

This price will be updated, in case of extension, to the same extent as the price of the Concert for full assistance.