HomeMy WebLinkAboutGREATWEST - CONTRACT - RFP - P832 BENEFITSADMINISTRATIVE SERVICES CONTRACT
BY AND BETWEEN
CITY OF, FORT COLLINS
(Herein called the Client)
AND
GREAT -WEST LIFE & ANNUITY INSURANCE COMPANY
(Herein called the Service Contractor)
Whereas, the Client desires to provide benefits for certain classes of individuals (hereinafter called "Members") in
accordance with a written employee welfare benefit plan established by the Client;
Whereas, under said plan the Client will bear all liabilities but desires that the Service Contractor provide certain services
in connection with the administration and operation of the plan without assuming any such liability (hereinafter called "the
Plan");
Whereas, the Plan is an employee benefit plan and the Client, who is both the fiduciary of the Plan and the Plan
Administrator, hereby retains the Service Contractor to provide services for the Plan in accordance with the following
terms and conditions;
Now, therefore, in consideration of the payments to the Service Contractor as provided in the Payment Schedule,
Appendix A, and subject to the terms and conditions contained herein, it is hereby agreed as follows:
Section 1. Definitions
As used in this Contract, its Appendices and Attachments:
a. Affiliate" means a person or entity within the same common control group as determined under Internal
Revenue Code section 414(c) and the regulations thereunder, and for Service Contractor includes a
person or entity with whom the Service Contractor operates under a joint marketing or joint venture
contract.
b. "Claim Overpayment" is a claim payment, or a portion thereof, with a minimum amount of $250, that
(based on applicable Plan terms and provisions):
i. is in excess of the benefit amount otherwise payable;
ii. should not have been paid; or
iii. is paid to wrong payee(s).
C. "Health Information" means any information related to health care treatment, payment or operations that
identifies or could reasonably be used to identify a Member.
d. "Plan Administrator" shall have the meaning ascribed to the term "administrator" as defined in ERISA
and shall have a comparable meaning for non-ERISA plans,
e. "Plan Month" shall mean a calendar month.
11.3 Termination Upon Notice. This Contract may be terminated:
a. at any time by either the Service Contractor or the Client, provided written notice of such
termination is given at least ninety (90) days in advance of the effective date of the termination;
b. upon amendment of the Plan irk a manner deemed unsatisfactory by the Service Contractor, and
on notice to the Client, sucl)l termination shall be effective on the effective date of such
amendment.
11.4 Immediate Termination. This Contract shall terminate immediately and without notice:
a. at the option of the Service Contractor upon termination of the excess loss policy, if any;
b. upon failure of the Client to:
i. make payments set forth in Section 4 of this Contract, entitled `Payments to the Service
Contractor'; or
ii. fund the Transfer 'Account, in which instance the Service Contractor shall solely
suspend plan operations for a period not to exceed twenty-four (24) hours, during which
time the Client shall fund the Account in full.
11.5 Reinstatement after Termination. If the Service Contractor terminates this Contract under Section 11.3 or 11.4,
and the Client desires to reinstate this Contract, it will be reinstated only if:
a. the Service Contractor agrees; and
b. the Client pays a Reactivation Fee of the greater of five hundred dollars ($500) or two percent
(2%) of the average amount of the monthly claims for the last three months; and
C. the Client pays all outstanding amounts plus interest accruing from the date of termination at the
rate of the lesser of one and one-half percent (1.5%) per month or the maximum allowed
pursuant to state law; and
d. the Client reimburses the Service Contractor for any network access fees required to be paid by
the Service Contractor on behalf of the Client following termination of this Contract.
11.6 Termination by Law. If any state or other jurisdiction enacts a law which prohibits or effectively prevents the
continuance of this Contract, or the existing law is interpreted by a governmental entity to so prohibit or
effectively prevent the continuance of this Contract, the Contract shall terminate automatically as to such time or
jurisdiction on the effective date of such law or interpretation.
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11.7 Termination for Breach. In addition to the foregoing, if one Party has materially breached this Contract (the
"Breaching Party") and the other Party (the "Nonbreaching Party") desires to terminate this Contract, the
Nonbreaching Party shall give the Breaching Party specific written notice of the nature of the breach. The
Breaching Party shall have 30 days to cure such breach. If the breach remains uncured 30 days following the
notice of breach, this Contract shall terminate as of the end of such 30 day cure period. This Section shall not
apply to immediate breaches as set forth in Section 11.4 above.
11.8 Effect of Termination.
H
11.8.1 If on the date this Contract terminates the Client has not made all payments then due under this
Contract, the Service Contractor will have the right to immediately stop providing the Services, including
but not limited to processing claims, on the effective date of such terminatiop: In this case, information
regarding all outstanding claims which are unpaid (regardless of when the claim was incurred and
regardless of when the Service Contractor received the claim) or received after such date will be
returned by the Service Contractor to the Client. In addition, the Client will notify each Member covered
under the Plan of such termination.
11.8.2 Upon termination of this Contract or upon termination of individual Employee or Dependent coverages, it
is the Client's responsibility to take reasonable steps to prevent further use of I.D. cards, including
prescription drug cards, if applicable, by any Employees or their Dependents. post termination. If the
Client fails to update the eligibility records in a timely manner using BENLink, the Client will be -
responsible for reimbursing the Service Contractor for any claims incurred by the Service Contractor on
behalf of a former Member who retains and uses a health plan card or a, prescription drug card after
Coverage ends under the Plan.
11.8.3 With respect to claims incurred prior to and not processed before termination of this Contract, the
Service Contractor shall not be responsible for adjudicating the claims unless Service Contractor agrees
in writing to do so and the Client pays the terminal fee set forth in Appendix A. Such adjudication shall
be limited to claims incurred prior to the termination of this Contract and submitted for, consideration
within the 15-month period immediately following the termination date. If the Service Contractor does
not process such claims, then the Service Contractor will send the claims to the Client or to Client's
designated representative upon request.
Section 12. Subcontracting
The material and significant duties to be performed by the Service Contractor under this Contract may, with the prior
approval of the Client, be performed directly, wholly or in part, under a contract with an organization of the Service
Contractor's choosing. Such approval shall not be unreasonably withheld. Except as provided above, the Service
Contractor may, at its discretion, contract with any organization to perform any other duties under this Contract.
Section 13 Compensation to Agents or Brokers
The Client acknowledges that Service Contractor may pay reasonable compensation to the agent or broker of record, if
any. Any and all agents and brokers are hereby declared to be (an) agent(s) of the Client and not of the Service
Contractor. The Client shall notify the Service Contractor, in writing, if the Client changes its agent or broker.
Section 14. Advertising
The Client will not use Service Contractor's name in any release or printed forms unless approved in advance by the
Service Contractor. The Service Contractor will not use the Client's name in any release or printed forms unless
approved in advance by the Client.
Section 15.Other Financial Provisions
15.1 Savings Initiatives.
15.1.1 In its sole discretion, Service Contractor may undertake initiatives in addition to the services described in
this Contract for the purpose of saving additional money for the Plan. Examples of such initiatives might
include, but are not limited to subrogation and right of recovery, provider and incentive bonus
arrangements, and provider bill/fee negotiation and discounts on claims from providers outside of the
Service Contractor's primary network of providers.
15.1.2 For purposes of pursuing savings under this provision, the'Service Contractor may retain third party
vendors.
15.1.3 For its services in obtaining savings fothe Plan, Service Contractor shall be entitled to retain:
a. for subrogation and right of recovery, the amount referred to in 15.2 below; and
b. for all other savings initiatives, 25% of the savings realized.
Such charges are reflected as a claim expense for the applicable Member.
15.2 Subrogation and Right of Recovery. For purposes of subrogation and right of recovery, the Service Contractor in
consultation with the Client, will have the sole right to make claims under the Subrogation and'Right of Recovery
Provision contained in the Plan. In its sole discretion, the Service Contractor may litigate, negotiate, settle,
compromise, release,or waive any such claim. The Client hereby assigns to the Service Contractor all of its
rights to make, litigate, negotiate, settle, compromise, release or waive any such claim.
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Recoveries under this Section will be distributed as follows:
a. first, to the Service Contractor to be applied to reduce the Service Contractor's payment of
specific stop -loss benefits under the ,excess loss contract, if any, issued by the Service
Contractor to the Client for the employee or dependent for whom the recovery was obtained;
and '
b. second, to the Service Contractor to be applied to reduce the Service Contractor's payment of
aggregate stop -loss benefits under the excess loss contract, if any, issued by the Service
Contractor to the Client, and
C. third, 25% to the Service Contractor for its services in obtaining the recovery; and
d. fourth, the remainder, if any, to the Client.
Action taken under the Subrogation and Right of Recovery Provision contained in the Plan may result in incurring
legal expenses. Such legal expenses will be borne by the Service Contractor and the Client in the same
proportion as any money recovered under the Subrogation and Right of Recovery Provision and is distributed
between the Service Contractor and the Client. Legal expenses will not be included in the calculation of specific
stop -loss benefits, or the aggregate stop -loss benefits, if any, pursuant to the excess loss contract issued by the
Service Contractor to the Client.
15.3 Compensation from Others. The Client acknowledges that in addition to the fees charged to the Client under
this Contract, the Service Contractor may recei�Ae compensation from health care providers and vendors that
contract with the Service Contractor. Such compensation may be paid to Service Contractor to defray its
expenses in performing its duties under this Contract and for providing services for the providers or vendors in
accordance with their contractual arrangements. The Service Contractor shall be entitled to receive and retain
such compensation from the providers or vendors regardless of the form or manner in which it is received.
15.4 Access Fees. The Service Contractor may negotiate arrangements with third parties to provide Members
services and benefits that are not otherwise covered under the Plan. The Service Contractor may retain any
fees received from the third parties pursuant to their contractual arrangements.
15.5 Surcharge Payment. For any state in which a surcharge payment is required to be made to that state, to fund
medical care for uninsured populations, finance the operation of risk pools or other purposes required by the
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state, Service Contractor shall render such payments in accordance with that state's requirements and shall
draw such funds from the Transfer Account.
Section 16. Miscellaneous
16.1 Reliance: ,The Service Contractor shall be entitled to rely upon any communication believed by the Service
Contractor to be genuine and to have been signed or presented by the proper party or parties. For verification of
persons eligible for the coverages provided under the Plan, the Service Contractor will rely solely upon
information in its computer records at the time eligibility verification is requested. These records will be based
upon eligibility information provided to the Service Contractor by the Client.
16.2 Notices. Any notice which may be given under this Contract shall be in writing and may either b�b personally'
delivered, sent by registered or certified mail through the United States Postal Service, return receipt requested,
or by reputable overnight carrier, delivery prepaid addressed as follows. A notice so delivered shall be deemed
given on the date of delivery if personally delivered or delivered by overnight carrier, and on the date indicated
on the return receipt if delivered by the United States Postal Services.
16.2.1 To the Service Contractor:
GREAT -WEST LIFE & ANNUITY INSURANCE COMPANY
Denver National Accounts Department, Employee Benefits
8505 E. Orchard Road
Greenwood Village, CO 80111
With a copy to
GREAT -WEST LIFE & ANNUITY INSURANCE COMPANY
General Counsel
8525 E. Orchard Road
Greenwood Village, CO 80111
16.2.2 To the Client:
CITY OF FORT COLLINS
215 North Mason, 2" Floor
PO Box 580
Fort Collins, CO 80522-0580
Phone number: (970) 221-6843
16.2.3 A party's address may be changed by notice to the other in accordance with this section.
16.3 ' ,Waiver. Failure by the Client or the Service Contractor to insist upon compliance with any provision of this
Contract at any given time or under any given set of circumstances shall not operate to waive or modify such
provision or in any manner render it unenforceable, as to any other time or as to any other occurrence and no
waiver of any of the terms or conditions of this Contract shall be valid or of any force or effect unless contained in
a written instrument specifically expressing such waiver and signed by a person duly authorized to sign such
waiver.
16.4 Amendments. Except with respect to modification of fees as described in Section 4 of this Contract, no alteration
or modification of the terms and conditions of this Contract shall be valid or of any force or effect unless in each
instance it is contained in a written instrument expressing such alteration or modification and executed for the
Client and the Service Contractor by their officers duly authorized to execute such alteration or modification.
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16.5 Assignment. Other than assigning the right to receive money, neither party shall transfer its rights or delegate its
duties under this Contract except as permitted elsewhere in this Contract, without the express written consent of
the other party; provided, however, that the Service Contractor may transfer any portion of its rights or delegate
any portion of its duties under this Contract to its Affiliate. The Client's reorganization, any merger in which the
Client is not the surviving company, and any transfer of the Client's assets whether by bulk sale or otherwise,
shall be deemed to be a transfer or delegation by Client. Any transfer or delegation by a party in violation of this
Section shall be void and of no force or effe t and shall entitle the other party to immediately terminate this
Contract.
16.6 Inurement. This Contract shall be binding upon and shall inure to the benefit of the parties hereto and their
permitted respective successors and permitted assigns and delegates.
16.7 Force Majeure. In the event that either party is unable to perform under this Contract on account of strikes,
accidents, acts of Nature, severe weather conditions, fire, governmental restrictions, computer system failure or
any other reason which is beyond the reasonable control of the parties, then performance under this Contract
shall be excused for a reasonable period of time to enable the parties to resume performance. If a party is
unable to resume, its�,performance within such reasonable period of time, the other party may terminate this
Contract as provided herein.
16.8 Entire Contract. This Contract, including any schedules, appendices or supplements thereto, (together with the
Great -West Life & Annuity Insurance Company Application for Group Coverage and other attached papers, if
any), shall constitute the entire contract between the parties and shall govern the rights, liabilities and obligations
of the parties hereto, except as it may be modified in. accordance with the provisions of this Contract. This
Contract supersedes all prior proposals, representations, communications, negotiations and contracts between
the parties, whether oral or written.
16.9 Controlling Law. This Contract shall be construed and enforced according to the laws of the state of Colorado to
the extent that such laws are not preempted.
16.10 Provisions Separable. The provisions of this Contract are independent of and separable from each other. In the
event any provision of this Contract shall be held illegal, invalid or unenforceable in whole or in part, for any
reason by law or a court of competent jurisdiction, said illegality or invalidity shall not affect the remaining parts of
this Contract, but it shall be construed and enforced as if said illegal or invalid provisions had not been included
herein either initially, or beyond the date it is first held to be illegal or invalid if after the effective date of this
Contract, provided the basic purposes hereof can be effectuated through the remaining valid and legal
provisions.
16.11 Gender and Number. Any reference in the masculine gender herein shall be deemed to also include the
feminine gender, unless expressly provided otherwise. Wherever appropriate, any reference in this Contract in
the singular shall include the plural, and any references in the plural shall include the singular.
16.12 Counterparts. This Contract may be executed in any number of counterparts, each of which shall be deemed an
original, and said counterparts shall constitute b6tbne and the same instrument.
16.13 Currency and Place of Payments. All sums payable to, or payable by, the Service Contractor pursuant to this
Contract shall be payable in the lawful currency of the United States of America at its Greenwood Village,
Colorado office.
16.14 Headinos. Section, sub -section or paragraph headings contained in this Contract are for reference purposes
only and shall not affect the meaning or interpretation of this Contract.
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IN WITNESS WHEREOF, the parties hereto have caused this Contract to be executed by their respective officers duly.
authorized to do so, to be effective as of January 1, 2003.
Dated at �� i C1NS LC-) , this ---t'
(City) (State) (Date)
day of�-�1_����
(Month) (Year)
Qitq Clerk
THE CITY OF FORT COLLINS, COLOR/A/DO
By: Q�2
a - ! +� X, - v
John . Fischbach
City Manager
By: J v/�` "�
y�
Jam s B. 'Neill II, CPPO, FNIGP
Direct r of urchasing & Risk Management
APPRQV D AS TO FORM: GREAT -WEST LIFE & ANNUITY INSURANCE COMPANY
Assistari ity Ktrorney
By:
D. (2. fie^ .. ��
Secretary
August 25, 2003
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Appendix A
Payment Schedule
To be attached to and made a part of the Administrative Services Contract
Effective Gate January 1, 2003
By and between
CITY OF FORT COLLINS
AND
GREAT -WEST LIFE & ANNUITY INSURANCE COMPANY
Service Fees Schedule.
The Service Contractor shall have the right to adjust the, fees listed below as specified under Section 4 of the Contract.
A. The Client shall make payments to the Service Contractor in advance for service fees listed below by the first
day of each Plan month in which the Service Contractor performs the listed services. A grace period of 30 days
is granted after such monthly payment due date.
Services Provided as described in Provided as described in A�endix BB:
Includes:
Basic Claims Adjudication Services,
Direct Claim and Verification Service, and
Actuarial and Underwriting Services
('Basic ASO Service Fee")
Care Management (includes Utilization Management and Case Management)
Disease Management
Maternity Management
Access to Managed Health Care Network
Certificates of Creditable Coverage
Document Preparation
BENLink
I.D. Cards
Prescription Drug Card Service
II
The monthly amount due will be determined as follows for the Plan Year beginning on January 1, 2003 and ending on
December 31, 2003:
For Employees Covered under the PPO Plan
For Employees Covered under the POS Plan
For Employees Covered under the POS Vision Plan
$ 21.78
$ 26.03
$0.80
The monthly amount due will be determined as follows for the Plan Year beginning on January 1, 2004 and ending on
December 31, 2004:
For Employees Covered under the PPO Plan
For Employees Covered under the POS Plan
$ 27.88
$ 32.43
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For Employees Covered under the POS Vision Plan $ 1.00
.Of these fees, the Basic ASO Service Fee of $17.79/POS employee and $16.53/PPO emploype is subject to the 2003
IN Performance Standards Program as described in Appendix D.
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B. The Client agrees to compensate the Service Contractor for services listed below as follows:
Amount Due
Subrogation and Recovery 25% of all recovered amounts
The Service Contractor reserves the ri ht to offset the amount due for this service against recovery
amounts.
2. The cost of customized or bulk printing will be billed as charged to the Service Contractor for any
documents not specifically listed in Appendix B.
3. The cost of any mass mailings to plan participants will be billed separately.
C. For the adjudication of claims incurred prior to the termination of this Contract and submitted for consideration
within the15-month period immediately following the termination date, the Client shall pay to the Service
Contractor an administrative fee of :
$63.46 per Employee for the 2003 Plan Year beginning on January 1, 2003 and ending on December
31, 2003, and
$73.95 per Employee for the 2004 Plan Year beginning on January 1, 2004 and ending on December
31, 2004
on the first day of the'last Plan month prior to the end of this Contract.
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Appendix B
Services to be Provided by the Service Contractor
To be attached to and made a part of the Administrative Services Contract
Effective Date January 1, 2003
By and between
CITY OF FORT COLLINS
AND
GREAT -WEST LIFE & ANNUITY INSURANCE COMPANY
The Service Contractor will perform the following services which are included in the Basic ASO Service Fee:
Basic Claims Adjudication Services and Direct Claim and Verification Service
These Basic Services provide for the processing of all claims incurred and received while this Contract is ih force. The
services to be performed by the Service Contractor are:
1. Preparation of claim checks and Explanation of Benefit forms on a universal check form to be mailed by the
Service Contractor;
2. Claims and correspondence and telephone inquiries come directly to the Service Contractor; claim checks and
correspondence are mailed directly to employees and/or assignees; copies of Explanation of Benefit forms are
sent to the Client upon request;
3. Maintenance of individual benefit records for determination of plan benefits and satisfaction of deductibles;
4. Follow up for additional medical or service information from provider;
5. Coordinate benefit payments with other employee plans;
Preparation of IRS Reports (1099) Medical Provider Fees;
7. Claim control practices; and
8. Verification of eligibility as to coverage and benefits.
9. Maintenance of records for the determination of overutilization or plan abuse by users and providers.
Ill
The first "Plan Year" shall begin on January 1, 2003 and shall continue until the beginning of the second
Plan Year. The second Plan Year shall begin on January 1, 2004 and successive Plan Years shall begin
with the anniversary of such date.
Section 2. Services I
The Service Contractor will provide the services listed in Appendices B through F subject to modification as provided
herein, for the administration and, operation of the Plan; such services'will be coordinated by a representative of the
Service Contractor to assure effective and efficient operation of the Plan.
It is understood that the Service Contractor performs purely non -discretionary and ministerial functions for the Client
within a framework of policies, interpretations, rules, practices and procedures made by the Client. The Service
Contractor shall perform Services in accordance with the terms of the Plan, including but not limited to the terms of the
summary plan description (SPD).
Any review by the Service Contractor of a claim or of charges declined is made as a service for the Client, who retains
the final responsibility for determining its liability under, the Plan.
If the Client has not adopted a final SPD, the Service Contractor will process benefit payments in accordance with its
standard policies and procedures for the benefits selected by the Client as set forth on the master application form or
prior carrier booklet with appropriate modifications. When following such standard policies and procedures, the Service
Contractor will not be responsible for any act taken that may conflict with the terms of the SPD that is ultimately adopted.
However, in the event that the Client amends its Plan to include items that the Service Contractor cannot administer,
nothing herein shall be construed to require the Service Contractor to so administer said amendments but, rather, this
Contract shall remain in full force and effect as if said amendments had not been made. In the event a Plan amendment
is administratively burdensome. for the Service Contractor to administer, a charge may be imposed or other fees, as
applicable, may be adjusted pursuant to the Client's knowledge and consent.
Section 3. Banking Arrangements
3.1 Establishment and Maintenance of Transfer Account. The Client shall establish and maintain a bank account
("the Transfer Account") with sufficient funds to comply with section 3.2 below. The Client shall make available
funds in the Transfer Account sufficient to honor all of the Client's obligations under this Contract.
3.2 Rioht of Service Contractor to Demand Monies from Transfer Account. The Service Contractor shall have the
right to demand monies from the Transfer Account on a weekly with week delay basis in an amount sufficient to
satisfy all of the Client's obligations under this Contract incurred as of the date of demand, including:
a. past due, overdue or other unsatisfied obligations, if any; and
b. benefit claims paid by the Service Contrdctor to Members who were not eligible for Plan benefits and
with respect to whom the Client does not in a timely manner notify Service Contractor of such Member's
lack of eligibility.
The Service Contractor shall not be authorized to demand monies from the Transfer Account for any purpose
other than in order to satisfy the Client's obligations as set forth in this Contract.
3.3 Notice to Bank of Service Contractor's Rights. The Client shall notify the bank:
a. that the Client has authorized the Service Contractor to demand monies from the Transfer Account;
2
Actuarial and Underwriting Services
This includes those services which concern th'e pricing of benefit types and the actuarial estimate of the incurred but
unreported claim reserve. Such services include:
1. Benefit design advice;
2. Annual re -rating of the existing plan;
3. Pricing proposed benefit plan alternatives; an�
4. Advice on the expected financial results of plan changes.
The Service Contractor will perform the followinq services which are riot included in the Basic ASO Service Fee:
Document Preparation
Document Preparation includes basic drafting which consists of preparation of the employee Summary Plan Description.
The cost of printing the Summary Plan Description and other documents if any is included.
I.D. Cards
Identification cards will be prepared for enrolled employees based on eligibility information provided by the Client.
Certificates of Creditable Coverage
In accordance with federal regulations, individuals will be provided with Certificates of Creditable Coverage at specified
times which will contain documentation of prior coverage including coverage period.
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Appendix C
Managed Care Services
(Not Included in the Basic ASO Service Fee)
To be attached to and made a part of the Administrative Services Contract
Effective Date January 1, 2003
By and between
CITY OF FORT COLLINS
AND
GREAT -WEST LIFE & ANNUITY INSURANCE COMPANY
Managed Care
Programs. The Service Contractor agrees to provide services to allow the Client to establish the following
programs under its Plan:
a. Provider Network. A Provider Network consisting of participating hospitals, physicians, other health care
professionals and other types of providers as appropriate (collectively called "Providers"). A higher level
of benefits is typically paid when the Member receives covered health care services from the Provider
Network or as otherwise set forth in the Plan
b. Medical Management. A medical management program known as Care Management ("CM"). A care
manager will assess the health care needs of a Member with a long-term and/or complex illness or
injury, develop appropriate discharge plans, and coordinate needed medical services. A care manager
will also review medical necessity and appropriateness of care though pre-treatment authorization of
inpatient hospitalization and certain outpatient procedures, review of continuinghospital stays, and an
appeal process. Written notice will be promptly provided to the Member, the hospital where appropriate,
and the treating physician of the status of each authorization.
C. Subcontractors. The Service Contractor may occasionally utilize services of subcontractors to assist
with assessment of the case. Payment of said subcontractor fees will be the responsibility of the Client.
However, the Service Contractor will be liable for payment of the subcontractor fees if the benefits
payable exceed the applicable amounts pursuant to the excess loss contract.
The Service Contractor will develop mechanisms for early identification of potential cases to benefit from
the CM program. In the CM Program, the Members' individual needs are assessed with both the
Member and the attending physician. An alternative treatment -plan to traditional care is developed and
presented to the Member and family members and the physician for approval. The alternative treatment
plan is implemented via coordination by the CM medical professionals. Claims reflective of the
alternative treatment plan are submitted and reviewed by the CM Program. The CM Program monitors
the medical necessity of the care until case closure.
The Service Contractor is not required to seek Client's approval prior to the implementation of any
alternative treatment plan where:
i. all expenses to be payable under the alternative treatment plan are normally covered under the
Client's Plan; or
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ii. with respect to the Client who has a separate excess loss policy in effect with the Service
Contractor covering its excess loss under the Plan, expected benefits payable outside or within
the alternative treatment' plan exceed the applicable stop loss protection. point.
In all cases, the Client agrees that expenses for the alternative treatment plan may be included as
eligible expenses even if they are not included as such under the Client's Plan.
d. Adverse Determination/Additional Revi�L If a Member receives an adverse determination under one of
these programs and seeks additional review (as entitled by law or by the terms of the Plan), by a third
party or an independent utilization review organization, any cost or fee for such additional review shall be
billed to the Client or charged against the Transfer Account.
2. Provider Network Product(s
a. Networks. The Service Contractor shall contract with one or more networks of Providers to furnish
health care services in conjunction with the Provider Network Product.
b. Availability and Incentives to Members. 'The Service Contractor shall offer and the Client shall make the
Networks available to Members. It is the duty and responsibility of the Client to include in the Plan
incentives and/or disincentives to Members to encourage use of the services of the Networks.
C. Provider Network Directories. The Service Contractor shall include a listing of Network Providers on the
OneHealthPlan.com website, which will be periodically updated to reflect changes in the participation of
Providers.
d. Standard and Character of Performance. The Service Contractor, through its contracts with Networks,
shall use customary and reasonable care and proper diligence in the performance of its services under
this Appendix. ;For purposes of this contract, the Client will be deemed the "Administrator" and "Named
Fiduciary" of the -Plan.
3. Disease Management Program for Chronic Medical Conditions
Ir
a. The Service Contractor, through its own employees, Affiliates and/or employees of contracted third -party
vendor(s), will provide Disease Management services to Members identified as and consenting to be
service recipients under the program.
b. The Service Contractor, through its own employees, Affiliates and/or employees of contracted third -party
vendor(s), will perform an initial identification of Members meeting predetermined medical criteria
indicating the potential to be service recipients. This identification process will be based on information
legally obtained through claims, Members' self -referral or other valid sources.
C. The Member who consents and is accepted into the program ("Participant") will receive services
consisting of assessment and education t?r targeted diseases. The services are designed to enable the
Participant to gain knowledge and skills necessary to prevent severe chronic medical conditions,
manage his or her life-long condition and improve quality of life. The program does not provide medical
treatment, therapeutic services or hands-on home nursing. The program neither warrants nor
guarantees the well-being or improvement of the Participant's chronic medical condition.
d. The Client agrees to provide 100% benefit reimbursement under its Plan, without application of the
deductible or copayment, for all services received under the disease management program. The benefit
reimbursement amount does not apply to the Member's lifetime maximum under the self -funded plan.
"Chronic Medical Condition" means an illness for which there is no cure; however, medical treatment is available.
It is a long-term illness that does not ordinarily pose an immediate threat to one's life. Chronic medical conditions
covered under this program may include, but are not limited to, intense diabetes, asthma or cardiac conditions.
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4. Maternity Management Care Program
This program monitors the health and well-being of pregnant mothers. Care managers are trained to identify
potential difficulties and maintain regular phone contact with pregnant mothers, checking the status of their
pregnancy and answering questions about pregnancy and delivery. The program neither warrants nor
guarantees a normal or safe pregnancy or delivery. Nor does it guarantee the health or well-being of pregnant
mothers or their newborn child(ren).
i
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Appendix D
Performance Standards Program
(Not Included in the Basic ASO Service Fee)
Effective D�te January 1, 2003
By and between
CITY OF FORT COLLINS
AND
GREAT -WEST LIFE & ANNUITY INSURANCE COMPANY
Great -West Life & Annuity Insurance Company ("Seraice Contractor') guarantees to provide an acceptable level of
service as described below or to pay the penalties also described below. An executed copy of the Administrative
Services Contract signed by an authorized representative of the Client is required in order for the Service Contractor to
process the payment of any penalty. For purposes of this agreement, any penalty is calculated from the Basic
Administration Fee which is defined as $17.78 per covered POS employee and $16.53 per covered PPO employee in
each month of the guarantee period.
1. New Case Implementation Performance Standards — Applicable to initial issue of:
Health Identification Cards
Booklet Draft
Network Directories
a. Initial Medical/PCs Identification Cards: Service Contractor will initiate a request for identification cards
and mail said cards by December 23, 2002 upon receipt, in the Service Contractor's Home Office, of
complete and accurate eligibility information following the receipt of the completed "Application for Group
Coverage." The City will submit eligibility information no later than November 13, 2002.
b. Booklet Draft: The initial booklet draft will be sent via email on or about October 1, 2002. The final
booklet will be sent via electronic .pdf file within 15 days of approval by the City but no later than
December 13, 2002. This assumes receipt at the Service Contractor's Home Office, of the completed
"Application for Group Coverage" and approval by the City no later than November 28, 2002.
C. Network Directories: The initial s6pply of network directories will be delivered to the City prior to
the Open Enrollment period that begins on October 7, 2002.
Penalty: Performance will be measured by the Service Contractor's internal reports. Failure to achieve the minimum
performance standard will result in a credit to the administration fee, less managed care fees and commissions, of 2%
of such fee due and paid for the first Plan Month.
A review of the Service Contractor's performance under the New Case Implementation Performance Standard will be
completed at the end of the first three consecutive Plan Months of the first Plan Year. Any penalties owed by the
Service Contractor will be used to reduce the administration fee in the first month following the review.
24
Claims Service Performance Standards: Applicable to:
Claims Timeliness (Turnaround)
Claims Financial Accuracy
" Claims Payment Accuracy
Claims Procedural Accuracy
Claims Call Service
a. Claims Timeliness (Turnaround): 90% of the claims will be processed (paid, pended for additional
information or denied) within 14 calendar days and 98% will be processed ( paid, pended for additional
information or denied) within 21 calendar days of the Service Contractor's receipt ati its designated
National Imaging Center in Ft. Scott, Kansas.
Penalty: Performance will be measured using the Service Contractor's BEN 501 Claims Service Report
specific to the Client. Performance will be measured annually based on the Plan Year beginning with the
first Plan Month. Failure to achieve the minimum performance standard will result in a credit to the
Administration Fee, less managed care fees and commissions, if applicable, of 2% of such fee due and
paid for the Plan Year.
b. Claims Financial Accuracy: Claims will be processed with a financial accuracy of at least 99%.
Financial accuracy is defined as the total dollar amount of claims paid correctly divided by the total dollar
amount of claims paid during the time period covered by this guarantee.
Penalty: Performance will be determined by an audit of the Wyoming Benefit Payment Office performed
by the Service Contractor using claims selected at random of a sufficient quantity to guarantee the of
statistical accuracy of the audit. Performance will be measured annually based on the Plan Year
beginning with the first Plan Month. Failure to achieve the minimum performance standard will result in a
credit to the Administration Fee, less managed care fees and commissions, if applicable, of 2% of such
fee due and paid for the Plan Year.
C. Claims Payment Accuracy: Claims will be processed with a payment accuracy of at least 98%.
Payment accuracy is defined as the total number of claims paid with the correct dollar amount divided by
the total number of claims paid for the time period covered by this guarantee.
Penalty: Performance will be determined by an audit of the Wyoming Benefit Payment Office performed
by the Service Contractor using claims selected at random of a sufficient quantity to guarantee the
statistical accuracy of the audit. Performance will be measured annually based on the Plan Year
beginning with the first Plan Month. Failure to achieve the minimum performance standard will result in a
credit to the Administration Fee, less managed care fees and commissions, if applicable, of 1 % of such
fee due and paid for the Plan Year.
d. Claims Procedural Accuracy: Claims will be processed with a procedural accuracy of at least 98%.
Procedural accuracy is defined as the total dollar amount of claims processed with nonpayment errors
divided by the total number of claims processed for the time period covered by this guarantee.
Penalty: Performance will be determined by an audit of the Wyoming Benefit Payment Office performed
by the Service Contractor using claims selected at random of a sufficient quantity to guarantee the
statistical accuracy of the audit. Performance will be measured annually based on the Plan Year
beginning with the first Plan Month. Failure to achieve the minimum performance standard will result in a
credit to the Administration Fee, less managed care fees and commissions, if applicable, of 1 % of such
fee due and paid for the Plan Year.
25
e. Claims Call Service: The average monthly hold time in the Wyoming Benefit Payment Office will not
exceed 30 seconds. Abandoned calls shall be no more than 2% of all incoming calls.
Penalty: Performance will be determined from Great -West's internal Telephone Response Report for
the Wyoming Benefit Payment Office. Performance will be measured annually based on the Plan Year
beginning with the first Plan Month. Failure to achieve the minimum performance standard will result in a
credit to the Administration Fee, less rronaged care fees and commissions, if applicable, of 2% of such
fee due and paid for the Plan Year. II
A review of the Service Contractor's performance under the Claims Service Performance Standard will be completed
within 3 months of the end of the Plan Year. Any penalties owed by the Service Contractor will be used to reduce the
administration fee in the first month following the review. However, performance will be monitored and reported to the
City on a quarterly basis by the Denver Sales Office to allow for more timely intervention in the event a problem is
identified.
3. Sunset Provision
This Performance Standards Program covers the period from January 1, 2003 through December 31, 2003 and will
not be automatically renewed.
26
Appendix E
BENLink
To be attached to and made a part of the Administrative Services Contract
Effective Date January 1, 2003
By and Between
CITY OF FORT COLLINS
and
GREAT -WEST LIFE & ANNUITY INSURANCE COMPANY
For Clients using BENLink online services, the following provisions shall apply:
The Service Contractor grants the Client the non-exclusive, non -transferable right to use BENLink in accordance with this
Contract while this Contract is in effect
The Client is responsible for performing all BENLink functions in order to administer the Plan, including but not limited to
the following:
1. Acquisition and maintenance of completed, executed and accurate enrollment applications for every eligible
employee or dependent;
2. Updating information regarding all Members including, but not limited to, recording changes for name,
beneficiary, benefits or primary care physicians, within 10 working days of the Client's receipt of notice or
change.
The Client shall be responsible for reimbursing the Service Contractor for any claims paid on behalf of a terminated
Member where the Client failed to update BENLink and remove the Member therefrom in a timely manner. Such
payments shall be funded through the Transfer Account as set forth in Section 3 of the Contract. .
The Service Contractor is relieved of any duties imposed upon it under other terms of this contract to the extent those
duties can be performed by the Client using BENLink.
BENLink may be used only to administer the Plan. With the Service Contractor's prior consent, the Client may
subcontract, delegate or assign its rights or duties related to BENLink, or allow a third party "read only access" to the
Client's data on BENLink. In this event, the following terms apply:
The Client shall retain ultimate responsibility for all duties and obligations under the Contract. Any third party
shall be subject to such duties and obligations. The Client shall be responsible for monitoring and overseeing the
third party's performance pursuant to said subcontract, delegation, or assignment and shall remain fully
responsible as stated herein notwithstanding said delegation. The Client shall be responsible for any breach by
a third party of such duties and obligations, and the Client indemnification provisions under the Contract shall
apply to any such breach by a third party.
2. The Service Contractor shall have no obligations to any third party, nor any liability for the BENLink services
performed by any third party.
3. The Client shall abide by the Privacy of Health Information requirements set forth in Section 5.5 of the Contract.
27
BENLink must not be used in any manner not expressly allowed by this Contract.
Client acknowledges that Service Contractor' is under no obligation to provide support for BENLink, except for
maintenance of the BENLink system itself and basic technical assistance via telephone, facsimile and electronic mail
during the Service Contractor's regular business hours, The Client,shall be responsible for all Internet service provider
charges, and all related long distance charges, if any.
The Service Contractor shall have no liability with aspect to the Client's use of BENLink, and further, makes no
representations or warranties with respect to BENLink. The Service Contractor is not responsible for mistakes make by
the Client in its use of BENLink.
BENLink online services will terminate immediately upon misuse of BENLink by the Client or its subcontractors,
delegates or assigns and may terminate, in the sole discretion of the Service Contractor, upon discontinuation of the
BENLink product.
28
Appendix F
License Agreement
for
Pharmacy Benefit Manager Service
To be attached to and made a part of the Administrative Services Contract
By and between
CITY OF FORT COLLINS
AND
GREAT -WEST LIFE & ANNUITY INSURANCE COMPANY
1. Services to be Provided by PBM
The Service Contractor shall arrange for services to be provided by the pharmacy benefit manager (PBM)
identified in this Appendix in support of the prescription drug benefit provided under the Client's Plan as follows:
a. The PBM services shall be provided by AdvancePCS, L.P.
b. The PBM shall perform pharmacy services for Members through its network of participating pharmacies.
C. The PBM shall adjudicate claims for prescription drugs covered under the Plan submitted by participating
pharmacies using the PBM's electronic on-line claim adjudication system. The PBM's claim adjudication
system will include all Plan information regarding deductibles, copayments, coinsurance, Member out-of-
pocket maximums, benefit maximums and any other features of the Plan to be used in processing claims.
Participating pharmacies may collect from Members at point of sale the amount specified in the -Plan. The
PBM shall reimburse participating pharmacies for such claims according to the terms of the PBM's contfact
with the participating pharmacy.
d. The PBM shall accept claims submitted by Members directly to the PBM on the PBM's standard,ciaim form,
or otherwise agreed upon form, together with proof of payment. The PBM shall process such claims and
produce and mail to the Member an explanation of benefits and, if any payment is due the Member, a check
for the reimbursement amount specified in the Plan.
2. Services to be provided by Service Contractor
The Service Contractor shall provide the following support for the prescription drug benefit provided under the
Client's Plan:
a. Based on information it receives from Client, timely notify PBM of the identity of each Member eligible for
prescription drug benefits under the Plan, the date the Member becomes eligible, and the date the
Member's eligibility ends.
b. Reimburse PBM for the total of the amount of all payments due pursuant to Section [9] of this Appendix for
drugs provided to Members during the preceding billing period. After reimbursing PBM, Service Contractor
shall be entitled to initiate recovery to its own account by including the full amount of such reimbursement to
PBM in the amount it next transfers from Client's account pursuant to Client's transfer schedule.
C. Support Client's efforts to improve the cost -benefit relationship of its prescription drug benefit plan through
regular consultation with Client and PBM.
29
b. that if, the Transfer Account does not have sufficient funds to cover any demand by the Service
Contractor the bank shall honor such demand pursuant to a line of .credit established by the Client; and
C. that the bank shall honor any such demand from the Service Contractor without reservation or proof of
rights of any kind whatsoever.
3.4 Maintenance of Transfer Account After Termination of Contract. The Client shall continue to maintain the
Transfer Account pursuant to the terms of this Section 3 for 15 months after the termination of this Contract in
order for Service Contractor to process claims that were incurred prior to the termination of this Contract.
Section 4. Payments to the Service Contractor
4.1 Service fees. The Client shall make payments to the Service Contractor of amounts due for monthly service fees
and other service fees and expenses as set forth in the Payment Schedule in Appendix A.
Charges for hourly services will be determined in accordance with the Service Contractor's established time
allocation procedures, and those of other organizations from whom hourly services are purchased. These
charges will be made only if both parties agree on the Service Contractor's providing any hourly services.
Printed material created at the Client's request and not listed in Appendix A will be billed for separately when
furnished.
4.1.1 The Client acknowledges that the Payment Schedule is based on information provided by the Client
including but not limited to the number of employees and dependents that the Plan will cover. The
Service Contractor has the right to revise any Payment Schedule retroactively to the effective date or the
anniversary date, as applicable, to reflect actual participation in the Plan. Any difference between
payments made under the Payment Schedule and the Revised Payment Schedule will be collected from
or credited to the Client.
4.1.2 Any proposed Payment Schedule will become final when the.Service Contractor delivers a final written
schedule, signed by its officer, to the Client. ,
4.2 Amendment of Fees.
4.2.1 The Service Contractor or Client may propose changes to the fees under this Contract:
W
a. if the Client amends its Plan to modify benefits; or
b. upon modification of the Service Contractor's administrative duties; or
C. if the Service Contractor's cost of operation is increased by virtue of a change in charges to the
Service Contractor by a governmental unit, but such adjustment shall be limited to the amount of
the change; or
d. on the first anniversary of the Plan Year and annually thereafter; or
e. on any Plan Month subsequent to a Plan Year anniversary, provided that no renewal
adjustments were made at the time of such anniversary; or
upon addition or deletion of coverage for any subsidiary or Affiliate or corporate division of
Client; or
g. if the excess loss contract, if any, between the Service Contractor and Client is terminated; or
d. Make available to Client the advisory and consulting services of Service Contractor's pharmacy services
support unit.
e. Provide Client with standard reports consisting of data, provided by the PBM describing claims, utilization,
and other pertinent information. II
f. Through Service Contractor's medical m�hagement unit support the prior authorization provisions of the
Plan.
3. Third -Party Litigation
Neither the Service Contractor nor the PBM shall have any duty on Client's behalf to participate in or in any way
pursue any claim in any class action or other litigation commenced by a third -party to recover damages of any type
whatsoever in connection with drugs provided to Members.
4. Prior Authorization
The PBM and Service Contractor will cooperate to administer the Plan's provisions whereby certain prescription
drugs or drug classes are subject to prior authorization before being approved as a covered benefit.
5. Mail Service Program
The PBM shall administer the Plan's provisions whereby certain prescription drugs may be provided through the
PBM's mail order pharmacy service.
a. The PBM shall provide Client with appropriate numbers of its standard information material explaining its
mail service and the forms necessary for Members to utilize the service. The PBM shall make available to
Members toll -free telephone access to a pharmacist and customer service representative. Access to a
pharmacist shall be available 24 hours per day, seven days per week.
b. Subject to and in accordance with the Plan and applicable law, the PBM shall dispense through its mail
service pharmacy new or refill prescription drug orders upon receipt from a Member of a valid prescription
order or a completed refill order form, and the applicable copayment or coinsurance amount. The PBM
shall cause the filled prescriptions to be mailed to each Member via common carrier at the address shown
on the PBM's records, so long as such address is in the United States. Neither Service Contractor nor the
PBM shall have any liability to Client or any Member for any delay in delivery due to circumstances beyond
the PBM's control.
C. PBM shall at all times while this Appendix is in effect operate its mail service pharmacy in compliance with
all applicable state and federal laws and regulations, and shall dispense only those prescription drugs
which, in its sole discretion, fulfill requiremeAts of the prescription writer and comply with such laws. The
PBM shall have the right to refuse to fill or renew a prescription for any Member when, in the participating
pharmacist's professional judgment, the filling or renewing of such prescription is not in the best interest of
the Member, or the pharmacist has reason to doubt the authenticity of the prescription. The PBM may from
time to'time implement programs through its mail service pharmacy to promote certain prescription drugs.
d. Client acknowledges that the PBM's mail service pharmacy may from time to time engage in therapeutic
interchanges.
e. The PBM's mail service pharmacy may dispense drugs to Members even if the prescription is not
accompanied by the correct copayment, coinsurance or deductible amount. If Service Contractor is charged
30
for any uncollectible copayment, coinsurance or deductible amount, Client shall be liable to Service
Contractor for such amount if reasonable collection efforts by the PBM fail.
6. Plan Changes
If Client elects to change the prescription drug benefits of the Plan, including but not limited to covered drugs,
copayment, coinsurance or deductible amounts, or prior authorization, Client shall advise Service Contractor in
writing, and Service Contractor shall inform PBM. Whether the changes can be implemented, and/or implemented
by the date Client requests, will be determined at least in part by the PBM.
7. Proprietary Rights
The format of all reports, printouts and copies therefrom, and any prior and future versions thereof by any name,
are the property of the PBM and are protected by copyright which the PBM owns. 11
8. Limitations
The Service Contractor does not direct or exercise any control over the professional judgment exercised by any
pharmacist in dispensing prescriptions or providing pharmaceutical -related services at a PBM participating
pharmacy. Participating pharmacies are independent contractors, not subcontractors or agents of the Service
Contractor, and the Service Contractor shall not have any liability to Client or any Member for any loss or damage
related to or in any way growing out of any act or omission of any PBM participating pharmacy or its agent or
employee. 1''
9. Payments
For the PBM's services, Client shall pay Service Contractor the amounts Service Contractor bills for drugs
provided to Members during the preceding billing period.
Charges for drugs provided to Members may be based on the average wholesale price of a prescription drug'as
calculated by the PBM using a variety of factors, including but not limited to the First DataBank National Drug Data.
File or other nationally recognized pricing source. The PBM's method of calculating the average wholesale price
of a prescription drug may change from time to time, as the PBM shall determine. Service Contractor, shall have
no duty to notify Client of any such change.
Client acknowledges that the Service Contractor's net cost to provide the pharmacy benefit management services
described in this Appendix might be more or less than the payments called for by this section, and Client agrees
,that the Service Contractor is at risk for such difference.
10. Termination
a.' This Appendix may be terminated at any time upon thirty (30) days prior written notice by either party to the
other. In addition, this Appendix shall terminate automatically when the first of the following events occurs:
the Administrative Services Contract ends;
the Plan terminates;
iii. the Service Contractor no longer administers the Plan;
iv. the Plan no longer includes a prescription drug benefit that utilizes a PBM;
31
B
V. Client commits a material breach of this Appendix or defaults in the performance of any of its duties or
obligations under this Appendix and such breach or default continues for a period of fifteen (15) days
after Service Contractor gives Client written notice specifying the nature of the breach or default.
b. Termination of this Appendix while the Administrative Service Contract continues in effect shall be a
modification of the Service Contractor's administrative duties for purposes of Section 4.2.1-b of the
Contract. I
32
h. if there is a change in the number of employees and/or dependents covered under the Client's
Plan for any benefit coverage provided under the Client's Plan which equals or exceeds:
i. 10% in any Plan Month when compared to any prior Plan Month; or
ii. 25% during any period of three consecutive months.
The Client agrees to make vailable to the Service Contractor all information necessary to
determine whether the changos set forth in Cor ii. above have occurred. If the change in the
number of employees and/or dependents covered under the Plan is such that a change in fees
results, then the Service Contractor will advise the Client of its intention to change the fees.
I
The effective date of the change in fees under subsections a. through In. above will be the effective date of the
event that causes such change.
4.2.2 Modification of fees may be made by written notice to the Client by the Service Contractor. If the Client
pays such revised fees or fails to object to such revision in writing within 15 calendar days of receipt, this
Contract shall,be deemed modified to reflect the fees as communicated by the Service Contractor.
4.3 Claims. The Client shall pay the Service Contractor:
a. an amount equivalent to the claims incurred by Members under Client's Plan as determined by
the Service Contractor, including costs and expenses of investigation of claims. The Service
Contractor will make a good faith attempt to contact Client to inform it of any such investigation
and provide an estimate of the cost of it;
b. the deficit permitted to be recovered by the Service Contractor, if any, and other payments owed ,
by the Client, other than premium, under an excess loss policy, if any; and
C. the Client's portion of network access fees and provider incentive payments, if any, as
determined by the Service Contractor, under fee arrangements negotiated by the Service
contractor with health care providers. '
4.4 Premiums for Insurance. The Client and the Service Contractor acknowledge that:
a. the Client may have purchased one or more insurance policies from the Service Contractor, in
its capacity as an insurer, including but not limited to insurance for group life and accidental
death and dismemberment, excess loss insurance, long term disability insurance, dental
insurance, vision insurance, or other insurance; and
b. the Client is required to pay the Service Contractor a periodic premium for such policies.
4.5 Lack of Sufficient Funds. To the extent that the bank in which the Transfer Account is established and
maintained honors any demand for funds by the Service Contractor in an amount less than the amount
demanded, any funds that are made available to the Service Contractor from the Transfer Account shall be
applied first to the payment of the Service Contractor's service fees, second to any premiums for insurance, and
third to the payment of claims. To the extent that any check, draft, money order, or other financial instrument
issued by or,on behalf of the Client is honored in an amount less than the face amount of that instrument any
funds that are made available to the Service Contractor through such instrument shall be applied in the same
manner. Nothing in this subsection shall limit the Service Contractor's rights under this Contract, including but
not limited to the right to terminate this Contract.
Section 5. Client Responsibilities
5.1 Payments to Service Contractor. The Client shall make all payments as set forth in this Contract.
4
5.2 , Enrollment and Determination of Eligibility.
5.2.1 The Client shall:
a. handle routine inquiries from Members and prospective Members, including inquiries concerning
enrollment in the Plan; and I .
b. handle enrollment activity; and
C. notify prospective Members of their right to enroll in the Plan.
5.2.2 In determining any person's right to benefits under the Plan, the Service Contractor shall rely on
eligibility information consistent with the description in the Plan and information provided by the Client. It
is mutually understood that the effective performance. of this Contract by the Service Contractor will
require that it be advised on a timely basis by the Client of the identity of persons covered under the
Plan, and the'effective date or the termination date of their coverage. For the purpose of determining
fees under this Contract, a Member shall be considered to be:
a. enrolled on the first day of the first month following the month in which the Member is eligible to
receive benefits under the Plan; and
b. terminated on the last day of the last month in which the Member is eligible to receive benefits
under the Plan.
Retroactive adjustments for Member enrollment or termination will be allowed for periods not exceeding
sixty (60) days. Retroactive adjustments for termination are limited to Basic ASO Service Fees as set
forth in Appendix A.
5.3 Plan Benefits. Except as otherwise explicitly provided in this Contract, the Client shall retain the responsibility for
all Plan benefit claims and all expenses incident to the Plan. The Client shall be responsible for:
a. Any state premium or similar tax, however denominated, including any penalties and interest if
applicable, payable with respect thereto, assessed against the Service Contractor on the basis
of and/or measured by the amount of Plan benefits administered by the Service Contractor
pursuant to this Contract;
b. The consequence of any acts or omissions by Client occurring during the operation of this
Contract alleged to be a breach of fiduciary duty, or a breach of duty or trust, or other
contractual duty regardless of the source of law serving as a basis for such allegation;
C. Reimbursing the Service Contractor for any Plan benefit claims paid by the Service Contractor
to Members who were not eligible for Plan benefits and with respect to whom the Client does not
timely notify Service Contractor of such Member's lack of eligibility.
5.4 COBRA. If COBRA is applicable to the Client, the Client is responsible for performing the duties required by the
Consolidated Omnibus Budget Reconciliation Act of 1985, as amended (COBRA), including but not limited to:
a. notifying employees and covered spouses and dependents at their last known address of their
rights under COBRA when they first become covered under the Plan;
b. notifying qualified beneficiaries of their continuation rights upon occurrence of qualifying events;
E
C. notifying Service Contractor of COBRA -related eligibility changes as they occur. This includes
but is not limited to termination of coverage under the Plan as a result of a qualifying event,
subsequent election of'coverage and payment of premiums and reinstatement of coverage;
d. processing elections from continuants; and
e. billing and collection.
At the Clients' option and for a fee payable to the Service Contractor, the Service Contractor will arrange with a
third party administrator to perform some or all of the required duties. Whether the Client or a third party
administrator performs COBRA administration, the Service Contractor shall have no Liability resulting from the
failure of the Client, including its employees, directors, or officers', or a third party administrator, to fulfill any
obligations under the COBRA laws or this Contract.
5.5 Privacy of Health Information. The Parties agree to protect the privacy of Health Information in
accordance with the Privacy Agreement, which is incorporated herein by reference. 5.5.1 The
Client or the, Service Contractor may terminate this Contract if the Service Contractor reasonably
determines that the Client or any of its.subcontractors or agents, to whom Health Information has been
disclosed under this Contract, has materially violated any provision of this Section.
5.6 Delays. It is mutually agreed that the Service Contractor shall not be responsible for delay in the performance of
its duties under this Contract or for non-performance hereunder, if such delay or non -,performance is caused or
contributed to in whole or in part by the failure of.the Client to promptly furnish any required information.
5.7 Furnishing of Information. The Client shall furnish the Service Contractor with correct and complete information
required by the Service Contractor to provide services in accordance with this Contract, including, but not limited
to, eligibility information, identity of agents and brokers, confirmation of overdraft protection on the Transfer
Account, and information to verify contribution and participation requirements with respect to insurance policies
issued by the Service Contractor. The information will be furnished at the times and in such manner as the
Service Contractor may request. The Service Contractor will assume that all such information is complete and
accurate and will be under no duty to question the accuracy of such information. The Service Contractor, of its
discretion, may charge additional reasonable fees to the extent additional services are required because.
information is not furnished, is incomplete or inaccurate or is not furnished at the time or in the manner as
requested.
5.8 Member Appeals. The Client acknowledges that its Plan provides Members with the right to appeal benefit
claims that have been denied and file other complaints and grievances with the Plan Administrator. The Client
shall encourage Members to exhaust their opportunity to resolve such matters under the internal grievance and
complaint procedure described in the SPD. The Client shall notify the Service Contractor of any appeal that the
Client receives and shall notify the Service Contractor of the resolution of such appeal. The Service Contractor
shall not be responsible for any costs related to such appeal and shall not be required to process any benefit
payments approved by the Client as the result of an appeal by or on behalf of any Member without written
direction from the Client. In the event Plan Administrator determines claims should be paid which are not
considered covered benefits under the Plan, and Client has purchased excess loss coverage from Service
Contractor, such amounts shall be paid outside of such agreements, and shall be the Client's full liability. The
Client shall offer all appeals and make all appeal decisions with due regard for state and federal law to the extent
it may apply including but not limited to Internal Revenue Code section 105(h), and ERISA if the Client's Plan is
an ERISA plan.
5.9 Client's Affiliates. Employees and Dependents of Client's Affiliates may be added to the Plan by giving advance
notice to and receiving approval from the Service Contractor. The Client will ensure that the Transfer Account is
adequately funded and that all other required payments are rendered to reflect such additions.
6
5.10 Disclosure to Members. The Client will distribute SPDs to all Members as may be required by law. The Client
will make all disclosures to employees and dependents under its Plan required by applicable law. including but .
not limited to the Health Insurance Portability and Accountability Act, the Newborn's And Mother's Health
Protections Act, the Women's Health and Cancer Rights Act, ERISA and COBRA.
5,11 Leaal Proceedinas. The Service Contractor shall consult with the Client or legal counsel designated by the
Client in claim matters that are beyond the ordi ary. Client shall be responsible for its own defense of any legal
action brought by a third party related to the PI n. Nothing herein shall require the Client to defend the Service
Contractor in an action in which the Service Contractor is a named party. Nothing herein shall require the
Service Contractor to defend the Client. The Service Contractor and the Client shall cooperate in the defense of
any legal proceeding and each party will furnish the other and its legal counsel with all pertinent information
regarding the proceeding.
Section 6 Indemnification and Limitation of Liability
6.1 Client's Indemnification. To the extent permitted by law and The Charter of the City of Fort Collins, the Client
shall indemnify, protect and hold the Service Contractor harmless from any and all loss, liability, claim, damage
or expense (including attorney's fees, court costs and expenses of litigation) arising out of any act or omission of
the Client, its Affiliates or subcontractors in connection with the Plan or in connection with this Contract, including
compensatory, punitive, or other damages. The Client's duty to indemnify and hold the Servipe Contractor
harmless shall not extend to acts or omissions of providers who render health care services to Members.
Nothing herein shall be construed as a waiver of procedural and other requirements of the Colorado
Governmental Immunity Act.
6.2 Service Contractor's Indemnification. To the extent permitted by law and The Charter of the City of Fort Collins,
the Service Contractor shall indemnify, protect and hold the Client harmless from any and all loss, liability, claim,
damage or expense (including attorney's fees, court costs and expenses of litigation) arising out of any act or
omission of the Service Contractor, its Affiliates or subcontractors in connection with the Plan or in connection
with this Contract, including compensatory, punitive, or other damages.
The Service Contractor's duty to indemnify and hold the Client harmless shall not extend to acts or omissions of
providers who render health care services to Members.
6.3 Exclusion from Indemnification. The Parties shall not be responsible for each other's lost profits, exemplary,
special, punitive or consequential damages or be liable to the other for the same.
6.4 Survival. The terms of this Section shall survive the termination of this Contract
Sectiop 7. Authority to Control and Manage the Plan
7.1 Agency Relationship. The Service Contractor in performing its duties under this Contract is acting only as an
agent of the Client, and the rights and responsibilities of the parties shall be determined in accordance with the
law of agency except as otherwise herein provided.
7.2 Service Contractor's Control and Authority.
7.2.1 The Service Contractor and the Client agree that while this Contract is in effect the Service Contractor
and its delegates shall have exclusive authority to provide the Plan with the services listed in the
attached Appendices, and that during such time the Client shall not undertake on its own nor shall it
authorize or allow any other person or entity to provide any of those services without the prior written
consent of the Service Contractor.
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7.2.2 The Service Contractor and the Client agree that the Service Contractor shall have no liability under this
or any other agreement between the said parties with respect to any payment of benefits or other act
that violates the provisions of subsection 7.2.1 above.
7.3 Client's Control and Authority. The parties acknowledge that the Client and the Plan Administrator have the
exclusive authority to control and manage the Plan. The Client expressly agrees that the Service Contractor is
not the Plan Administrator. The Client expressl� agrees that the Service Contractor is not the named fiduciary or
a fiduciary of the Plan and that neither the Client nor the Plan Administrator will designate the Service Contractor
as the named fiduciary or,a fiduciary of the Plan.
The Service Contractor shall have no power, discretion or authority or control over the Plan or Plan assets or
responsibility for the terms or validity of the Plan or to alter, modify, or waive any terms or conditions of the Plan,
or to waive any breach of any such terms or conditions, or to .bind the Client, or to waive any ,of its rights, by
making any statement or by receiving at any time any notice or information.
The Service Contractor shall have no power, discretion or authority to act for or on behalf of the Client other than
as herein expressly granted, and no other or greater power or authority shall be implied by the grant or denial of
power or authority specifically mentioned herein.
7.4 Plan Documents. The Client acknowledges that the Plan Administrator has the responsibility to provide
Members with a summary plan description ("SPD") and to make available to Members certain other materials
and information. To the extent that the Client uses documents, including but not limited,to the SPD, or other
materials or information provided to the Client by the Service Contractor for the purpose of satisfying the Plan
Administrator's obligations, the Client acknowledges that it adopts such documents and other material and
information as its own as if they were drafted and made available to Members solely by the Client and under the
authority of the Plan Administrator. The fact that the Service Contractor has drafted or assisted in drafting any
document, including but not limited to the SPD, or provided any other materials or information to the Client, shall
not be construed as the exercise of any discretion, authority or control by the Service Contractor with respect to
the Plan, and shall not be construed as establishing any fiduciary, agency, trust, or other similar 'relationship
whatsoever between the Service Contractor and any Member.
7.5 Relationship to Members. Nothing herein will be deemed to impose upon the Service Contractor any obligation
to any Member under the Plan.
Section 8. Right to Audit
Each party shall have the right at all reasonable times to inspect and copy the records of the other that are pertinent to
the operation of the Plan. Such inspection shall be conducted at the office of the party being inspected where the
records are kept. Any costs of such inspection shall be borne'by the inspecting Party. The parties shall cooperate with
each other and make all reasonable efforts to confine any audit to a reasonable' length of time.
Section 9. Service Contractor's Use and Disclosure of Records
9.1 Confidentiality. The Service Contractor shall maintain confidentiality, in accordance with applicable law, with
respect to all Health Information of Members, including but not limited to medical records, in its possession
pertaining to,Members under the Plan.9.2 Use and Disclosure of Medical Records. The Service
Contractor will use Health Information solely for the purpose of fulfilling its duties under this Contract, and
will not disclose such information to anyone other than its officers, employees, its delegates, Affiliates, those
parties with whom the Service Contractor has a contract or other arrangement whereby that third party assists
the Service Contractor in performing its duties under this Contract and upon lawful order of a court or a public
agency with appropriate jurisdiction over the subject matter; provided, however, that such disclosure shall not
exceed the extent reasonably necessary for that third party to provide such assistance, and further provided, that
the Service Contractor shall require that third party maintain those medical records as strictly confidential.
9.3 Custody of Records. The Service Contractor shall hold all papers, books, files, correspondence and records of.
all kinds which at any time shall come into its possession or under its control relating to the transactions
performed by the Service Contractor for the Client under this Contract, and shall, to the extent permitted by law,
surrender them to the Client upon prior request, except the Service Contractor may periodically destroy such
material as it would usually destroy in the normal course of business.
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10.1 Procedure. The Service Contractor shall take appropriate steps as it would for its own business under similar
circumstances to collect claim overpayments, whether or not the overpayment results from the Service
Contractor's error or mistake.
10.2 Responsibility.
10.2.1 The Service Contractor will be responsible for Claim Overpayments resulting from the Service
Contractor's error or mistake, provided the overpayment is:
a. discovered and determined to be a Claim Overpayment before the end of'a 24-month
period immediately following the date on which the claim in question was paid; and
b. uncollected at the end of the Service Contractor's collection process. Such process shall
not last longer than 24 months after the date on which the claim is determined to be the
claim overpayment.
10.2.2 The Service Contractor will not be responsible for claim overpayments that are caused directly or
indirectly by the Client, its agents or employees, or providers.
10.2.3 The Client agrees to reimburse the Service Contractor a maximum of 25% of the returned overpayment
for collection costs.
Section 11. Term and Termination of Contract
j 1.1 Contract Term. This Contract shall be effective on January 1, 2003, (the "Effective Date"), and shall continue in
force for one year (the "Initial Term"), unless terminated earlier pursuant to this Section. This Contract shall
expire at the end of the Initial Term, subject to the right of the parties to renew the Contract as set forth herein, in
which case, the Contract shall remain in force until the expiration of the period for which the Contract was
renewed (the "Renewal Term"), unless terminated earlier pursuant to this Section.
11.2 Contract Renewal. The Service Contractor shall submit to the Client, not later than sixty (60) days prior to the
expiration of the Initial Term and 120 days prior >o any Renewal Term, the Service Contractor's proposed terms
and conditions for the renewal of the Contract (the "Renewal Proposal"). If prior to the expiration of the Contract,
the parties do not agree on the terms and conditions under which the Contract will be renewed, unless expressly
directed by the Client to discontinue service as of the expiration date, the Service Contractor may elect to
continue providing Services beyond the expiration date in order to facilitate continuity of service for Members. In
that case, this Contract shall be deemed to have been renewed under the terms and conditions of the Renewal
Proposal as if the Client had affirmatively assented to the Renewal Proposal and this Contract shall be deemed
to have been renewed. Notwithstanding anything above to the contrary, the Service Contractor shall not be
obligated to provide services after the expiration of this Contract, except to the extent expressly required to do so
under another provision of this Contract. Once this Contract is renewed, whether by express agreement or
deemed renewal, this Contract may be terminated only as set forth below in this Section. in the event Service
Contractor does not provide Client with a timely Renewal Proposal, the current Contract terms shall apply until
30 days after such Renewal Proposal is sent.
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