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HomeMy WebLinkAboutRFP - P999 BENEFITS CONSULTANT (2)REQUEST FOR PROPOSAL CITY OF FORT COLLINS BENEFITS CONSULTANT PROPOSAL NO. P999 PROPOSAL DATE: 2:00 p.m. (Our Clock) September 29, 2005 TABLE OF CONTENTS Invitation to Bid Page 3 Business Associate Agreement – Security Standards Page 4 Section I - Purpose and Plan Information A. Purpose Page 5 B. Eligible Employees Page 5 C. Plan Year and Open Enrollment Page 5 D. Present Benefit Plans Page 5-6 E. Wellness Program Page 6 Section II - Scope of Services A. Ongoing 1. Self-Insured Health Plan Page 7 a) Statistical analysis Page 7 b) Policy analysis Page 7 c) Administrative Support Page 7 2. Other Benefits Page 7 3. Contract Negotiation Page 8 4. Legal Support Page 8 5. General Guidance Page 8 6. Additional Request for other Services Page 9 Section III - Qualifications Page 9 Section IV - Questionnaire Page 10-11 Attachment A Page 12 Section V Review and Assessment & Reference Evaluation Page 13-14 Section VI Miscellaneous Page 15 Section VII Professional Services Agreement Page 16-21 3 REQUEST FOR PROPOSAL CITY OF FORT COLLINS Proposal Number P999 Benefits Consultant The City of Fort Collins is seeking proposals from firms for securing employee benefits consulting services. Written proposals, five (5) will be received at the City of Fort Collins' Purchasing Division, 215 North Mason St., 2nd floor, Fort Collins, Colorado 80524. Proposals will be received before 2:00 p.m. (our clock), September 29, 2005. Reference RFP P999. If delivered, they are to be sent to 215 North Mason Street, 2nd Floor, Fort Collins, Colorado 80524. If mailed, the address is P.O. Box 580, Fort Collins, 80522-0580. Questions concerning the scope of the project should be directed to Amy Sharkey (970) 416- 2721. Questions regarding proposals submittal or process should be directed to David Carey, C.P.M., Buyer, (970) 416-219. A copy of the Proposal may be obtained as follows: 1. Download the Proposal/Bid from the BuySpeed Webpage, https://secure2.fcgov.com/bso/login.jsp 2. Come by Purchasing at 215 North Mason St., 2nd floor, Fort Collins, and request a copy of the Bid. Sales Prohibited/Conflict of Interest: No officer, employee, or member of City Council, shall have a financial interest in the sale to the City of any real or personal property, equipment, material, supplies or services where such officer or employee exercises directly or indirectly any decision- making authority concerning such sale or any supervisory authority over the services to be rendered. This rule also applies to subcontracts with the City. Soliciting or accepting any gift, gratuity favor, entertainment, kickback or any items of monetary value from any person who has or is seeking to do business with the City of Fort Collins is prohibited. Collusive or sham proposals: Any proposal deemed to be collusive or a sham proposal will be rejected and reported to authorities as such. Your authorized signature of this proposal assures that such proposal is genuine and is not a collusive or sham proposal. The City of Fort Collins reserves the right to reject any and all proposals and to waive any irregularities or informalities. Sincerely, James B. O'Neill II, CPPO, FNIGP 4 Director of Purchasing & Risk Management 5 NOTE: To participate in the RFP process vendors need to sign and return this Business Associate Agreement. Business Associate Agreement – Security Standards This agreement is entered into between ___________________________ (Business Associate) and the City of Fort Collins. Business Associate agrees that it will implement policies and procedures to ensure that its creation, receipt, maintenance, or transmission of electronic protected health information (“ePHI”) on behalf of the City of Fort Collins complies with the applicable administrative, physical, and technical safeguards required to protect the confidentiality and integrity of ePHI under the Security Standards 45 CFR Part 164. Business Associate agrees that it will ensure that agents or subcontractors agree to implement the applicable administrative, physical, and technical safeguards required to protect the confidentiality and integrity of ePHI under the Security Standards 45 CFR Part 164. Business Associate agrees that it will report security violations to the City of Fort Collins, Security Manager. By: _________________________________ Date: ________________ ____________________________________ PRINT NAME ____________________________________ TITLE Please return to: City of Fort Collins Attn: Purchasing-RFP P.O. Box 580 Ft. Collins, CO 80522-0580 -or- fax back to: (970) 221-6707 6 BENEFITS CONSULTANT REQUEST FOR PROPOSAL Section I. Purpose and Plan Information A. Purpose This document is a request for proposals from qualified firms, related to securing employee benefits consulting services. B. Eligible Employees The City of Fort Collins has approximately 1,400 employees with benefits. Benefits are provided for all full and part-time classified and unclassified management employees. Certain seasonal and contractual employees are also eligible. The City added retirees to its current plans for coverage (January 1, 1996). * See attachment A. C. Plan Year and Open Enrollment Open enrollment is traditionally held in October/November with an effective date of January 1 to coincide with the calendar year and the City’s fiscal year. D. Present Benefit Plans The benefit plans for which services are requested are listed below. Plans indicated by asterisk (*) are incorporated into a Section 125 flexible benefits plan. In addition, the medical plans are protected from claims over $120,000 through a Stop Loss insurance contract through American Stop Loss. Health Plans* (Self-Funded, Employee/Employer Shared Cost) PPO: 2 Options, High and Low Deductible TPA: Great-West Healthcare PBM: Express Scripts, Inc. POS 2 Options, In-network only plan and In-network/Out-of-network plan, administered by Great-West Healthcare Dental Plans* (Self-Funded, Employee/Employer Shared Cost) 2 Options: Basic and Comprehensive Administered by Delta Dental Vision Plan (Self-Funded, Employee Paid) 1 Option Administered by Vision Service Plan Term Life Insurance Basic Life & AD&D*: Sun Life of Canada Mandatory 1x salary or $10,000, Employer Paid Voluntary 1, 2 or 3x salary 7 Supplemental Life & AD&D: Sun Life of Canada (AD&D -Employees Only) Voluntary 1, 2, or 3x salary Voluntary Spousal Coverage $25,000-100,000 Voluntary Childrens’ Coverage $5,000 or $10,000 Voluntary Life: Anthem Life Voluntary, $10,000-$300,000, in $10,000 units Voluntary Family Coverage Available Long-term Disability* (Sun Life of Canada, Fully Insured, Employer Paid) Long Term Care (Transamerica Occidental, Employee paid Life Insurance) Flexible Spending Accounts (Administered in-house; employee paid) Health Care and Dependent Care Transplant Coverage (BCS Transplant Insurance) Stop Loss Coverage (Great-West Healthcare) Coverage takes effect after individual has $120,000 of total claims in one calendar year. E. Wellness Program The City has a wellness program which includes educational seminars, exercise programs, and healthy lifestyle incentive programs. 8 Section II. Scope of Services A. Ongoing 1. Self-Funded Health Plan a) Statistical analysis: Provide quarterly report which includes an analysis of income and expense for the prior quarter. Provide annual report which includes an analysis of income and expense for the prior year and a projection for the forthcoming year including projected adequate reserve levels for plan. Establish annual premium rates, including COBRA, hourlies, and retirees. b) Policy analysis: Provide general guidance on trends in benefits offered and eligibility requirements. Recommend plan changes based on these trends. Advise and consult on methods for improving cost containment and claims administration. For above, where applicable, provide cost analysis of possible impact on plan. c) Administrative Support: Revise and maintain Plan Document, including preparation of amendments and the restatement of the Plan Document, as needed. Review for accuracy and appropriateness revisions to the Summary Plan Description. Review unusual claims situations, such as appeals which cannot be resolved at the peer review level or which require special handling. 2. Other Benefits: Revise and maintain dental plan document and flexible benefits plan document, including preparation of amendments and the restatement of the Plan Documents, as needed. Review for accuracy and appropriateness revisions to Summary Plan Descriptions. Review contracts with vendors to insure accuracy and comprehensiveness of coverage. Provide guidance in contract interpretation, as needed. Advise on required reserves for medical and dental plans. Assist in the modification and pricing of any current or newly considered flexible benefit plan provisions. 9 Advise and consult on trends in benefit plans being offered locally and nationally (such as medical, dental, vision, etc.). Assist with development of Requests For Proposals (RFP’s) for various vendors in compliance with City purchasing requirements. This may include developing evaluation criteria and evaluating/summarizing proposal information. 3. Contract Negotiation: Work with City Purchasing and Benefits to advise on negotiations with third party administrators, utilization review firms, HMO's, PPO’s, stop loss, long term disability, prescription drug discount programs, and life/AD&D insurance carriers. 4. Legal Support: Assist in the preparation of governmental filings. Provide notification and updates on changing laws, regulations, and administrative or judicial ruling which relate to benefits programs. Review plan documents to ensure compliance with appropriate laws and regulations and notify of any necessary plan document amendments. 5. General Guidance: Provide answers or guidance to any general or technical benefits questions. If requested, review communication materials (open enrollment, summary plan descriptions, memos, etc.) for content, appearance, and compliance with laws and regulations. The Consultant will be working on a frequent basis with the Benefits Administrator. The consultant will be expected to assist the City on a regular basis and in a timely manner to provide guidance to technical problems that may arise. In the past, it is not uncommon to conduct several telephone calls per week and a meeting every month. The Consultant is not expected to attend open enrollment meetings with employees. However, the Consultant may occasionally be expected to attend a special meeting to provide expert guidance and discussion of the plans. 6. Additional Requests for other services: The City reserves the right under the terms of this RFP to request duties unrelated to this defined set of consulting services. The Scope of these services and related cost will be agreed to prior to the consultant performing any work. Compensation for these services will be based on a “not to exceed” amount. Restating plan documents should be part of the normal contract with amendments and updating documents. Estimated frequency is expected to be every 3-5 years. 10 11 Section III. Qualifications 1. Prior experience with governmental entities as clients. 2. Prior experience with organizations with at least 600 employees as clients. 3. Prior experience with self-funded health and dental plans. 4. Understanding of, and direct experience with, northern Colorado demographic area healthcare delivery concerns. (e.g. single hospital, limited PPO arrangements, consolidated specialty physicians). 5. Proposals shall be accepted on a fee only basis. The City of Fort Collins will not consider a commission-based proposal. 12 Section IV. Questionnaire 1. Describe your firm, its history and size, the locations in which it operates, and the number of employees. 2. Location of the office from which consulting services would be provided, and the employee turnover rate among consultants and staff personnel of this office during the past two years. 3. What is your firm's philosophy in the approach to benefits consulting? 4. Provide information on principal consultant who would be responsible for the City of Fort Collins' account. What is their professional background and experience? Specifically include individuals experience dealing with public employers. If you expect to utilize other personnel to accomplish the duties specified in this RFP, provide the same information requested above for each of the personnel listed. 5. If the principal consultant were to leave your firm, how would service be provided? How soon would a new principal consultant be assigned to the City’s account? 6. What is the principal consultant's experience with self-funded benefit plans (specifically, medical and dental)? 7. For how many clients does the principal consultant provide services? 8. List the five (5) largest clients in which principal consultant is involved on an ongoing basis and which the company can provide as a reference. Provide name of client, contact name, address, telephone number and number of employees. 9. List other self-funded governmental plans for which the firm has served, the capacity in which it served, and whether it is an active account. Provide name of client, contact name, address, telephone number and number of employees. 10. Who would be directly responsible for handling problem claims review and appeals when requested by the City. What are their qualifications? Would your firm be willing to render a determination on such claims? 11. Submit a sample of annual and periodic reports you provide similar clients. 12. One area of interest for the City is improving its management reporting and analysis of the self-funded healthcare plan. Provide a description of how your firm assists clients in this area, along with a sample report you would offer the City as part of this contract. 13. What is your experience in dealing with demographic area healthcare delivery concerns, such as a single hospital, limited PPO arrangements, and consolidated specialty physicians? 14. What is your experience in developing/evaluating/maintaining Section 125 plans? 15. What is your experience with negotiating for services of third party administrators, utilization review, HMO's, stop loss, long term disability, prescription drug discount and 13 life insurance carriers? 16. What resources do your firm have available in the area of developing technical employee communications? 17. Describe any pending litigation against your firm. 18. Describe the professional liability coverage carried by your firm. 19. Describe any problems you foresee in your ability to conduct the services described in this Request for Proposal. 20. Describe additional costs, if any, which may be charged for minor requests/questions that require minimal research time. 21. Proposed cost of basic duties: The length of the contract will be for a period of one (1) year plus up to four (4) additional one-year periods. It is expected that the firm will provide all of the Scope of Services described in Section II. The proposed fees should include all costs (i.e., miscellaneous administrative, travel, etc.) State an annual cost for each of the contract years, the maximum annual consulting cost for the proposed services. (Do not respond with hourly rates.) Total Cost not to exceed: January – December 2006 January – December 2007 January – December 2008 January – December 2009 January – December 2010 Cost of additional services: The City recognizes that at times various projects and services may develop that are not part of the proposed Scope of Services. State the current hourly billing rates for each level of employee that may be involved in conducting additional services. 22. Beyond the stated scope of services, what additional services would you anticipate for a client like the City? What would be the estimated cost of those additional services? 14 Attachment A City of Fort Collins Eligibility Classified and Unclassified Management: (1,321 employees, includes Fire and Police)  Medical  Dental  Vision  Flexible Spending Accounts  Life Insurance  Long Term Disability (excludes Fire and Police)  Employee Assistance Program  457 Deferred Compensation Plan  401(a) Money Purchase Plan  Defined Benefit Pension Plan Contractual: (47 employees)  Medical  Dental  Vision  Flexible Spending Accounts  Life Insurance  Employee Assistance Program Seasonals: - must work minimum of 30 hours/week at least six months out of year- approximately 200 employees Medical (POS Option 1 (In-Network) only) Retirees:  Medical- currently 25 employees participating  Dental - currently 17 employees participating  Vision - currently 4 employees participating This Request for Proposal (RFP) only includes consulting services for medical, dental, vision, prescription drug, flexible spending accounts, life insurance, stop loss, utilization review/case management, and long term disability. It does NOT include consulting services for the Employee Assistance Program, 457 deferred compensation plan, 401(a) money purchase plan, or defined benefit plan. 15 Section V. Review & Assessment Professional firms will be evaluated on the following criteria. These criteria will be the basis for review of the written proposals and interview session. Based on results of the initial evaluation, the City will select finalists for consideration. Any or all proposals may be rejected by The City. The finalists may be asked to make formal presentations of their proposals, as well as to demonstrate their systems and procedures for providing employee benefits consulting services. The rating scale shall be from 1 to 5, with 1 being a poor rating, 3 being an average rating, and 5 being an outstanding rating. WEIGHTING QUALIFICATION STANDARD FACTOR 2.0 Scope of Proposal Does the proposal show an understanding of the project objective, methodology to be used and results that are desired from the project? 2.0 Assigned Personnel Do the persons who will be working on the project have the necessary skills? Are sufficient people of the requisite skills assigned to the project? 1.0 Availability Can the work be completed in the necessary time? Can the target start and completion dates be met? Are other qualified personnel available to assist in meeting the project schedule if required? Is the project team available to attend meetings as required by the Scope of Work? 1.0 Motivation Is the firm interested and are they capable of doing the work in the required time frame? 2.0 Cost and Work Hours Do the proposed cost and work hours compare favorably with the project Manager's estimate? Are the work hours presented reasonable for the effort required in each project task or phase? 2.0 Firm Capability Does the firm have the support capabilities the assigned personnel require? Has the firm done previous projects of this type and scope? 16 Reference Evaluation (Top Ranked Firm) The Project Manager will check references using the following criteria. The evaluation rankings will be labeled Satisfactory/Unsatisfactory. QUALIFICATION STANDARD Overall Performance Would you hire this Professional again? Did they show the skills required by this project? Timetable Was the original Scope of Work completed within the specified time? Were interim deadlines met in a timely manner? Completeness Was the Professional responsive to client needs; did the Professional anticipate problems? Were problems solved quickly and effectively? Budget Was the original Scope of Work completed within the project budget? Job Knowledge a) If a study, did it meet the Scope of work? b) If Professional administered a construction contract, was the project functional upon completion and did it operate properly? Were problems corrected quickly and effectively. 17 Section VI. Miscellaneous Your response to this RFP and any subsequent correspondence related to this proposal process will be considered part of the contract, if one is awarded to you. All data included in this RFP, as well as any census data and attachments, are proprietary to The City. It is for your exclusive use in preparing a proposal and must not be shared with any other firm or used for any other purpose. The use of The City’s name in any way as a potential customer is strictly prohibited. Your proposal must clearly indicate the name of the responding organization, as well as the name, address and telephone number of the primary contact at your organization for this proposal. Your proposal must include the contact name for local service and account management whom The City can call directly. The City assumes no responsibility or liability for any costs you may incur in responding to this RFP, including attending meetings or negotiations. Your company will be bound to comply with the provisions set forth in this RFP unless any and all deviations are explicitly stated in your proposal. The City shall not infringe upon any intellectual property right of any vendor, but specifically reserves the right to use any concept or methods contained in the proposal. Any desired restrictions on the use of information contained in the proposal should be clearly stated. Responses containing your proprietary data shall be safeguarded with the same degree of protection as The City’s own proprietary data. All such proprietary data contained in your proposal must be clearly identified. The City shall not be under any obligation to return any materials submitted in response to this RFP. The City expects to enter into a written Agreement (the “Agreement”) with the chosen vendor (“Chosen Vendor”) that shall incorporate this RFP and your proposal. The anticipated terms and conditions of the Agreement are set forth in this RFP; however, the City may include additional terms and conditions in the Agreement as deemed necessary. Sample Professional Services Agreement is attached. 18 PROFESSIONAL SERVICES AGREEMENT THIS AGREEMENT made and entered into the day and year set forth below, by and between THE CITY OF FORT COLLINS, COLORADO, a Municipal Corporation, hereinafter referred to as the "City" and _____, [insert either a corporation, a partnership or an individual, doing business as____________], hereinafter referred to as "Professional". WITNESSETH: In consideration of the mutual covenants and obligations herein expressed, it is agreed by and between the parties hereto as follows: 1. Scope of Services. The Professional agrees to provide services in accordance with the scope of services attached hereto as Exhibit "A", consisting of _____ (_____) page[s], and incorporated herein by this reference. 2. The Work Schedule. [Optional] The services to be performed pursuant to this Agreement shall be performed in accordance with the Work Schedule attached hereto as Exhibit "B", consisting of _____ (_____) page[s], and incorporated herein by this reference. 3. Time of Commencement and Completion of Services. The services to be performed pursuant to this Agreement shall be initiated within _____ (_____) days following execution of this Agreement. Services shall be completed no later than _____. Time is of the essence. Any extensions of the time limit set forth above must be agreed upon in writing by the parties hereto. 4. Early Termination by City. Notwithstanding the time periods contained herein, the City may terminate this Agreement at any time without cause by providing written notice of termination to the Professional. Such notice shall be delivered at least fifteen (15) days prior to 19 the termination date contained in said notice unless otherwise agreed in writing by the parties. All notices provided under this Agreement shall be effective when mailed, postage prepaid and sent to the following addresses: Professional: City: With Copy to: In the event of any such early termination by the City, the Professional shall be paid for services rendered prior to the date of termination, subject only to the satisfactory performance of the Professional's obligations under this Agreement. Such payment shall be the Professional's sole right and remedy for such termination. 5. Design, Project, Indemnity and Insurance Responsibility. The Professional shall be responsible for the professional quality, technical accuracy, timely completion and the coordination of all services rendered by the Professional, including but not limited to designs, plans, reports, specifications, and drawings and shall, without additional compensation, promptly remedy and correct any errors, omissions, or other deficiencies. The Professional shall indemnify, save and hold harmless the City, its officers and employees in accordance with Colorado law, from all damages whatsoever claimed by third parties against the City; and for the City's costs and reasonable attorneys fees, arising directly or indirectly out of the Professional's performance of any of the services furnished under this Agreement. The Professional shall maintain commercial general liability insurance in the amount of $500,000 combined single limits, and errors and omissions insurance in the amount of ___________. 6. Compensation. [Use this paragraph or Option 1 below.] In consideration of the services to be performed pursuant to this Agreement, the City agrees to pay Professional a fixed fee in the amount of _____ ($_____) plus reimbursable direct costs. All such fees and costs 20 shall not exceed _____ ($_____). Monthly partial payments based upon the Professional's billings and itemized statements are permissible. The amounts of all such partial payments shall be based upon the Professional's City-verified progress in completing the services to be performed pursuant hereto and upon the City's approval of the Professional's actual reimbursable expenses. Final payment shall be made following acceptance of the work by the City. Upon final payment, all designs, plans, reports, specifications, drawings, and other services rendered by the Professional shall become the sole property of the City. 6. Compensation. [Option 1] In consideration of the services to be performed pursuant to this Agreement, the City agrees to pay Professional on a time and reimbursable direct cost basis according to the following schedule: Hourly billing rates: _____ Reimbursable direct costs: _____ with maximum compensation (for both Professional's time and reimbursable direct costs) not to exceed _____ ($_____). Monthly partial payments based upon the Professional's billings and itemized statements of reimbursable direct costs are permissible. The amounts of all such partial payments shall be based upon the Professional's City-verified progress in completing the services to be performed pursuant hereto and upon the City's approval of the Professional's reimbursable direct costs. Final payment shall be made following acceptance of the work by the City. Upon final payment, all designs, plans, reports, specifications, drawings and other services rendered by the Professional shall become the sole property of the City. 7. City Representative. The City will designate, prior to commencement of work, its project representative who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the project. All requests for contract interpretations, change orders, and other clarification or instruction shall be directed to the City Representative. 21 8. Monthly Report. Commencing thirty (30) days after the date of execution of this Agreement and every thirty (30) days thereafter, Professional is required to provide the City Representative with a written report of the status of the work with respect to the Scope of Services, Work Schedule, and other material information. Failure to provide any required monthly report may, at the option of the City, suspend the processing of any partial payment request. 9. Independent Contractor. The services to be performed by Professional are those of an independent contractor and not of an employee of the City of Fort Collins. The City shall not be responsible for withholding any portion of Professional's compensation hereunder for the payment of FICA, Workers' Compensation, other taxes or benefits or for any other purpose. 10. Personal Services. It is understood that the City enters into this Agreement based on the special abilities of the Professional and that this Agreement shall be considered as an agreement for personal services. Accordingly, the Professional shall neither assign any responsibilities nor delegate any duties arising under this Agreement without the prior written consent of the City. 11. Acceptance Not Waiver. The City's approval of drawings, designs, plans, specifications, reports, and incidental work or materials furnished hereunder shall not in any way relieve the Professional of responsibility for the quality or technical accuracy of the work. The City's approval or acceptance of, or payment for, any of the services shall not be construed to operate as a waiver of any rights or benefits provided to the City under this Agreement. 12. Default. Each and every term and condition hereof shall be deemed to be a material element of this Agreement. In the event either party should fail or refuse to perform according to the terms of this agreement, such party may be declared in default. 13. Remedies. In the event a party has been declared in default, such defaulting 22 party shall be allowed a period of ten (10) days within which to cure said default. In the event the default remains uncorrected, the party declaring default may elect to (a) terminate the Agreement and seek damages; (b) treat the Agreement as continuing and require specific performance; or (c) avail himself of any other remedy at law or equity. If the non-defaulting party commences legal or equitable actions against the defaulting party, the defaulting party shall be liable to the non-defaulting party for the non-defaulting party's reasonable attorney fees and costs incurred because of the default. 14. Binding Effect. This writing, together with the exhibits hereto, constitutes the entire agreement between the parties and shall be binding upon said parties, their officers, employees, agents and assigns and shall inure to the benefit of the respective survivors, heirs, personal representatives, successors and assigns of said parties. 15. Law/Severability. The laws of the State of Colorado shall govern the construction, interpretation, execution and enforcement of this Agreement. In the event any provision of this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction, such holding shall not invalidate or render unenforceable any other provision of this Agreement. 16. Special Provisions. Special provisions or conditions relating to the services to be performed pursuant to this Agreement are set forth in Exhibit "C", consisting of four (4) page[s], attached hereto and incorporated herein by this reference. 23 THE CITY OF FORT COLLINS, COLORADO By: _________________________________ Darin Atteberry City Manager By: _________________________________ James B. O'Neill II, CPPO Director of Purchasing & Risk Management DATE: ______________________________ ATTEST: _________________________________ City Clerk APPROVED AS TO FORM: _________________________________ Assistant City Attorney [Insert Professional's name] or [Insert Partnership Name] or [Insert individual's name] Doing business as ____[insert name of business] By: __________________________________ Title: _______________________________ CORPORATE PRESIDENT OR VICE PRESIDENT Date: _______________________________ ATTEST: _________________________________ (Corporate Seal) Corporate Secretary 24 EXHIBIT “C” HIPAA HEALTH INFORMATION PRIVACY & SECURITY A. Obligations and Activities of the Business Associate (Great-West Life & Annuity Insurance Company). 1. Business Associate agrees to not use or disclose Protected Health Information other than as permitted or required in the Administrative Services Agreement of which this Appendix is a part or as required by law. 2. Business Associate agrees to use appropriate safeguards to prevent use or disclosure of the Protected Health Information other than as provided for by this Appendix. 3. Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to Business Associate of a use or disclosure of Protected Health Information by Business Associate in violation of the requirements of this Appendix. 4. Business Associate agrees to report to the Plan Sponsor (City of Fort Collins, Colorado) any use or disclosure of the Protected Health Information not provided for by this Appendix of which it becomes aware. 5. Business Associate agrees to ensure that any agent, including a subcontractor, to whom it provides Protected Health Information received from, or created or received by Business Associate on behalf of the Plan Sponsor agrees to the same restrictions and conditions that apply through this Appendix to Business Associate with respect to such information. 6. Business Associate agrees to make internal practices, books, and records, including policies and procedures and Protected Health Information, relating to the use and disclosure of Protected Health Information received from, or created or received by Business Associate on behalf of, the Plan Sponsor available to the Plan Sponsor, or to the Secretary, in a time and manner or designated by the Secretary, for purposes of the Secretary determining the Plan Sponsor's compliance with the Privacy Rule. 7. Business Associate agrees to document such disclosures of Protected Health Information and information related to such disclosures as would be required for the Plan Sponsor to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR § 164.528. 8. Business Associate agrees to provide to the Plan Sponsor or an Individual, in a reasonable time and manner, information collected in accordance with Section A.7. of this Provision, to permit Plan Sponsor to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR § 164.528. B. Permitted Uses and Disclosures by Business Associate 1. Except as otherwise limited in this Appendix, Business Associate may use or disclose Protected Health Information on behalf of, or to provide services to, the Plan Sponsor for the following purposes, if such use or disclosure of Protected Health Information would not violate the Privacy Rule if done by the Plan Sponsor or the minimum necessary policies and procedures of the Plan Sponsor: performing plan administration functions, obtaining premium bids from insurance companies or other health plans for providing insurance coverage under or 25 on behalf of the group health plan, or modifying, amending, or terminating the group health plan. 2. Except as otherwise limited in this Appendix, Business Associate may use Protected Health Information to provide data aggregation services to the Plan Sponsor as permitted by 42 CFR § 164.504(e)(2)(i)(B). 3. Business Associate may use Protected Health Information to report violations of law to appropriate Federal and State authorities, consistent with § 164.502(j)(1). C. Obligations of Plan Sponsor 1. Plan Sponsor shall notify Business Associate of any restriction to the use or disclosure of Protected Health Information that the Plan Sponsor has agreed to in accordance with 45 CFR § 164.522, to the extent that such restriction may affect Business Associate's use or disclosure of Protected Health Information. 2. Plan Sponsor shall not request Business Associate to use or disclose Protected Health Information in any manner that would not be permissible under the Privacy Rule if done by Plan Sponsor. D. Termination 1. In addition to the termination provisions set forth in the Administrative Services Agreement of which this Appendix is a part, the following termination provisions are applicable: a. Upon the Plan Sponsor's knowledge of a material breach by Business Associate of this Appendix, the Plan Sponsor shall either: i. Provide an opportunity for Business Associate to cure the breach or end the violation and terminate the Administrative Services Agreement of which this Appendix is a part if Business Associate does not cure the breach or end the violation within the time specified by Plan Sponsor; or ii. Immediately terminate the Administrative Services Agreement of which this Appendix is a part if Business Associate has breached a material term of this Appendix and cure is not possible; or iii. If neither termination nor cure are feasible, the Plan Sponsor shall report the violation to the Secretary. E. Effect of Termination 1. Except as provided in paragraph (2) of this section E, upon termination of the Administrative Services Agreement of which this Appendix is a part, for any reason, Business Associate shall return or destroy all Protected Health Information received from the Plan Sponsor, or created or received by Business Associate on behalf of the Plan Sponsor. This provision shall apply to Protected Health Information that is in the possession of subcontractors or agents of Business Associate. Business Associate shall retain no copies of the Protected Health Information. 2. In the event that Business Associate determines that returning or destroying the Protected Health Information is infeasible, Business Associate shall provide to the Plan Sponsor notification of the conditions that make return or destruction infeasible. Upon the Plan Sponsor's agreement that return or destruction of Protected Health Information is infeasible, Business Associate shall extend the protections of this Appendix to such Protected Health Information and limit further uses and disclosures of such Protected Health Information to those purposes 26 that make the return or destruction infeasible, for so long as Business Associate maintains such Protected Health Information. F. Miscellaneous 1. The Parties agree to take such action as is necessary to amend this Appendix from time to time as is necessary for Plan Sponsor to comply with the requirements of the Privacy Rule and the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191. 2. The respective rights and obligations of Business Associate under Section E of this Provision shall survive the termination of the Administrative Services Agreement of which this Appendix is a part. 3. Any ambiguity in this Appendix shall be resolved to permit the Plan Sponsor to comply with HIPAA. G. Security Standards 1. Business Associate agrees that it will implement policies and procedures to ensure that its creation, receipt, maintenance, or transmission of electronic protected health information ("ePHI") on behalf of Plan Sponsor complies with the applicable administrative, physical, and technical safeguards required to protect the confidentiality and integrity of ePHI under the Security Standards 45 CFR Part 164. 2. Business Associate agrees that it will ensure that agents or subcontractors agree to implement the applicable administrative, physical, and technical safeguards required to protect the confidentiality and integrity of ePHI under the Security Standards 45 CFR Part 164. 3. Business Associate agrees that it will report security violations to the Plan Sponsor. H. Definitions 1. "Protected Health Information" shall have the same meaning as the term "protected health information" in 45 CFR § 164.501, limited to the information created or received by Business Associate from or on behalf of the Plan Sponsor. 2. "Secretary" shall mean the Secretary of the Department of Health and Human Services or his designee.