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HomeMy WebLinkAboutC01-252 Administrative Services Agreement with Mountain StatesG, 0 ADMINISTRATIVE SERVICES AGFEEMENT This Agreement is made and executed as of January 1, 2001 by and between MOUNTAIN STATES ADMINISTRATIO',I CO., INC. (hereinafter referred to as "MSA ") and EAGLE COUNTY (hereinafter referred to as the "CLIENT "). MSA is engaged in the business of performing services as Employee Benefit Administrators and the CLIENT hereby engages MSA to provide certain administrative services for EAGLE COUNTY E1,11PLOYEE BENEFIT PLAN (hereinafter referred to as the "Plan "). For the consideration detailed herein, it is mutually agreed as follows: Services To Be Performed: MSA will: Review all claim documents thoroughly and coordinate them with doctors, hospitals, and other providers of services, to determine that the charges and services /supplies are usual and customary. Receive claims documents and verify the eligibility of the claimant based on information provided by the CLIENT. Process and distribute copies of Explanation of Benefits and benefit checks. Answer telephone /mail inquiries from participants and providers regarding eligible benefits. Correspond (telephone /letter) with claimants or providers of services if additional information is necessary to expedite claim processing. Process claims according to the Coordination of Benefits provision of the Plan. Handle all claims expeditiously. Notify the CLIENT regarding any claims which, in MSA's opinion, may involve probable third party liability, subrogation or other litigation. Provide written explanation to the claimant for ineligible claims. Provide the necessary information to the CLIENT for the preparation of ERISA reports and filings. MSA shall remit the monies received by the CLIENT for payment of life insurance premiums, accidental death and dismemberment insurance premiums, reinsurance premiums and any other premiums and /or fees to the applicable carriers or entitled entities on behalf of the CLIENT if such an arrangement is mutually decided upon when MSA begins providing services for the CLIENT. Page 1 of 7. C) ej Payments will be made provided that such monies are received by MSA from the CLIENT within sufficient time to be sent via regular mail prior to the due dates specified by the carriers or entitled entities. Overnight mail charges will be billed to the CLIENT for premiums and /or fees NOT received by the CLIENT within sufficient time for remittance prior to the due dates. MSA is only acting as an agent for the CLIENT, and the payment of the premiums and /or fees to such carriers or entitled entities for particular coverage(s) is strictly the responsibility of the CLIENT. Provide 1099 reports to providers, of services and to the Internal Revenue Service. Provide the following monthly reports: A. Check Register B. Benefit Analysis C. Paid Claims Analysis by Participant D. Eligibility List E. Specific Coverage Report F. Aggregate Coverage Report Provide the following annual reports: A. Year -to -Date Benefit Analysis B. Incurred Lag Study C. D. Provide the following services: Yes A. Check Printing Yes B. Forms Printing (non - internal) Yes C. Envelopes and Letterhead N/A D. Creation or preparation of Plan Document N/A E. Creation and /or preparation of Plan Document Amendments N/A F. Creation and /or preparation of Summary Plan Description/ Employee Booklets N/A G. Booklet Printing Yes H. Long Distance phone calls Yes 1. Postage Yes J. Photocopying N/A K. Custom I.D. Card preparation N/A L. SAS 70 Report — Upon Request Yes M. Plan Building after Initial Set -up * It is recommended that all suggested wording will be reviewed by the CLIENT'S Legal Counsel. Page 2 of 7. ci C Service Fees: The CLIENT agree6 to pay to MSA for the services to be performed herein the following fees: A. An initial one -time fee of N/A B. A monthly fee of $13.84 /employee /month Medical $2.44 /employee /month Dental $5.68 /participant/month Flexible Spending $0.38 /employee /month Bank Reconciliation C. Optional Service: Benefit Management Coordination at 20% of definable savings or the rate of $90.00 an hour. The monthly fee is based upon a predetermined claims utilization of N/A _ (monthly claims per 100 employees). For actual claims utilization exceeding this number, the CLIENT will pay an additional fee of ,$ NIA per claim. Fees are due and payable on or before the 10th of each month, based on enrollment on the first day of that month. Fees not paid by the end of each month for which they are due will be subject to an interest rate of 1.5% monthly on the unpaid balance. A portion of the above may be paid to insurance agents or brokers providing other servicing functions. MSA will make no retroactive bill adjustments of more than 90 (ninety) days from the date of the occurrence (eligibility /termination), or discovery of an occurrence. In addition to the monthly fee, the CLIENT shall reimburse MSA for the actual expenses incurred on behalf of the CLIENT as follows: No A. Check Printing Yes B. Forms Printing (non - internal) No C. Envelopes and Letterhead N/A D. Creation or preparation of Plan Document No E. Creation and /or preparation of Plan Document Amendments N/A F. Creation and /or preparation of Summary Plan Description/ Employee Booklets N/A G. Booklet Printing No H. Long Distance phone calls No I. Postage No J. Photocopying N/A K. Custom I.D. Card preparation NIA L. SAS 70 Report @ $400 per report Yes M. Plan Building Fee after Initial Set -up @ $150.00 /hour (fee may not apply in all situations) * It is recommended that all suggested wording will be reviewed by the CLIENT'S Legal Counsel. Page 3 of 7. C C Relationship Between the Parties: MSA performs ministerial services under the direction of the CLIENT's Plan Document, Corporate policies, rules, practices, procedures and interpretations. MSA is not a Plan fiduciary as defined in the Employee Retirement and Income Security Act of 1974 ( ERISA). The CLIENT will not direct MSA to take any act or action that would constitute a violation under any ERISA provision. MSA shall not have discretionary authority or control respecting the Plan's assets and shall not render investment advice on the Plan's assets. MSA will not provide nor be responsible for the expense or cost of Legal counsel, Actuaries, Consulting physicians or dentists, Certified Public Accountants or Auditors, Investment Counselors or other professional services to the CLIENT's Plan unless employed by MSA at its sole discretion. Term of Agreement: The term of this Agreement shall be from January 1, 2001 to December 31, 2001 . At the end of the term, if neither Party requests a change, the Agreement will be automatically renewed. The fees are subject to negotiation on the anniversary date of the Contract or any monthly due date after the end of the original term providing MSA gives no less than 30 days written notice of its intent to adjust the fees. The new fees will continue in force one year from the effective date of the change unless there are significant changes in the required services or nature of the CLIENT. Ownership of Records and Files: The CLIENT owns all claim records. MSA will maintain those records in conjunction with the administrative services to be performed herein. The confidentiality of the records will be maintained by MSA and the information therein will not be divulged or made available to persons other than those authorized by the CLIENT or a court of competent jurisdiction. In the event of termination of this Agreement, MSA will make available to the CLIENT upon written request and within 30 days of that request, the information on all claims history. This information will include electronic and printed media. The CLIENT will pay all costs in providing the information, including computer charges, programming, labor, mailing or shipping costs, etc. Annual Appropriation: Notwithstanding anything herein contained to the contrary, the CLIENT'S obligations under this agreement are expressly subject to an annual appropriation being made by the Board of County Commissioners in any amount sufficient to pay for sums due hereunder. In the event sufficient funds shall not Page 4 of 7. e r be appropriated for the payment of sums due hereunder, this agreement may be terminated by either party without penalty; provided, however, that in the event of such termination MSA shall be paid for all work performed under this agreement up to the date of termination. The CLIENT'S obligations hereunder shall not constitute a general obligation indebtedness or multiple year direct or indirect debt or other financial obligation whatsoever within the meaning of the Constitution or laws of the State of Colorado. . Termination Of This Agreement: Either party may terminate this Agreement at any time upon written notice to the other party thirty (30) days in advance of the date of termination, unless another date is agreed upon by both parties. However, upon written notice, this Agreement will terminate immediately as of the date the first of the following events occur: 1. The service fee is not paid within 30 days of its due date, if desired by MSA, 2. the CLIENT fails to provide adequate funds to honor claims payments on a timely basis, 3. Either party ceases to do business. All obligations, duties and responsibilities of MSA under this Agreement will cease as of the date of termination, including further responsibility for work in process but incomplete on the termination date. If claims are to be processed or other services performed after the termination date, the fees for such services will be based on the average fees during the last three months of the Agreement, as follows: 100% of the average fees during the first month after termination, 75% the second month, 50% the third month and 25% each month thereafter until no further claims services are required as determined by the CLIENT. • Monthly fees due following the date of termination must be received by MSA prior to the performance of the agreed upon services. General Provisions: The CLIENT agrees to indemnify and hold harmless MSA against any and all loss, liability or damage (including payment of reasonable attorney's fees) which MSA may incur by reason of failure of the CLIENT or its employees or agents to abide by the terms of this Agreement or for disputes arising out of partial or total denial of a claim or for action taken by MSA at the direction of the CLIENT. MSA agrees to indemnify and hold harmless against any and all loss, liability or damage (including payment of reasonable attorney's fees) which the CLIENT may incur by reason of failure of MSA to abide by this Agreement or by reason of an interpretation of the Plan terms by MSA which is not a good faith interpretation or for MSA's negligence, fraud, embezzlement, or other willful Page 5 of 7. C � misconduct. Clerical error is not negligence if MSA makes prompt attempt to correct the error once it is discovered. The parties to this Agreement agree that any disputes arising hereunder shall be resolved by dispute resolution procedures which are alternatives to litigation in state or federal courts. Accordingly, the parties agree that upon the occurrence of a dispute between them regarding any matter under this Agreement, they shall meet in an attempt to determine the proper or appropriate procedures for resolving that dispute, including negotiation between the parties, mediation, mini - trials, or arbitration. In the event the parties are unable to agree upon the procedures to be utilized in resolving the dispute, then arbitration, as provided herein, shall be the deemed procedure. All arbitration proceedings shall be conducted in accordance with the procedures of the American Arbitration Association (AAA), and shall be conducted at the AAA Offices in Denver, Colorado. The parties agree that the AAA procedures shall be modified to provide that an evidentiary hearing before the arbitrators shall be held within sixty (60) days following the date the matter is submitted to the AAA and that an award or other determination of arbitrators shall be made in writing within fifteen (15) days following the conclusion of the evidentiary hearing. The parties agree that the award of the arbitrators, or in the event of any other dispute resolution procedure utilized then the stipulation or agreement of the parties regarding the resolution of the dispute, shall be binding upon the parties and no court action may be commenced with respect to that dispute. MSA intends to provide blanket Fidelity and Errors and Omissions insurance in amounts not less than $100,000. In the event of reduction of these limits, the CLIENT will be notified in writing of such fact. The CLIENT may, at its discretion, name MSA as a named insured on the CLIENT's Fidelity and Errors and Omissions insurance policies. Failure to enforce any provision of this Agreement does not effect the rights of the parties to enforce such provision in another circumstance. Neither does it effect the rights of the parties to enforce any other provision of the Agreement at any time. If any provision of this Agreement is determined to be unenforceable or invalid, such determination will not effect the validity of the other provisions contained in the Agreement. MSA will have no responsibility to verify information received in good faith from the CLIENT, its employees or their dependents, or medical /dental providers. The validity, interpretation and performance of this Agreement shall be controlled and construed according to the laws of the State of Colorado. Page 6 of 7. Additional Services: Any changes in the Plan found to be incompatible with existing systems and procedures and approved by MSA which require additional programming, reports or services will be at the expense of the CLIENT. The CLIENT agrees to make changes in benefits effective only after allowing forty -five (45) days prior notice to MSA, unless agreed upon by MSA and appropriately written by amendment to this Contract. Other Applicable Agreements: The following MSA Agreements are by this reference incorporated into this Agreement: Client's Initials Title of Agreement Date This Agreement may be changed at any time by written amendment, provided such amendment is agreed to and signed by duly authorized representatives of both MSA and the CLIENT. The signatures below bind both parties to the terms of this Agreement. Signed in Vovci (-0 by: MOUNTAIN STATES ADMINISTRATION CO., INC. Signed in t�,O).Ag _� 0. EAGLE COUNTY, COLORADO %f 11 �JW &i Page 7 of 7.