HomeMy WebLinkAboutC97-080 Mountain States Administration CoCC?$045ADMINISTRATIVESERVICESAGREEMENTThisAgreementismadeandexecutedasofSeptember1,19_96byandbetweenMOUNTAINSTATESADMINISTRATIONCO.,INC.(hereinafterreferredtoas“MSA”)andEAGLECOUNTY(hereinafterreferredtoasthe“Client”).MSAisengagedinthebusinessofperformingservicesasEmployeeBenefitAdministratorsandtheCLIENTherebyengagesMSAtoprovidecertainadministrativeservicesforEAGLECOUNTYEMPLOYEEBENEFITPLAN(hereinafterreferredtoasthe“Plan”).Fortheconsiderationdetailedherein,itismutuallyagreedasfollows:ServicesToBePerformed:MSAwill:Reviewallclaimdocumentsthoroughlyandcoordinatethemwithdoctors,hospitals,andotherprovidersofservices,todeterminethatthechargesandservices/suppliesareusualandcustomary.ReceiveclaimsdocumentsandverifytheeligibilityoftheclaimantbasedoninformationprovidedbytheCLIENT.ProcessanddistributecopiesofExplanationofBenefitsandbenefitchecks.Answertelephone/mailinquiriesfromparticipantsandprovidersregardingeligiblebenefits.Correspond(telephone/letter)withclaimantsorprovidersofservicesifadditionalinformationisnecessarytoexpediteclaimprocessing.ProcessclaimsaccordingtotheCoordinationofBenefitsprovisionofthePlan.Handleallclaimsexpeditiously.NotifytheCLIENTregardinganyclaimswhich,inMSA’sopinion,mayinvolveprobablethirdpartyliability,subrogationorotherlitigation.Providewrittenexplanationtotheclaimantforineligibleclaims.ProvidethenecessaryinforriiationtotheCLIENTforthepreparationofERISAreportsandfilings.Provide1099reportstoprovidersofservicesandtotheInternalRevenueService.Page1of7. CCProvidethefollowingmonthlyreports:A.CheckRegisterB.BenefitAnalysisC.PaidClaimsAnalysisbyParticipantD.EligibilityListE.SpecificCoverageReportF.AggregateCoverageReportProvidethefollowingannualreports:A.Year-to-DateBenefitAnalysisB.IncurredLagStudyC.____________________D._____________________E.______________________Providethefollowingservices:YesA.CheckPrintingYesB.FormsPrinting(non-internal)YesC.EnvelopesandLetterheadN/AD.CreationorpreparationofPlanDocument*N/AE.Creationand/orpreparationofPlanDocumentAmendments*N/AF.Creationand/orpreparationofSummaryPlanDescription/EmployeeBooklets*N/AG.BookletPrintingYesH.LongDistancephonecallsYesI.PostageYesJ.PhotocopyingYesK.Customl.D.Cardpreparation*isrecommendedthatallsuggestedwordingwillbereviewedbytheCLIENT’SLegalCounsel.ServiceFees:TheCLIENTagreestopaytoMSAfortheservicestobeperformedhereinthefollowingfees:A.Aninitialone-timefeeofN/AB.Amonthlyfeeof$11.60/employee/monthMedical$2.10/employee/monthDental$5.00/participant/monthFlexibleSpending$0.90eachIDCard$0.35/employee/monthBankReconciliationC.OptionalService:BenefitManagementCoordinationat20%ofdefinablesavingsortherateof$75.00anhour.Page2of7. CCThemonthlyfeeisbaseduponapredeterminedclaimsutilizationof_N/A_-(monthlyclaimsper100employees).Foractualclaimsutilizationexceedingthisnumber,theCLIENTwillpayanadditionalfeeof$N/Aperclaim.Feesaredueandpayableonorbeforethe10thofeachmonth,basedonenrollmentonthefirstdayofthatmonth.Aportionoftheabovemaybepaidtoinsuranceagentsorbrokersprovidingotherservicingfunctions.Inadditiontothemonthlyfee,theCLIENTshallreimburseMSAfortheactualexpensesincurredonbehalfoftheCLIENTasfollows:NoA.CheckPrintingYesB.FormsPrinting(non-internal)NoC.EnvelopesandLetterheadN/AD.CreationorpreparationofPlanDocument*NoE.Creationand/orpreparationofPlanDocumentAmendments*N/AF.Creationand/orpreparationofSummaryPlanDescription/EmployeeBooklets*N/AG.BookletPrintingNoH.LongDistancephonecallsNoI.PostageNo].PhotocopyingYesK.Customl.D.Cardpreparation*ItisrecommendedthatallsuggestedwordingwillbereviewedbytheCLIENT’SLegalCounsel.RelationshipBetweentheParties:MSAperformsministerialservicesunderthedirectionoftheCLIENT’sPlanDocument,Corporatepolicies,rules,practices,proceduresandinterpretations.MSAisnotaPlanfiduciaryasdefinedintheEmployeeRetirementandIncomeSecurityActof1974(ERISA).TheCLIENTwillnotdirectMSAtotakeanyactoractionthatwouldconstituteaviolationunderanyERISAprovision.MSAshallnothavediscretionaryauthorityorcontrolrespectingthePlan’sassetsandshallnotrenderinvestmentadviceonthePlan’sassets.MSAwillnotprovidenorberesponsiblefortheexpenseorcostofLegalcounsel,Actuaries,Consultingphysiciansordentists,CertifiedPublicAccountantsorAuditors,InvestmentCounselorsorotherprofessionalservicestotheCLIENT’sPlanunlessemployedbyMSAatitssolediscretion.Page3of7. CCTermofAgreement:ThetermofthisAgreementshallbefromSeptember1,1996toAugust31,1997Attheendoftheterm,ifneitherPartyrequestsachange,theAgreementwillbeautomaticallyrenewed.ThefeesaresubjecttonegotiationontheanniversarydateoftheContractoranymonthlyduedateaftertheendoftheoriginaltermprovidingMSAgivesnolessthan30dayswrittennoticeofitsintenttoadjustthefees.ThenewfeeswillcontinueinforceoneyearfromtheeffectivedateofthechangeunlesstherearesignificantchangesintherequitedservicesornatureoftheCLIENT.OwnershipofRecordsandFiles:TheCLIENTownsallclaimrecords.MSAwillmaintainthoserecordsinconjunctionwiththeadministrativeservicestobeperformedherein.TheconfidentialityoftherecordswillbemaintainedbyMSAandtheinformationthereinwillnotbedivulgedormadeavailabletopersonsotherthanthoseauthorizedbytheCLIENToracourtofcompetentjurisdiction.IntheeventofterminationofthisAgreement,MSAwillmakeavailabletotheCLIENTuponwrittenrequestandwithin30daysofthatrequest,theinformationonallclaimshistory.Thisinformationwillincludeallhardcopyrecordsaswellaselectronicandprintedmedia.TheCLIENTwillpayallcostsinprovidingtheinformation,includingcomputercharges,programming,labor,mailingorshippingcosts,etc.AnnualAppropriation:Notwithstandinganythinghereincontainedtothecontrary,theCLIENT’SobligationsunderthisagreementareexpresslysubjecttoanannualappropriationbeingmadebytheBoardofCountyCommissionersinanyamountsufficienttopayforsumsduehereunder.Intheeventsufficientfundsshallnotbeappropriatedforthepaymentofsumsduehereunder,thisagreementmaybeterminatedbyeitherpartywithoutpenalty;provided,however,thatintheeventofsuchterminationMSAshallbepaidforallworkperformedunderthisagreementuptothedateoftermination.TheCLIENT’SobligationshereundershallnotconstituteageneralobligationindebtednessormultipleyeardirectorindirectdebtorotherfinancialobligationwhatsoeverwithinthemeaningoftheConstitutionorlawsoftheStateofColorado.TerminationOfThisAgreement:EitherpartymayterminatethisAgreementatanytimeuponwrittennoticetotheotherpartythirty(30)daysinadvanceofthedateoftermination,unlessanotherdateisagreeduponbybothparties.However,uponwrittennotice,thisPage4of7. CCAgreementwillterminateimmediatelyasofthedatethefirstofthefollowingeventsoccur:1.Theservicefeeisnotpaidwithin30daysofitsduedate,ifdesiredbyMSA,2.theCLIENTfailstoprovideadequatefundstohonorclaimspaymentsonatimelybasis,3.Eitherpartyceasestodobusiness.Allobligations,dutiesandresponsibilitiesofMSAunderthisAgreementwillceaseasofthedateoftermination,includingfurtherresponsibilityforworkinprocessbutincompleteontheterminationdate,Ifclaimsaretobeprocessedorotherservicesperformedaftertheterminationdate,thefeesforsuchserviceswillbebasedontheaveragefeesduringthelastthreemonthsoftheAgreement,asfollows:•100%oftheaveragefeesduringthefirstmonthaftertermination,75%thesecondmonth,50%thethirdmonthand25%eachmonththereafteruntilnofurtherclaimsservicesarerequiredasdeterminedbytheCLIENT.•MonthlyfeesduefollowingthedateofterminationmustbereceivedbyMSApriortotheperformanceoftheagreeduponservices.GeneralProvisions:TheCLIENTagreestoindemnifyandholdharmlessMSAagainstanyandallloss,liabilityordamage(includingpaymentofreasonableattorney’sfees)whichMSAmayincurbyreasonoffailureoftheCLIENToritsemployeesoragentstoabidebythetermsofthisAgreementorfordisputesarisingoutofpartialortotaldenialofaclaimorforactiontakenbyMSAatthedirectionoftheCLIENT.MSAagreestoindemnifyandholdharmlessagainstanyandallloss,liabilityordamage(includingpaymentofreasonableattorney’sfees)whichtheCLIENTmayincurbyreasonoffailureofMSAtoabidebythisAgreementorbyreasonofaninterpretationofthePlantermsbyMSAwhichisnotagoodfaithinterpretationorforMSA’snegligence,fraud,embezzlement,orotherwillfulmisconduct.ClericalerrorisnotnegligenceifMSAmakespromptattempttocorrecttheerroronceitisdiscovered.ThepartiestothisAgreementagreethatanydisputesarisinghereundershallberesolvedbydisputeresolutionprocedureswhicharealternativestolitigationinstateorfederalcourts.Accordingly,thepartiesagreethatupontheoccurrenceofadisputebetweenthemregardinganymatterunderthisAgreement,theyshallmeetinanattempttodeterminetheproperorappropriateproceduresforresolvingthatdispute,includingnegotiationbetweentheparties,mediation,miniPage5of7. Ctrials,orarbitration.Intheeventthepartiesareunabletoagreeupontheprocedurestobeutilizedinresolvingthedispute,thenarbitration,asprovidedherein,shallbethedeemedprocedure.AllarbitrationproceedingsshallbeconductedinaccordancewiththeproceduresoftheAmericanArbitrationAssociation(AAA),andshallbeconductedattheAAAOfficesinDenver,Colorado.ThepartiesagreethattheAAAproceduresshallbemodifiedtoprovidethatanevidentiaryhearingbeforethearbitratorsshallbeheldwithinsixty(60)daysfollowingthedatethematterissubmittedtotheAAAandthatanawardorotherdeterminationofarbitratorsshallbemadeinwritingwithinfifteen(15)daysfollowingtheconclusionoftheevidentiaryhearing.Thepartiesagreethattheawardofthearbitrators,orintheeventofanyotherdisputeresolutionprocedureutilizedthenthestipulationoragreementofthepartiesregardingtheresolutionofthedispute,shallbebindinguponthepartiesandnocourtactionmaybecommencedwithrespecttothatdispute.MSAintendstoprovideblanketFidelityandErrorsandOmissionsinsuranceinamountsnotlessthan$100,000.Intheeventofreductionoftheselimits,theCLIENTwillbenotifiedinwritingofsuchfact.TheCLIENTmay,atitsdiscretion,nameMSAasanamedinsuredontheCLIENT’sFidelityandErrorsandOmissionsinsurancepolicies.FailuretoenforceanyprovisionofthisAgreementdoesnoteffecttherightsofthepartiestoenforcesuchprovisioninanothercircumstance.NeitherdoesiteffecttherightsofthepartiestoenforceanyotherprovisionoftheAgreementatanytime.IfanyprovisionofthisAgreementisdeterminedtobeunenforceableorinvalid,suchdeterminationwillnoteffectthevalidityoftheotherprovisionscontainedintheAgreement.MSAwillhavenoresponsibilitytoverifyinformationreceivedingoodfaithfromtheCLIENT,itsemployeesortheirdependents,ormedical/dentalproviders.Thevalidity,interpretationandperformanceofthisAgreementshallbecontrolledandconstruedaccordingtothelawsoftheStateofColorado.AdditionalServices:AnychangesinthePlanfoundtobeincompatiblewithexistingsystemsandproceduresandapprovedbyMSAwhichrequireadditionalprogramming,reportsorserviceswillbeattheexpenseoftheCLIENT.TheCLIENTagreestomakechangesinbenefitseffectiveonlyafterallowingforty-five(45)dayspriornoticetoMSA,unlessagreeduponbyMSAandappropriatelywrittenbyamendmenttothisContract.Page6of7. COtherApplicableAgreements:CThefollowingMSAAgreementsarebythisreferenceincorporatedintothisAreement:Client’sInitialsTitleofAgreementDateThisAgreementmaybechangedatanytimebywrittenamendment,providedsuchamendmentisagreedtoandsignedbydulyauthorizedrepresentativesofbothMSAandtheCLIENT.ThesignaturesbelowbindbothpartiestothetermsofthisAgreement.Signedin___________by:SignedinFf9le1(‘;by:MOUNTAINSTATESADMINISTRATIONCO.,INC.(Title)(Date)EAGLECOUNTY,COLORADO(D’ate)(Name)(Title)Page?of?.