HomeMy WebLinkAboutResolution # 3825 - administrative services agreement with health allianceRESOLUTION NO. ~R~S
A RESOLUTION APPROVING AN ADMINISTRATIVE SERVICES
AGREEMENT BETWEEN THE CITY OF CANTON AND HEALTH ALLIANCE,
AND DIRECTING THE MAYOR AND CITY CLERK TO EXECUTE AND
DELIVER SAID AGREEMENT ON BEHALF OF THE CITY OF CANTON,
ILLINOIS.
WHEREAS, the Finance Committee of the City of Canton has determined that it is
necessary and in the best interest to enter into an agreement with Health Alliance to
administer the City's dental plan as set forth in Exhibit A attached hereto and
incorporated herein; and,
WHEREAS, the City Council of the City of Canton has made a similar determination.
NOW, THEREFORE, BE IT RESOLVED by the Mayor and the City Council of the
City of Canton, Illinois, as follows:
1. That the Agreement attached hereto and incorporated herein as Exhibit A was hereby
approved by the Canton City Council.
2. That the Mayor and City Clerk of the City of Canton, Illinois are hereby authorized
and directed to execute and deliver said Agreement on behalf of the City of Canton.
3. That this Resolution shall be in full force and effect immediately upon its passage by
the City Council of the City of Canton, Illinois and approval of the Mayor thereof.
PASSED by the City Council of the City of Canton, Illinois at a regular meeting this
~~.. ~ day of Septanber , 2007 upon a roll call vote as follows:
AYES: Aldeztnen I,ewi.s, Straxxlberg, Nfeade, Nidiffer, West, Sarff, Berardi.
NAYS: None.
ABSENT: Alderrnaxi Schenck.
APPROVED:
odney . Heinze, Mayo
ATTEST: ~' ~ ~ ' 4.,C ~~^ ~ ~~i~
Nancy ites, City Clerk
ADMINISTRATIVE SERVICES AGREEMENT
THIS AGREEMENT is made and entered into this I" day of May, 2007 by and between
Health Alliance Medical Plans, Inc., an Illinois corporation ("Health Alliance") and City of
Canton ("Plan Administrator").
WHEREAS, Health Alliance is validly organized, duly authorized and licensed as a third
party administrator and preferred provider administrator under Illinois statutes; and
WHEREAS, the Plan Administrator, in its capacity as Plan sponsor, has established the
employee welfare benefit plan described in Exhibit " 3" of this Agreement ("Plan") for certain
eligible Covered Persons; and
WHEREAS, the Plan Administrator has requested Health Alliance to act as its agent with
regard to certain administrative services and payment of Plan benefits for Covered Services.
NOW, THEREFORE, in consideration of the mutual covenants contained herein, the
above-mentioned recitals, which are incorporated herein by this reference, and other valuable
consideration, the adequacy and receipt of which is hereby acknowledged, the parties hereto agree
as follows:
PARTI
DEFINITIONS
The words and terms set forth below which are not otherwise defined will have the following
meanings:
1.1 "COBRA" means the Consolidated Omnibus Budget Reconciliation Act of 1985, as
amended, and the regulations there under.
1.2 "Covered Person" means a Participant, eligible Dependent or qualified beneficiary under
COBRA who elects coverage under the Plan and properly enrolls in accordance with the
procedures established by the Plan Administrator or its delegate.
1.3 "Covered Services" means those Health Care Services for which the Plan is obligated to
pay benefits to or for Covered Persons pursuant to the terms, conditions and limitations
set forth in the Summary Plan Description/Plan Document.
1.4 "Designated Record Set" means enrollment, payment, claims adjudication, and case or
medical management or disease management records maintained by a Health Alliance or
Plan Administrator; or records used in whole or in part by Health Alliance or Plan
Administrator to make decisions about a Covered Person. For purposes of this definition,
the term "record" means any item, collection or grouping of information that includes
Protected Health Information and is maintained, collected, used or disseminated by or for
Health Alliance or Plan Administrator.
1.5 "Employee" means an employee of the Employer who is a member of a group or
classification of employees to whom benefits under the Plan have been extended and
continue to be extended by designation of the Employer.
1.6 "Employer" means City of Canton and the Plan Sponsor.
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,'
1.7 "Health Care Services" means the dental services provided by a licensed provider.
1.8 "Participant" means an eligible Employee, Retired Employee or a former Employee who
is a qualified beneficiary under COBRA who elects coverage under the Plan and properly
enrolls in accordance with the procedures established by the Plan Administrator or its
delegate.
1.9 "Protected Health Information" means all individually identifiable health information
transmitted or maintained by Health Alliance or Plan Administrator regardless of form.
1.10 "Summary Plan Description/Plan Document" means the written Plan description and any
amendment thereto and provided to Employees. The document will contain all
information required in a manner calculated to be understood by the average Participant
and be sufficiently accurate and comprehensive to reasonably apprise such Participants of
their rights and obligations under the Plan.
PART II
PLAN BENEFITS
2.1 The Plan benefits subject to this Agreement are dental benefits.
PART III
PLAN ADMINISTRATOR RESPONSIBILITIES
3.1 The Plan Administrator represents that it is the Plan fiduciary having authority to control
and manage the operation and administration of the Plan. Except as otherwise
specifically provided herein, the Plan Administrator retains all liabilities under the Plan
and Health Alliance neither insures nor underwrites any such liability of the Plan
Administrator. In performing its obligations under this Agreement, with respect to the
Plan Administrator, Health Alliance acts only as the provider of the services described in
this Agreement and, with respect to Covered Persons, acts only as the agent of the Plan
Administrator.
3.2 The Plan Administrator will pay Health Alliance's charges for services performed under
this Agreement as set forth in the Schedules attached to this Agreement and any sales or
use tax, premium tax or any similar benefit-related or Plan-related charge, surcharge or
assessment, however denominated, which may be imposed by any governmental
authority. Health Alliance has the right to change the charges:
a. on the date a significant change is made in the Plan; or
b. on the date the number of Employees covered by the Plan has changed by
twenty-five percent (25%) or more since the date the then-current charges were
effective.
A grace period of thirty-one (31) days without interest will be allowed for the payment of
every charge due and payable after the effective date. Failure of the Plan Administrator
to pay any charge within the grace period will result in the automatic termination of this
Agreement at the end of the grace period. The Plan Administrator will remain liable to
Health Alliance for charges that are due and unpaid as of the date of termination.
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3.3 The Plan Administrator will provide funds for the payment of Plan benefits for Covered
Services, and the Plan Administrator will comply in all respects with the funding
procedures as set forth in Exhibit "1" of this Agreement.
3.4 The Plan Administrator will provide Health Alliance the Summary Plan Description/Plan
Document needed to process, adjudicate and pay Covered Person claims under the terms
of this Agreement. The Plan Administrator must notify Health Alliance in writing of any
changes in the Summary Plan Description/Plan Document, no less than thirty-one (31)
days prior to the effective date of the change.
3.5 The Plan Administrator will provide information to Health Alliance regarding the
eligibility and entitlement of Covered Persons to receive Plan benefits in a form approved
by Health Alliance to perform its functions under the terms of this Agreement. In
determining any person's right to Plan benefits, Health Alliance shall rely on eligibility
information provided by the Plan Administrator and will have no obligation with respect
to any changes in the eligibility status of a Covered Person prior to receipt of proper
notification in writing by the Plan Administrator.
3.6 The Plan Administrator acknowledges that it is solely responsible for complying with all
Plan reporting and disclosure requirements imposed by the Internal Revenue Code and all
other applicable federal, state and local laws. Health Alliance will have no responsibility
with respect to such requirements, except to provide the Plan and the Plan Administrator,
upon its reasonable request, with information in its possession that is necessary for the
Plan Administrator to complete required reports.
3.7 In the event the Plan Administrator should request an audit with respect to the
administration of the Plan under this Agreement, the Plan Administrator agrees to:
a. Pay the Plan's auditors to perform the audit. Treat all of Health Alliance's
proprietary information and all information concerning claims or claimants in a
confidential manner, and to use such information only for purposes necessary
for completion of the audit except where fraud is alleged.
b. Health Alliance requires a minimum ten-day (10) notice of all audits. Health
Alliance will pull requested documentation in preparation for the audit when
appropriate notice is given.
c. Allow Health Alliance to review the audit results and to include with the official
audit report a supplementary statement from Health Alliance containing facts it
deems pertinent to the audit.
3.8 The Plan Administrator will indemnify Health Alliance for and save Health Alliance, its
directors, officers and employees harmless from and against all loss, liability, damage,
expenses or other obligation including reasonable attorneys' fees and court costs, for
which Health Alliance may become liable:
a. for any sales or use tax, premium tax or any similar benefit-related or Plan-
related charge, surcharge or assessment, however denominated, including any
penalties and interest payable with respect thereto, assessed by any
governmental authority against Health Alliance on the basis of and/or measured
by the amount of Plan benefits administered by Health Alliance pursuant to this
Agreement;
as a result of any acts or omissions occurring while this Agreement is in effect
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alleged to be a breach of fiduciary duty;
c. arising in connection with payment of Plan benefits and administrative services
performed under this Agreement;
d. arising out of any claim, legal action or proceeding instituted by any third party
regarding unclaimed or abandoned property, or laws relating thereto, or any
escheat obligations, as related to Plan benefits administered pursuant to this
Agreement, including any penalties and interest payable with respect thereto; or
arising from any allegation of a breach of confidentiality related to the release of
confidential information to, or any improper use of such information by, the
Plan Administrator or a third party.
PART IV
HEALTH ALLIANCE RESPONSIBILITIES
4.1 Health Alliance will receive and adjudicate properly submitted claims for payment of
Covered Services received during the contract period and disburse benefit payments and
provider authorizations to the persons entitled thereto that it determines to be due in
accordance with the terms of the Plan.
4.2 Health Alliance will perform or retain services of a vendor to perform certain
identification and follow-up recovery services in connection with claims adjudicated or
paid which may be eligible for reimbursement to the Plan under workers' compensation,
subrogation, personal injury laws, third party liability laws and coordination of benefits.
Plan reimbursement will be net of the vendor's fee for any such services.
43 Health Alliance will notify any Covered Person whose request for payment of Covered
Services it denies in whole or in part of the reasons for the denial, and of that Covered
Person's rights to have the denial reviewed in the manner and within the time limits then
required by the Plan.
4.4 Plan Administrator, acting as Plan fiduciary, reserves to itself the authority and
responsibility to make a full and fair review of each claim denial and to notify the
claimant in writing of its decision on review in accordance with the requirements of the
Plan relating thereto. Plan Administrator acknowledges that this reservation of authority
is reflected in the Summary Plan Description/Plan Document.
4.5 Health Alliance will provide the Plan Administrator services and assistance in connection
with the design and development of the Plan, initially and in connection with Plan
revisions. Service and assistance includes: underwriting and actuarial services; estimates
of initial Plan costs; cost projections of any proposed Plan revisions; and dra8ing and
printing of the Summary Plan Description/Plan Document.
4.6 Health Alliance will provide to the Plan Administrator the following:
a. Reports regarding the Plan as agreed to by the Plan Administrator and Health
Alliance as set forth in Exhibit " 2" of this Agreement. Upon request, Health
Alliance will provide ad hoc reports at a fee to be determined based on the
number of hours required for completion. A minimum $500 fee per Plan year
will be charged per ad hoc report.
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Administrative forms needed to facilitate the performance of the Health Alliance
duties pursuant to this Agreement.
c. Current listings of Covered Persons based on enrollment and disenrollment
information provided by the Plan Administrator.
4.7 In the event the Plan Administrator should request an audit with respect to the
administration of the Plan under this Agreement, Health Alliance agrees to:
a. Allow the Plan Administrator's auditors to examine Health Alliance's records
and transactions used to perform the administrative services under this
Agreement at any time during the normal business hours of Health Alliance,
provided that at least ten (10) days prior notice in writing has been given by the
Plan Administrator of its intent to audit Health Alliance's records.
b. Allow the Plan Administrator or any third party representative chosen by the
Plan Administrator, other than a representative whose action would be
considered to be a conflict of interest by Health Alliance, to perform portions of
the audit on site in Health Alliance's claims processing and accounting
locations.
4.8 Health Alliance will credit to the Plan administrative fees in Schedule "A" of this
Agreement for Participants whose Plan enrollment terminated up to ninety (90) days prior
to the date of notification of termination. Health Alliance will not credit administrative
fees beyond ninety (90) days prior to the date of notification for retroactive terminations.
4.9 In the event a Covered Person's Plan enrollment is retroactively terminated by the Plan
Administrator effective more than 90 days prior to Health Alliance's receipt of notice of
such termination, Health Alliance will attempt to recover Plan benefits paid for Covered
Services received by the Covered Person after the effective date of termination but not
more than one year prior to Health Alliance's receipt of the notice thereof.
4.10 Health Alliance will maintain errors and omissions coverage during the term of this
Agreement with liability limits not less than $1,000,000. Health Alliance will also
maintain comprehensive general and professional liability insurance, at minimum limits
of $1,000,000 per occurrence and $3,000,000 annual aggregate of all claims.
4.11 Health Alliance will indemnify the Plan Administrator and save it harmless from and
against all claims, lawsuits, settlements, judgments, costs, penalties and expenses,
including attorneys' fees, with respect to this Agreement resulting from or arising out of
the gross negligence or the dishonest, fraudulent or criminal acts of Health Alliance or its
employees, acting alone or in collusion with others.
PART V
CONFIDENTIALITY
5.1 Health Alliance and the Plan Administrator agree to ensure the confidentiality of all
information exchanged between the Plan Administrator and Health Alliance including,
but not limited to: (a) the terms of this Agreement; (b) details of the operation of
administrative services, including the provider discounts; (c) financial, utilization or any
other information related to the management and administration of the Plan. Information
may be used in a blinded, cumulative manner by Health Alliance for general Plan
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performance comparisons.
PART VI
HIPAA COMPLIANCE
6.1 The provisions of this Part VI shall supersede any conflicting or inconsistent terms of this
Agreement, including all exhibits, schedules and other attachments hereto and all
documents incorporated herein by reference. The parties understand and acknowledge
that Health Alliance is performing services for and on behalf of the Plan pursuant to this
Agreement as a "business associate" of the Plan for purposes of the Health Insurance
Portability and Accountability Act of 1996 ("HIPAA") and the health information
privacy standards promulgated there under at 45 C.F.R. Parts 160 and 164 (the "Privacy
Regulations"). The parties recognize that HIPAA and the Privacy Regulations require
the imposition of certain safeguards to protect the privacy of individually identifiable
health information that is created or received by Health Alliance in performing services
for or on behalf of the Plan pursuant to this Agreement ("Protected Health Information").
The Plan and Health Alliance will fully comply with all applicable Privacy Regulations
and other applicable federal and state law respecting the privacy of health information,
and hereby agree to amend this Agreement to the extent necessary to allow the Plan to
comply with the Privacy Regulations, the standards for electronic transactions (45 C.F.R.
Parts 160 and 162) and the security standards (45 C.F.R. Part 142) promulgated or to be
promulgated under HIPAA, and to incorporate any material required to be incorporated
thereby.
6.2 Health Alliance may:
a. Use Protected Health Information in its possession for the proper management
and administration of Health Alliance and to fulfill any of the present or future
legal responsibilities of Health Alliance, provided that such uses are permitted
under state and federal confidentiality laws; and
b. Disclose Protected Health Information in its possession to third parties for the
purpose of the proper management and administration of Health Alliance or to
fulfill any of the present or future legal responsibilities of Health Alliance if (i)
the disclosures are required by law, as defined in 45 C.F.R. § 164.501 or (ii)
Health Alliance has received from the third party written assurances regarding
the confidential handling of such Protected Health Information as required under
45 C.F.R.§164.504(e)(4)(ii).
6.3 With regard to its use and disclosure of Protected Health Information, Health Alliance's
obligations are to:
a. Use and disclose the Protected Health Information only as required to satisfy its
obligations under this Agreement and as permitted by this Part VI or as
otherwise required by law.
Use commercially reasonable efforts to maintain the security of the Protected
Health Information to prevent its use or disclosure other than as provided for in
this Part VI.
c. With respect to Protected Health Information in a Designated Record Set, have
responsibility for responding to requests to access such Protected Health
Information by a Covered Person. Plan Administrator delegates to Health
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Alliance the authority to determine on behalf of Plan Administrator whether to
deny access to such requested Protected Health Information.
d. Promptly after receipt of a request from a Covered Person (whether made
directly to Health Alliance or through Plan Administrator) to access Protected
Health Information in a Designated Record Set, respond to the request in the
time and manner required under 45 C.F.R. § 164.524.
e. Upon request, make Protected Health Information in a Designated Record Set
available to Covered Person on behalf of Plan Administrator for inspection and
copying to enable Plan Administrator to fulfill its obligations under the Privacy
Rule, including without limitation 45 C.F.R. § 164.524. With respect to
Protected Health Information in a Designated Record Set, Health Alliance will
have responsibility for responding to requests to amend such Protected Health
Information by a Covered Person. Plan Administrator delegates to Health
Alliance the authority to determine on behalf of Plan Administrator whether to
deny a requested amendment to such Protected Health Information.
£ Promptly after receipt of a request from a Covered Person (whether made
directly to Health Alliance or through Plan Administrator) to amend Protected
Health Information in a Designated Record Set, respond to the request in the
time and manner required under 45 C.F.R. § 164.526.
g. Upon request, make Protected Health Information in Designated Record Set
available to Plan Administrator for amendment to enable Plan Administrator to
fulfill its obligations under the Privacy Rule, including without limitation 45
C.F.R. § 164.526.
h. Document disclosures of Protected Health Information and information related
to such disclosures as required by and in accordance with 45 C.F.R. § 164.528.
i. Promptly after receipt of a request from a Covered Person (whether made
directly to Health Alliance or through the Plan Administrator), respond to the
request for an accounting of disclosures in the time and manner required under
45 C.F.R. § 164.528.
j, Upon request, make Protected Health Information in a Designated Record Set
available to Plan Administrator to provide an accounting of disclosures to enable
Plan Administrator to fulfill its obligations under the Privacy Rule, including
without limitation 45 C.F.R. § 164.528.
k. Handle Covered Person requests for privacy protection for Protected Health
Information pursuant to the requirements of the Privacy Regulations at 45
C.F.R. § 164.522.
1. Promptly report to the Plan Administrator, in writing, any use or disclosure of
the Protected Health Information that is not permitted by this Part VI of which
Health Alliance becomes aware.
m. Require all Health Alliance subcontractors and agents to which it provides the
Protected Health Information to agree, in writing, to adhere to the same
restrictions and conditions on the use and disclosure of Protected Health
Information as apply to Health Alliance pursuant to this Part VI.
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n. Make available all Health Alliance's records, books, agreements, policies and
procedures relating to the use and disclosure of the Protected Health Information
to (i) Plan for purposes of enabling the Plan Administrator to determine Health
Alliance's compliance with the terms of this Part VI and (ii) the Secretary of the
U.S. Department of Health and Human Services for purposes of determining the
Plan's compliance with the Privacy Regulations, subject to attorney-client and
other applicable legal privileges.
o. Within 30 days after termination of this Agreement, Health Alliance agrees to
return or destroy all the Protected Health Information it then maintains pursuant
to 45 C.F.R.§164.504(e)(2)(I), if feasible to do so, and unless otherwise
prohibited from doing so by state or federal law and/or regulation requiring the
maintenance of certain documents containing Protected Health Information. If it
is infeasible for Health Alliance to return or destroy said Protected Health
Information, Health Alliance shall provide Plan with written notification
including a statement that Health Alliance has determined that it is infeasible to
return or destroy the Protected Health Information in its possession, and the
specific reasons for such determination. Health Alliance further agrees to extend
any and all protections, limitations and restrictions contained in this Part VI to
its use and/or disclosure of any Protected Health Information retained after the
termination of this Agreement, and to limit any further uses and/or disclosures to
the purposes that make the return or destruction of the Protected Health
Information infeasible.
6.4 With regard to its use and/or disclosure of Protected Health Information, the Plan's
obligations are:
a. The Plan Administrator agrees to provide Health Alliance with a copy of the
notice of privacy practices that the Plan shall provide to Participants in
accordance with 45 C.F.R. § 164.520, as well as of any changes to such notice.
b. The Plan Administrator agrees to provide Health Alliance with notice of any
changes in, or revocation of, a consent or authorization to use or disclose
Protected Health Information made by a party from whom Protected Health
Information was obtained by the Plan or Health Alliance, if such changes affect
Health Alliance's permitted or required uses and disclosures, within one
business day following the change or revocation.
c. The Plan Administrator agrees to notify Health Alliance of any restriction on the
use or disclosure of Protected Health Information that the Plan has agreed to in
accordance with 45 C.F.R.§164.522, within one business day following such
agreement.
d. The Plan Administrator shall not request Health Alliance to use or disclose
protected Health Information in any manner that would not be permissible under
the Privacy Regulations if done by the Plan.
6.5 The Plan Administrator acknowledges and agrees on behalf of the Plan that the Privacy
Regulations allow the Plan to permit Health Alliance to disclose or provide access to
Protected Health Information, other than "summary health information"(as defined in 45
C.F.R. § 164.504) and Plan enrollment information, to only those employees or other
persons under the control of the Plan Sponsor who are identified by name or position in
the Plan documents as the persons who are to be given access to Protected Health
Information solely to carry out the particular Plan administration functions that the Plan
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Sponsor performs for the Plan. The Plan hereby warrants and represents that it has
received the Plan Sponsor's certification that the Plan documents have been amended to
incorporate, and the Plan Sponsor agrees to, the provisions required by the Privacy
Regulations as a precondition to disclosure of Protected Health Information to the Plan
Sponsor. Accordingly, notwithstanding any other terms and conditions of this
Agreement, to the extent that the fulfillment of its obligations under this Agreement
requires Health Alliance to disclose or provide access to Protected Health Information to
the Plan Sponsor or any employee or other person under the control of the Plan Sponsor,
Health Alliance shall make such disclosure of or provide such access to Protected Health
Information only as follows:
a. Health Alliance shall disclose summary health information to any employee or
other person under the control of the Plan Sponsor upon such person's written
request on behalf of the Plan Sponsor for the purpose of obtaining premium bids
for the provision of health insurance, HMO or stop-loss coverage for the Plan or
modifying, amending or terminating the Plan; and
Health Alliance shall disclose or make available Protected Health Information,
other than summary health information, at the direction of the Plan to only the
following employees or other persons under the control of the Plan Sponsor
identified in the Plan documents solely for the purpose of carrying out the Plan
administration functions that the Plan Sponsor performs for the Plan:
City TreasurerBudget Officer
6.6.1 With regard to security of Electronic Protected Health Information, Health Alliance's
obligations are to:
a. Implement administrative, physical and technical safeguards that reasonably and
appropriately protect the confidentiality, integrity and availability of the
electronic Protected Health Information that it creates, receives, maintains or
transmits on behalf of the Plan as required by the Security Rule.
b. Ensure that any agent, including a subcontractor, to whom it provides such
information, agrees to implement reasonable and appropriate safeguards to
protect it.
c. Promptly report to the Plan Sponsor any Security Incident, with respect to
electronic Protected Health Information, of which it becomes aware.
d. Authorize termination of the contract by the covered entity if the covered entity
determines that the business associate has violated a material term of the
contract.
PART VII
RESPONSIBILITY FOR PROVISION OF SERVICES
7.1 Health Alliance does not nor does it intend to, engage in the performance or delivery of
medical, hospital or other types of health care. Nothing herein will be construed to imply
that Health Alliance, its officers, directors, employees or agents are engaged in the
practice of medicine or other health care professions related thereto. Any determination
under a preauthorization program, if any, or quality assurance or utilization management
program or respecting what is "medically necessary" for purposes of determining
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reimbursement under this Agreement is expressly recognized as not interfering with any
determination by providers of medical and hospital services with respect to the medical
needs and the appropriate treatment of a Covered Person.
PART VIII
PLAN ADMINISTRATOR LIABILITY
8.1 Health Alliance does not insure nor underwrite the liability of the Plan Administrator
under the Plan. The Plan Administrator retains the ultimate responsibility for claims
made pursuant to the Plan and ultimate liability related to excess loss filing and exposure.
The Plan Administrator is responsible for all expenses incident to the Plan except any
expenses that this Agreement expressly states will be borne by Health Alliance.
PART IX
HEALTH ALLIANCE LIABILITY
9.1 Health Alliance will use reasonable care and due diligence in the exercise of its powers in
the performance of its duties under this Agreement. Health Alliance will not be liable for
any mistake of judgment or other actions taken in good faith.
9.2 In the event Health Alliance makes an incorrect payment pursuant to this Agreement,
which is a result of the failure of Health Alliance to exercise reasonable care in making
the payment (e.g., clerical error in the issuance of a draft), Health Alliance will be liable
for its mistake. However, if the incorrect payment is the result of incorrect or incomplete
information provided by the Plan Administrator to Health Alliance, Health Alliance will
not be liable for the incorrect payment. The Plan Administrator and Health Alliance will
make a diligent effort to recover any incorrect excess payment made. Health Alliance is
not required to institute any court proceedings.
PART X
RESOLUTION OF DISPUTES
10.1 For purposes of this Section, "Dispute" means any dispute or claim between the Plan
Administrator and Health Alliance arising out of or related to the interpretation or
application of this Agreement or breach thereof.
10.2 Resolution of disputes will be subject to good faith negotiation between the parties. The
complaining party will notify the other party in writing of such dispute, and the parties
will attempt to resolve the dispute within ninety (90) days of the date of such notice or
within such time as is mutually agreed upon by the parties in writing. In the event the
dispute cannot be settled by the mutual cooperation of the parties, the dispute will be
referred to an independent review organization identified by a nationally recognized
board or association. The parties hereto will be legally bound by the outcome of any
such appeal.
PART XI
TERM AND TERMINATION
11.1 The effective date of this Agreement is May 1, 2007.
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11.2 When executed by both parties, this Agreement will be effective as of the date set forth
above and will continue in effect unless otherwise amended or terminated.
11.3 This Agreement may be terminated with or without cause by a party at any time upon
providing the other party ninety (90) days prior written notice.
11.4 This Agreement may be terminated by either party for cause by giving thirty-one (31)
days notice to the other party in writing of such intention to terminate the Agreement.
For purposes of this Section 13.4, "cause" is defined as an intentional or willful violation
of any of the provisions of this Agreement by a party or failure to abide by all applicable
state and federal laws and regulations that pertain to it. The party seeking to terminate
this Agreement for cause must specify in writing to the other party the nature of the cause
that is the basis for its termination.
11.5 In the event either party to this Agreement becomes insolvent, makes a general
assignment for the benefit of creditors, suffers or permits the appointment of a receiver
for its business or its assets or avails itself of, or becomes subject to, any proceeding
under the Federal Bankruptcy Act, or any statute of any state relating to insolvency or the
protection or rights of creditors, or becomes subject to rehabilitation, then, at the option
of the other party, this Agreement will terminate and be of no further force and effect.
11.6 The parties will cooperate with each other to resolve promptly any outstanding financial
or administrative issues upon termination of this Agreement.
PART XII
INDEPENDENT CONTRACTOR
12.1 Except as otherwise specifically stated in this Agreement, each party is acting as an
independent contractor and not as the agent, employee, partner or co-venturer of the other
party.
12.2 Health Alliance will not be considered to be the Plan Administrator, a fiduciary or trustee
of the Plan.
PART XIII
OTHER PERSONS NOT A PARTY
13.1 No person will have any rights under this Agreement unless he or she is a party hereto.
This Agreement is not intended to, and will not, create any rights in any person, including
a Covered Person, who is not a signatory hereto. The covenants, undertakings and
agreements set forth in this Agreement will be solely for the benefit of, and will be
enforceable only by, the parties hereto or their respective successors and assigns as
permitted hereunder.
PART XIV
AMENDMENTS AND ASSIGNMENTS
14.1 Except as otherwise expressly set forth herein, this Agreement will not be amended,
altered, changed or assigned at any time without the express written consent of each of
the parties hereto and any such amendments of this Agreement will be by written
amendment signed by each of the parties and made a part of this Agreement. The
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foregoing notwithstanding, Health Alliance will have the right to amend this Agreement
upon thirty-one (31) days notice to the Plan Administrator in order to conform to the
terms and provisions hereof to applicable state and federal law.
14.2 The specific duties and obligations of the parties as set forth in this Agreement will not be
assigned or transferred to other persons or entities without the express written consent of
each of the parties hereto, which written consent will not be unreasonably withheld.
PART XV
TRADEMARKS AND SYMBOLS
15.1 The Plan Administrator and Health Alliance reserve the right to control the use of their
respective symbols, trademarks and service marks, presently existing or subsequently
established. The Plan Administrator and Health Alliance agree not to use words,
symbols, trademarks, service marks and other devices, including the corporate name of
the other party in advertising, promotional materials or otherwise without the prior
written consent of the other party. The Plan Administrator and Health Alliance will cease
any previously approved usage immediately upon termination of this Agreement. The
Plan Administrator and Health Alliance further agree that any advertising, promotional
materials or otherwise which include the name of the Plan Administrator or Health
Alliance, are the property of the appropriate namesake and will be returned to the
appropriate property owner either upon request or at termination of this Agreement.
PART XVI
APPLICABLE LAW
16.1 This Agreement shall be subject to and construed under the laws of the State of Illinois.
PART XVII
NOTICES
17.1 Any notice required under the terms of this Agreement will be sent by United States mail
with postage prepaid, return receipt requested and addressed as follows:
Health Alliance Medical Plans, Inc. City of Canton
Chief Executive Officer City TreasurerBudget Officer
301 South Vine Street 2 North Main Street
Urbana, Illinois 61801-3347 Canton, Illinois 61520
and any such notice will be effective upon the earlier of receipt by the party to which it is
addressed or three (3) days after notice is sent.
17.2 Parties may change the address to which notices are to be sent by providing notice
pursuant to this section.
PART XVIII
REFERENCES AND SECTION HEADINGS
18.1 Any reference to the singular will include reference to the plural and vice versa. Section
headings are intended for purposes of description only and will not be used for purposes
ASO-12 City of Canton
of interpretation of this Agreement.
PART XIX
SEVERABILITY AND SUPERVENING LAW
19.1 The invalidity or unenforceability of any term or provision of this Agreement will not
impair or affect any other provision hereof which will remain in full force and effect.
The parties recognize that this Agreement at all times is to be subject to applicable state,
local and federal law. Any provisions of the law that invalidate, or otherwise are
inconsistent with, the terms of this Agreement or that would cause one or both of the
parties to be in violation of law, will be deemed to have superseded such terms of this
Agreement, provided however, that the parties will exercise their best efforts to
accommodate the terms and intent of this Agreement to the greatest extent possible
consistent with the amended requirements of law.
PART XX
SURVIVAL
20.1 Provisions contained in this Agreement that by their sense and context are intended to
survive completion of performance or termination of this Agreement shall so survive.
PART XXI
ENTIRE CONTRACT
21.1 This Agreement and the attached Schedules and Exhibits, which are incorporated herein
by this reference, constitute the entire contract between Health Alliance and the Plan
Administrator. This Agreement supersedes any and all previous oral and written
agreements between the parties relating to the subject matter of this Agreement.
IN WITNESS WHEREOF, the parties have executed this Agreement on the day and year
first appearing above.
HEALTH ALLIANCE MEDICAL PLANS, INC. CITY OF CANTON
By:
Date:
Its:
Attest:
By:
Date:
Its:
Attest:
ASO-13 City of Canton
CITY OF CANTON
SCHEDULE "A"
COMPENSATION TERMS
PLAN YEAR May 1, 2007-April 30, 2008
1. Plan Administrator will pay Health Alliance the following fee per Employee per month
(PEPM) within thirty-one (31) days from the date of invoice:
Dental Claims Administration $~PM
a~So K~
2. Health Alliance will cover the costs of printing for the following standard materials:
Summary Plan Description/Plan Document, amendments, cover letter, identification
cards, Plan highlights and enrollment applications. The Plan Administrator is responsible
for the cost of postage for mailings that include the Summary Plan Description/Plan
Document.
3. The Plan Administrator will reimburse Health Alliance its printing and/or postage costs,
plus twenty percent (20%), for any special printing or mailing for the Plan, except for the
items specified in number 2 above.
4. In the event a Covered Person's Plan enrollment is retroactively terminated by the Plan
Administrator effective more than 90 days prior to Health Alliance's receipt of notice of
such termination, Health Alliance will attempt to recover funds paid for up to one year
under the terms of this Agreement at a collection fee of twenty percent (20%) of
recoveries. Eighty percent (80%) of recoveries will be reimbursed to Plan Administrator
on the funding invoice.
5. Plan Year means May 1, 2007 through April 30, 2008.
IN WITNESS WHEREOF, the parties have executed this Agreement on the day and year
appearing below.
HEALTH ALLIANCE MEDICAL PLANS, INC. CITY OF CANTON
By:
Date:
Its:
Attest:
By:
Date:
Its:
Attest:
ASO-14 City of Canton
EXHIBIT "1"
FUNDING PROCEDURES
The Plan Administrator will pay for Covered Services as follows:
Health Alliance will make benefit determinations and prepare a funding invoice on a
weekly basis for dental claims. The Plan Administrator will be informed via facsimile
with supporting documentation of the amount due for claims payment.
2. Health Alliance will automatically draw down funds from the Employer's bank account
and deposit such funds into the Health Alliance account at the Busey Bank in Urbana,
Illinois. Health Alliance will not release provider or Participant payments until Health
Alliance has sufficient funds from the Plan Administrator in the account at Busey Bank to
cover such payments.
Illinois law requires prompt payment of clean claims within thirty (30) days of receipt. If
Plan Administrator fails to cover payments as required above, Plan Administrator will be
responsible for payment of any interest due providers for late payment.
ASO-15 City of Canton
EXHIBIT " 2"
THIRD PARTY ADMINISTRATIVE SERVICES
Health Alliance will provide the following Third Party Administrative services:
Administrative Services
Benefit design consultation "
Drag and print approved Summary Plan Description/Plan Document
Print and distribute standard identification cards
Communications
Client Services Representative
Toll-free telephone line for Covered Persons
Process enrollment applications
Provide operational forms and standard letters
Maintenance of records
Provide HIPAA Certificates of Creditable Coverage
Manage requests for accessing and amending Protected Health Information
Track and provide an accounting of disclosures as required under the Privacy
Regulations of HIPAA
2. Accounting Services
Assist with banking arrangements
Fund account reconciliation
Claims/Premium Administration
Claims processing and adjudication (Dental)
Explanation of benefits (EOB) form
Quality control and claims audit
Coordination of benefits (COB) >$0
Third party liability/subrogation recovery
Fees apply based on a percent of recovery
Payment of claims with remittance advice electronically or in paper format
Provide detailed monthly billing for administrative services
4. Reporting
Weekly
Claims Funding Invoice
Weekly Check Register
Monthl
Aggregate Monthly Paid Claims Report
Monthly Premium Invoice
Plan Administrator Overrides Report
uarterl
Aggregate Monthly Paid Claims Report
Aggregate Not Covered Savings Report
Aggregate Paid Claims Trail Report
Aggregate Utilization Report
Benchmark Utilization Report
Additional reports are available upon request. The minimum fee is $500 per report per Plan
year.
ASO-16 City of Canton
EXHIBIT " 3"
SUMMARY PLAN DESCRIPTION/PLAN DOCUMENT
ASO-17 City of Canton