HomeMy WebLinkAboutHR1998-0093 - Original - Blue Cross of Washington and Alaska - Administrative Service Contract - 01/01/1998 •, e
BLUE CROSS OF WASHINGTON AND ALASKA
CONTRACT ADMINISTRATION AGREEMENT
This Agreement is effective this first day of January 1998, by and
between the CITY OF KENT (hereinafter referred to as the "Plan
Sponsor") , and BLUE CROSS OF WASHINGTON AND ALASKA (hereinafter referred
to as the "Contract Administrator") .
WHEREAS, the Plan Sponsor has established an employee benefit plan
(hereinafter referred to as the "Plan") which provides for payment of
certain welfare benefits to and for certain eligible individuals as
defined by the Plan Document, such individuals being hereinafter
referred to as "Participants, Dependents and Beneficiaries"; and,
WHEREAS, the Plan Sponsor has chosen to self-insure the benefit
program(s) provided under the Plan; and
WHEREAS, the Plan Sponsor desires to engage the services of the Contract
Administrator to provide administrative services for the Plan;
NOW THEREFORE, in consideration of the mutual covenants and conditions
as contained herein the parties hereto agree as follows:
SECTION I DUTIES AND RESPONSIBILITIES OF THE PLAN SPONSOR
1.01 The Plan Sponsor shall provide the Contract
Administrator with a copy of the Plan Document and any
other documents describing the benefit program(s) which
the Contract Administrator may rely upon in performing
its responsibilities under this Agreement.
1.02 The Plan Sponsor shall have final discretionary
authority to determine the benefit provisions and to
construe and interpret the terms of the Plan.
1.03 The Plan Sponsor shall have final discretionary
authority to determine eligibility for benefits and the
amount to be paid by the benefit program(s) .
1.04 Unless specifically delegated to the Contract
Administrator by this Agreement, the Plan Sponsor shall
be responsible for the proper administration of the Plan
including:
a. providing the Contract Administrator a complete and
accurate list of all individuals eligible for
benefits under the benefit program(s) upon which
the Contract Administrator shall be entitled to
rely until it receives documentation of any change
thereto;
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b. notifying the Contract Administrator on a monthly
basis of changes in eligibility;
C. distributing to all eligible Participants,
Dependents and Beneficiaries all appropriate and
necessary materials and documents, including but
not limited to benefit program booklets, summary
plan descriptions, material modifications, the Plan
Document, amendments to the Plan Document,
identification cards, enrollment applications and
notice forms necessary for the operation of the
Plan;
d. providing the Contract Administrator with any
additional information necessary to perform its
functions under this Agreement as may be requested
by the Contract Administrator from time to time;
e. maintaining adequate funds from which the total
cost of all claims for each preceding (week/month]
will be paid to the Contract Administrator by wire
transfer. Funds must be provided within forty-
eight (48) hours of phone notification by the
Contract Administrator to a person designated by
the Plan Sponsor.
1.05 The Plan Sponsor shall be responsible for all taxes,
assessments and fees levied by any local, state or
federal authority in connection with the Contract
Administrator's duties pursuant to this Agreement.
1.06 The Plan Sponsor shall be responsible for the Plan's
continuing compliance with federal, state and local laws
and regulations, including but not limited to the
Internal Revenue Code, the Employee Retirement Income
Security Act of 1974 (ERISA) , and the Consolidated
Omnibus Budget Reconciliation Act of 1985 (COBRA) , and
the Health Insurance Portability and Accountability Act
of 1996 (HIPAA) . The Plan Sponsor, and not the Contract
Administrator, is the "plan administrator" for purposes
of 29 USC Section 1002 (16) (a) and 26 USC Section
4980B(g) (3) and the "plan sponsor" for purposes of 29
USC Section 1161, et seq. The Plan Sponsor shall be
responsible for determining whether it is subject to
COBRA and for notifying Participants, Dependents and
Beneficiaries of their COBRA rights both initially and
upon the occurrence of a qualifying event, for
calculating and collecting premiums for COBRA
continuation of coverage and for promptly notifying the
Contract Administrator when an individual is no longer
eligible for COBRA continuation of coverage.
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1.07 The Plan Sponsor shall be responsible for defending any
legal action brought against the Plan, including a claim
for benefits by or on behalf of any individual or
entity, including but not limited to any Participant or
former Participant, Dependent, Beneficiary, any
fiduciary or other party. This responsibility includes
the selection and payment of counsel. The Plan Sponsor
shall not settle any legal action or claim without the
prior consent of the Contract Administrator if the
action or claim could result in the Contract
Administrator being liable, including for example, any
liability for contribution to or indemnification of the
Plan Sponsor or other third party either directly or
indirectly.
1.08 In the event the Contract Administrator does not have
adequate information to complete the Certificate of
Group Health Coverage as required by HIPAA, the Plan
Sponsor shall be responsible for completing the missing
information on the Certificate and forwarding it to the
Participant or Dependent upon their termination from the
Plan or upon request within 24 months of termination.
SECTION II DUTIES AND RESPONSIBILITIES OF THE CONTRACT
ADMINISTRATOR
2.01 The Contract Administrator agrees to perform the
following administrative services for the Plan Sponsor:
a. assist in the preparation and printing of the Plan
Document, benefit program booklets, identification
cards, and other materials necessary for the
operation of the Plan;
b. process all eligible claims incurred after the
effective date of this Agreement which are properly
submitted in accordance with the procedures set
forth in the Plan Document. Checks will be issued
on the contract Administrator's check stock, but
the responsibility for funding benefits is the Plan
Sponsor's and the Contract Administrator is not
acting as an insurer. The Contract Administrator
shall make reasonable efforts to determine that a
claim is covered under the terms of the benefit
program(s) , to apply the coordination of benefits
provisions, identify subrogation claims, and make
reasonable efforts to recover subrogated amounts
administratively, and prepare and distribute
benefit payments to Participants, Dependents and
Beneficiaries and/or service providers;
C. perform reasonable internal audits;
d. answer inquiries from the Plan Sponsor,
Participants, Dependents and Beneficiaries, and
service providers regarding the terms of the Plan,
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although final authority for construing the terms
of the Plan's eligibility and benefit provisions is
the Plan Sponsors;
e. prepare and provide to the Plan Sponsor monthly
reports of claims paid under the Plan in accordance
with Attachment C;
f. prepare and provide the Plan Sponsor with an annual
report of the operations of the Plan in accordance
with Attachment C;
g. provide information to the Plan Sponsor for
preparing Form 55001s; however, the Plan Sponsor
shall be solely responsible for insuring timely
filing of the Form 55001s;
h. coordinate with any stop-loss insurance carrier;
i. when "preferred provider" benefits are provided,
maintain a network of hospital and professional
providers; paid claims will reflect any negotiated
provider discounts;
j . perform utilization management services including,
preadmission review, admission review, length of
stay assignment, focused concurrent review,
discharge planning, individual case management and
retrospective review.
k. provide a Certificate of Group Health Coverage to
Participants and Dependents when their coverage
under this Plan terminates or upon their request
within 24 months of termination. In the event the
Contract Administrator does not have adequate
information to complete the Certificate, the Plan
Sponsor will be responsible for completing the
missing information on the Certificate and
forwarding it to the Participant or Dependent.
SECTION III LIMITS OF THE CONTRACT ADMINISTRATOR'S RESPONSIBILITY
3.01 It is recognized and understood by the Plan Sponsor that
the Contract Administrator is not an insurer and that
the Contract Administrator's sole function is to provide
claims administration services and the Contract
Administrator shall have no liability for the funding of
benefits.
3 .02 If during the course of an audit performed internally by
the Contract Administrator pursuant to Section 2.Ol,c.
or by the Plan Sponsor pursuant to Section VI of this
Agreement any error is discovered, the Contract
Administrator shall use reasonable efforts to recover
any loss resulting from such error.
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3,03 The Contract Administrator is an independent contractor
with respect to the services being performed pursuant to
this Agreement and shall not for any purpose be deemed
an employee of the Plan Sponsor.
3.04 This Agreement is between the Contract Administrator and
the Plan Sponsor and does not create any legal
relationship between the Contract Administrator and any
Participant, Dependent, Beneficiary or any other
individual.
3.05 It is recognized by the parties that errors may occur
and it is agreed that the Contract Administrator will
not be held liable for such errors unless they resulted
from its gross negligence or willful misconduct. The
Plan Sponsor agrees to defend, indemnify, and hold
harmless the Contract Administrator from all claims,
damages, liabilities, losses, and expenses arising out
of the Contract Administrator's performance of
administration services under the terms of this
Agreement, so long as they did not arise out of the
Contract Administrator's gross negligence or willful
misconduct.
SECTION IV FEES OF THE CONTRACT ADMINISTRATOR
4.01 By the first of each month, The Plan Sponsor shall pay
the Contract Administrator in accordance with the fee
schedule set forth in Attachment D which is incorporated
herein by reference.
4.02 Late Payments
a. If, for any reason whatsoever, the Plan Sponsor
fails to make a timely payment required under this
Agreement, the Contract Administrator may suspend
performance of services to the Plan Sponsor,
including processing and payment of claims, until
such time as the Plan Sponsor makes the required
payment, including interest as set forth in b.
below.
b. The Contract Administrator will charge interest to
the Plan Sponsor on all late payments, including
amounts paid to reinstate this Agreement after
termination pursuant to Section 9.05, at the
average annual prime rate posted by Seattle First
National Bank plus two (2) percent on the amount of
the late payments for the number of days late.
Interest will be in addition to any other amounts
payable under this Agreement.
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C. In the event of late payment, the Contract
Administrator may terminate this Agreement pursuant
to Section 9.05. Acceptance of late payments by
the Contract Administrator shall not constitute a
waiver of its right to cancel this Agreement due to
delinquent or nonpayment of fees.
SECTION V OUT-OF-AREA PROGRAM
5.01 B1ueCard* Access Fees
Blue Cross/Blue Shield Plans outside of the Washington
and Alaska service area may charge Blue Cross of
Washington and Alaska a fee (referred to as an access
fee) for making their discounted rates and the resulting
savings available on claims incurred by Enrollees. The
access fee, if one is charged, is up to ten (10)
percent, but not to exceed $2,000 for any claim, of the
discount the Plan has obtained from its providers. The
access fee may be charged only if that Plan's
arrangement with the provider prohibits billing
Enrollees for amounts in excess of the discounted rate.
However, providers may bill for deductibles,
coinsurance, amounts in excess of stated benefit
maximums, and charges for noncovered services. In the
event a participating provider discount cannot be passed
along to Enrollees, no discount or access fee will
apply.
*The BlueCard is a program name established by the Blue
Cross and Blue Shield Association.
When BCWA is charged an access fee, BCWA will pass the
charge along to the Group as a claims expense. If BCWA
receives an access fee credit, BCWA will give the Group
a claims expense credit. Access fees are considered a
claims expense because they represent claims dollars
BCWA is unable to, or in the case of a credit, avoid
paying.
Instances may occur in which BCWA does not pay a claim
(or pay only a small amount) because the amounts
eligible for payment were applied to the deductible
and/or coinsurance. If the Plan's arrangement with its
providers allows the discounted payment rate to apply
when the amount is fully or mostly a patient obligation,
BCWA will pay the Plan's access fee and pass it along to
the Group as a claims expense even though the Group paid
little or none of the claim.
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SECTION VI AUDIT
6.01 Within thirty (30) days of written notice from the Plan
Sponsor, the Contract Administrator shall allow an
authorized agent of the Plan Sponsor to inspect or audit
all records and files maintained by the Contract
Administrator which are directly pertinent to the
administration of the Plan. Such documents shall be
made available at the administrative office of the
Contract Administrator during normal business hours.
The Plan Sponsor shall be liable for any and all fees
charged by the auditor. Any agent or auditor that has
access to the records and files maintained by the
Contract Administrator shall agree not to disclose any
proprietary or confidential information used in the
business of the Contract Administrator.
SECTION VII SUBROGATION
7.01 The Contract Administrator shall make reasonable efforts
to pursue subrogation claims administratively on behalf
of the Plan. However, the Contract Administrator shall
have no affirmative duty to pursue subrogation claims
beyond those specified in section 2.O1,b. The Plan
Sponsor shall have the sole discretion to bring any
legal claim or action to enforce the Plan's subrogation
provisions. The Contract Administrator will cooperate
with the Plan Sponsor in the event the Plan Sponsor
brings any legal action to enforce the subrogation
provisions of the Plan. Any costs and attorneys' fees
incurred in pursuing such subrogation claims shall be
the responsibility of the Plan Sponsor.
SECTION VIII TERM OF AGREEMENT
8.01 The term of this Agreement shall be the period from
12:01 a.m. on January 1, 1998, to midnight on December
31, 1998 (hereinafter referred to as the "Agreement
Period") . ,
8.02 Except as stated otherwise in section 9.03 below, the
terms and conditions of this Agreement and the fee
schedule set forth in Attachment D are established for
the Agreement Period.
8.03 The Plan Sponsor acknowledges that the fee schedule set
forth in Attachment D and the services provided for in
this Agreement are based upon the terms of the Plan and
the enrollment as they exist on the effective date of
this Agreement. Any substantial change, whether
required by law or otherwise, in the terms and
provisions of the Plan or in enrollment may require that
the Contract Administrator incur additional expenses.
The parties agree that any substantial change, as
determined by the Contract Administrator, shall result
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in the alteration of the fee schedule, even if the
alteration is during the Agreement Period. The phrase
"any substantial change" shall include, but not be
limited to:
a. a fluctuation of ten (10) percent or more in the
number of Participants, Dependents and
Beneficiaries as set forth on the census
information included in Attachment B which is
herein incorporated by reference and made a part of
this Agreement;
b. the addition of benefit program(s) or any change in
the terms of the Plan's eligibility rules, benefit
provisions or record keeping rules that would
increase administration costs by more than $2,000;
C. any change in claims administrative services,
benefits or eligibility required by law;
d. any change in administrative procedures from those
in force at the inception of this Agreement which
is agreed upon by the parties;
e. any additional services which the Contract
Administrator undertakes to perform at the request
of the Plan Sponsor which are not specified in this
Agreement such as the handling of mailings or
preparation of statistical reports and surveys not
specified in this Agreement.
SECTION IX TERMINATION
9.01 The Plan Sponsor may terminate this Agreement at any
time by giving the Contract Administrator thirty (30)
days written notice.
9.02 This Agreement will terminate on the last day of the
Agreement Period or the last day of any extension of the
Agreement Period granted by the Plan Administrator.
9.03 Either party may terminate this Agreement effective
immediately by giving written notice to the other if a
party becomes insolvent, makes a general assignment for
the benefit of creditors, files a voluntary petition of
bankruptcy, suffers or permits the appointment of a
receiver for its business or assets, or becomes subject
to any proceeding under any bankruptcy or insolvency
law, whether foreign or domestic. A party is insolvent
if it has ceased to pay its debts in the ordinary course
of business; cannot pay its debts as they become due; or
the sum of its debts is greater than the value of its
property at a fair valuation.
9.04 If loss of services is caused by, or either party is
unable to perform any of its obligations under this
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Agreement, or to enjoy any of its benefits because of
natural disaster, action or decrees of governmental
bodies or communication failure not the fault of the
affected party, such loss or inability to perform shall
not be deemed a breach. The party who has been so
affected shall immediately give notice to the other
party and shall do everything possible to resume -
performance. Upon receipt of such notice, all
obligations under this Agreement shall be immediately
suspended. If the period of nonperformance exceeds
thirty (30) days from the receipt of such notice, the
party whose performance has not been so affected may, as
its sole remedy, terminate this Agreement by written
notice to the other party effective immediately. In the
event of such termination, the Plan Sponsor shall remain
liable to the Contract Administrator for all payments
due, together with interest thereon as provided for in
Section 4.02 .
9.05 The Contract Administrator may, in its sole discretion,
terminate this Agreement effective as of a missed
payment due date in the event that the Plan Sponsor
fails to make a timely payment required under this
Agreement.
9.06 In the event this Agreement is terminated prior to the
end of the Agreement Period, the Plan Sponsor shall
remain liable to the Contract Administrator for all
delinquent sums together with interest thereon as
provided for in section 4.02 above. Furthermore,
because the Contract Administrator will have incurred
fixed costs which, but for the termination, would have
been recouped over the course of the Agreement Period,
as liquidated damages, and not as a penalty, the Plan
Sponsor shall pay the Contract Administrator an amount
equal to two (2) months administration fee at the rate
set forth in Attachment D multiplied by the average
number of Participants, Dependents and Beneficiaries
covered by the Plan for the immediately preceding six
(6) month period or such shorter period if this
Agreement has not been in effect for a period of six (6)
months. The Plan Sponsor shall remain liable for claims
incurred during the Agreement Period but not paid during
the Agreement Period and for the claims run-out
processing fee set forth in subsection C of Attachment
D.
9.07 Within one hundred twenty (120) days of termination by
either party, the Contract Administrator shall deliver
to the Plan Sponsor an interim accounting. Within
fifteen (15) months of termination the Contract
Administrator shall deliver to the Plan Sponsor a
complete and final accounting of the status of the Plan.
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At the expense of the Plan Sponsor, the Contract
Administrator shall make available a record of
deductibles and coinsurance levels for each Participant,
Dependent and Beneficiary and deliver this information
to the Plan Sponsor or its authorized agent.
9.08 For the twelve (12) month period following termination
of this Agreement, the Contract Administrator shall
continue to process eligible claims incurred prior to
termination at the claims run-out processing fee rate
set forth in Attachment D.
SECTION X DISCLOSURE
10.01 It is recognized and understood by the Plan Sponsor that
the Contract Administrator is subject to all laws and
regulations applicable to contract administrators and
health care service contractors.
10.02 It is recognized and understood by the Plan Sponsor that
the Contract Administrator is not acting as an insurer
and also is not providing stop-loss insurance.
SECTION XI OTHER PROVISIONS
11.01 Choice of Law
The validity, interpretation, and performance of this
Agreement shall be controlled by and construed under the
laws of the State of Washington, unless federal law
applies. Any and all disputes concerning this Agreement
shall be resolved in King County Superior Court. The
party substantially prevailing shall be entitled to
recover its reasonable costs, including attorneys' fees.
11.02 Trademarks
The Contract Administrator reserves the right to, the
control of, and the use of the words "Blue Cross of
Washington and Alaska" and all symbols, trademarks and
service marks existing or hereafter established. The
Plan Sponsor shall not use such words, symbols,
trademarks or service marks in advertising, promotional
materials, materials supplied to Participants,
Dependents and Beneficiaries or otherwise without the
Contract Administrator's prior written consent which
shall not be unreasonably withheld.
11.03 Independent Corporation
The Plan Sponsor hereby expressly acknowledges, on
behalf of itself and all of its eligible employees and
their eligible dependents, its understanding that this
Contract Administration Agreement constitutes an
Agreement solely between the Plan Sponsor and the
Contract Administrator, that the Contract Administrator
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is an independent corporation operating under a license
with the Blue Cross and Blue Shield Association, an
association of independent Blue Cross and Blue Shield
Plans (the "Association") permitting the Contract
Administator to use the Blue Cross Service Mark in the
States of Washington and Alaska, and that the Contract
Administrator is not contracting as the agent of -the
Association.
The Plan Sponsor further acknowledges and agrees that it
has not entered into this Contract Administration
Agreement based upon representations by any person other
than the Contract Administrator, and that no person,
entity or organization other than the Contract
Administrator shall be held accountable or liable to the
Plan Sponsor for any of the Contract Administrator's
obligations to the Plan Sponsor created under this
Contract Administration Agreement. This provision shall
not create any additional obligations whatsoever on the
Contract Administrator's part other than those
obligations created under other provisions of this
Contract Administration Agreement.
11.04 Notice
Except for the notice given pursuant to section 1.04,e. ,
any notice required or permitted to be given by this
Agreement shall be in writing and shall be deemed
delivered three (3) days after deposit in the United
States mail, postage fully prepaid, return receipt
requested, and addressed to the other party at the
address as shown below.
11.05 Integration
This Agreement, including any appendices or attachments
incorporated herein by reference, embodies the entire
Agreement and understanding of the parties and
supersedes all prior oral and written communications
between them. The terms hereof may be modified only by
a writing signed by both parties hereto.
11.06 Assignment
Neither party shall assign this Agreement or any of its
duties or responsibilities hereunder without the prior
written approval of the other.
SECTION XII ATTACHMENTS TO THE CONTRACT ADMINISTRATION AGREEMENT
12.01 The following attach to and become part of the body of
this Agreement and they are herein incorporated by
reference.
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Attachment A - Plan Document No. 7486T
Program Number 13595
Program Number 13596
Program Number 13597
Program Number 17620
Program Number 17884
Attachment B - Census
Attachment C - Reporting
Attachment D - Fee Schedule
Attachment E - Right Of Conversion
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The parties below have signed as duly authorized officers and have
hereby executed this Agreement. If this Agreement is not signed and
returned to the Contract Administrator within sixty (60) days of its
delivery to the Plan Sponsor or its agent, the Contract Administrator
will assume the Plan Sponsor's concurrence and the Plan Sponsor will be
bound by its terms.
IN WITNESS WHEREOF the parties hereto sign their names as duly
authorized officers and have executed this Agreement.
CITY OF KENT
BY: DATE:
Ti e
BY: DATE:
Title
Address:
BLUE CROSS OF WASHINGTON AND ALASKA
BY. DATE: September 23, 1997
Title: Sr. Vice President, General Manager
Group Market Services
Address: P.O. Box 327
Seattle, WA 98111-0327
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Attachment A
CITY OF KENT
(Plan Sponsor)
PLAN DOCUMENT
The employee benefit programs set forth in the Plan Document are
available to certain eligible individuals as defined within the benefits
programs. The entire Plan Document consists of the following: the Plan
Document face page, the attached benefit booklet for Program Number
13595, Program Number 13596, Program Number 13597, Program Number 17620,
Program Number 17884, The enrollment applications of eligible persons on
file with the City of Kent and all attachments, endorsements, and riders
included or issued hereafter. All benefits of this Plan Document are
subject to the terms and conditions stated herein and any endorsements
or riders included or issued thereafter. The City of Kent has the
discretionary authority to determine eligibility for benefits and to
construe the terms used in this Plan Document.
Blue Cross of Washington and Alaska has been selected by the City of
Kent to administer the benefits of this Plan Document. Blue Cross of
Washington and Alaska is not the Underwriter of this Plan Document. The
City of Kent is solely and totally responsible for: funding benefits
under the benefit programs; compliance with all applicable laws and
regulations affecting the benefit programs; and fiduciary liability for
the benefit programs. If, for any reason, the Contract Administration
Agreement between Blue Cross of Washington and Alaska and the City of
Kent terminates, Blue Cross of Washington and Alaska shall be relieved
of its administrative duties under this Plan Document, except as
otherwise provided in the Contract Administration Agreement.
This Plan Document attaches to and becomes a part of the Contract
Administration Agreement effective January 1, 1998.
CITY OF KENT
� R
s V
By: Date —/j•
le
By: Date:
Title
PLAN DOCUMENT EFFECTIVE DATE: January 1, 1998
PLAN DOCUMENT NUMBER: 7486T
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Attachment 8
Census Information
Administration Fees effective January 1, 1998 are based on the
following:
Number of Active and Retired Enrollees:
Employee Spouse Children
Medical/RX 658 440 709
Dental 694 458 767
Vision 696 458 767
Number of COBRA Enrollees:
Medical/RX 2 1 3
Dental 2 1 1
Vision/RX 2 1 1
Other Carriers Offered: Group Health Cooperative.
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Attachment C
Reporting
The following reports will be provided to the Plan Sponsor within the
fees set forth in Attachment D:
Report Title Frequency
Weekly Claims Recap Weekly
Detail Claim Runs Monthly
Premium/Claims Report Monthly
Large Claims Analysis Yearly
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Attachment B
Census Information
Administration Fees effective January 1, 1998 are based on the
following:
Number of Active and Retired Enrollees:
Employee Spouse Children
Medical/RX 658 440 709
Dental 694 458 767
Vision 696 458 767
Number of COBRA Enrollees:
Medical/RX 2 1 3
Dental 2 1 1
vision/RX 2 1 1
Other Carriers Offered: Group Health Cooperative.
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Attachment D
Fees of the Contract Administrator
Pursuant to the Contract Administration Agreement, the Group shall pay
the Contract Administrator a fee, as set forth below, for administrative
services.
A. Administration Fees:
Composite
13595, -01, -99 $ 31.77
13596, -01, -99 $ 31.77
17620 $ 31.77
13597, -01 $ 5.53
17884 $ 1.74
B. Other Fees:
$1.75 per booklet
$ .75 per I.D. card
Prescription drug charge - $1.20 per claim
Conversion Contract Fee - $1,000 per conversion
C. Claims runout processing fee:
5t of runout claims processed
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