ORDER NO. 28593
Employee Benefit Administrative Services
Came to be heard this the 12a` day of April 2004 with a motion made by Commissioner
Baldwin, Seconded by Commissioner Nicholson, the Court unanimously approved by a
vote of 3-0-0 to authorize the County Treasurer to provide all documents to the County
Attorney with respect to the 2004 Employee Benefit Administrative Service Agreement
for confirmation that the same conforms to EBA's bid.
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COMMISSIONERS' COURT AGENDA REQUEST
PLEASE FURNISH ONE ORIGINAL AND NINE COPIES OF THIS REQUEST AND DOCUMENTS TO BE
REVIEWED BY THE COURT.
MADE BY: Pat Tinley
MEETING DATE: April 12, 2004
SUBJECT: (PLEASE BE SPECIFIC)
OFFICE: County Treasurer /County Judge
TIME PREFERRED:
Consider and discuss approval of 2004 Employee Benefit Administrative Service
Agreement and authorize County Judge to sign same.
EXECUTNE SESSION REQUESTED: (PLEASE STATE REASON) N/A
N~-1vIE OF PERSON ADDRESSING THE COURT:
ESTIMATED LENGTH OF PRESENTATION:
IF PERSONNEL MATTER -NAME OF EMPLOYEE:
N/
Time for submitting this request for Court to assure that the matter is posted in accordance with Title 5, Chapter
551 and 552, Government Code, is as follows:
Meeting scheduled for Mondays:
THIS REQUEST RECEIVED BY:
THIS REQUEST RECEIVED ON:
5:00 P.M. previous Tuesday.

All Agenda Requests will be screened by the County Judge's Office to determine if adequate information has been
prepared for the Court's formal consideration and action at time of Court Meetings. Your cooperation will be
appreciated and contribute towards you request being addressed at the earliest opportunity. See Agenda Request Rules
Adopted by Commissioners' Court.
County Treasurer, County Jude
10 mins.
MEMORANDUM
TO: PAT TINLEY, COUNTY JUDGE
FROM: BARBARA NEMEC, COUNTY TREASURER
DATE: MARCH 31, 2004
SUBJECT: EMPLOYEE BENEFIT ADMINISTRATIVE SERVICE
AGREEMENT
The above contract merely outlines the responsibilities of each party. T-~e only -
reference to dollars is-FBA's administrative fee,-the PPO fee and the COBRA/HIPPA
fees charged by FBA.,: which _are the fees,_submitted in their proposal. -
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agr~ement_withyour signature as soonas pgssi e. - - - -
- - ` `Please~eturn-the aho~e
,-
-CC:-Buster Baldwin, -Comm,°Pct _1
Bill Williams, Comm. Pct 2
Jonathan- Comm.~ct_3- -
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- Dave Nicholson, Comm. Pct 4_ _-_
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Tommy-Tomlinson, County Auditor
Bryan Finley, Finley & Associates
Ray Rothwell, Employee Benefit Admin.
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MEMORANDUM
TO: BARBARA NEMEC
'IREASUREg/EMPLOYEE BENEFITS OFFICER
FROM: PAT TINLEY ~
COUNTYdUD
DATE: MARCH 23, 2004
SUBJECT: EMPLOYEE BENEFIT ADMINISTRATIVE SERVICE
AGREEMENT
It was not my intention to ask you for a legal opinion concerning any aspects of _.
the Employee Benefit Administrative Service Agreement Rather, I was asking for your - -
written confirmation that the material factual components of that agreement (i.e. specific
costs; time periods, etc.) are the same as submitted in the written bid by EBA and the_ .._. __ -. -
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subse- cent award made by the Commissioners Court to EBA. The confirmation would _ _ _
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.~ -lie very sunilar to the ~vntten:summary andanal~!sis _of all of the bias ~vhicfi you presented= - _ __
.. _ .~ m
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to Cpmmics1oneiS Courton~ecember 15;~~3: -: - - _ - _ -
cc: County Auditor

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MEMORANDUM
TO: PAT TINLEY COUNTY JUDGE
FROM; BARBARA NEMEC COUNTY TREASURE
DATE: MARCH 22, 2004
SUBJECT: EMPLOYEE BENEFIT ADMINIISTRATIVE SERVICE
AGREEMENT
In your memo dated March 02, 2004 you asked that I forward another copy of the above
referenced document along with written confirmation that the same conform to EBA's
bid. Attached is another copy, however since I am not familiarwith the legalities of
--_
- contracts or agree~nents,3~end =a11_ such documents to the county attorney for_approval. -
__ -
I have-sent a .copy of this memo -and Se~ce Agi`eetrtent-to Mr-=Motley:-- _ _-
CC: Commissioners
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KERB COUNTY
~"`' ADMINISTRATIVE SERVICE AGREEMENT
This Agreement is made and entered into this Ist day of January 2004, by and between
Employee Benefit Administrators, Inc., a corporation duly licensed as a TPA, organized and existing
under the laws of the State of Texas with its principal place of business at 355 Spencer Lane, Suite
10 I ,San Antonio, Texas 78201, hereinafter referred to as ContractAdministrator, and Kerr County,
with its principal place of business at 700 Main Street, Rm. BA104, Kerrville, Texas, 78028,
hereafter referred to as the Plan Sponsor.
WITNESSETH
WHEREAS, the Third Party Administrator (TPA Contract Administrator) has developed a
system of procedures, forms, manual and computer applications designed for the efficient
administration of Employee Group Health Benefit Plans, hereinafter referred to as the System; and
WHEREAS, The Plan Sponsor desires to avail itself of the said System and the services of the TPA
Contract Administrator for the purpose of Contract administration of the Plan Sponsor's employee
benefit Plan, herein after referred to as the Plan. The Plan will be funded by contributions from the
Employer and the employee in accordance with the attached Schedule A.
In consideration of these premises, it is agreed as follows:
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-- DUTIES OFTPA-CONTRACT ADIvIINISfiRATOR
The TPA-Contract Administrator is empowered and entrusted with the responsibility of
administering the Plan as set forth in the Plan Document and directed by the Plan Sponsor. In
accordance thereof, the TPA-Coritract Administrator shall comply with the following: ,
1) Payments to the TPA-Contract Administrator -The TPA-Contract Administrator shall
accept payments from the Plan Sponsor in fulfillment of its contractual obligations to provide TPA
services. In addition, theTPA-Contract Administrator shall accept any other payments properly due
to the Plan for contributions, refunds of premiums, etc., and shall promptly credit such payments to
the appropriate Health Fund Account. All premiums received by the TPA-Contract Administrator
from the Plan Sponsor are considered to be received by the Insurer.
2) Notice ofTPA-Contract Administrator's Capacity and Responsibilities. Written notice of
the TPA-Contract Administrator's responsibility shall be provided to all plan participants. It is hereby
agreed that the disclosures provided in the Summary Plan Description, which is provided to all
participants, shall be considered proper compliance with this provision.
Should there be a necessity to bill any individual participant, the participant shall be provided
with a written, detailed explanation of the billing, and the Plan Sponsor shall be notified of any such
correspondence and/or billing.
3) Maintenance of Information -The TPA-Contract Administrator shall maintain complete
~,~,~..
and accurate records of ali transactions, to include record of all monies received and disbursed.
Information shall be maintained on forms (Enrollment, claims, etc.) which have been approved by
the Plan Sponsor.
The TPA-Contract Administrator shall maintain the records for the duration of this
Agreement. At the time of termination of the Agreement, the TPA-Contract Administrator agrees
to turn over all records to the Plan Sponsor, within a reasonable period of time to allow all records
to be posted, but no later than one hundred twenty (120} days after the effective date of the
termination. The Plan Sponsor will then be responsible for maintaining the records for at least six
(6) years after the end of the Agreement's term.
The TPA-Contract Administrator shall maintain the books and records in accordance with
prudent standards of insurance record keeping and in compliance with Department of Labor
regulations, Internal Revenue Service guidelines and ERISA requirements.
The TPA-Contract Administrator agrees, and the Plan Sponsor authorizes, to make the
records available to appropriate, authorized agents of the various agencies having jurisdiction over
the Plan. Agencies which may have a requirement to review the records include: Texas Department
of Insurance, Department of Labor, and Internal Revenue Sen-ice. In addition, the TPA-Contract
Administrator agrees to make the records available to any agency which the Plan Sponsor, by written
_ permission, so authorizes.
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Trade Secrets, rcluding_the identity, addresses, employment information and~or medical -
_ history of the participants, are confidential and will be pcotec~ed aga'irist ariy unauthorized disclosure.
The -Plan Sponsor will be granted continuing access to the records at any reasonable time,
during regular office hours, or as otherwise arranged. Access will be restricted only in regards to the
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- TPA=Contract Administrator's proprietary rights iri=the System: - - ~---
4} Confidentiality of Personal Information -Any information which identifies a participant
covered by the Plan is confidential. During the time the information relating to the participants is in
the TPA Contract Administrator's custody or control, the TPA-Contract Administrator shall take
all reasonable precautions to prevent disclosure or use of the information for a purpose unrelated to
administration of the plan.
5) Approval of Advertisine -The TPA-Contract. Administrator shall advertise (notify) the
participants of new products, etc. only with the prior approval of the Plan Sponsor. The TPA-
ContractAdministrator shall use the Plan in it's outside advertising only with the approval of the Plan
Sponsor.
6) Underwriting Provision -All eligible participants will be covered under the Plan except
those specific individuals who are considered ~o be temporary or_casual-labor (and. paid .cash or
equivalent benefits by the Plan Sponsor). Individual eligibility in the plan will be the final decision
of the Plan Sponsor. The Plan Sponsor has the sole discretion to allow late enrollment as defined in
"' the Plan Document under LATE ENROLLEES.
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~. 7) Premium & Contribution Collection -Contributions, company and payroll deductions,
collected by the Plan Sponsor on behalf of the Plan, are held by the Plan Sponsor in a fiduciary
capacity.
8} Claims Payment and Banking Arrangement
a} If it is determined that a payment has been made under the Plan to an ineligible Plan
Participant and/or provider ofservice, or ifit is determined that more or less than the correct amount
of any payment has been paid, Contract will use reasonable efforts to recover any such payment
made. TPA Contract Administrator shall not be required, except in the case of willful misconduct
or gross negligence, to reimburse Purchase or initiate collection or legal proceedings for any Such
recovery.
b) Plan Sponsor shall establish a bank account on which TPA Contract Administrator shall
write checks for the payment of Benefit Program claims and expenses. Plan Sponsor agrees and is
obligated to arrange for sufficient funds to be available in such account to cover all checks validly
issued against the account. TPA Contract Administrator shall notify Plan Sponsor, simultaneous with
the release of checks, the amount that is required to be deposited by Plan Sponsor to cover the checks
issued.
c)-TPA Contract Administrator shall have the right to terminate this Agreement upon notice
to, Plan Sponsor_in the. evcn~_that_Plan SPo_nsor fails to fund such account within three (3)""banking
~_ -- -- -
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--~ days after notice is g"iven" by TPA Contract Administrator ,that such funds are required=to=tie --- --
-deposited. - -
d) Notice by TPA Contract Administrator, as contemplated in paragraph two (2) above, shall
be sufficient if given by telephone or by uS. mail, fax, delivery service-or personal delivery to Plan
Sponsor's designee-or the signatory to this Agreement at the- telephone number, fax .number ar ° --
address specified in this Agreement. Any telephonic or fax notice given will be confirmed in writing
within twenty-four (24) hours.
9) Adjudication of Claims -The payment of claims will be in accordance with the benefits set
forth in the Plan Document.
10) COBRA Administration -The administration of this Plan will include the COBRA
administration in accordance with all applicable laws and_regulations, unless the Plan Sponsor has
declined this service in writing.
11) HIPAA Administration (Health Insurance Portability and Accountability Act) -The
administration of this Plan will include the HIPAA administration in accordance with all applicable
laws and regulations, unless the Plan Sponsor has declined this service in writing.
12) Compensation of TPA -Contract Administrator -The TPA-Contract Administrator shall
be compensated for his services in accordance with a compensation schedule which sets forth the fee
based on the level of service performed, as listed below:
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Glaims Adjudication Fee
14.00 per employee
PPO Administration Fee
3.00 per employee
*Plus 10% of Savings of Non-Network
Negotiated PPO Fees
COBRA Notif cation Fee
$ .50 per employee
COBRA Administration Fee
2% of COBRA Participant's premium
(This fee is paid by Cobra participant)
ANNUAL PLAN DOCUMENT FEE (Please Select One Option)
_ Lump sum of $10.00 per Employee per year
_ Monthly fee of $1.00 per Employee per month.
In addition to the above, the TPA Contract Administrators shall do the following:
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_ 1) The -TPA-Contract Administrator shall confer with the -Plan Sponsor at reasonable
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_~ intervals throughout--the term of this agreement and further agrees to ztotify the ~Plaii Sponsor,- --
immediately, onany matters outside the normal scope of business which equ'ires theplan Sponsor's -
decision and/or authorization.
2) The TPA Contract Administrator-shall indemnify, defend, save and hold the Plan Sponsor
harmless from and against any claims, suits, actions, liabilities, losses and damages of any kind
including but not limited to, direct, indirect, consequential or punitive expenses or fees, including
attorney's fees, with respect to the Plan which result from or arise out of the dishonest, fraudulent or
criminal acts of the TPA-Contract Administrator's employees. The TPA-Contract Administrator
shall maintain a Fidelity Bond in the form and amount required by the Texas Department of
Insurance.
DUTIES OF THE PLAN SPONSOR
The Plan Sponsor will furnish an executed copy of the complete Plan Document, together
with all addenda, appendices and exhibits, which shall constitute the entire Plan, to the TPA-
Contract Administrator within thirty (30) days after the effective date of this agreement.
The Plan Sponsor shall provide the TPA Contract Administrator with continuing and up-to-
date listings of eligible employees, who are participants in the plan, and of such other persons who
are participating as dependents under the Plan. The Plan Sponsor shall notify the TPA Contract
Administrator of any change in classification or the ineligibility of any Participating Employee or
-~ Participating Dependent in a timely manner and assumes the responsibility for the erroneous
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disbursement of benefits by the TPA-Contract Administrator in the event of neglect to provide such
notification.
The procedures by which information is transmitted from the Plan Sponsor to the TPA-
ContractAdministrator may be changed as required but will include such documents as enrollment
cards, change cards, and such other reports and documentation as may be required from time to
time.
The Plan Sponsor shat[ indemnify, defend, save, and hold the TPA-Contract Administrator
harmless from and against any claims, suits, actions, liabilities, losses and damages of any kind
including, but not limited to, direct, incidental, consequential or punitive expenses or fees, including
attorney's fees, with respect to the Plan, arising within the scope of authority hereby granted to the
TPA-Contract Administrator by the Plan Sponsor.
The Plan Sponsor acknowledges that the TPA-Contract Administrator does not insure nor
underwrite the liability of the Plan Sponsor under the Plan.
DEFAULT OF PLAN SPONSOR
In the event that the Plan Sponsor shall fail to make any of the required contributions to the
Plan, as specified in the Plan Document, the TPA -Contract Administrator shall have the right to
terminate this Agreement upon thirty (30) days written notice to the Plan Sponsor.
In the event of termination of this Agreement resulting from the default of the Plan Sponsor,
as provided above, the TPA-Contract Administrator shall charge, and the Plan Sponsor shall pay to
the TPA-Contract Administrator, all fees, commitments, and obligations incurred by the TPA-
Contract Administrator through such date of termination, including the cost of collection.
TERMINATION OF AGREEMENT
This Agreement is automatically renewable after three (3) years on the anniversary date of the
Agreement, unless either party gives a thirty (30) day written notice, prior to the anniversary date, of
its intention to terminate the Agreement.
Upon the termination ofthe Agreement, for whatever cause, the TPA-Contract Administrator
agrees to turn over all records to the Plan Sponsor within one hundred twenty (120) days of the
effective date of the termination.
MODIFICATION OF AGREEMENT
No alterations, modifications, amendments or variations in this Agreement or in the terms
thereof shall be valid or binding upon either party unless made in writing, executed by both parties
to this Agreement and annexed hereto.
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APPLICABLE LAW
This Agreement shall be governed by the Laws of the State of Texas, both as to performance
and as to interpretation.
ENTIRE AGREEMENT
This Agreement, together with all addenda, appendices, and exhibits (which term shall
include, but not be limited to, the Plan Document; insurance policies of any nature which pertain to
the benefits to be administered under the Plan; etc.) supersedes any and all prior representations,
conditions, warranties, proposals, or other agreements between the parties hereto, oral or written, in
relation to the services and Systems of Employee Benefit Administrators, Inc. which are rendered or
are to be rendered in connection with its participation with the Plan Sponsor in the administration
of the Contract.
This Agreement, together with the aforesaid addenda, appendices and exhibits constitutes the
sole, full and complete Agreement between the parties hereto.
The parties hereto, having read and understood the entire Agreement, acknowledge and agree
that there are no other representations, conditions, promises, agreements, understandings, or other
warranties that exist outside this Agreement which have been made by either party or has led to the
execution of this Agreement by either party. Any statements, proposals, representations, conditions,
. warranties, understandings, or agreements which may have been heretofore made by either of the
parties hereto, and which are not expressly contained or incorporated by reference herein, are void
and of
no effect.
CONTRACT PERIOD
This Agreement shall commence upon its execution on the effective date and will continue
until 12:00 midnight, for three years at which time and upon each succeeding anniversary date
thereof, it shall automatically renew for a subsequent three year term unless either the Plan Sponsor
or the TPA-Contract Administrator shall have given to each other at least thirty (30) days prior
written notice of its intent to terminate.
EXECUTION
This Agreement shall become effective on the 1st day ofJanuary 2004, when executed by an
authorized representative of each of the parties hereto, and may be executed in one or more
counterparts. It is understood and agreed that the signature of any party hereto on any counterpart
shall be of sufficient evidence of his/her execution thereof.
MEDIATION
The parties shall mediate any dispute prior to any litigation being commenced.
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PLAN SPONSOR: Kerr County
By:
Date
Title
TPA-CONTRACT ADMINISTRATOR: Employee Benefit Administrators, Inc.
By:
Date
Title
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-- DECLINATION OFTPA-CONTRACT ADMINISTRATORS SERVICES
FOR COBRA ADMINISTRATION
Employer/Plan Sponsor: Plan Sponsor
Plan Contract Period:
We are aware of the COBRA guidelines and will be responsible for the COBRA
notification/administration for our employees.
We do not appoint Employee Benefit Administrators, Inc. as the administrator for the COBRA
Notification/Administration.
EMPLOYEE BENEFIT ADMINISTRATORS, INC.
TPA-Contract Administrator
BY:
Plan Sponsor
BY:
Dated
Date
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