ORDER N0.28647 EMPLOYEE BENEFIT ADMINISTRATIVE SERVICES AGREEMENT Came to be heard this the 10th day of May 2004 with a motion made by Commissioner Nicholson, Seconded by Commissioner Letz, the Court unanimously approved by a vote of 4-0-0, approve the changes to the Administrative Service Agreement between Kerr County and Employees Benefit Administrative Inc. and authorize the County Judge to sign the same and return to EBA. `~-'J 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 OFFICE: County Judge MEETING DATE: May 10, 2004 TIME PREFERRED: SUBJECT: (PLEASE BE SPECIFIC) Review, discuss and consider approval of 2004 Employee Benefit Administrative Service Agreement. EXECUTNE SESSION REQUESTED: (PLEASE STATE REASON) NAME OF PERSON ADDRESSING THE COURT: County Judge ESTIMATED LENGTH OF PRESENTATION: IF PERSONNEL MATTER -NAME OF EMPLOYEE: 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: 5:00 P.M. previous Tuesday. THIS REQUEST RECEIVED BY: THIS REQUEST RECEIVED ON: 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. 5~A CF ~ ~~' i '~ ~~ ~i', O ~` ~ ~ °~nty o1 ,tie COI!NTt' JUDCE PAT TINLEt' COMMISSIONERS COURT H.A. "BUSTER° BALDWIN• PCT. I ~~'ILLIAM "BILL ~~'ILLIAMS, PCT. 2 JONATHAN LETZ, PCT. .~ DAt'E HICHOLSON, PCi. ~ May 13, 2004 C~OG°~1~ THE COUNTY COURT o>~ KERB COUNTY, TEXAS 700 Mnw RICRRVn.Lr, Tt:xns 78028 TLi.(830)792-2211 Fnx:(830)792-2218 E-Mnn,. keucocc « ktccom Mr. Ray Rothwell Employee Benefit Administrators, Inc. 355 Spencer Lane, #101 San Antonio, Texas 78201 Re: Kerr County Administrative Service Agreement Dear Mr. Rothwell: Enclosed is a signed copy of the Kerr County Administrative Service Agreement, between Kerr County and Employee Benefit Administrators, Inc. Please return an executed copy for our files. Should you have any questions, please do not hesitate to contact Pat Tinley, County Judge, at 830-792-2211. Sincerely, ~ ~ . ~~.~ ~. Kathy K. Mitchell Court Coordinator enclosure cc: Barbara Nemec, County Treasurer Jannette Pieper, County Clerk Tommy Tomlinson, County Auditor CLERK JANNETT PIEPER COURT COORDINATOR THEA SOVIL . ^---- - VLF P v -- C c~_.-Y.~-, C.lt, (~ KERB COUNTY t ~ .. , ; _ .., ~, ADMInISTRAT[VC SERVICE AGREEMENT This Agreement is made and entered into this lst day offanuary 2004, by and between Employee Benefit Administrators, Inc., a corporation dul}~ 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 I 0 I ,San Antonio, `T'exas 78201, t~crcinaftcr referred to as ContractAdministrator,and, KerrCounty, with its l~rincil~al place of I~usincss at 700 Main S[reet, Rm. BA104, Kerrville, Texas, 7£3028, hereafter referred to as the Plan Sponsor. t1`ITNESSETH WHEREAS, the Third Parn• Administrator (TPA Contract Administrator) has developed a system of procedures, Corms, manual and computer applications designed for the eTTicieni 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 PIan Sponsor's employee benefit Plan, herein after referred to as the Pian. 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: DUTIES OFTPA-CONTRACT ADMINISTRATOR The TPA-Contract Administrator is empowered and entrusted with the responsibilit}' of administering the Plan as set forth in the Plan Document and directed by the Plan Sponsor. In accordance thereof, the TPA-Contract 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 proe~ide TPA services. In addition, the TPA-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 pro~~ided 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 partic{pant; 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 aii transactions, to include record of all monies received and disbursed. Information shall lie maintained on forms (Enrollment, claims, etc.) which have been approved ley 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 co allow all records to he posted, but no later than one hundred twenty (i20) days after the effective date of the termination. The Pian Sponsor will then Inc responsil~tc for maintaining the records for at (cast six (6) years after the end of the Agreement's term. Tlie 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 oCLabor, 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. Trade Secrets, including the identity; addresses, employment information and/or medical history of the participants, are confidential and will be protected against any unauthorized disclosure. The Plan Sponsor `mill 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 TPA-Contract Administrator's proprietary rights in 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 Advertising -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 to 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. 2 7) Premium & Contribution Collection - Contril~ulions, company and payroll deductions, collected by the Plan Sponsor on behalf of the Plan, arc held by the Plan Sponsor in a fiduciary capaci ly. 8) Claims Payment and Ranking Arrangement a) If it is determined that a pa}•mcnt has been made under chc Plan to an ineligible Plan Participant and/or provider ofservice, or if it is determined that more or Icss than the correct amount of any payment has been paid, Contract ~~~ill use reasonable c{rorts to recover any such payment made. TPA Contract Administrator shall not be required, except in the ~casc of willful misconduct or gross negligence, to reimburse Purchase or initiate collection or legal proceedings for any .Such recovery. ~ ,. I~) 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 coffer the-checks issued. c) TPA Contract Administrator shall have the right to terminate this Agreement upon notice to Plan Sponsor in the event that Plan Sponsor fails to fund such account within three (3) banking days- after notice is given by TPA Contraci_- Admiriistrator_~thaf= such=funds -are •required,._to- be _ deposited. - d) Notice by TPA Contract Administrator, as contemplated in paragraph tt~~o (2) above, shall be sufficient if given by telephone or by U.S. mail, fax, delivery service or personal deliver}' to Plan Sponsor's designee or the signatory to this Agreement at the telephone number, fax number or address specified in this Agreement. Any telephonic or fax notice given will be confirmed in writing within t~n~enty-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 oCTPA-Contract Administrator -The TPA-Contract Administrator shall be compensated Cor his services in accordance with a compensation schedule which sets forth the fee based on the level of service performed, as listed below: 3 Claims Adjudication Fec 14.00 pcr cml~loycc PPO Administration Fcc * ~ 3.00 1~er employcc *Plus l0% of Sa~~ings of Non-Network Negotiated PPO Pecs COBRA Notification Fcc $ .50 pcr cmploycc COBRA Administration Fcc 2% of COBRA Participant's premium (This fee is paid by Cobra participant) " Lump sum oC$ oyee pcr year nt [y fee of $1.00 per Employee per m In addition to the above, the TPA Contract Administrators shall do the following: _ 1) The TPA-Contract Administrator shalt confer with the Plan Sponsor at reasonable~ intervals throughout the -term of this agreement and further agrees to notify the Plan Sponsor,-.: _ immediately, on any matters outside the normal scope ofbusiness which requires the Plan Sponsorss 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 kine~ 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, fratidulent of 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 o. 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 Sponsorshall provide the TPA-ContraetAdministratorwithcontinuing artd 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 Depcndcnt in a timely manner and assumes the responsibility for the erroneous 4 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 "I'PA- Coniract Administrator may be changed as rcyuired 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 shall 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 shalt have the right to terminate this Agreement upon thirty (30) days written notice.to the Plan Sppisot, In the event of termination of this Agreement resulting_from-the default of the Pian 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 Mqy ~, {exm~t~i-ed.. by e~i-t~er'~t~-~/ ~y-}t~ ~tVi~ o~ 3~d~.y5 ~riorta~e~~~-Een 1/~.o~1-yce~~~~{` This Agreement' Upon the termination of the 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. \40DIFICATION 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. 5 AI'I'LIC:ABLC LAW ~hhis Agrccmcnt shall Ix' governed by the Laws of the State of Texas, both as to performance and as to interpretation. EI~TTIRE AGREEMEI\'T phis Agrccmcnt, together with all addenda, appendices, and exhibits (which term shall include, but not be limited to, the Pfan Document; insurance policies ofany nature which pertain to the benefits to he 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 shaol~commence upon its execution on the effective date and will continue until 12:00 midnight, for~lu~ year, r r 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 ~+er r,-,K~u~ a.~reerr-er,-!`: -ti-t,~ ~ a~~es may ~F~eiie~all mediate dispute prior to any litigation being commenced. G * Kerr County, at its option, may renew this agreement for two (2) sittceessive one-year periods on the same terms and conditions and for the same consideration and fees to the TPA-Contract Administrator as herein specified. PLANT SPONSOR: Kcrr County By - v ~ Date Ti TPA-CONTRACT ADMINISTRATOR: ~"Cmployee Benefit Administrators,-Inc." By: " Date Title 7 DECLINATION OFTPA-CONTRACT ADMINISTRATORS SERVICES FOR COBRA ADMINISTRATION Employer/Plan Sponsor. flan Sponsor Ilan Contract Period: We arc aware of the COB[tA 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 8 J.J ~2~~ PUBLIC PARTICIPATION FORM FOR KERR COUNTY COMMISSIONERS' COURT Instructions: Fill out all appropriate blanks. Please print or write legibly. Present to the County Clerk prior to the time that the Agenda Item (or Items) you wish to address are discussed. Name: (..,,_ ~~[~..~ . Address: / Cif (,7 i~~~ ~ t ••~ -- Telephone: ~ ~f7 "~ : > 6 ~ `"'` ,.,5 ~~--~ ~~ Place of Employment: ° Employment Telephone: Do you represent any particular group or organization? Yes ^ No ^'~^ If you represent a group or organization, please state the name, address and telephone number of such group or organization. Which agenda Item (or Items) do you wish to address? ..- 0 In general, are you for or against such Agenda Item (or Items)? For ^ Against 0~ Signature NOTE: This Public Participation Form must be presented to the County Clerk prior to the time the agenda item(s) are discussed. Once you reach the podium, please state your name and who/what __ you represent clearly for the court reporter to accurately record who you are.