R2011-04 AUTHORIZING AGREEMENT - Laserfiche WebLink

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IV. SCOPE OF SERVICES AND RESPONSIBILITIES OF THE PARTIES A. ERR Proqram Application. 1. Responsibilitv for Preparinq and Submittina ERR Proaram Application(s). Employer will � be solely responsible for preparing and submitting the ERR Program application(s) in order to be certified by HHS for participation in the ERR Program. HCSC agrees to provide, to the best of its ability, any data in HCSC's possession that Employer requests. 2. Assistance with ERR Proqram Application(s). Upon Employer's request and in consultation with Employer, HCSC shall provide any or all of the following for Employer's use in the ERR Program Application(s): • Description of procedures and programs currently in place for Employer's Group Health Plan(s) that have generated or have the potential to generate cost savings with respect to plan participants with a Chronic and High-Cost Condition, including the conditions for which the Group Health Plan(s) has such programs and procedures in place and how it was determined that the identified conditions satisfy the $15,000 threshold; • Assistance in identifying all Benefit Options under the Group Health Plan(s) for which Early Retirees can be claimed for ERR Program purposes; • Confirmation that HCSC's antifraud program applies to Employer's Group Health Plan(s) and is supported by policies and procedures to detect and reduce fraud, waste, and abuse, and that HCSC will produce those policies and procedures, and necessary information, records and data, upon request of the Secretary of the Department of Health and Human Services, to substantiate existence of those policies and procedures and their effectiveness; and • Projected amount of ERR Program reimbursement expected for each of the first two Plan Year cycles of Employer's Group Health Plan(s), including, upon request, a low-end estimate and a high-end estimate of expected ERR Program proceeds and an estimate that represents the Group Health Plan(s) most likely amount of program proceeds of each plan year cycle. 3. List of Earlv Retirees. a. Responsibilitv and Standard for Determininq Earlv Retirees. Employer shall be solely responsible for determining whether an enrollee in Employer's Group Health Plan is an Early Retiree using information reasonably available to Employer in accordance with 45 C.F.R. §149.2 and §149.335. HCSC shall have no responsibility to determine or confirm whether a particular enrollee is an Early Retiree according to ERR Program Requirements. b. Responsibilitv for Preparinct Lists of Earlv Retirees. Employer shall be solely responsible for preparing and submitting to HHS all Lists of Early Retirees for each reporting period and for deleting from such list any individual who does not meet the requirements for an Early Retiree for ERR Program purposes. -3 -