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R2000-207 AUTHORIZING APPLICATIONS
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R2000-207 AUTHORIZING APPLICATIONS
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3/29/2016 11:49:26 AM
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3/29/2016 11:49:24 AM
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Resolution/Ordinance
Res Ord Num
R2000-207
Res Ord Title
AUTHORIZING APPLICATIONS FOR GROUP HEALTH INSURANCE COVERAGE
Approved Date
10/16/2000
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or Provider furnishing Covered Services. All benefits payable to the Covered Person which <br /> remain unpaid at the time of the death of the Covered Person will be paid to the estate of the <br /> Covered Person. <br /> B. Once Covered Services are rendered by a Provider, the Covered Person has no right to re- <br /> quest the Claim Administrator not to pay the Claim submitted by such Provider and no such <br /> request by a Covered Person or his agent will be given effect. Furthermore,the Claim Adminis- <br /> trator will have no liability to the Covered Person or any other person because of its rejection <br /> of such request. <br /> C. Neither the Plan nor a Covered Person's claims for payment of benefits under the Plan are <br /> assignable in whole or in part to any person or entity at any time. Coverage under the Plan , <br /> is expressly non-assignable or non-transferable and will be forfeited if a Covered Person at- <br /> tempts to assign ortransfer coverage or aids or attempts to aid any other person in fraudulent- <br /> ly obtaining coverage underthe Plan. However,if the Claim Administrator makes payment be- ! <br /> cause of a person's wrongful use of the identification card of a Covered Person,such payment � <br /> will be considered a proper payment and the Claim Administrator will have no obligation to I <br />' pursue recovery of such payment. �i <br /> The Employer represents that it has included the provision stated in this Section XI. in its Plan Doc- �il <br /> ument. , <br /> XII. LATE PAYMENTS AND REMEDIES <br /> A. If the Employer fails to pay when due any amount required to be paid to the Claim Administra- <br /> tor hereunder, and such default is not cured within ten (10) days of written notice to the Em- <br /> ployer,the Claim Administrator may, at its option,terminate this Agreement as of the effective <br /> date specified in such notice. <br /> B. If either the Employer or the Claim Administrator fails to perform any obligation or covenant <br /> provided hereunder, other than those specified in Section XII. A. above, and such default is <br /> not cured within thirty(30)days of written notice to the defaulting party, then the party provid- <br /> ing such notice may, at its option,terminate this Agreement as of the effective date specified <br /> in such notice. <br /> C. All rights and remedies given to the Employer or the Claim Administrator underthis Agreement <br /> shall be distinct,separate and cumulative,and the use of one or more thereof shall not exclude <br /> or waive any other right or remedy allowed at law or in equity,unless specifically waived in this <br /> Agreement. Further, no waiver of any breach or default of either party hereunder shall be im- <br /> plied from any omission by the other party to take any action on account of any similar or differ- <br /> ent breach or default. Nor shall the Claim Administrator's failure to provide the Employer with <br /> timely notice of any amount due hereunder be considered a waiver of payment of any amount <br /> which may otherwise be due hereunder from the Employer. <br /> D. If the Employer fails to make any payment required by this Agreement when due, the Claim <br /> Administrator, at its option, may charge interest on such late payment or payments from the <br /> due date at an annual rate of twelve (12%) percent. <br /> In addition, if the Employer becomes insolvent, however evidenced, or is in default of its ob- <br /> ligation to make any Transfer Payment as provided hereunder, or if any other default hereun- <br /> der has occurred and is continuing,then any indebtedness of the Claim Administrator to the <br /> Employer(including any and all contractual obligations of the Claim Administrator to the Em- <br /> __ , ployer) may be offset and/or recouped and applied toward the payment of the Employer's ob- <br /> ligations hereunder, whether or not such obligations, or any part thereof, shall then be due <br /> the Employer. <br /> E. If the Claim Administrator terminates this Agreement for failure of the Employer to make pay- <br /> ment or payments due the Claim Administrator and/or for failure to perform any other obliga- <br /> - 7 - <br />
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