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R99-108 AUTHORIZING APPLICATIONS
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R99-108 AUTHORIZING APPLICATIONS
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4/7/2016 4:50:09 PM
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4/7/2016 4:50:07 PM
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Resolution/Ordinance
Res Ord Num
R99-108
Res Ord Title
AUTHORIZING APPLICATIONS FOR GROUP HEALTH INSURANCE COVERAGE
Approved Date
7/12/1999
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Administrator reserves the right, upon at least sixty (60) days written notice to the Employer to <br /> � adjust the service charges within such twelve(12)month period. Further, in the event of termina- <br /> tion of this Agreement, the Claim Administrator reserves the right to adjust the service charges <br /> applicable to the processing of Claims after the date of termination. <br /> C. In addition, the Claim Administrator's compensation for its services under this Agreement shall <br /> include the difference between the Net Claim Payments reimbursed to the Claim Administrator <br /> by the Employer under this Agreement and the net amounts paid to Providers by the Claim <br /> Administrator after giving effect to the Claim Administrator's Separate Financial Arrangements <br /> with Providers. <br /> VIII. TRANSFER PAYMENT <br /> In consideration of the Claim Administrator's obligations as set forth in this Agreement and at the end <br /> of each Transfer Payment Period, the Employer shall transfer to the Claim Administrator's account <br /> number#81880-01258 at Bank of America an amount equal to the Transfer Payment Period's Net <br /> Claim Payments plus the applicable service charges. For purposes of this agreement, the Transfer <br /> Payment Period shall be weekly.The Claim Administrator shall advise the Employer's Financial Divi- <br /> sion by facsimile or telephone (at a facsimile or telephone number to be furnished by the Employer <br /> prior to the effective date of this Agreement) of the amount of Net Claim Payments pursuant to this <br /> Agreement for which reimbursement has not been previously made by Employer to the Claim Admin- <br /> istrator, plus the applicable service charges. If any day on which a Transfer Payment is due is a holi- <br /> day, such payment will be made on the next business day. <br /> IX. CLAIM SETTLEMENTS <br /> A. A Claim Settlement shall be determined for each monthly period. Such period will be referred to <br /> � as the "Claim Settlement Period."The Claim Settlement shall reflect the sum of the following: <br /> 1. All Net Claim Payments calculated on the basis of Claim Payments paid by the Claim Admin- <br /> istrator in the particular Claim Settlement Period. <br /> 2. All Net Claim Payments calculated on the basis of Claim Payments paid by the Claim Admin- <br /> istrator in prior Claim Settlement Periods that have not been included in a prior Claim Settle- <br /> ment. <br /> 3. The service charges specified in Section VII. of this Agreement. <br /> The sum of 1., 2., and 3. above shall be referred to as the Claim Settlement Total. <br /> B. If, within the Claim Settlement Period, the Claim Settlement Total exceeds the Transfer Pay- <br /> ments,the Employer will pay the difference to the Claim Administrator.The Claim Settlement will <br /> be determined within sixty(60)days from the last day of the Claim Settlement Period.The Claim <br /> Administrator will notify the Employer in writing of the results of the Claim Settlement. Any sums <br /> due the Claim Administrator will be paid by the Employer within ten (10) days from the date the <br /> Claim Administrator notifies the Employer. <br /> C. If,within the Claim Settlement Period,the Transfer Payments exceed the Claim Settlement Total, <br /> the Claim Administrator may, at its option, pay such difference to the Employer, apply the differ- <br /> ence against amounts then owed the Claim Administrator by the Employer or authorize a reduc- <br /> tion equal to such difference from the next Claim Settlement due the Claim Administrator from <br /> the Employer. <br /> X. CLAIM PAYMENTS, NET CLAIM PAYMENTS, AUDITS AND CORRECTIONS OF ERRORS <br /> A. Upon receipt of a Claim,the Claim Administrator will make a Claim Payment provided that all pay- <br /> � ments due the Claim Administrator under the terms of the Agreement are paid when due, and <br /> provided further, that the Employer performs all of its other obligations under the Agreement. <br /> - 5 - <br />
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