R95-141 AUTHORIZING APPLICATIONS FOR GROUP HEALTH INSURANCE COVERAGE

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• B1ueCross B1ueShield An Independent Licensee of the � ' Of Ill11101S Blue Cross and Blue Shield Association �� � � ADMINISTRATIVE SERVICES AGREEMENT This Agreement made as of November 1, 1994 by and between Health Care Service Corporation, a Mutual Legal Reserve Company(hereinafter referred to as the"Claim Administrator"),and City of Deca- tur(hereinafter referred to as the"Employer"), Employer Group Number 992844 ,WITNESSETH AS FOL- LOWS: WHEREAS, the Employer has established and adopted an employee welfare benefit plan ("Plan") as de- scribed in the Plan Document attached hereto as Exhibit A; WHEREAS, the Employer desires to retain the Claim Administrator to provide certain administrative ser- vices with respect to the attached Plan; NOW, THEREFORE, in consideration of these premises and the mutual promises and agreements here- inafter set forth, the parties hereby agree as follows: , I. APPOINTMENT I The Employer hereby retains and appoints the Claim Administrator to provide services as hereinafter described in connection with the administration of the Plan. � II. SERVICES TO BE PROVIDED BY THE CLAIM ADMINISTRATOR During the continuance of this Agreement, the Claim Administrator will perform such services as are set forth in Exhibit I, attached hereto and made a part hereof. The Claim Administrator at its discretion may contract with other entities for performance of any of the services to be performed by the Claim Administrator hereunder. III. CERTAIN RESPONSIBILITIES OF THE EMPLOYER AND THE CLAIM ADMINISTRATOR A. The Employer retains full and final authority and responsibility for the Plan and its operation. The Claim Administrator is empowered to act on behalf of the Employer in connection with the Plan only as expressly stated in this Agreement or as mutually agreed to in writing by the parties here- to. B. The Claim Administrator shall have no responsibility for or liability with respect to the compliance or non-compliance of the Plan with any applicable federal, state or local rule of law, and the Em- ployer shall have the sole responsibility for and shall bear the entire cost of compliance with all federal, state and local rules and laws including, but not limited to, any licensing, filing, reporting and disclosure requirements as may apply to the Plan, and all costs, expenses and fees relating thereto. C. The Claim Administrator shall, to the extent possible, advise the Employer of any legal actions against it or the Employer which involve the Plan or the obligations of the Employer or the Claim Administrator under the Plan or this Agreement. The Employer shall undertake the defense of such action and be responsible for the costs of defense; provided, however, that the Claim Ad- ministrator shall have the option,at its sole discretion,to employ attorneys selected by it to defend any such action, the costs and expenses of vvhich shall be the responsibility of the Employer. � It is further agreed that the Claim Administrator(provided no conflicts of interest exist) shall fully cooperate with the Employer, at no cost to the Claim Administrator, in the Employer's defense of any action arising out of matters related to the Plan or this Agreement. - 1 -