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R89-148 AUTHORIZING APPLICATIONS FOR GROUP HEALTH INSURANCE COVERAGES
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R89-148 AUTHORIZING APPLICATIONS FOR GROUP HEALTH INSURANCE COVERAGES
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8/5/2016 3:15:57 PM
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Resolution/Ordinance
Res Ord Num
R89-148
Res Ord Title
AUTHORIZING APPLICATIONS FOR GROUP HEALTH INSURANCE COVERAGES
Approved Date
10/30/1989
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3 . Such information as to Plan benefits as will enable <br /> the Claim Administrator to accurately prepare any <br /> reports required under this Agreement. <br /> The Employer, furthermore, shall use its best <br /> efforts to cooperate with and assist the Claim <br /> Administrator, as applicable, in the performance of <br /> its duties hereunder . <br /> H. 1 . The Claim Administrator in its sole discretion <br /> reserves the right to pay any benefits that are <br /> payable under the terms of this Agreement directly <br /> to the Covered Employee or to the Provider of the <br /> service . <br /> 2 . The Employer represents that it has communicated <br /> the provision contained in Article III H. 1 . of <br /> this Agreement to its employees and that said <br /> provision is contained in the Employer' s agreement <br /> with its employees to provide health care coverage. <br /> IV. SERVICE CHARGE <br /> A. The Employer will pay a Service Charge to the Claim <br /> Administrator as payment for the processing of Claims <br /> and administrative and other services provided to the <br /> Employer . This Service Charge will be the following <br /> percentage and will be applied to all amounts paid by <br /> the Claim Administrator in accordance with this <br /> Agreement: <br /> ����� ��,.rQ� 1 . 95� of Claim Payments plus $1 . 70 per Covered Employee <br /> I � per month for administration of the Medical Services <br /> 4�f��d Advisory ( "MSA" ) Program. <br /> The Service Charge will be computed and payable in <br /> accordance with the Article IV. below. <br /> B. The Service Charge, which is guaranteed for a twelve <br /> ( 12 ) month period from the Effective Date of this <br /> Agreement has been determined in accordance with the <br /> Claim Administrator' s current regulatory status and the <br /> existing benefit program. Should future legislation or <br /> administrative rule or regulation ( i ) obligate the Claim <br /> Administrator to pay any new taxes or other fees imposed <br /> upon or resulting from this Agreement, or ( ii ) mandate a <br /> new or modify a current benefit, then the Claim Admin- <br /> istrator reserves the right, upon at least sixty ( 60 ) <br /> days written notice to the Employer to adjust the <br /> Service Charge within such twelve ( 12 ) month period. <br /> V. TRANSFER PAYMENT <br /> A. In consideration of the Claim Administrator' s <br /> obligations as set forth in this Aqreement and in <br /> -4- <br />
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