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<br />DEFINITIONS: The following terms where used in this Agreement, have these meanings: <br /> <br />o We, us, or our - The Texas Municipal League Group Benefits Risk Pool, known as the Group <br />Benefits Administrator herein, or any subcontractor which it designates to perform the functions <br />and meet the obligations to which it agrees in this Agreement. <br /> <br />o You or your - The Employer named in the Schedule. <br /> <br />o The Plan - The employee benefit plan which the Employer named in the Schedule has adopted to <br />provide medical expense benefits to eligible persons, as defmed, and which is attached to and forms <br />a part of this Agreement. <br /> <br />o Eligible Persons - Employees and dependents who are eligible for benefits under the Plan. <br /> <br />You have adopted the Plan and asked us to administer the benefits it provides. <br />of the mutual promises contained in this Agreement, it is agreed as follows, <br /> <br />Therefore, in consideration <br />. <br /> <br />I. OUR DUTIES <br /> <br />a. )Ve agree to process all claims presented on behalf of eligible persons for the payment of <br />benefits according to the terms of the Plan. Payment of claims shall be advanced by our <br />check subject to immediate reimbursement by you in accordance with paragraph Il.a. of <br />this Agreement. We advance funds only for pw:poses of administrative and accountin~ <br />convenience. We do not insure the Plan. We will not pay any benefits which are not <br />payable under the Plan. We will not process any claim which was incurred prior to the <br />Effective Date shown in the Schedule, unless authorized by you in writing prior to <br />payment. <br />b. We agree to provide, at monthly intervals, a listing of all Plan benefits paid. One custom <br />report is provided, at your request, at no cost per plan year. Subsequent custom reports will <br />be billed as shown in the schedule. <br />c. We agree to design, review and print standard forms to explain benefits to employees, <br />standard enrollment cards, standard ID cards and one (I) standard benefit book every two <br />(2) years. <br />d. We agree to provide underwriting services including (i) annual cost projections, (ii) cost <br />projections for Plan modifications; and estimates of reserve amounts required to fund the <br />Plan on a current basis. <br />e. We agree to provide assistance to you in designing your Plan benefits based on coverage <br />adequacy, cost control effectiveness, and medical or economic developments. <br />f, We agree to provide an annual report of tax reportable claim payments to medical care <br />providers. <br />g. We agree to allow you to obtain a third party to conduct an on site claims audit at our <br />offices. Such claims audit will be limited to once per agreement year and the date(s) will <br />be mutually agreed upon. We agree to not unnecessarily delay the claims audit by not <br />mutually agreeing to a date, <br />h. We agree to administer all provisions contained in the Plan booklet/document adopted by <br />the Employer. <br />1. We agree to use care and diligence in the exercise of our powers and the performance of <br />our duties as Group Benefits Administrator hereunder but shall not be liable for any <br />mistake or judgment or other action taken in good faith or for any loss unless resulting <br />from our gross negligence. <br /> <br />Page 2 of 5 <br />