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2000-041-RES AUTHORIZING THE EXECUTION OF A GROUP
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2000-041-RES AUTHORIZING THE EXECUTION OF A GROUP
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Last modified
8/18/2006 4:29:33 PM
Creation date
7/20/2001 4:18:48 PM
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CITY CLERK
Doc Name
2000
Doc Type
Resolution
CITY CLERK - Date
4/10/2000
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<br />DEFINITIONS: The following t(""IlJ1S where used in this Ablfcement, have these meanings: <br /> <br />o We, us, or our - 'fne TML Intergo...emm"lltal Employee Benetlts Pool, blown as lilt: Group <br />B("'"Ilefits 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 l~lau - The employee benefit plan which the Employer named in the Schedule has adopted to <br />provide medic.-al expense benefits to eligible persons, as defined, and which is aUached to and fonns <br />it part ofthis Agreement. <br /> <br />o . .Eligible Persons - Employees and depelldenL'\ who are eligible for l:x.:ncfits under the Plan. <br /> <br />You have adopted the Plan and asked us to administer the benefits it provides. lberefore, in consideration <br />of the mutual promises contained in this Agreement, it is agreed as follows. <br /> <br />I. OUR DIJTIES <br /> <br />a. 'We agree to process all claims presented On behalf of eligible persons for the pa,)ment of <br />benefits according to the tt:rms of the Plan. Payment of elainlS shall be advanced by our <br />eheck subject to immediate reimbursement by YOll in accon.lance with para!;.'T'clph Il.a. of <br />this Ab't'~ement. We advance funds only ror plll:poses of administrative and ac~ounting <br />con Vl:n ience. 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 />paymc.'I1t. <br />b. We agree to provide, at munthly intervals, a listing of all Plan benefits paid. Om: custom <br />report is provided, at your request, at no eost per plan year. Subsequent custOm n."ports will <br />be billed as shown in the schedule. <br />c. We agree to design, review and print standard torms to eAplain benetits to l."IIlployees. <br />standard emollment cards, standard ID cards and one (I) standard benetlt book every two <br />(2) ycaflt. <br />d. We agree to provide unuerwriting services including (i) annual cost projections, (ii) cost <br />projections for Plan modifications; and estimates of reserve amolUlts requircd to fund the <br />Plan on a current basis. <br />e. We agree to provide assistance tu you in designin~ your Plan benefits based on COV'l.T.&ge <br />adequacy, cust control effectivl.lless, and medical or economic developments. <br />f. We agree to provide 3" annual report of tax reportable claim payments to medic-.d care <br />providers. <br />g. We agree to allow you to obtain a third party 10 conduct an on site claims audit at our <br />ollkes. Such claims audit will be limited to once per agreeml.'I1t year and the date(s) will <br />be mutually agreed upon. We agree to not Imnccessarily delay the claims audit by not <br />Illutually agrecinl; 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 diligl.llce in the exercise of our powers and the performance of <br />our duties as Group Benefits Administrator hc.'l'eunder but shall not be liable for any <br />mistake or judgmenl or Othl.T action taken in good faith or tOr any loss unless resultinl; <br />from our gross negligence. <br /> <br />P.11:1: 2 or:; <br />
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