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<br />GROUP BENEFITS SERVICES AGREEMENT <br />NON-P ARTICIP A TING <br /> <br />This Agreement is between the Employer named in the Schedule and the Tcxas Municipal League Group <br />Benefits Risk Pool, 1821 Rutherford Lane, Suite 300, Austin, Texas 78754 <br /> <br />SCHEDULE <br /> <br />1. Employer: City of Paris <br />2. Plaee of Delivery: Austin, Texas <br />3. Effective Date: 5-1-96 <br />4. Monthly Service Charge: <br /> <br />A. <br /> <br />B. <br />C. <br />D. <br />E. <br /> <br />Claims Administration <br />Medical <br />Dental <br />Vision <br /> <br />$ 7.50 <br />$ .80 <br />$ <br />$ 1.65 <br />$ <br />UJ.5. <br />$10.10 <br /> <br />U.R. <br />PPO Access Fee <br />Centers of Excellence <br />Total <br /> <br />F. <br />G. <br />H. <br /> <br />Health Check - AutoAudit <br />Large Case Management <br />Custom Claims Reports <br /> <br />No Charge <br />$65.00/hr as required <br />$60.00/programming hour <br /> <br />DEFINITIONS: The following terms where uscd 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 funetions <br />and meet the obligations to which it agrees in this Agreement. <br /> <br />o You oryour - 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 cligible persons, as defined, 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 tiS to administer the benefits it provides. Therefore, in eonsideration <br />of the mutual promises contained in this Agreement, it is agreed as follows. <br /> <br /> <br />GHOUl' lIt:Nt:t1TS RISK "OOL <br />