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1991-124-RES WHEREAS, the City Council of the City of Paris, is desirous of providing health care for the City of Paris
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1991-124-RES WHEREAS, the City Council of the City of Paris, is desirous of providing health care for the City of Paris
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8/18/2006 4:33:29 PM
Creation date
4/12/2005 2:00:35 AM
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CITY CLERK
Doc Name
1991
Doc Type
Resolution
CITY CLERK - Date
12/9/1991
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<br />1.07 Purchast. shall designate in writing a contact person who will be empowered to act <br />on behalf of Purchaser with regard to the terms of the Agreement and with whom <br />Contractor can coordinate and resolve all questions arising in the course of <br />administration. <br /> <br />SECTION lWO <br />OBUGATION OF CON1RACfOR <br /> <br />2.01 Contractor shall administer Purchaser's Benefit Program in accordance with the <br />benefit plan description provided and the administrative practices and procedures <br />established; <br /> <br />2.02 Contractor shall recommend to Purchaser appropriate changes and modification to <br />the Benefit Program and its administrative practices and procedures where required; <br /> <br />2.03 Contractor shall provide or arrange for suitable facilities, equipment, and personnel <br />necessary for proper administration of the Benefit Program; <br /> <br />2.04 Contractor shall, upon request, assist Purchaser in establishing appropriate banking <br />arrangements for program administration; <br /> <br />2.05 Contractor shall, upon request, install standard administrative materials, including an <br />administration manual, participant and provider claim forms, and participant <br />identification cards; <br /> <br />2.06 Contractor shall, upon request, assist Purchaser in incorporating the Benefit Program <br />description and design into a plan document and booklet for Participants; <br /> <br />2.07 Contractor shall provide claims processing services to include: <br /> <br />a. Review and validation of all claims submitted for payment, <br /> <br />b. Determination of benefits in accordance with the specifications of the Benefit <br />Program, <br /> <br />c. Coordination of benefits with other plans, where appropriate, <br /> <br />d. Preparation and mailing of explanation of benefit forms, and <br /> <br />e. Preparation and mailing of claim drafts drawn on Purchaser's bank account <br />as provided in Section Six: <br /> <br />2.08 Contractor shall establish liaison with Purchaser's designee, providers and Participants, <br />as required, to obtain and follow-up on additional service information, to verify <br />eligibility of Participants and to assist in resolving claims problems; <br /> <br />2.09 Contractor shall provide periodic written reports to include: <br /> <br />a. Monthly check reconciliation reports, <br /> <br />2 <br />
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