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2000-041-RES AUTHORIZING THE EXECUTION OF A GROUP RESOLUTION NO. 2000-041 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PARIS, PARIS, TEXAS, AUTHORIZING THE EXECUTION OF A GROUP BENEFITS SERVICES AGREEMENT WITH TEXAS MUNICIPAL LEAGUE INTERGOVERNMENTAL EMPLOYEE BENEFITS POOL (TML- IEBP) FOR TERM LIFE INSURANCE, STOP-LOSS INSURANCE FOR MEDICAL/DENTAL/VISION PROGRAM, THIRD-PARTY ADMINISTRATION SERVICES FOR THE ABOVE COVERAGE, MAINTENANCE DRUG PROGRAM, AND LONG TERM DISABILITY; MAKING OTHER FINDINGS AND PROVISIONS RELATED TO THE SUBJECT; AND PROVIDING AN EFFECTIVE DATE. WHEREAS, the City Council of the City of Paris did heretofore, on March 8, 1999, in Resolution No. 99-029, authorize the execution"of a Group Benefits Services Agreement with Texas Municipal League Group Benefits Risk Pool for the furnishing and delivery of (1) Term Life Insurance, (2) Stop-loss Insurance for its otherwise self-funded MedicalIDentalIVision Program, (3) Third-Party Administration Services for the above coverage, (4) Maintenance Drug Program, and (5) Long Term Disability; and, WHEREAS, said agreement expires on April 30, 2000, and it is deemed appropriate that a new contract be executed; and, WHEREAS, the form of the agreement with the Texas Municipal League Intergovernmental Employee Benefits Pool, attached hereto as Exhibit A, should, in all things, be approved, and the Mayor should be authorized to execute the same; NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PARIS, PARIS, TEXAS: Section 1. That the findings set out in the preamble to this resolution are hereby in all things approved. Section 2. That the the form of the Group Benefits Services Agreement with the Texas Municipal League Intergovernmental Employee Benefits Pool (TML-IEBP) for (I) Term Life Insurance, (2) Stop-loss Insurance for its otherwise self-funded Medical/Dental/Vision Program, (3) Third-Party Administrative Services for the above coverage, (4) Maintenance Drug Program, and (5) Long Term Disability, attached hereto as Exhibit A, be, the same is hereby, approved; and, Section 3. That the Mayor be, and he is hereby, authorized and direcled to execute, on behalf of the City of Paris, the Group Benefits Services Agreement with the Texas Municipal League, under the terms and conditions and in the form shown in Exhibit A, attached hereto. Section 4. That this resolution shall be effective from and after its date of passage. PASSED AND APPROVED this 10th day of April, 2000. Charles H. Neeley, Mayor ATTEST: Mattie Cunningham, City Clerk APPROVED AS TO FORM: GROUP BENEFITS SERVICES AGREEMENT NON-PARTICIPATING This Agrcemenl is between the Employ~r named in thc Schedule and the TML Inteq;ovenunental Employee Benelits Pool, 1821 Rutherford Lane, Suite 300, Austin, Texas 78754 SCHEDULE \. Employer: City of Paris 2. :Place of Delivery: Austin, Texas 3. Effective Date: May 1,2000 4. Monthly Service Charge per employec per month: . Claims Administration Medical Dental Vision Utilization Rcview PPN Access Fec S8.00 50.90 SO,40 S 2.00 $3.00 . . 5. Optional Services (per employee pcr month) . First Call High Risk Prcgnaney Medical Conversion HIPAA Compliance Adm. COC Administration SO.OO 50.00 SO.OO SO.OO SO.50 SO,OO SO.OO . . . . . . 6. Total 514.80 HealthChex - AutoAudit Large Case Managemcnl Transplant Centers Custom Claims Reports Rx Card Claims Benefit Booklets (every 2 years) PPN Directories Retiree Dm."'Ct Billing Hospital Audit Subrogation No Charge Included in UR Fee Included in PPN Fee S150.00fprogramming hour S 0.32fclaim lucluded For Number of EE Plus 10':1. Included For Numbe.' ofEE Plus 10% 51,OOfmonlhfemployee 20% oCsaviugs - Outside Vendor 20% of savings - Outside V cndor Note I - PPN AecC$S Fcc Includes Full Network Pace 1 nf, EXHIBIT "An DEFINITIONS: The following t(""IlJ1S where used in this Ablfcement, have these meanings: o We, us, or our - 'fne TML Intergo...emm"lltal Employee Benetlts Pool, blown as lilt: Group B("'"Ilefits Administrator herein, or any subcontractor which it designates to perform the functions and meet the obligations to which it agrees in this Agreement. o You or your - The Employer named in the Schedule. o The l~lau - The employee benefit plan which the Employer named in the Schedule has adopted to provide medic.-al expense benefits to eligible persons, as defined, and which is aUached to and fonns it part ofthis Agreement. o . .Eligible Persons - Employees and depelldenL'\ who are eligible for l:x.:ncfits under the Plan. You have adopted the Plan and asked us to administer the benefits it provides. lberefore, in consideration of the mutual promises contained in this Agreement, it is agreed as follows. I. OUR DIJTIES a. 'We agree to process all claims presented On behalf of eligible persons for the pa,)ment of benefits according to the tt:rms of the Plan. Payment of elainlS shall be advanced by our eheck subject to immediate reimbursement by YOll in accon.lance with para!;.'T'clph Il.a. of this Ab't'~ement. We advance funds only ror plll:poses of administrative and ac~ounting con Vl:n ience. We do not insure the Plan. We will not pay any benefits which are not payable under the Plan. We will not process any claim which was incurred prior to the Effective Date shown in the Schedule.. unless authorized by you in writing prior to paymc.'I1t. b. We agree to provide, at munthly intervals, a listing of all Plan benefits paid. Om: custom report is provided, at your request, at no eost per plan year. Subsequent custOm n."ports will be billed as shown in the schedule. c. We agree to design, review and print standard torms to eAplain benetits to l."IIlployees. standard emollment cards, standard ID cards and one (I) standard benetlt book every two (2) ycaflt. d. We agree to provide unuerwriting services including (i) annual cost projections, (ii) cost projections for Plan modifications; and estimates of reserve amolUlts requircd to fund the Plan on a current basis. e. We agree to provide assistance tu you in designin~ your Plan benefits based on COV'l.T.&ge adequacy, cust control effectivl.lless, and medical or economic developments. f. We agree to provide 3" annual report of tax reportable claim payments to medic-.d care providers. g. We agree to allow you to obtain a third party 10 conduct an on site claims audit at our ollkes. Such claims audit will be limited to once per agreeml.'I1t year and the date(s) will be mutually agreed upon. We agree to not Imnccessarily delay the claims audit by not Illutually agrecinl; to a date. . h, We agree to administer all provisions contained in the Plan booklet/document adopted by the Employer. 1. We agree to use care and diligl.llce in the exercise of our powers and the performance of our duties as Group Benefits Administrator hc.'l'eunder but shall not be liable for any mistake or judgmenl or Othl.T action taken in good faith or tOr any loss unless resultinl; from our gross negligence. P.11:1: 2 or:; are inadequate to fund the obligation at the time it is determined. you agree to take the appropriate budgetary action sufficient to pay the obligation. f. You agree to pay us a monthly service charge determined by multiplying the Monthly Service Charge shown in the Schedule of this Agreement by the number of employees covered under the Plan as of the first day or each calendar month conunencing on the Effective Date of this Agreement. Payment shall be due 3S of the first day of each calendar month and shan be payable no lOll",,. than the twl.:ntieth (20th) of the month, g. You agree to act on all benetit appeals in accordance with the provisions outlined by the Plan. h. You agree that if a payment is made to or on behalf of an ineligible pc..non or if ISn overpayment is made to a covered person, the Group Benefits Administrator shall attempt, with full cooperation and assistance of the Employer, to recover such payment through rc:imbursemcnt or from future benefits that become due to such person or entity. The Group Benefits Administrator shan not be responsible for any such payment or overpayment lIDless it was due to gross negligence of the Group Benefits Administrator. I. You a2rce to become a member of thc TML IntergovenunentaJ Employee Benefits Pool and 10 be bound by the terms of the TML Intergovt..'TlU1lental Employee Benefits Pool Inlerlocal Agreeml,.'Ut. Where there are conflicts between this agn.."\.'1l1cnt and the Intc..,.local Agreement, the l..::rms of this Agr'CI...'1l1ent control. m. DURATION OF AGREEMENT This agreement shall take effect on the effective date and shall automatically be renewl,.-d for a successive twelve (12) month period unless terminated by either party as set forth in Sc.."..tion IV. Modification of the agreement is acceptable as outlined in Section V. lV. TERMINATION OF AGREEMENT a. You can terminate this Agreement by giving US written notice of your intent to do so. at least J I days prior to the termination date. b. We CaD terminate this Agreement: (i) immediately, by written nOlice to you, if you fail to providc flUlds requin.:d by the Plan.. fail to pay our charges when due. or in any other way f.1il to perfonn your duties under the Agreement; (ii) 31 days after giving you written notice of our intent to do so. e. You agree to pay us tor any outstanding charges within 31 days of your receipt of our bill. If you do not pay such charges within the 31 day period, in addition 10 that payment, you will also pay us for any attorney's fees or other collection fees we incur, plus the maximum int\,.'Tcst aUowed by law. d. We will have no further obligation to process claims after this Agtecment terminates. V. MODIFICATION OF AGREEMENT a. If you and we agree on the tams of the modifications, this A&fCcment can hc modified at any time_ b. We can change any of the charges shown in the Schedule 31 days after giving you written notice or our intent to do so, Such written notice shall supersede the applicable itCIrus(S) in the schedule and any prior such notice(s). Howcva, no such change shall tak.e effect sooner than the r~t aruuversary of the Effective Date shown in the schedule. I'J.!( 4 or, are inadequale to fund the obligation at the time il is detconined. you a!:l'ee to take the appropriate budget",>, action sufficient to pay the obligation. f. You agree to p"y us a monthly service charge determined by multiplying the Monthly Service Ch;uge shown in Ille Schedule of this Agreement by lhe number of employees covered under the Plan as of the fIrSt day of each calendar nionth commencing on the Effective Date of this Agreement. Paymenl shall be due as of the first day of each cal~'Ddar month and shall be payable no lat~T than the tw~'Dtieth (20th) of the mnnlh. g. You agree 10 acl on all benelit appeals in aecord:mce with the provisions outlined by the Plan. b. You agree that if a payment is made 10 or on behalf of an ineligible p<.Tson or jf lID overpayment is made to a covered person, the Group Benefits Administrator shall attempl, with full cooperation and assistance of the Employer, to recover such paymenl througb Io:imbursemcnl or from future benefits thaI 1x:come due to such person or entity. The Group Benefits Administntor shall nol be responsible for any such paymcnt Or overpayment unless it was due 10 gross negligence nf the Group Denefits Administrator. i. You a\:Iee to become a member of thc TML Intergovcnunental Employee Benefits Pool and to be bound by the terms of thc TML Intergovt:mmental Employee Denefits Pool lnlcrlocal Agreem~'DI. Where there are conn iets 1x:1 ween this agrc<.'l11cnt and the Int~Tlocal A!:l'eemenl, the t,;nns of this Agn:~'l11ent control. m. DURATION OF AGREEMENT This agreemenl shall lake eft!:ct on Ihc effective dale and shall automalically be renew~-d for a succcssive twelve (12) month period unless terminated by either party as set forth in S.vtion IV. Modification oCthe agreement is acceptable as oullined in Section V. IV. TERMINATiON OF AGREEMENT a. You can termillale this Agreement by giving US written nntiee of your intent to do so, at Icast 31 days prior 10 the terminaliun date. h. We can terminate this Agnemenl: (i) immediately, by written noliee to you, if you fail to proYide f\Olds requir.~l by the Plan, fail 10 pay our charges when due, or in any other way fail to perform YOllr duties under the Agreement; (ii) 31 days after giving YOll written ooltec of our intenl to do 50. C. You agree to pay US lor any outstanding charges within 31 days of your receipt of our bill. If you do not pay soeb charges within the 31 day period, in addition to thaI payment, you will also pay us for any attorney's fees or otber colleclion fees we incur, pIllS the maximum int."Icst allowed by law. d. We will have no further obligalton to process claims after this Agreement terminates. V. MODIFlCATlON OF AGREEMENT a. If you and we agree on the term5 of the modifications, this Agreement can he modified at any time. b. We can change any of the charges sbown in the Schedule 31 days after giving you written notice 01' our int.'Ut to do so. Such written notice shall slIpersede the applicahle ilcms(s) in the schedule and allY prior sucb notice(s). HOWCYeI, no such change shall take cffecl sooner than the r~t aruuversary oftbe Effective Dale shown in the schedule. r'g< 4 .U VI. DISCLAIMER We act only as a providcr of services 10 your Plan. We do nol insure your Plan in any way. We are not a fiducial)'. This AgreeDlent is made binding by the signature of your and our representatives who are duly aulhori7.ed tn utcr into such 31,'TCements. FOT lhe TML Intergovernmental Employee BenenU Pool For Ihe City of Pari, Terry D. Hale Print name Charles H. Neelev Print name F.xeclltive Director Tille Mayor Tille April 10. 2000 Date Date r.o' S .IS ArrACHMENT A TML INTERCOVERNMENTAL EMPLOYEE BENEFITS POOL Aso BANKINC ARRANGEMENT EMPLOYER: EFFECTIVE DATf: CITY OF PARIS MAY 1, 1999 PLEASE CHECK THE REIMBURSEMENT FREQUENCY DEStRED AND EITHER ISSUED OR CLEARED. I ISSUED I CLEARED REIMBURSEMENT PREFlINDINC PllEFUNOING FREQUENCY REQUIREMENl" REQUtKEMENT WEEKLY N/A 1" AND 15'" NONE MONTliLY AUTHORIZED OfFICIAL Charles H. Neeley TITlE Mayor DATE April 10. 2000