2006-040-RES-Intergovernmental employee benefits pool
RESOLUTION NO. 2006-040
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PARIS,
PARIS, TEXAS, AUTHORIZING THE CITY MANAGER TO EXECUTE
ANY AND ALL NECESSARY DOCUMENTS ASSOCIATED WITH
ENTERING INTO A CONTINUATION OF COVERAGE ADMINISTRATIVE
AGREEMENT WITH TML INTERGOVERNMENTAL EMPLOYEE
BENEFITS POOL; MAKING OTHER FINDINGS AND PROVISIONS
RELATED TO THE SUBJECT; AND PROVIDING AN EFFECTIVE DATE.
WHEREAS, the City Manager and the City Finance Director have identified the necessity
of entering in a Continuation of Coverage Administrative Agreement with TML Intergovernmental
Employee Benefits Pool to assist the City of Paris in complying with the requirements of
Continuation of Coverage as required by Federal Law; and1
WHEREAS, the City has received recommendations from representatives of the Texas
Municipal League Intergovernmental Employee Benefits Pool I which acts as the administrator of the
Citi s health insurance program; and1
WHEREAS, the City Council desires to authorize the City Manager to execute any and all
necessary documents associated with entering into a Continuation of Coverage Administrative
Agreement; 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 City Manager is hereby authorized to execute any and all documents
necessary and required associated with entering into a Continuation of Coverage Administrative
Agreement.
Section 3. That this resolution shall be effective May II 2006.
PASSED AND APPROVED this 13th day of MarchI 2006.
I' _,
ATTEST:
/ anice Ellis, City Clerk
APPROVED AS TO FORM:
1; f.~56 j i
,/ ., ~ 1"'-
, hn D. Lestock, Assistant City Attorney
IITML
t41 Intergovernmental
Employee Benefits
Pool
CONTINUATION OF COVERAGE ADMINISTRATIVE AGREEMENT
City of Paris
May 2006
WHEREAS, the undersigned Employer is an Employer Member of the TML Intergovernmental Employee Benefits Pool
(hereinafter referred to as the "Pool");
WHEREAS, the undersigned Employer sponsors an employee benefit plan;
WHEREAS, the undersigned Employer is responsible for the administration of its employee benefit plan as the Plan
Administrator; and
WHEREAS, the undersigned Employer wants the TML Intergovernmental Employee Benefits Pool to assist the Employer in
complying with the requirements of Continuation of Coverage as required by Federal law.
NOW THEREFORE, in consideration of the promises, mutual covenants and agreements contained herein, the undersigned
Employer and the Pool agree as follows:
I. Effective Date
As of the first day of , 20_ the Pool will commence Continuation of Coverage administration
for the undersigned Employer for all qualifying events occurring thereafter and during the term of this agreement.
II. Employer Duties
1. The undersigned Employer will notify the Pool's Billing/Eligibility Representative assigned to the Employer
via FAX or Telephone (with a written follow up) within one (1) business day of a qualifying event, as
defined by the Continuation of Coverage statute and its amendments, of a Covered Employee for which the
Employer has knowledge. Examples of this include termination; resignation; death; retirement if the
employee does not enroll for retiree coverage when offered under the Employer's benefit plan; reduction in
hours (including reduction to zero hours) and absence from work for an injury or illness after all earned sick
leave, vacation leave and FMLA has been exhausted.
2. The undersigned Employer will distribute Attachment A, which advises each Covered Individual of their
rights and responsibilities under Continuation of Coverage. The Employer will certify through a letter to the
Pool that the Attachment A was distributed to all Covered Individuals as of the date the Pool commenced
Continuation of Coverage Administration.
3. The undersigned Employer will distribute Attachment A to all employees who become covered by the
Employer's benefit plan after the date the Pool commenced Continuation of Coverage administration and
include verification of the distribution with the enrollment card when it is submitted to the Pool.
4. The undersigned Employer will notify the Pool via FAX or Telephone (with a written follow-up) within one
(I) business day of gaining knowledge that a Covered Individual has legally separated, divorced or is no
longer eligible for coverage e.g. a child, over age 19, who is no longer a full-time student as defined by the
Employer's health benefit plan or the Covered employee or dependent is voluntarily dropped from coverage.
5. The undersigned Employer will notify the Pool at least ten (10) business days prior to any open enrollment
period. The notice to the Pool will include the dates of the open enrollment.
6. The undersigned Employer will immediately notify the Pool of any suspected claim, demand or suit arising
from the administration of Continuation of Coverage.
EXHIBIT A.
7. To the extent allowed by law, the undersigned Employer will indemnify and hold harmless the Pool and its
officers, agents, employees and representatives from all suits, actions, losses, damages (including punitive
damages), claims or liability of any type, including without limiting the generality of the foregoing all
expenses oflitigation, court costs, and attorney's fees, resulting from the failure of the undersigned Employer
to give any notice required by this Agreement. The undersigned Employer will fund this obligation out of
current revenues in the year the obligation is determined or will levy a tax to fund the obligation if current
revenues are insufficient.
III. Pool Duties
1. The Pool staff will monitor changes in Continuation of Coverage and the case law which develops
interpreting Continuation of Coverage.
2. The Pool will provide election notices within 14 days of the receipt of notices of qualifying events sent by the
Employer.
3. The Pool will provide the appropriate notification letters to the employee or their dependent(s) as required by
Continuation of Coverage statutes.
These letters may include any or all ofthe following:
a) benefit availability - initial notice, enrollment card and cost;
b) confirmation of enrollment and payment coupons
c) notice of termination letters
1. Failure to reply
2. Failure to make initial payment
3. Failure to make regular payment
4. End of eligibility (no longer qualified)
5. End of eligibility period
d) open enrollment
e) contribution change and revised payment coupons
Q conversion to an individual policy
g) Medicare eligibility
h) verification of full-time student status
i) verification of incapacitated child status
4. The Pool will provide the Continuation of Coverage participants with ID cards, a benefit booklet, and other
materials as the need may arise.
5. The Pool will maintain records that all required notifications were sent and copies are available to the
Member upon request.
6. The Pool will collect the required contributions at the maximum amount allowed by law. Upon notice for the
Employer under II.I., the Pool has fourteen (14) days to send the Continuation of Coverage notice. Once the
election notice is mailed the qualifying beneficiary has sixty (60) days to elect Continuation of Coverage. If
the qualified beneficiary elects Continuation of Coverage the qualified benefit has forty-five (45) days from
election to make the first payment. If insignificant partial payments are made TML IEBP contacts the
qualified beneficiary for full payment. The qualified beneficiary has thirty (30) days from deficiency
notification to make payment. Insignificant payment deficiency is $50 or 10% of amount due.
7. The Pool will periodically provide the Employer, for their review, with the text of the letter and notices to be
used in administering this Agreement. The Pool maintains final authority over the text of these letters and
notices. The Pool reserves unto itself the right to modify the letters and notices as may be required pursuant
to the Continuation of Coverage statute, any applicable case law and to promote the efficient administration
of the Agreement.
8. As allowed by law, the Pool will indemnify, defend, reimburse, and hold harmless the Employer and its
employees from any and all liabilities, claims, demands, or suits arising from or related to the provision of
Continuation of Coverage administrative services unless those liabilities, claims, demands, or suits arise out
of the Employer's failure to give any notice as required in 11,1,2,3,4,5 and 6 of this Agreement. The Pool,
upon notice by the Employer will immediately investigate, handle, respond to and defend any such claims,
demands or suits at its sole expense. If the liability, claim, demand or suit is based on negligence this contract
of indemnity shall apply and the negligence of the Employer and the Pool will be on a percentage basis as in
a pure comparative negligence situation under the law.
9. The Pool's responsibilities under this contract are for Continuation of Coverage that the Employer is required
to provide under Federal law, and does not have any responsibility for other benefits such as group life
insurance or disability.
IV. Notice
Any notice to be given under this Agreement, other than those in II, I, 2, 3, 4 and 5 of this Agreement, shall be deemed
given and received on the first to occur of the following: (a) actual receipt by the party to be notified; or (b) five days
after deposit of such notice in the US Mail system if sent by Certified Mail, Return Receipt Requested, postage prepaid,
and addressed to the party to be notified at the address of such party set forth below or as designated from time to time
in writing by giving not less than ten days in advance notice to the other party. The initial addresses for the Pool and
Employer shall be as follows:
Address of Pool
Address of Emplover
Executive Director
TML Intergovernmental Employee Benefits Pool
Texas Municipal Center
1821 Rutherford Lane, Suite 300
Austin, Texas 78754-5151
Finance Director
Gene Anderson
City of Paris
135 1st Street South East
Paris. Texas 75640
V. Compensation
I. The Employer will pay the Pool a one-time $50 set up fee for each employee and dependent that enrolls in
Continuation of Coverage. A family unit that enrolls at the same time will be charged only one $50 set up
charge.
2. Other special services which may be requested by the Employer but are not contained in this Agreement, will
be billed at a mutually agreeable hourly rate.
VI. Miscellaneous Provisions
I. This Agreement represents the complete understanding of the parties and may not be modified or amended
without the written agreement of both parties.
2. The parties agree that venue for any dispute arising under the terms of this Agreement shall be in Austin,
Travis County, Texas.
3. The parties agree that venue for any dispute arising out of the performance under their Agreement shall be in
Austin, Travis County, Texas.
4. In performing the administrative services under this Agreement, the Pool may rely without qualification on
the information provided by the Employer.
5. The Pool agrees to take over the remaining Continuation of Coverage administration for any of the
Employer's current Continuation of Coverage participants, without Employer compensation, so long as the
Employer furnishes the information necessary to effectuate the transfer.
6. This Agreement is entire as to all of the performance to be rendered under it. If any term or provision of this
Agreement is held by a court of competent jurisdiction to be invalid, void or unenforceable, the remainder of
the provision of this Agreement shall be void and of no force and effect.
7. It is understood that the Pool will charge the Continuation of Coverage participant the administration fee
allowed by the Continuation of Coverage statute.
VII. Termination
1. Term of this initial Agreement shall be from its effective date through April 30, 2007, at 12:01 a.m. The
Employer member may annually renew the Agreement for the subsequent twelve (12) month period (May I
through April 30) by executing and returning the Pool's rerate notice and benefit selection for each year.
2. Either party may terminate this Agreement at anytime by giving the other party written notice at least thirty
(30) days prior to the specified date.
3. This Agreement terminates, without further notice, on the date the undersigned Employer is no longer an
Employer Member of the Pool.
4. All records in possession of the Pool relating to Continuation of Coverage administration at termination of
the Agreement will be transferred to the Employer within forty-five (45) business days.
5. Should this Agreement terminate for any reason it does not relieve either party of their duties nor obligations
during the period when this Agreement was in full force and effect.
This Agreement is entered into for the Employer Member under authorization of
, at a duly called
meeting held on
by:
(Signature)
City of Paris
(Employer Member/Group Name)
(Authorized Official Title)
(Date)
This Agreement Entered Into and Accepted By:
TML INTERGOVERNMENTAL EMPLOYEE BENEFITS POOL
BY:
TITLE: Executive Director
at Austin, Texas
Date