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Item C43 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: Februarv 18. 2004 Division: Manaeement Services Bulk Item: Y es ~ No Department: Group Insurance AGENDA ITEM WORDING: Approval of contract ameqdment with Acordia National for monthly claim administration fees for dental and vision coveraee. This amendment is reauired effective Januarv 1. 2004 as our dental and vision coveraee is no loneer provided bv Acordia National therefore eliminatine the need for administrative fees. except for the handline of run- out claims. ITEM BACKGROUND: Current contract effective October 1. 2002 throueh September 30.2003 with renewals for FY 03-04 & FY 04-05. PREVIOUS RELEVANT BOCC ACTION: BOCC approved on April 17. 2003 to have dental and vision coveraee available to employees throueh a third party. Effective January 1. 2004 the dental and vision coveraee is provided bv American General. CONTRACT/AGREEMENT CHANGES: The per employee per month (PEPM) fee for dental and vision administration will expire December 31. 2003 and run-out claims will be processed from January 1. 2004 throueh March 31.2005 at a cost of 10% of paid claims. STAFF RECOMMENDATIONS: Approval TOTAL COST: $256.000.00 BUDGETED: Yes-X- No COST TO COUNTY: $256.000.00 SOURCE OF FUNDS: Primarily Ad Valorem REVENUE PRODUCING: Yes No X AMOUNTPERMONTH_ Year APPROVED BY: County A~ OMB~:.'ing _ /} ~sk M";'gement~ DIVISION DIRECTOR APPROVAL: ~ U.e-~ Sheila A. Barker DOCUMENTATION: Included To Follow_ Not Required_ DISPOSITION: /, i jr; AGENDA ITEM #~ MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Acordia National Effective Date:October 1. 2003 Expiration Date:Seotember 30.2004 Contract Purpose/Description:Approval of contract amendment with Acordia National for monthly claim administration fees for dental and vision coverage. Contract Manager:Maria Z. Fernandez (Name) 4448 (Ext. ) Administrative Services (Department) for BOCC meetin 18 2004 A enda Deadline: Febru 3 2004 Total Dollar Value of Contract: $256.000.00 Budgeted? YeslZl No 0 Account Codes: Grant: $N/ A County Match: $N/ A CONTRACT COSTS Current Year Portion: $_ 502-08002-53'0310-_-_ - - - - ----- - -- - - -- - -- - - -- ADDITIONAL COSTS Estimated Ongoing Costs: $-"yr For: _ (Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Date In ~~~~ Date Out ~A )/3/01 dd7 Division Director Risk Management ~1 YesO No~ O.M.B./Purchasing County Attorney Comments:_ OMB Form Revised 9/11/95 MCP #2 AMENDMENT TO ADMINISTRATIVE SERVICES AGREEMENT TIllS AGREEMENT, made and entered into this 18th day of February, 2004 by and between Board of County Commissioners of Monroe County (hereinafter called "Employer") and ACORDIA NATIONAL, of Charleston, West Virginia, (hereinafter called "Acordia National); WIINE~~EIH WHEREAS, the Employer presently receives third party administration (TP A) services from Acordia National for certain of Employer's employee benefit plans; and WHEREAS, the services provided by Acordia National are defined in an administrative services only agreement between the Employer and Acordia National dated July 1, 1996; and WHEREAS, said agreement has been amended on June 18, 1997; July 16, 1997; February 11, 1998; June 10, 1998; April 14, 1999; and WHEREAS, a new administrative service agreement was entered September 8, 1999, between the parties; and WHEREAS, said agreement was renewed October 1,2003; and WHEREAS, the Employer revised its employee benefits plan effective January 1,2004; NOW, THEREFORE, the parties hereto agree as follows: 1) The administrative fee for Acordia National's TP A services for run-out claims shall be 10% of total paid dental and vision claims for January 1, 2004 through March 31,2005. 2) The per employee per month (pEPM) fee for dental and vision expires December 31,2003. 3) This administrative fee supersedes the stated administrative fee in any prior agreements between employer and Acordia National. 4) All services between Employer and Acordia National remain the same as agreed upon in the administrative services agreement dated September 8, 1999, as renewed October 1,2003. IN WITNESS WHEREOF, the Employer and Acordia National have caused this amendment to agreement to be executed this L-.J day of r 1,20L-.J. ATTEST: DANNY L. KOLHAGE CLERK Board of County Commissioners of Monroe County By: By: Deputy Clerk Mayor ACORDIA NATIONAL Witness By Its , I RENEWAL AGREEMENT This renewal agreement is entered into by and between Board of County Commissioners of Monroe County, Florida; 1100 Simonton Street, Room 2-268; Key West, Florida 33040 (hereafter Employer) and Acordia National of 602 Virginia Street, East Charleston, WV 25301. WHEREAS, on October 1,2002, the Employer and Acordia National entered into an agreement (hereafter the original agreement) whereby- Acordia National performs claim. achninistration for the Employer's employee welfare benefit plan; and WHEREAS, the current contract will expire on September 30, 2003 and the Employer desires to extend the original agreement for another year, therefore, the parties agree as follows: 1. This first one-year renewal term will commence immediately upon the expiration of the current contract. Therefore this renewal will become effective October 1, 2003, and will expire September 30, 2004. 2. In all other respects the terms and conditions of the otiginal agreement remain in full force and effect. the parties hereto have executed this Renewal Agreement this ~ day of ~O e: ~ BOARD OF COUNTY COM:M:rSSIONBRS OF MONROE COUNTY, FLORIDA Deputy Clerk By~~J~.>n ~ Mayor/Chairma.i1 By ~CO~j{~ ; President 71; ADMINISTRATIVE SERVICE AGREEMENT rl- TillS AGREEMENT, made and entered into the / day of ~ ~ by and between Monroe County (hereinafter called "Employer") and ACORDIA NATIONAL of602 Virginia Street, East, Charleston, WV 25301, is hereinafter set forth: WITNESSETH i -I ; WHEREAS, Employer has established an employee welfare benefit plan (hereinafter called "Plan") for the purpose of providing medical, dental, vision, utilization review, Consolidated Omnibus Budget Reconciliation Act of 1985 ("COBRA"), Health j- Insurance Portability and Accountability Act of 1996 ("HIP M"), and other benefits for its employees; WHEREAS, Employer desires to engage the services of Acordia National as agent for the Employer for the purpose of effecting claim administration under its :Plan; and NOW, THEREFORE, in consideration of the mutual covenants and promises hereinafter contained, the parties hereto agree as foliows: 1) 2) The effective date of the Employer's Plan shall be October 1. The Plan Year shall be from October 1 thru September 30 of each year. 3) 4) The Employer's Tax Identification Number is 596000749 For each Plan Year, the Employer shall provide monies sufficient to pay benefits under the Employer's Plan on a timely basis. "Timely" shall be defined as within thirty (30) days of Acordia National's notification, oral or written, that benefit claims have been processed for payment. In the event Employer shall fail to provide sufficient monies to fund its claims in a timely manner, a ten percent (10%) surcharge shall be added to the monthly administrative fee due Acordia National, which surcharge shall become chargeable beginning on the thirty-first (31st) day after AcordiaNational's notification, as desqribed herein. Employer acknowledges and agrees that Acordia National shall not have any financial duty or responsibility to release claim payments if Employer has not sufficiently funded the same. 5) Employer acknowledges and agrees that Acordia National shall not have any financial duty or responsibility to see that the Employer deposit meets the Employer's Plan requirements; however, Acordia National shall keep the Employer advised as to the amount of deposit needed to meet said requirements on a timely basis. Employer further acknowledges and agrees that Acordia National shall not be deemed a fiduciary for the Plan within the meaning of the Employee Retirement Income Security Act of 1974 ("ERISA"). Accordingly, the services to be performed by Acordia National hereunder shall be limited to the ministerial services set forth herein and the performance by AcordiaNatioI:j.al shall be subject in all respects to review by Employer within the framework of Plan provisions as well as polices, interpretations, rules, practi<;:es and procedures established by Employer. Acordia National sh~ll not have any 2 Medical Claims Administration discretionary authority or control with regard to the management of Plan assets. To the extent permitted by law, Acordia National shall not incur any liability for any acts or for failure to act except for its own willful misconduct in administering the Plan. 6) The monthly capitation fee for administrative services will be: October 1. 200~ $10.19 PEPM* $ 1.80 PEPM* $ 0.41 PEPM* PERFORMED BY KPHA $ 0.40 PEPM* Dental Claims Administration Vision Claims Administration Pre-certification Administration HIP AA Administration · Per Employee, Per Month The above monthly capitation fee shall apply to renewal effective October 1, 2002, and will remain the same for renewals effective October 1,2003 and October 1, 2004. Payment of the fees established above is due from the Employer on or before the lOth day of each month, beginning on the 10th day of October, 2002. The fee quoted is a three (3) year guarantee effective October 1,2002. The cost of any additional services rendered by Acordia National on behalf of the Employer necessitated by a change in federal or state law will also be charged to the Employer in addition to the monthly fee. Employee counts for purposes of monthly administrative fee billing may not be reduced by more than 10% of the billed enrollment unless an explanation is provided. Administrative fee adjustments must be done monthly and cannot be adjusted 3 retroactively in excess of90 days prior to the month invoiced. Acordia National reserves the right to withhold any fees due to the client if administrative fees are outstanding. Acordia National shall provide generic enrollment forms, claim forms and other administrative and plan forms. In the event Employer desrres customized administrative andplan forms, Acordia National will direct the printing of same, however, the cost of such printing shall be paid solely by the Employer. 7) Acordia National shall provide the following services in connection with the administration of Em pI oyer's Planes): a) Provide assistance to enroll all eligible Employees (as defined in the Employer's Plan) in Employer's Plan, as agreed. with Employer; b) Design and obtain other coordinating or supplemental types of insurance coverage, where necessazy,as requested by Employer in writing; c) Assist and advise employer in revising Plan Document. Provide prototype plan Documents and Identification Cards (ill Cards) for the Employer. Arrange for printing and-preparation of such documents. The cost of the printing will be the responsibility of the Employer; d) Conduct information programs for all eligible Employees to fully explain the benefits available under the Employer's Plan, as requested by Employer; 4 e) Respond to telephone and mail inquiries from Plan participants regarding benefits available to them and their dependents. f) Provide information concerning Plan benefits and participants, based upon information provided by Employer; g) Review and analyze all claims and determine whether the charges of health care providers submitted are within reasonable payment guidelines and/or are related to diagnostic related groups, preferred provider organization agreements or other industry standards; h) Correspond with claimants, as necessary, to prove claims and to ascertain whether other coverage exists which. might pay the claim in whole or part; i) Receive, review, and administer all claims for benefits under the Employer's Plan, including the evaluation ofclaims made; standard evaluation of the eligibility status of all claimants, coordination of and at least annual auditing of the Utilization Review and Case Management function, provide the County with results of Utilization Review audit, appropriate Coordination of Benefits evaluation of all claims, supply data to Health Recoveries, Inc. necessary for subrogation and other functions usual to the efficient and cost effective administration of claims; 5 0) p) q) r) j) Aid the employer in developing an efficient claims control program; k) Provide information, on request, for the completion by the Employer of all necessary IRS and ERISA filings; 1) Provide Employer with a monthly report of claims paid; m) Do all things necessary to properly effect the responsibilities of a claims administrator under the Employer's Plan, provided that all such actions/non-actions not otherwise required by this Agreement shall first be approved by Employer. , , i. I n) Provide assistance and resources to Monroe County in , I I'. I I ; identifying, analyzing and maintaining the Employer's PIan in accordance with state and federal laws, industry standards, regulations and changes that affect the Plan; Report all potential excess claims to the excess insurer, and provide Employer with monthly updates; Make documents available to the Employer and/or their Consultants for periodic audit of files for accuracy and efficiency ofAcordia National's claims administration, and; Process, authorize, and issue payment of all complete and eligible claims within twenty (20) days of receipt; Provide the County with adequate training and make available access to its on-line computerized claim system.. 6 s) Acordiaagrees that this contract is not assignable by Acordia without prior written permission from Monroe County. 8) Acordia National shall provide COBRA administrative services, if desired by Employer (check one blank below). It is agreed and understood that COBRA administration services are provided for medical and dental plans only and are not . provided for 125 Reimbursement Account Plans. Applicable Non-applicable X In the event Employer desires Acordia National to provide COBRA administration services, Acordia National agrees to: a) Provide initial notification of continuation of coverage option to all employees; b) Provide notification, enrollment information and enrollment forms to all qualified beneficiaries within 14 days of notification of Employer of a qualifying event; c) Provide monthly billing and collection services for all qualified beneficiaries who elect to continue coverage under the program and supply monthly reports of premiums collected by Employer; d) Track participating beneficiaries and notify them: of their right to convert if a conversion option is available under Employer's Plan; 7 e) Process all.claims for continuing beneficiaries under a segregated category and report, through regular monthly reporting . series, claims experience of continuing beneficiaries (COBRA claims will be aggregated during the normal check processing cycle but reported separately at month's end); f) On an annual basis, at the beginning of Employer's Plan Year, provide rates to be charged continuing participants for coverage in the new Plan Year; g) Provide prototype language to be included in the Plan document to ensure compliance with COBRA legislation; I I. h) Provide prototype language for inclusion in Employer's Summary Plan Description and coordinate, at Employer's option, the printing of new plan booklets at employer's expense; and i) Mail all correspondence to Plan participants or qualified beneficiaries directly to the last known address of the employee and/or dependent by first class mail. In consideration for receipt of these services from Acordia National" Employer agrees to: a) Notify Acordia National within thirty (30) days of qualifying events for which the Employer has knowledge. Qualifying events include: Termination of employment for any reason short of gross misconduct; and employee's reduction of work hours, the 8 9 a) Provide for the Employer's review, prototype modifications to the plan document and SPD (Booklet) to address HIP AA requirements; b) Perform programming required to the Multi-Claim System to track the applicable eligibility infomnation and maintain credited coverage information on both a current and future basis; c) Coordinate the receipt of all certificates of coverage, or other proofof coverage, for all new ezpployees enrolling in the benefit plan; d) . Perform the administrative requirements to.analyze the determination of pre-existing conditions and establish the waiting periods that would apply for all new employees and existing employees having pre-existing conditions; e) Develop and distribute to all required parties the notifications and correspondence documenting pre-existing conditions; f) Issue certificates of coverage for all employees and their dependents upon termination or upon request; g) Prepare and distribute standard reports documenting completed HIP AA activities; and 10 h) Serve as an information resource for HIP AA questions. 11) Subrogation and Fee Negotiation: a) This will serve to confirm our understanding that the Employer desires to utilize the subrogation and related services offered by Healthcare Recoveries, Inc. in connection with the Employer's health plan. b) The administrative fee for Acordia National's Fee Negotiation Services with health care providers shall be 25% of savings. 12) In the absence of a designation by the Employer and except for disposition ; ! I I i , I I I i I I I i I ! of disputed claims, Acordia National shall determine the manner in which payment of benefits shall be made as it shall deem it to be necessary and appropriate in accordance with provisions of Employer's Plan, and shall not be responsible in the exercise of such judgment in the absence of willful misconduct on the part of Acordia National. 13) To the extent required by law to purchase such coverage, each Employer shall name Acordia National as an additional insured under its fiduciary bond which shall be conditioned upon faithful performance of its duties hereunder, and such,fiduciary bond shall in all respects comply with the requirements of the Employee Retirement Income Security Act of 1974, as amended. 14) Acordia agrees to defend, indemnify and hold harmless Employer against all claims, damages, liabilities and expenses actually and reasonably incurred or imposed on Employer in connection with any actual or threatened claim, action, suit, proceeding, settlement or compromise thereof which arises from Acordia' s administration of claims 11 under Employer Planes) other than hi accordance with Plan provisions as well as the negligence, willful misconduct of Acordia, its employees, representatives, or agents. The right to be defended, indemnified and held harmless shall extend to Employer's affiliates as well as the employees of Employer, their estates, executors, administrators, guardians, conservators and heirs and shall apply after the employee cease employment with Employer with respect to acts or omissions of Acordia prior to such cessation. 15) The terms of this Agreement shall be from the effective date hereof and continue for a period of one year. This Agreement shall be renewed for two (2) successive one-year periods at the sole discretion of the Employer, unless either party gives the other notice of cancellation in accordance with the terms set forth below. If either party desires to modify or terminate this Agreement, it shall notify the other in writing at least thirty (30) days prior to the effective date of such modification or termination. In the case of proposed modification the party receiving the notification of the proposed modification shall itself notify the other party within ten (to) days notice of its agreement to the proposed modification. Failure to do so shall terminate this Agreement as of the end of the Employer's Plan Year. 16) This Agreement may be terminated by either the Employer ()rAcordia National at any time provided that Acordia National gives the Employer ninety (90) days prior written notice or that the Employer gives Acordia National at least thirty (30) days prior written notice. The prior written notice will state the prospective effective date of the termination. Termination of this Agreement will not terminate the rights or obligations of either party arising out of the period during which this Agreement was in effect. Upon the termination of this Agreement, and if the same is not renewed, Acordia 12 National shall return all files of closed or pending claims covered by this Agreement to the Employer or their designee. 17) Employer agrees that during the term of this Agreement and for a period of three years after its termination it will not induce any employee of Acordia National to leave Acordia National's employment or directly or indirectly assist any other person or entity in requesting or inducing any such employee of Acordia National to leave such employment. 18) Monroe County's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Board of County, Commissio!lers. 19) Acordia National Warrants that it is not employed, retained or otherwise had acted in its behalf any former County officer subject to the prohibition in Sec 2 of Ordinance no 10-1990 or any County officer or employee in violation of Sec 3 Ordinance 10-1990 and that no employee or officer of the County had any interest, financially or otherwise, in Acordia National except for such interest, permissible by law and fully disclosed by affidavit attached hereto. For breach or violation of this paragraph, the County may, in its discretion, terminate this agreement without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, give or consideration paid to the former County officer or employee. 19) A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to public entity, may not be awarded or perform 13 work as a contractor, supplier, subcontractor, Or consultant under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a period of36 months from the date of being placed on the convicted vendor list. 20) All notices hereunder shall be in writing and mailed by certified mail, return receipt requested. Notices to the Employer shall be at the address first above written and to Acordia National at 602 Virginia Street, East, Charleston, WV 25301, Attention: President, at such other addresses as the parties may from time to time designate in writing. 20) The Employer and Acordia National agree that this agreement shall be administered and construed according to the laws of the State of Florida. In the event that any matter of disagreement arises, it shall be decided by a court of competent jurisdiction with venue in Monroe County, Florida. 21) In the event this Agreement is terminated, the.parties will have the option of agreeing to completion of claims administration services for claims existing at termination for a ninety (90) day period following termination of this Agreement upon terms negotiated between the parties. 22) This Agreement, together with the written proposal submitted by Acordia and the Plan constitute the entire Agreement between the Employer and Acordia National. 14 IN WITNESS WHEREOF, the Employer and Acordia National have caused this Agreement to be executed by their respective proper corporate officers, effective as of the I SI- of rf) &-- , 2oLht. ATTEST: ArrEST: Its AC~NATIO~ By UJ -I! 1f Its C///e~ f)~e:/(A//~ tJ,cRLG".A- 15 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: Februarv 18. 2004 Division: Manae:ement Services Bulk Item: Yes -X- No Department: Group Insurance AGENDA ITEM WORDING: Approval of contract amendment with Acordia National for monthly claim administration fees for dental and vision coverae:e. This amendment is reauired effective Januarv 1. 2004 as our dental and vision coverae:e is no lone:er provided bv Acordia National therefore eliminatine: the need for administrative fees. except for the handline: of run- out claims. ITEM BACKGROUND: Current contract effective October 1. 2002 throue:h September 30. 2003 with renewals for FY 03-04 & FY 04-05. PREVIOUS RELEVANT BOCC ACTION: BOCC approved on April 17. 2003 to have dental and vision coverae:e available to employees throue:h a third p~rtv. Effective January 1. 2004 the dental and vision coverae:e is provided bv American General.' CONTRACT/AGREEMENT CHANGES: The per emploveeper month (PEPM) fee for dental and vision administration will expire December 31.2003 and :run-out claims will be processed from January 1. 2004 throue:h March 31. 2005 at a cost of 100/'0 of paid claims. STAFF RECOMMENDATIONS: Approval TOTAL COST: $256.000.00 BUDGETED: Yes ~ No COST TO COUNTY: $256.000.00 SOURCE OF FUNDS: Primarily Ad Valorem REVENUE PRODUCING: Yes No X AMOUNTPERMONTH_ Year APPROVED BY: County Atty* OMB/Purc asing _ Risk Management ~ DIVISION DIRECTOR APPROVAL: ~ ~ ~ Sheila A. Barker DOCUMENTATION: Included To Follow_ Not Required_ AGENDA ITEM # t lf3 DISPOSITION: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Acordia National Effective Date:October 1. 2003 Expiration Date:Seotember 30.2004 Contract Purpose/Description:Approval of contract amendmeljlt with Acordia National for monthly claim administration fees for dental and vision cover~ge. Contract Manager:Maria Z. Fernandez (Name) 4448 (Ext. ) Administrative Services (Department) for BOCC meeting on Februarv 18 2004 Agenda Deadlirle: Februarv 3.2004 CONTRACT COSTS Total Dollar Value of Contract: $256.000.00 Budgeted? Yes[8J No D Account Codes: Grant: $N/A County Match: $N/ A Current Year Portion: $_ 502-08002-530310-_-_ - - - - ----- - - - - ----- - - - - ----- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: _ (Not included in dollar value above) (eg. maintenance, utilities, ianitorial, salaries, etc.) CONTRACT REVIEW Date In ~A JI3/o1 YeSDNO@/~' tl~ ddo'j YesDNo@ ~ ~~~~ _ Changes Needed r-1 ~... YesD Nol.i:::r" ~ Date Out Risk Management J.l3&..i YesDNo~ Division Director O.M.B./Purchasing County Attorney Comments:_ OMB Form Revised 9/11/95 MCP #2 AMENDMENT TO ADMINISTRATIVE SERVICES AGREEMENT THIS AGREEMENT, made and entered into this 18th day of February, 2004 by and between Board of County Commissioners of Monroe County (hereinafter called "Employer") and ACORDIA NATIONAL, of Charleston, West Virginia, (hereinafter called "Acordia National); W!INE~~EIH WHEREAS, the Employer presently receives third Partb' administration (TP A) services from Acordia National for certain of Employer's employee benefit plans; and WHEREAS, the services provided by Acordia National are defined in an administrative services only agreement between the Employer and Acordia National dated July 1, 1996; and WHEREAS, said agreement has been amended on June 18, 1997; July 16, 1997; February 11, 1998; June 10, 1998; April 14, 1999; and WHEREAS, a new administrative service agreement was entered September 8, 1999, between the parties; and WHEREAS, said agreement was renewed October 1, 2003; and WHEREAS, the Employer revised its employee benefits plljn effective January 1, 2004; NOW, THEREFORE, the parties hereto agree as follows: 1) The administrative fee for Acordia National's TP A services for run-out claims shall be 10% of total paid dental and vision clailns for January 1,2004 through March 31,2005. 2) The per employee per month (PEPM) fee for dental and vision expires December 31,2003. 3) This administrative fee supersedes the state~ administrative fee in any prior agreements between employer and Acordia National. 4) All services between Employer and Acordia National remain the same as agreed upon in the administrative services agreement dated September 8, 1999, as renewed October 1,2003. IN WITNESS WHEREOF, the Employer and Acordia National have caused this amendment to agreement to be executed this L-] day of r 1, 20L-]. ATTEST: DANNY L. KOLHAGE CLERK. Board of County Commissioners of Monroe County By: By: Mayor Deputy Clerk ACORDIA NATIONAL By Witness Its RENEWAL AGREE:MENT This renewal agreement is entered into by and between Board of County Commissioners of Monroe County, Florida; 1100 Simonton Street, Room 2-268; Key West, Florida 33040 (hereafter Employer) and Acordia National of 602 Virginia Street, East Charleston, WV 25301. WHEREAS, on October 1, 2002, the Employer and Acordia National entered into an agreement (hereafter the original agreement) whereby Acordia National performs claim administration for the Employer's employee welfare benefit plan; and WHEREAS, the current contract will expire on September 30,2003 and the Employer desrres to extend the original agreement for another year, therefore, the parties agree as follows: 1. This first one-year renewal term will commence immediately upon the expiration of the current contract. Therefore this renewal will become e:ttfective October 1,2003, and will expire September 30, 2004. 2. In all other respects the terms and conditions of the olriginal agreement remain in full force and effect. the parties hereto have executed this Renewal Agreement this ~ day of ~ <.1 ~ ~ BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA Deputy Clerk By~~Ja.>n ~ Mayor/Chairman By ::07W;; Vl. ; President ~ ADMINISTRATIVE SERVICE AGREEMENT ISI- THIS AGREEMENT, made and entered into the. day of ~ ~ by and between Monroe County (hek'einafter called "Employer") and ACORDIA NATIONAL of602 Virginia Street, East, Charleston, WV 25301, is hereinafter set forth: WITNESSETH WHEREAS, Employer has established an ehlployee welfare benefit plan (hereinafter called "Plan") for the purpose of providing medical, dental, vision, utilization review, Consolidated Omnibus Budget Reconciliation Act of 1985 ("COBRA"), Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), and other benefits for its employees; WHEREAS, Employer desires to engage the services of Acordia National as agent for the Employer for the purpose of effecting claim administration under its Plan; and NOW, THEREFORE, in consideration of the mutual covenants and promises hereinafter contained, the parties hereto agree as follows: 1) 2) The effective date of the Employer's Plan shall be October 1. The Plan Year shall be from October 1 thru September 30 of each year. 3) 4) The Employer's Tax Identification Number is 596000749 For each Plan Year, the Employer sh~ll provide monies sufficient to pay benefits under the Employer's Plan on a timely basis. "Timely" shall be defined as within thirty (30) days of Acordia National's notification, oral or written, that benefit claims have been processed for payment. In the event Employer shall fail to provide sufficient monies to fund its claims in a timely manner, a ten percent (10%) surcharge shall be added to the monthly administrative fee due Acordia National, which surcharge shall become chargeable beginning on the thirty-first (31 st) day after Acordia National's notification, as described herein. Employer acknowledges and agrees that Acordia National shall not have any financial duty or responsibility to release claim payments if Employer has not sufficiently funded the same. 5) Employer acknowledges and agrees that Acordia National shall not have any financial duty or responsibility to see that the Employer deposit meets the Employer's Plan requirements; however, Acordia National shall keep the Employer advised as to the amount of deposit needed to meet said requirements on a timely basis. Employer further acknowledges and agrees that Acordia National shall not be deemed a fiduciary for the Plan within the meaning of the Employee Retirement Income Security Act of 1974 ("ERISA"). Accordingly, the services to be performed by Acordia National hereunder shall be limited to the ministerial services set forth herein and the performance by Acordia National shall be subject in all respects to review by Employer within the framework of Plan provisions as well as polices, interpretations, rules, practices and procedures established by Employer. Acordia National shall not have any 2 Medical Claims Administration discretionary authority or control with regard to the management of Plan assets. To the extent permitted by law, Acordia National shall not incur any liability for any acts or for failure to act except for its own willful misconduct in administering the Plan. 6) The monthly capitation fee for administrative services will be: October 1. 2002 $10.19 PEPM* $ 1.80 PEPM* $ 0.41 PEPM* PERFORMEU BY KPHA $ 0.40 PEPM* Dental Claims Administration Vision Claims Administration Pre-certification Administration HIP AA Administration . Per Employee, Per Month The above monthly capitation fee shall apply to renewal effective October 1, 2002, and will remain the same for renewals effective October 1,2003 and October 1, 2004. Payment of the fees established above is due from the Employer on or before the 10th day of each month, beginning on the 10th day of October, 2002. The fee quoted is a three (3) year guarantee effective October 1,2002. The cost of any additional services rendered by Acordia National on behalf of the Employer necessitated by a change in federal or state law will also be charged to the Employer in addition to the monthly fee. Employee counts for purposes of monthly administrative fee billing may not be reduced by more than 10% of the billed enrollment unless an explanation is provided. Administrative fee adjustments must be done monthly and cannot be adjusted 3 retroactively in excess of 90 days prior to the month invoiced. Acordia National reserves the right to withhold any fees due to the client if administrative fees are outstanding. Acordia National shall provide generic enrollment forms, claim forms and other administrative and plan forms. In the event Employer desrres customized administrative and plan forms, Acordia National will direct the printing of same, however, the cost of such printing shall be paid solely by the Employer. 7) Acordia National shall provide the following services in connection with the administration of Employer's Planes): a) Provide assistance to enroll all eligible Employees (as defined in the Employer's Plan) in Employer's Plan, as agreed with Employer; b) Design and obtain other coordinating or supplemental types of insurance coverage, where necessary, as requested by Employer in writing; c) Assist and advise employer in revising Plan Document. Provide prototype Plan Documents and Identification Cards (ID Cards) for the Employer. Arrange for printing and-preparation of such documents. The cost of the printing will be the responsibility of the Employer; d) Conduct information programs for all eligible Employees to fully explain the benefits available under the Employer's Plan, as requested by Employer; 4 e) Respond to telephone and mail inquiries from Plan participants regarding benefits available to them and their dependents. f) Provide information concerning Plan benefits and participants, based upon information provided by Employer; g) Review and analyze all claim~ and determine whether the charges of health care providers submitted are within reasonable payment guidelines and/or are related to diagnostic related groups, preferred provider organization agreements or other industry standards; Correspond with claimants, as necessary, to prove claims h) and to ascertain whether other coverage exists which might pay the claim in whole or part; i) Receive, review, and administer all claims for benefits under the Employer's Plan, including the evaluation of claims made; standard evaluation of the eligibility status of all claimants, coordination of and at least annual auditing of the Utilization Review and Case Management function, provide the County with results of Utilization Review audit, appropriate Coordination of Benefits evaluation of all claims, supply data to Health Recoveries, Inc. necessary for subrogation and other functions usual to the efficient and cost effective administration of claims; 5 j) Aid the employer in developing an efficient claims control program; k) Provide information, on request, for the completion by the Employer of all necessary IRS and ERISA filings; 1) Provide Employer with a monthly report of claims paid; m) Do all things necessary to properly effect the responsibilities of a claims administr~tor under the Employer's Plan, provided that all such actions/non-actions not otherwise required by this Agreement shall first be approved by Employer. n) Provide assistance and resources to Monroe County in identifying, analyzing and maintainirtg the Employer's Plan in accordance with state and federal laws, industry standards, regulations and changes that affect the Plan; 0) Report all potential excess claims to the excess insurer, and provide Employer with monthly updfltes; p) Make documents available to the Employer and/or their Consultants for periodic audit of filesl for accuracy and efficiency of Acordia National's claims adminis!tration, and; q) Process, authorize, and issue payment of all complete and eligible claims within twenty (20) days of receipt; r) Provide the County with adequate training and make available access to its on-line computerized claim system. 6 s) Acordia agrees that this contract is not assignable by Acordia without prior written permission from Monroe County. 8) Acordia National shall provide COBRA administrative services, if desired by Employer (check one blank below). It is agreed an~ understood that COBRA administration services are provided for medical arid dental plans only and are not provided for 125 Reimbursement Account Plans. Applicable Non-applicable X In the event Employer desires Acordia National to provide COBRA administration services, Acordia National agrees to: a) Provide initial notification of continuation of coverage option to all employees; b) Provide notification, enrollmient information and enrollment forms to all qualified beneficiaries within 14 days of notification of Employer of a qualifYing event; c) Provide monthly billing and collection services for all qualified beneficiaries who elect to continue coverage under the program and supply monthly reportsiofpremiums collected by Employer; d) Track participating beneficiaries and notify them of their right to convert if a conversion option is available under Employer's Plan; 7 e) Process all claims for continuing beneficiaries under a segregated category and report, through regular monthly reporting . series, claims experience of continuing beneficiaries (COBRA claims will be aggregated during the normal check processing cycle but reported separately at month's end); f) On an annual basis, at the beginning of Employer's Plan Year, provide rates to be charged cOlltinuing participants for coverage in the new Plan Year; g) Provide prototype language to be included in the Plan document to ensure compliance with COBRA legislation; h) Provide prototype language for inclusion in Employer's Summary Plan Description and coordinate, at Employer's option, the printing of new plan booklets at employer's expense; and i) Mail all correspondence to Plan participants or qualified beneficiaries directly to the last knoWn address of the employee and/or dependent by first class mail. In consideration for receipt of these services from Acordia National, Employer agrees to: a) Notify Acordia National within thirty (30) days of qualifying events for which the Employer has knowledge. Qualifying events include: Termination of employment for any reason short of gross misconduct; and employee's reduction of work hours, the 8 10 National shall return all files of closed or pending claims covered by this Agreement to the Employer or their designee. 17) Employer agrees that during the term of this Agreement and for a period ofthree years after its termination it will not induce any employee of Acordia National to leave Acordia National's employment or directly or indirectly assist any other person or entity in requesting or inducing any such employee of Acordia National to leave such employment. 18) Monroe County's performance and obligation to pay under this contract is contingent upon an annual appropriation by the Board of County, Commissio~ers. 19) Acordia National Warrants that it is not emp~oyed, retained or otherwise had acted in its behalf any former County officer subject to the prohibition in Sec 2 of Ordinance no 10-1990 or any County officer or employee in violation of Sec 3 Ordinance 10-1990 and that no employee or officer of the County had any interest, financially or otherwise, in Acordia National except for such interest, permissible by law and fully disclosed by affidavit attached hereto. For breach or violation of this paragraph, the County may, in its discretion, terminate this agreement without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, give or consideration paid to the former County officer or employee. 19) A person or affiliate who has been placed on the convicted vendor list following a conviction for public entity crime may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to public entity, may not be awarded or perform 13 work as a contractor, supplier, subcontractor, or consultant under a contract with any public entity, and may not transact business with any public entity in excess of the threshold amount provided in Section 287.017, for CATEGORY TWO for a period of36 months from the date of being placed on the convicted vendor list. 20) All notices hereunder shall be in writing and mailed by certified mail, return receipt requested. Notices to the Employer shall be at the address first above written and to Acordia National at 602 Virginia Street, East, Charleston, WV 25301, Attention: President, at such other addresses as the parties may from time to time designate in writing. 20) The Employer and Acordia National agree that this agreement shall be administered and construed according to the laws of the State of Florida. In the event that any matter of disagreement arises, it shall be decided by a court of competent jurisdiction with venue in Monroe County, Florida. 21) In the event this Agreement is terminated, the parties will have the option of agreeing to completion of claims administration services for claims existing at termination for a ninety (90) day period following termination ofthis Agreement upon terms negotiated between the parties. 22) This Agreement, together with the written proposal submitted by Acordia and the Plan constitute the entire Agreement between the Employer and Acordia National. 14 IN WITNESS WHEREOF, the Employer and Acordia National have caused this Agreement to be executed by their respective proper corporate officers, effective as of the /SI- of ()J~ ,2on;;t. COUNTY OF iOE By Mayor Charles 'Sonny" McCoy. Its ATTEST: AC~NATIO~ By if -;J 1J Its C/!/€.c t1;::J~/CA//rJ, (}FRLGA- ATTEST: 15