HomeMy Public PortalAboutAddendum No. 1 to Contract No. 115-2020 - Finance - Principal Life Insurance Company - Online Benefit Subscriber AgreementI*
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Addendum No. 1 to Contract 115-2020
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COBRA SERVICES, AMENDMENT
To
Online Benefit Administration Subscriber Agreement
This Amendment to the Online Benefit Administration Subscriber Agreement ("Amendment") is
made and entered into effective September 17, 2020 (the "Effective Date") by and between Principal Life
Insurance Company ("Principal Life") and City of Richmond Indiana ("Employer").
WHEREAS, the parties entered into an agreement titled "Online Benefit Administration Subscriber
Agreement" (OBSA) effective September 15, 2020; and
WHEREAS, Employer has independently concluded that it is required to perform certain duties under the
Health Plan Provisions of the Consolidated Omnibus Budget Reconciliation Act of 1985 ("COBRA"), 26
U.S.C. Section 4980B; and 29 U.S.0 Section 1161 et seq., as may be amended.
WHEREAS, Employer wishes to use the COBRA Administration Services provided by Principal Life's
selected vendor, Businessolver; and
WHEREAS, the parties desire to amend the Agreement as of the Effective Date on the terms. and conditions
set forth herein.
WHEREAS, in the OBSA, Exhibit A and Exhibit B were included in the Agreement to detail the selected
services and corresponding pricing. The parties have decided to change the services and resulting pricing;
and
NOW, THEREFORE, in consideration of the mutual covenants herein expressed, the parties hereby agree
as follows:
1. Employer retains responsibility for the following COBRA administration duties:
a. Qualified Beneficiary — Employer is responsible for the determination of individuals
being Qualified Beneficiary(ies), as defined under COBRA, as subsequently amended;
b. Initial Notification — Employer is responsible for the initial notification of all covered
of newly covered active employees and dependents of the continuation rights unless
Employer elects the optional service to process initial notifications on behalf of
Employer. if elected, this optional service as reflected in Exhibit C, Employer is
responsible for providing Principal Life with names and current addresses of any covered
or newly covered active employees and spouses, except where the information is
available to Principal Life through the OBSA Services.
c. Qualifying Events — Employer shall, within thirty (30) days of a qualifying event (or
within thirty (30) days of being notified), notify Principal Life by mail, fax, or update to
the OBSA Services website of a Qualifying Event, as defined under COBRA, as
subsequently amended;
d. Gross .Misconduct — Employer will be solely responsible for determining whether or
not an employee has been terminated for gross misconduct under the provisions of
COBRA;
City of Richmond. Indiana
COBRA Services Amendment Page 1 o f 5 09/17/2020
This document contains customer confidential information.
No part may be copied or disclosed without permission from the Director-eBenefits Edge
Classification: Customer Confidential
i
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Principal"
Health Plan Information — Employer is responsible for notifying Principal Life in
writing of the terms and conditions of the health plan(s) under which a Qualified
Beneficiary is covered, including but not limited to:
i. - Carrier Information including name and address of each;
ii. Coverage date including effective date of coverage for 'each Qualified
Beneficiary, except where the information is available through the OBSA
Services;
iii. Premium rate(s) and any change(s) thereto;
iv. Calculation for premiums using an actuarially calculated premium, as defined
under COBRA, for any self -funded plan. Employer shall bear the total expense
for computing this premium.
f. Addresses — Employer is responsible for providing the last known address of each
Qualified Beneficiary.
g. Notices in Writing. Employer shall provide Principal Life within thirty (30). days prior
written notice of any change in carrier(s), benefits(s), coverage(s) or premium rate(s).
Neither Principal Life or Businessolver will be responsible for the payment or collection
of any additional premium for which adequate prior notice was not received.
2. Compliance With Laws. Businessolver shall perform the COBRA Services in accordance with
a reasonable good faith interpretation of the federal COBRA requirements. Except for such
responsibility assumed by Businessolver in Exhibit C, Employer will be responsible for (a)
compliance with all laws and governmental regulations affecting its business and (b) any use
Employer may make of the COBRA Services to assist it in complying with such laws and
governmental regulations.
3. Limitation of Liability. In addition to the Limitation of Liability outlined in the OBSA,
neither Principal Life or Businessolver shall be liable for any federal or state tax or penalty of
any nature which may be imposed under any law or regulation that was caused by Employer's
negligence. Businessolver has agreed to hold harmless and indemnify Employer for any
Department of Labor or Internal Revenue Service excise taxes, or penalties pertaining to a
failure under COBRA caused by negligence of Businessolver in performance of the services
referenced in Section 1 above and in Exhibit C.
4. The PricinL3 and Fees for COBRA Services is added to Exhibit A as follows: ,
COBRA Service
Unit Price / Quantity
Estimated
Monthly
Administration Fee
$35 Per Employee Per Month EPM) x. 411 lives
$308.25
Take Over Letters Mailing
$8 Per Letter plus postage costs
Varies
The Administration Fee is based on the total employee records including retirees and COBRA
members and will be billed monthly. Services included in this fee are listed in Exhibit C.
This pricing assumes the Platinum Partner pricing status of the current Agent of Record, Horan
Assoc. This pricing will be adjusted if the pricing criteria for the Agent of Record changes.
Agent of Record changes which result in subsequent price changes will coincide with the
effective date of the Agent of Record change.
City of Richmond Indiana
COBRA Services Amendment 'Page 2 o f 5 09/17/2020
This document contains customer confidential information.
No part may be copied or disclosed without permission from the Director-eBenefits Edge
Classification: Customer Confidential
:S
Prindpar
The Take Over Letters are sent via US Postal Service to Employer's. COBRA participants as of
the start of the COBRA service. This letter informs those individuals of the new COBRA
vendor contact information and instructions for premium payments. The fee will be. billed
within 30 days of providing the service.
Businessolver will collect premiums from Employer's COBRA participants, deposit those
premiums and remit the applicable portion of those premiums to the Employer via ACH to
Employer's banking account. The additional 2% COBRA administration fee as allowed under
COBRA rules will be retained.by Businessolver.
Any postage or delivery costs for COBRA services will be included in invoices as incurred.
Optional COBRA Services are available as requested by Employer periodically, subject to the
following fees which will be billed within 30 days of providing the service:
Paper Open Enrollment Kits $10.06 Per Kit with up to 3 inserts, plus postage costs
$13.50 Per Kit with over 3 inserts, plus postage costs
Principal Life Insurance Company
By;RL&A&A��\L_Date: 9a /_2 6a��
ata ie Book -Sangster, rector-eBenefits Edge
City of Richmond Indiana
By:
Emily Pal er, Controller
City of Richmond Indiana
COBRA Services Amendment
Date:
Page 3 o f ' 5 09/17/2020
This document contains customer confidential information.
No part may be copied or disclosed without permission from the Director-eBenefits Edge
Classification: Customer Confidential
Principal`
Exhibit C—Scope of Services - COBRA
Service List for City of Richmond Indiana
Introduction
This Exhibit provides an overview of the responsibilities, obligations and assumptions for both
Businessolver and City of Richmond Indiana ("Employer") to administer their COBRA duties and
responsibilities.
Implementation and Set -Up
Businessolver staff will work with Employer to develop takeover documentation that will include
plan rates, plan information, current COBRA participants and Pending Qualified Beneficiaries. A
COBRA module will be set up on the enrollment platform that includes the plan set-up, rate set-up,
eligibility, and COBRA rules/parameters.
A process to collect premiums from COBRA participants and remit the applicable portion of those
premiums to Employer's banking account will be established.
The production, assembly, and fulfillment of Takeover -Letters for COBRA participants will be.
provided for an additional fee.
Initial COBRA Rights Services
An initial COBRA rights notice will be provided to new plan participants, including new employees,
acquisition employees, and new companies/groups entering the plans, with an initial COBRA rights
notice. The notice will be mailed via first class postage.
A separate initial rights notice to dependents will be mailed if a second address is provided that is
different from the employee's home address. This notice will be mailed via first class postage. .
Returned and/or undeliverable initial rights notices will be tracked and reported. An additional initial
rights notice will be mailed if an updated address is provided.
Qualifying Event Services
Qualifying Event paperwork will be assembled and mailed via first class postage to pending
Qualifying Beneficiaries within the time limits required by statute.
Separate Qualifying Event paperwork will be mailed via first class postage to dependents if a second
address is provided that is different from the employee's,home address.
Returned and/or undeliverable Qualifying Event documentation will be tracked and reported. An
additional qualifying event packet will be mailed if an updated address is provided.
Annual payment coupon sheets will be provided to those Qualifying Beneficiaries who elect
COBRA.
City of Richmond Indiana
COBRA Services Amendment Page 4 o f 5 09/17/2020
This document contains customer confidential information.
No part may be copied or disclosed without permission from the Director-e Benefits Edge
Classification: Customer Confidential
.. .
Principal
Sero rroyrded
Ongoing Administrative COBRA Services
Compliance
■ Timely updates to COBRA documentation and processes will be provided as
legal/legislative updates occur.
■ An electronic archival of COBRA election history and payment history will be provided.
Participant Services
■. Participants' termination/conversion notices will be developed and mailed via first class
postage as required.
■ Short Payment reminders will be mailed to participants as necessary.
■ A toll -free COBRA customer service number will be provided. Service will be available
from 8:00 a.m. to 5:00 p.m. Central Time Monday through Friday
■ The following COBRA timelines will be monitored and managed as required by statute:
■ 60 day election window for COBRA Qualifying Beneficiaries.
■ 45 day payment grace period for initial Qualifying Beneficiary payment
■ 30 day grace period required for monthly payment submission
■ 18, 29, or 36 month COBRA eligibility periods
■ USERRA 24 month Health Benefit Continuation eligibility period
Accounting and Account Management Services
Short and non -sufficient fund payments received from COBRA participants will be managed as
directed by Employer. Non -sufficient fund fees incurred will be charged back to the participant and
considered non-payment of premium.
Employer will be provided with the following web -based access:
■ Access to view Qualified Beneficiary and Pending Qualified Beneficiary correspondence
and/or documentation
■ Access to view status and payment history of Qualified Beneficiaries
■ Access to view Qualified Beneficiary elections and election history
■ Access to COBRA reports .
Open Enrollment Services
An address spreadsheet listing Qualifying Beneficiaries will be provided to Employer to use for
sending open enrollment materials.
The production, assembly, and fulfillment of open enrollment kits for COBRA participants can be
provided for an additional fee, if elected by Employer.
City of Richmond Indiana
COBRA Services Amendment Page 5 o f 5 09/17/2020
This document contains customer confidential information.
No part may be copied or disclosed without permission from the Director-eBenefits Edge
Classification: Customer Confidential