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HomeMy Public PortalAboutRES-CC-2003-19Resolution 19-2003 A RESOLUTION ADOPTING A PEACE OFFICER LINE OF DUTY DEATH BENEFIT CONTRACT WITH PUBLIC EMPLOYEES' HEALTH PROGRAM WHEREAS, Moab City offers a Peace Officer Line of Duty Death Benefit for its Public Safety Employees, and WHEREAS, Moab City has previously been insured through the Public Employees' Health Program to provide that benefit, and WHEREAS Public Employees' Health Program will offer the benefit directly without the services of an underwnter, and WHEREAS, Moab City wishes to continue to offer this benefit for its Public Safety Employees, NOW, THEREFORE, we, the Governing Body of the City of Moab do hereby adopt the Peace Officer Line of Duty Death Benefit Contract as follows See attached contract Passed and adopted by action of the Governing Body of the City of Moab in open session this 24th day of June, 2003 CITY OF MOAB By Li. j g J.-L., David L Sakrison Mayor .c_11211) C ' Rachel Ellison City Recorder Resolution MI9 2003 Page 1 of I Utah Rettreme, ystems Retirement Office 560 East 200 South Salt Lake City UT 84102 2021 (801) 366-7700 (800) 365-8772 Toll Free (801) 366-7734 Fox www urs org ROBERT V NEWMAN May 30, 2'1703rect« Moab City 115 West 200 South Moab, UT 84532 Dear Benefits Administrator, Public Employees Health Program 560 East 200 South Salt Lake City UT 84102 2004 (801) 366 7500 (800) 365-8772 Toll Free (801) 366-7596 Fax www pehp org LINN J BAKER Director The Public Employees Health Program (PEHP) is pleased to announce that we are now offenng the $50,000 Peace Officer Line of Duty Death Benefit directly to all eligible agencies through our Group Tenn Life Program We are terminating our policy with Beneficial Life as ofJune 30, 2003 and will administer the benefit internally This change will allow us to provide a more efficient administration of the program at a lower cost As of July 1, 2003, the premium for the Peace Officer Line of Duty Death Benefit will decrease to $ 1 33 per eligible employee per month and all claims will be processed through the PEHP Group Term Life Department As in the past, your premium, along with a list of eligible employees, should be submitted to PEHP at 560 E 200 S , Salt Lake City, UT 84117 In order to continue your Peace Officer Line of Duty Death Benefit through PEHP, simply complete the enclosed contract by having an authorized employee of your agency fill out the "Date" and "Signature/Title" areas at the end of the last page Once the contract is received by our office, we will complete the PEHP portion and send a copy to you for your records We look forward to continuing to work with you and to providing this valuable benefit to your peace officers Please feel free to contact me if you have any questions or concerns at 801-366-7542 or by email at chns lamkin@pehp org Sincerely, Chris A Lamkin Life and Accident Program Manager Ulah State R.linment Board DUANE C FRLS$Y Resident EDWARD i ALTER JOHN L LUNT CUFFORD D WHIIE F JAMES COWAN Vice President PHIDiP W CLINGER RIMS P SORENSEN AGREEMENT UTAH RETIREMENT SYSTEMS PUBLIC EMPLOYEES HEALTH PROGRAM AND MOAB CITY THIS AGREEMENT is made and entered into by and between Moab City, a political subdivision of the State of Utah, hereinafter referred to as "GROUP" and the UTAH RETIREMENT SYSTEMS, by and through its Public Employees' Benefit and Insurance Program, hereinafter referred to as the "PUBLIC EMPLOYEES' HEALTH PROGRAM" or "PEHP" WITNESSETH WHEREAS, the Utah State Legislature enacted statutes that provides for a S50,000 Line -of -Duty Life Insurance Benefit of peace officers of State and political subdivisions, and WHEREAS, GROUP, a division of the Utah Retirement Systems, was directed to establish and administer this program, and WHEREAS, the GROUP employing members under Utah Code Annotated Title 53, Chapter 13 desire to provide a life insurance benefit to its peace officers NOW THEREFORE, in consideration of the promises and of the covenants and conditions to be kept by the respective parties, this agreement is made between PEHP and GROUP to provide a S50,000 Line -of -Duty Life Insurance Benefit upon the following terms and conditions I Coverage 1 Employee means all peace officers under U C A Title 53, Chapter 13, who are employed and compensated for services by the GROUP 2 GROUP agrees to cover all active Employees I 3 The effective date of the coverage is the day the Employee becomes an active Employee and premiums are submitted by GROUP on the Employee's behalf 4 The coverage on any covered Employee ceases automatically on whichever of the following dates occurs first A The date this coverage is canceled, B The end of a coverage penod for which a premium contnbution was made, or C The Employee terminates employment or has become ineligible 5 An Employee may designate a pnmary beneficiary and a contingent beneficiary at the time of application for coverage An Employee may change his or her beneficianes by filing a wntten notice of the change with PEHP The change shall take effect as of the date the Employee stgned the notice of change, whether or not the Employee is living at the time of such filing, but without prejudice to PEHP on account of any payment made by it before receipt of such notice II Premiums and Records 1 GROUP agrees to remit premiums for the coverage in a timely manner from the beginning of the coverage penod The coverage penod will be either bi-weekly, monthly semi-monthly or annually 2 GROUP agrees to remit premiums for coverage to PEHP together with a remittance report listing eligible Employees for which premium is being submitted Premiums and remittance reports shall be submitted to PEHP by the due date specified on the PEHP billing statement 2 3 PEHP shall maintain, or cause to be maintained, records covering claims submitted to PEHP hereunder as well as payment disbursed by it The records shall be maintained for the same penod of time that PEHP retains like records in connection with its claims administration provided to other policy holders PEHP may, at its option, provide appropnate data to the GROUP for audit and review where disclosure of the onginal records would jeopardize other confidential or propnetary information of PEHP 4 Clencal errors in keeping records shall not invalidate coverage otherwise in force nor continue coverage otherwise terminated Premium adjustments shall be made if a Clencal error has caused an incorrect amount of premium to be collected or paid 5 PEHP may revise any premium rate schedule no more frequently than annually unless a change in the coverage affecting rates occurs, and then may do so upon the effective date of such change III Claims Payment 1 Line of Duty Death means a death resulting from external force or violence occasioned by an act of duty as an Employee 2 A wntten notice of claim must be given to PEHP within twenty (20) days after the Line of Duty Death of an Employee, unless it was not reasonably possible to do so Notice given by or on behalf of an Employee or his beneficiary, if any, to PEHP at its office in Salt Lake City, Utah, with information sufficient to identify the Employee, shall be deemed notice to PEHP 3 When PEHP receives a notice of a Line of Duty Death, it will furnish to the claimant the form it customanly uses to establish proof of loss If such forms are not furnished within 3 fifteen (15) days after the receipt of the notice of claim, the claimant shall be deemed to have complied with the requirements as to proof of death Once supplied, the wntten proof of loss, together with all supporting matenals necessary to establish proof of loss, must be retumed to PEHP at its office within ninety (90) days after the date of the death causing the loss under this coverage Failure to furnish such proof within the time required will not invalidate or reduce any claim if it was not reasonably possible to give proof within such time, provided such proof is furmshed as soon as reasonably possible 4 Benefits payable hereunder will be paid as soon as reasonably possible after receipt of an acceptable wntten proof of loss together with all supporting matenals described in Section 22 If benefits are not paid within 30 days, interest will begin to accrue 30 days following PEHP's receipt of proof of loss form and supporting materials The interest rate will be based on the current yield on the ninety (90) day US Treasury Bill and will be fixed on the date that interest begins to accrue 5 All benefits will be payable to the designated beneficiary If there is no beneficiary designated by the Employee or if the designated beneficiary is not alive at the death of the Employee, PEHP will pay the benefits of this coverage to the next -of -kin of the deceased in the order of precedence established under Title 75, Chapter 2, of the Utah Uniform Probate Code If any payment remains unpaid at the death of the beneficiary, or if the beneficiary is a minor or is, in the opinion of PEHP, legally incapable of giving a valid receipt and discharge for any payment, PEHP, at its option, may pay such benefit to any relative or relatives by blood or connection by mamage of the Employee who is deemed by PEHP to be equitably and legally entitled to receive the payment Any 4 payment made in good faith pursuant to this provision fully discharges PEHP to the extent of the payment 6 Catastrophic Coverage A Act of Terronsm means an act, including but not limited to the use of force or violence and/or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organization(s) or government(s), comm►tted for political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear An Act of Terronsm is not a Catastrophic Event under this Agreement B Act of War means war, invasion, acts of foreign enemies, hostilities or warlike operations (whether war be declared or not), civil war, rebellion, revolution, insurrection, civil commotion assuming the proportions of or amounting to an upnsing, military or usurped power An Act of War is not a Catastrophic Event under this Agreement C Catastrophic Event means all individual losses ansing out of and directly occasioned by one sudden, unexpected, unusual specific event occumng at an identifiable time and place D Aggregate benefits payable for any single Catastrophic Event shall be limited to S50 million per year If benefits payable due to a Catastrophic Event exceed S50 million, benefits shall be paid on a pro rata basis E Aggregate benefits payable due to Acts of War, Acts of Terronsm, nuclear, biological or chemical agents shall be limited to 10% of the current coverage in 5 effect for each covered person, up to a maximum aggregate pay out of $5 million per year If benefits payable due to the causes listed above exceed $5 million per year, benefits shall be paid on a pro rata basis F Benefits under this Agreement shall be subject to all of the limitations, exclusions and terms of any reinsurance coverage in place to reinsure the coverages available under this Agreement 7 Accidental deaths are routinely investigated Absolutely no benefit will be paid to a beneficiary if the beneficiary mtentionally takes the life of the insured Employee 8 No legal action may be brought against PEHP for unpaid benefits until at least sixty (60) days after wntten proof of loss has been furnished to PEHP in accordance with the requirements stated above No legal action may be brought after the expiration of three (3) years after the time wntten proof of loss is requited to be furnished 9 PEHP, at its own expense, shall have the nght to require, at its own discretion and expense, that an autopsy be performed on the body of a deceased Employee during the pendency of a claim hereunder l0 At the time of the claim, PEHP, at its own expense, has the nght and opportunity to examine and receive medical reports, medical records, and hospital records relating to the care, treatment, and relevant medical history of the person whose death is the basis for a claim Any person claiming benefits shall cooperate with PEHP as necessary to implement this provision 6 IV Term and Termination 1 Unless sooner terminated as herein provided, this Agreement shall be effective for and pertain to claims mcurred dunng the penod July 1, 2003, through June 30, 2004, and will automatically be renewed annually Either party may terminate this Agreement by giving thirty (30) days wntten notice to the other party 2 Upon termination or expiration of this Agreement, PEHP shall continue to process and pay claims for services incurred by GROUP's eligible Employees pnor to the date of termination or expiration of this Agreement V General Provisions 1 Any provision of this Plan which, on its effective date, is or may be found to be in conflict with the applicable law shall be severable, and not invalidate the remainder of this Agreement 2 This Agreement, and any modifications to it, constitutes the entire contract between the parties 3 No change in this Agreement shall be valid unless approved by PEHP in wnting as an amendment to this Agreement 4 If GROUP, or an authonzed representative disagrees with any decision made by PEHP which effects it, it may request a full review of the claim or submit the gnevance by wntmg to PEHP Claims Review Committee 560 East 200 South Salt Lake City, Utah 84102 7 By By (Title) 8 An appeal must be submitted within sixty (60) days after receiving the notice of an adverse action of PEHP If the GROUP desires to appeal the dectston of that Committee, the appeal must be directed to the Executive Director of the Utah Retirement Systems Further appeal may be made to accordance with the procedures established under U C A § 49-11-613 A copy of this procedure is available from the PEHP Clams Review Committee IN WITNESS WHEREOF, the parties have executed this agreement thus o?'��day of June, 2003 PdV UBLIC EMPLOYEES HEALTH PROGRAM GROUP A.6,1,AAA �5� (Tttl � r: aa,p eqpi;„,,,, c► t-tj `-2.e, e..e1,-dLivr