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
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