HomeMy Public PortalAbout2022-23 Town of Gulf Stream_HRA_Admin Agree
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THIRD PARTY ADMINISTRATOR ADMINISTRATIVE SERVICE AGREEMENT
S105 HEALTH REIMBURSEMENT ARRANGEMENT PLAN
TOWN OF GULF STREAM
1. Introduction
➢ TPA Service Statement
Chard, Snyder & Associates, LLC provides TPA expertise to Plan Sponsors for the alleviation of administrative
requirements related to qualified and non-qualified employee benefit plans under current laws and regulations.
➢ Administrative Agreement Description
The following agreement outlines applicable services and fees offered by Char d, Snyder & Associates, LLC for the
implementation and administration of a Section 105 Health Reimbursement Arrangement Plan (HRA). Request for
services must be authorized by execution of this agreement by Town of Gulf Stream (“Plan Sponsor” or
“Employer”) and Chard, Snyder & Associates, LLC (“TPA”).
2. TPA Service Package Synopsis
➢ Services Offered
TPA will provide the services described in Schedule A. These services will be based upon information supplied by
the Plan Sponsor and its Participants. The TPA shall perform services in the order work is received.
➢ Services Unavailable
TPA will not provide the following services:
o Legal services such as Plan drafting and/or legal counsel;
o Services required of the ERISA Plan Administrator as “defined in the Plan”;
o Services pertaining to COBRA Administration as “defined in the Plan” unless the Plan Sponsor has signed a
full or FSA-only COBRA Administrative Agreement for the TPA
3. Plan Sponsor Responsibilities
The Plan Sponsor shall be responsible for the follo wing activities associated with the setup, administration and
implementation of a Section 105 Health Reimbursement Arrangement Plan:
o Provide the TPA with any information deemed necessary, including, but not limited to, employee census records,
plan year enrollment data, checking account and bank related information relating to the Plan, and changes in
employment status and/or contributions of the Plan’s Participants. The TPA relies on the accuracy of the
information furnished by the Plan Sponsor or the Pla n Sponsor’s advisors. The TPA will not be responsible for
errors due to reliance upon information provided by the Plan Sponsor. Corrections of such errors, and information
not provided in a compatible electronic format may cause extraordinary labor charg es and may be subject to
additional billable fees as described in the Fee Statement;
o Provide Payroll Contribution Reporting to TPA each pay period in order for TPA to post participant contribution
amounts to participant accounts each pay period and for the Plan Sponsor to verify and report to TPA participant
status such as active or termination and contribution amount changes. For Eligible Plans that set up Recurring
Contribution Reporting, Plan Sponsor will provide a Payroll Contribution Report as of th e first payroll at the
beginning of the plan year. The TPA will then automatically post recurring contributions to the Plan each pay period
throughout the remainder of the plan year on behalf of the Plan Sponsor. Plan Sponsors that set up Recurring
Contribution Reporting will be responsible for reporting to TPA participant changes such as status changes and
contribution amount changes. TPA will process contributions to the Plan based on the Recurring Contribution
Report received for the first payroll each pay period and treat all participants as active unless otherwise notified by
the Plan Sponsor;
o Payment of validated claims made pursuant to the Plan;
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o Payment of expenses incidental to the Plan, except for expenses specifically assumed by the TPA in this Agr eement;
o Delegation of the responsibilities of ERISA Plan Administration;
o Delegation of the responsibilities of COBRA Plan Administration;
o Timely and accurate filing of requisite reports. Most reports subject to penalty for late filing;
o Compliance to Plan regulations under the Internal Revenue Code, as amended and any other governing regulations
and/or entities.
4. TPA Account Funding and Payment
TPA will operate an account to pay claims approved by Plan Sponsor (the “TPA’s Account”). Plan Sponsor authorizes
TPA to pay approved claims by checks issued from the TPA’s Account, or ACH transfers issued from the TPA’s
Account, and payable to corresponding Plan participants. The Plan Sponsor shall enter into such agreements and provide
instructions to its bank as are necessary to implement this section of the Agreement.
Funding for any payment approved to pay claims under the Plan is the sole responsibility of the Plan Sponsor, and the
Plan Sponsor agrees to accept liability for, and provide sufficient f unds to satisfy, all payments to Participants under the
Plan. If the Plan Sponsor does not satisfy the requirements set forth herein in a timely fashion, the TPA reserves the
right to suspend its services until such obligations are met.
If the Plan Sponsor has chosen the weekly funding option, the following shall apply: (1) at least one week prior to the
date on which TPA first provides the Services, Plan Sponsor will make a deposit into the TPA’s Account in an amount
equal to 5% of the expected annual elections; and (2) deposits into the TPA’s Account will be processed as selected by
the Plan Sponsor in the implementation papers regarding commencement of the services under this Agreement. If the
Plan Sponsor has chosen the daily funding option, the f ollowing shall apply: (1) Plan Sponsor will deposit funds into the
TPA Account to cover benefit claims incurred by Plan participants on a daily basis; (2) such daily deposit shall be
processed in an amount equal to the total benefit claims approved for reimbursement during that day; and (3) TPA will
notify the Plan Sponsor as of the closing of operations the total amount of claims pending to be reimbursed processed
during that working day. Please refer to the Plan’s implementation papers for additional fund processing details.
TPA shall have sole authority to provide whatever notifications, instructions or directions as may be necessary to
accomplish the disbursement of such Plan Sponsor funds to pay for approved claims. TPA is merely a collections agent
for the Plan Sponsor and any funds collected belong to the Plan Sponsor (and not to TPA or the Plan). Plan Sponsor
agrees to sufficiently fund the bank account from which funds will be transferred to TPA, remove any filters to prevent
TPA from conducting an ACH Pull, and monitor its balance to prevent overdraft.
Notwithstanding the preceding, Plan Sponsor and TPA agree that funds submitted by Plan Sponsor in
accordance with the terms specific in this section are general assets of Plan Sponsor and not “Plan a ssets” as
defined in the Employee Retirement Income Security Act of 1974 (“ERISA”) and regulations thereunder. Plan
Sponsor warrants that funds transferred to TPA in accordance with the terms specified in this section are not
deposited in an account, fund, or trust under the name of the Plan. As of the termination of this Agreement, TPA
agrees to return to Plan Sponsor any unused funds after all Plan claims pending to be reimbursed are paid to
Plan participants and after all invoices for services rendered by TPA are paid in full by Plan Sponsor.
5. Reports and Data, Ownership
All reports, data, and Plan-related information shall remain the sole property of the Plan Sponsor. The TPA will provide the
Plan Sponsor with any requested information using the electronic or printed format as used by the TPA for administration
procedures.
6. Terms of this Agreement
➢ Willful Execution and Termination
This Agreement will be in effect beginning the date the Plan Sponsor and the TPA (the Parties of this Agreement)
provide written execution and will end upon termination. Either Party may terminate this Agreement as of the first
day of any Plan Year by providing a 30 (thirty) day prior written notice. Either Party may terminate this Agreement
during the Plan Year if the other Party has materially breached this Agreement. In that case, the breaching Party
will have 30 (thirty) days to correct the breach. If the breaching Party does not correct the breach within that time,
the non-breaching Party will have the right to terminate the Agreement. If TPA is the breaching
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Party and does not correct the breach in accordance with this Section, then TPA agrees to waive termination fees
listed in Schedule 1 that are normally applied to terminating groups.
➢ Automatic Termination
This Agreement shall automatically terminate as of:
o The effective date of any legislation which makes the Plan and/or this Agreement ill egal; or
o The date the Plan Sponsor becomes insolvent, bankrupt, or subject to liquidation, receivership, or
conservatorship; or
o The termination date of the Plan (not to be misconstrued with the end of a Plan Year), subject to any
Agreement between the Parties regarding the adjudication of Plan Benefits after the Plan is terminated.
➢ Modifications and Amendments
This Agreement (and the attached Schedules) represents the entire Agreement between both Parties and may not be
modified or amended by Plan Sponsor without written consent of TPA. TPA may amend this Agreement from time
to time upon written notice to Plan Sponsor; provided, however, that if the Plan Sponsor objects to any such
amendment or modification, it may exercise its termination rights under this Agreement.
➢ Rights of Assignment
This Agreement cannot be assigned by the Plan Sponsor without TPA’s written consent.
7. Fee Schedule and Terms of Payment
➢ Fees Statement and Guarantees
The Plan Sponsor agrees to pay TPA appropriate fees as indicated in Schedule 1 and deemed necessary by this
Agreement. Fees are based upon the scope of services to be performed. To the extent Plan Sponsor has prefunded
amounts as forth Section 4 above, any undisputed TPA invoice for services rendered that remains unpaid by Plan
Sponsor after 30 days of the invoice may be deducted from the TPA’s Account by the TPA through an ACH Pull.
The TPA reserves the right to require additional fees for extraordinary e xpenses which include but are not limited to
multi-location groups, groups which necessitate travel expenses, customized and/or TPA nonstandard Plan Sponsor
requested materials, IRC changes to the Plan that required plan design changes which may cause extr aordinary
labor, plan document revisions and mailing expenses, corrections of errors and information not provided in a
compatible format by the Plan Sponsor which may cause extraordinary labor, TPA approved and reasonable changes
to prototype plan documents requested by the Plan Sponsor, and services in addition to what is provided with this
Agreement. Prior notification will be given, if applicable. The fees stated in this agreement are guaranteed for a
period of 36 months, commencing on the date of this agreement.
➢ Fee Frequency
The TPA will provide billing for services as follows:
o Plan Document Fees, and Installation and Implementation Fees will be billed at or before the first month of the
Plan Year;
o Base Annual Fee will be billed at or before the first month of the Plan Year;
o Monthly Administrative Fees for services incurred will be calculated and billed at the end of each Plan Month;
o Termination Fees for services will be billed at time of Plan Termination;
o Additional Fees for extraordinary expenses as described in the Fee Statement will be billed in accordance with
services incurred.
➢ Payment Requirements
The TPA provides the following payment requirements for the administration of a Section 105 Health
Reimbursement Arrangement Plan:
o Monthly Administrative Fees shall be based on number of Participants. Participants are defined as all eligible
employees who have submitted an election form (or other conveyance of enrollment as deemed by the Plan
Sponsor) expressing intent to participate in the Plan’s Health Reimbursement Arrangement Account for the
Plan Year. The Participant count obtained from results of the enrollment process shall be commensurate of the
regular monthly Administrative Fee for the entire Plan Year. Additional co nsideration will be given for
mergers, spin-offs, acquisitions, partial terminations (layoffs) and high enrollment periods throughout the Plan
Year.
o Amounts outstanding over 60 (sixty) days will be considered delinquent. Failure to make timely payments c an
and will result in work being stopped.
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8. Statement of Disclosure
The services provided in this engagement are not designed for the disclosure of errors, fraud, and / or illegal acts that
may exist, nor can they be relied on for such disclosure. In addition, the TPA has no responsibility to identify and
communicate significant deficiencies or material weaknesses in the Plan Sponsor’s internal control as part of this
engagement.
9. Indemnification
Plan Sponsor agrees to indemnify, defend, and hold TPA, its representatives and employees harmless and to reimburse
TPA for any losses TPA might suffer as a result of the Plan Sponsor's failure to comply with its representations and
warranties and with the terms and conditions of this Agreement, or to otherwise timely provide TPA with information
and/or documentation reasonably requested by TPA that is necessary for TPA to fulfill the terms and conditions of this
Agreement. The terms of this paragraph will remain in effect indefinitely rega rdless of why and when this Agreement
terminates.
10. Consequential Damages, Limitation of Liability
➢ Consequential Damages
Notwithstanding anything in this Agreement to the contrary, TPA will not be liable to the Plan Sponsor for any special,
indirect, incidental, consequential or similar damages, including lost revenue, lost profits and lost or damaged data, even
if TPA was advised of the possibility of such damages.
➢ Limitation of Liability
Notwithstanding anything in this Agreement to the contrary, in no event will TPA’s aggregate liability under this
Agreement for all damages permitted under this Agreement exceed the annual service fee paid by the plan sponsor to
TPA during the 12 months before TPA receives written notice of the first dama ges claim. This limitation on TPA’s
liability for permitted damages will not apply to permitted damages caused by TPA’s fraud, gross negligence or willful
misconduct.
11. Arbitration of Claims and Waiver of Class Action
➢ Disclosure
This section contains provisions regarding arbitration of claims and waiver of class, collective or group actions. By
accepting these provisions, the Plan Sponsor and TPA are giving up the right to sue each other in court, including the
right to trial by jury.
➢ Arbitration of Claims
Any dispute, claim or controversy arising out of, in connection with or relating to the performance of this Agreement or
its termination, including the determination of the scope or applicability of this Agreement to arbitrate, will be resolved
by binding arbitration before a single arbitrator at a location chosen by TPA, in accordance with the Commercial
Arbitration Rules of the American Arbitration Association (the “AAA”). To the extent that any of the provisions of this
Agreement conflict with the any AAA rules, the express provisions of this Agreement will apply. The arbitrator will be a
practicing attorney or retired judge with no less than ten years’ experience specializing in claims under the Employee
Retirement Income Security Act, the Patient Protection and Affordable Care Act and related provisions of the Internal
Revenue Service Code. The arbitrator’s award will be final and binding on the Parties, and judgment rendered thereon
may be entered in any court having jurisdiction. The arbitration proceedings and arbitrator’s award will be maintained by
the Parties and arbitrator as strictly confidential, except as is otherwise required by law or court order, or as is necessar y
to confirm, vacate or enforce the award, and for disclosure in confidenc e to the following representatives of a Party that
have a need to know and agree to keep such information confidential: attorneys, tax advisors, and senior management.
➢ Waiver of Class Action
Each Party may bring claims against the other only in its individual capacity and not as a plaintiff, representative or
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named Party in any putative class or representative proceeding. The arbitrator will have no authority to arbitrate a class,
collective, representative or group claim/action and will have no authority to make any determination as to the
enforceability of this agreement’s class/collective action waiver. Further, unless the plan sponsor and TPA agree
otherwise, the arbitrator will have no authority to consolidate the Plan Sponsor’s claims with any other c laims and may
not otherwise preside over any form of a class or representative proceeding.
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SCHEDULE A,
TPA ADMINISTRATIVE SERVICES
S105 HEALTH REIMBURSEMENT ARRANGEMENT PLAN
TPA provides assistance to Plan Sponsors who setup and administer the Health Reimbursement Arrangement under Section
105 of the Internal Revenue Code. The TPA will provide the following administrative services checked below on a recurrent
basis for the fees quoted in this Agreement:
Section 105 Health Reimbursement Arrangement Plan Design and Document Services
TPA will furnish a prototype Health Reimbursement Arrangement Plan Document, Summary Plan Description and other
necessary forms for adoption of the Plan by the Plan Sponsor. These documents are only specimens and may be
reviewed by the Plan Sponsor’s attorney or tax advisor at their discretion. TPA will not normally revise Plan documents
except for the creation of amendments or restatements as required by Plan design changes. TPA will provide midyear
Plan amendments and/or restatements as established by the S105 IRC when applicable or requested by the client.
Document service will be billed in accordance with Schedule 1.
Section 105 Health Reimbursement Arrangement Plan Installation and Implementation Services
Services to include setup of Plan in administration systems, development and setup of all appropriate
communication requirements, and all applicable services related to the preparing of an enrollment ready group. All
materials required for the setup and implementation of the Plan will be provided by the TPA according to fees
described in Schedule 1.
Section 105 Health Reimbursement Arrangement Plan Enrollment Services
TPA is dedicated to providing education driven enrollment campaigns. Fees for services will be charged in
accordance with Schedule 1. Following are the services available for the enhancement of the Plan Sponsor’s
enrollment campaign:
Group Meetings
o On-site or web-enabled meetings
Benefits Fairs
o Promotional Giveaways and Brochures, Question and Answer Session
Enrollment Materials for eligible Employees
o Standard Enrollment Materials
Section 105 Health Reimbursement Arrangement Plan Administration Services
The TPA will provide a completed, signature-ready Form 5500 for each Plan Year it is represented; and other
government forms when applicable. Actual filing will remain the responsibility of the Plan Sponsor. All
administration, accounting, and reimbursement checks from the Health Reimbursement Account will be handled by the
TPA. Following are the Plan Administration services provided by the TPA:
Issue reimbursements (according to frequency indicated on Schedule 1)
Provide entry of claims submitted by Participants
Online account access, including claim status, claim preparation and account balances
Provide payment register for check / direct deposit processing and auto debit services
Online Quarterly Employee Statements (Participants must provide email to receive statements)
Provide on-demand online reporting for Plan Sponsor
Optional debit card program offered in accordance with Schedule 1 attached
HRA 5500 preparation, when applicable
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SCHEDULE 1,
TPA ADMINISTRATIVE CHARGES
S105 HEALTH REIMBURSEMENT ARRANGEMENT PLAN
__________________________________________________________________________________________
➢ Administration Fees
o Annual Renewal Fee: ..................................................................................................................................... Waived
o Administration Fee (Per Participant Per Month):
• Weekly Reimbursements (includes global debit card if HRA plan design allows) .$4.75 (Minimum: $125.00)
o Midyear Termination Fee: ................................................................ Plan administration fee through run-out period
o Plan Year End Termination Fee: ...................................................... Plan administration fee through run-out period
o Debit Card Fee (global activation): ................................................................................................................. Included
ADDITIONAL ADMINISTRATION SERVICES AND FEE DETAIL
➢ Plan Design & Document Services
o Renewal Plan Document Amendments/Restatements: ................................................................................ Included
o Midyear or IRC Mandated Plan Document Amendments/Restatements: ..................................................... $250.00
➢ Plan Enrollment Services
o Employee Meetings/Fairs/Webinars (each): ................................................................................................. Included
o Travel and Lodging Expenses for Employee Meetings/Fairs (more than 50 miles from Mason, OH): ............... At Cost
o Enrollment Materials:
• Standard printed enrollment materials (each): ....................................................................................... Included
• Customized printed enrollment materials (materials, printing, time and labor): ......................................... At Cost
• Online enrollment ................................................................................................................................. Included
➢ Plan Administration Services
o Reimbursement Payments to home address (based on reimbursement frequency):........................................... Included
o Online Quarterly Employee Statements by email: ....................................................................................... Included
o On-Demand Online Reporting to Employer: ............................................................................................... Included
o Direct Deposit Installation and Setup:
• Data entry of Employee bank account information: ............................................................................. Included
• ACH electronic transfers and Report Preparation (for Employer’s and Employees’ designated accounts): . Included
• Direct deposit application forms (for participants): ................................................................................. Included
o Debit Card Transaction Reports to Employer (if have debit card option): ....................................................... Included
➢ Optional Use of TPA Bank Account Fees
o Use of TPA Bank Account Fee (based on number of participants): ............................................ If applicable, see chart
Participants Monthly Fee
1-99 $50.00
100-499 $125.00
500+ $225.00
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PLAN EXECUTION
S105 HEALTH REIMBURSEMENT ARRANGEMENT PLAN
Employer: Town of Gulf Stream
Address: 100 Sea Road
Gulf Stream, FL 33483
Agreement Effective: 10/01/2022 - 09/30/2025
Subsequent Plan Years: 10/01 - 09/30
Month/Day – Month/Day
On behalf of the above Plan, the undersigned authorized Plan Representative hereby requests the specific services outlined in
this S105 Health Reimbursement Arrangement Plan Agreement.
Signed On /DateSigned/
Signature /DocusignSignature/
Name /FullName/
This Agreement is not effective until properly countersigned by an authorized representative of TPA:
TPA: Chard, Snyder & Associates, LLC
Address: PO Box 249
Fort Washington, PA 19034-9998
President
Date 10/01/2022
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Rebecca Tew
7/6/2022 | 07:21:47 PDT