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I BILL NO. 89-144
SPONSORED BY COUNCILMAN SCHEULEN
ORDINANCE NO.
'r
AN ORDINANCE OF THE CITY OF JEFFERSON, MISSOURI, AUTHORIZING THE
MAYOR AND CITY CLERK TO EXECUTE AN AGREEMENT WITH EMPLOYEE BENEFIT y
ADMINISTRATORS FOR THE ADMINISTRATION OF HEALTH CARE PLAN AND
I; CAFETERIA PLAN FOR THE CITY.
3
{ BE IT ENACTED BY THE COUNCIL OF THE CITY OF JEFFERSON, MISSOURI,
` AS FOLLOWS:
Section 1. The Mayor and City Clerk are hereby authorized and }'
directed to execute an agreement with Employee Benefit
Administrators for the administration of health care plan and
I .
cafeteria plan for the City.
Section z . The agreement shall be substantially the same in
form and content as that agreement attached hereto as Exhibit A.
vim Section 3 . This Ordinance shall be in full force and effect
from and after the date of its passage and approval .
' . Passed Approved L,,-46= zr
iding ficer Mayor t
ATTEST: 4
City Clerk
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ADMINISTRATIVE AGREEMENT %A
.,. � This Agre ent, made and entered into this day of
Is
L , 1989, by and between the City of Jefferson, a; .
Missouri, hereinafter referred to as "City" ; and Employee Benefit
Administrators, Inc. , hereinafter referred to as "EBA" .
WITNESSETH, k �
WHEREAS, City as {
y a program, of medical, hospital, and health .
t benefits (��Plan'o) ' for certain of its employees and annuitants; and
WHEREAS, the City has adopted a Flexible Benefits Plan , %Y
• (hereinafter the "Cafeteria Plan") under the Section
':,• ) provisions of
,fy 125 of the Internal Revenue Code of 1954 ; and ;1,jFty
WHEREAS the City desires t ate
t: , o delegate certain administrative
functions in connection with the aforesaid plan; and
WHEREAS City has re
y guested EBA to furnish administrative r,; t;; ,-�• � _
services in connection with the Plan and the Cafeteria Plan and
t WHEREAS it is the U
purpose of this Agreement to establish an
agency relationship whereby EBA will undertake to act as agent. ."r�;1`°� „�
,?n
for Cit y in (i) ' receivin g and
:,.
'
processing claims for benefits M,
under the Plan and Cafeteria Plan; (ii) disbursing claim payments ? 4
under the Plan and Cafeteria Plan; and iii ;�, :
additional duties as set forth herein. ( . ) Performing such
NOW, THEREFORE, in consideration of the mutual promises and
covenants contained herein, it is hereby agreed as follows: `f
�g
SECTION 1. HEALTH PLAN ADMINISTRATORS ?
Sec 1-1. Duties and Responsibilities of City. '
t..
(a) The City shall be the Plan Administrator [within the F
meaning of Section 3 (16) (A) of the Employee Retirement Income
Security Act of 1974 and Section 414 (g) of the Internal Revenue
Code of 1954) of the Plan, but it delegates all ministerial duties
associated therewith to the Claims Administrator.
(b) The City shall have final authority in the decision
regarding the insurance company or companies chosen to provide the
insured protection under the Plan.
(c) The City shall have final authority regarding the choice
of benefits and provisions in the Self-Funded portion of the Plan, '
as outlined in the Plan Document. The City agrees to abide by and
observe the provisions of the Plan Document.
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(d) The City shall be responsible for payment of all premiums
required by the insurance companies, the expense of the Claims t;Yy r
Administrator as hereinafter agreed to and the contributions to the
Trust Account or Fund described in Section 1-3 hereof, if one is
established. In addition, the City shall be responsible for >f' �
withholding any amounts from the pay of employees in the event
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; employee contributions are required under the Plan and a payroll
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deduction or similar procedure is utilized therefor. t ,,'
}. (e) The City agrees to take the following actions with respect
to the Plan to facilitate proper administration by the Claims
Administrator: ;.
` (1) Supply the Claims Administrator with all informationfi�r4;:
required with respect to employees and dependents
eligible to participate in the Plan and notify the Claims
r; Administrator of all changes occurring thereafter with
respect to the eligibility status of all Plan
participants.
(2) Advise the Claims Administrator promptly upon acquisition
of any new or different insurance contract or upon
changes in the City's organization which might affect the ;•1>,
status of the Plan as in effect at the time. "
3 Provide the Claims Administrator with such additional
information with respect to matters incidental to the
Plan as may be requested by the Claims Administrator from
time to time. `'1
r (f) The City shall be the named fiduciary under the Plan with �s
the authority to manage, acquire or dispose of the assets of the
plan on a discretionary basis although such authority may be ;cs
delegated, in whole or in art to other fiduciaries as provided
g ► P ► P
".: in the Trust Agreement, if there is one, or otherwise by anf,
appropriate writin '
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The City shall be the final determiner of all appeals or
denied claims insofar as the Self-Funded portion of the Plan is t
concerned. #'
(h) The City shall be responsible for the status of the Plan
e}r under state insurance laws and under local, state and Federal tax
laws. , k
Sea. 1-2. Duties and Responsibilities of Claims Administration.
� ;4 (a) Upon receipt of a claim for benefits, EBA shall review the
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claim and determine whether it has been properly filed and the
amount, if any, which is due and payable with respect thereto.
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(b) EBA on behalf of the City shall disburse claim payments
,y that EBA determines to be due in accordance with the provisions
of the Plan to the person or assignee entitled thereto. °>
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(c) EBA shall take all reasonable steps to process claims
and disburse claim payments accurately, and expeditiously.
(d) EBA also agrees to the following list of duties and
`. responsibilities: ?.
- _r (1) Notification to claimants and City of rejected claims '±
and reason for the rejection. ,
(2) Advising and aiding claimants in meeting requirements for trio.
additional information and proper completion of claim
forms.
(3) Claim investigation. f7
(4) Performing on a sample basis internal audits on claim
payments. ; t
, n
(5) Discussion of claims, where applicable, with physicians
and other providers of services.
(6) Obtaining and furnishing information, as necessary, } §:
regarding non-duplicating or coordination of benefits.
t: (7) Application of claims control procedures necessary to the
4 :. effective implementation of the basic principles of the
Plan. is
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(8) Preparation of monthly, quarterly, and annual claim y`
reports on a timely basis.
(9) Preparing for City information reports required in
connection with claim a
p yments under the Plan to
providers of health care services pursuant to Section
6041, IRC.
L:
(10) Preparing a reconciliation of drafts cleared for the
` Plan.
(11) Design and print Plan document.
(12) Design Plan booklets describing benefits of the Plan and -'
deliver booklets to City for issuance to employees
eligible under the terms of the administration Agreement.
(13) Periodic review of claim experience and provision of r
underwriting advice.
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(14) Evaluation and payment or declination of the amount- of
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claim presented, based on a schedule of benefits and
' taking into account, as necessary, the Coordination of
Benefits provision.
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(15) Investigation of claims whose charges appear higher than
regular and customary.
z* (16) Storage of claim payment records.
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(17) Reporting to the IRS of payments to addressees as
required.
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4' (18) Return of all claim files and related information to the
C` City upon termination of the Agreement. `�? : %d` ♦♦ -,'
�•, �!',fly,, 'S'f:"k)
(19) Provide copies of employees claim payment record to City a �; tr3i
for its information. ;
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(20) Provide periodic educational classes for City employees
s, on the health insurance plan. .r,s,
(21) Administration of Consolidated Omnibus Budget
Reconciliation Act (COBRA) , including notification
to employees and billing.
(22) Solicitation of quotes from reinsurers as needed or
directed by City.
(23) Filing of claims with reinsurers.
Sec. 1-3. Method for Payment of Claims �
,1
fit (a) City shall maintain a Clearing Account with Central Trust
t: Bank or such other bank as City shall select, hereinafter "Bank",
on behalf of the City which EBA shall utilize. The City will
provide, through EBA, sufficient funds at all times to pay expenses
incurred by the Plan. Any remaining balance and accrued interest
on the account is the property of the Plan. EBA shall keep the
City informed as to the balance in the clearing account and shall '
notify the City if additional deposits are needed to ensure prompt
< ° payment of claims.
b Claims under the Plan shall be
_ ( ) paid by a check payable
through Bank prepared by EBA as agent for City. A
(c) In the event EBA pays any person less than the amount to
which he is entitled under the Plan EBA will
promptly adjust the
underpayment. In the event EBA overpays any person entitled to
benefits under the plan, or pays benefits to any person not
entitled to them, EBA shall take all reasonable steps to recover
y
the overpayment except that EBA shall not be required to initiate
4
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court proceedings to recover an overpayment. EBA shall promptly
notify the City if it is unsuccessful in recovering any
overpayment. '
d The determination of the extent of the benefits to which ' '?
any claimant is entitled under the Plan shall initially rest with fip7 :ur:
EBA. However, in the event that the City determines that EBA has
Y!
misinterpreted the Plan and so informs EBA in writing, all claims ;:
t reported after delivery of such writing to EBA shall be processed
and paid in accordance with City's interpretation as set forth in
such writing. ' s?
Sec. 1-4. Administration Charge .
(a) The charge of City for services by EBA under this
Agreement shall be $4. 25 per participating employee per month, plus
$ -0- per participating dependent unit per month. This charge
shall remain in effect for 1991 and 3.992 unless significant changes `. '
in duties are directed and agreed upon.
iy (b) By the 10th of each month, the City shall submit to EBA
a statement showing additions and deletions of the named employeesLA}{g �G� .
3 along with payment for that month of the administration charge ,_,;'.a:>
determined on the basis set forth in the preceding paragraph ; ;r ,, ,,
Est
- (c) Not less than ninety (90) days prior to renewal of any
Alft
year in which this Agreement is in effect, EBA may propose int,L4
'i writing a revision in the administration charge for the following � }
year with exception noted in paragraph (a) above. City shallot, •Y;
advise EBA in writing as to the acceptability of such proposal
within thirty (30) days after receipt thereof. If agreement is not
I- reached with respect to such proposal at' least thirty (30) days
prior to such renewal, this Agreement shall terminate effective as
of midnight of such renewal date. The foregoing shall be subject >.
to any revisions in the administration charge pursuant to Sections '
4 or 12 hereof. As used herein, "year" means any period of twelve
�{ consecutive months commencing on the effective date.
I' SECTION 2. FLEXIBLE BENEFIT PLAN ADMINISTRATION
�f!
r:. Sec. 2-1. Duties and Responsibilities of City.
I (a) The City, or appointed representative of the City, shall
perform the following services necessary for the administration of
the Cafeteria Plan:
rF (1) Submit initial setup information as requested by EBA.
t, i�
(2) Secure a signed Administrative Service Agreement on the
!¢ provided contract form with EBA. t
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(3) Ensure that the Flexible Benefits Plan documents are t
executed and provide a copy of all such documentation to
EBA. '
(4) Ensure that salary reduction agreements are signed by the
employee and provide copies of these agreements to EBA.
(5) Enroll and submit new employee in accordance with the
eli g ibilit y re quirements and re-enrollment periods
> �, •4�
specified in the plan documents. ,Rs:Y.
(6) Ensure that completed employee expense vouchers and
receipts are returned on a timely basis to the City and
F, a copy provided to ESA of these vouchers.
( ) Review and counsel with employees whose vouchered ;w==.r-<<.,•,
expenses are not equal to reimbursements. Take an
appropriate and legal action to ensure that employees are
during not reimbursed more than actual expenses
L. P g the
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Cafeteria Plan year or secure the return of any
overpayment in accordance with the Cafeteria Plan
documents. ?'
(8) Conduct an annual review of employee benefit elections.
Advise EBA of any changes in employee benefits under the ,Y. ,t•„�;},.
• Cafeteria Plan. Provide EBA a copy of all changes and
Cf¢sF �y7 44''t
signed Salary Reduction Agreements reflecting these ;+��},
changes.
(9) Make necessary changes in the payroll in accordance with
each employee's Salary Reduction Agreement and ensurek y
that employee W-2 forms will reflect new Fn
gross taxable �;i , ;
wages after the salary reduction.
(10) Provide information on employee terminations to EBA so zr
as to reflect the termination.
(11) Provide pertinent information to EBA that is requested
. ,: for tax reporting or Cafeteria Plan administration. .'
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See. 2-2. Duties and Responsibilities of EBA
(a) EBA shall perform the following clerical and accounting .2
services necessary for the administration of the Cafeteria Plan: t
(1) Establish a database of all pertinent employee and '
employer information based on information to be provided
by the City.
�•`tip
'. : (2) Update database monthly for employee changes
terminations, new employee, benefit election changes,,
etc. ) based on information to be provided by the City.
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(3) Where appropriate, as determined by EBA, EBA shall
;. provide a monthly statement of benefit accounts for each
employee with reimbursement check prepared by EBA on the F
employer account. This will be sent by EBA to the
b em
ess designated nated employee. This statement will
g Y each to i
P Y � 4
J also be the voucher for the actual expenses incurred by
the employea. This voucher and actual receipts will be a,4,
returned to EBA on a monthly basis. A copy of the
original survey form signed by the employee along witht '
,n Ax
instructions for completing the voucher will be sent with
this statement.
(4) Provide a review verifying compliance with federal
discrimination rules based on information received from
the City. , ', x,
(5) Assist City in preparation of an annual report to be sj{•"Ak
s :4 filed in accordance with the Internal Revenue Service. 'Mt9t ..3
1 :. I{ eyNO{x}.xr
' 6 Assist City in preparation of Department of Labor r
a: reporting requirements, and other reporting requirements
ti as may hereafter be established, if any, on a timely
.,
basis.
Sec. 2-3. Administration Charge.
�.
(a) EBA shall receive, as compensation for its services under ,7
the Cafeteria Plan, a charge of 4.00 per participating employee
per month. '
t f •"{:r
SECTION 3. PRECERTIFICATION FOR HOSPITALIZATION ,y
(a) Pre-authorization of hospital confinement and surgeries
` shall be a requirement with a 20% reduction of benefits for failure
of the employee to obtain pre-certification.
'r>
(b) It shall be a requirement to obtain second opinions on x
non-emergency surgeries. Deductibles shall be waived and benefits
paid at 100% for second and third surgical opinion. If this
requirement is not met, benefits shall be paid at 60%.
* '{ (c) EBA shall receive as compensation for its
-
recertification program,, a charge of ,$2. 00 per participating
:�.,:.... p P 9 � g P ,
' employee per month.
r,+;fit SECTION 4. ADDITIONAL DUTIES OF EBA
(a) The duties set forth herein may be modified by mutual
i _ agreement. The revised duties and the administration charges
F t4 7
�'''�' ,''•�rr,tu•}!. "{` ''�;s,•r�iti� x1 r4 .fx� ., +{}? -i.a; 13"": ,i:F' t-. 5
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therefore, if any, shall be evidenced by written agreement between
the parties hereto.
(b) If any change in law or regulations imposes greater duties
or obligations on EBA than contemplated by the Agreement in forces ;: :
} at the time of such change, EBA shall promptly notify the City, and r"
a change to this Agreement, including charges if required, will be rz_
negotiated. !n.'
SECTION S. DETERMINATION OF ELIGIHTLITY a tt ,yr7";
In determining any person' s right to benefit under the Plan sit
s or Cafeteria Plan, EBA shall rely on eligibility information
furnished by City prior to submission of the claim. It is mutually
understood that the effective performance of this Agreement by EBA
will require that it be advised by City periodically, but not less v!•;. +,
.tr
frequently than monthly during the term of t1zis Agreement, of the
ra. identity of individuals eligible for benefits, the effective date
or the termination date (as the case may be) of their eligibility
and the extent of the benefits to which they are entitled. City
shall also cause to be furnished to EBA such other information as
may reasonably be required for the proper administration of the -+:X�•= , ;;
Plan and Cafeteria Plan a ''
(c) It is mutually agreed that EBA shall not be responsible
it for delay performance of this Agreement or for the non-
performance
F . � y in the P g
of this Agreement which delay or non-performance is
caused or contributed to by the failure of City to furnish any such
t information.
SECTION 6. RECORD RETENTION AND REVIEW
EBA shall maintain records covering claims submitted under the
Plan and Cafeteria Plan, as well as payments disbursed by EBA. Any
duly authorized representative or representatives of City shall
have the right to examine or audit such records during the regular
business hours of EBA.
'Y; SECTION 7. AGENCY AGREEMENT r�
`t (a) It is mutually recognized that EBA, in performing its
obligation under this Agreement, is acting only as agent of City 3
and shall not be designated or deemed the administrator with
respect to the Plan or Cafeteria Plan for the purpose of the
y Employee Retirement Income Security ACt of 1974 or any other
" Federal or State law of similar nature.
;,•.' (b) In the event that its officers, directors, employees, or !f
agents are made parties to any judiciary or administrative
I•,. ,r:x tC.9''Y,'""" .0 $ '{Y �'d+r1..,..,5�;• ,r; y.-',av;ury.{•".n
r, r. y ygy {idrf� '•i 4 ��l Yt�'�� J,/� i Tt
�} Y a h� {f .;�t 5 j �. t { .� r! t i , �' t t•, �P;,�L <�
a � jt`' fbt,;.:r t;'.�}4 i k tj.xF "f 1 i 'r .'.r" },i.r;, o✓'.
S:4ti`��W, >�•rC'%'✓,,rY'r�t� {Srj rr,.°`7�'�. �.'c. t rt ; 'f�' s. ,!} i �r ,L•; t ' , a�S 1 4 i� F
fa,.s+zt`..;X?,�;r}'rc�,x;�s, �ti� •`,Nr fi,ff F ,t,c: � > ir. t Jk,'•4,°� ��. :4`:.
. .�{5\':r, �'' ��ri�{ifi �" tit t} ,,t � yttt t ;. 'r:ji t, "1.ri 1. 1 ik••:t.y Y:.. �Y,a<�{r f• �� �rI
ti yp
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k tiY qt �'�, 5'S 1{ j4 t ' ,t' r '.'"><.?{ 9, tK1•'Yf'abFr .. t �,.
1z Y
01-4- WE t�r, - w), t kYYY �.t f•�'.,r.... .n G '�f i..+rr.
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:t
proceeding arising in whole or in part out of any function
r'- performed by one or more of them under this Agreement, City shall $'
hold them harmless for all judgments, settlements, and costs `
(including attorneys' fees) which they incur or pay in connection tl`
;r therewith, except City shall not reimburse the amount of any
judgment or award (or attorneys fees with respect thereto) if the
'< court rendering the judgment or the agency making the award decrees
' that it was caused by the negligence, fraud, or criminal conduct
of EBA its agents, employees, officers or directors. ;
E,�.. r • ees g P Y ,
• (c) The defense of any legal action instituted on a claim for
benefits under the Plan and/or Cafeteria Plan shall not be an
obligation of EBA. EBA shall, however, cooperate with City by ` T
furnishing such evidence as it has available in connection with the y :°
defense of any such action.
r' SECTION S. LAWS GOVERNING CONTRACT
This Agreement shall be governed by and shall be construed in ; ,; ;<
accordance with the laws of the State of Missouri.
y�7f±F;t-k
SECTION 9. TERM OF AGREEMENT
This Agreement shall become effective on January 1, 1990, and
end as of midnight December 31, 1990. It shall be renewed ;{k; : '•
`:.. , a:
' t
automatically for two successive periods of twelve (12) months .,
unless City or EBA gives written notice to the other of intention ,r
not to renew the Agreement at least ninety (90) days prior to the
end of the then current period. r "
r,
SECTION 10. MODIFICATION OF AGREEMENT ¢
' This Agreement constitutes the entire contact between the
parties and no modification or amendment hereto shall be valid �h
unless in writing and signed by the parties. r
�y
SECTION 11. MODIFICATION OF PLAN OR CAFETERIA PLAN
(a) Any modification or amendment of the Plan or Cafeteria
Plan shall be duly communicated in detail and in writing by City
to EBA. Such communication shall also set forth the effective
` . date of the modification or amendment.
(b) Any revision in the administrative charge shall be
mutually agreed to in writing by EBA and the City.
(c) City shall furnish EBA with a copy of each modification
or amendment of the Plan or Cafeteria Plan as soon as is by<
9
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:F� � �.+( ,{,':r.,l yr a.�. � '.i k•r}rr. t t ., r$'•;r.' �;,+��.�" �' S .
S',i t..;71 a}} ,�, r"`� •y.Lt� r��tf:t:`r�''S`'rY .Jr.r4 {`�JC't r ti,i 74(..` r J1 i .t. 2. tr.11 }�' tt ,k r' t'<ff>� -}�� �F�.A•'r}.}�{�'"�:'}'.r.T Y� �' S .�t •�
r r.�41�;�i?S'.`H}.T.t'C,�}kJe,� '�.,`��•,!,y� r. '?G,rt .Y! ryr j !.� r r l�r: U r ri ,t! ;1. t :.l. { r� `+ .ti r)• ;•h �1`i.fir C�(Cl�� w.. � V
`•-°xt t y '3 r"" !•{' tt t '> '! 7 %,.r, f ?t.,t {f t�. r 5 {S .r 1'F`l c t{ 1Ps .. ,�. ,.t't
r
r' : i ,', ld,c, �` �,.t.'- 1 ,t • , , .. ,i'ri /-. •..iY,Prtt °`;' �w tij4m ��.� ��� .d,,,�. ti �
}}
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{y[ ,,,�tgrp , {.,; rF {;7 t4 � ��y ":`'�,;r„�eki. �!`t�a�',.sag t,�,r,=r(`� 'r4`f7t^�•1�tt������'�1 ��"kp�x4y�W'k`r'�g$€4 �y>*''�,�'��.�;.
e;i���� .. �" JeN�:v.a�.�.•,t� tf'+}.b 1� 'y lS'�"tst✓rR �, r ' < Rltri j.Fi..is<�(, ;u
y 1 uijC['r2'+.t,. t.�`t`.'wsC�ra`�.•.t. ?•.s +* 4' reties,+.Nft...t.l.Fr .1..• . f: .<r,+^f,.t S,'r .. t x�.:Fj x:, a.4{ �� ey$x r.wa.ti. ..,
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practicable and in advance of the effective date of such
modification, if possible. After receipt by EBA of a copy of "they
�= modification or amendment, the term "Plan" or "Cafeteria Plan" as ,
used in this Agreement shall include each such modification or
amendment as of the implementation date agreed upon by the parties °
e
hereto. '
�x
< r
SECTION 12. CONFIDENTIALITY '
EBA acknowledges that the City is under a legal obligation to
•V ��ii �4'ii�{�4 4
maintain the confidentiality of employee records. EBA agrees to
s comply with such reasonable procedures for maintaining ' •' '•
confidentiality as shall be specified by the City. All employee
information shall remain the property of the City and shall be
surrendered entirely to the City in the event of the termination
of this Amendment. EBA reserves the right to retain copies as to
such information. EBA agrees to allow properly authorized
employees of the City to inspect the records on reasonable notice
during regular office hours upon request. The City acknowledges
that it shall have no ownership or other interest in any computer
software or programs purchased or created by EBA.
9
SECTION 13 . TERMINATION OF AGREEMENT
(a) This Agreement shall terminate upon the earlier of the .0,
following dates: p `
.� .• �t 5. xt�lY
(i) Ninety (90) days written notice by the City or EBA. 4 ,
(ii) on any other date mutually agreeable to City and EBA. ^.
} (iii) December 31, 1992 .
r
(b) In the event of termination of this Agreement, EBA shall
complete processing of all claims for benefits under the Plan
A and/or Cafeteria Plan received prior to termination of the
Agreement.
SECTION 14. INDEPENDENT CONTRACT RELATIONSHIP
EBA is a duly registered corporation within the State of
Kansas rendering administrative services to various employers and
entities, including the City. For all purposes, EBA shall be i
considered an independent contractor for payroll taxation,
workmen's compensation and liability purposes, and no employee of
t %
;
EBA shall be considered for any purpose to be an employee of the
City. EBA reserves to itself the right to determine duties,
obligations and compensation of its employees and shall have the
.i.
10 .
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'•y} ° k�','rrP r 'xf� `^ st`'` ,,., k ✓ t eS�+F °i �,, �s,.;
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}t s .{(' x i �„(-$y`�gt�t.SJ;Lw•-�`9. r! i r a � a �!i'!� 1 (t s Ya�§1�,� �I � q'�t•
T5C i1�t n �tt�l{{jj,,�1`�}�'��•t .tlfF"F,,?x�i'��1"F.t} yt F 7q+9i��,i rA{ .t t jSr 5 t >r, t S' 1 °sp f �, i}�.! 7yr7+^/.y}';`�Qr'�„ �'1��C�I' �
.Z ..+Y.,F�.'�ct37 t+�'�7`�t; •,'�' yl 't{ `Aa Sit �. t a� .�. F t'r..rt '�i f F}, y'�exF' f.„.t« a1 �,
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widest possible discretion in selecting its methods of operation.
rlt:
`{ `v The duties of EBA in providing administrative services to the
City on the Plan and Cafeteria Plan shall be independent o third
' severable from any insurance policies or benefits sold by
`-. parties or by EBA.
1,
rr:'/• SECTION 15. PLAN UPDATES
EBA agrees to advise the City from time to time, as shall be
necessary, of any changes in any law or regulation affecting r'
�.,
Flexible Benefits Plans which shall come to the attention of EBA.
z, f. f
EBA shall not, without the consent of the City in writing,
engage any professio the benefit of the
nal services for
City.
a .If i'OSmw,xyC..,
SECTION 16 CAPTION
The captions or headings in this amendment are made for
convenience and general reference only and shall not be construedk
to describe, define .or limit the scope or intent of the provisionsg
,h ?. of this Agreement. ' .
17. NOTICE t
SECTION
i.red or allowed under the terms of this
CD
s
Where notice is required
{ Agreement, such notice shall be mailed first class with postage
' prepaid as follows:
4
City: City of Jefferson
u >, Attn: Personnel and Safety Officer
320 East McCarty
t
Jefferson City, Missouri 65101
<a;
Employee Benefit Administrators, Inc.
EBA: `
• ,�� p. O. Box 14970 v
'*}rt Shawnee Mission, KS 66215
Aa. ,.
SECTION 1S. INVALIDITY
The provisions of this Agreement shall be severable and if
1.
any provision shall be invalid or void of unenforceable in whole
or in part for any reason, the remaining provisions shall remain .!
in full force and effect. x
i
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fi a i r;S 1' ;, r sS°'X�'2.. V X s•t� t. � t+ 1 1. t,i t 1`Y fss i i.{f,:�i'a�alp�tit s�,l�,��.iyti 4.r±},�7� y�.
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" t't' ,�.. R�,t!`?r�1.s`�i,3:2y'��t�}.!p"+,hl��;�tr�-e1?S.,.f'x}y� x4�.�f J`swtyU;l3ei,;yot e'.ts;si�, rt (t.��2; �t � e .�+.,�. .�a! ..'y.y'�rl.{`,t.tx,..;,��''s7+ i5; r•.w
`"a�G�Y'. u,S x �V :t^=+, ,;�:��.�.._.{��.(� ',.F � �t. '{Sh}xc r ty:x.i;+Ut✓ .frtits .\ t.ly:tv'f a /. •3,.q�r,:�t;,•ir, ^'t'•t4 ;i'�•,.?,�e:ii^ t� t s Y
1 ` y t }1L""�5 ! a � s 1.Pi- a n � {.1.•,J , ,i} x s � kJ� 't f S �'. i �t ayS,, f it ik t is �j it y r"' { •y .
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.1P i7. .�" .`s' } ).t�.',:. { �.r' .ti4} -�9f' t .m•.K.n rK -a�+`� y rt,
IN WITNESS WHEREOF, the parties hereto have caused this
.`, e'x' Agreement to be executed in duplicate as of the date first above
v ' written by their respective officers duly authorized to do so.
CITY OF JEFFERSON EMPLOYEE BENEFIT ADMINISTRATORS,
INC
+. MAYO TITLE: ,qd,
{' ATTEST:
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�'�.�.��,✓,�, ���' V, Gt).off Pr �
CITY CLERK TITLE
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APPRO D AS ORM:
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ADMINISTRATIVE AGREEMENT
TABLE OF CONTENTS
HEALTH PLAN ADMINISTRATORS • • • • • . ' 1 ''
..
Duties and Responsibilities of City. • 2
Duties and Responsibilities of Claia►s Administration. 4
• • • •
:> Method for Payment of Claims
. . . . 5
"{. Administration Charge o t
5 ;
FLEXIBLE BENEFIT PLAN ADMINISTRATION
Duties and Responsibilities of City. 5 5
f?4 Duties and Responsibilities of EBA
Administration Charge. F`
7
PRECERTIFICATION FOR HOSPITALIZATION . • • • • • '
7 '
ADDITIONAL DUTIES OF EBA • • • • .
+- g
DETERMINATION OF ELIGIBILITY
P
i�+ • • • • • o • • • • • lr td i•..
2a' RECORD RETENTION AND REVIEW • R
,{
a. AGENCY AGREEMENT • . . . • • • • j.
9
t.> LAWS GOVERNING CONTRACT •
1%
TERM OF AGREEMENT . .
r°<< . . • .
MODIFICATION OF AGREEMENT
9 z
MODIFICATION OF PLAN OR CAFETERIA PLAN
10
CONFIDENTIALITY . . . . . • -
;a
.. .t�; ; TERMINATION OF AGREEMENT
10
gig'""?#;.',i�,•,
w •,:,r' INDEPENDENT CONTRACT RELATIONSHIP • • • • ' ' '
:'. . . 11 c
o
PLAN .UPDATES . • • • •
11
CAPTION
11
NOTICE . . .
. . . . . . . . . . . . .
INVALIDITY o '
e
rp�
s!'
13
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