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Home My WebLink AboutRES.1455.05-03-1999044=�C�7�I'a%L•� RESOLUTION NO. I, A RESOLUTION AUTHORIZING THE CITY MANAGER TO EXECUTE AN ADMINISTRATIVE SERVICES ONLY FUNDING AGREEMENT AND OTHER SUPPORTING DOCUMENTS, WITH DELTA DENTAL PLAN OF MISSOURI WHEREAS, the City provides Dental insurance for it's employees and allows those employees to purchase dependent dental coverage at the City's group rate, and; WHEREAS, the City believes that self insuring the Employees Dental benefit offers a number of short and long term advantages including broadening the dental providers network, improving Employee access and service and long term rate stabilization, and; WHEREAS, the City will require professional assistance in the administration of such a program. BE IT RESOLVED BY THE COUNCIL OF THE CITY OF CAPE GIRARDEAU, MISSOURI, AS FOLLOWS: ARTICLE 1. The City Manager, for and on behalf of the City of Cape Girardeau, is hereby authorized to execute an "ADMINISTRATIVE SERVICES ONLY FUNDING AGREEMENT" and other supporting documents as may be needed, with Delta Dental Plan of Missouri. A copy of said Agreement is attached to this Resolution and made a part hereof. ASSEL 19. AND ADOPTED THIS DAY OF , Leli d J. 'weedy. -° Deputy City_ .G -perk A. M. Spradling, III 101yor � n F C� Leli d J. 'weedy. -° Deputy City_ .G -perk A. M. Spradling, III 101yor Group Number: ADMINISTRATIVE SERVICES ONLY FUNDING AGREEMENT FOR AGREEMENT EFFECTIVE DATE JULY 1, 1999 CONTRACT RENEWAL DATE JULY 1 OF EACH YEAR This Agreement is attached to and made part of the Group Enrollment Agreement. Delta Dental Plan of Missouri ("DDPM") and Employer, hereafter referred to as the Group Sponsor, agree as follows: WHEREAS, The Group Sponsor has established a benefit plan to provide for certain classes of employees and their eligible dependents, identified in the Group Enrollment Agreement under which DDPM will arrange to pay benefits to which they are entitled, and WHEREAS, DDPM is willing to provide benefits under the Group Enrollment Agreement, for that purpose, NOW THEREFORE, it is agreed as follows: 1 This Agreement shall be effective on the date specified above. 2. The provisions of this Agreement shall apply to the specified coverage under the Group Enrollment Agreement, Schedule of Benefits and Membership Certificate. 3. A claim shall be deemed to be incurred on the date the dental care is rendered to the Participant. A claim shall be deemed to be paid when a valid draft for payment for such benefit has been issued to the person or institution authorized for such purpose by the Membership Certificate. 4. a. The retention charge for the contract year commencing July 1, 1999 is identified in the Retention Schedule, which is attached to and made a part of this Agreement. b. The Group Sponsor will be billed this charge on a monthly basis. Payment of this advance billing will be made by the first day of the month following receipt of the billing. c. DDPM will notify the Group Sponsor thirty (30) days prior to the contract renewal date of the retention charge that will be applied for the following contract year. While this charge is guaranteed for the contract year, the charge could be revised during the year with the agreement of both parties based on a change in the Benefit Plan. 5. a. Each week, DDPM will be reimbursed for the eligible claims paid. A weekly transfer banking system will be implemented. Under this system, each Thursday, DDPM will telephone or fax the appropriate designee of the Group Sponsor and advise the designee of the amount of claims for the weekly payment. In addition, DDPM will mail the weekly invoice and supporting claim listing. Each Friday morning, the Group Sponsor's weekly reimbursement will be transferred for deposit to the designated DDPM account. b. In the event the Group Sponsor fails to make funds available as specified above, DDPM shall have no obligation to pay such claims out of its own funds. 6. DDPM shall have no liability under this Agreement for benefits required to be paid from the Group Sponsor's funds. The Group Sponsor shall have no liability for benefits required to be paid from DDPM funds. It is agreed that the benefits paid from the funds of the Group Sponsor and DDPM are, and shall be, mutually exclusive. 7. DDPM hereby acknowledges that the Group Sponsor is the plan Administrator of the Benefit Plan (within the meaning of ERISA) with the sole discretion and authority to administer the Benefit Plan, to interpret the terms of the Benefit Plan and to decide all matters arising in connection with the administration of the Benefit Plan, including the discretionary authority and power to make factual determinations and to determine all matters relating to eligibility, enrollment, coverage and termination of coverage. Pursuant to this Agreement the Group sponsor hereby delegates to DDPM solely the responsibility for daily processing of benefit claims. 8. This Agreement may be terminated by DDPM or the Group Sponsor as of the first day of any policy month by giving written notice to the other party at least thirty (a0) days prior to such termination date. This Agreement shall automatically terminate as of the earliest of the following dates: a. The day on which the Group Sponsor shall not have made funds available for the payment of all benefits required to be paid from his funds in accordance with this Agreement; b. The date on which the Group Sponsor discontinues payment of the monthly retention charges; C. The date of termination of the Group Enrollment Agreement. 9. In the event of contract termination, adjudication and payment for claims received after midnight on the termination date will be the responsibility of the Group Sponsor. Adjudication and payment of claims incurred during the existence of this Agreement and submitted to DDPM within 2 twelve (12) months following termination of the Agreement will be administered by DDPM, subject to payment by the Group Sponsor of additional retention charges not to exceed the aggregate of the retention charges paid to DDPM by the Group Sponsor for the final two (2) months of the Agreement term. Claims submitted to DDPM after twelve (12) months following termination date will be the responsibility of the Group Sponsor. 10. The Group Sponsor assumes the legal role as the program fiduciary. Except as otherwise explicitly provided in this Agreement, DDPM shall have no responsibilities with respect to the administration of any benefit plan established by the Group Sponsor including, without limitation, notification to Participants concerning the availability of continuation coverage. 11. This Agreement supersedes any prior Agreement and shall continue until termination; provided, however, the obligations of the parties shall survive termination to the extent necessary to effect the intent of the parties as herein expressed. No modification, amendment or assignment of this Agreement shall be valid unless made in writing and executed by authorized officers of DDPM and the Group Sponsor. 12. The terms and provisions of this Agreement shall be construed and enforced in accordance with the laws of the State of Missouri. 13. If any provisions of this Agreement shall be found by a court of competent jurisdiction to be void, invalid, or unenforceable, the same shall either be reformed to comply with applicable law, or stricken if not so conformable so as to affect the validity or enforceability of this Agreement. The validity or unenforceability of any terms or provisions hereof shall in no way affect the validity or enforceability of any other terms or provisions. IN WITNESS WHEREOF, DDPM and the Group Sponsor have caused this Agreement to be executed, to be effective July 1, 1999. CITY OF CAPE GIRARDEAU DELTA DENTAL PLAN OF MISSOURI By: By: Title: Title: Date: 3 Date: