Resolution No. 5821
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RESOLUTION NO. 5821
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A RESOLUTION OF THE CITY COUNCIL OF THE
CITY OF VERNON APPROVING AND AUTHORIZING
THE EXECUTION OF A MUTUALLY PREFERRED
PAYOR AGREEMENT (GUSI-2R04) BY AND BETWEEN
THE CITY OF VERNON AND UNITED OF OMAHA
LIFE INSURANCE COMPANY (OMAHA)
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WHEREAS, the City Council of the City of Vernon adopted
Resolution No. 5813 on August 21, 1990, declaring its intention
to renew the Master stop Loss Policy and Administrative Services
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Contract with Omaha; and
WHEREAS, the City of Vernon and Omaha desire to enter
into a written agreement effective September 1, 1990, to provide
the terms and conditions under which Omaha is able to enter into
Mutually Preferred provider agreements with certain preferred
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provider organizations and/or health care providers.
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NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF
THE CITY OF VERNON AS FOLLOWS:
SECTION 1: The City Council of the City of Vernon
hereby finds and determines that the recitals contained
hereinabove are true and correct.
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SECTION 2: The City Council of the City of Vernon
hereby approves the Mutually Preferred Payor Agreement,
effective September 1, 1990, a copy of which has been presented
to the City Council concurrently with this resolution and the
City Council hereby orders said Agreement to be received and
filed by the City Clerk.
SECTION 3: The City Council of the City of Vernon
hereby authorizes the Mayor and the City Clerk to execute said
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Agreement for, and on behalf of, the City of Vernon.
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SECTION 4: The City Clerk of the City of Vernon shall
certify to the passage of this resolution and thereupon and
thereafter the same shall be in full force and effect.
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APPROVED AND ADOPTED this 4th day of September, 1990.
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.-- -LEONIS C. mu;-URG, Ma -or
ATr~ //o/~~
BROCE V. MALKENHORST, city Clerk
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STATE OF CALIFORNIA )
) ss
COUNTY OF LOS ANGELES )
I, BRUCE V. MALKENHORST, City Clerk of the City of
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4 Vernon, do hereby certify that the foregoing Resolution, being
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Resolution No. 5821, was duly adopted by the city council of the
City of Vernon at a regular meeting of the City Council duly
held on Tuesday, September 4. 1990. and thereafter duly signed
by the Mayor of the City of Vernon.
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BRUCE V.
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(SEAL)
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MUTUALLY PREFERRED
PAYOR AGREEMENT
(GUSI- 2R04)
This Mutually Preferred Payor Agreement, effective September 1, 1990, is between City of
Vernon (Employer) and United of Omaha Life Insurance Company (the Company), in its own
right and on behalf of each PPO and/or Provider referred to in section 3 below.
WHEREAS, The Company has entered and will enter into Mutually Preferred provider
agreements with certain preferred provider organizations (PPOs) and/or health care providers
(Providers), which agreements are referred to herein as "Provider Agreements"; and
WHEREAS, Employer, on an independent and voluntary basis, desires to contract with certain
PPO(s) and/or Providers by entering into this Payor Agreement;
IT IS THEREFORE AGREED AS FOLLOWS:
1. Employer authorizes the Company to enter into Provider Agreements and amendments
thereto, on behalf of Employer, which Provider Agreements may specify fee amounts which
shall be accepted by Providers as payment in full for health care services provided to
persons covered under Employer's health benefit plan.
2. Employer agrees to be bound by and comply with all terms and conditions of Provider
Agreements which apply to Employer and its health benefit plan.
3. The Company shall furnish Employer with a listing of Mutually Preferred Providers who
shall be considered preferred providers pursuant to this Payor Agreement.
4. Employer may inspect, at its sole cost, all Provider Agreements applicable to Employer's
health benefit plan at the Company's Home Office in Omaha, Nebraska, during the
Company's regular business hours. Upon request from Employer, the Company shall, at no
cost to Employe:, furnish one copy of (a) any applicable Provider Agreement with a PPO
and (b) any applicable standard form Provider Agreement intended for use with health care
providers. Upon request from Employer and at Employer's sole cost, the Companies shall
furnish Employer with a copy of all applicable Provider Agreements with health care
providers. Employer shall hold all copies of Provider Agreements in a confidential manner
and shall not disclose any of the terms of such Provider Agreements to any other party
without the Company's prior written consent.
5. Employer shall pay the Company a monthly administration fee as shown in the Utilization
Management Agreement between Employer and the Company.
6. Employer agrees that the Company does not assume any liability for the negligent,
fraudulent or any other acts or omissions of Employer or any PPO and/or Provider. It is
acknowledged that the Company has no control over patient care. The Provider shall
remain solely responsible for the quality of health care services.
7. No change or amendment to this Payor Agreement shall be effective unless such change or
amendment is agreed to in writing by Employer and an officer of the Company.
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8. This Payor Agreement may be terminated with respect to a specific PPO and/or Provider
in accordance with the terms of the applicable Provider Agreement or, if no such
termination provisions are included in the applicable Provider Agreement, either Employer
or the Company may terminate the applicability of this Payor Agreement with respect to
a particular PPO and/or Provider by giving sixty (60) days' advance written notice thereof
to the other party.
9. Either Employer or the Company may terminate this Payor Agreement with respect to all
PPOs and Providers by giving sixty (60) days' advance written notice thereof to the other
party.
10. This Payor Agreement shall automatically terminate with respect to all PPOs and Providers
when the Administrative Services Agreement between Employer and the Company
terminates.
CITY OF VERNON
UNITED OF OMAHA LIFE
INSURANCE COMP ANY
By<r!f7-Z<&c-:':7~(rUC~"I;; ,
By ~c~// Z"r-
Mayor
Title
Assistant Vice President
Title
Date
September 11, 1990
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Date
Attest:
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Bruce V4 Malkenhorst, City Clerk
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