Resolution No. 90911
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
RESOLUTION NO. 9091
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
VERNON APPROVING AND RATIFYING THE EXECUTION OF
LETTER OF UNDERSTANDING AMENDING AGREEMENT WITH
UNITED OF OMAHA LIFE INSURANCE COMPANY REGARDING
PLAN COVERAGE FOR EMPLOYEE
WHEREAS, the City of Vernon has agreements with United of
Omaha Life Insurance Company ("Omaha") for administering the City's
employee health care plan; and
WHEREAS, on August 22, 1989, the City Council of the City of
Vernon adopted Resolution No. 5657 approving an Administrative
Services Agreement with United of Omaha Life Insurance Company
("Omaha") that was effective September 1, 1989 (the "Agreement"); and
WHEREAS, the COBRA eligibility for medical and dental
coverage for Lynn Bohlander would have been exhausted on May 31, 2006,
except that member was incorrectly advised that the COBRA coverage
would end on August 31, 2006; and
WHEREAS, under the terms of the Agreement, the City makes
fall final decisions regarding the plan; and
WHEREAS, the Acting Risk Manager reviewed the administrative
error and suggested that the City make an exception for the COBRA
coverage for Lynn Bohlander and allow COBRA eligibility for medical
and dental through August 31, 2006, provided the appropriate COBRA
premium was paid; and
WHEREAS, there is no claim impact involving the requested
exception; and
WHEREAS, Omaha has requested that the City sign a Letter of
Understanding amending the Agreement to allow the extension of
1 COBRA eligibility for medical and dental through August 31, 2006 for
2 Lynn Bohlander with the understanding that any claims incurred while
3 under COBRA coverage are not reimbursable under the specific and
4 aggregate stop loss provisions under policy G0002R05; and
5 WHEREAS, in accordance with the direction of the City
6 Council on June 7, 2006, the Chief Deputy City Attorney/Acting Risk
7 Manager executed a Letter of Understanding on June 12, 2007, subject
8 to ratification by the City Council; and
9 WHEREAS, the City Council desires to approve and ratify the
10 actions of the Chief Deputy City Attorney/Acting Risk Manager in
11 executing the Letter of Understanding respecting Lynn Bohlander.
12 NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
13 CITY OF VERNON AS FOLLOWS:
14 SECTION 1: The City Council of the City of. Vernon hereby
15 finds and determines that the recitals contained hereinabove are true
16 and correct.
17 SECTION 2: The City Council of the City of Vernon hereby
18 ratifies the execution of the Letter of Understanding with United of
19 Omaha Life Insurance Company by the Chief Deputy City Attorney/Acting
20 Risk Manager on June 12, 2006, a copy of which is attached hereto as
21 Exhibit A and incorporated by reference.
22
23
24
25
26
27
28
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
SECTION 3: The Acting 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.
APPROVED AND ADOPTED this 5th day of July, 2006.
ATTEST:
BRUCE V. LKENHORST, JR.
Acting Ci y Clerk
LEONIS C. MAL RG, Mayor
3 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
STATE OF CALIFORNIA )
ss
COUNTY OF LOS ANGELES )
I, BRUCE V. MALKENHORST, JR., Acting City Clerk of the City of
Vernon, do hereby certify that the foregoing Resolution, being
Resolution No. 9091, was duly adopted by the City Council of the City
of Vernon at a regular meeting of the City Council duly held on
Wednesday, July 5, 2006, and thereafter was duly signed by the Mayor of
the City of Vernon.
BRUCE V. MALKENHORST, JR.
Acting City Clerk
(S EAL )
- 4 -
EXHIBIT
0
UNITED Of OMAHA LIFE INSURANCE COMPANY
'Woodward Health Care Service Center
M e s P.O.Box 9
Woodward, OK 73802
June 7, 2006
City of Vernon
Attn: Cindy Calzada
4305 S. Santa Fe Ave
Vernon, CA 85004-2202
Re: Plan Coverage for Lynn Bohlander
Dear Ms. Calzada:
This letter serves as an amendment to the Administrative Services Agreement of September 1, 1989,
between United of Omaha Life Insurance Company ("Company") and City of Vernon (the
"Agreement'). The terms of this letter are made a part of the Agreement and are subject to all
provisions of the Agreement not in conflict with the provisions of this letter.
City of Vernon and Company agree as follows:
1. Company shall, as an exception to the terms of City of Vernon's self -funded group health plan
(Group Plan G0002R05), agree to allow COBRA eligibility for medical and dental through August
31, 2006, provided appropriate COBRA premium is paid. Per COBRA guidelines, the member's
COBRA coverage would have been exhausted on May 31, 2006. The member was inadvertently
advised by the City of Vernon, that COBRA coverage would end on August 31, 2006. Therefore,
the City of Vernon feels that an exception is warranted due to the incorrect communication
provided. At this time, there is not any claim impact involving this exception request. However,
any claims incurred while under COBRA coverage is not reimbursable under the specific or
aggregate stop loss provisions under policy G0002R05.
2. 'Notwithstanding anything to the contrary in the Agreement, City of Vernon agrees that it shall
indemnify, defend and hold Company harmless from any liability, loss, costs, expenses or
damages (including, without limitation, attorneys' fees, court costs and extra -contractual and
punitive damages) incurred by Company arising out of or resulting from this letter or any act or
omission of Company in the performance of its duties under this letter. This obligation to
indemnify, defend and hold Company harmless shall be in addition to, and shall not replace, any
other obligation of Employer in the Agreement to indemnify, defend and hold Company harmless.
3. Company assumes no responsibility for any tax or legal consequences that City of Vernon, the
plan sponsor or any person covered under City of Vernon's plan may incur under any state or
federal law as a result of this letter.
4. Company and City of Vernon acknowledge and agree that Company only provides ministerial
claims processing services for City of Vernon's self -funded group health plan and that Company
has no authority to act, and does not act, as a fiduciary for the plan in any manner whatsoever.
5. The terms of this letter shall be read together and construed as one document with the
Agreement, but to the extent of any inconsistency or ambiguity, this letter shall govern.
a
6. Except as expressly provided in this letter, all of the provisions of the Agreement shall remain in
full force and effect.
7. Where the provisions of this letter and those of the group health plan conflict, the provisions of
this letter will apply.
8. The terms of this letter may be modified or amended only by an instrument In writing, duly
executed and delivered by the parties hereto.
9. Any number of counterparts of this letter may be executed and each such executed counterpart
shall be deemed an origin
Cory Michel
Vice President, Underwriting
Date:_ !' ?
AGRE913 TO and ACCEPTED FOR:
By:
Titl IEF TY ATTORNEY/ACT'ING RISK MANAGER
Date: —/X
cc: Gallagher Benefit Services, Inc.
Souther California Group Office
Group Premium Administration
Group Claims
Contract Side of Master Contract File
�•+F�;vvr
UNITED Of OMAHA LIFE INSURANCE COMPANY
Woodward Health Care Service Center '
P.O. Box 9
Woodward, OK 73802
NilIi1181.�0111ifNi7
June 7, 2006
City of Vernon
Attn: Cindy Calzada
4305 S. Santa Fe Ave
Vernon, CA 85004-2202
Re: Plan Coverage for Lynn Bohlander
Dear Ms. Calzada:
This letter serves as an amendment to the Administrative Services Agreement of September 1, 1989,
between United of Omaha Life Insurance Company ("Company") and City of Vernon (the
"Agreement"). The terms of this letter are made a part of the Agreement and are subject to all
provisions of the Agreement not in conflict with the provisions of this letter.
City of Vernon and Company agree as follows:
1. Company shall, as an exception to the terms of City of Vernon's self -funded group health plan
(Group Plan G0002R05), agree to allow COBRA eligibility for medical and dental through August
31, 2006, provided appropriate COBRA premium is paid. Per COBRA guidelines, the member's
COBRA coverage would have been exhausted on May 31, 2006. The member was inadvertently
advised by the City of Vernon, that COBRA coverage would end on August 31, 2006. Therefore,
the City of Vernon feels that an exception is warranted due to the incorrect communication
provided. At this time, there is not any claim impact involving this exception request. However,
any claims incurred while under COBRA coverage is not reimbursable under the specific or
aggregate stop loss provisions under policy G0002R05.
2. 'Notwithstanding anything to the contrary in the Agreement, City of Vernon agrees that it shall
indemnify, defend and hold Company harmless from any liability, loss, costs, expenses or
damages (including, without limitation, attorneys' fees, court costs and extra -contractual and
punitive damages) incurred by Company arising out of or resulting from this letter or any act or
omission of Company in the performance of its duties under this letter. This obligation to
indemnify, defend and hold Company harmless shall be in addition to, and shall not replace, any
other obligation of Employer in the Agreement to indemnify, defend and hold Company harmless.
3. Company assumes no responsibility for any tax or legal consequences that City of Vernon, the
plan sponsor or any person covered under City of Vernon's plan may incur under any state or
federal law as a result of this letter.
4. Company and City of Vernon acknowledge and agree that Company only provides ministerial
claims processing services for City of Vernon's self -funded group health plan and that Company
has no authority to act, and does not act, as a fiduciary for the plan in any manner whatsoever.
5. The terms of this letter shall be read together and construed as one document with the
Agreement, but to the extent of any inconsistency or ambiguity, this letter shall govern.
6. Except as expressly provided in this letter, all of the provisions of the Agreement shall remain in
full force and effect.
7. Where the provisions of this letter and those of the group health plan conflict, the provisions of
this letter will apply.
S. The terms of this letter may be modified or amended only by an instrument in writing, duly
executed and delivered by the parties hereto.
9. Any number of counterparts of this letter may be executed and each such executed counterpart
shall be deemed an origin
Cory Michel
Vice President, Underwriting
Date:_
AGRE TO and ACCEPTED FOR:
By: U
Tit) iEF TY ATTORNEYJArING RISK HANAGER
Date: "/�-
cc: Gallagher Benefit Services, Inc.
Southern California Group Office
Group Premium Administration
Group Claims
Contract Side of Master Contract File