Resolution No. 2010-194RESOLUTION NO. 2010-194
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
VERNON APPROVING AND AUTHORIZING THE EXECUTION OF A
COBRA ADMINISTRATIVE SERVICE AGREEMENT BY AND
BETWEEN THE CITY OF VERNON AND IGOE ADMINISTRATIVE
SERVICES
WHEREAS, the City of Vernon (the "City") desires to retain
the services of a reputable independent contractor to provide
administrative and clerical services relating to the City's compliance
with health-care coverage continuation requirements under the
Consolidated Omnibus Budget Reconciliation Act of 1985 ("COBRA"); and
WHEREAS, Igoe and Company, doing business as Igoe
Administrative Services ("Igoe"), has provided such services in the
past and therefore can provide the administrative and clerical
services required by the City in a more efficient and effective
manner; and
WHEREAS, in order to ensure the uninterrupted provision of
such services to the City, the Risk Manager has recommended that the
COBRA Administrative Service Agreement with Igoe ("Agreement") setting
forth the terms and conditions under which Igoe will perform the
services be approved commencing January 1, 2011, and be reevaluated on
an annual basis; and
WHEREAS, the City Council desires to approve the Agreement
and engage the services of Igoe; and
WHEREAS, the City Council of the City of Vernon has
determined that, pursuant to the provisions of subsection (b)(1) of
Section 2.27 of the Vernon City Code, it is in the public interest and
necessity to enter into the Agreement with Igoe to provide the
administrative and clerical services required by the City in an
efficient and effective manner.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY OF VERNON AS FOLLOWS:
SECTION l: The City Council of the City of Vernon hereby
finds and determines that the recitals contained hereinabove are true
and correct.
SECTION 2: The City Council of the City of Vernon hereby
approves the Agreement with Igoe, a copy of which is attached hereto
as Exhibit A.
SECTION 3: The City Council of the City of Vernon hereby
authorizes the Mayor or Mayor Pro-Tem to execute the Agreement for, and
on behalf of, the City of Vernon and the City Clerk, or Deputy City
Clerk, is hereby authorized to attest thereto.
SECTION 4: The City Council of the City of Vernon hereby
authorizes the City Administrator, or his designee, to take whatever
actions are deemed necessary and desirable for the purpose of
implementing and carrying out the purpose of this Resolution and the
transactions herein approved or authorized.
SECTION 5: The City Council of the City of Vernon hereby
directs the City Clerk, or the City Clerk's designee, to send a fully
executed Agreement to Igoe.
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SECTION 6: The City Clerk of the City of Vernon shall
certify to the passage, approval and adoption of this resolution, and
the City Clerk of the City of Vernon shall cause this resolution and
the City Clerk's certification to be entered in the File of
Resolutions of the Council of this City.
APPROVED AND ADOPTED this 20th day of December, 2010.
Name: Hilario Gon7alps
Title: Mayor / ayor Pro- em=-
A EST:
Wiglard G guc ', City Clerk
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STATE OF CALIFORNIA )
) ss
COUNTY OF LOS ANGELES )
I, Willard G. Yamaguchi, City Clerk of the City of Vernon, do
hereby certify that the foregoing Resolution, being Resolution
No. 2010-194, was duly passed, approved and adopted by the City Council
of the City of Vernon at a regular meeting of the City Council duly
held on Monday, December 20, 2010, and thereafter was duly signed by
the Mayor or Mayor Pro-Tem of the City of Vernon.
Executed this 7'Y- day of December, 2010, at Vernon, California.
(SEAL)
Willa Ya a chi, City Clerk
M
COBRA ADMINISTRATIVE SERVICES AGREEMENT
This Agreement is entered into effective as of January 1, 2011 (The EffectiVe"Ilato) between
City of Vernon (hereinafter referred to as "Client"), with principal offices at 4305 Santa Fe Avenue, City of
Vernon, State of California, and Igoe & Company Incorporated dba Igoe Administrative Services
(hereinafter referred to as "Igoe Administrative Services" or "Business Associate"), with principal offices at
15090 Avenue of Science, Suite 201, City of San Diego, State of California.
In consideration of the mutual covenants contained in this Agreement, Client and Igoe
Administrative Services agree as follows and that all terms and conditions contained within are in full force,
and are not negotiable:
1. Client desires to have Igoe Administrative Services provide administrative and clerical
functions related to Client's compliance with Health Care Coverage Continuation under
the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), as amended.
2. In consideration for the fees and charges detailed below, Igoe Administrative Services
hereby agrees to perform said administrative and clerical functions subject to the following
terms and conditions:
a. The terms Administrative and Clerical Functions to be performed by Igoe
Administrative Services are defined as:
(1) Sending of notices to qualified beneficiaries (QBs) as required under
COBRA within the time required by law and with proof of mailing,
including without limitation (a) initial notification of all covered employees
and spouses of their continuation rights; (b) notification of coverage
continuation rights with election form; (c) notification of conversion rights
upon termination of group coverage when applicable; (d) notification of
coverage of continuation rights for subsequent qualifying events; (e)
notification of termination of COBRA continuation coverage for non-
payment of premium or at the end of any COBRA continuation period;
and (f) notice of unavailability of continuation coverage.
(2) Communicating with QBs regarding COBRA coverage.
(3) Collecting Premiums monthly from each QB.
(4) Reporting Premiums to Client and remitting premiums received minus all
applicable administrative fees each month to Client or Client's designee.
(5) Reporting enrollees to Client (courtesy copy sent to insurance carriers).
(6) Reporting terminations to Client.
(7) Sending DOL Notices (General Rights/New Hire Letters), as requested
by Client (additional fee will apply).
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(8) Sending HIPAA Certificates (included in notice).
(9) Maintain hard copy or electronic files of all notifications and
correspondence for seven years or longer if required by law.
(10) Communicate new premium rates to each QB upon open enrollment after
receiving such rate change notification from Client.
(11) Provide Client with copies upon request of all notifications,
correspondence, and other records in conjunction with the services
provided hereunder.
(12) Notify COBRA participants of their possible right to an additional
extension of benefits at 180 days and again at 90 days prior to
exhausting the statutory 18 months COBRA benefit eligibility, unless
otherwise requested in writing by the Client/Plan Sponsor.
b. The Administrative and Clerical functions do not include the amending and
republishing of the Client's plan document or booklets.
C. Igoe Administrative Services will provide COBRA Administrative forms as
applicable for Client's use. The forms are the sole proprietary property of Igoe
Administrative Services. Said form(s) may only be copied for Client's internal use
("internal use" includes transferring the forms to Client's employees and former
employees) and may not be communicated to, given to, or otherwise transferred
to any other person, corporation or entity, provided that Client may disclose such
forms where required by law.
d. In order for Igoe Administrative Services to perform under the terms of the
Agreement, Client agrees to be responsible for collection of the data necessary to
enable Igoe Administrative Services to comply with the provisions of COBRA.
Specifically, Client agrees to enter via Igoe's online system or download the QB
COBRA Qualifying Event information to Igoe Administrative Services within 30
days of the qualifying event or loss of coverage date (whichever is later), provided
that where the qualifying event is divorce, legal separation, or where a dependent
child ceases to be covered as a "dependent' Client agrees to notify Igoe
Administrative Services within 30 days of the date it is notified of such event.
e. Igoe Administrative Services agrees to comply with ongoing COBRA notice
requirements within fourteen (14) calendar days of receiving a Qualifying
,EvenVSpecial Rights information.
f. Igoe Administrative Services further agrees to account for collected premiums by:
(1) Placing collected premiums in an Igoe Administrative Services premium
fund account.
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(2) Providing Client with a report on or about the fifteenth (15th) of the month,
following a premium reporting month, which details premiums billed and
collected.
(3) Forwarding to Client, on or about the fifteenth (15th) of the month
following a premium reporting month, a check drawn on the Igoe
Administrative Services premium fund account for all net premiums
collected during the preceding premium reporting month. The premium
check shall be reduced by an amount equal to prior month's fees payable
to Igoe Administrative Services. If premiums collected are not sufficient
to pay Igoe Administrative Services fees, Igoe Administrative Services
will detail and bill the excess amount due to Client.
Igoe Administrative Services will report to Client on a monthly basis all new
COBRA enrollees (those who have elected to receive coverage) and all
terminations. Further, Igoe Administrative Services will provide courtesy
notification to Client's insurer or administrator. It is Client's responsibility to verify
that these additions and terminations were appropriately acted upon by Client's
insurer or administrator.
Igoe Administrative Services will advise Client of all law or regulation changes
affecting COBRA and will, by the required effective date, fully comply.
(1) Client will pay to Igoe .Administrative Services administrative fees in
accordance with the COBRA Administrative Services Fee Schedule
which is included in the Administrative Services Agreement for the given
plan year. Client agrees to pay the administrative fees to Igoe
Administrative Services within ten (10) days of receipt of invoice. Failure
to pay fees within thirty (30) days of due date,will result in Igoe
Administrative Services suspending all administrative services. While in
a suspension status, all services outlined in section 2(b) will cease and
be held in a pending status until such time payment for services has
been received. A fee of $250.00 must be paid in full for services to be
reinstated. If payment is 'not received thirty (30) days following the
suspension of services, Igoe Administrative Services will terminate this
Agreement in accordance with section 4(e), below. The Fee Schedule in
effect as of the Effective Date of this Agreement is set forth in Exhibit A
which is attached to this Agreement and made a part hereof.
(2) At any time during the period covered by this Agreement should the total
number of benefit covered employees decrease by 20% or more from
the total number of benefit covered employees at the time such
Agreement was entered, Igoe Administrative Services reserves the right
- to require Client -to pay all monthly administrative fees, including the
Qualified Beneficiary Fee ("QB" Fee), as indicated in Exhibit A, in
advance of the performance of work set forth in the contract.
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(3) Should Client, at any time during the coverage period of this Agreement,
file in the United States for the Debt Relief or Reorganization of any
type, all services from the date of the filling forward shall be terminated
immediately.
Igoe Administrative Services will use reasonable care and due diligence in the
performance of its responsibilities hereunder. Client agrees that Igoe
Administrative Services is not assuming the title and liabilities of Administrator or
Plan Administrator as defined by the COBRA or ERISA law. Client agrees that
this responsibility is, and remains, that of the Client.
k. Client agrees to accurately complete all necessary and pertinent data fields and
forward such data to Igoe via Igoe's online services or other approved electronic
data feed format. In the plan takeover process client may, with the approval of
Igoe, forward certain required data in paper format. Further, Client agrees that the
provision of this data will provide the basis of Igoe Administrative Services
Administrative actions under this Agreement. Changes to any data received may
only be made in writing and are only effective when acknowledged by Igoe
Administrative Services in writing.
Igoe Administrative Services will attend any audit or hearing held by a
government agency or bureau regarding compliance issues directly pertaining to
administration services performed by Igoe Administrative Services during the
term of this Agreement and will provide any and all requested documents in their
possession. This provision will survive the expiration or termination of this
Agreement.
3. Business Associate Contract Provisions.
a. Definitions. Terms used, but not otherwise defined, in this section shall have the
same meaning as those terms in 45 CFR §§ 160.103, 164.402, and 164.501. As
used below "Business Associate" refers to Igoe Administrative Services and.
"Covered Entity" to Client.
b. Obligations and Activities of Business Associate in accordance with HIPAA
regulations regarding Protected Health Information (PHI) and Electronic
Protected Health Information (EPHI):
(1) Business Associate agrees to not use or further disclose Protected
Health Information other than as permitted or required by the Agreement
or as Required By Law.
(2) Business Associate agrees to use appropriate safeguards to prevent use
or disclosure of the Protected Health Information other than as provided
for by this Agreement.
(3) Business Associate agrees to mitigate, to the extent practicable, any
harmful effect that is known to Business Associate of a use or disclosure
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of Protected Health Information by Business Associate in violation of the
requirements of this Agreement.
(4) Business Associate agrees to report to Covered Entity any use or
disclosure of the Protected Health Information not provided for by this
Agreement of which it becomes aware.
(5) Business Associate agrees to ensure that any agent, including a
subcontractor, to whom it provides Protected Health Information received
from, or created or received by Business Associate on behalf of Covered
Entity agrees to the same restrictions and conditions that apply through
this Agreement to Business Associate with respect to such information.
(6) Business Associate agrees to make internal practices, books, and
records relating to the use and disclosure of Protected Health Information
received from, or created or received by Business Associate on behalf of
Covered Entity available to the Covered Entity, or at the request of the
Covered Entity to the Secretary, in a time and manner designated by the
Covered Entity or the Secretary, for purposes of the Secretary
determining Covered Entity's compliance with the Privacy Rule.
(7) Business Associate agrees to document such disclosures of Protected
Health Information and information related to such disclosures as would
be required for Covered Entity to respond to a request by an Individual
for an accounting of disclosures of Protected Health Information in
accordance with 45 CFR §164.528.
8) Business Associate agrees to implement any and all administrative,
technical and physical safeguards necessary to reasonably and
appropriately protect the confidentiality, integrity and availability of
electronic Protected Health Information that it creates, receives,
maintains or transmits on behalf of Covered Entity.
9) Business Associate agrees to ensure that access to Electronic Protected
Health Information related to the Covered Entity is limited to those
workforce members who require such access because of their role or
function.
10) Business Associate agrees to implement safeguards to prevent its
workforce members who are not authorized to have access to such
Electronic Protected Health Information from obtaining access and to
otherwise ensure compliance by its workforce with the Security Rule.
11) Business Associate agrees to ensure that any agent, including a
subcontractor, to whom it provides Electronic Protected Health
Information received from, or created or received by Business Associate
on behalf of, Covered Entity agrees to the same restrictions and
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conditions that apply to Business Associate with respect to such
information.
12) Business Associate agrees to report to Covered Entity, in writing, any
security incident of which it becomes aware. Security incident shall
mean successful unauthorized access to, disclosure, modification or -
destruction of, or interference with, the Electronic Protected Health
Information by a third party.
13) Upon request from Covered Entity, Business Associate agrees to provide
information to Covered Entity on unsuccessful unauthorized access, use,
disclosure, modification or destruction of the Electronic Protected Health
Information to the extent such information is available to Business
Associate.
14) As required by the Security Rule, Business Associate agrees to treat a
material breach of this Agreement as a breach of the Agreement and to
an early termination of the Agreement by Covered Entity.
c. Obligations and Activities of Business Associate in accordance with Section 13402(b)
of the Health Information Technology for Economic and Clinical Health Act of 2009
(the "HITECH Act"), and interim final regulations thereunder, as such provisions may
be amended from time to time or finalized:
(1) Business Associate will notify Covered Entity of any breach of unsecured
PHI pertaining to participants or dependents/beneficiaries in Covered
Entity's Plan occurring on or after September 23, 2009, to the extent
such breach becomes known to Business Associate or would have
become known to Business Associate through the exercise of reasonable
diligence. Business Associate will notify Covered Entity without
unreasonable delay and in no case later than 60 days following the
discovery of a breach. 'Business Associate" for this limited purpose shall
include Business Associate's owners, officers, employees, and
independent contractors, with the exclusion of any individual responsible
for a breach.
(2) Business Associate will include in such notification, to the extent
possible, the identification of each individual whose unsecured PHI has
been, or is reasonably believed to have been, accessed, acquired, used
or disclosed during the breach.
(3) Business Associate will include in such notification any other available
information that the Covered Entity is required to include in its notification
to the individual pursuant to 45 Code of Federal Regulations §
164.404(c), promptly upon such information becoming available to
Business Associate.
(4) For purposes of this section, "breach"" is as defined at 45 Code of
Federal Regulations §164.402 including the exclusions set forth at
§164.402(2). -
(5) For purposes of this section, "unsecured PHI" is as defined at 45 Code of
Federal Regulations §164.402.
d. Obligations and Activities of Business Associate in accordance with Section 1798.82
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of the California Civil Code
Except to the extent its obligation to do so is preempted by the provisions of the
Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), including
provisions of the HITECH Act, Business Associate shall notify Covered Entity of
any breach of unencrypted data owned or licensed by Covered Entity, and
maintained by Business, Associate. "Breach" for these purposes means
acquisition of unencrypted data by an unauthorized person, or the reasonable
belief of such acquisition, that compromises the security, confidentiality, or
integrity of personal information consisting of medical or insurance information
pertaining to California residents, subject however to the good faith exception set
forth in Civil Code § 1798.82(d).
e. Permitted Uses and Disclosures by Business Associate. Except as otherwise
limited in this Agreement, Business Associate may use or disclose Protected
Health Information to perform functions, activities, or services for, or on behalf of,
Covered Entity as specified in the Administrative Services Agreement, provided
that such use or disclosure would not violate the Privacy Rule if done by Covered
Entity:
f. Obligations of Covered Entity. Plan Sponsor (Client) on behalf of Covered Entity
shall notify Business Associate of any restriction to the use or disclosure of
Protected Health Information that Covered Entity has agreed to in accordance
with 45 CFR 164.522, to the extent that such restriction may affect Business
Associate's use or disclosure of Protected Health Information.
Permissible Requests by Covered Entity. Plan Sponsor (Client) on behalf of
Covered Entity shall not request Business Associate to use or disclose Protected
Health Information in any manner that would not be permissible under the -Privacy
Rule if done by Covered Entity.
4. Term and Termination
a. Term. This Agreement shall remain in place in perpetuity beginning on the effective
date as defined above. Administrative Fees set forth in Exhibit A are subject to
annual review by Contract Plan Administrative Firm. Igoe Administrative Services
must give notice to Company regarding any change in fees at least sixty (60) days
prior to the rate effective date defined in Exhibit A. -If Company or Igoe
Administrative Services does not desire to renew, the terminating party must give the
non -terminating party written notice sixty (60) days prior to the expiration of this
Agreement of their intent not the renew said Agreement.
b. Early Termination by Client Without Cause. If at any time the client wishes to
terminate the COBRA services without cause, a sixty (60) day written notice must be
given to Igoe Administrative Services by the Client. Within ten days of. termination,,
and upon Client's written request, Igoe Administrative Services will provide Clientwith
a status report of each of the qualified beneficiaries who were subject to this
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Agreement, including all details necessary to transfer responsibility to the new
administrator.
c. Early Termination by Client With Cause. Upon Client's knowledge of a material
breach by Igoe Administrative Services of its duties under this Agreement, above,
Client shall either: (i) provide an opportunity for Igoe Administrative Services
to cure the breach or end the violation or, if Igoe Administrative Services does not
cure the breach or end the violation within the time specified by Client, terminate this
Agreement and the Business Associate Agreement provisions thereof; or (ii)
immediately terminate this Agreement and the Business Associate Agreement
provisions thereof if Igoe Administrative Services has breached a material term of this
Agreement and cure is not possible.
d. Early Termination by Igoe Administrative Services. if Igoe Administrative Services
suspends services for nonpayment in accordance with section 2(i)(1), above, and
payment is not received thirty (30) days following the suspension of services, Igoe
Administrative Services will terminate this Agreement effective immediately.
e. Effect of Termination on HIPAA Responsibilities. As used below "Business Associate"
refers to Igoe Administrative Services and "Covered Entity" to Client.
(1) Except as provided in paragraph (2) of this section, upon termination of
this Agreement, for any reason, Business Associate shall return or destroy all
Protected Health Information received from Covered Entity, or created or
received by Business Associate on behalf of Covered Entity. This provision
shall apply to Protected Health Information that is in the possession of
subcontractors or agents of Business Associate. Business Associate shall
retain no copies of the Protected Health Information. For purposes -..of this
section, "destruction" of unsecured PHI shall comply with guidelines
published on April 27, 2009 by the Department of Health and Human
Services, as modified by the Department in the preamble to interim final
regulations on breach notification for unsecured PHI (74 Federal Register
162 (August 24, 2009), pp. 42741-42743.
(2) In the event that Business Associate determines that returning or
destroying the Protected Health Information is infeasible, Business Associate
shall provide to Covered Entity notification of the conditions that make return
or destruction infeasible. Upon mutual agreement of the Parties that return or
destruction of Protected Health Information is infeasible, Business Associate
shall extend the protections of this Agreement to such Protected Health
Information and limit further uses and disclosures of such Protected Health
Information to those purposes that make the return or destruction in
for so long as Business Associate maintains such Protected Health
Information.
(3) Term. The Term of the Business Associate Contract Provisions of this
Agreement shall be effective upon your signature, and shall terminate when
all of the Protected- Health Information - provided by Covered Entity to
Business Associate, or created or received by Business Associate on behalf
of Covered Entity, is destroyed or returned to Covered Entity, or, if it is
infeasible to return or destroy Protected Health Information, protections are
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extended to such information, in accordance with the termination provisions
in this Section.
Venue in the Event of Legal Dispute. Should either party institute legal action to
enforce its rights under this Agreement, the venue shall be in San Diego County,
State of California, and the prevailing party in such action shall be entitled to recover
reasonable attorney's fees and costs.
5. Indemnity: Igoe Administrative Services shall indemnify, defend and hold harmless
Client, its affiliates, directors, officers and employees or any of them from any claim,
expense, loss, damage, settlement, judgment, penalty and liability, including reasonable
attorneys' fees and court costs (individually and collectively, "Claims") resulting in any way
from or arising out of Igoe Administrative Services' performance of or failure to perform
this Agreement, including, without limitation, Claims resulting from or arising out of acts or
omissions by Igoe Administrative Services, it's employees, officers, directors, agents, or
other individuals who provide services under this Agreement. Client shall indemnify,
defend and hold harmless Igoe Administrative Services, its affiliates, directors, officers
and employees or any of them from any claim, expense, loss, damage, settlement,
judgment, penalty and liability, including reasonable .attorneys' fees and court costs
(individually and collectively, "Claims") resulting in any way from or arising out of Client's
performance of or failure to perform this Agreement, including, without limitation, Claims
resulting from or arising out of acts or omissions by Client, its employees, officers,
directors, or agents. Notwithstanding the above, each party shall bear its own costs and
expenses required to comply with notification duties resulting from a breach of unsecured
PHI as set forth in 45 Code of Federal Regulations §§ 164.404, 164. 406, and 164,408,
with regard to Covered Entity, and as set forth in 45 Code of Federal Regulations §
164.410, with regard to Business Associate, and under comparable California law._...
6. Miscellaneous.
Applicable Law. This Agreement shall be governed by and construed in
accordance with the laws of the State of California.
b. Assignability. This Agreement and the rights, benefits, privileges, duties and
responsibilities of the parties hereto may not be assigned by any other party
hereto without the prior written consent of the parties hereto.
C. Availability of Counsel. All parties hereby acknowledge that they have read this
Agreement in its entirety and have, to the extent to which they deem necessary,
consulted with counsel before executing this Agreement.
d. Binding Nature of Agreement. This Agreement is binding upon and shall inure to
the benefit of the heirs, executors, successors and assigns of the parties hereto.
e. Complete Agreement. This Agreement constitutes the complete Agreement of
the parties regarding its subject matter and replaces and supersedes any prior
written or oral agreement between the parties regarding its subject matter.
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Confidentiality: Igoe Administrative Services will maintain the confidentiality of all
records and information obtained in conjunction with the services to be performed
hereunder. The information therein shall not be divulged or disclosed or made
available to persons, other than Client, without written approval of the Client or a
court of competent jurisdiction. This paragraph will survive the termination or
expiration of the Agreement.
g. Construction and Severability. The captions of this Agreement and its
paragraphs and subparagraphs are for the convenience of the parties only and
shall not be taken in account in the construction and interpretation of this
Agreement. All personal pronouns used in this Agreement, whether used in the
masculine, feminine or neuter gender, shall include all other gender, the singular
may include the plural, and vice versa as the context may require. The terms of
this Agreement are severable; should any portion of this Agreement be invalid or
unenforceable, such invalidity or unenforceability shall not affect the validity or
enforceability of the remainder of this Agreement and this Agreement shall be
construed and interpreted as though such invalid or unenforceable provision was
not contained herein.
Duplicates. This Agreement is executed in duplicate, each of which shall
constitute an original, but all of which together comprise but a single Agreement.
Independent Contractor: Igoe Administrative Services' relationship with Client is
that of independent contractor and nothing in this Agreement shall be construed
as creating the relationship of employer or employee between Client and officers,
employees, or agents of Igoe Administrative Services or the relationship of a
partnership or joint venture between the parties.
Modifications. This Agreement may not be modified or amended except by the
parties to this agreement by means of written modification or amendment of this
Agreement or their legal successors in interest. The Parties agree to take such
action as is necessary for Covered Entity to comply with the requirements of the
Privacy Rule and the Health Insurance Portability and Accountability Act, Public
Law 104-191.
k. Warranties. No representations or warranties have been provided by any party to
this Agreement or to any other party to this Agreement except as specifically set
forth in this Agreement.
Regulatory References: A reference in this Agreement to a section in the Privacy
Rule means the section as in effect or as amended, and for which compliance is
required.
M. Survival. The respective rights and obligations of Business Associate under
- - Section 3(b), 3(c) and 3(d) of this Agreement shall survive the terminationofthis - -
Agreement.
n. Interpretation. Any ambiguity in this Agreement shall be resolved in favor of a
meaning that permits Covered Entity to comply with the Privacy Rule.
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The parties to this Agreement consent and agree to all of its provisions and by their signature
cause this Agreement to become effective on the date first above written.
Client 1 Plan Sponsor (Client) on behalf of Covered Entity:
Bv:
Name:
Title:
Company: City of Vernon
Date:
Igoe Administrative Services I Business Associate:
By: /'L
er
Company: Igoe Administrative Services
Date: September 1, 2010
ATTEST:
Willard G.-,Yamaguchi,:City Clerk
APPROVED AS TO FORM:
Willard G. Yamaguchi, Interim
City Attorney
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EXHIBIT A - City of Vernon
COBRA Administration Fees (1) Twelve (12) Months Fee Guarantee
Rate Renewal Date: January 1, 2011
These fees do not apply to Clients with Cal Choice as their insurance carrier. lfyou are currently using Cal Choice as your insurance carrier, or plan
to switch to Cal Choice upon renewal, please contact our Business Development Department for an updated fee schedule
Base Monthly Fee Per QB Notice/Special Rights
Notice Fee
$75.00 $20.00
M Igoe Administrative Services will retain a 2%premium fee for each QB and family. Upon initial notification; the QB Fee" is chargedper
qualifying evendspecial rights notice issued. Should Igoe Administrative Services be required to re -issue the qualifying event/special
rights notice, an additional $10.00 fee will be charged.
(2) Download data must be formatted to match our software specifications. If additional work is required in order to complete the download,
additional expenses may apply.
ADMINISTRATIVE SERVICES PROVIDED
Special Rights Notification (Qualifying Event Notice)
INCLUDED
HIPAA Certificates (Certificate of Credible Coverage)
INCLUDED
COBRA Election Tracking
INCLUDED
COBRA Premium BillinglRemittance
INCLUDED
HR Online Access
INCLUDED
Qualified Beneficiary Online Access
INCLUDED
Processing of COBRA Open Enrollment (OE)
$25.00per renewing benefit plan "plus
These services include entering of new/changed benefits plans and rates; mailing letters to
$10.00 for each pending or active QB
COBRA participants Illustrating new/changed benefit plans and rates; generation of new
and family ($100 minimum)
coupons for all re -enrolled participants; and, processing of all enrollments, changes or
Postage expenses are included in the above
terminations.
fees,- however, additional charges may apply
for mailing of provider directories. $75/hr will
apply for the entry of rates associated with all
age -rated plans.
Dedicated Account Manager
INCLUDED.
Postage
INCLUDED
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OPTIONAL SERVICES
Sending of Initial DOUGeneral Rights Notices: $2.50 per Letter
Premium Remittance to Multiple Locations: Based on time required
Information Systems Programming/Consultation Based on time required
System Corrections Based on time required
If at any time during the plan year, should the total number of benefit covered employees decrease by 20% or more from the total
number of benefit covered employees at the time the Administrative Services Agreement was entered, Igoe Administrative Services
reserves the right to require Employer to pay all administrative fees, including the Qualified Beneficiary Fee ("QB" Fee), as
indicated in this Exhibit A, in advance of the performance of work set forth in the contract.
Fees for Mergers/Acquisitions will be determined based on the time required to complete said service and will be agreed to by both
parties prior to the performance of such services.
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t mh'-f*
December 22, 2010
IGOE Administrative Services
Attn: Michael C. Igoe, President/CEO
15090 Avenue of Science, Suite 201
San Diego, CA 92128
Re: COBRA Administrative Services Agreement
Dear Mr. Igoe:
Transmitted herewith is an original fully executed agreement as referenced above, approved by
City Council on December 20, 2010, through Resolution No. 2010-194.
If you have any questions regarding this matter, please contact me at (323) 583-8811 ext. 175.
truly
171
WILLARD G.
City Clerk
WGY:dj
Enclosure
c: Karina Rueda
Resolution No. 20 10- 194
Agreement No. 10-090
Ea cfusivefy Industrial
COBRA ADMINISTRATIVE SERVICES AGREEMENT
This Agreement is entered into effective as of January 1, 2011 (The Effective Datb), b-6tWe0n
City of Vernon (hereinafter referred to as "Client"), with principal offices at 4305 Santa Fe Avenue, City of
Vernon, State of California, and Igoe & Company Incorporated dba Igoe Administrative Services
(hereinafter referred to as "Igoe Administrative Services" or "Business Associate"), with principal offices at
15090 Avenue of Science, Suite 201, City of San Diego, State of California.
In consideration of the mutual covenants contained in this Agreement, Client and Igoe
Administrative Services agree as follows and that all terms and conditions contained within are in full force
and are not negotiable:
Client desires to have Igoe Administrative Services provide administrative and clerical
functions related to Client's compliance with Health Care Coverage Continuation under
the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), as amended.
2. In consideration for the fees and charges detailed below, Igoe Administrative Services
hereby agrees to perform said administrative and clerical functions subject to the following
terms and conditions:
a. The terms Administrative and Clerical Functions to be performed by Igoe
Administrative Services are defined as:
(1) Sending of notices to qualified beneficiaries (QBs) as required under
COBRA within the time required by law and with proof of mailing,
including without limitation (a) initial notification of all covered employees
and spouses of their continuation rights; (b) notification of coverage
continuation rights with election form; (c) notification of conversion rights
upon termination of group coverage when applicable; (d) notification of
coverage of continuation rights for subsequent qualifying events; (e)
notification of termination of COBRA continuation coverage for non-
payment of premium or at the end of any COBRA continuation period;
and (f) notice of unavailability of continuation coverage.
(2) Communicating with QBs regarding COBRA coverage.
(3) Collecting Premiums monthly from each QB.
(4) Reporting Premiums to Client and remitting premiums received minus all
applicable administrative fees each month to Client or Client's designee.
(5) Reporting enrollees to Client (courtesy copy sent to insurance carriers).
(6) Reporting terminations to Client.
(7) Sending DOL Notices (General Rights/New Hire Letters), as requested
by Client (additional fee will apply).
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(8) Sending HIPAA Certificates (included in notice).
(9) Maintain hard copy or electronic files of all notifications and
correspondence for seven years or longer if required by law.
(10) Communicate new premium rates to each QB upon open enrollment after
receiving such rate change notification from Client.
(11) Provide Client with copies upon request of all notifications,
correspondence, and other records in conjunction with the services
provided hereunder.
(12) Notify COBRA participants of their possible right to an additional
extension of benefits at 180 days and again at 90 days prior to
exhausting the statutory 18 months COBRA benefit eligibility, unless
otherwise requested in writing by the Client/Plan Sponsor.
b. The Administrative and Clerical functions do not include the amending and
republishing of the Client's plan document or booklets.
C. Igoe Administrative Services will provide COBRA Administrative forms as
applicable for Client's use. The forms are the sole proprietary property of Igoe
Administrative Services. Said form(s) may only be copied for Client's internal use
("internal use" includes transferring the forms to Client's employees and former
employees) and may not be communicated to, given to, or otherwise transferred
to any other person, corporation or entity, provided that Client may disclose such
forms where required by law.
d. In order for Igoe Administrative Services to perform under the terms of the
Agreement, Client agrees to be responsible for collection of the data necessary to
enable Igoe Administrative Services to comply with the provisions of COBRA.
Specifically, Client agrees to enter via Igoe's online system or download the QB
COBRA Qualifying Event information to Igoe Administrative Services within 30
days of the qualifying event or loss of coverage date (whichever is later), provided
that where the qualifying event is divorce, legal separation, or where a dependent
child ceases to be covered as a "dependent" Client agrees to notify Igoe
Administrative Services within 30 days of the date it is notified of such event.
e. Igoe Administrative Services agrees to comply with ongoing COBRA notice
requirements within fourteen (14) calendar days of receiving a Qualifying
Event/Special Rights information.
f. Igoe Administrative Services further agrees to account for collected premiums by:
(1) Placing collected premiums in an Igoe Administrative Services premium
fund account.
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(2) Providing Client with a report on or about the fifteenth (15th) of the month,
following a premium reporting month, which details premiums billed and
collected.
(3) Forwarding to Client, on or about the fifteenth (15th) of the month
following a premium reporting month, a check drawn on the Igoe
Administrative Services premium fund account for all net premiums
collected during the preceding premium reporting month. The premium
check shall be reduced by an amount equal to prior month's fees payable
to Igoe Administrative Services. If premiums collected are not sufficient
to pay Igoe Administrative Services fees, Igoe Administrative Services
will detail and bill the excess amount due to Client.
g. Igoe Administrative Services will report to Client on a monthly basis all new
COBRA enrollees (those who have elected to receive coverage) and all
terminations. Further, Igoe Administrative Services will provide courtesy
notification to Client's insurer or administrator. It is Client's responsibility to verify
that these additions and terminations were appropriately acted upon by Client's
insurer or administrator.
Igoe Administrative Services will advise Client of all law or regulation changes
affecting COBRA and will, by the required effective date, fully comply.
i. (1) Client will pay to Igoe Administrative Services administrative fees in
accordance with the COBRA Administrative Services Fee Schedule
which is included in the Administrative Services Agreement for the given
plan year. Client agrees to pay the administrative fees to Igoe
Administrative Services within ten (10) days of receipt of invoice. Failure
to pay fees within thirty (30) days of due date will result in Igoe
Administrative Services suspending all administrative services. While in
a suspension status, all services outlined in section 2(b) will cease and
be held in a pending status until such time payment for services has
been received. A fee of $250.00 must be paid in full for services to be
reinstated. If payment is not received thirty (30) days following the
suspension of services, Igoe Administrative Services will terminate this
Agreement in accordance with section 4(e), below. The Fee Schedule in
effect as of the Effective Date of this Agreement is set forth in Exhibit A
which is attached to this Agreement and made a part hereof.
(2) At any time during the period covered by this Agreement should the total
number of benefit covered employees decrease by 20% or more from
the total number of benefit covered employees at the time such
Agreement was entered, Igoe Administrative Services reserves the right
to _require __Client _to -pay all monthly_ administrative fees, including the - -
Qualified Beneficiary Fee ("QB" Fee), as indicated in Exhibit A, in
advance of the performance of work set forth in the contract.
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(3) Should Client, at any time during the coverage period of this Agreement,
file in the United States for the Debt Relief or Reorganization of any
type, all services from the date of the filling forward shall be terminated
immediately.
Igoe Administrative Services will use reasonable care and due diligence in the
performance of its responsibilities hereunder. Client agrees that Igoe
Administrative Services is not assuming the title and liabilities of Administrator or
Plan Administrator as defined by the COBRA or ERISA law. Client agrees that
this responsibility is, and remains, that of the Client.
k. Client agrees to accurately complete all necessary and pertinent data fields and
forward such data to Igoe via Igoe's online services or other approved electronic
data feed format. In the plan takeover process client may, with the approval of
Igoe, forward certain required data in paper format. Further, Client agrees that the
provision of this data will provide the basis of Igoe Administrative Services
Administrative actions under this Agreement. Changes to any data received may
only be made in writing and are only effective when acknowledged by Igoe
Administrative Services in writing.
Igoe Administrative Services will attend any audit or hearing held by a
government agency or bureau regarding compliance issues directly pertaining to
administration services performed by Igoe Administrative Services during the
term of this Agreement and will provide any and all requested documents in their
possession. This provision will survive the expiration or termination of this
Agreement.
Business Associate Contract Provisions.
a. Definitions. Terms used, but not otherwise defined, in this section shall have the
same meaning as those terms in 45 CFR §§ 160.103, 164.402, and 164,501. As
used below "Business Associate" refers to Igoe Administrative Services and
"Covered Entity" to Client.
b. Obligations and Activities of Business Associate in accordance with HIPAA
regulations regarding Protected Health Information (PHI) and Electronic
Protected Health Information (EPHI):
(1) Business Associate agrees to not use or further disclose Protected
Health Information other than as permitted or required by the Agreement
or as Required By Law.
(2) Business Associate agrees to use appropriate safeguards to prevent use
or disclosure of the Protected Health Information other than as provided
- - for by this -Agreement.
(3) Business Associate agrees to mitigate, to the extent practicable, any
harmful effect that is known to Business Associate of a use or disclosure
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of Protected Health Information by Business Associate in violation of the
requirements of this Agreement.
(4) Business Associate agrees to report to Covered Entity any use or
disclosure of the Protected Health Information not provided for by this
Agreement of which it becomes aware.
(5) Business Associate agrees to ensure that any agent, including a
subcontractor, to whom it provides Protected Health Information received
from, or created or received by Business Associate on behalf of Covered
Entity agrees to the same restrictions and conditions that apply through
this Agreement to Business Associate with respect to such information.
(6) Business Associate agrees to make internal practices, books, and
records relating to the use and disclosure of Protected Health Information
received from, or created or received by Business Associate on behalf of
Covered Entity available to the Covered Entity, or at the request of the
Covered Entity to the Secretary, in a time and manner designated by the
Covered Entity or the Secretary, for purposes of the Secretary
determining Covered Entity's compliance with the Privacy Rule.
(7) Business Associate agrees to document such disclosures of Protected
Health Information and information related to such disclosures as would
be required for Covered Entity to respond to a request by an Individual
for an accounting of disclosures of Protected Health Information in
accordance with 45 CFR §164.528.
8) Business Associate agrees to implement any and all administrative,
technical and physical safeguards necessary to reasonably and
appropriately protect the confidentiality, integrity and availability of
electronic Protected Health Information that it creates, receives,
maintains or transmits on behalf of Covered Entity,
9) Business Associate agrees to ensure that access to Electronic Protected
Health Information related to the Covered Entity is limited to those
workforce members who require such access because of their role or
function.
10) Business Associate agrees to implement safeguards to prevent its
workforce members who are not authorized to have access to such
Electronic Protected Health Information from obtaining access and to
otherwise ensure compliance by its workforce with the Security Rule.
- - - - - - - - - - - - 11) Business Associate -agrees --to ensure - that- any agent, including a - - -
subcontractor, to whom it provides Electronic Protected Health
Information received from, or created or received by Business Associate
on behalf of, Covered Entity agrees to the same restrictions and
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conditions that apply to Business Associate with respect to such
information.
12) Business Associate agrees to report to Covered Entity, in writing, any
security incident of which it becomes aware. Security incident shall
mean successful unauthorized access to, disclosure, modification or
destruction of, or interference with, the Electronic Protected Health
Information by a third party.
13) Upon request from Covered Entity, Business Associate agrees to provide
information to Covered Entity on unsuccessful unauthorized access, use,
disclosure, modification or destruction of the Electronic Protected Health
Information to the extent such information is available to Business
Associate.
14) As required by the Security Rule, Business Associate agrees to treat a
material breach of this Agreement as a breach of the Agreement and to
an early termination of the Agreement by Covered Entity.
c. Obligations and Activities of Business Associate in accordance with Section 13402(b)
of the Health Information Technology for Economic and Clinical Health Act of 2009
(the "HITECH Act"), and interim final regulations thereunder, as such provisions may
be amended from time to time or finalized:
(1) Business Associate will notify Covered Entity of any breach of unsecured
PHI pertaining to participants or dependents/beneficiaries in Covered
Entity's Plan occurring on or after September 23, 2009, to the extent
such breach becomes known to Business Associate or would have
become known to Business Associate through the exercise of reasonable
diligence. Business Associate will notify Covered Entity without
unreasonable delay and in no case later than 60 days following the
discovery of a breach. "Business Associate" for this limited purpose shall
include Business Associate's owners, officers, employees, and
independent contractors, with the exclusion of any individual responsible
for a breach.
(2) Business Associate will include in such notification, to the extent
possible, the identification of each individual whose unsecured PHI has
been, or is reasonably believed to have been, accessed, acquired, used
or disclosed during the breach.
(3) Business Associate will include in such notification any other available
information that the Covered Entity is required to include in its notification
to the individual pursuant to 45 Code of Federal Regulations §
164.404(c), promptly upon such information becoming available to
Business Associate.
(4) For purposes of this section, "breach"" is as defined at 45 Code of
Federal Regulations §164.402 including the exclusions set forth at
§164.402(2).
(5) For purposes of this section, "unsecured PHI" is as defined at 45 Code of
Federal Regulations §164.402.
d. Obligations and Activities of Business Associate in accordance with Section 1798.82
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of the California Civil Code
Except to the extent its obligation to do so is preempted by the provisions of the
Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), including
provisions of the HITECH Act, Business Associate shall notify Covered Entity of
any breach of unencrypted data owned or licensed by Covered Entity, and
maintained by Business Associate. "Breach" for these purposes means
acquisition of unencrypted data by an unauthorized person, or the reasonable
belief of such acquisition, that compromises the security, confidentiality, or
integrity of personal information consisting of medical or insurance information
pertaining to California residents, subject however to the good faith exception set
forth in Civil Code § 1798.82(d).
e. Permitted Uses and Disclosures by Business Associate. Except as otherwise
limited in this Agreement, Business Associate may use or disclose Protected
Health Information to perform functions, activities, or services for, or on behalf of,
Covered Entity as specified in the Administrative Services Agreement, provided
that such use or disclosure would not violate the Privacy Rule if done by Covered
Entity.
Obligations of Covered Entity. Plan Sponsor (Client) on behalf of Covered Entity
shall notify Business Associate of any restriction to the use or disclosure of
Protected Health Information that Covered Entity has agreed to in accordance
with 45 CFR 164.522, to the extent that such restriction may affect Business
Associate's use or disclosure of Protected Health Information.
g. Permissible Requests by Covered Entity. Plan Sponsor (Client) on behalf of
Covered Entity shall not request Business Associate to use or disclose Protected
Health Information in any manner that would not be permissible under the Privacy
Rule if done by Covered Entity.
4. Term and Termination
Term. This Agreement shall remain in place in perpetuity beginning on the effective
date as defined above. Administrative Fees set forth in Exhibit A are subject to
annual review by Contract Plan Administrative Firm. Igoe Administrative Services
must give notice to Company regarding any change in fees at least sixty (60) days
prior to the rate effective date defined in Exhibit A. If Company or Igoe
Administrative Services does not desire to renew, the terminating party must give the
non -terminating party written notice sixty (60) days prior to the expiration of this
Agreement of their intent not the renew said Agreement.
b. Early Termination by Client Without Cause. If at any time the client wishes to
terminate the COBRA services without cause a -sixty (60) day-writterrnoticemust-be -
given to Igoe Administrative Services by the Client. Within ten days of termination,
and upon Client's written request, Igoe Administrative Services will provide Client with
a status report of each of the qualified beneficiaries who were subject to this
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Agreement, including all details necessary to transfer responsibility to the new
administrator.
c. Early Termination by Client With Cause. Upon Client's knowledge of a material
breach by Igoe Administrative Services of its duties under this Agreement, above,
Client shall either: (i) provide an opportunity for Igoe Administrative Services
to cure the breach or end the violation or, if Igoe Administrative Services does not
cure the breach or end the violation within the time specified by Client, terminate this
Agreement and , the Business Associate Agreement provisions thereof; or (ii)
immediately terminate this Agreement and the Business Associate Agreement
provisions thereof if Igoe Administrative Services has breached a material term of this
Agreement and cure is not possible.
d. Early Termination by Igoe Administrative Services. If Igoe Administrative Services
suspends services for nonpayment in accordance with section 2(i)(1), above, and
payment is not received thirty (30) days following the suspension of services, Igoe
Administrative Services will terminate this Agreement effective immediately.
e. Effect of Termination on HIPAA Responsibilities. As used below "Business Associate"
refers to Igoe Administrative Services and "Covered Entity" to Client.
(1) Except as provided in paragraph (2) of this section, upon termination of
this Agreement, for any reason, Business Associate shall return or destroy all
Protected Health Information received from Covered Entity, or created or
received by Business Associate on behalf of Covered Entity. This provision
shall apply to Protected Health Information that is in the possession of
subcontractors or agents of Business Associate. Business Associate shall
retain no copies of the Protected Health Information. For purposes of this
section, "destruction" of unsecured PHI shall comply with guidelines
published on April 27, 2009 by the Department of Health and Human
Services, as modified by the Department in the preamble to interim final
regulations on breach notification for unsecured PHI (74 Federal Register
162 (August 24, 2009), pp. 42741-42743.
(2) In the event that Business Associate determines that returning or
destroying the Protected Health Information is infeasible, Business Associate
shall provide to Covered Entity notification of the conditions that make return
or destruction infeasible. Upon mutual agreement of the Parties that return or
destruction of Protected Health Information is infeasible, Business Associate
shall extend the protections of this Agreement to such Protected Health
Information and limit further uses and disclosures of such Protected Health
Information to those purposes that make the return or destruction infeasible,
for so long as Business Associate maintains such Protected Health
Information.
(3) Term. The Term of the Business Associate Contract Provisions of this
Agreement shall be effective upon your signature, and shall terminate when
- - - - - - all of the -Protected- Health Informationprovidedby Covered Entity- to - - -
Business Associate, or created or received by Business Associate on behalf
of Covered Entity, is destroyed or returned to Covered Entity, or, if it is
infeasible to return or destroy Protected Health Information, protections are
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extended to such information, in accordance with the termination provisions
in this Section.
f. Venue in the Event of Legal Dispute. Should either party institute legal action to
enforce its rights under this Agreement, the venue shall be in San Diego County,
State of California, and the prevailing party in such action shall be entitled to recover
reasonable attorney's fees and costs.
Indemnity: Igoe Administrative Services shall indemnify, defend and hold harmless
Client, its affiliates, directors, officers and employees or any of them from any claim,
expense, loss, damage, settlement, judgment, penalty and liability, including reasonable
attorneys' fees and court costs (individually and collectively, "Claims") resulting in any way
from or arising out of Igoe Administrative Services' performance of or failure to perform
this Agreement, including, without limitation, Claims resulting from or arising out of acts or
omissions by Igoe Administrative Services, it's employees, officers, directors, agents, or
other individuals who provide services under this Agreement. Client shall indemnify,
defend and hold harmless Igoe Administrative Services, its affiliates, directors, officers
and employees or any of them from any claim, expense, loss, damage, settlement,
judgment, penalty and liability, including reasonable attorneys' fees and court costs
(individually and collectively, "Claims") resulting in any way from or arising out of Client's
performance of or failure to perform this Agreement, including, without limitation, Claims
resulting from or arising out of acts or omissions by Client, its employees, officers,
directors, or agents. Notwithstanding the above, each party shall bear its own costs and
expenses required to comply with notification duties resulting from a breach of unsecured
PHI as set forth in 45 Code of Federal Regulations §§ 164.404, 164. 406, and 164.408,
with regard to Covered Entity, and as set forth in 45 Code of Federal Regulations §
164.410, with regard to Business Associate, and under comparable California law., ,
6. Miscellaneous.
Applicable Law. This Agreement shall be governed by and construed in
accordance with the laws of the State of California.
Assignability. This Agreement and the rights, benefits, privileges, duties and
responsibilities of the parties hereto may not be assigned by any other party
hereto without the prior written consent of the parties hereto.
Availability of Counsel. All parties hereby acknowledge that they have read this
Agreement in its entirety and have, to the extent to which they deem necessary,
consulted with counsel before executing this Agreement.
d. Binding Nature of Agreement. This Agreement is binding upon and shall inure to
the benefit of the heirs, executors, successors and assigns of the parties hereto.
e. Complete Agreement. This Agreement constitutes the complete Agreement of
the parties regarding its subject matter and replaces and supersedes any prior
written or oral agreement between the parties regarding its subject matter.
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Confidentiality: Igoe Administrative Services will maintain the confidentiality of all
records and information obtained in conjunction with the services to be performed
hereunder. The information therein shall not be divulged or disclosed or made
available to persons, other than Client, without written approval of the Client or a
court of competent jurisdiction. This paragraph will survive the termination or
expiration of the Agreement.
g. Construction and Severability. The captions of this Agreement and its
paragraphs and subparagraphs are for the convenience of the parties only and
shall not be taken in account in the construction and interpretation of this
Agreement. All personal pronouns used in this Agreement, whether used in the
masculine, feminine or neuter gender, shall include all other gender, the singular
may include the plural, and vice versa as the context may require. The terms of
this Agreement are severable; should any portion of this Agreement be invalid or
unenforceable, such invalidity or unenforceability shall not affect the validity or
enforceability of the remainder of this Agreement and this Agreement shall be
construed and interpreted as though such invalid or unenforceable provision was
not contained herein.
h. Duplicates. This Agreement is executed in duplicate, each of which shall
constitute an original, but all of which together comprise but a single Agreement.
Independent Contractor: Igoe Administrative Services' relationship with Client is
that of independent contractor and nothing in this Agreement shall be construed
as creating the relationship of employer or employee between Client and officers,
employees, or agents of Igoe Administrative Services or the relationship of a
partnership or joint venture between the parties.
Modifications. This Agreement may not be modified or amended except by the
parties to this agreement by means of written modification or amendment of this
Agreement or their legal successors in interest. The Parties agree to take such
action as is necessary for Covered Entity to comply with the requirements of the
Privacy Rule and the Health Insurance Portability and Accountability Act, Public
Law 104-191.
k. Warranties. No representations or warranties have been provided by any party to
this Agreement or to any other party to this Agreement except as specifically set
forth in this Agreement.
Regulatory References: A reference in this Agreement to a section in the Privacy
Rule means the section as in effect or as amended, and for which compliance is
required.
M. Survival. The respective rights and obligations of Business Associate under
- - - - -- - -- - -Section 3(b), 3(c) and of this Agreement shall survive the termination. of this
Agreement.
n. Interpretation. Any ambiguity in this Agreement shall be resolved in favor of a
meaning that permits Covered Entity to comply with the Privacy Rule.
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The parties to this Agreement consent and agree to all of its provisions and by their signature
cause this Agreement to become effective on the date first above written.
Client 1 Plan Sponsor (Client) on behalf of Covered Entity:
By:���
EST:
Name: Hilario Gonzales
Title: IdYia/ W llard G m gu i, . City ClerkIq -
ROVE F RM:
Company: City of Vernon ,
Date: /�� Willard G. ag chi I terim
ity Attorney
Igoe Administrative Services 1 Business Associate:
Michael i . loo
a r'
Company: Igoe Administrative Services
Date: September 1, 2010
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EXHIBIT A
EXHIBIT A - City of Vernon
COBRA Administration Fees (t) Twelve (12) Months Fee Guarantee
Rate Renewal Date: January 1, 2011
These fees do not apply to Clients with Cal Choice as their insurance carrier. If you are currently using Cal Choice as your insurance carrier, or plan
to switch to Cal Choice upon renewal, please contact our Business Development Department for an updated fee schedule
Base Monthly Fee Per QB Notice/Special Rights
Notice Fee
$75.00 $20.00
(')Igoe Administrative Services will retain a 2% premium fee for each QB and fami/y Upon initial notification, the "QB Fee" is charged per
qualifying event/special rights notice issued. Should Igoe Administrative Services be required to re -issue the qualifying event/special
rights notice, an additional $ I0.00 fee will be charged.
(2) Download data must be formatted to match our software specifications. If additional work is required in order to complete the download,
additional expenses may apply.
ADMINISTRATIVE SERVICES PROVIDED
Special Rights Notification (Qualifying Event Notice)
INCLUDED
HIPAA Certificates (Certificate of Credible Coverage)
INCLUDED
COBRA Election Tracking
INCLUDED
COBRA Premium Billing/Remittance
INCLUDED
HR Online Access
INCLUDED
Qualified Beneficiary Online Access
INCLUDED
Processing of COBRA Open Enrollment (OE)
$25. 00 per renewing benefitplan—plus
These services include entering of new/changed benefits plans and rates; mailing letters to
$10.00 for each pending oractive QB
and family ($100 minimum)
COBRA participants Illustrating new/changed benefit plans and rates; generation of new
coupons for all re -enrolled participants; and, processing of all enrollments, changes or
Postage expenses are included in the above
terminations.
fees; however, additional charges may apply
for mailing of provider directories. $75/hr will
apply for the entry of rates associated with all
age -rated plans.
Dedicated Account Manager
INCLUDED.
Postage
INCLUDED
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OPTIONAL SERVICES
Sending of Initial DOLIGeneral Rights Notices:
Premium Remittance to Multiple Locations:
Information Systems Programming/Consultation
System Corrections
$2.50 per Letter
Based on time required
Based on time required
Based on time required
If at any time during the plan year, should the total number of benefit covered employees decrease by 20% or more from the total
number of benefit covered employees at the time the Administrative Services Agreement was entered, Igoe Administrative Services
reserves the right to require Employer to pay all administrative fees, including the Qualified Beneficiary Fee ("QB" Fee), as
indicated in this Exhibit A, in advance of the performance of work set forth in the contract.
Fees for Mergers/Acquisitions will be determined based on the time required to complete said service and will be agreed to by both
parties prior to the performance of such services.
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Document Generated on September 1, 2010
STAFF REPORT
Risk Management
DATE: December 14, 2010
TO: Honorable Mayor and City Council
FROM: Willard G. Yamaguchi, Risk Manager
RE: Igoe Administrative Services
COBRA Services Agreement
RECEIVED
DEC 1 4 2010
CITY CLERK'S OFFICE
Igoe Administrative Services provides administrative and clerical functions related to the City's
compliance with health care continuation under the Consolidated Omnibus Budget
Reconciliation Act (COBRA) of 1985.
The base monthly fee is $75, plus additional costs for letters and notices as needed. The total
cost for FY 2009-2010, was $2,781.76.
Recommendation
It is hereby recommended that the attached COBRA Administrative Services Agreement with
Igoe Administrative Services be approved effective January 1, 2011, for the City's
administration of the COBRA plan.