PSA - North American Administrators - Services for Flexible Benefit Plans and Processing of Claims for Medical Reimbursement

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FLEXIBLE BENEFIT PLAN ADMINISTRATIVE SERVICE AGREEMENT This agreement is made and entered into as of this 1st day of January 2017, by CITY OF SOUTH BEND ("Employer"), and NORTH AMERICA ADMINISTRATORS, L.P., ("NAA!'). The purpose of this agreement is to set forth the basis on which NAA is to provide services with respect to the Employer's Flexible Benefit Plan ("Plan") beginning January 2017, ("Effective Date"), in consideration of payment by the Employer to NAA of the fee prescribed here below, and the performance by the Employer of the obligations described in this agreement. 1. NAA shall: (a) Track each eligible employee's transactions based on documents furnished by the Employer each month. (b) Provide reports as needed to assist in administering the Employer's Plan. (c) Have the right to retain outside services at cost whenever necessary. (d) Provide forms necessary to administer the Plan. (e) Provide monthly audit reports, quarterly reports, annual reports, and aggregate discrimination compliance reports. (f) Process claims for medical reimbursement or dependent care as consistent with the applicable laws governing such distributions including run -out claims for each prior year the contract was in effect, if not terminated. 2. Employer shall: (a) Furnish documents representing transactions for the month for each eligible employee to NAA on a monthly basis. (b) Fully comply with all I.R.S. requirements under Section 125 of the Internal Revenue Code and do nothing to cause the Plan to fail to qualify under Section 125 of the Internal Revenue Code. (c) To the extent the Plan requires contributions and/or expenses by the Employer, pay such items timely and in accordance with the terms of the Plan. (d)Perform all functions necessary to maintain the Plan in compliance with the Employee Retirement Income Security Act of 1974. (e) Provide education and enrollment time for the 125 Plan for participants during ordinary business hours of the Employer. 3. Reimbursement and Fees: Employer shall pay North America Administrators, L.P. a fee for services as follows: (a) A $3.55 per month fee to be paid on all eligible employees participating on the Premium Plus Plan effective date. This fee is to be paid monthly from the time the employee becomes eligible until the end of the plan year during which employment termination occurs or upon termination of the Plan. (b) A $WAIVED initial enrollment fee per participating employee is to be paid by the