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Home My WebLink AboutPSA - North American Administrators - Services for Flexible Benefit Plans and Processing of Claims for Medical Reimbursement1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND. INDIANA 46601-1830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS February 28, 2017 Melissa Davis North American Administrators 1826 Elm Hill Pike Nashville, TN 37210 RE: Professional Services Agreement Dear Ms. Davis: PHONE 574/235-9251 FAx 574/235-9171 The Board of Public Works, at its meeting held on February 28, 2017, approved the above referenced agreement to provide services for the flexible benefit plans and process claims for medical reimbursement and dependent care in the amount of $3.55 per eligible employee per month plus a $300 initial document fee. Enclosed please find a copy of the agreement for your records. If you have any further questions regarding this matter, please call this office at (574) 235- 9251. Sincerely, Linda M. Martin, Clerk Enclosure c: Tierra Davis, Human Resources Chris Villaire, Human Resources John Murphy, Administration & Finance Jen Hockenhull, Administration & Finance GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JANES A. MUELLER THERESE J. DORAU 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 Employer for set up of database and employee education. This fee is paid upon execution of this agreement. (c) An initial document fee for drafting the Plan Document and Summary Plan Description is as follows. Any amendments to the documents are charged separately and additionally as incurred. (i) Plan Document - $250.00 (ii) Master Summary Plan Description - $50.00 NOTE: North America Administrators, L.P. prepares the documents required by the Employer for review and approval by an attorney. NAA is not in the practice of Law, nor intends to enter the practice of Law. (d) A $300.00 annual fee is to be paid by the Employer for filing with the Department of Labor and 5500 IRS form for the Plan (if requested). (e) A $2.00 per document fee for summary plan description printing (if requested). (f) Other fees incurred per 1(c). 4. Liability and Indemnity: Employer is contracting with North America Administrators, L.P. ("NAA") exclusively for the services listed above. NAA does not receive premiums under this Agreement, insure the plans or underwrite the liability of the Employer under the Plan. The Employer retains the ultimate responsibility for claims made under the Plan except as specifically assumed in this agreement by North America Administrators, L.P. ("NAA"). 5. Amendment or Cancellation or Modification: The term of this agreement shall be January 1, 2017 through December 31, 2017. This agreement may be amended at any time by mutual agreement as reflected in writing signed by both parties hereto. Either party may cancel this agreement by giving sixty (60) days written notice to the other party; however, cancellation shall not be effective prior to the end of the then current plan year. In the event of cancellation of this agreement, NAA agrees to the continuation of the Plan's administration for claims incurred prior to the cancellation date, for a period of thirty (30) days following the effective date of cancellation. The administrative fee shall be the fee enforce as of the date of cancellation. This agreement may be modified only by mutual agreement of the parties, CITY OF SOUTH BEND and North America Administrators, L.P., in writing. 6. Entirety of Agreement: All negotiations whether oral or written, are merged into this agreement when executed by the agreeing parties, CITY OF SOUTH BEND and North America Administrators, L.P. This agreement contains the entire understanding of the parties with respect to this Administrative Service Agreement. 7. Confidentiality: North America Administrators, L.P. agrees to keep confidential all information concerning the Employer, its affiliates and employees, covered employees and beneficiaries that it acquired in connection with the performance of its services hereunder except where disclosure is required by Federal or State Law. 8. Severability: If any part of this Agreement is held to be void as against public policy, or illegal, or unenforceable for any reason, the balance of this Agreement shall continue to be valid and binding on the parties hereto. 9. Hold Harmless: NAA may rely on all information appearing proper on its face furnished to it by the Employer, and shall have no duty to verify any such information independently. NAA shall have no liability for the erroneous payment, in good faith, of claims. The Employer agrees to indemnify, hold harmless and defend NAA for any acts or omissions of NAA not caused by gross negligence, willful misconduct or lack of good faith or want of reasonable and ordinary care. In the event of any litigation relating to NAA's duties as set forth in the agreement, NAA will be entitled to recover from the Employer all reasonable attorney's fees and other reasonable costs incurred. The Employer will indemnify and hold harmless NAA, its officers, directors, representatives, agents and successors or assigns from any and all actions, causes of action, claims demands, liabilities, damages, costs and expenses, including reasonable attorney fees, which be in existence at any time, including those which may arise after termination and which arise out of the payment or declination of claims or processing of claims. 10. Breach or Default: Should either party breach any part or all of this Agreement, or default upon any or all of its obligations under this Agreement, the party at fault agrees to pay all costs including attorney fees under this Agreement for damages resulting from such breach or default This contract has been executed in South Bend (City), Indiana (State) this 1st day of January 2017 by the duly authorized officers of North America Administrators, L.P. and CITY OF SOUTH BEND. This agreement shall be governed in accordance with the laws of the State of Indiana. A copy of this contract was delivered to North America Administrators, L.P. this 1st day of January 2017, at Nashville, Tennessee. NORTH AMERICA ADMINISTRATORS, L.P. CITY OF SOUTH BEND By: Daniel 1. Du a By: (Please t�'prO�WP4Q��Pu Signature: Signature: Wn pltq +' t Tide: Pre - Title: - L. L NORTH AMERICA ADMINISTRATORS, L.P.__� NASHVIL•I E, TENNESSEE BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 02/10/2017 Name Tierra Davis Department Admin & Finance BPW Date 02/28/2017 Phone Extension 5510 Required Prior to Submittal to Board id Legal ® Attorney Name Michael Schmidt Controller ® Controller review is required for all Contracts $5,000.00 or more and greater than one year in length per the City Purchasing Policy Purchasing Check the Appropriate Item Type — Required for All Submissions ® Agreement ❑ Contract ❑ Proposal ❑ Addendum ® Professional Services ❑ Resolution ❑ Bid Opening ❑ Bid Award ❑ Req. to Advertise ❑ Title Sheet ❑ Quote Opening ❑ Quote Award ❑ Change Order No. ❑ C/O & PCA No. ❑ PCA ❑ Ease/Encroach. ❑ Traffic Control I-1 Other: Company or Vendor Name NORTH AMERICAN ADMINISTRATORS, L.P. New Vendor ❑ Yes ® No ❑ If Yes, Approved by Purchasing MBE/WBE Contractor ❑ MBE ❑ WBE MBE/WBE Contractor Requested ❑ No ❑ Yes Name of Company Project Name Flexible Benefit Plan Project Number Funding Source Claims Administration Account No. 711-0401-671-34-18 Amount $3.55 per eligible employee per month and a $300 initial document fee. Terms of Contract Fee is to be paid monthly. Purpose/Description NAA will provide services in respect to the Flexible Benefit Plans. NAA will process claims for medical reimbursement and dependent care. ® Required Contractor's Certification Form Attached (Non - Amount of Required For Chanqe Orders Only I Increase Decrease Previous Amount Current Percent of Change: New Amount Total Percent of Change: Copy Original ® ❑ John M Dispersal After Approval , Christine Villaire, Jennifer Hockenhull, Tierra Davis