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Agreement, City & Delta Dental ~ ",t 'bo."'<I' CITY OF DUBUQUE, IOWA MEMORANDUM March 29, 2000 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Administrative Services and Financial Agreement between City of Dubuque and Delta Dental of Iowa Personnel Manager Randy Peck is recommending approval of an Administrative Services and Financial Agreement between the City of Dubuque and Delta Dental of Iowa. I concur with the recommendation and respectfully request Mayor and City Council approval. ¡1t,Ji ~71% ç2 - M~hael C. Van Milligen MCVM/dd Attachment cc: Barry Lindahl, Corporation Counsel Tim Moerman, Assistant City Manager Randy Peck, Personnel Manager \-fI '::\n'cnqn¡J V',on /~\~ 8')\\;OJ,-" .. 60 :S Hd O£ t\~\4 00 03N=J:J3B {;~r,¿~ c2j uvnP?t~ zJ -/~ /dL /¿/f#o ~ ",t 'bo.'" CITY OF DUBUQUE, IOWA MEMORANDUM March 21, 2000 TO: Michael C. Van Milligen City Manager Randy Peck \'7 ') Personnel Manager ~ J FROM: SUBJECT: Administrative Services and Financial Agreement between the City of Dubuque and Delta Dental Plan of Iowa On March 8, 2000, I received the attached Administrative Services and Financial Agreement between the City of Dubuque and Delta Dental Plan of Iowa for services related to the administration of the City's dental plan. The effective date of this agreement is July 1, 1999. The administrative fee for processing dental claims increased from $2.45 per contract per month to $2.56 per contract per month. This rate went into effect on July 1, 1999, and will remain in effect through June 30, 2000. The rate was approved by the Health Care Committee on April 30, 1999. This agreement has been reviewed by corporation counsel, Barry Lindahl, and the Segal Company, our benefit and actuarial consultant, and they found the terms to be acceptable. The Health Care Committee has also approved the agreement. On behalf of the Health Care Committee, I request that the City Council approve a motion authorizing you to sign the agreement. If you have any questions, please feel free to call. cc: Health Care Committee ADMINISTRATIVE SERVICES and FINANCIAL AGREEMENT THIS AGREEMENT is by and between Delta Dental Plan oflowa (Delta), and City of Dubuque (Employer). Group name A. WHEREAS, the following circumstances exist: Delta is a nonprofit corporation authorized by the Comntissioner of Insurance for the slate of Iowa to transacl business as a dental service plan. B. Employer desires to create or has established a dental benefits plan for its eligible Employees, Employer desires to enter into a fmancial arrangemenl with Delta under which Employer is solely responsible for the Claims Paid for covered dental services provided to its Members subject to the lirnilalion on Employer's fmancialliabiJity sel forth in the stop loss coverage provisions of this Agreement. c. D, Employer desires that Delta pay claims for dental services furnished to Members and provide other adntinistrative services. NOW, THEREFORE, in consideralion of the mutual promises and covenants hereinafter set forth, it is hereby agreed as follows: I. Definitions. a. "Administrative Fee" means either an amount per contract or a percentage of Claims Paid, whichever is applicable, that Delta charges the Employer and which includes allocations for Delta's cost of administering Employer's plan and general operating costs. The Administrative Fee during the Contracl Period is stated in the Schedule of Fees attached to this Agreement. b, "Administrative Services" means those services 10 be performed by Della for Employer in connection with this Agreement, including, but not limited to the following: claims processing, customer services, accounting services, actuarial services, enrollment services, data processing services, and such other related services as the parties may agree are appropriate and necessary 10 accomplish the objectives of this Agreement. Adntinistralive Services expressly excludes any services for the administration of continued dental coverage pursuant to the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), as amended, or any state or federal law relating to continuation coverage of the Employer's plan. c, "Agreement" means this Adntinistrative Services and Financial Agreement, Group Application, Schedule of Fees attached to it initially and as such may be revised or amended, the Benefits Certificate(s), and the Subscribers' names and/or applications for coverage, d, "Benefits Certifieate" means the written document(s) which describe and defme a welfare benefit plan for dental services which the Employer established for its Members. e. "Claims" means claims for dental services that are furnished to Members with a date of service as defined in the Schedule of Fees as Claims Eligible for Payment. f. "Claims Paid" means the amount calculated by deducting from the Covered Charges any amounts attributable to Provider Savings, deductibles, copayment, coinsurance, or Contract Limitations as deemed in the Benefits Certificate(s), The amount of Claims Paid during the Contract Period is determined by the date of Delta's check orremitlance. g. "Contract Limitations" means the amounts which are the liability of the Subscriber under this Agreement, These include the services which are not covered, charges for dental services which are nol dentally necessary, penalties for failure to follow notification requirements, and charges for services that have reached a contract maximum, h. "Contract Period" means the period of time set forth in the Schedule of Fees or the most recent revision to the Schedule of Fees, i, "Covered Charges" means the amount a provider bills a Member. or Delta, less services not covered. Services which are covered are those dentally necessary and dentally appropriate procedures as outlined in the Benefits Section of the Benefits Certificate(s). j. "Delta Allowance" means the amount which equals the lesser of the Covered Charge for a service, supply, or any dental procedure covered under the dental plan or an amount which Delta establishes, annually, as its maximum allowable fee for the same service or supply. For all dental procedures covered under the plan, the maximum allowable fee is established by Delta Dental Plan of Iowa for a covered dental procedure that is dentally necessary and dentally appropriate. It is developed from various sources, such as contracts with dentists, input from our dentist consultants, the simplicity or complexity of the procedure, and the billed charge for the same procedures by dentists in Iowa. For services billed by providers outside of Iowa, the maximum allowable fee is based on information from that state's Delta Plan, k. "Employee" means an active Employee of Employer forpnrposes of Social Security laws or who otherwise is included as an Employee as required by law (or a member of the Board of Directors of an Employer). I. "Incurred Date" means the date dental services are provided, With regard to inpalient hospital or facility services, the dale of admission is the Incurred Dale, m, "Member" means any person entitled to receive dental benefits as deemed in the Benefits Certificate(s). n. "Provider Savings" means the amount saved due to our contracts with providers. It is calculated as the difference between the Covered Charge and the Delta Allowance. 2 o. "Subscriber" means any individual identified by Employer as a person eligible for dental coverage subjecl to the terms, conditions and limitations described in the Benefits Certificate(s) and who is named on an identification card issued by Delta, 2. Responsihilities of Employer. a, Furnishing Information. Employer agrees to furnish Delta with timely reports and information in a form and manner required by Delta so that Delta properly may discharge its responsibilities under this Agreement, including bur not limited to, information pertaining to Members for the pnrpose of detennining eligibility for coverage under the Benefits Certificate(s), and information necessary for the proper administration of coordination of benefits and other limitations and exclusions contained in the Benefils Certificate(s). b. Persons Eligible for Coverage. Prior to the Effective Date of this Agreement, Employer shall deliver to Delta a list of the names and/or completed applications for each person that Employer shall designate as being eligible for benefits set forth in the Benefits Certificate(s), On or before the flfSI of each month thereafter Employer shall notify Delta in writing of those persons who are no longer eligible as of that month, and thereafter Delta shall not pay Claims for services furnished such persons on or after the date of termination. At any lime during the Contract Period, Employer may certify to Delta the names of additional eligible persons. Delta shall, from and after the commencement date of coverage Delta eslablishes for such person, pay Claims with Incurred Dates on or after the effective date of coverage in accordance with the terms and conditions set forth in this Agreement. c. Failure to Provide Information. Employer's failure to provide timely and accurate information may cause Delta to make incorrect payments. In that event, Employer may be liable for all or part of any incorrect payments made. 3. Payment of Claims and Administrative Fee. Employer authorizes Delta and Delta agrees to process Claims on a regular basis, subject to the limitations, conditions, and exclusions stated in the Benefits Certificate(s). Employer will pay or reimburse Delta for the Claims Paid and Adntinistrative Fee as set forth in this paragraph. a. Monthly Payment Delta will bill Employer by the twentieth (2rJh) calendar day of each month. The bill will show the amount of Claims and Administrative Feefor the preceding month. Employer shall promptly pay Delta at Delta's office the total shown within ten (10) days from receipt of the bill, and in any event, no later than the last calendar day of the month. /fthe due date falls on a weekend or holiday. payment is due the preceding business day, 4, Late Payments. All payments must be paid on time in accordance with paragraph 3, If the Employer fails to make timely payments in full. Delta may, at its option, immediately stop the payment of all claims for the Employer's Members, regardless of the Incurred Date and may terminate this Agreement retroactively to the last day of the month for which full payment was made without any further notice. Payments not made when due also will be subjecllo an interest charge at the then prevailing prime rate plus two percent (2%) per annum, The acceptance by Delta of any late paymenls or partial payments shall not constitute a waiver of this provision. 5, Examination of Books and Records. a, Delta may examine the fmancial records of Employer reasonably related to the adntinistration of this Agreement, upon reasonable nolice, as often as Delta deems appropriate, to determine whether Employer has sufficient amounts on deposit to ensure payment of Claims and Administrative Fee. b. Employer or its authorized representative may exantine or audit Delta's records reasonably related to Delta's discharge of Employer's liability to pay Claims, Such exantination shall be conducted during regular business hours, upon reasonable advance written notice. Records subject to exantination shall include case listings, third-party explanations of dental benefils, eligibility records, claims history, and coordination of benefits procedures, The examination period may cover the current Contract Period and the two years previous only. Upon completion of the exantination, Employer shall share its exantination fmdings with Delta and conduct an exit conference with Delta. c, It is agreed that disclosure of any information under this paragraph to Employer or Delta has been made in reliance upon the other party's representation that such information shall be used by it for the sole and exclusive purpose of examining or auditing information related to the administration of the dental plan. Such information shall not be disclosed or otherwise made available to any person or organization not directly involved in the exantination or audit and Delta and Employer shall implement whatever reasonable safeguards are necessary to ensure that such informalion remains confidential, subject to the Iowa Public Records Act, Iowa Code chapter 22. 6, Change of Agreement. a. Delta will provide Employer ninety (90) days prior written notice of any amendment or termination under this paragraph. b. Changes to this Adntinistrative Services and Financial Agreement or Benefits Certificate(s) will be effective only when the written amendment has been signed by authorized representatives of Delta and the Employer. 7, Liabilities of the Parties. a, Employer has the liability for all Claims payments for its Members, Delta has no liability for Claims if Employer fails to payor reimburse Delta in accordance with this Agreement. Employer agrees to hold harmless and indemnify Delta or any of its directors, officers, or employees for any and all loss, liability, damage, expense, or other cost or obligation, including reasonable attorneys' fees, resulting from and arising out of claims, demands, or lawsuits brought against Delta by Members, or other persons by reason of the performance or nonperformance of Employer's responsibilities under this Agreement, or 4 in connection with benefits or coverage information disclosed at Employer's request or disclosed during an examination or audit of books and records, provided the directors, officers, or employees of Delta shall have performed their duties with ordinary care and such directors, officers, or employees of Delta shall not be liable for any mistake of judgement or other action taken in good faith. Delta has made a good faith determination of what the premium tax liability shall be under this Agreement based upon Iowa Code Chapter 432, If the governmental authority responsible for collecting such taxes determines thaI additional taxes should have been assessed for the charges collected by Delta under this Agreement, the Employer agrees to indemnify Delta for such liability, b. Delta agrees to hold harmless and indemnify Employer or any of its directors, officers, or employees for any and all loss, liability, damage, expense, or other cost or obligation, including reasonable attorneys' fees, resulting from and arising out of claims, demands, or lawsuils brought against Employer by reasons of Delta's failure to perform its responsibilities under this Agreement (or policy), 8, Use of Trademarks. Delta and Employer reserve the righl to control the use of their respective corporate names and any other respective symbols, assumed names, trademarks, and service marks, presently existing or subsequently established. Delta and Employer agree not to use the corporate name, symbol, assumed names, trademarks, or service marks of the other in advertising, promotional material, or otherwise without the prior written consent of the other. Any previously approved usage will cease inunediately upon the termination of this Agreement and any materials using such names or marks are the property of the appropriate namesake and will be returned to the appropriate property owner upon request or at the lermination of this Agreement. 9. Term and Termination. a, Term and Notice of Termination. This Agreement shall become effective on the date deemed on the Schedule of Fees and shall continue in force for the time period deemed in the Schedule of Fees, However, either party may terminate this Agreement at any time by giving written notice of termination delivered to the other party alleast sixty (60) days in advance of the effective date of termination, b, Renewal Terms. The parties may agree to renew the Agreement for successive Contract Periods as defined in the Schedule of Fees, Delta may change Administrative Fee, stop loss premiums and other fmancial faclors upon renewal. c. Immediate Termination. Delta may terminate this Agreemenl at any time without notice if Employer fails to make timely and complete payments in accordance with this Agreement, or Delta determines thaI the Employer has inadequate funds 10 make payments required by this Agreement, Delta may terminate the Agreement retroactively to the last day of the month for which Employer made full payment. Employer is solely responsible for notifYing its Subscribers of the termination of this Agreement for nonpayment or for any other reason, d, Effects of Termination. If Delta terminates this Agreement for nonpayment by the Employer, Delta will not pay any Claims beyond the effective date of the termination regardless of when the services were received, Any liability of either party to the other for amounts owed or owing, or for indemnification for premium taxes under this Agreement shall nol be extinguished by the termination of this Agreement. 10, Termination and Claims Payments. If, following termination of this Agreement for reasons other than Employer's nonpayment, Claims for the most recent Contract Period are submitted to Delta for payment in the period specified in the Benefits Certificate(s) for timely filing of claims, Delta will pay claims in accordance with this Agreement and bill Employer in accordance with the procedures set forth in paragraph 4 above, II. Force Majeure. The parties to this Agreement shall be excused from performance under this Agreemenl for any period during which they are prevented from performing any responsibilities under this Agreement, in whole or in part, as a result of an Act of God, war, civil disturbance, court order, labor dispute, or other cause beyond its reasonable control and such nonperformance shall not be grounds for termination or default. 12, Complete Agreement. The parties agree that this Agreement, including all Benefit Certificate(s), Schedule of Fees, Amendments, Group Application for Coverage, and the Subscribers' names and/or applications for coverage constitutes the "Complete Agreement" between the parties and supersedes all related discussions and communications between the parties, All statements made by the employer to the Employee or statements made by the Employee or his/her family members to their dentist concerning whal is covered in the Complete Agreement is deemed to be a representation and nol a Warranty. No statemenl by the Employer, Employee, or members of the Employee's family concerning matters allegedly covered in the Complete Agreement shall be relied upon by the Employee's dental provider without verifying that the coverage is set forth in the Complete Agreement. 13. Governing Law. To the extent not superseded by the laws of the United States, this Agreement shall be construed in accordance with the laws of the Stale oflowa. Any action in regard to this Agreement or arising out of the lerms of this Agreement shall be instituted and litigated in the state or federal courts located in the Stale of Iowa and no other. 14. Notices and Communication. Delta shall be entitled to rely upon any communication or notice from the Employer to Delta in connection with this Agreement to be genuine, truthful, and accurate. and to have been authorized, signed, or issued by an officer or agent of Employer empowered 10 make such representation on behalf of the Employer. 15. Delta shall secure and maintain during the term of this Agreement insurance coverage as sel forth on the attached schedule and shall cause the City of Dubuque, Iowa, to be listed as an additional insured on said Delta insurance coverage, The mailing of written notices or other communications by regular U.S, Mail, postage prepaid, shall be deemed sufficient service for the pnrpose of this Agreement if addressed to the last address furnished in writing. 6 Notice to Delta Dental Plan oflowa may be addressed: Delta Dental Plan of Iowa 2401 SE Tones Dr., Suite 13 Ankeny, IA 50021 And until another address is furnished in writing, notice to Employer may be addressed: City of Dubuque City Hall - 13th & Central Dubuque, Iowa 52001 IN WITNESS WHEREOF, the parties have executed this Agreement, in duplicate counlerparts, each counterpart being deemed as original, on the date stated below, ~ID;rnJJ/' ~ ~ By WI {Ø¡ J71~~~er ::~ Of<zÞ Title Title President and CEO Date Date W -í/ Oð ", ;;~ 4 Title Secretary Date ~/ /ðð 7 S¡:HEJUL.: CF ;=-:E =~=Ieye~:¡:'an Seen'!er Fuil L2-;a .~arr.e anc Ac::ra:!" :::~f c. 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'c- r.ave t:2"-r1 ir.:::.::-.2'".. Co" cr ;a.'¡æ! ::-.e effec-:le ate ci ~':e Acres!!".e,,"~- -" .~-, [J '12."S' tr"oæ:ar-.s :t.e l=es 'He!e !r-.c.:r-.","- ar:é Fžc:: 'Nitt:ir: -:l':ë: s~..e Ccr.::ac: ;:=-.::é cr 'Nm-.:n ::-.e s;:: rr.::n= ic:ie-Nir.; :::e !!'.c ci :t.e Cc=c: ;::2!':C::, W NcO"",,:ic;:a¡:ie _. We->-;cy Tr-.:ns:er A:-..c= NlA . . ......... .... . A CORDm 'ODUCER 515,223'6BOO DATE IMMIDD/VVI 12/29/99 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, COMPANIES AFFORDING COVERAGE Holmes Murphy & Associates P,o, Box 9207 Des Moines, IA 50306-9207 COMPANY A Chubb Group Delta Dental Plan of Iowa 2401 SE Tones Drive, #13 Ankeny IA 50021 i COMPANY , B AIG/illinois Nationa' ,"UREO I COMPANY I C i COM~ANV THIS IS TO THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION DF ANY CONTRACT OR OTHER DDCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, :0 .TR TYPE OF 'NSURANCE POUCV NUMBER POUCV EmCTIVE POUCV EXPIRATION I DATE IMMIOO/vVI DATE IMMIOO/vVI UMITS A GENERAL UABIUTY X COMMERCIAL GENERAL LlABILITV CLAIMS MAOE 0 OCCUR OWNER'S' CONTRACTOR'S PROT 35357170 1/01/00 1/01/01 GENERAL AGGREGATE . PRODUCTS, COMPIOP AGG I . PERSONAL' ADV INJURV 2DDOOOO 2DDOOOO EACH OCCURRENCE I . FIRE DAMAGEJAnyo"" 1,.., I. MEa EXP lAnyon, ","onl 1000000 1000000 100000 5000 ~UTOMOBILE LIABILITY ANV AUTO All OWNED AUTOS SCHEDULEO AUTOS HIRED AUTOS NON,OWNED AUTOS t=]RAGE UABILITY R ANV AUTO RCESS UABILITY UMBRELlA FORM laTHER THAN UMBRELLA FORM I WORKERS COMPENSATION AND I EMPLO""RS' LIABILITY THE PROPRIETOR! I PARTNERS/EXECUTIVE R NeL OFFICERSARE. EXCL B I OTHER 17029719 Professioanlliab DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/SPECIAL ITEMS Additional Insured IGLI: City Df Dubuque, Iowa COMBINED SINGLE LIMIT I. BODILY INJURV IP"..'~I BODILV INJURV IP"K"",n" PRDPERTV DAMAGE AUTDDNLV,EAACCIDENT I. OTHER THAN AUTD DNLV. EACH ACCIDENT . AGGREGATE' EACH DCCURRENCE AGGREGATE WC STATU, T I . I. OTH' 1/01/00 1/01/01 EL EACH ACCIDENT . ELDISEASE,POLlCVLlMIT I. EL DISEASE, EA EMPLDVEE I. I $3.000,000 limit Df liBb $250,000 Retention City of Dubuque Attn: Randy Peck 50 West 13th Street Dubuque, IA 52001 SHOULD ANV OF THE ABOVE DESCRIBED POUCIES BE CANCELlEO BEFORE THE EXPlRATlDN DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVDR TO MAIL -2Q.. DAVS WRITTEN NOTICE TO THE CERTIFICATE HOLOER NAMED TO THE LEFT. BUT FAILURE TD MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABIUTY OF AUTH ITS AGENTS OR REPRESENTATIVES. w INSURANCE SCHEDULE INSURANCE REQUIREMENTS FOR PROFESSIONAL SERVICES 1, Any policy of insurance or certificate of insurance required hereunder shall be with a carrier authorized to do business in Iowa and a carrier that has received a rating of A or better in the current Best's Rating Guide. 2. Any policy of insurance required hereunder shall provide for a thirty (30) day notice to the City of any material change or cancellation of the policy prior to its expiration date. 3. shall have its insurance agent or company certify in writing that any policy of insurance required herein with an aggregate limit of liability has not been reduced by paid or reserved claims at the time of issuance of policy or certificate, 4. shall furnish copies of the following policies to the City, with limits not less than the following, or greater if required by law. COMMERCIAL GENERAL LIABILITY: General Aggregate Limit Products-Completed Operation Aggregate Limit Personal and Advertising Injury Limit Each Occurrence Limit . Fire Damage Limit (anyone occurrence) Medical Payments $2,000,000 $1,000,000 $1,000,000 $1,000,000 $ 50,000 $ 5,000 OR Combined Single Limit Medical Payments $2,000,000 $ 5,000 Umbrella or Excess Liability* $ Coverage is to include: occurrence form, premises/operations/products/completed operations coverage, independent contractors' coverage, contractual liability, broad form property damage, personal injury, City of Dubuque named as an additional insured with thirty (30) days written notice of change or cancellation. PROFESSIONAL LIABILITY STATEMENT: shall furnish a certificate of insurance showing professional liability limits with limits of not less than $1,000,000 during the term of the project. *To be determined on a case-by-case basis.