HomeMy WebLinkAboutTASC (2)INSURANCE NOT ON FILE
,WORK MAY NOT PROCEED
CLERK OF COUNCIL
IND DATE:
N
0
(M) 0
S1;MON i
for Retiree Dental Benefits Billin
THIS AGREEMENT, entered into by and between Total
Corporation ("TASC") and (the "Employer") City ofSagta Ana becomes effector
signature on the Plan Application. The services apply to the Plan Year as not
Application for retiree dental billing and continuing for successive years in whi
Level Agreement exists. The terms of this Ao eement shall be in effect indefinit
automatically renewable. This Agreement is applicable to the Plan specified or
Plan Application which is attached hereto as Exhibit A.
1. Services to be Provided
Under this Agreement, TASC is considered to be the Administering
provide timely administration and management of the appropriate Plan and
as outline in the appropriate Product Administration manual/portfulio.
2. Employer Responsibilitv
Under this Agreement, the Employer is considered the Plan Sponsor
the Employer must forward to TASC all relevant information in order for
functions to be performed in timely manner. This includes timely payment of
invoices. Failure to provide inputs on a timely basis will result in delays and possi
which will be the liability of the Employer. The Employers are responsible for i
Plan Participants on the services beine provided. Employer is responsibl
www.tascanline.comrprociderslFf[PAAr' to execute and file the Business Associ.
Provided by TASC. You will received information regarding this within a fevy' wee
I
EXHIBIT G j
A-2017-243
services
;date of
he Plan
Service
will be
d in the
will
to this,
ve
their
visltin.-
Tlhe
25E-69
Employer shall have the sole and final discretionary authority in respect ko I "al and
administrative functions of the Plan.
3. Financial Responsibilities
Responsibility of Plan beneficiaries lies with the Plan Sponsor. TASC is m rely he agent
managing the administration of those benefits.
4. Fees and Terms of Payment
A. The Ediploytr agrees to pay TASC for services provided under this \o •c ment in
accordance with the appropriate Plan fee schedule, 1
B. Invoices for services will occur 43 days prior to the service period (Pl�rr Year start)
and are due seven days from the invoice date. Ill
C. Fees may be subject to change without formal notice. Fees for servic�s o tside the
Services to be provided under this Agreement —or for additonal servic rha become
necessary due to missing, incomplete or incorrect information — wi be invoiced
separately and will be disclosed to the Employer prior to incurring the ixpells CFees
are calculated on the number of employees in the Plan, includi g telminated
employees, at the time of invoice.
D. Employer is responsible for Administration Fees for Entire Plan. Rilurelto remit
l
payment for administrative services may result in termination of s rvic s or the
Forwarding to collections for appropriate disposition.
5. Termination of Agreement
1
A. Except as a result of nonpayment of tees, this Agmententshall continuc in e. Feot until
it is terminated by Employer or T.ASC with sixty days written notict prior to Plan
f
renewal date. i
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25E-70 '
b'
B. If service§ are terminated by Employer prior to the end of the existing Ian bear, the
Employer is responsible for administration fees for the remainder of th it Ph n year.
C. Non-payrneut of administration fees andto failure to remit finding on k tint ly basis
may result in Plan termination. if services are terminated under this A reer lent, the
Employer will be responsible for completing any outstanding services In 1'(Ution.
it is understood that termination of this Agreement also terminates the prow Sion the
TASC prototype Plan Document at which time the Plan will hencefort be erceived
as individually designed and the sole responsibility of the Employer.
D. If terminated for failure to pay fees this Agreement may be terminate by —ASC by
providing the employer with a 10 day written notice of said tau-nif atior. Upon
communication of Employer's intention to file Bankruptcy, TASC res rveslthe right
to terminate services immediately.
6. insurance
TASC shall provide Plan $ponsor a certificate of insurance demonstrating professional
liability insurance coverage with a combined single limit of not less that+. S I AO.. 00 �cr claim
with $2.000,000 in the aggregate prior to the start of work pursuant to this Ag cement. The
following requirements apply to -the insurance to be provided by TASC pursuant this section:
A. TASC shall maintain all insurance required above in fill force and effee forilicesitirc
period covered by this Agreement.
B. Certificates of insurance shall be banished to the City upon eceylutioti of this
Agreement and shall be approved by the City.
C. Certificates and policies shall state that the policies shall not be canceledI
or rlduced in
coverage or changed in :ury othcr material aspect without thirty ( . drprier .vrmcn
3
25E-71
notice to the City.
7. Confidentiality 1
I
ff TASC receives from the City information which due to the nature of suc I int{,nnation
is reasonably understood to be confidential and/or proprietary, TASC agrees that i shall not use
or disclose such information except in the performance of this Agreement, and fui her I'.grces to
exercise, the same degree of care it uses to protect its own information of like imp rtan e, but in
no event less than reasonable care. "Confidential Wormation" 'shalt include all t npublic
information. Confidential 'information includes not only written informati n, l ut also
information transferred orally, visually, electronically, or by other means. Confidential
information disclosed to either party by any subsidiary and/or avert of the other p rty i4 covered
by this AgrcernenL • The foregoing obligations of non-use add nondisclosure shad not) apply to
any information that (a) has beendisclosed in publicly available sources; (b) is, lh ougl no fault
of the TASC disclosed in a publicly available source; (c) is in.rightful possessio oft TASC
without an obligation of confidentiality; (d) is required to be disclosed by operat on Of law; or
(e) is independently developed by the TASC without reference to information di. cloy d by the
City.
8. Limitations of Warranties and Liabitities
A. Except as expressly set forth in this Agreement, TASC disclaims any ai d a�l express
warranties, warranties of fitness for a particular purpose and implied ,vanjanties of
merchantability.jl
F. TASC will not be liable for any loss of business or profits, or any
incidental, punitive, or similar damages, or, other than as set forth in
for claims of damages made by any third petty for any cause
25E-72
of the form of action, whether in contract or in tort, including negligln
ce, [ven if it
has been advised of the possibility ofsuch damag(s.
C. Each party acknowledges that this limitation of liability reflectsan i formed.
voluntary allocation between the parties of the risks (known and unkn wn) that may
exist in connection with this Agreement.
D. in no event will TASC's liability exceed the payments made by Empl yerlto TASC
within the previous six months for services provided under this A,m cmelnt. This
shalt be Employer's exclusive remedy. �I
E. No action, regardless of Conn, atising out of the services provided u{tder this
Agreement, may be brought by Employer later than two years after t e da a the last
services are provided under this Agreement.
8. Execution and Delivery
This Agreement may be executed and delivered (including by facsimile orl Portable
Document Format (PDF) transmission) in ore or more counterparts, all of vhicl
will be
considered on and the same agreement and will become effective when one or mo a co, Interparts
have been sighed by each of the parties and delivered to the other party. Any su It facsimile or
t
PDF documents and signatures shall have the same force and of ect as manually-s'Rttejoriginals
and shall be binding on Employer and TASC.
9. Discrimination
TASC shall not discriminate because of race, color, creed, religion, sex, rnariial status,
I
sexual orientation, age. national origin. ancestry, or disability, as defined and prohibited by
applicable law, in the recruitment, selection, training, utilization, promotion, tenni ati i or other
employment related activities. TASC affirms that it is tin equal opportunity emp overland shall
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25E-73
comply with all applicable federal, state and local laws and regulations.
W. Records
TASC shilI keep records and invoices in connection with the work robe
this Agreement TASC shall maintain complete and accurate records with respt
incurred under this agreement and any services, expenditures, and disbursements
City for a minimum period of three (3) years. or for any longer period required by
date of final payment to TASC under this Agreement. All such records and im
clearly identifiable: TASC shall allow a representative of the City to examine, at
transcripts or copies of such records and any other documents created pursuant to
during re6mlar business hours. TASC shall allow inspection of all work, dt
proceedings, and activities related to this Agreement for a period of three (3) yea
Of final payment to TASC under this Agreement.
11. ConfIlet of Interest Clause
TASC covenants that it presently has no interests and shall not have
indirect, which would conflict in any matmer with performance of services
Agreement.
12. Governing Law
This Agreement shall be governed under the laws of the State of
6
ed tinder
the costs
ed to the
from the
shall be
ad make
the date
or
this
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i
13. Entire Aereeinent
This Ageement represents the entire agreement or the parties and so
written or oral agreements. This Agreement shall not be altered or amended.
ATTEST:
MARLA HUIZAR
Cle,4s o f the Counci I
AP,PR.OVED f1S,TO,FOR,ti1:
SONIA R. CARVALHO
City Attomey
By:0.L�+ F
Laura A. Rossini
Senior Assistant City Attomey
RECO:NIMENDED FOR APPROVAL:
ED RAYA
Executi vc Director of Personnel Services
CITY OF SANTA ANA
CYNI TEfA J. KURTZ
Interim City Manager
TOTAL ADNILNISTRA
CORPORATION
prior
25E-75
A-2017-243
ATTEST:
Daisy GOrneZ
Clerk of the. Council
RECOMMENDED FOR APPROVAL:
Director Human Resources
CITY OF SANTA ANA
KristineRidge-
City
Manager
EXHIBIT A
PLAN APPLICATION'
25E-76
Ii TASC Retiree Billing Application
Follow these instructions for fast :uud clFciene processing of your Plan Application,
• Cliwna must coatpko: aft Semons.
• Picax print le fl-ty far fixing.
C:nnraa I ASC (m 2-SSS-595-2261) far .tisialmice will, the Plan Applkarisn.
Fa.¢ lv;ar eomPlru•d Plan Av licarion Awng wirh your lac to Cad •2-11.45S4 tit mail it to TASC, 2302
pO Box:L4140. 41ad:i ,w Wl 537043L40.
(1)EMPLOYER/ADMINISTRATOR
a+:n.,rc Namc 1 ;w( (C _f i '1(lil'/�
i n
::mnpmty^!>,ex:(Fulllegain>me. indudiny :lhi if appliubl.) � <1.% - ...J(�%-r { ��1�-)!+
C:onq+any PhvsirA Addm;5:n.t PO Boa} Ib' l � J !/19 Gg• `,- -ft 'nru. Zip
Aradiny:lJ.l:•x:—ifiiiaro,r from
Namc.. and ux (U 3J ufanp other asrnmen!•r ewnz,L'en:.milkd Campanile, amr arc Pamidpacing
E-nt2:1 A:wrcts —WA _`I'C
21wne Num6,:r/ 11 -'� / F>r Nurnbnr LF r 7 17
Swiaa. Fc.1'MUD+_J�s—r Gf•li f � i AIC_SorSIC Code{Fum:Jnr. ifL.3 Fenn iiCU, iina 3,i)
Un you pima micresr i.. m ach.rbnsrnw' •J Yes C?1:.o ffy's. nna;ua a([n:plolep a�__
If eon are s turrgne Cliznr aTASC. Fleas. nne which Beni v: O Fleails:nn (FSA) 0 HRA O COBRA 0 ERI 5A l O FNB.n
(2) PAYMENT
r„c Adnrnwrsririi P o' mJ utvnis frryse,n:}' arc J�xe:mi,!eJ i,v a fie ahmhdz and invoked m die tmpinya 11w A.'.mi,tiscran ' n:. s doe ar rin:e of an-
aliarien. (Sm:rf, Uaknu nsiduw add-0iiaatry nx.)ddJirmul its may be andind.robedeamlintd byln>lrcdew ol':hz Plat .ltdi Jtinn.
swnoc I One To.,. So.. op ; ee I Adminu¢>dort F•x I other tcv I
i Retiree Billing
I
fA CD 3 /'
�(• y�l l�jJ') Grlrue_:.� !r tilC-..rk• I
• Fecs jm srbjwr to 8san±e pending revimv of Nan Deg:nncnc.utd informgnon. and deremintatron of reork (nvrhzd, Ux lilin;J
O Chick B.— 0 MaxerCmd O V;v, 0 Arneri:,,, ExFrrt
ufCardholde,;NJm•:cn Card;
—
C.trd a —. _. ._ —.. _..... Esp. D>r-.
(3) E-PAY
','ASCs sra:drai m<d,nd rut su.4:nisinn oFa(rains[rarun fcs ii via Ed'J:; l'/irU •I:i3 nriicr.'I:•l :C cunvndrufp ,'..doer,
mare.. Simph curl-0e:e the 4pinP wlte,v-i licilld.Mmvi.nd,bic>ad:r,,:arm:r :vurt or::,ide rile the At
oniv hr.... d •ing she or Jrmsmr in dm nunn..-apcciEed in dr. un !ruri_>riet:. the ltne:mee in d:e>nd:or:::[:on mprase»
:r<Y u• i re:.:!aciianioo ai Ct FAC ix:mnonu,: r>n:rion Poli ^•s1•[Igor AI'H \envoi'. P>rdciPn:[s.
nnac;:.d E rv,r—r Lim
�Gtrt
:1 u':' itasr.,n;:?m:i•rr l:h+ any nnovn: Xumlrer
'j rmn!.; nmrc;,l�v.. _. �irro no. ;:•.:..,:.d1.J:- Ta•gn: r•• •n, r .r::.r..uri,rr C7n .�.nu,wn'. ..
dnJ .amid nzm!� r: vc e::,r.en,,.r ::.ecJ::vrir.:i ;r; y.:::: y .u: •:..:a i•..:7:-
U
I'rr
vm:r eirez:,nt
[hz Nrntrinrion
cgwrzat.n[>eiai-
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25E-77
(4) AUTHORIZATION
1
pc...
L
I %:,nify tharsh. n4n ' m lis . rej 6el.w.hlw I f1PAA Busilic-s lutfi&;-eel rt, acce�s
hiforill,itm "ll .... Let, flf.
Null.
llroi,idv:•A56C Nmn_.KEN 1-c 3
P,,. L7CI IV_61�
rktds
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(5) PLAN DESIGN
Racm Billifig P131, Clpd...
"'Were 11C N11.1441 Drjksdrld Amldp.uing 00
ill-mc fnforon.,,..x,n
Previous TP. (company wine. miracr miinc.ind D lai.ee uj
0 Employcr
Formal 1,60mi'm AAM ire pmvi'ledl
b U=al worlm"mc ( &u ribe)
A. Available Sariefir.1
ll.nafim Available ro lUxice.:
. jenol 0 vida'i 0 Df� (D M.die:tm P.1
zible Beans
f3owfia Adul;niamred b y Rede. Billing:%Qicjj O,Duqud 0 Vision 0 Life, 0 Mmlicllm 61
.ilh arta
E. E.mlinl.nc
M'w
Encollmenr Infuniladca -M Ile Prwd,d w RcrErcc Billing: 0 eleg,tillic File 0 paper Form 0 Omer '!..Sscrf
Bold, Som D= _'Z,
. �Y.�L _ Accit c Bell& End Due: _Wii U`z_
Raim, Xledic.m. rzdgibi'
Required Doc-m=mrfotj: 4 Silill-d 1VPY atch'. Medium Pita A & 8 Cud
0.414.
A"llself sum!"'i'm adage)
OFer, 13.11 Am= Sun Cv,. Opdn Er.r.-itmericEnd Nut
druidic CNwre Dudli,,e 0am. '31 11-7
C.
Cwk' Mine Policy NuasherConnc,Kame'If �P[..' cmicur
t finePlumberNt"Ale,
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7-f-(zeo3
3.
4.
A.,e; Arrad, fur all Kmz tila mrc enenc'widl efNrl'o Jacear."I der'.
Tra.,wmi....
-3 EDI Fria 0 0"fler J F17 P SiN Q
17. GeneeJ Informidal,
C ACH 0
25E-78