R10-134
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1 RESOLUTION NO. RIO- 13'/
2
3 A RESOLUTION OF THE CITY OF BOYNTON BEACH,
4 FLORIDA, APPROVING A COBRA ADMINISTRA TIVE
5 SERVICES AGREEMENT WITH MANGROVE BENEFIT
6 SERVICES, INC., TO PROVIDE COBRA ADMINISTRATIVE
7 SERVICES AND ASSIST THE CITY AS PLAN SPONSOR
8 REGARDING THE CITY'S WELFARE BENEFIT HEAL TH
9 PLANS; PROVIDING AN EFFECTIVE DATE.
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12 WHEREAS, the City Commission of the City of Boynton Beach desires to authorize
13 the City Manager to execute a COBRA Administrative Agreement with Mangrove Benefit
14 Services, Inc., to provide COBRA Administrative Services and assist the City as Plan Sponsor
15 in complying with certain Federal requirements regarding the City's welfare benefit health
16 plans including Medical, Dental and Vision.
17 NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF
18 THE CITY OF BOYNTON BEACH, FLORIDA, THAT:
19 Section 1. The foregoing "Whereas" clauses are hereby ratified and confirmed as
20 being true and correct and are hereby made a specific part of this Resolution upon adoption
21 hereof.
22 Section 2. The City Commission of the City of Boynton Beach, Florida does
23 hereby approve authorize the City Manager to execute a COBRA Administrative Agreement
24 with Mangrove Benefit Services, Inc., to provide COBRA Administrative Services and assist
25 the City as Plan Sponsor in complying with certain Federal requirements regarding the City's
26 welfare benefit health plans including Medical, Dental and Vision.
27 Section 3. This Resolution shall become effective immediately upon passage.
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S:\CA\RESO\Reso - Approve Mangrove Benefit (COBRA) doc
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1 PASSED AND ADOPTED this ~ day of September, 2010.
2 CITY OF BOYNTON BEACH, FLORIDA
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23 ATTEST:
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S"\CA\RESO\Reso - Approve Mangrove Benefit (COBRA) doc
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MANGROVE BENEFIT SERVICES, INC.
COBRA ADMINISTRATIVE SERVICES AGREEMENT
WITH
CITY OF BOYNTON BEACH
THIS AGREEMENT (hereinafter referred to as the "Agreement") is entered into as of the .:?R day Of~ 201 0
(the "Effective Date") by and between Mangrove Benefit Services, Inc. (hereinafter referred to as "Mangrove"), a Flori corporation, and City of
Boynton Beach (hereinafter referred to as the "Plan Sponsor") which sponsors an employee welfare benefit plan. Recurring service to begin on the
.l.:. day of October, 201 L.
WITNESSETH THAT:
WHEREAS, the Plan Sponsor is responsible for the administration of its employee welfare benefit plan providing medical benefit
(hereinafter referred to as the "Plan"); and
WHEREAS, the Plan Sponsor desires to retain Mangrove and Mangrove desires to accept such appointment to provide administrative
services for the Plan related to assisting the Plan Sponsor in complying with certain requirements of the Internal Revenue Code of 1986, as amended
(the "Code") and the Employee Retirement Income Security Act of 1974, as amended ("'ERISA") that pertain to continuation of health benefits
coverage regulated by the Consolidated Omnibus Budget Reconciliation Act of 1986, as amended ("COBRA") and the Health Insurance Portability
and Accountability Act of 1996 ("HIP AA"):
NOW, THEREFORE, in consideration of the premises and of the mutual covenants and agreements contained herein, Mangrove and the
Plan Sponsor hereby agree upon the following terms and conditions:
1. Services to Be Performed The Plan Sponsor hereby engages Mangrove to provide the administrative services specified in Schedule A
Schedule AI. and Schedule A2. (the "Services") attached hereto.
2. Effective Date: Term and Termination This Agreement shall be effective on the date stated above as the effective date and shall continue
in effect for an initial three (3) year term. This Agreement shall automatically renew for successive one (I) year terms unless (a) canceled by
either party. upon notice given in accordance with paragraph 10, at least sixty (60) days prior to the date of termination specified in such notice
or (b) otherwise in accordance with this agreement or for a stated extended period by mutual agreement of the parties as hereinafter provided. If
Mangrove fails to provide services in accordance with the contract then plan sponsor can terminate services at will with a 30 day notice, Both
parties agree to re-negotiate the Agreement in good faith if it becomes necessary to re-negotiate the Agreement due to a change in applicable
law.
3. Relationship of Parties Plan Sponsor and Mangrove are separate and independent entities. The relationship between them is purely
contractual. and neither is an agent, employee or servant of the other. As independent contracting parties, the Plan Sponsor and Mangrove
maintain separate and independent management and they each have full authority and responsibility regarding their own organization, method
of operation and structure. Except as may be otherwise expressly provided herein, neither party shall have the right or authority to assume or
create any obligation, express or implied, on behalf of the other party. Plan Sponsor understands and acknowledges, and shall not represent
otherwise, that Mangrove is not the Plan Administrator of the Plan for purposes of ERISA or a fiduciary as defined under ERISA Mangrove
shall provide only administrative and ministerial services to the Plan under this Agreement and shall not exercise any discretionary authority or
control with respect to the Plan.
4. Responsibilities of Plan Sponsor In providing the Services, Mangrove shall rely upon the Plan Sponsor to do the following:
A. Provide complete and accurate information regarding plans, rates and current participants and all data requested on the setup forms.
B. Determine and accurately report, on a timely basis, the occurrence of qualifYing events for COBRA Plan participants.
C. Review the reports provided by Mangrove and advise Mangrove of any discrepancies in such reports within ten (10) days after receipt
D. Submit all data to Mangrove in standard format through electronic means of website entry or Mangrove specified file format.
E. Initiate contact with the Plan Sponsor's carriers to have direct access for plan participants with respect to premium remittance, enrollment
and disenrollment in carriers' plans, consistent with the agreed-to terms.
F. When requested by Mangrove, use written forms of communication (including electronic mail) in relaying information to Mangrove.
5. Indemnification and Hold Harmless In performing the administrative services provided under this Agreement, Mangrove may rely
without qualification on the information provided by Plan Sponsor. Mangrove shall not be responsible for the consequences of any action taken
or omitted by the Plan Sponsor or Plan Administrator in connection with the administration of the Plan. including but not limited to incomplete
or inaccurate information and/or the failure of the Plan Sponsor to act or supply information on a timely basis. The Plan Sponsor shall
indemnifY and hold harmless Mangrove, its officers, directors, employees, shareholders. successors and assigns, from and against any and all
liabilities, claims, costs, demands, expenses or loss including but not limited to reasonable attorney's fees and other costs of litigation whether
suit be instituted or not, at pretrial, trial and appellate levels resulting from or attributable to any action or omission by the Plan Sponsor, except
to the extent that such action or omission is the result of the Plan Sponsor's reasonable reliance on Mangrove to provide the services specified in
Schedule A. Schedule AI. and Schedule A2. Mangrove shall indemnifY and hold harmless the Plan Sponsor, its officers, directors, employees,
shareholders, successors and assigns from any claim. expense or liability including but not limited to reasonable attorney's fees and other costs
of litigation. incurred by the Plan Sponsor as a consequence of any such reasonable reliance on the services of Mangrove.
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6. Sample Letters Mangrove uses standard forms of communication including letters to Qualified Beneficiaries of the Plan Sponsor. The Plan
Sponsor agrees that the communications are satisfactory or, if not satisfactory, the Plan Sponsor will provide modifications to Mangrove. The
Plan Sponsor shall be liable for any modifications to the communications materials.
7. Compensation To Manl!:rove Mangrove shall be compensated for providing services under this agreement. The compensation shall be as
specified in Schedule A., Schedule A.I. and Schedule A2. attached hereto. Mangrove will provide Plan Sponsor a three (3) year rate guarantee
of fees described in Schedule A, Schedule AI. and Schedule A.2. After the initial three (3) year term, such Schedule A., Schedule A.I. and
Schedule A2. may be substituted from time to time with Mangrove's then current schedule. However, any increase in the cost of service shall
not take effect until ninety (90) days after the Schedule A., Schedule A.I. and Schedule A.2. has been mailed to the Plan Sponsor, except for
additional administrative services and/or expenses agreed upon by the Plan and Mangrove.
Plan Sponsor agrees to pay the full balance of all service fees detailed in a monthly invoice, due within fifteen (IS) days from the date the bill is
rendered. If payment for services is not made after IS days from the date the bill is rendered, Mangrove reserves the right to charge a I v,%
finance charge per month (or, if such rate is in excess of the rate allowed under applicable law, the maximum rate allowed under such law), to
any unpaid service fee balance after thirty (30) days from the due date to the Plan Sponsor's account. If Plan Sponsor does not pay any fee due
to Mangrove hereunder within thirty (30) days from the day that the bill is rendered, Mangrove may suspend and/or cancel the Services until
payment is received by Mangrove. In the event Mangrove so suspends its services because of Plan Sponsor's failure to pay the service fees,
Mangrove shall have no liability or responsibility for any claims, taxes or liabilities incurred by Plan Sponsor or the employees of the Plan
Sponsor as a result of such suspension. Plan Sponsor agrees to pay all collection costs, including but not limited to attorney fees and court costs
that are necessary to collect any unpaid service fee balance and to reimburse Mangrove for sums expended on behalf of Plan Sponsor.
8. Ril!:hts with Rel!:ard to Overnavrnents If funds have been disbursed to which participants are not legally entitled, by mistake or
otherwise, Plan Sponsor and Mangrove agree that such amounts are debts owed. Plan Sponsor and Mangrove further agree to assist one another
to the fullest extent possible in recovering said funds from participants.
9. Notices All notices, requests, demands and other communications hereunder required by the provisions of this Agreement shall be in writing
and shall be deemed to have been properly given or served by depositing the same with the United States Postal Office, or any official
successor thereto, designated as registered or certified mail, return receipt requested, bearing adequate postage at the addresses set below:
MANGROVE NAME AND ADDRESS: PLAN SPONSOR NAME AND ADDRESS:
Mangrove Benefit Services, Inc. City of Boynton Beach
Attn: Compliance & Contracts Manager 100 E. Boynton Beach Blvd.
1501 S. Church Avenue Boynton Beach, Fl. 33425
Tampa, FL 33629
Each such notice shall be effective upon being deposited as aforesaid. The time period within which a response to any such notice must be
given, however, shall commence to run from the date of receipt of the notice by the addressee thereof.
10. Successors and Assil!:ns This Agreement and each and every covenant, agreement and provision hereof shall be binding upon and inure to
the benefit of the parties hereto and their respective successors and assigns.
11. Status Under HIPAA Administrative Simplification Rules Plan Sponsor acknowledges that Mangrove is not a business associate of
Plan Sponsor's plan(s), as the term "business associate" is defined under 45 C.F.R. ~I60.103. If Mangrove's status should change in the future
so that it should be treated as a Business Associate under HIP AA, Mangrove and Plan Sponsor, on behalf of its plan(s), agree to negotiate in
good faith to promptly enter into a business associate agreement.
Mangrove agrees to take reasonable and appropriate steps to safeguard individually identifiable medical information ("Medical Information").
Such steps shall include administrative procedures (such as training its employees on the sensitivity of Medical Information), technical
safeguards (such as computers on passwords and firewalls on computers that could reasonably require fire walls) and physical safeguards (such
as shredding paper documents containing Medical Information and storing documents containing Medical Information in designated locations
during non-work hours). Mangrove agrees to take reasonable and appropriate steps to use and disclose Medical Information only for purposes
related to the Plan Sponsor and its plan(s), to discipline Mangrove's employees who fail to follow such steps and to mitigate the harmful effects
of any inappropriate use or disclosure of Medical Information.
12. Governinl!: Law Except as required by federal law, this Agreement and Mangrove's actions on behalf of the Plan Sponsor and its plan(s)
shall be governed by and construed in accordance with the laws of the State of Florida. To the extent that (a) the Plan Sponsor initiates legal
proceedings against Mangrove relating to this Agreement; or (b) any legal proceedings relating to this Agreement are initiated by Mangrove
against the Plan Sponsor, the parties consent and agree to the exclusive jurisdiction of the state courts of Palm Beach County, Florida or the
district court of the Southern District of Florida, as appropriate.
13. Captions and Headinl!:s The captions and headings of the various sections of this Agreement are for convenience only and are not to be
construed as confining or limiting in any way the scope or intent of the provisions hereof.
14. Modifications This Agreement may not be changed or terminated orally. This Agreement or any of its provisions may be modified,
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SCHEDULE A.
COBRA ADMINISTRATIVE SERVICES
FOR
CITY OF BOYNTON BEACH
1. GENERAL NOTICE OF COBRA RIGIITS:
Initial notice advising employee and any dependents newly enrolled in active plan of their COBRA rights
Deoartment of Labor Model Notice: lfthe Plan Sponsor has not contracted with Mangrove to perform the General Notification Service, Plan Sponsor takes
full legal responsibility and liability to distribute this initial notice properly per the requirements of Code Section 4980B(f)(6)(A). Mangrove shall have no
liability or responsibility for compliance with this portion of the law unless specifically contracted for in this Services Schedule A., Schedule A.I. and
Schedule A.2.
2. NOTICES TO OUALIFIED BENEFICIARIES:
A. Welcome letter to COBRA "takeover" participants
B. Election Notice (Employee, Spouse or Dependent) - notification with continuation fact sheet and election form
C. Initial Billing (with payment coupons and mailing labels)
D. Notice of Premium Shortage - for insignificant amounts
E. Continuation Coverage Termination Notice including failure to make full initial or regular payment, attainment of the end of eligibility
period and request to terminate.
F. Notice of Unavailability of COBRA Continuation Coverage
G. Open Enrollment Support (mailing labels for open enrollment materials; optional additional support available at additional cost)
H. Coverage Change Notification (with coupons and mailing labels)
1. End of Eligibility Conversion Notice
J. Secondary QualifYing Event Confirmation Notice
K. Non-Sufficient Funds Notice
L. Participant Billing Statement - available through web-site
M. HlPAA Certificates of Creditable Coverage-upon termination of COBRA coverage (for COBRA coverage period only)
3. ELIGIBILITY NOTIFICATIONS:
Eligibility Notices will be issued to Plan Sponsor directly
A. Reinstatement Notice (upon election and receipt of first premium payment)
B. Notice of Loss of COBRA Coverage
C. Corrected Address Notice
4. PREMIUM REMITTANCE
Premiums collected will be issued to Plan Sponsor directly after the close of each month for the previous month's coverages.
5. HIP AA CERTIFICATES:
HlPAA Certificate of Creditable Coverage for continuants and dependents ending COBRA coverage is included in basic COBRA services.
6. SPECIAL NON STANDARD REPORT REOUESTS - Although over twenty (20) reports are available online via www.emangrove.com, printed
reports are also available via mail, email or fax at a charge of$25.00 per report.
7. CUSTOM REPORTS (OPTIONAL):
Standard reports are provided at no additional fee. Custom reports and special requests can be provided for an additional fee, to be determined
based upon Plan Sponsor specifications. Mangrove fees for custom reports and special requests are charged at $150.00 per labor hour.
Mangrove requires a minimum of three (3) weeks notice prior to delivery of reports and reserves the right to negotiate fees and delivery date
based on available staff resources/project complexity.
8. PROFESSIONAL. PERSONALIZED CUSTOMER SERVICE:
A. The Mangrove office is staffed with Benefit Specialists Monday - Friday 8 am to 8 pm.
B. Mangrove will not be open on published holidays.
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SCHEDULE A.1.
COBRA
ADMINISTRATIVE SERVICES FEES
FOR
CITY OF BOYNTON BEACH
BENEFIT ENROLLED COBRA
EMPLOYEES BASE ADMINISTRATION
CHARGE
900-1000 $0.45 per
insured per
month
First month fees due with signed agreement $426.60 mo.
based on
948
Notes and Assumptions:
1. Mangrove will retain the 2% COBRA administration fee
2. Assumes group does not exceed 25% turnover, annually. Any overage to be charged at $20 per QualifYing Event Notice
3. Setup and Renewal fees are included
4. Takeover for people on COBRA are included
5. Rate corrections and late charges processing fees are charged at an additional $12.50 per continuant. Includes amending client master and
each active continuant's rates on Mangrove's system to correct inaccurate or late rate information and subsequent processing of additional
funds as required by the carrier(s).
6. Fees for services requested other than those included in Schedule A., Schedule A.I and Schedule A.2. will be charged at an hourly rate
depending upon the project specifications.
7. Full open enrollment support upon request includes gathering materials, stuffing, addressing and mailing is charged at $10.00 plus postage
per package with a minimum charge of$I50.00.
8. Pricing includes fees for all benefit enrolled employees regardless of election choice. Counts of benefit enrolled employees are to be
emailed to your Mangrove Account Manager when employee counts change and every six months after initial implementation.
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SCHEDULE A.2.
OPTIONAL ADMINISTRATIVE SERVICES REQUEST
FOR
CITY OF BOYNTON BEACH
GRACE PERIOD PAYMENT REMINDER NOTICES- REOUEST:
Plan Sponsor wishes to provide grace period payment reminder notices to each COBRA participants who are in danger of losing
0 COBRA due to non-payment. Plan Sponsor understands this Notice will be billed at $5.00 per notice.
Signature: Date: Title:
..............................................................................................................................................................................................................................................................................,
BLANKET GENERAL (INITIAL) NOTICE MAILING TO ALL BENEFIT ENROLLED EMPLOYEES - REOUEST:
0 Plan Sponsor selects this service and requests Mangrove to send a General (Initial) Notice to all benefit enrolled employees. Plan
Sponsor understands this Notice will be billed at $3.50 per notice.
Signature: Date: Title:
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1N WlTNgsS WI-JEREOFI by phal;;1ng their dIaly lIWhorizlcd lipamrcs below, \hI:r pattit:S beieby eKCClW ,. Asrnmeo:r and ape to b;
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Prin~ Name p . lII1IC
ClII.f~udw Officc:r ---A>->, C/I{ /)1::.. n" yQ IL
Tille ~'i) Tit~
59-6000282
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3016
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