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Home My WebLink About2001 S Personnel - NCACC & Cinga for Health Insurance ` ANNUAL PARTICIPATION AGREEMENT RESOLUTION TO ADOPT THE |NTERbOCAL AGREEMENT AND T]JOIN THE NORTH CAROLINA ASSOCIATION OF COUNTY COMMISSIONERS HEALTH INSURANCE TRUST VVITNES8ETH: ' WHEREAS, the Member Group desires to provide to its employees insurance and other group benefits as authorized by G. S. 153A-92(d); and WHEREAS, the North Carolina Association of County Commissioners Health Insurance Trust, d.b.a. NCACC Group Benefits Pool ("the Pnpi^) has been established by counties pursuant to G. S. 153A-445(m)(1) and G. S. 16OA-460 through 16OA-464; and WHEREAS, it is desirable for the Member Group to join the Pool in order to provide a method of risk sharing for health-related claims of its employees; NOW, THEREFORE, BE IT RESOLVED that the Board of the Member Group hereby adopts the interlocal agreement entitled "Interlocal Agreement for a Group Self Insurance Fund for Health, Dental, Life and Disability Risk Sharing,' and thereby joins and agrees to participate in the Pool, which has been formed to create a group fund to pay and service the health-related claims of the employees of the counties and other local agencies joining the Pool. FURTHER, BE IT RESOLVED that the undersigned official of the Member Group is authorized to execute the Agreement to join the Pool. TERMS AND CONDITIONS 1. Agreement and Continuation of Coverage. The term of this Agreement is for one (1) year commencing on the medical benefit plan effective date, A Member Group's coverage will be automatically renewed on the anniversary date even though payment for this coverage may not have been received. This Continuation of Coverage will be on the same terms and conditions as the expiring coverage until and unless notified by the Member Group. Each renewal shall be subject to recalculation of contributions. 2. Applicable Coverages. This Agreement applies to those coverage limits, deductibles and exposures as stated in the Summary Plan Description or otherwise provided to the Member Group at renewal. 3. Contribution Determination. Contributions are based upon the number of employees and the number of dependents applied to a specific rate, which includes estimated claims liability and/or fees, combined to create a Member Group's total annual contribution, It is the responsibility of the Member Group to provide accurate exposure data within thirty(30)days of the first of each month. Should this not be done, it will be at the discretion of the Pool to adjust contributions accordingly. 4. Charges. Changes in rates, discounts and other charges will occur only on the Member Group's renewal date and will remain in effect for a twelve (12) month period. However, the Pool reserves the right to make contribution changes in the event of substantive changes in the governing laws or the underlying plan assumptions. It is the responsibility of the Pool to inform the Member Group sixty (60) days prior to the effective date of such off cycle 5. Contribution Collection. Contributions are due on or before the fifth (5 th)of each month. 6. Claims Administration. a. Claims Filing/Reporting. All claims must be reported to the Claims Administrator in order to receive reimbursement. It is the responsibility of the employees of the Member Group to report any eligible claims. Claims must be filed as outlined in the Summary Plan Description. If a claim is made or suit is brought against the Member Group, the Member Group shall immediately forward to the Pool every demand, notice, summons or other process received by the Member Group or its representative. � '- b. Claims Filing Limit. The Pool will pay eligible claims incurred up to midnight on the date oftermination, provided such claims are submitted for payment to the Claims Administrator within twelve (12) months of the covered occurrence. Any claims submitted later than twelve (12) months following the date of termination shall be returned to the individual filing the claim. c. Settlement Authority. The Pool or its designee retains sole authority tm adjudicate claims. 7. Termination bythe Pool. This Agreement can be canceled by the Pool only on a renewal date and only after having given written notice by certified mai|, return receipt nequested, to the Member Group at least sixty (60) days before such anniversary date except that the Pool may cancel at any time: (i) after giving ten (1D) days written notice tnthe Member Group if the Member Group has failed to pay any contribution when due. or. (ii) an a result of substantive reorganization or dissolution of the Member. If the Pool chooses not to uonna| for non'poymert, payment of the Member Group's claims will be suspended immediately until the balance due is paid in full. 8' Termination by the Member Group. The Member Group may cancel this Agreement without penalty effective on their renewal date, after giving written notice to the Pool at least thirty (30) days prior to such renewal dote. The Member Group may also terminate the Agreement in the event of an off cycle contribution change as outlined in Article 4above. if the Member Group wishes to terminate the Agreement due to an off cycle contribution change, the Member Group must notify the Pool thirty(30) days prior to the date this contribution change will go into effect, In no event will termination become effective prior to thirty (30) days from the date of notice of termination by the Member Group, 9. Termination Penalty. In the event the Member Group fails to comply with the provisions as outlined in Article 8 above, or if the Pool cancels for non-payment, the Member Group will be liable as follows: (i) if notice to the Pool is less than thirty(30)days before the Member Group's renewal date but prior to the renewal effective date, ten percent � (10%) of the annual estimated renewal contribution will be payable, (ii) if notice to the Pool is after the renewal date, � the full annual estimated renewal contribution will bepayable. | / 10. Member Group Appeals. The Member Group shall have the right to appeal any decision or recommendation to the Pool's Board of Trustees, whose determination will be final. Any appeal shall be made in writing to the Pool's Director of Risk Management within thirty<3O>days of the decision or recommendation. 11' Membership. |n the interest cfproviding effective governance, the Member Group urat least one uf its budgetary contributors must be a member of the North Carolina Association of County Commissioners. 12' Notice. Any written notice to the Pool shall be made by first class mail, postage prepaid, and delivered to the Pool's Director ofRisk Menmgement, North Carolina Association of County Commissioners, PD Box 1488, Raleigh, NC 27602-1488. 13. Sevarmbi|ity. If any portion of this Agreement shall be declared illegal or unenforceable for any veason, the remaining portions shall continue in full force and effect, 14. Special Conditions. m, Orange County offers C|GNAofNorth Carolina (a non'B|uoCmoo and Blue Shield plan) to its employees as a health insurance plan option and may continue to do so on a"grandfather" basis since joining the NCACC Trust, without regard tothe member urpercentage of employees participating in C|GN& Orange County would be expected to comply with any future minimum participation requirements as might be adopted by the NCACC Trust Board of Trustees in the following circumstances; • If Orange County discontinued offering a Trust (Blue Cross and 8|uo Shield administered) health maintenance organization product while continuing to offer a competitors health maintenance organization product; or • |f Orange County discontinued its C|GNA option; or • If Orange County offered additional health insurance carriers for medical coverage. b' Orange County has two sub-groups included in the health coverage: Orange Community Housing n and the Orange County Visitors Bureau. The NCACC Trust agrees to continue coverage fovthenoenUbesintha Orange County group, c' Orange County is entering into the NCACC Trust only for coverage as to the health insurance and is not entering into Ufe, danta), disability, or other insurance programs through the NCACCTruoL TO BE COMPLETED BYMEMBER GROUP: Name uf Member Group � By: Date: Signature ol authorized representative of Member Group -S' kdlerl /1' gZA- 1641-'s Printed Name of Authorized Representative `