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HomeMy WebLinkAboutRES-1995-050 Resolution to Adopt the Interlocal Agreement and to Join the Health Insurance Trust Group Self Insurance Fund for Health, Dental, Life and Disability Risk Sharing - 19 1,5 J-3 RESOLUTION TO ADOPT THE INTERLOCAL AGREEMENT AND TO JOIN THE HEALTH INSURANCE TRUST GROUP SELF INSURANCE FUND FOR HEALTH, DENTAL, LIFE AND DISABILITY RISK SHARING WHEREAS Orange r nnnt�� —� provides to its employees (County or Local Agency) insurance and other health benefits; and WHEREAS, the North Carolina Association of County Commissioners Health Insurance Trust,hereafter referred to as "NCACC HIT",has been established by counties pursuant to G.S. 153A-445(a)(1) and G.S. 160A-460 through 160A-464; and WHEREAS, it is desirable for Ornnge Cnnnty to join NCACC (County or Local Agency) HIT and participate in its insurance and 4ealth benefits fund 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 County Commissioners of Orate County hereby adopts the interlocal agreement entitled "Interlocal Agreement for a Group Self-Insurance Fund for Health, Dental, Life and Disability Risk Sharing" with the amendments set out in the attached Memorandum of Agreement and thereby joins and agrees to participate in NCACC HIT 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 Trust. BE IT FURTHER RESOLVED that Flnine Nnlmec� Percnnnel Nrentnr is (County Official) authorized to execute the application to join NCACC HIT. This the 12th day of Ortnber , 199 . ATTEST Clerk Moses Carey, Chair Orange County Board of Commissioners cc: NCACC,P.O.Box 1488 Raleigh,NC 27602 Memorandum of Agreement Between Orange County and the North Carolina Association of County Commissioners (NCACC) Health Insurance Trust WHEREAS, Orange County has adopted a resolution dated October 12, 1995 authorizing Orange County to enter into an Interlocal Agreement (hereafter called Agreement)with the NCACC Health Insurance Trust(hereafter called NCACC Trust) which Agreement will provide for a self insurance fund for group health, dental, life, and disability risk sharing; and WHEREAS,the Agreement for group self insurance fund for group health, dental, life, and disability risk sharing is a part of that resolution, and WHEREAS, the Agreement does not fully describe the terms, conditions and implementation of the Agreement between Orange County and the NCACC Trust; and WHEREAS, Orange County and the NCACC Trust have agreed to clarify and provide more detail as to the terms, conditions and implementation of the Agreement. The parties therefore agree that the Agreement is subject to the following terms and conditions: 1. The Agreement covers the period January 1, 1996 through December 31, 1996. 2. Orange County may cancel the Agreement on its anniversary date of membership (January 1) after having given the NCACC Trust at least ninety (90) days written notice prior to this anniversary date. 3. Orange County's monthly health insurance contributions for the covered period are those set out in Appendix A. These contributions can only be increased and the frequency changed during the covered period with the written consent of Orange County. Orange County will consent to an increase in its contributions if the NCACC Trust: As a whole, experienced a deficit at the end of its plan year, and The NCACC Board of Trustees determined a special assessment against all plan members was necessary to offset the deficit, and Designated a pro-rata share to Orange County. Orange County's refusal to consent to an increase in contributions or change in frequency, except as described in this paragraph, is not grounds for cancellation of the Agreement by the NCACC Trust pursuant to Article VIII, Section 2 of the Agreement during the covered period. 4. Orange County offers HealthSource of North Carolina (a non-Blue Cross and Blue -2- Shield plan)to its employees as a health insurance plan option and may continue to do so on a "grandfather" basis when it joins the NCACC Trust, without regard to the number or percentage of employees participating in HealthSource. 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 Blue Shield) health maintenance organization product while continuing to offer a competitor's health maintenance organization product; or If Orange County discontinued its HealthSource option; or If Orange County offered additional health insurance carriers. 5. Orange County's health insurance plan reserves held by Blue Cross and Blue Shield of North Carolina as of December 31, 1995 will continue to be held by Blue Cross when Orange County joins the NCACC Trust and accounted for and distributed by Blue Cross, as provided for by the contract between Blue Cross and Orange County. 6. The underwriting, eligibility and benefit provisions of Orange County's existing contract with Blue Cross and Blue Shield as of December 31, 1995 are hereby incorporated in this Agreement with the NCACC Trust with the following exceptions: 1) that Orange County's existing Blue Cross and Blue Shield Traditional Plan will change to the Blue Cross and Blue Shield Preferred Provider Plan(PPO Select Plan S3) effective January 1, 1996 and 2)that the monthly contributions for coverage will be as designated by the NCACC Trust. Among other things,this means Orange County employee eligibility for health insurance will remain the same as in the referenced contract with Blue Cross. 7. Orange County has two sub-groups on its Blue Cross health insurance coverage for the Orange Community Housing Corporation and the Orange County Visitors Bureau. The NCACC Trust agrees to continue coverage for these in-the Orange County group on the same basis as Blue Cross and Blue Shield has done. 8. Orange County is entering into the NCACC Trust only for coverage as to health insurance and is not entering into life, dental, disability or other insurance programs through the NCACC Trust. 9. The NCACC Trust may only cancel Orange County's contract for health insurance coverage through the Trust for refusing or failing to comply with a loss prevention recommendation submitted to Orange County by the Trust with Orange County's written consent. 10. To the extent that the NCACC Trust can cancel the Agreement under Article VIII, 10/11/95 08:13 $1 919 733 1065 NCACC [ 002 OCT-10-1995 17:05 FROM GRPINM COUNTY PEFE0NP*L, I u �s Yrs.xsnea r.� -3- Section 2 of the Agreement,it may only do so following at Iasi thirty(3 0)days written notice from the NCACC Trust to Orange County of the NCACC Trust's intent to cancel and the rmson(s)for the cancellation. 11. The Agr c:meat may be cancelled by Orange county after riving fi$een(15)dxTs written notice to the NCACC Trost if the NCACC Trmst fails to comply with the terms and conditions of the Agreement. Cancellation by Change County,under this paragraph,will be preceded by at least thirty(30)days written notice from Orange County to the NCACC Trust of Osage County's intent to cancel and the reason(s)for the cancellation. 12. The NCACC Twat covers COBRA participants under the Trust and administers COBRA in a manner consistent with that provided by Blue Cross and Blue Shield through "COBRA Seri." 13. It is wknowledged that the NCACC Trost will occasionally make changes in the Interlocal Agreemmt to more econamically and efficiently serve all counties;but it is also acImowledged that Orange County has the right to cancel its participation at any awniversary if it does not agree to such changes or if it desires to cancel far any reason. Arun+amendment purporting to change underwriting,eligtbllity,benefit or contribution requiremenMs may only be made effective, without Orange County's COWL t,wine the nw plant year for ahicb Orange County has cat opportunity to cancel as provided in psragregh member 2 of this Memoraad=of Agreement. 14. Article VIII,Section 2c refers to%nay underwriting requirement of the Trust." T ese uoerwd*V requ a neuU are those set out in this Agreement,includ those itaoorpo=aded by reference in Item 6 of this Agreement. This is the 17, day of October ,1995. X�e Attcst- the Board Ron Aycock ve MMCW Moses trey,Chair N.C.Association of County Cammassinners Orange County Board of Co ernes Appendix A Orange County Health Insurance Contributions For January 1, 1996 through December 31, 1996 Blue Cross and Blue Shield Preferred Provider Plan (Preferred Care Select-Plan PPO-S3) Category Monthly Contribution Employee Only $162.85 Employee and Child(ren) $314.29 Employee and Spouse $343.61 Employee and Family $488.54 Blue Cross and Blue Shield Personal Care Plan (Option 100) Catego1y Monthly Contribution Employee Only $162.85 Employee and Child(ren) $314.29 Employee and Spouse $343.61 .Employee and Family $488.54 INTERLOCAL AGREEMENT FOR A GROUP SELF INSURANCE FUND FOR HEALTH, DENTAL, LIFE AND DISABILITY RISK SHARING This Agreement is made and 'entered into by and between all the parties who are now or may hereafter become members of this Trust and join in a group fund for the purchase of life and accidental death or dismemberment or other health insurance, and for risk sharing in the provision of accident and health benefits,which may include hospitalization,medical,surgical,major medical,dental and any other health care benefits, and long or short term disability, which Trust is acting by and through its Board of Trustees as provided herein. Article I. Purposes of the Aereement. 1. To carry out the desire of certain counties of the State of North Carolina to create and become the North Carolina Association of County Commissioners Health Insurance Trust, hereafter referred to as the "Trust", and to enable these counties to pool the risk of payment of the employee benefits set forth above pursuant to the provisions of North Carolina General Statutes 153A-445(a)(1) and 160A- 460 through 160A-464. 2. To designate a Board of Trustees to direct the affairs of the Trust and to describe the responsibilities of the Board. 3. To provide for payment,from the assets of the fund and from excess insurance purchased by the Trust, any insurance premiums and claims for health benefits covered by the Trust's plan, which awards have been sustained by final judgement where suit shall have been filed as authorized by the rules of the Trust. 4. To provide for payment by members of the Trust of premiums and contributions based upon appropriate classification rates,experience modifications,or other methodologies with which the Trust will establish and maintain a fund for the payment of the premiums and claims of covered employees, and their dependents, and retired employees and their dependents, of members and for payment of the administrative costs of operating the Trust. -2- Article II. Duration of the Agreement. This agreement shall remain in force until terminated by the Board of Trustees. Article III. Board of Trustees: Creation, Powers and Duties. 1. The counties that are signatories hereto do hereby establish the North Carolina Association of County Commissioners Health Insurance Trust, hereafter referred to as the "Trust", as a joint interlocal agency to operate a fund for employee insurance benefits and accident and health benefits risk sharing, hereafter referred to as the "Fund". The Trust and the Fund shall be governed by a Board of Trustees composed of seven (7) elected officials or employees of county governments who are members of the Trust and who shall be appointed by the President of the North Carolina Association of County Commissioners, hereafter referred to as the "Association". Three of the initial appointees shall serve three and one-half(31/2)year terms ending December 31, 1998;two shall serve two and one- half(21/2)year terms ending December 31, 1997;and two shall serve a one and one-half(11/2)year term ending December 31, 1996. Following these initial appointments, terms of Trustees shall be for three calendar years beginning January 1 of the first year and ending December 31 at the end of the third year. A member of the Board of Trustees shall continue to hold office until his successor is selected. Any vacancy shall be filled for the unexpired portion of the term by appointment by the President of the Association. A member of the Board of Trustees who ceases to be an elected official or employee of county government,or whose county ceases to be a member of the Trust shall be deemed to vacate his seat on the Board. 2. The Board of Trustees annually shall select a chairman from among its membership to preside for the ensuing year. A majority of the membership of the Board shall constitute a quorum thereof and any question may be decided by a majority vote. 3. The Board of Trustees shall have the following powers and duties: a) To control and supervise the affairs of the Trust and the Fund; b) To establish,operate and enforce administrative rules,regulations and bylaws as between the Trust and the individual members of the Trust; -3- c) To establish terms and conditions of coverage within the pool, including underwriting criteria and exclusions of coverage; d) To select and designate a Plan Administrator for the Trust, agree upon the terms of service fees to be paid to the Plan Administrator and assess the performance of the Plan Administrator,and to negotiate,review,and give final approval to any Agreement between the Trust and the Plan Administrator and to execute such Agreement; e) To select and designate other contractor(s) for the Trust, agree upon the terms of service fees to be paid to such other contractor(s) and assess the performance of such other contractor(s), and to negotiate, review, and give final approval to any agreement(s) between the Trust and other contractor(s) and to execute such agreement(s); f) To ensure that all claims are paid promptly; g) To take all necessary precautions to safeguard the assets of the Trust; h) To maintain minutes of its meetings; i) To delineate the areas of authority delegated by the Board of Trustees to the Plan Administrator and to other contractor(s); D To exercise sole discretion in determining whether applicants for membership shall be admitted to the Trust and whether existing members shall be suspended or expelled, subject to the following limitations: (1) Only governmental units, institutions or agencies in the State of North Carolina shall be eligible for membership; and (2) A member may be suspended or expelled only after receiving sufficient notice pursuant to Article VIII, paragraph 2, of this Agreement. The Board of Trustees may promulgate rules and regulations, as needed, regarding admission, suspension or expulsion of members; k) To approve and monitor all loss control programs; 1) To negotiate,execute and monitor any other contracts and agreements necessary to effectuate -4- this Interlocal Agreement; m) To bear sole responsibility for any dispositions out of the Fund by way of dividends or distribution, if any, of accumulated reserves to the members of the Trust. Any such dispositions shall be made solely at the discretion of the Board of Trustees; and n) To contract for and purchase excess insurance as deemed necessary to safeguard the assets of the Trust. Article N. Duties of Plan Administrator; Duties Of Other Contractors 1. The Board of Trustees shall designate a Plan Administrator for the Trust and its Fund. The Plan Administrator may contract with such other contractor(s) as is necessary for the administration of claims and services of this Trust and to provide for the coverage and services contemplated by this agreement. The Plan Administrator shall directly supervise other contractor(s) for the Trust. The Plan Administrator shall deposit to the account of the Trust at any bank or banks designated by the Board of Trustees,all contributions as collected, and such monies shall be disbursed only as provided by the rules, regulations and bylaws of the Board of Trustees, and the agreement(s) with the other contractor(s). The Plan Administrator shall receive a fee which shall be negotiated from time to time by the Board of Trustees, and which shall be set forth in the Agreement between the Trust and the Plan Administrator. All other contractors who render services for the Trust shall receive a fee which shall be negotiated from time to time by the Board of Trustees, and which shall be set forth in the agreement between the Plan Administrator and the contractor. 2. The duties and responsibilities of other contractor(s) may include, but are not limited to, claims administration, program development and loss control on behalf of the members. Other contractor(s) may be used to assist the Board of Trustees in determining all contributions due the Fund, and in such capacity,the contractor(s)may be required to prepare for payment all approved items of expense and claims, and give a monthly accounting of all monies and claims so handled. The responsibilities and duties of other contractor(s) shall be more particularly defined and described in the agreement(s) executed with the Plan Administrator. All books and records kept by a contractor that relate to the Trust shall be open to inspection by the Board of Trustees and the Plan Administrator or their agents at all reasonable times. Article V. Contributions to the Fund; Audits. 1. Contributions to the Fund by individual members shall be determined by the Board of Trustees. The Board of Trustees shall have the discretion to modify the contributions as may be necessary to maintain the soundness of the Fund. The Board of Trustees is authorized to determine the method and timing of payment of contributions to the Fund and the method and timing of the distribution of any accumulated reserves,with due regard..for the interests of the members and the financial security of the Fund. The Board of Trustees may distribute accumulated reserves in the form of a reduction of premiums and contributions if it so chooses. 2. The Fund shall be audited annually by a certified public accounting firm. The Board of Trustees shall obtain periodically an appropriate actuarial evaluation of the loss and loss adjustment expense reserves of the Fund including an estimate of losses and loss adjustment expenses incurred but not reported. Article VI. Amendment of the Agreement. The Board of Trustees of the North Carolina Association of County Commissioners Health Insurance Trust is hereby authorized to make any amendments to this agreement which would not fundamentally alter the contemplated arrangement. Any amendment shall be proposed by a member of the Trust or, alternatively, by the designated Plan Administrator,and submitted in writing to the Board of Trustees not less than thirty (30)days prior to the next regularly scheduled meeting of the Board of Trustees. A proposed amendment shall be adopted if approved by a two-thirds (2/3)vote of the Board of Trustees. Written notice of any amendment proposed for adoption by the Board of Trustees shall be mailed to each member not less than twenty(20)days in advance of the meeting at which such proposal is to be considered. Written notice of amendments finally adopted by the Board of Trustees shall be mailed to each member not more than thirty (30) days after adoption. Only such proposed amendment or amendments as are specifically submitted in writing in advance -6- may be considered by the Board of Trustees. Article VII. Terms, Conditions and Limits of Liability Exclusions Insuring Agreements Assistance and Cooperation of Members Subrogation and other Terms and Conditions of Membership 1. For the purposes of this Interlocal Agreement, the terms accident and health benefits shall include, but are not limited to, hospitalization, medical, surgical, major medical, dental and any other health care benefits,as they are subsumed or described in the policy or risk sharing contract approved by the Board of Trustees from time to time. 2. Terms, conditions and limits of liability, exclusions, insuring agreements, assistance and cooperation of members,subrogation and other terms and conditions of membership shall be governed by the policy or risk sharing contract approved by the Board of Trustees from time to time. Article VIII. Cancellation. 1. This Contract can be cancelled by the member only on a Trust anniversary date and only after having given written notice to the Trust at least ninety (90)days prior to such anniversary date. The Trust anniversary date shall be July 1 of each year. 2. This Contract can be cancelled by the Trust only on an anniversary date and only after having given written notice to the member at least ninety (90) days before such anniversary date except that the Trust may cancel at any time after giving fifteen (15) days written notice to the member if (a) the member has failed to pay any contribution when due, or (b) the member has refused or failed to comply with any loss prevention recommendation submitted to the member by the Trust or by the Service Agent(s) on behalf of the Trust, or (c) the member has refused or failed to comply with any underwriting requirement of the Trust. 3. If at any time this Contract is cancelled by any party, the Trust holds any contributions which are refundable to the member, such contributions shall be refunded following the time that the statute of limitations on all claims for the year has run. -7- Article IX. Terms of Azreement Conformed to Statute Terms of this Agreement which are in conflict with the provisions of North Carolina Law are hereby amended as necessary from time to time to conform to such law. Article X. Effective Date of A--reement. Any member who formally applies for membership in this Trust and Fund by submission of a resolution requesting membership in said Trust and Fund and is accepted by the Board of Trustees shall thereupon become a party to this Agreement and be bound by all of the terms and conditions hereof,and such resolution shall constitute a counterpart of this Agreement. G:\SHARED\HIM\INTRLCL2