1147-Flexible Spending Account AdministrationC_- I i "Al
AGREEMENT FOR SERVICES
FLEXIBLE SPENDING ACCOUNT ADMINISTRATION
AGREEMENT made this first day of September 1995, between Seminole County, Florida Government,
(Employer, and Flex Comp of America, I nc. ('Consultants").
WHEREAS Employer Intends to continue its Cafeteria Compensation Plan (the "Pla in compliance with
Section 125 and other applicable sections of the Internal Revenue Code;
WHEREAS the Employer may wish to establish a Consolidated Omnibus Budget Reconciliation Act of 1086
(hW9in referred to as COBRA) continuation of coverage notification program for qualified beneficlarlos of Its
Sections t 05(e) and 125 health plan(s), and the Employer may desire to contract Consultants for the purpose
of advising Employer (Plan Administrator) in complying with the provisions of Title X of COBRA,
WHEREAS Employer intends to ensure c =piiance with the neon- Discrimination 1 of Sections 7e.
105, 108, 120, 125, and 120 of the Internal Revenue Code-, and
WHEREAS the Consultants are making available such administrative services as are desired by Employer,
NOW THEREFORE. in consideration of the mutual promises and agreements herein contained, the receipt
and sufficiency of which Is hereby acknowledged the parties agree as follows
ARTICLE I
FLEXIBLE SPENDING ACCOUNT ADMINISTRATIVE RESPONStSILITIES
1. Consultant agrees to make available a model Cafeteria Compensation Plan that may be used as
the basis for Employees Plan.
2- Employer will be Plan Administrator, and hereby designates and appoints Consultants to perform
the functions and duties necessary to prepare, implement and operate the Plan for the Plan Administrator.
3. Employer agrees to provide data to make necessary payroll deductions and assist Consultants in
implementing and operating the Man as designed by the Plan Administrator.
4. Consultants agree to perform all the functions and duties essential in preparation and
implementation of Flexible Spending Accounts
5. Consultants agree that on an annual basis they shall review affected portions of he Cafeteria saran
and related documentation and at no cost, update the Plan and related documentation.
8. Consultants shall prepare and provide descriptive brochures, booklets, election forms. and all
other documentation required to be provided to Plan participants during the initial enrollment.
7. Consultants agree to perform all the duties and functions essential to Continuing operation of the
Flexible Spending Account Administration after its Implementation, which will include annual program
reviews and preparation of required governmental reports relating to the Plan.
8. Employer and Consultant acknowledge the Employer's obligation to comply with confidentiality
provisions of Chapter 119, Florida statutes, and that this Statute governs the terms of this agreement.
s. In the event that Employer elects to use a Claims Payment account maintained by Consultants at
a bank or other tnsotutlon of Consultants' choosing for the payment of premiums or other fees due under the
normal operation of the Plan, Consultants shall be entitled to offset account charges with bank - initiated
credits on Employer funds deposited In such account.
10. Consultants warrant that the Plan and the method of implementation prescribed by Consultant
satisfy current interpretation of IRS regulations and state and federal law.
S —//
AGENDA I M
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MAY 61998
AGREEMENT made this first day of September 1995, between Seminole County, Florida Government,
(Employer, and Flex Comp of America, I nc. ('Consultants").
WHEREAS Employer Intends to continue its Cafeteria Compensation Plan (the "Pla in compliance with
Section 125 and other applicable sections of the Internal Revenue Code;
WHEREAS the Employer may wish to establish a Consolidated Omnibus Budget Reconciliation Act of 1086
(hW9in referred to as COBRA) continuation of coverage notification program for qualified beneficlarlos of Its
Sections t 05(e) and 125 health plan(s), and the Employer may desire to contract Consultants for the purpose
of advising Employer (Plan Administrator) in complying with the provisions of Title X of COBRA,
WHEREAS Employer intends to ensure c =piiance with the neon- Discrimination 1 of Sections 7e.
105, 108, 120, 125, and 120 of the Internal Revenue Code-, and
WHEREAS the Consultants are making available such administrative services as are desired by Employer,
NOW THEREFORE. in consideration of the mutual promises and agreements herein contained, the receipt
and sufficiency of which Is hereby acknowledged the parties agree as follows
ARTICLE I
FLEXIBLE SPENDING ACCOUNT ADMINISTRATIVE RESPONStSILITIES
1. Consultant agrees to make available a model Cafeteria Compensation Plan that may be used as
the basis for Employees Plan.
2- Employer will be Plan Administrator, and hereby designates and appoints Consultants to perform
the functions and duties necessary to prepare, implement and operate the Plan for the Plan Administrator.
3. Employer agrees to provide data to make necessary payroll deductions and assist Consultants in
implementing and operating the Man as designed by the Plan Administrator.
4. Consultants agree to perform all the functions and duties essential in preparation and
implementation of Flexible Spending Accounts
5. Consultants agree that on an annual basis they shall review affected portions of he Cafeteria saran
and related documentation and at no cost, update the Plan and related documentation.
8. Consultants shall prepare and provide descriptive brochures, booklets, election forms. and all
other documentation required to be provided to Plan participants during the initial enrollment.
7. Consultants agree to perform all the duties and functions essential to Continuing operation of the
Flexible Spending Account Administration after its Implementation, which will include annual program
reviews and preparation of required governmental reports relating to the Plan.
8. Employer and Consultant acknowledge the Employer's obligation to comply with confidentiality
provisions of Chapter 119, Florida statutes, and that this Statute governs the terms of this agreement.
s. In the event that Employer elects to use a Claims Payment account maintained by Consultants at
a bank or other tnsotutlon of Consultants' choosing for the payment of premiums or other fees due under the
normal operation of the Plan, Consultants shall be entitled to offset account charges with bank - initiated
credits on Employer funds deposited In such account.
10. Consultants warrant that the Plan and the method of implementation prescribed by Consultant
satisfy current interpretation of IRS regulations and state and federal law.
S —//
AGENDA I M
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ARTICLE II
TERMINATION OF CAFETERIA PLAN SERVICES UNDER THIS AGREEMENT
The Employer at its discretion may terminate the portion of this agreement relating to Plan
administrative services for cause at any time. Cause for termination Shall include but not be limited to any of
the following reasons:
t. In the event Consuttants become bankrupt or insolvent, or if Consuktants are suspended or
restricted from performance by any Federal or State regulatory authority. Termination shall also be available
to Employer in the event Consultants are unable to perform as set forth in this agreement;
2. Consultants fail to meet with employees in advance of each salary determination period and
provide timely information to Employer so that salary checks can be timely prepared with minimal additional
administrative efforts or fail in other ways to facilitate administrative implementation within existing Employer
resources, as may have been agreed upon.
3. Employer or any of its employees receive an inquiry from the IRS indicating the possibility that all
or some portion of the Plan Is not legally or validly implemented:
4. Employer is required for any reason to verify employee reimbursement claims.
5. Any portion of the Plan (or the type of plan adopted) is ruled Illegal by statute, regulation or
opinion of any governmental body or use of any element of the Plan Is restricted;
Employer may elect to terminate the Plan without cause at any time, but if such termination occurs
during the Plan Year following the date of this Agreement or the renewal of this Agreement, Consultant shall
be paid adual costs for performing normai calculations necessary to enable Employer to make any required
reports and to adjust employee accounts so as to conform with pertinent regulations governing such
terminations.
ARTICLE Ill
NON - DISCRIMINATION SERVICES
i . Consultants agree to ensure that the Flexible Spending Accounts which are incorporated into the
Plan comply with documentation and employee notiticatlon requirements.
2_ Employer hereby designates and appoints Consultants to perfprm the functions and duties
necessary to prepare, implement and operate the monitoring and testing procedures required to demonstrate
non- discamination for the Spending Account portion of the Plan.
3. Consultants agree to fumish documentation that in the opinion of its counsel meets the written
requirements of the Code as amended.
4. Consultants shalt test Flexible Spending Accounts for non - discrimination compliance using the
data provided by the Employer.
5. Con9ultants shall provide all reports and data needed for tax reports and audit files in pursuit of
compliance with the Code.
a. Employer acknowledges that Consultants are not responsible for any penalties resulting from
inaccurate reports produced from faulty data supplied by Employer.
ARTICLE IV
TERMINATION OF NON - DISCRIMINATION SERVICES UNDER THIS AGREEMENT
The Employer at Its discretion may term the portion of this agreement relating to non -
dis loi: I the even Consultants Consultants bec bankrupt or ca i or if lim to
f or
following:
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rest+icted from peifomrance by Federal or Stale regulatory authority. Termination shall also occur in the
event Consultants are unable to perform as set forth in this agreement.
ARTICLE V
COBRA RESPONSIBILITIES OF CONSULTANT
Consultant herein agrees to provide the COBRA administrative services upon request of Employer including
but not limited to:
1. Development, design and installation of the COBRA administration program.
2. Notifying qualified beneficiaries of their tight to continue coveraga as required under COBRA
legislation following notification by the Employer to Consultants of a qualifying event.
3. Enrollment of qualified beneficiaries when applicable into the continuation of coverage (COBRA)
program.
4. Collection of said premiums from qualified beneficiaries enrolfifrg in the Continuation of coverage
(COBRA) program. Remittance of collected premiums to Insurer or Employer for said qualified beneficiaries
each month.
5. Preparation and submission of monthly reports indicating qualified beneficiaries electing to
continue coverage and qualified beneficiaries who are terminating coverage to the Employer, artd as deemed
necessary by the Consultant, or to the Claims Administrator or Carrier or their successors
6. Advise and assist the Employer with the implementation and application of the COBRA
notification program.
7. Address any and all Inquiries from third party claims payers with respect to the coverage status of
qualified beneficiaries.
e. Hold Employer harmless from COBRA penalties imposed for failure to comply with statutory
requirements, providing that Employer has performed responsibilities outlined in this agreement.
ARTICLE VI
COBRA RESPONSIBILITIES OF EMPLOYER AS PLAN ADMINISTRATOR
if COBRA services are requested, the Employer hereby agrees to perform the functions and duties
set forth as follows:
1. Distribution to each employee and hisfher dependents at their residence address by first class
mail an explanation of the Continuation of Coverage Rights and ReWmments at the time said employee
qualifies to receive coverage under the Plan sponsored by the Employer.
2. Notify Consultants within a period of till days after becoming aware of the occurrence of a
qualifying event.
3. Provide to Consultants the proper billing rates to be used in prcparing the monthly statements to
those efeding continuation of coverage.
4. Make payment of all premiums, fees and contributions required to continue an yy insurer, Health
Maintenance Organization, sen4nsured or similar program for services as contracted by the £rnployer.
5. Maintain the current status of the program and Plan under state Insurance laws and under local.
state and federal tax laws.
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ARTICLE Vll
TERMINATION OF COBRA SERVICES UNDER THIS AGREEMEN
1. In the event that either party fails to comply with its obligations in any material respect under this
agreement and fails to correct such noncompliance within 30 days after receipt of written notice of such
failure and requesting that H be corroded, the other party may terminate this agreement by tendering a
notice of termination to the noncomplying party 30 days prior to the effective date of such termination with a
disposition of pending matters to be concluded as provided herein.
2. The Employer and Consultant further agree that if Consultant has failed to maintain a satisfactory
quality of service and such failure hae not been corrected within 30 days after receipt of written notice from
Employer, the Employer may terminate the COBRA services under this agreement by tendering a notice of
termination to the other party 30 days prior to the effective date of such termination with a disposition of
pending matters to be concluded as provided herein.
ARTICLE VIII
TERM; BASIS FOR RENEWAL OF SERVICES AGREEMENT
This Agreement shalt remain in effect for the period of the current Plan: Year, and except for reasons as
specified below and as stipulated in Articles lit and XI, this services agreement shall automatically renew
thereafter from year to year.
1. Employer and Consultant mutually agree to extend the existing contract for revised
compensation or,
2_ Consultant advises the Plan Administrator that it does not wish to continue to provide any
administrative services to the Plan Administrator. in which case, notification of non- renewal shall be made to
the Plan Administrator In writing, not less than 90 days prior to the expiration of this agreement or,
3. The Employer as Plan Administrator advises Consultant it no longer desires Consultant to provide
specific administrative services 10 the Man Administrator. In which case, notification of non - renewal shall be
made to Consultant in writing, not less than 80 days prior to the expiration of this agreement or,
4. The Employer as Plan Administrator executes such renewal agreement or other services
agreement replacing (his services agreement.
in the case of non - renewal, the Plan Administrator shall have the right to receive all ttm Plan
Administrator files and relevant documentation relative to the plans being administered. If (he Plar
Administrator Mess to receive such Information. then the Plan Administrator shall provide access to such
materials to Consultant if any suit or suits are filed against Consultant with respect to the Plan Administrators
COBRA or other affected benefit accounts.
ARTICLE IX
MISCELLANEOUS PROVISIONS
1. The Employer as Plan Administrator shall defend and indemnify Consultant against any and all
claims, loss, damages, expense and liability arising from Employer's failure to perform hereunder unless the
Same ari claims, Of the aims, lo ss, negligence
damages, es, C e pe ns se e an Consultant agility rising from and settant s indemnify failure t Employer
conform
f
any and aIt clss, dmp expense
hereunder unless the same results tram Employers negligence.
2, Settlement of disputes shall be under Section 55.1 'Prompt Payment Procedures, for payment
disputes, and Section 220.102, 'ConVac t Claim$,* Seminole County Code, for contract claims. In the event
to t esolve t di disputes through voluntary med a i n, wittt the costs exhausted, voluntary parties mediation exercise
hared equally. ego
3. Should the Plan Administrator matte a modification of the Plan provisions which substantially
increase or decrease the services to be rendered during the term of this contract, the fees stated in this
agreement may be adWed as mutually agreed upon by the Plan Administrator and Consultant. f=ailure to
reach agreement with rasped to such fee adjustment shall be cause for termination of the portion of this
wntas relating to the
pending administrative
strti Services in provided y either party upon 80 days written notice of the
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4. This agreement will be construed according to the taws of the State of Florida, and all provisions
hereof shall be administered according to the laws of such State.
5 Consultant shall have the right to retain outside services at its cost and at no cost to Em
whenever necessary induding administrative services, provided that such action will not relieve Consultant of any Obligations hereunder, and also provided that consultant gives notice of such adion to Employer.
6. Consultants shall be entitled to the following consideration:
aj an initial setup fee is not required.
b) a monthly administration fee is not required as long as Professional insurance
„orWation (PiC) is used for enrolling the Flexible Spending Accounts, and PIC has access to payroll
reductions for its various products_
c} an annual re- enrollment fee is not required as Fong as PIC products are supporting the
administration costs,
d) no fee is being imposed for Non - Discrimination services described in this agreement. in
the event software becomes necessary for the determination of compliance under future legislation,
Employer shelf have the fight to reject software offered by Consultant. Any fee imposed for compliance
software shall Include necessary conversion software and services described earlier in this agreement.
Plan, either its own accou or a Claim Payment acccountprovided by Connsultant� jhe Consultant hl t
responsible only for the cost of the initial checks ordered. The initial order will be for the number of c
deemed reasonably sufficient for the proper operation of the first year of the Plan_ ecks
f} if Employer Select$ COBRA services, Consultant wilt charge a fee of $15.00 per
qualifying event to be paid as billed monthly. in addition. Consu ge ltant will retain the 2% COBRA surchar
allowable under Section 162 of the Code.
7. Nothing contained herein shall obligate Employer to utilize Consultants as their agents or brokers
In providing existing fringe benefits to employees.
6. Consultants wilt maintain a $50,000 blanket Fidelity bond and shall provide the same to Employer
upon request.
9. Consultants agree that their employees and/or agents shall treat and maintain as Employees
confidential property and shall not disclose to others or use during or subsequent to the termination of this
Agreement, any information (including any technical information, employees, financing, or costs) which may
come within their knowledge or which may be developed by Consultant, its employees or agents, in the
performance of its obligations hereunder, without in each instance securing the prior written consent of
Employe-.
10. This Agreement constitutes the entire agreement and understanding between the parties hereto
pertaining to the subject matter contained herein and cancels and supersedes any and ail other prior and
contemporaneous oral or written agreements, understandings, negotiations, or discussions. Any
reptesentation, promise, modification. or amendment to this Agreement shall not be binding on either party
unless in writing. stating with specificity the proposed modification, amendment, promise, or representation
WA signed by the party to be bound. Neither party may assign any of its fights, duties, or obligations without
the prior written consent of the other party. No modification or amendment of any provision of this
agreement shall be construed as a waiver, breach. or cancellation of any other provision. No waiver b
either party with rasped to any breach of default or of any right or remedy, shalt be deemed to constitute a
continuing waiver of any other breach or default or of any other right or remedy, unless such waiver is in
writing and signed by the party to be bound.
11. Where other related administrative services are to be provided by Consultant, amendments to
this basic agreement, if any, are incorporated by reference. Any such amendments shalt be subject to the
terms and conditions of the basic agreement unless specified to the contrary.
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IN WITNESS VVHERe-OF, the parties hereto have caused this Agreement to be executed oo the day
and year nrsi written above.
ye n aunty 8Oara of County Commissioners:
B
Consultant: Flex Comp of America, Inc.
By. a992
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Professional Insurance Corporation
- Fax Cover Sheet -
Date: 5/6/985
Pages: 7 including this page
To: William A. Simmons
City Manager
City of Sanford
Phone: 407 - 330 -5604
Fax Phone: 407 - 330 -5606
MAY 61998
1: � � �� ✓ /J1
From: Doug Murdock
Phone: 407 - 366 -4252 (ext. 1 )
Fax: 407- 365 -2555
Subject: Agreement for services between FlexComp of
America and Seminole County.
The following is the copy of the agreement you requested. Please let
me know if it is not legible and I'll get a better copy to you.
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sent by: norKGenter eoU 4Uldbb2bbb
Ub/01/98 10:15AM Job 309
PIC, EMPLOYER AGREEMENT
(TO BE COMPLETED IN FULL)
PROFESSIONAL INSURANCE CORPORATION
GENERAL INFORMATION
Page 212
r LS�1.�
I
Name of organization Board of County Commissioners of Seminole Co unty
Year Established
Account Contact Name: Li Eiland
_
Acltlrt .__ 1301 E. Second Street ci San ford
y
FL jil 3''- 7 1.
Phone ( 407 321 -1130 (ext 79 5_0) ;Mature of Business Count Government
(Include Area Code)
-
Total Number of Eligible Full -Time Employees 1150
INSURANCE COVERAGES
'?A LIFE: E- mployer will pay NA k Employee will pa },NA
DISABILITY
% of Premium
Y_ INCOME: Employer will pay 0 Employee will pay 1
% of Premituli
MEDICAL EXPENSE: Employer will pay NA o Employee will pay NA
f CANCER:
;� of Prornitttil
Employer will pay 0 % Employee will pay 100
% of Premium
ACCOUNT DESCRIPTION
it Account a Cafeteria Benefit Program (Section 125)? XX Yes No
_
I ?i: ><' , Income is: — included in (under) Section 125. k Included on an individual by individual basis ; .
not included in (under) Section 125.
partially included in (under) section 125. What !� of premntm
,._ � l (JE'E (iii() \tE? )
is partially included in (under) Section 125.
Aft -.- rur employees exempt from Social Security taxes? Yes No
BILLING INSTRUCTIONS
_Y_ Monthly Semi- ylonthly i (3l, -XAf 1,1 y
l or Rec. paper bill from PIC Send paper bill to PIC
_ -- Tape -Lo -tape bill
Processor's Name for tape to -tape bill only
Address:
Liliin8s To
:Ad.: eas st IJ liferenl
Thar; Above•)
Name: _
Address:
Phone:
Phone:
AUTHORIZATION
T'lus Agreement authorizes the contact of employees/ members of this Organization concerning insurance to be provided by
I' oftrssional Insurance Corporation. Authorization is given to send billings to the location named above. 1'he respon ihilitc
tit ojssuring that premiums have been remitted to Professional insurance Corporation on behalf of their employees/mi^mlers
is that of the Organization named above. Either the Organization or Professional Insurance Corporation may, upon r easonahh
nonce to the other, terminate this Agreement, in w _ vent the payment of premiums v, ilI be a matte r of ac countin dirt cti�
he t <.vc m
t n each employee /member Profess surance Corpo n.
3a Si ature
AD
_ - mployer. , uthorized Official
- - -- --
0 Yes, Please send it group kit
Signature of PI Insurance Representative Agent Number
i:n plo':er may by subject to certain State and /or Federal Employment celat - laws (including FRISA, ll<L Sections 89 and VZ , and
;.d i le:ly responsible for compliance with these taws including any required benefit payments nat covered by in ln r',.,n
f h! - :.,x�'j -. �s �'# �'t�r• - 1," � t � r r .r � _
SIC co
MM
.. �,�nseds i Guarantee Issue Yes No
Plans�af�Cvver � � $ —
�.. Date
)ngmal - Home Office; I Copy - Employer; 1 Copy - RAD /Agent
Office Approval
Supply Nu. 1.16416M -3.ii
in. 2