1998 Administrative Services AgreementThe item(s) noted below is/are attached and forwarded to your office for the following action(s):
❑
Development Order
❑
Mayor's signature
❑
Final Plat (original mylars)
❑
Recording
❑
Letter of Credit
❑
Rendering
❑
Maintenance Bond
®
Safe keeping (Vault)
❑
Ordinance
®
Record Custodian
❑
Performance Bond
❑
Resolution
®
Attached is an original Amendment to BCBS Agreement 12-10-18
Once completed, please:
❑ Return original
❑ Return copy
Special Instructions:
Please file and maintain this 1 of 2 originals in regards to the amendment to the BCBS Health
Insurance ASO agreement effective January 1, 2019 and executed by the Mayor on December
10, 2018. The other original was forwarded to BCBS.
Please advise if you have any questions regarding the above.
Th you!
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From
T:\Dept_forms\City Clerk Transmittal Memo - 2009.doc
Date
EXHIBIT "B"
to the
ADMINISTRATIVE SERVICES AGREEMENT
between
BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. D/B/A FLORIDA BLUE
and
CITY OF SANFORD
FINANCIAL ARRANGEMENTS
Effective Date
The effective date of this Exhibit is January 1, 2019.
II. Monthly Payments.
A. Each month, Florida Blue will notify the Employer of the amount due to
satisfy the previous month's paid claims liability. Florida Blue also will
provide the Employer with a detailed printout of the previous month's
claims payments. The Employer agrees to pay the full amount of the bill
within ten (10) days of the written notification. If the payment is not
received by Florida Blue by the payment due date, the payment will be
considered past due and subject to a late payment charge, as set forth
below. Additionally, Florida Blue will immediately suspend claims until
payment is received by Florida Blue.
B. The Employer agrees to pay to Florida Blue, each month during and after
the term of this Agreement, an administrative fee, as set forth below. The
Employer agrees to pay to Florida Blue, each month, the administrative
fee within ten (10) days of the written notification of the amount due. If
payment is not received by Florida Blue by the due date, the payment will
be considered past due and subject to a late payment charge, as set forth
below. Additionally, Florida Blue will immediately suspend claims until
payment is received by Florida Blue.
III. Funding Information
A. Method of Funding Transfer: ACH
IV. Administrative Fees:
A. Administrative fees during the term of the Agreement:
$53.10 per enrolled employee per month from January 1, 2019 through
December 31, 2020. This fee includes a $4.00 Agent of Record fee.
$55.75 per enrolled employee per month from January 1, 2021 through
December 31, 2022. This fee includes a $4.00 Agent of Record fee. -
B. Administrative fees after the termination of the Agreement: 15% of claims
paid. This should not exceed seven months of the current administration
fee, times the current enrollment, at time of cancellation.
C. Florida Blue will pay Employer a $25,000 wellness contribution in 2019,
2020 and 2021, upon Employer executing the Amendment in 2019, 2020
and 2021. This is to be utilized by the Employer for any wellness related
initiatives or activities.
D. Access fees of up to 4.14% of Network Savings may be assessed for
claims incurred in states under the BlueCard program as explained in
more detail under Section 3.9 below. This access fee will not exceed two
thousand dollars ($2,000) for any one claim and will not apply in Florida
and Alabama.
V. Late Payment Penalty
A. A daily charge of .00038 times the amount of overdue payment.
The provisions of the Prompt Payment Act shall apply to this Agreement.
VI. Expected Enrollment
A. The administrative fees referenced above are based on an expected
enrollment of: 448.
B. If the actual enrollment is materially different from this expected
enrollment, Florida Blue reserves the right to adjust the administrative fees
as set forth in the Agreement. Administrative fees will be charged based
on actual enrollment.
... 1111 11111-1111 1 li lFEfjj,;;,j
N
THIS AMENDMENT, entered into on 2018 is by and
between Blue Cross and Blue Shield of Florida, Inc. d/b/a Florida Blue (hereinafter called
"Florida Blue") and City of Sanford (hereinafter called the "Employer"). In consideration of
the mutual and reciprocal promises herein contained, the Administrative Services
Agreement between Florida Blue and the Employer (hereinafter "Agreement') effective
October 1, 2004 is amended as follows:
Section 1, subsection 1.1, is hereby amended to extend the term of the Group Health
Plan until December 31, 2022 unless the Agreement is terminated earlier in
accordance with the terms of the Agreement.
2. Exhibit 8 to the Agreement is hereby amended, effective January 1, 2019. The
revised Exhibit B is attached to this Amendment and replaces the Exhibit B
previously attached to the Agreement.
3. Except as otherwise specifically noted in this Amendment, all other terms and
conditions of the Agreement shall remain unchanged and in full force and effect.
IN WITNESS WHEREOF, this Amendment has been executed by the duly
authorized representatives of the parties.
ATTEST.'
BLUE CROSS AND BLUE SHIEL '
OF FLORIDA, INC. D/BIA FLORID''
BLLIE
LA�ny
Title:
ATTEST CITY OF SAN
0-M 6- � i1A' 0- 01 11A 14 M 0. 1 R Q
Traci Houchin By: Jeff Triplel
City Clerk Mayor