Ordinances No. 14,298ORDINANCE NO. 14,298
AN ORDINANCE OF THE CITY COUNCIL OF THE CITY OF BAYTOWN, TEXAS,
AUTHORIZING THE CITY MANAGER TO EXECUTE AND THE CITY CLERK TO
ATTEST TO A SERVICE AGREEMENT WITH RELIASTAR LIFE INSURANCE
COMPANYNOYA FINANCIAL AS THE CARRIER/ADMINISTRATOR FOR THE
CITY OF BAYTOWN'S STOP LOSS COVERAGE; AUTHORIZING PAYMENT OF
AN AMOUNT NOT TO EXCEED ONE MILLION NINE HUNDRED THIRTY
THOUSAND AND NO! 100 DOLLARS ($1,930,000.00) FOR THE SPECIFIC AND
AGGREGATE STOP LOSS COVERAGE; AND PROVIDING FOR THE EFFECTIVE
DATE THEREOF.
*************************************************************************************
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF BAYTOWN, TEXAS:
Section 1: That the City Council of the City of Baytown, Texas, hereby authorizes the City
Manager to execute a service agreement with ReliaStar Life Insurance CompanyNoya Financial, as the
carrier. administrator for the City of Baytown's stop loss coverage. Said agreement is attached hereto as
Exhibit "A" and incorporated herein for all intents and purposes.
Section 2: That the City Council of the City of Baytown authorizes payment to ReliaStar
Life Insurance CompanyNoya Financial in an amount not to exceed ONE MILLION NINE HUNDRED
THIRTY THOUSAND AND NO'100 DOLLARS ($1,930,000.00) pursuant to the agreement referenced
in Section 1 hereof.
Section 3: That for the specific and aggregate stop loss coverage, the City Manager is
hereby granted general authority to approve any change order involving a decrease or an increase in costs
of FIFTY THOUSAND AND NOA00 DOLLARS ($50,000.00) or less; however, the original contract
price may not be increased by more than twenty-five percent (25%) or decreased by more than twenty-
five percent (25%) without the consent of the contractor to such decrease.
Section 4: This ordinance shall take effect immediately from and after its passage by the
City Council of the City of Baytown.
INTRODUCED, READ and PASSED by the affirmativ�ote of the City Co l of the Cityof
Baytown this the 12t" day of December, 2019. ` J
ATTEST:
LE H, City Clerk
APPROVED AS TO FORM:
ObNACIO RAMIREZ, SR., C& Afi4mey
u
19
cobfs0l .legal %Karen.Files.City Council Ordinances\2017\December 14 StopLossCoverage.doc
Exhibit "A"
ADMINISTRATION AGREEMENT
ReliaStar Life Insurance Company, Minneapolis, MN VOVA.
ReliaStar Life Insurance Company of New York, Woodbury, NY
Members of the Voya® family of companies FINANCIAL
(the "Company")
Policyholder Name (the"Policyholder') City of Baytown
Policy Effective Date 01/01/2020
Insurance Contracts. The Company issues insurance policies and certificates based on your application and our state approved products (the "Policies").
Our obligations are determined solely by the terms of the policies we issue.
EXCESS RISK COVERAGE
Claim Administration. Upon determination of a potential claim under the Policy, you will confirm employees' eligibility for coverage and provide
required eligibility and claim documentation to the Company, either directly or through your health claim administrator. The Company shall be
responsible for all claim reviews, determinations and payments under the Policy.
Confidentiality. We will keep confidential all information provided to us by you or your health claims administrator in connection with the Policy, in
compliance with applicable law. You authorize your health claims administrator, if any, to release to the Company information and data regarding claims
paid to be used in connection with the Policy.
GROUP ANNUAL TERM LIFE, PERSONAL ACCIDENT INSURANCE, DISABILITY, CRITICAL ILLNESS, ACCIDENT
AND/OR HOSPITAL CONFINEMENT INDEMNITY COVERAGE
Policy Administration. Your group policy will be "Self -Administered". This means that you or a third party that you engage will be responsible to maintain
all enrollment, beneficiary, and billing records for the Policies (as applicable). The records you keep must provide the ability for you and/or your
employees to:
• appropriately apply Policy limits and rules
• know how much coverage the employee has at all times
• provide the employee with the appropriate "Conversion" and/or "Portability" documentation (as applicable)
• set up any payroll deductions correctly
• pay premium to the insurance company with supporting documentation
• file a claim
The parties agree that the Policies will be self-administered by Policyholder and that the insurance charges reflect that arrangement.
Communications. All forms and other materials we provide to you must be presented to employees without alteration. Any benefit and eligibility
descriptions you or your third party service provider communicates to employees must be consistent with the materials and guidelines we provide to
you. We will work carefully with you to make corrections in the case of any inadvertent error in communications. However, you are responsible for any
costs incurred in correcting errors caused by incorrect data you provide to employees or to Company, including incorrect benefit descriptions and
eligibility determinations.
Evidence of Insurability. If evidence of insurability is required in connection with an application for coverage under the terms of a Policy, you will apply
the evidence of insurability rules appropriately, obtain the necessary forms from any applicant for such coverage and provide those forms to the
Company.
Claim Administration. Upon receipt of notice of a potential claim under a Policy, you will confirm employees' eligibility for coverage and provide
required claim documentation at the Company's request. The Company shall be responsible for all claim reviews, determinations and payments.
Certificates of Insurance and Summary Plan Description. If you request that we provide Summary Plan Description(s) ("SPD") for distribution to ERISA
plan participants, we will provide the SPD using our standard language and format unless otherwise directed by you. If we agree to electronically post
certificates of insurance and/or SPDs for access by your employees, you are responsible for assuring that each covered employee is informed how the
documents can be accessed and that each employee has access or otherwise receives a copy(ies) of these documents. Any legal advice as to the style,
format, content or distribution of the SPD or distribution of the certificate of insurance must be provided by your legal counsel. We are unable to
provide legal advice to your plan and assume no responsibility for meeting ERISA's disclosure requirements.
Self -Administered Page 1 of 2 - Incomplete without all pages. Order#173385 05/17/2018
GENERAL ADMINISTRATION -ALL PRODUCTS:
Record Keeping. You agree to maintain accurate books and records documenting the administration of the Policies, including employee demographics,
eligibility records, dependent data, coverage amounts, enrollment history, payroll deductions, benefit elections and beneficiary designations (as
applicable). Such records must be maintained for a period of seven (7) years following termination of the Policies to which they relate. Upon reasonable
notice, we shall have the right to review, inspect and audit, at our expense, the books, records, data files or other information maintained by you or your
vendor related to the Policies.
Transmission of Data. You are responsible for the accuracy and security of data transmitted to us, including data transmitted by any third party service
provider you engage to assist in administration of your benefit plans. Each party will establish and maintain (1) administrative, technical and physical
safeguards against the destruction, loss or alteration of data, and (2) appropriate security measures to protect data, which measures are consistent with
all state and federal regulations relating to personal information security, including, without limitation, the Gramm -Leach -Bliley Act.
Premium payment. If you engage a third party to submit premium to us, we will not consider the premium paid until it is received in our Home Office.
General terms. This Agreement will remain in effect during the duration of the Policy and will terminate automatically upon termination of all Policies.
This Agreement may be amended only in writing signed by both parties. In the event of any conflict or inconsistency between the terms of this
Agreement and the terms of any Policy, the terms of the Policy shall control.
Governing law. This Agreement shall be governed in all respects, including validity, interpretation and effect, without regard to principles of conflict of
laws, by the law of the State of Texas.
Accepted and Agreed to:
Policyholder Name (Please print.)
,11111* Policyholder Authorized
Print signer's name and title
RELIASTAR LIFE INSURANCE COMPANY
RELIASTAR LIFE INSURANCE COMPANY OF NEW YORK
Date
� 4 A--�,, , :5�
Company Authorized Signature Date
Print signer's name and title Mona Zielke, Vice President
Self -Administered Page 2 of 2 - Incomplete without all pages. Order#173385 05/17/2018