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2014-318 HR - UnitedHealthCare for United HealthCare Application for Excess Loss Insurance Policy $1,625,322
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2014-318 HR - UnitedHealthCare for United HealthCare Application for Excess Loss Insurance Policy $1,625,322
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Last modified
5/16/2017 3:32:16 PM
Creation date
8/8/2014 11:38:20 AM
Metadata
Fields
Template:
BOCC
Date
9/17/2013
Meeting Type
Regular Meeting
Document Type
Others
Agenda Item
09/17/2013
Amount
$1,625,322.00
Document Relationships
2015-141-E County Manager - UnitedHealthCare of NC - Amendment to Excess Loss Insurance Policy $635,758
(Linked From)
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\Board of County Commissioners\Contracts and Agreements\General Contracts and Agreements\2010's\2015
R 2014-318 HR - UnitedHealthCare for application for Excess Loss Insurance Policy
(Linked To)
Path:
\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2014
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Section I—Definitions <br /> When these terms are capitalized in the Agreement they have the meanings set forth below. The words may be <br /> singular or plural. <br /> Agreement Period: The period of twelve (12) months commencing on the Effective Date and automatically <br /> continuing for additional 12-month periods until the Agreement is terminated. <br /> Bank: JPMorgan Chase Bank,New York,New York- <br /> Bank Account: Benefits Demand Deposit Bank Account maintained for the payment of Plan benefits, expenses, <br /> and fees. <br /> Employee: A current or former employee of Customer or its affiliated employer as described in Section 2.4. <br /> IRC: The United States Internal Revenue Code of 1986,as amended from time to time. . <br /> Network: The group of Network Providers United makes available to the Plan who have entered into or are <br /> governed by contractual arrangements under which they agree to provide health care services to Participants and <br /> accept negotiated fees for these services. <br /> Network Pharmacy: A pharmacy,including a specialty pharmacy and mail order pharmacy which has entered into <br /> or is governed by a contractual arrangement with United under which the pharmacy agrees to provide prescription <br /> drug services to Participants. <br /> Network Provider: The physician, or medical professional or facility which participates in a Network. A provider <br /> is only a Network Provider if they are participating in a Network at the time services are rendered to the Plan <br /> Participant. <br /> Overpayments: Payments that exceed the amount payable under the Plan. This term does not include <br /> overpayments caused by untimely or inaccurate eligibility information. <br /> Participant: Employee or dependent who is covered by the Plan. <br /> PHI: Any information United receives or provides on behalf of the Plan which is considered Protected Health <br /> Information as the term is defined in the privacy regulations of the Health Insurance Portability and Accountability <br /> Act of 1996. <br /> Plan: The plan to which this Agreement applies,but only with respect to those provisions of the plan relating to the <br /> Self-Funded health benefits United is administering,as described in the Summary Plan Description. <br /> Plan Administrator: The current or succeeding person, committee,partnership, or other entity designated the Plan <br /> Administrator who is generally responsible for the Plan's operation. <br /> Proprietary Business Information:Nonpublic information,trade secrets,and other data including,but not limited <br /> to,sales and marketing information,management systems,strategic plans and other information about the disclosing <br /> party's business,industry,products and services,plans, specifications,operation methods,pricing,costs,techniques, <br /> manuals,know-how and other intellectual property, in written,oral or other tangible form,provided by one party to <br /> another or its representative; and all information, documents, technology, products, and services containing or <br /> derived from Proprietary Business Information which was or may have been transmitted,given or made available to <br /> or viewed by one party or another in the course of the receiving party's relationship. United's Proprietary Business <br /> Information shall include,but not be limited to,discounts and other financial provisions related to United's Network <br /> of healthcare providers and claims data from which those financial provisions can be derived and financial <br /> provisions related to prescription drug products covered under the medical benefit, the Prescription Drug List, <br /> reimbursement rates,compensation arrangements,and all other financial provisions related to the pharmacy benefits <br /> contained in this Agreement. While the Prescription Drug List is considered United's Proprietary Business <br /> Information, it may be disclosed in the limited circumstances outlined in this Agreement. This information is <br /> collectively known as"United's Financial PBI". <br /> 1 <br />
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