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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
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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
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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
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2014
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For payments Customer makes after thirty(30)days of receiving notice of the amounts that Customer owes United, <br /> United will charge interest at the interest rate that United charge its other self-funded customers. <br /> Section 7—Providing Funds For Benefits <br /> Section 7.1 Providing Funds for Benefits. The Plan is Self-Funded. Customer is solely responsible for providing <br /> funds for payment for all Plan benefits payable to Participants,Network Providers,or non-Network Providers. <br /> Section 7.2 Bank Account. United, on Customer's behalf, will open and maintain a Bank Account at the Bank to <br /> provide United the means to access Customer's funds for the sole purpose of payment of Plan benefits, Plan <br /> expenses (such as state surcharges or assessments) and, when authorized by Customer, service fees. The Bank <br /> Account will be a part of the network of accounts that have been established at the Bank for United's self-funded <br /> customers.The funds in the Bank Account are Customer's and will not be comingled with any other customer funds. <br /> Section 7.3 Balance In Account. Customer will maintain a minimum balance in the Bank Account in an amount <br /> equal to not less than 6 days of expected Bank Account activity.United will establish this amount based on expected <br /> Plan benefit payments, with appropriate adjustments for anticipated non-daily activity (e.g., prescription drug <br /> benefits and service fee payments) as determined by United. United will determine if circumstances warrant <br /> increasing this minimum balance, and will notify Customer if and when the required balance or the amount <br /> identified above changes. <br /> The required minimum balance is based on Customer's financial condition as assessed by United. In the event <br /> United determines,based on reasonable information and belief,that Customer's financial condition has deteriorated <br /> or Customer continues to fail to comply with the material financial obligations specified in this Agreement, United <br /> may revise the required balance effective five(5)days from the date of notice. <br /> Section 7.4 Issuing and Providing Funds for Checks and Non-Draft Payments. The checks and/or non-draft <br /> payments United writes and issues to pay Plan benefits under this Agreement will be written and/or issued from one <br /> or more common accounts that are a part of the network of accounts maintained at the Bank for United's self-funded <br /> customers.When the checks for Plan benefits are presented to the Bank,the Bank will notify United and United will <br /> direct the Bank to either reject the checks or to withdraw funds from the Bank Account to fund the checks that are <br /> cashed. <br /> Section 7.5 Transfers of Funds. Funds will also be withdrawn from the Bank Account when a transfer of funds <br /> United made to pay Plan benefits is completed, such as when an electronic funds transfer has been made to a health <br /> care provider to pay benefits under the Plan. United will direct the Bank to withdraw funds from the Bank Account <br /> to fund the non-draft payments as they are issued. <br /> Section 7.6 Calls for Funds. The withdrawals for Plan benefits and service fees are paid for by the balance <br /> Customer maintains in the Bank Account. This balance will be drawn down each banking day to satisfy the <br /> previous day's liability. <br /> Customer will authorize United to initiate Automated Clearing House(ACH) transfers from Customer's designated <br /> benefit funding bank account to the Bank Account for the amount needed to pay claims processed and fees that are <br /> due. Every 5 business day(s), United will notify Customer of the amount due and United will within one business <br /> day, ACH, initiate transfers from Customer's designated funding bank account to the Bank Account in an amount <br /> necessary to pay Plan benefits. The number of days between transfers and the method of transfer are based on <br /> Customer's financial condition as of the Effective Date as assessed by United, as well as Customer's compliance <br /> with material financial obligations.United reserves the right to increase the frequency of such fund transfers and/or <br /> change the method of transfer if United determines, based on reasonable information and belief, that Customer's <br /> financial condition has deteriorated, or Customer continues to fail to comply with the material financial obligations <br /> specified in this Agreement. <br /> Section 7.7 Underfunding. If Customer does not provide the amounts sufficient to maintain the required minimum <br /> balance in the Bank Account, or to cover Bank Account withdrawals: (1) Customer must immediately correct the <br /> deficiency and provide prompt notice to United. (2) If United learns of the funding deficiency, United will notify <br /> Customer within one business day so Customer can correct the deficiency. (3)United may stop issuing checks and <br /> non-draft payments and suspend any of its other services under this Agreement for the period of time Customer does <br /> not provide the required funding. (4)If Customer does not correct the funding deficiency within three business days <br /> of United's notice to Customer,United may terminate this Agreement as otherwise set forth in this Agreement,such <br /> 9 <br />
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