Orange County NC Website
Browse       Search
EXHIBIT A-SERVICES <br /> The following are the administrative services United has agreed to provide to Customer. Customer may request that <br /> United provide services in addition to those set forth in this Agreement. If United agrees to provide them, those <br /> services will be governed by the terms of this Agreement and any amendments to this Agreement. Customer will <br /> pay an additional fee,determined by United,for these additional services. <br /> The Services described in this Exhibit will be made available to Customer's eligible Participants consistent with the <br /> Summary Plan Description under which the Participant is covered. <br /> A. ACCOUNT MANAGEMENT SERVICES <br /> Service Comments <br /> Implementation and maintenance of account. <br /> Enrollment meetings and support for locations that meet Minimum six weeks nonce of meeting. <br /> United's criteria. <br /> Standard initial enrollment kit. <br /> Bulk mailing of initial enrollment kits to Customer based <br /> on United's criteria. <br /> Ongoing account management including: <br /> • Designated account resources. <br /> • Ongoing management and review of benefits and data. <br /> Standard accounting structure based on United's criteria: <br /> • Suffixes to accommodate separate claims reporting for <br /> different benefit plans. <br /> • Claim accounts to accommodate separate claims data for <br /> different locations and <br /> _Maintenance of up to 2 separate benefit plans. <br /> Electronic Bill Presentment and Payment(EBPP),which <br /> provides capabilities to: <br /> • View invoices online. <br /> • Sort and search enrollee information. <br /> • Download billing information. <br /> • Remit payment online. <br /> Online administration services accessed through United's Customer reporting is included to the extent indicated in <br /> Employer eServices Web site including online eligibility Section D.eServices Customer Reporting Services. <br /> _maintenance and claim status inquiry_ <br /> Issuance of HIPAA Certificates of Creditable Coverag�__ <br /> Summary Plan Description(SPD)Assistance. United will If the SPD is not finalized sufficiently in advance of the <br /> prepare a customized draft of an SPD,either for each plan or Effective Date of United's services,United will either(i) <br /> multiple plans, as mutually agreed upon with one additional utilize the summary of Plan benefits and exclusions that United <br /> draft, in response to Customer's comments, and a final draft has created based on its understanding of Customer's Plan <br /> SPD. "Plan", for purposes of this paragraph, means each ' design and which Customer has reviewed and approved or(ii) <br /> individual plan design administered by United. The SPD will create,at United's discretion,an operational SPD which will be <br /> be in English. based upon the summary of Plan benefits that Customer has <br /> reviewed and approved. United will administer claims and <br /> United will print each SPD in its standard size and with otherwise provide its services in accordance with this summary <br /> United's standard cover in a quantity equal to 110% of the ' of Plan benefits and exclusions or operational SPD,as the case <br /> number of Employees participating in the plan,and ship to a may be,and it will govern and remain in full force and effect <br /> single location and/or post online. until a final SPD is provided to United <br /> If United is providing Drafts only or if Customer is producing <br /> the Final SPDs,Printing of SPDs will be at an additional cost. <br /> Summary of Benefits and Coverage: <br /> • Electronic version in United's standard format. <br /> • For medical Plans administered by United. <br /> • Initial request and up to 1 amendment�erear. <br /> 16 <br />