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HomeMy WebLinkAboutC-7944-1 - Benefit Coordinators Corporation Adminstration AgreementBCC BENEFIT COORDINATORS CORPORATION ADMINISTRATION AGREEMENT AMENDMENT THIS AMENDMENT, effective as of January 1, 2024 ("Amendment Effective Date"), amends the Administration Agreement ("Agreement") dated January 1, 2021 between Self Insured Services Company dba Benefit Coordinators Corporation ("BCC') and City of Newport Beach ("Employer") FOR GOOD AND VALUABLE CONSIDERATION, the receipt and sufficiency of which are hereby acknowledged, the undersigned parties agree as follows: 1. Section IV —Termination & Revision. Employer and BCC amend the Agreement to extend the period of performance and Schedule of Fees to be in force through December 31, 2025. 2. Continuation of Agreement. Except as amended herein, the terms and conditions of the Agreement shall remain in full force and effect. 3. Binding Agreement. The parties hereto acknowledge that each has read this Amendment, understand it, and agree to be bound by its terms and conditions as stated herein. Through duly authorized representatives, the undersigned parties hereby execute this Amendment effective as of Amendment Effective Date. CITY 0 13E�CjS�`/By: T1L Title: � p � Date: 11 a -( SELF INSURED SERVICES CORPORATION dba BENEFIT COORDINATORS CORPORATION By: Title: V.P. Pittsburgh Operations Date: 12.21.23 APPROVED AS TO FORM: CITY ATTO NEY'S OFFICE By: r n G. H , orn©y r77 3 Attest: ! d4 Leilani 1. Brow , MMC, City Clerk Date: Benefit Coordinators Corporation • w%v\v.bcntcel.com Two Robinson Plaza, Suite 200, Pittsburgh, PA 15205 • t 1-800-685-6100 • F-112 276.6650 a BENEFIT COORDINATORS CORPORATION ADMINISTRATION AGREEMENT M Name of Employer City of Newport Beach Business Address 100 Civic Center Drive Beach, CA 92660 Employer's tax identification number (EIN): 95-6000751. 1BCC In consideration of the covenants and obligations hereinafter set forth to be well and faithfully performed by the respective parties hereto, Self Insured Services Company, doing business as, Benefit Coordinators Corporation (hereinafter referred to as the "Administrator") and Employer hereby agree as follows: SECTION I - SERVICES TO BE PROVIDED TO EMPLOYER 1.1 In consideration of the fees to be paid to it, the Administrator hereby agrees to provide administrative services to Employer in connection with the agreements identified in the "Services Exhibit" attached to this Benefit Coordinators Corporation Plan Administration Agreement (the "Administration Agreement" or the "Agreement"), as more fully set forth in each agreement's respective Exhibit hereunder, and in accordance with the following terms and conditions. 1.2 Administrator shall perform the services under this Agreement (the "Services") in a professional and diligent manner and in accordance with industry standards. Administrator has obtained and will at all times maintain during the term of this Agreement, all applicable licenses, permits, approvals and certifications necessary to provide the Services. In performance of this Agreement, Administrator shall comply with all applicable Federal, State and local laws, statutes, ordinances, rules and regulations. SECTION II -ADMINISTRATION FEES 2.1 Employer shall pay fees to the Administrator as set forth in the Schedule of Fees Exhibit of this Agreement, which shall not exceed Seventy Five Thousand Dollars and 00/100 ($75,000.00). The "start up" fees for the purpose of establishing the services in connection with Employer shall be due and payable upon execution of this Agreement and shall not be refundable under any circumstances. The Administrator's fees will be subject to revision at the contract renewal and any change in fees will be communicated to Employer thirty (30) days prior to the effective date of the change. Administrator reserves the right, with 30 days' notice, to modify fees if Employer's employee base is modified by a 20% or greater percentage. 2.2 Employer and the Administrator acknowledge that the Administrator's fees for the services rendered by the Administrator in connection with the welfare benefit plans covered by this Administration Agreement (collectively the "Plans") will be paid by Employer, except as indicated in Schedule of Fees Exhibit. 2.3 Employer specifically acknowledges that the Administrator will have the right to immediately terminate services under this Agreement in the event that Employer fails to comply with the terms of the Agreement in any material respect, including, but not limited to, any failure by Employer or its agents to pay any fee of the Administrator when due. In the event of any such termination, the Administrator will notify Employer prior to the effective date of termination in accordance with Section 4.1. As an alternative to termination of services, BENEFIT COORDINATORS CORPORATION (BCC) I WWW.BCCBENEFITSOLUTIONS.COM TWO ROBINSON PLAZA, STE. 200, PITTSBURGH, PA 15205 1 T412.276.1111 I F412.276.6650 the Administrator, in its sole discretion, may offer Employer the opportunity to continue service by paying all past due amounts along with a reinstatement fee. 2.4 Employer shall reimburse the Administrator for any expenses incurred for the printing and postage of any material produced specifically for Employer and sent via U. S. mail to the participants that is outside the scope of services listed on the Schedule of Fees. 2.5 Employer shall reimburse the Administrator for any charges incurred due to insufficient funds, returned check fees or the like incurred through Employer's funding of its payment of fees due the Administrator or claims payments. SECTION III - LIABILITY & INDEMNITY 3.1 The Administrator does not insure nor underwrite the liability of Employer under the Plans. Employer retains the ultimate financial and fiduciary responsibility for claims made under the Plans, and for all expenses incident to the Plans, except as specifically assumed by the Administrator in this Agreement. 3.2 Employer agrees to indemnify the Administrator, its successors and assigns, and hold it unharmed against any and all loss, damage and expense, including attorneys' fees (collectively, a "Loss"), occasioned by claims, demands or lawsuits brought against the Administrator to recover benefits under the Plans except to the extent such Loss resulted from the fraud, negligence or willful misconduct of the Administrator. This section shall not be construed to prevent Employer from pursuing a breach of contract action against the Administrator for any failure of the Administrator to properly perform its duties under this Agreement. 3.3 The right to be defended, indemnified and held unharmed, hereunder shall extend to the Administrator's employees, their estates, executors, administrator, guardians, conservators and heirs and shall apply after the employee ceases employment with the Administrator with respect to acts or omissions during employment. 3.4 Employer agrees to indemnify the Administrator for any charges or fees incurred or arising due to Employer's lack of timely reporting of eligibility changes or terminations. This indemnification will extend to any liability relating to the performance, or failure to perform, of any agent performing any of Employer's duties under this Agreement, including, but not limited to, any failure in the delivery of timely and accurate enrollment or eligibility data by any agent with which Employer has contracted to provide such data. 3.5 The Administrator agrees to indemnify Employer, its successors and assigns, and hold it unharmed against any and all loss, damage and expense, including attorneys' fees, occasioned by claims, demands or lawsuits brought against Employer relating to the performance of, or failure to perform, the responsibilities placed on the Administrator by this Administration Agreement. 3.6 LIMITATION OF LIABILITY. EXCEPT FOR THE INDEMNIFICATION OBLIGATIONS OUTLINED IN SECTION III ABOVE, EACH PARTY'S AGGREGATE, CUMULATIVE LIABILITY IN CONNECTION WITH THIS AGREEMENT SHOULD BE LIMITED TO DIRECT DAMAGES AND CAPPED AT THE AMOUNT EQUAL TO FEES ACTUALLY RECEIVED BY ADMINISTRATOR FROM EMPLOYER UNDER THE ORDER FORM WHICH THE EVENT CAUSING LIABILITY ARISES. These limitations and exclusions apply to all claims or causes of action on whatever basis and under whatever theory brought and irrespective of whether the Party has advised or has been advised of the possibility of such claim. All claims and causes of action brought by Employer hereunder shall be brought within ninety (90) calendar days of the termination or expiration hereof or within six (6) months of the date the harm is actually discovered, whichever occurs first. IN NO EVENT SHALL EITHER PARTY BE LIABLE TO THE OTHER PARTY FOR ANY INDIRECT, INCIDENTAL, CONSEQUENTIAL, RELIANCE OR PUNITIVE DAMAGES OR LOST OR IMPUTED PROFITS OR LOST DATA. 2 SECTION IV - TERMINATION & REVISION 4.1 The terms in this Administration Agreement shall be from the effective date hereof and shall terminate on December 31, 2023, unless modified or terminated earlier by the parties hereto. If either party desires to modify or terminate this Administration Agreement, it shall notify the other party in writing delivered at least 30 days prior to the effective date of such modification or termination or, in the event of a proposed modification due to a change in the local, state, or federal law, as soon as feasibly possible thereafter. In the case of a proposed termination, the effective date will be no sooner than the end of the coverage month following 30 days from the date of delivery of the notice. 4.2 In the case of a proposed termination by Employer, the Administrator must return a timeline of actual disengagement of services, not to be more than an additional 90 days. If Employer does not agree and requires an earlier timeline than the one proposed, Employer assumes responsibility and liability for any outstanding and new errors, discrepancies and unresolved issues even if the issue resulted from a period during which Administrator was the Administrator. If no refusal is delivered to Administrator within 10 days, the proposed termination timeline shall be deemed to have been accepted. If Employer requires additional time to access the system, a signed amendment is required prior to the termination date. Access will be granted at a fee of $500 per month. If Employer does not timely respond with aforementioned amendment and/or payment prior to the termination date, Employer understands that system access will be revoked and data will be purged as of the effective date of termination with no ability to reactivate. 4.3 All obligations of the Administrator related to the relevant rights of the employees and their dependents to payment of benefits from the Plan will be terminated and extinguished on the effective date of termination given in the notice of this Administration Agreement, except as provided in Section 4.5 and 4.6 below. 4.4 Either party may terminate this Agreement upon: (i) the occurrence of a material breach by the other party, which material breach has not been cured within 30 days after written notice; (ii) termination or suspension by the other party of its business; (iii) the other party becoming subject to any bankruptcy or insolvency proceeding under the laws of any jurisdiction; (iv) the other party is unable to pay its debts as they become due, becomes insolvent or becomes subject to direct control by a trustee, receiver or similar authority; or (v) the other party goes into liquidation, voluntarily or otherwise. This Agreement may be terminated by any federal, state, municipal, local, territorial, or other governmental department, regulatory authority, judicial or administrative body, whether domestic, foreign or international with jurisdiction over the parties ("Regulator"), or by the parties at the direction of any Regulator. 4.5 Except for terminations as provided in 4.4 above, upon execution of a Run Out Agreement, the Administrator will continue to process claims and/or qualifying events incurred prior to the termination date for a period not to exceed ninety (90) days from the termination date, at the standard monthly fee. 4.6 In the event of termination, the Administrator agrees to cooperate fully with Employer and to assist Employer in working out all details necessary in the assumption of the Services by a new provider. In order to assist in the transition, Employer or a new provider shall have full access to all records, files, including computer files (i.e., magnetic tape, disc, etc.), facilities and premises necessary for performance of the Services. Upon termination, all fees due the Administrator will be payable immediately. 4.7 In the event of termination by Employer within the first 12 month contract term, prior to the first Effective Date renewal, payment for the full term shall become immediately due and payable to Administrator. 4.8 All notices hereunder shall be in writing and either delivered personally or mailed via certified mail, return receipt requested. Notices to Employer shall be delivered or mailed to the address first written above. Notices to the Administrator shall be delivered or mailed to Benefit Coordinators Corporation, at Two Robinson Plaza, Suite 200, Pittsburgh, PA 15205-1324. From time to time, either party may designate a different address in a written notice to the other party. SECTION V - ASSIGNMENT 5.1 Employer may not assign its rights or obligations under this Administration Agreement, whether by operation of law or otherwise, without the prior express written consent of Administrator. Any attempted assignment or any change of control or sale of a majority of the equity or assets of Employer will automatically terminate this Administration Agreement and all sums due hereunder shall be immediately due and payable. Administrator may assign this Administration Agreement without Employer's prior consent and all of Administrator's rights, title and interest herein shall inure to the benefit of such assignee, its successors and assigns. SECTION VI - FORCE MAIEURE 6.1 No party shall be liable or responsible for delays or errors by reason of circumstances beyond its reasonable control, including, but not limited to, acts of civil or military authority, national emergencies, labor difficulties, fire, mechanical breakdown, hurricane, flood or catastrophe, Acts of God, insurrection, war, riots or failure of communication or power supply. SECTION VII - CONFIDENTIAL INFORMATION 7.1 The parties hereto will maintain the confidentiality of all medical, prescription, and other patient -identifiable health information relating to claims administered under this Administration Agreement in accordance with applicable laws and regulations, including the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), as may be amended from time to time. The parties acknowledge that the Administrator will have access to Patient Information in order to provide services and/or perform the obligations undertaken herein and that Patient Information may be obtained from and/or distributed to Employer and/or any other third party in connection with services provided herein, including any and all disclosures made by the Administrator, such as, but not limited to, those made to a new vendor upon transition of services following termination of this Administration Agreement. 7.2 Employer acknowledges that certain management reports, reporting packages, utilization data, and/or claims information may contain Patient Information. Employer further acknowledges that (i) its request to the Administrator to disclose Patient Information to any third party (e.g. broker, healthcare consultant, etc.) constitutes Employer's direction and authorization to disclose such information to the third party; and (ii) the Administrator will disclose such information pursuant to Employer's direction until such time as the Administrator receives written notice from Employer to cease further disclosures. Employer acknowledges the requirements and obligations under HIPAA regarding the disclosure of Patient Information to third parties on its behalf. Accordingly, if and when required, Employer agrees to enter into "Business Associate" contracts (as such term is defined in Title 45, Section 160.103 of the Code of Federal Regulations) with such parties as well as any other agreements required by state, federal law or regulation. SECTION VIII - MISCELLANEOUS PROVISIONS 8.1 Benefits under the Plans covered by this Agreement are provided solely from Employer's general assets and insurance purchased by Employer (if any). If the Plans provide for employee contributions through payroll withholding, Employer represents to the Administrator that it will comply in all material respects with the requirements of all applicable laws, including those related to trust, reporting and disclosure requirements under the Employee Retirement Income Security Act of 1974 ("ERISA") if applicable. 8.2 Any claim and/or lawsuit initiated by the Employer in connection with this Administration Agreement (i) shall be governed by, and construed and enforced in accordance with, the substantive laws of the Commonwealth of Pennsylvania, without regard to its principles of choice of laws; and (ii) be brought in a court with competent jurisdiction located in the Commonwealth of Pennsylvania. Employer hereby (i) consents and submits to the in personal jurisdiction of any state or federal court located within the Commonwealth of Pennsylvania, and (ii) waives any right to transfer or change the venue of litigation brought against the Administrator by the Employer. Any claim and/or lawsuit initiated by Administrator in connection with this Administration Agreement (i) shall be governed by, and construed and enforced in accordance with, the substantive laws of the State of California, without regard to its principles of choice of laws; and (ii) be brought in a court with competent jurisdiction located in the State of California. Administrator hereby (i) consents and submits to the in personal jurisdiction of any state or federal court located within the State of California, and (ii) waives any right to transfer or change the venue of litigation brought against Employer by Administrator. 8.3 This is the entire agreement between the parties. There are no representations, understandings, or agreements between the parties on the subject matter of this agreement other than as set forth in this Administration Agreement. 8.4 If any provision of this Administration Agreement or the application of any such provision shall be held by a court of competent jurisdiction to be contrary to law, the remaining provisions of this Administration Agreement shall continue in full force and effect. 8.5 The failure of Administrator to enforce or insist upon compliance with any of the terms or conditions of this Agreement, the waiver of any term or condition of this Agreement, or the granting of an extension of time for performance, shall not constitute the permanent waiver of any term or condition of this Agreement and this Agreement and each of its provisions shall remain at all times in full force and effect. 8.6 The Plan "Administrator" (as defined in Section 3(16)a of the Employee Retirement Income Security Act of 1974 ("ERISA") and "Named Fiduciary" (ERISA Section 402(a)(2)) of the Plan is Employer. The undersigned warrants and represents that the undersigned has full power and authority to enter into this Agreement, to bind each Party hereto, and to grant the rights set forth herein effective as of January 01, 2021. 'PROVED AS TO FORM: ITY ATTORNEY'S OFFICE %ate lllyzozo 3y: 14.-_. •For Aaron C. Harp, City Attorney uM M4410 CITY OF NEWPORT BEACH Signature: WVI Printed Name: Title: �Vm M (Authorized Officer) Date: Attest: h �(j/�Self Insured Services Company dba mid, ! r'I \/ BENEFIT COORDINATORS CORPORATION Lellani I. Brown,'MMC, City Clerk Date: I l - it U% Signature: Printed Name: Signed in Counterpart Title: (Authorized Officer) Date: any state or federal court located within the State of California, and (ii) waives any right to transfer or change the venue of litigation brought against Employer by Administrator. 8.3 This is the entire agreement between the parties. There are no representations, understandings, or agreements between the parties on the subject matter of this agreement other than as set forth in this Administration Agreement. 8.4 If any provision of this Administration Agreement or the application of any such provision shall be held by a court of competent jurisdiction to be contrary to law, the remaining provisions of this Administration Agreement shall continue in full force and effect. 8.5 The failure of Administrator to enforce or insist upon compliance with any of the terms or conditions of this Agreement, the waiver of any term or condition of this Agreement, or the granting of an extension of time for Performance, shall not constitute the permanent waiver of any term or condition of this Agreement and this Agreement and each of its provisions shall remain at all times in full force and effect. 8.6 The Plan "Administrator' (as defined in Section 3(16)a of the Employee Retirement Income Security Act of 1974 ("ERISA") and "Named Fiduciary" (ERISA Section 402(a)(2)) of the Plan is Employer. The undersigned warrants and represents that the undersigned has full power and authority to enter into this Agreement, to bind each Party hereto, and to grant the rights set forth herein effective as of January 01, 2021. APPROVED AS TO FORM: CITY ATTORNEY'S OFFICE Date u / 3/2020 mon C. Harp, City Attorney MAii-I .j w CITY OF NEWPORT BEACH Signature: Printed Name: Title: (Authorized Officer) Date: Self Insured Services Company dba BENEFIT COORDINATORS CORPORATION Signature: _lidbtvl\% Printed NI/am/e:: cJ 0 Title: V/" (Authorized Officer) Date: �9 /� / / // �/l D`�t/ BENEFIT COORDINATORS CORPORATION ADMINISTRATION AGREEMENT SERVICES EXHIBIT This Exhibit is effective January 01, 2021, and continues in force until amended. ® BenXcel® ® Retiree Billing Administration BENEFIT COORDINATORS CORPORATION ADMINISTRATION AGREEMENT BENXCEL EXHIBIT BenXcel Usage Agreement By using the BenXcel online benefits administration system provided by Administrator, Employer agrees to be bound by the following terms and conditions of this BenXcel Usage Agreement: SECTION I - GENERAL INFORMATION 1.1 The BenXcel online benefits administration system is a fully integrated web enrollment and HR administration tool, which empowers HR departments to manage all benefit administrative tasks online and in real-time. SECTION II —THE ADMINISTRATOR'S RESPONSIBILITIES In consideration of the fees to be paid to it, Administrator shall provide the following services: 2.1 Administrator shall provide Employer and its employees with access, via the internet, to the BenXcel online benefits administration system, in connection with the performance of services by Administrator on behalf of Employer pursuant to the administration agreements set forth on the Services Exhibit in this Administration Agreement. 2.2 Administrator shall provide demonstrations of the BenXcel online benefits administration system for the benefit of Employer and its employees, and training for administrative personnel and support services for the ongoing utilization of the system. 2.3 Administrator shall make the BenXcel online benefits administration system available on a best efforts basis. This includes having backups of data, multiple and in most cases redundant connections to the internet, and readily available technical expertise. Administrator reserves the right to schedule periodic maintenance for the BenXcel system, including repairs, upgrades and reconfigurations. During such maintenance periods, Employer and its employees may be unable to access or use the BenXcel system. 2.4 The services provided by Administrator and the BenXcel online benefits administration system are expected to change from time to time. Administrator reserves the right to change any service offered or the features of any service offered or its system without notice, including changes to access and use procedures and system hardware and software. 2.5 Administrator has taken reasonable actions to ensure that personal information with respect to Employer and/or its employees are disclosed only to those designated by Employer. However, Employer acknowledges that the internet is an open system and Administrator cannot and does not warrant or guarantee that third parties will not intercept personal information. 2.6 Administrator has taken reasonable actions to ensure that the BenXcel online benefits administration system satisfies the requirements of the Health Insurance Portability and Accountability Act of 1996, including but not limited to the regulations with respect to privacy and security of health information. SECTION III — EMPLOYER'S RESPONSIBILITIES Employer shall: 3.1 Be responsible for any and all expenses and charges associated with accessing the internet and connecting to the website containing the BenXcel online benefits administration system, any service fees associated with such access and connection, and for providing all equipment necessary for Employer and/or its employees to make such connection, including, without limitation, computer and modem. 3.2 Employer shall be responsible for authorizing and revoking security access to its employees and/or representatives in accordance with Administrator's security procedures. Employer shall be solely responsible for maintaining the confidentiality of accounts and passwords and for restricting access to computers of employees and/or representatives to whom Employer grants security access under the BenXcel online benefits administration system. 3.3 Employer shall be solely responsible for any and all activities which occur under accounts and passwords of employees and/or representatives to whom Employer grants security access. Employer agrees to notify Administrator immediately if Employer has any reason to believe that the security of an account has been compromised. 3.4 Employer shall be solely responsible for implementing appropriate safeguards and procedures in order to satisfy Employer's responsibilities under the Health Insurance Portability and Accountability Act of 1996, including but not limited to the regulations with respect to administrative requirements. Employer certifies that any and all access to protected health information by employees and/or representatives to whom Employer grants security access is solely and exclusively for purposes of treatment, payment or healthcare operations, and that such access to protected health information is both permitted and satisfies the minimum necessary standard under the Health Insurance Portability and Accountability Act of 1996. SECTION IV - INTELLECTUAL PROPERTY 4.1 All content included on the BenXcel site, such as text, graphics, logos, button icons, images, audio clips, information, data, photographs, graphs, videos, typefaces, graphics, music, sounds, and other material and software (the Materials) is the property of Administrator or its content suppliers and is protected by copyrights, trademarks, trade secrets, or other proprietary rights, and these rights are valid and protected in all forms, media, and technologies existing now or hereinafter developed. All such content is copyrighted as a collective work under the US copyright laws (17 U.S.C. § 101, et. seq.) and international treaty provisions, and Administrator owns a copyright in the selection, coordination, arrangement, and displayed enhancement of such content. All software used on this site is the property of Administrator or its software suppliers and is protected by US and international copyright laws. Employer may not modify, remove, delete, augment, add to, publish, transmit, participate in the transfer or sale of, create derivative works from, or in any way exploit any of the content on the site, in whole or in part. Any use other than as contemplated herein, including the reproduction, modification, distribution, transmission, republication, display, or performance of the content on this site, except as specifically permitted below, is strictly prohibited. BenXcel is a trademark of Administrator. All other marks, names, and logos mentioned on the BenXcel site are the property of their respective owners. Employer's use of the Administrator's trademarks is strictly prohibited. SECTION V - INCORPORATION BY REFERENCE 5.1 The terms and provisions of the Administration Agreement are made a part hereof and incorporated herein by reference. BENEFIT COORDINATORS CORPORATION ADMINISTRATION AGREEMENT RETIREE BILLING EXHIBIT Retiree Billing and Remittance Services Agreement Employer hereby appoints the Administrator to provide retiree billing and remittance services (the "Services") under Employer's employee welfare benefit plan(s) identified below. The Administrator agrees to provide the Services, effective January 01, 2021, under the following terms and conditions of this Agreement: SECTION I - PLAN INFORMATION 1.1 Plan Name(s) City of Newport Beach Health & Welfare Plan. SECTION II —THE ADMINISTRATOR'S RESPONSIBILITIES 2.1 Maintain eligibility for the various insurance products under the Plan in accordance with the carrier policies. 2.2 Update coverage amounts when approval notification has been received from a carrier when applicable. 2.3 Invoice individual retirees for premiums relating to any coverages for which the retirees are required to pay. 2.4 Remit retiree premiums back to Employer, when active employee premiums for products are not being invoiced by the Administrator or to the carrier but when the Administrator is invoicing Employer for the active employee premiums for the products. SECTION III - EMPLOYER'S RESPONSIBILITIES 3.1 Provide employee eligibility information and documentation to the Administrator on a timely basis. 3.2 Review monthly invoices for errors and/or omissions, and promptly (and in no event later than 60 days) notify the Administrator of any such errors or omissions. 3.3 Remit fees to the Administrator on a timely basis. 3.4 Provide timely notification of all Plan, rate and insurance carrier changes to the Administrator. SECTION IV - INCORPORATION BY REFERENCE 4.1 The terms and provisions of the Administration Agreement are made a part hereof and incorporated herein by reference. BENEFIT COORDINATORS CORPORATION ADMINISTRATION AGREEMENT SCHEDULE OF FEES EXHIBIT Schedule of Fees as of January 01, 2021 *3 -year rate agreement* RETIREE Administration: Initial, non-refundable Setup Fee due upon execution of this Agreement: $1,200.00 one-time fee Monthly Administration Fee: $4.75 per Retiree per Month Minimum Monthly Fee: $N/A Other Fees and Services: Annual COBRA/Retiree Open Enrollment Fulfillment Services • OPTION A: Printed Packets $8 PER PACKET • OPTION B: Printed OE Letters w/BCC Hosted $4 PER LETTER OE Webpage • OPTION C: BCC Hosted Webpage and $2 PER COBRA BENEFICIARY COBRA/Retiree Report Meetings, Health Fairs No charge for webinars. On-site meetings may incur time/travel charge. Fee will be quoted when a meeting is requested. Additional Services and Materials Fees quoted upon request Wire Transfer Fee: $25.00 per wire Development hours exceeding standard $125/hour development time (as quoted per project) ACH Transfer Fee: No Charge Non -Sufficient Funds Fee: $25.00 per rejected check/transaction Reinstatement Fee: Determined by Administrator at time of reinstatement