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2016-137
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2016-137
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Last modified
9/16/2016 11:37:49 AM
Creation date
9/16/2016 11:37:46 AM
Metadata
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Template:
Official Documents
Official Document Type
Agreement
Approved Date
09/13/2016
Control Number
2016-137
Agenda Item Number
8.V.
Entity Name
Johns Eastern Company Inc.
Subject
Third Party Administration Services
Self Funded Worker's Compensation and Liability
Project Number
UPC 3228
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4.20 Non-Discrimination. TPA shall not discriminate against any person in the performance of <br /> the duties,responsibilities and obligations under this Agreement because of race,age,religion,color, <br /> gender, national origin, marital status, disability or sexual orientation. <br /> 4.21 Successors. This Agreement shall be binding upon and shall inure to the benefit of all <br /> assigns, transferees and successors in interest of the Parties. <br /> 4.22 Assignment. Neither this Agreement nor any interest herein may be assigned,transferred or <br /> encumbered by any party without the prior written consent of the other Party. <br /> 4.23 Medicare, Medicaid, and SCHIP (State Children's Health Insurance Program) <br /> Extension Act of 2007 ("MMSEA"). TPA acknowledges and agrees that IRC has an obligation to <br /> perform Mandatory Insurer Reporting("MIR")as set forth in Section 111 of the MMSEA.MMSEA <br /> provided for mandatory reporting requirements for group health plan arrangements and for liability <br /> insurance(including self-insurance),no-fault insurance, and workers'compensation(see 42 U.S.C. <br /> 1395y(b)(7) & (8)). IRC agrees to properly register with the Centers for Medicare and Medicaid <br /> Services ("CMS'') as the Responsible Reporting Entity ("RRE"), to provide to TPA all relevant <br /> information including the RRE,Identification Number(s)assigned, and to properly designate a MIR <br /> reporting agent acceptable to TPA. IRC agrees that for each and every claim reported to TPA in <br /> which IRC possesses the information, TPA shall provide the following information as soon as <br /> required to comply with applicable law and avoid fines and penalties: claimant's first and last name, <br /> social security number, date of birth and gender. IRC consents to the disclosure of any required <br /> information to TPA's designated third party for processing IRC's MIR. <br /> 4.24 Funds for Payment of Claims.IRC has the sole obligation and responsibility for funding the <br /> payment of claims made by its employees in accordance with the Workers' Compensation Law as <br /> adopted and amended by the State of Florida and the applicable rules and regulations as promulgated <br /> by the applicable agencies of the State of Florida relating to the Workers' Compensation Law. TPA <br /> assumes no duty to fund any such claims at any time and shall have no obligation to advance funds <br /> for any such payment. IRC agrees to inform TPA of all relevant details with respect to any such <br /> accounts in order to TPA to perform its duties under this Agreement. <br /> TPA will analyze the account from time to time and will submit advisory reports, including any <br /> deficiencies to the account. As a result of the advisories,the IRC agrees to fund any increase within <br /> thirty(30) days of notification. <br /> In the event of cancellation or nonrenewal of this Agreement, IRC agrees to fund an amount <br /> sufficient to fund all of IRC's outstanding obligations as they become due. <br /> If, at any time, IRC or its carrier fails to provide adequate funding, TPA may issue "stop payment" <br /> orders on outstanding payments. Any bank charges resulting from inadequate funding including,but <br /> not limited to, interest, stop payment charges and overdraft fees shall be the obligations of IRC and <br /> Page 9 <br />
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