06/22/2021 (3) - Laserfiche WebLink

Home Browse Search

860520 11.2.2016 Clarity shall provide the following services with respect to the COBRA Administrative Plan Service. (a) Provide notification containing the information required to be included in the COBRA initial notification to all benefit eligible employees and dependents who are participants under the plan(s) and whose names and addresses are furnished by Client. (b) Advice employees and other qualified beneficiaries of their rights to elect and receive COBRA continuation coverage under the plan(s), after Client has notified Clarity of the occurrence of qualifying events. Covered employees and other qualified beneficiaries shall be notified in writing by first class U.S. mail with proof of mailing or an equivalent process. Clarity shall take all commercially reasonable action to mail the notice within five (5) business days of receiving proper notice from Client. (c) Clarity shall receive and document election resoonses. (d) Clarity shall collect premiums (including administrative charges) directly or through a Designated Client Bank Account ("DCBA") from or on behalf of individuals who elect to continue coverage under the plan(s) ("continuants"), and forward the amount of the paid premiums, less the administrative charges, to Client, or its health insurance carrier, on a monthly basis. Clarity shall consider COBRA premiums to be timely paid if, within 30 days of the due date, such premiums are actually delivered to Clarity or said DCBA, postmarked by the U.S. Postal Service, or sent by express delivery service (with evidence thereof), unless Client advises Clarity in writing that a longer period applies under the plan(s). Premium payments made through the secure Member Portal will be considered timely if Member submits a payment before 12:59am CST on the last day of the premium payment grace period. For premium payment made by check (Paper Cash Letter), actual delivery, postmark or evidence of express delivery will also be used to determine timeliness of COBRA elections based on applicable statutory periods. Cient shall execute an ACH Funds Settlement Agreement which authorizes Clarity to initiate credit and debit entries. (e) Clarity shall make available to Client online status reports, accessed through the secure Client Portal, for each continuant electing continued coverage under the plan(s). These status reports will include continuants who are current on their premium payments, and continuants who have been canceled for failing to remit premium payments pursuant to the requirements of COBRA, as implemented in accordance with this Agreement. (f) Upon Client's request and provision of the proper and complete information, Clarity shall mail Health Insurance Portability and Accountability Act (HIPAA) Certificates of Creditable Coverage. Upon request on behalf of an employee orformer employee, Clarity shall also mail such Certificate, if the request is made within 24 months of the later of: (1) the time the individual ceased to be covered under the respective plan or otherwise became covered under a COBRA continuation provision; or (2) in the case an individual was covered under such provision, at the time the individual ceases to be covered under such provision; provided the Client gives Clarity the proper and complete information. Clarity shall mail the Certificate, first class U.S. Mail, directly to covered employees and qualified beneficiaries. Notices shall only be sent to those covered employees and beneficiaries as Client expressly requests in writing. Clarity shall have no other obligation with regard to HIPAA or state law compliance. (g) If the plan(s) offer an option of conversion to an individual health insurance policy when COBRA coverage under the plan(s) is exhausted, and if the Client has provided Clarity with proper and complete information regarding the existence and terms of such conversion option, then Clarity shall provide the continuant with a notice of his or her conversion rights under the plan(s). Such notice shall be provided in writing by first class U.S. mail with proof of mailing or an equivalent process, within one hundred eighty (180) days of the end of the maximum COBRA coverage period. Clarity shall not be responsible for notifying the employee or other qualified beneficiary of any conversion right outside of COBRA coverage; for determining whether the plan(s) offers an option of conversion; or if the employee or other qualified beneficiary is eligible forconversion. 12 53