HomeMy WebLinkAbout2023-130ADADMINISTRATIVE SERVICES AGREEMENT
BETWEEN
AMERITAS LIFE INSURANCE CORP.
AND
INDIAN RIVER COUNTY
Table of Contents
SectionI.................................................................................................................. Scope of Agreement
Section II........................................................................................Services to be Provided by Ameritas
Section III....................................................................................................Obligations of Plan Sponsor
Section IV........................................................................................................... Banking Arrangements
Section V................................................................................. Administrative Service Charge Schedule
Section VI............................................................................................................Term and Termination
Section VII.................................................................................................................General Provisions
Administrative Services Agreement
This Administrative Services Agreement ("Agreement") is between Indian River County ("Plan
Sponsor"), and Ameritas Life Insurance Corp., a Nebraska corporation ("Ameritas"), and is effective
upon the date set forth herein. Throughout the Agreement Ameritas and Plan Sponsor may be referred
to individually as "Party" or collectively as "Parties."
WHEREAS, Plan Sponsor has established and will administer an employee Dental benefit plan
("Plan") according to the Employee Retirement Income Security Act of 1974 ("ERISA") or the Public
Health Service Act ("PHSA"), as applicable, for its employees and their dependents;
WHEREAS, Plan Sponsor desires to utilize the services of Ameritas to assist in its duties to administer
the Plan; and
WHEREAS, Ameritas has agreed to provide such non -fiduciary administrative services in connection
with the Plan such as processing of claims and other services under the terms and conditions of this
Agreement.
NOW, THEREFORE, in consideration of the premises and mutual promises contained in this
Agreement, Plan Sponsor and Ameritas hereby agree as follows:
Section I. Scope of Agreement
Ameritas agrees to perform certain non -fiduciary administrative services, such as claim processing and
other services specified herein for the Plan, as amended, as described in Addendum A.
Section II. Services to be Provided by Ameritas
Ameritas shall perform the following administrative services in connection with the Plan:
A. Process claims and determine the Plan benefits applicable to Covered Employees and their
dependents (collectively, "Covered Persons"), including coordination of benefits, where
applicable, in accordance with the terms of the Plan and as specified to Ameritas by Plan
Sponsor, using Ameritas' claim paying system as specified to Ameritas by Plan Sponsor.
Ameritas will process claims incurred on or after the Effective Date of this Agreement and
received while this Agreement is still in effect.
B. Notify a Covered Person of the initial denial of a claim (benefits) and his or her right of review
of the denial as specified by the Plan Sponsor and in accordance with the terms of the Plan.
C. Issue checks in payment of benefits payable under the Plan which, subject to the terms of this
Agreement, shall be paid through the bank account as set forth in Section IV. of this
Agreement.
D. Answer benefits and claims questions and inquiries of Covered Persons and providers through
toll free telephone number.
E. Communicate with Plan Sponsor as is necessary to verify eligibility of Covered Persons.
F. Provide to Plan Sponsor estimated Plan benefit costs after the Initial Term, and Plan design
and underwriting services in connection with benefit revisions, addition of new benefits, and
extensions of coverage to new Covered Persons, as requested by the Plan Sponsor.
G. Bond all of its employees who will be handling funds of Plan Sponsor.
H. Prepare reports regarding the Plan for use by Plan Sponsor in accounting for and managing the
Plan, which shall include the standard reports identified in Addendum D.
I. Prepare and provide form 1099 MED for each provider of services, in accordance with IRS
rules.
J. Provide Plan identification cards, Ameritas PPO dentist lists, if applicable, and a description
of the Plan, as set forth in Addendum A, for each of the Plan Sponsor eligible employees.
K. Assist Plan Sponsor upon requests in connection with the general administration of the Plan,
administration and record keeping systems for the ongoing operation of the Plan and
reconciliation of claims paid. As mutually agreed by the Parties, Ameritas will provide forms,
including claims forms, related to the general administration of the Plan.
L. Maintain all benefit payment records as to requests for benefits for a period of seven (7) years
following the month in which the final benefit payment was made, or such longer period as
required by applicable law. In the event of discontinuance of this Agreement, Ameritas, upon
the Plan Sponsor's request and their expense, shall promptly forward to Plan Sponsor the
subject records in its possession in the format identically maintained by Ameritas at the time
the Agreement is discontinued. During the time in which Ameritas is to maintain benefit
payment records, Ameritas shall be permitted, if it so desires, and unless otherwise prohibited
by law, to destroy hard copies whenever the information has been transferred to microfiche or
such other similar process which permits the retention of such information.
M. If it is determined that any payment has been made under this Agreement to an ineligible
person, or if it is determined that more or less than the correct amount has been paid by
Ameritas, Ameritas will make a diligent attempt to recover the overpayment or will adjust the
underpayment in accordance with Ameritas' established claim practices. However, in no event
shall such recovery or adjustment be performed in a manner violative of any state's Unfair
Claims Practices Act. Ameritas shall not initiate court proceedings for any such recovery. In
the event, however, that Ameritas is sued by any beneficiary seeking to recover an adjustment
to an alleged underpayment, then the decision whether to defend such court suit shall be the
responsibility of Plan Sponsor. Plan Sponsor may direct Ameritas to enter into a settlement or
to forego the defense to any such action, provided, however, that Plan Sponsor shall ensure
that Ameritas is fully reimbursed and indemnified for any and all payments made by reason of
such decision by Plan Sponsor.
N. If the Plan includes PPO benefits, Ameritas shall arrange for those contracted dental providers
comprising the Ameritas PPO Network to render services to those Covered Persons who seek
such services from a member of the Ameritas PPO Network. Ameritas' foregoing obligation,
when measured at an individual provider level, is subject to the provider's then -current patient
load and ability to accept new patients. Ameritas represents and warrants that in exchange for
rendering services to the Covered Persons, each participating provider member of the Ameritas
PPO Network agrees to accept the amount set forth in their respective fee schedule as payment
in full for procedures listed on the fee schedules and further, that the participating providers
have agreed to bill Covered Persons only for the cost of services not covered under the Plan.
Section III. Obligations of Plan Sponsor
Plan Sponsor or Plan Sponsor's subcontractor shall:
A. Promptly and diligently provide eligibility information for Covered Persons under the Plan,
on or after the Effective Date of this Agreement, to Ameritas in a format mutually agreed
upon by Plan Sponsor and Ameritas.
B. Provide benefit information, eligibility information and periodic (at least monthly) updates of
additions, deletions and changes with regard to Covered Persons by an agreed upon medium.
C. Designate personnel with authority to answer questions relative to eligibility so that accurate
eligibility information is available to Ameritas upon request.
D. Maintain and administer the Plan in compliance with ERISA or the PHSA, as applicable;
provide discretionary authority and exercise control respecting Plan management and claims
decisions.
Section IV. Banking Arrangements
During the term of this Agreement:
A. All benefit payments made by Ameritas on behalf of the Plan will be issued by Ameritas on
checks payable through Ameritas' bank of choice.
B. Ameritas will send to Plan Sponsor, or, upon request and authorization, an entity designated
by Plan Sponsor ("Designee"), the Weekly Paid/Denied Claim Report identified in Addendum
D. Accompanying this report will be a cover letter setting forth the total amount paid as
reflected by the report. Three (3) business days after sending, Plan Sponsor or Designee will
pay or cause to be paid to Ameritas the amount listed in the letter in a mutually agreed upon
format. Plan Sponsor will complete and provide all necessary authorizations to accommodate
the payment.
C. Failure to reimburse Ameritas in accordance with the above will result in interest being charged
on the unpaid amount from the date due until fully paid at a rate equal to the lower of a) ten
percent (10%) per year or, b) the maximum rate allowable by applicable usury laws and may
result in the discontinuance of the Agreement in accordance with Section VI.
Section V. Administrative Service Charge Schedule
A. Except as otherwise provided hereafter, the administrative service charge for each month of
this Agreement shall be as specified in Addendum B ("Administrative Service Charge"), both
for the Initial Term of this Agreement and for any Subsequent Agreement Period unless
adjusted by Ameritas in accordance with Section V(E) or otherwise agreed by the Parties.
Initial Term and Subsequent Agreement Period shall be as defined in Section VI., below.
B. The Administrative Service Charge as applied and provided for in Addendum B, will start on
the first day of the month falling on or after the date the applicable coverage is effective. The
Administrative Service Charge for the applicable coverage will cease on the last day of the
month falling on or after the date of termination of the applicable coverage. There will be no
pro rata charges or credits for partial month.
C. Ameritas will refund unearned Administrative Service Charges to Plan Sponsor for up to three
(3) months before the date Ameritas receives evidence that a refund is due.
D. Prior to the first (1St) day of each month of this Agreement, Ameritas will submit a report to
Plan Sponsor, or, if applicable to Designee, identifying the Covered Person(s) and listing the
Administrative Charges for the month. Remittance of the Administrative Service Charges shall
be due by the first (1 st) of the month and past due on the tenth (10th) of the month. Such report
and remittance shall be subject to audit and adjustment, as necessary, by Ameritas within ninety
(90) days of receipt.
E. The Administrative Service Charge may be adjusted by Ameritas at the start of any Subsequent
Agreement Period following the Initial Term, provided Ameritas has given Plan Sponsor at
least forty-five (45) days advance written notice of its intent to adjust the Administrative
Service Charge. Subsequent Agreement Period shall be as defined in Section VI., below.
Should Ameritas fail to timely deliver any Administrative Service Charge change notice, the
Administrative Service Charge contained in the notice shall still be effective but not until the
first month following the month in which the advance notice period required hereunder ended.
Upon the delivery of such Administrative Service Charge change notice, Addendum B attached
hereto shall be deemed to be modified without any further action by the parties.
Section VI. Term and Termination
A. Term
1. Although executed on the dates shown below, this Agreement shall be effective as of
10/1/2023 (the "Effective Date") through 9/30/2024 (This time period shall be considered
the "Initial Term").
2. This Agreement shall be automatically renewed for successive twelve (12) month periods
beginning the first day following the expiration of the Initial Term and each anniversary of
such date thereafter, unless terminated as provided for herein. Such renewal periods shall
be considered "Subsequent Agreement Periods."
B. Termination
1. Termination without cause. This Agreement may be terminated without cause by either
Party at the expiration of the Initial Term or any subsequent term with at least thirty (30)
days written notice to the other Party in advance of such date. The Parties may also
mutually agree in writing to terminate at any time.
2. Termination with Cause. Either Party has the right to terminate this Agreement upon at
least 30 days' advance written notice of such termination to the other Party if the Party to
whom such notice is given breaches any material provision of this Agreement. The Party
claiming the right to terminate shall provide the facts underlying its claim of breach and
cite the relevant sections of this Agreement that are claimed to have been breached.
Remedy of such breach to the satisfaction of the other Party, within 30 days of the receipt
of such notice, shall revive this Agreement for the remaining portion of its then -current
term, subject to any other rights of termination contained in this Agreement.
C. Effect of Termination
1. Termination of this Agreement for whatever reason, shall not terminate the rights or
liabilities of either Party arising out of a period prior to termination.
Ameritas will continue to process all claims received on or before the date the Agreement
is terminated. Upon request, and with appropriate guarantees of funding and agreement to
Administrative Service Charges from Plan Sponsor, Ameritas will, for a period of ninety
(90) days subsequent to the date of termination of this Agreement, continue to process
those standard claims containing expenses for services performed prior to the date of
termination of this Agreement which claims are received during said ninety (90) day
period. At the expiration of said ninety (90) day period, Ameritas will cease all claim
processing in accordance with (3) hereof.
Plan Sponsor agrees to reimburse Ameritas in the same manner as provided for in
accordance with Section IV. B., for benefit payments made subsequent to the date of
termination until all payments made by Ameritas have been reimbursed by Plan Sponsor.
Section VII. General Provisions
A. Plan Administration
1. The Plan Sponsor is the fiduciary with respect to the management, and administration of
the Plan and Ameritas does not insure or underwrite the liability of the Plan Sponsor under
the Plan. Ameritas shall not have discretionary authority or control over plan management
or disposition of assets of the Plan (including final claim decisions). In no event shall
Ameritas be responsible for Plan Sponsor's compliance with the requirements of ERISA
or PHSA if applicable. Ameritas shall not be responsible for complying with the provisions
of any federal or state laws and regulations pertaining to the Plan and Plan administration
(except as to its non -fiduciary administrative functions regarding processing claims and
customer claims service). The Plan Sponsor has final complete discretion to construe or
interpret the provisions of the Plan, to determine eligibility for benefits from the Plan, to
determine the type and extent of benefits, to be provided by the Plan, and to make final
claims decisions under the Plan. Plan Sponsor's decisions in such matters shall be
controlling, binding, and final. By this Agreement, Plan Sponsor is delegating to Ameritas
such authority as is necessary to process or otherwise resolve undisputed claims, eligibility
questions, or other matters governed by this Agreement, but the Plan Sponsor reserves
ultimate authority with respect to those and all other aspects of the Plan.
2. Ameritas shall have no responsibility to provide Summary Plan Descriptions or other
disclosures required under the PHSA; comply with COBRA or state continuation of
coverage requirements; or to comply with HIPAA portability requirements. If such
obligations exist, they shall be the sole responsibility of Plan Sponsor and not the
responsibility of Ameritas.
B. Indemnification
1. General Indemnity. Subject to the limitations on liability contained in Section VII.B.2,
below, each Party ("Indemnitor") shall indemnify and hold the other Party harmless from
and against any and all claims, suits, liabilities, obligations, damages and expenses
(including reasonable attorneys' fees and expenses of litigation) arising out of either
Indemnitor's (or Indemnitor's agent, employee, subcontractor, or Designee) performance
or failure to perform in accordance with the terms of this Agreement or any negligence or
willful misconduct of any kind on the part of Indemnitor. Ameritas or Plan Sponsor, as
applicable, shall reasonably cooperate with the indemnifying Party in connection with the
indemnifying Party's obligations under this section.
2. Limitation of Liability. Except for breach by either Party of Sections VII. C. or D., below,
neither Party shall be liable to the other for any indirect, special, incidental, exemplary,
reliance, punitive or consequential damages arising out of or related to this agreement, even
if advised of the possibility thereof.
3. Survival. The provisions of this Section VII. B. shall survive the expiration or termination
of the Agreement.
C. Proprietary Interest
Plan Sponsor acknowledges that the claims paying, administration and eligibility systems
employed by Ameritas and, if applicable, the Ameritas PPO Network and the listing of the
dental providers participating therein, have been developed by Ameritas and that Ameritas has
a proprietary interest therein. Plan Sponsor further agrees that at no time shall Plan Sponsor
or any of its employees use such other than for the intended purposes of this Agreement.
D. Confidentiality and Privacy
Except as otherwise provided in this Agreement, all information communicated to one Party
by the other Party, whether before or after the Effective Date of this Agreement, was and shall
be, to the extent permitted by law, received in confidence and shall be used only for purposes
of this Agreement. No such information, including without limitation the provisions of this
Agreement, shall be disclosed by the recipient Party to other persons including its own
employees, except as may be necessary by reason of legal, accounting, regulatory or
administrative requirements under this Agreement. The Parties further agree to comply with
all applicable laws respecting privacy and security, including HIPAA, and agree to abide by
the HIPAA Business Associate Addendum, which is incorporated herein and attached hereto
as Addendum E. The provisions of such Business Associate Addendum shall control as to all
matters falling within the scope of such Business Associate Addendum.
E. Examination of Records
Each Party shall have the right to examine any records of the other relating to the other Party's
obligations under this Agreement provided, however, such examination shall take place on a
regular working day in a manner agreed to between the Parties and in a manner designed to
protect the confidentiality of an individual's medical information. The cost of any such
examination shall be borne by the Party requesting the examination.
F. Entire Agreement, Amendments, May be signed in Counterparts, Notices
This Agreement and attached Addendums, shall constitute the entire agreement between the
Parties and all prior oral agreements shall be merged into this written Agreement. This
Agreement may be amended from time to time by written agreement between the Parties. The
Parties may execute this Agreement in one or more counterparts, each of which shall be deemed
an original, but all of which together shall constitute one and the same instrument. The Parties
may provide notice to each other as follows:
In the case of Ameritas:
Ameritas Life Insurance Corp.
5900 O Street
P.O. Box 81889
Lincoln, Nebraska 68501-1889
Attn: Group Department
In the case of Plan Sponsor:
INDIAN RIVER COUNTY
1800 27TH ST
VERO BEACH, FL 32960
ATTN: SUZANNE BOYLL
AIM/s"'••..
Plan Sponsor and Ameritas have caused this Agreement tobe executed on the dates set fgow••S!o,.,F
AMERITAS LIFE INSURANCE CORP. INDIAN RIVER COUNTY
•.oma i
By. a By: r. •off:
Bruce E. Mieth Print: Joseph H. Earman ♦•R' . ........
Senior Vice President — Group Operations
Date: 10/3/23
Attest: Ryan L. Butler, Clerk of
Circuit Court and Comptroller
Title: Chairman
Date: 12/26/2023
APPROVED AS TO FORM
AND SUIC
BY
ILLIAM K. DEBRAAL
COUNTY ATTORNEY
Addendum A
Plan Booklet
[See attached]
Addendum B - Administrative Service Charges
Administrative Service Charges
The Administrative Service Charges from Effective Date through 9/30/2024
$3.75 per Covered Persons per month
Fees shown above are based on the services outlined in Section II. Services to be Provided by
Ameritas.
Addendum C - Intentionally Omitted
Addendum D - Summary of Reports
Weekly Reports
Paid/Denied Claims Report
Monthly Reports
Fees List Bill
Annual Reports
Experience Detail Report
Customer Reporting Package
Claim Payment Summary
Claim Payment Breakdown by Procedure Type
Claim Summary — PPO vs. Non -PPO
Claim Payment analysis by Procedure Group
Claim Payment analysis by Category within Procedure Group
Claims Savings Categories
Claims Savings Categories — PPO
Claims Savings Categories — Non -PPO
PPO Savings Illustration
Fees include this reporting package. Deviations from these reports and/or frequency will be priced accordingly.
ADDENDUM E
HIPAA BUSINESS ASSOCIATE ADDENDUM
This HIPAA Business Associate Addendum ("BAA") supplements and is made a part of the
Administrative Services Agreement ("Service Agreement") by and between Ameritas ("Business
Associate") and the party identified in the Service Agreement above ("Covered Entity"). Covered
Entity and Business Associate shall be collectively referred to herein as the ("Parties").
RECITALS
A. Covered Entity and Business Associate have entered or may enter into one or more services
agreements (collectively the "Service Agreement") pursuant to which Business Associate is or
will be providing those certain agreed upon services for and on behalf of Covered Entity, some
of which may involve Business Associate's use, disclosure or creation of Protected Health
Information.
B. Covered Entity and Business Associate intend to protect the privacy and provide for the
security of Protected Health Information received, created, used, and disclosed to or by
Business Associate pursuant to the Service Agreement in compliance with HIPAA and
HITECH (each as defined below).
C. As part of the HIPAA and HITECH, the Standards for Privacy and the Standards for Security
of Individually Identifiable Health Information codified at 45 CFR Parts 160, 162 and 164
require Covered Entity to enter into a contract with Business Associate that includes and
imposes on Business Associate specific duties, obligations and requirements with respect to
Business Associate's use, disclosure, creation and general handling of Protected Health
Information, as set forth in, but not limited to, Title 45, §§ 164.502(e) and 164.504(e) of the
Code of Federal Regulations ("CFR") and as otherwise provided in this BAA.
In consideration of the mutual promises below and the exchange of information pursuant to this BAA,
the Parties agree as follows:
1) Definitions.
a) Specific Definitions.
i) "Breach" shall have the meaning given to such term under the Privacy Rule, at 45 CFR
§ 164.402.
ii) "Business Associate" shall have the meaning set forth above.
iii) "Compliance Date" shall mean, in each case, the date by which compliance with a
particular provision is required under HITECH; provided that, in any case for which that
date occurs prior to the effective date of this BAA, the Compliance Date shall mean the
effective date of this BAA.
iv) "Covered Entity" shall have the meaning set forth above.
v) "Data Agg_re atg ion" shall have the meaning given to such term under the Privacy Rule at
45 CFR § 164.501.
vi) "Designated Record Set" shall have the meaning given to such term under the Privacy
Rule, at 45 CFR § 164.501.
vii) "Electronic Health Record" shall have the meaning given to such term in 42 USC
17921(5).
viii) "Electronic Media" has the meaning in CFR § 160.103, which is:
(1) Electronic storage media including memory devices in computers (hard drives) and any
removable or transportable digital memory medium, such as magnetic tape or disk,
optical disk, or digital memory card; or
(2) Transmission media used to exchange information already in electronic storage media.
Transmission media include, for example, the Internet, extranet, leased lines, dialup
lines, private networks, and the physical movement of removable or transportable
electronic storage media. Certain transmissions, including paper, via facsimile, and
via telephone, are not considered transmissions via electronic media because the
information did not exist in electronic form before the transmission.
ix) "Electronic Protected Health Information" (or "EPHI") has the meaning of 45 CFR §
160.103 and is defined as protected health information contained in or transmitted on
electronic media received from us or created or received on behalf of us.
x) "Health Care Operations" shall have the meaning given to such term under the Privacy
Rule at 45 CFR 164.501.
xi) "HIPAA" shall mean the Health Insurance Portability and Accountability Act, 42 U.S.C.
§§ 1320d through 1320d-8, as amended from time to time, and all associated existing
and future implementing regulations, when effective and as amended from time to time.
xii) "HITECH" shall mean Subtitle D of the Health Information Technology for Economic
and Clinical Health Act (a.k.a. the "HITECH Act") provisions of the American
Recovery and Reinvestment Act of 2009, 42 U.S.C. §§17921-17954, as amended from
time to time, and all associated existing and future implementing regulations, when
effective and as amended from time to time.
xiii) "Individual" shall mean the person who is the subject of PHI and shall include a
person who qualifies as a personal representative in accordance with the Privacy
Rule.
xiv) "Privacy Rule" shall mean the standard for Privacy of Individually Identifiable Health
Information codified at 45 CFR Parts 160 and 164.
xv) "Protected Health Information" ("PHP') has the meaning in 45 CFR § 164.304.
xvi) "Required by Law" shall mean a mandate contained in law that compels a covered entity
to make a use or disclosure of PHI and that is enforceable in a court of law.
xvii) "Security Rule" shall mean the standard for Security of Individually Identifiable Health
Information codified at 45 CFR Parts 160, 162 and 164.
xviii) "Security Incident" has the meaning in 45 CFR § 164.304, which is the attempted or
successful unauthorized access, use, disclosure, modification, or destruction of
information or interference with system operations.
xix) "Subcontractor" shall have the meaning given to such term at 45 CFR § 160.103 and
includes any agent/agency relationships.
xx) "Unsecured Protected Health Information" (or "unsecured PHI") shall mean Protected
Health Information has the meaning as set forth in 45 C.F.R. 164.402.that is not rendered
unusable, unreadable, or indecipherable to unauthorized individuals through the use of a
technology or methodology specified by the Secretary in the regulations or guidance issued
pursuant to 42 U. S.C. §§17932(h)(2).
xxi) "Unsuccessful Security Incident" shall mean, without limitation, pings and other broadcast
attacks on Business Associate's firewall, port scans, unsuccessful log -on attempts, denial of
service attacks, and any combination of the above, so long as no such incident results in
unauthorized access, use, disclosure, modification or destruction of PER or intentional
interference with system operations in an information system that contains PHI.
b) Catch-all Definition. Terms used, but not otherwise defined, in this Addendum shall have the
same meaning as those terms in the Privacy Rule and Security Rule.
2) Obligations of Business Associate.
a) Permitted Uses. Business Associate shall not use PHI except for the purpose of performing
Business Associate's obligations under the Service Agreement and as permitted or required by
this BAA. Further, Business Associate shall not use PHI in any manner that would constitute
a violation of the Privacy Rule if so used by Covered Entity. However, Business Associate
may (i) use PHI for the proper management and administration of Business Associate and to
carry out the legal responsibilities of Business Associate, and (ii) provide Data Aggregation
services relating to the health care operations of Covered Entity if such services are provided
by Business Associate to Covered Entity under the Service Agreement.
b) Permitted Disclosures. Business Associate shall not disclose PHI in any manner that would
constitute a violation of HITECH and HIPAA (including without limitation the Privacy Rule)
if disclosed by Covered Entity. However, Business Associate may disclose PHI in a manner
permitted pursuant to the Service Agreement, for the proper management and administration
of Business Associate; and as required by law. Additionally, Business Associate may disclose
PHI in a manner allowed by law if Covered Entity specifically authorizes the disclosure. In no
event shall Business Associate be permitted to receive remuneration, either directly or
indirectly, in exchange for PHI, except as may be approved by Covered Entity in its sole
discretion and then, only to the extent permitted by 42 U.S.C. § 17935(d). To the extent that
Business Associate discloses PHI to a third party, Business Associate must prior to making any
such disclosure obtain, (i) reasonable assurances from such third party that such PHI will be
held confidential as provided pursuant to this BAA and only disclosed as required by law or
for the purposes for which it was disclosed to such third party, and (ii) an agreement from such
third party to immediately notify Business Associate of any breaches of confidentiality of the
PHI, to the extent it has obtained knowledge of such breach.
c) Appropriate Safeguards.
i) Business Associate will comply with all applicable federal and states laws and regulations
and implement administrative, physical, and technical safeguards that reasonably and
appropriately protect the confidentiality, integrity, and availability of EPHI that it creates,
receives, maintains, or transmits on behalf of the Covered Entity as required by the Security
Rule and as of the Compliance Date of 42 U.S.C. § 17931, comply with the Security Rule
requirements set forth in 45 C.F.R. §§ 164.308, 164.310, 164.312, and 164.316;
ii) Business Associate agrees to ensure that any agent, including a subcontractor, to whom
it provides EPHI agrees to implement reasonable and appropriate safeguards to protect it;
and
iii) Business Associate will report to Covered Entity as soon as reasonably practicable (i) any
use or disclosure of protected health information not provided for by this BAA of which it
becomes aware in accordance with 45 C.F.R. § 164.504(e)(2)(ii)(C); and/or (ii) any
security incident affecting EPHI of which Business Associate becomes aware in
accordance with 45 C.F.R. § 164.314(a)(2)(C) provided, however, that the Parties
acknowledge and agree that this Section constitutes notice by Business Associate to
Covered Entity of the ongoing existence and occurrence of Unsuccessful Security Incidents
for which no additional notice to Ameritas shall be required; and
iv) Business Associate agrees to promptly report to Covered Entity any Breach of which it
becomes aware as soon as reasonably practicable following Business Associate's discovery
of any Breach involving Covered Entity's unsecured PHI. The foregoing report shall
include identification of each Individual whose PHI Business Associate reasonably
believes to have been accessed, acquired, or disclosed during such Breach. As soon as
possible thereafter, and to the extent known, Business Associate shall also provide Covered
Entity with a description of (i) what happened, including the date of the Breach and the
date of the discovery, (ii) the types of unsecured PHI involved in the Breach, (iii) any steps
individuals should take to protect themselves from potential harm from the Breach, and
(iv) what Business Associate is doing to investigate the Breach, to mitigate harm to
individuals, and to protect against any further Breaches.
d) Restrictions on Disclosures. Business Associate will restrict its disclosures of the Individual's
PHI in the same manner as would be required for Covered Entity. If Business Associate
receives an Individual's request for restrictions, Business Associate shall forward such request
to Covered Entity within ten (10) business days.
e) Subcontractors. Business Associate shall ensure that any Subcontractor, to whom it provides
PHI agree in writing to the same or substantially similar restrictions and conditions that apply
to Business Associate with respect to such PHI. Business Associate will advise Covered Entity
if any such Subcontractor breaches its agreement with Business Associate with respect to the
disclosure or use of Covered Entity's Protected Health Information or EPHI.
f) Access to Protected Information. Business Associate shall make PHI maintained by Business
Associate or its agents or subcontractors in Designated Record Sets available to Covered Entity
for inspection and copying to enable Covered Entity to fulfill its obligations under the Privacy
Rule, including, but not limited to 45 CFR Section 164.524.
g) Amendment of PHI. Upon receipt of a request from Covered Entity for an amendment of PHI
or a record about an individual contained in a Designated Record Set, Business Associate or
its agents or subcontractors shall make such PHI available to Covered Entity for amendment
and incorporate any such amendment to enable Covered Entity to fulfill its obligations under
the Privacy Rule, including, but not limited to, 45 CFR Section 164.526. If any individual
requests an amendment of PHI directly from Business Associate or its agents or subcontractors,
Business Associate shall notify Covered Entity in writing within ten (10) days of the request.
Any decision to deny the requested amendment of PHI maintained by Business Associate or
its agents or subcontractors shall be the sole responsibility of Covered Entity.
h) Accounting Rights. Upon request for an accounting of disclosures of PHI from Covered Entity,
Business Associate and its agents or subcontractors shall make available to Covered Entity the
information required to provide an accounting of disclosures to enable Covered Entity to fulfill
its obligations under the Privacy Rule, including, but not limited to, 45 CFR Section 164.528.
As set forth in, and as limited by, 45 CFR section 164.528, Business Associate shall not provide
an accounting to Covered Entity of disclosures: (i) to carry out treatment, payment or health
care operations, as set forth in 45 CFR Section 164.502; (ii) to individuals of PHI about them
as set forth in 45 CFR 164.502; (iii) to persons involved in the individual's care or other
notification purposes as set forth in 45 CFR Section 164.510; (iv) for national security or
intelligence purposes as set forth in 45 CFR Section 164.512(k)(2); or (v) to correctional
institutions or law enforcement officials as set forth in 45 CFR Section 164.512(k)(5). Business
Associate agrees to implement a process that allows for an accounting to be collected and
maintained by Business Associate and its agents or subcontractors for at least six (6) years
prior to the request, but not before the compliance date of the Privacy rule. In the event that
the request for an accounting is delivered directly to Business Associate or its agents or
subcontractors, Business Associate shall forward it to Covered Entity. It shall be Covered
Entity's responsibility to prepare and deliver any such accounting requested. Business
Associate shall not disclose any PHI except as set forth in Sections 2(b) of this BAA.
i) Governmental Access to Records. If requested, Business Associate shall make its internal
practices, books and records relating to the use and disclosure of PHI available to the Secretary
of the U.S. Department of Health and Human Services (the "Secretary") for purposes of
determining Covered Entity's compliance with Privacy Rule in accordance with 45 CFR
164.504(e)(ii)(I).
j) Minimum Necessary. Business Associate (and its agents and subcontractors) shall only
request, use and disclose the minimum amount of PHI necessary to accomplish the purpose of
the request, use or disclosure and consistent with Covered Entity's minimum necessary policies
and procedures.
k) Data Ownership. Business Associate acknowledges that Business Associate has no ownership
rights with respect to the PHI.
1) Retention of PHI. Upon termination of the Service Agreement for any reason, Business
Associate shall return or destroy all PHI that Business Associate or its agents or subcontractors
still maintain in any form and shall retain no copies of such PHI. If return or destruction is not
feasible, Business Associate shall continue to extend the legally required protections of this
BAA to such information, and limit further use of such PHI to those purposes that make the
return or destruction of such PHI infeasible. If Business Associate elects to destroy the PHI,
Business Associate shall certify in writing to Covered Entity that such PHI has been destroyed.
m) Electronic Health Record. In the event that Business Associate in connection with rendering
the services under the Service Agreement uses or maintains an Electronic Health Record of
PHI of or about an individual, the Business Associate will provide an electronic copy of such
PHI in accordance with 42 U.S.C. § 17935(e) as of its Compliance Date. Moreover, in the
event that Business Associate uses or maintains an Electronic Health Record of PHI of or about
an individual, then Business Associate shall make an accounting of disclosures of such PHI in
accordance with the requirements for accounting of disclosures made through an Electronic
Health Record in 42 U.S.C. 17935(c), as of its Compliance Date.
n) Business Associate will not make or cause to be made any communication about a product or
service that is prohibited by 42 U.S.C. § 17936(a) as of its Compliance Date.
o) Business Associate will not make or cause to be made any written fundraising communication
that is prohibited by 42 U.S.C. § 17936(b) as of its Compliance Date.
p) Pursuant to the Privacy Rule, made applicable to Business Associate by HITECH, Business
Associate shall adopt, implement, and follow privacy policies and procedures in the same
manner and to the same extent as if it were a Covered Entity.
q) Pursuant to the Security Rule, made applicable to Business Associate by HITECH, Business
Associate shall adopt, implement, and follow security policies and procedures in the same
manner and to the same extent as if it were a Covered Entity.
3) Obligations of Covered Entity.
a) Covered Entity shall be responsible for using appropriate safeguards to maintain and ensure
the confidentiality, privacy and security of PHI transmitted to Business Associate pursuant to
this BAA, in accordance with the Covered Entity and requirements of the Privacy Rule, until
such PHI is received by Business Associate.
b) Covered Entity shall notify Business Associate of any limitation(s) in its notice of privacy
practices of Covered Entity in accordance with 45 CFR § 164.520, to the extent that such
limitation may affect Business Associate's use or disclosure of PHI.
c) Covered Entity shall notify Business Associate of any changes in, or revocation of, permission
by Individual to use or disclose PHI, to the extent that such changes may affect Business
Associate's use or disclosure of PHI.
d) Covered Entity shall notify Business Associate of any restriction to the use or disclosure of
PHI that Covered Entity has agreed to in accordance with 45 CFR § 164.522, to the extent that
such restriction may affect Business Associate's use or disclosure of PHI.
4) Term and Termination.
a) Term. This BAA shall be effective as of the effective date of the underlying Service Agreement
and shall terminate when all of the PHI provided by Covered Entity to Business Associate, or
created or received by Business Associate on behalf of Covered Entity, is destroyed or returned
to Covered Entity, or, if it is infeasible to return or destroy PHI, protections are extended to
such information, in accordance with the termination provision in this section.
b) Material Breach. A breach by Business Associate of any provision of this BAA, as determined
by Covered Entity, shall constitute a material breach of the Service Agreement and shall
provide grounds for immediate termination of the Service Agreement by Covered Entity
pursuant to the Service Agreement.
c) Reasonable Steps to Cure Breach. If Covered Entity knows of a pattern of activity or practice
of Business Associate that constitutes a material breach or violation of Business Associate's
obligations under the provisions of this BAA or another arrangement and does not terminate
the Service Agreement pursuant to Section 4 (b), then Covered Entity shall take reasonable
steps to cure such breach or end such violation, as applicable. If Covered Entity's efforts to
cure such breach or end such violation are unsuccessful, Covered Entity shall either (i)
terminate the Service Agreement, if feasible, or (ii) if termination of the Service Agreement is
not feasible, Covered Entity shall report Business Associate's breach or violation to the
Secretary of the Department of Health and Human Services.
d) Judicial or Administrative Proceedings. Either party may terminate the Service Agreement,
effective immediately, if (i) the other party is named as a defendant in a criminal proceeding
for a violation of HIPAA, HITECH or other security or privacy laws or (ii) a finding or
stipulation that the other party has violated any requirement of HIPAA, HITECH or other
security or privacy laws is made in any administrative or civil proceeding in which the party
has been joined.
5) Disclaimer. Covered Entity makes no warranty or representation that compliance by Business
Associate with this BAA, HIPAA or HITECH will be adequate or satisfactory for Business
Associate's own purposes. Business Associate is solely responsible for all decisions made by
Business Associate regarding the safeguarding of PHI.
6) Certifications. To the extent Covered Entity determines that such examination is necessary to
comply with Covered Entity's legal obligations pursuant to HIPAA and HITECH relating to
certification of its security practices, Covered Entity or its authorized agents or contractors, may,
at Covered Entity's expense, examine Business Associate's facilities, systems, procedures and
records as may be necessary for such agents or contractors to certify to Covered Entity the extent
to which Business Associate's security safeguards comply with HIPAA, HITECH or this BAA.
7) Amendment to Comply with Law. The Parties acknowledge that state and federal laws relating to
data security and privacy are rapidly evolving and that amendment of this BAA may be required
to provide for procedures to ensure compliance with such developments. The Parties specifically
agree to take such action as is necessary to implement the amendments and requirements of HIPAA
(including without limitation the Privacy Rule), HITECH and other applicable laws relating to the
security or confidentiality of PHI. The Parties understand and agree that Covered Entity must
receive satisfactory written assurance from Business Associate that Business Associate will
adequately safeguard all PHI. Upon the request of either party, the other party agrees to promptly
enter into negotiations concerning the terms of an amendment to this BAA embodying written
assurances consistent with the amendments and requirements of HIPAA (including without
limitation the Privacy rule), HITECH or other applicable laws. Covered Entity may terminate the
Service Agreement upon thirty (30) days written notice in the event (i) Business Associate does
not promptly enter into negotiations to amend this BAA when requested by Covered Entity
pursuant to this Section or (ii) Business Associate does not enter into an amendment to this BAA
providing assurances regarding the safeguarding of PHI that Covered Entity, in its sole discretion,
deems sufficient to satisfy the Covered Entity and requirements of HIPAA, including without
limitation the Privacy Rule, and HITECH.
8) Assistance in Litigation or Administrative Proceedings. Business Associate shall make itself, and
any subcontractors, employees or agents assisting Business Associate in the performance of its
obligations under the Service Agreement, available to Covered Entity, at no cost to Covered Entity,
to testify as witnesses, or otherwise, in the event of litigation or administrative proceedings being
commenced against Covered Entity, its directors, officers or employers based upon a claimed
violation of HIPAA, including without limitation the Privacy Rule, HITECH or other laws relating
to security and privacy, except where Business Associate or its subcontractor, employee or agent
is a named adverse party.
9) No Third -Party Beneficiaries. Nothing express or implied in this BAA is intended to confer, nor
shall anything herein confer, upon any person other than Covered Entity, Business Associate and
their respective successors or assigns, any rights, remedies, obligations or liabilities whatsoever.
10) Effect on Agreement. Except as specifically required to implement the purposes of this BAA, or
to the extent inconsistent with this BAA, all other terms of the Service Agreement shall remain in
force and effect.
11) Indemnification. In addition to any indemnification obligations, which are a part of the Service
Agreement, the Business Associate hereby indemnifies and agrees to hold the Covered Entity
harmless against any and all claims, liabilities, obligations, costs or damage, including Civil
Monetary Penalties, arising from a breach by the Business Associate of its obligations in
connection with this BAA or HITECH, or HIPAA.
12) Interpretation. This BAA shall be interpreted as broadly as necessary to implement and comply
with HIPAA and HITECH. The Parties agree that any ambiguity in this BAA shall be resolved in
favor of a meaning that complies and is consistent with HIPAA and HITECH in light of any
interpretation and/or guidance on HIPAA, the Privacy Regulation and/or the Security Regulation
issued by HHS from time to time.
13) Counterparts; Facsimiles. This BAA may be executed in any number of counterparts, each of
which shall be deemed an original. Facsimile copies hereof shall be deemed to be originals.
14) Disputes. If any controversy, dispute or claim arises between the Parties with respect to this BAA,
the Parties shall make good faith efforts to resolve such matters informally.