Service Solicited - 2023 - National Benefit Services (NBS) - National Benefit Services (NBS) - Amendment Legislative Notices to COBRA Schedules national
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AMENDMENT-LEGISLATIVE NOTICES TO COBRA SCHEDULES
CITY OF EAGLE
This amendment("Amendment')amends the Service Agreement("Agreement")between National Benefit
Services, LLC, a Utah Limited Liability Company, ("NBS") and City of Eagle("Client') and is effective May
1, 2023.
Capitalized terms not otherwise defined in this Amendment have the meanings ascribed to them in the
Agreement. In the event of a conflict between the terms of this Amendment and the Agreement, the terms
of this Amendment will control.
The parties agree to the following modifications of the Agreement.
AMENDMENT
1. The Agreement is amended as follows:
1.1. Section I.B.1 of COBRA Services Schedule A has been amended by adding the following Defined
Term to this section:
g. "Legislative Notice" means a notice to a Qualified Beneficiary required or necessitated by
either(1) a statute enacted by the United States Congress; (2) guidance or regulation from
the United States Department of Labor, the United States Department of the Treasury, or
the United States Department of Health and Human Services; or(3) a national emergency
declared by the President of the United States. Legislative Notice does not include a
COBRA initial notice, election notice, qualifying event notice, notice of unavailability of
COBRA coverage, notice of COBRA premium payment short by an insignificant amount,
notice of termination of COBRA, or individual conversion policy notice.
1.2. Section II.A. of COBRA Services Schedule A is amended to read as follows:
1. Create and mail the COBRA Qualifying Event notice and election packet to Qualified
Beneficiaries within fourteen (14) days of notice from Employer that a Qualifying Event has
occurred.
2. Create and mail other notices to Qualified Beneficiaries. Such notices may include: monthly
premium billing (coupon books), late payment notices and COBRA termination notices.
Such notices do not include Legislative Notices. If notices or communications in addition to
these are requested by the Employer, preparation and delivery of such notices or
communications may be billed at the Extra Hourly Work rate listed on Schedule B.
3. Create and mail Legislative Notices as necessary.
4. Create and mail monthly premium statements to Employer.
1.3. The Monthly Maintenance Fee description under the"Administration Services"section of COBRA
Schedule B is amended to read as follows:
• Includes Consultation and Support Services to Company, Employees, and Insurance
Carrier. Company Interface and Rate Changes, Computer Program and Web
Maintenance, and Maintenance of Database Files.
COBRA SERVICE AGREEMENT-AMENDMENT PAGE 1 OF 2
1.4. The"Administration Services" section of COBRA Schedule B is amended with the addition
of the following:
Legislative Notices $8.25/Notice/Qualified Beneficiaries
• Includes preparation of notice and mailing of notice to Qualified Beneficiaries.
Invoiced to entity responsible for the Monthly Maintenance Fee.
2. Subject to the specific modification made by this Amendment,all terms and conditions of the Agreement
remain in full force and effect.
IN WITNESS HEREOF, the Parties have executed this Amendment effective by their duly authorized
representatives.
CITY OF EAGLE
Signed;ji(��
�� ature)
Name: 1 ( sign 1)5(�rri
(print name)
Title:
(print title)
Date: 3 ?Jb 1ya3
NATIONAL BENEFIT SERVICES,LLC
Signed: dagal.,A 1W
(signature)
Name: Jalyn S. Pond
(print name)
Title: Senior Vice President Operations
(print title)
Date: March 27, 2023
COBRA SERVICE AGREEMENT AMENDMENT PAGE 2 OF 2