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EMPLOYEE GROUP INS. RENEWALS -2012
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EMPLOYEE GROUP INS. RENEWALS -2012
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Last modified
2/16/2017 12:29:05 PM
Creation date
7/12/2013 10:31:02 AM
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Contracts
Company Name
EMPLOYEE GROUP INS. RENEWALS
Contract #
A-2012-170
Agency
PERSONNEL SERVICES
Council Approval Date
8/6/2012
Expiration Date
12/13/2013
Destruction Year
2018
Notes
Amends A-2002-208 Amended by A-2014-176, A-2015-206, A-2015-207
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Stabilization means the negative or positive amount of Premiums paid under this plan after <br />deduction of claims paid, reserves for incurred but unreported claims and Delta Dental's <br />administrative charge. <br />In no event, however, shall the plus stabilization or any part of it be returned to the <br />Contractholder in a cash transaction and such amounts remaining upon termination of the <br />Contract shall remain with Delta Dental. <br />3.5 In the event the Contractholder chooses to convert to a self-funded plan during or at the end <br />of a Contract Term, the stabilization accumulated under this plan is combined with the <br />reserves held for incurred but unreported claims, with the balance used to pay for claims and <br />administration without regard to the date of service. <br />3.6 Except as provided in the next paragraph, an agreement between Delta Dental and the <br />Contractholder is required to change the Contractholder's Premium rates during a Contract <br />Term. <br />3.7 During a Contract Term, if any government agency imposes any new tax on Delta Dental <br />based on the amount of Premiums payable or the number of persons covered under this <br />Contract, or if the rate of any existing tax on the amount of Premiums or the number of <br />persons covered under this Contract increases, the Premiums stated in this Article will <br />increase by the amount of any such new or increased tax(es). <br />3.11 Premiums and eligibility may be adjusted retroactively by Delta Dental or the Contractholder, <br />but such adjustments are limited to the three-month period prior to the most current month <br />for which the Contractholder provides eligibility data. <br />Paragraph 9.2 is amended to read: <br />9.2 If Delta Dental terminates this Contract under paragraph 9.1 (a), all Benefits end and Delta <br />Dental is released from all further obligations of this Contract, effective the last day of the <br />month in which written notice of termination is given. The Contractholder will remain liable to <br />Delta Dental for the greater of: (1) the unpaid Premiums applicable for the period this <br />Contract was in effect before termination; or (2) the full amount of all Dentist's statements <br />paid or otherwise discharged by Delta Dental during the full term of this Contract, plus 14% <br />of such amount (to compensate Delta Dental for its administration of the dental plan), less <br />amounts actually paid by the Contractholder to Delta Dental during the term of such <br />Contract. <br />Appendix B, CODE ON DENTAL PROCEDURES AND NOMENCLATURE, attached hereto, is hereby <br />amended.
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