Loading...
HomeMy WebLinkAboutFlexible Benefit Plan City of Oshkosh Flexible Benefit Plan Agreement for Service 01/01/2004 - 12/31/2006 ß\ DI,;"ERSIFIED BENEFIT SER,;"ICES, INC. - pedicated to Excellence in Benefit Management Solatians AGREEMENT between the EMPLOYER designated below and DIVERSIFIED BENEFIT SERVICES, INe. ("DBS") WHEREAS, DBS made available a Flexible Benefit Plan that was established by the Employer and was designed to comply with Section 125 of the Internal Revenue Code (the "Code"). WHEREAS, the Flexible Benefit Plan incorporates professional material, and internally developed corporate information. NOW, TIfEREFORE, IN CONSIDERATION OF TIfE MUTUAL PROMISES AND AGREEMENTS HEREIN CONTAINED, TIfE RECEIPT AND SUFFICIENCY OF WHICH IS HEREBY ACKNOWLEDGED, TIfE PARTIES AGREE AS FOLLOWS: I. DBS agrees to continue to make available the Flexible Benefit Plan to be used as the Employer Flexible Benefit Plan. 'Employer agrees not to disclose details of the Plan to other parties or copy any materials provided, except for auditors, attorneys, and others to whom disclosure is legally required, unless DBS gives permission to do so. 2. Employer retains DBS as Plan Agent for the Employer Flexible Benefit Plan and authorizes DBS to perform all functions necessary to prepare, implement, and operate the Employer Flexible Benefit Plan. 3. Employer agrees to provide data that DBS needs in communication and enrollment of the Flexible Benefit Plan. Employer also agrees to make the necessary payroll deductions and assist DBS for implementing and operating the program. 4. DBS services may include some or all of the following items (as needed); restatement of a Flexible Benefit Plan document, summary plan description, ancillary forms, sample board of directors resolution, enrolhnent of the employees of the Employer, and claims recordkeeping. Also, annual discrimination testing required uoder Code Section 125, specifically the 25% test. The Employer agrees to provide all plan contribution information to DBS, including any group insurance premium contributions to allow DBS to conduct proper testing. Only the dependent care testing will be completed if the Employer elects not to provide group insurance premium contribution amouots to DBS. The testing will be conducted only if the Employer provides timely information on key and highly compensated employees as requested by DBS. Other package services specified in the attached Schedule A may be provided as noted by the Employer intials next to the package desired. 5. Employer agrees to pay to DBS the fees for services as listed in the attached Schedule A. If the Employer elects to have the employee pay the monthly ongoing administration fee and an employee terminates with a balance in an accouot, the Employer shall be responsible for the monthly fee from that point forward. In addition, Employer recognizes that the Plan allows employees to submit claims after Plan year-end for a specified period in accordance with the Plan document. Employer agrees that any claims processed during the extension period at Plan year end are at the Employer expense, unless otherwise specified in Schedule A. 6. Any overpayments to employees as a result of the Employer not notiJying DBS as to status changes via the DBS Status Change Notification Form or other agreed upon format by both parties as of the claim cut-off date, will be the responsibility of the Employer. Any subsequent bank charges as a result of the aforementioned will be the responsibility of the Employer. Requests by the Employer for processing special checks (meaning checks not processed at the regular claims processing date) due to an employee filing late claim(s), (meaning clairn(s) received by DBS after the claims deadline date), or for lost or stolen checks will be done for a fee of $25 per'check. If an employee or former employee fails to retain original documentation regarding claims submitted to DBS and the employee or former employee requests copies of claims and/or documentation from DBS because of an audit by the IRS or another agency, there will be a fee of $50/hour plus .25 per copy made. TIlls will only be authorized by the Employer and will be billed to the Employer if authorization is obtained. 7. Employer agrees to pay to DBS the agreed upon fee indicated for other services listed on attached Schedule A by placing initials next to the service package desired located at the bottom of schedule A. TIlls agreement does not cover any possible future Government imposed costs regarding auditing of Flexible Benefit Plans. Also, it is not within the scope of this agreement to cover possible future Government imposed costs with regard to filing fees for any Govermnent forms, documents, or year-end (5500) reports. The term "Government" shall include but not be limited to the United States Government, Internal Revenue Service, Deparhnent of Labor, or a State within the United States. 2 ß\ DI,;"ERSIFIED BENEFIT SER,;"ICES, INC. ":" Dedicated to Excellence in Benefit Management Solutions 8. TIlls agreement shall remain in effect for a period of three full plan years wherein both parties have signed and dated said Agreement ("Initial Term"), after which time it shall be renewed automatically for successive three plan year periods ("Renewal Terms"), uoless one party notifies the other in writing at least 90 days prior to the renewal date that it does not intend to renew. The renewal date shall be the end of the third plan year. Notification uoder Section 8 of this Agreement shall be deemed duly given if delivered by certified or registered mail with postage prepaid to DBS or the Employer. 9. Notwithstanding the preceding paragraphs, either party may terminate this Agreement for cause at any time. "Cause" shall be limited to any of the following reasons: (a) if either party fails to perform its duties hereuoder and such failure is not cured within thirty days of receipt of written notice thereof; (b) if all or any portion of the plan fails to comply with applicable provisions of the Code and regulations thereuoder or state regulations; or (c) if some or all of the Plan is not legally or validly implemented. 10. If the Employer terminates the Agreement without cause during the Agreement period ("Initial Term or Renewal Term"), the Agreement must be purchased by the Employer. Such Agreement buyout shall be based upon the fees that would have been charged for the remainder of the agreement period for such services as future enrolhnent, monthly athninistration, miscellaneous, and any package services that may apply. Such fees shall be those as set forth in the attached Schedule A of the Agreement. Payment of the final invoice shall be due upon receipt. If the final invoice is not paid as described DBS will not process claims and/or reports uotil full payment is made by the Employer. II. If the Employer is purchased by another organization and/or merges and/or affiliates with another organization, the terms of this Agreement shall remain in full force and shall be binding uotil the end of the term of the Agreement unless a buyout of the Agreement is agreed to. Any buyout of the Agreement shall be the fees that would have been charged for the remainder of the agreement period. Such fees shall be based upon the attached Schedule A of the Agreement including enrollment, monthly administration, miscellaneous, and any package fees that may apply. 12. DBS shall have the right to retain, at its own cost, outside services in preparing, implementing and operating of the Plan. 13. Nothing contained herein shall obligate Employer to utilize DBS as its agent or broker in providing group benefits to employees. 14. The Employer recognizes that the plan document is an important legal document and that it has been prepared based on the uoderstanding by DBS of the desired provisions. It may not conform to the Employer's situation and the Employer should consult with its attorney on the legal and tax implications of the plan. DBS cannot be responsible for the legal or tax aspects of the plan nor its appropriateness for the Employer situation as the Employer as Plan Administrator would only know those items. Employer recognizes that DBS is not a law firm and that DBS employees are not attorneys. Additionally, Employer recognizes that DBS is not an accounting (CPA) firm. 15. Employer agrees to indemnify and hold harmless DBS, its affiliates, and any of its directors, officers or employees with respect to any and all claims, liabilities, losses, damages, or expenses, including reasonable attorneys' fees, incurred by reason of the failure of the Employer to carry out its obligation uoder this Agreement on a timely and non-negligent basis, unless such failure is based upon the negligence ofDBS or any of its employees. 16. DBS agrees to indemnifY and hold harmless Employer, its affiliates, and any of its directors, officers or employees with respect to any and all claims, liabilities, losses, damages, or expenses, including reasonable attorneys' fees, incurred by reason of the failure of the DBS to carry out its obligation uoder this Agreement on a timely and non-negligent basis, unless such failure is based upon the negligence of Employer or any of its employees. 17. This Agreement, including Schedule A, constitutes the entire understanding of the parties and may be modified only in writing executed by both parties. It shall be binding upon both parties and their successors or assigns and shall be interpreted uoder the laws of the State of Wisconsin and is exlusive. 18. Plan years covered by the "Initial Term" of this Agreement shall be 1/1/2004 - 12/31/2006. ffi DI,;"ERSIFIED BENEFIT SER,;"ICES, INC. ":" Dedicated to Excellence in Benefit Management Solutioo,,' Datedthis 17th day of March, 2004. .1ItI\IJ! ~ Ci Witness: I hereby cenify that the necess;"y provisions have been made to pay the liability which will accrue under this contract. 7,Q ,~O("- VL<,~ City Comptroller ~ Title: Title: City Manager City C1 erk f~ Title: ^'" j,. "'<F>^- r Title: ~t~~.:v~ ß\ DI,;"ERSIFlED BENEFIT SER,;"ICES, INc. - Dedicated to Excellence in Benefit Management Solutions 4 Schedule A 1. Plan Implementation Fees for plan consultation, Plan Document amendments, updating, restatement, summary plan description changes, client generated benefit or plan changes that require the updating, changing, or restating of the plan document or summary plan description will be quoted and billed separately. Printing of summary plan descriptions will be quoted and billed separately). 2. Group Meetin2S Flexible Benefit Plan materials for new employees, video group presentationes) with the communication of the Flexible Benefit plan and explanation of expense worksheet and related materials to employees as needed. Fee: N/C 3. ComplianceÆmplovee EnrollmentlPlan Year Election Entrv/Related Services Emplover Choose Option(s) A. DDS full enrollment. Services will include comprehensive individual employee enrollment sessions with DBS Benefits Enrollers with review of employee flexible benefit plan worksheet/employee guide. The DBS notebook computer system may be utilized if appropriate. The individual enrollment sessions also include the completion of enrollment forms and providing employees with an expense reporting kit. TIlls section also includes establishing plan records on the DBS flexible benefit plan software administration system, preliminary plan compliance, election auditing, and other related in-house plan services. B. Emplover self-enrollment. Under option B (I) Employer will provide enrollment forms and/or packets or DBS will provide the Employer with seIf-enrolhnent packets including a worksheet, enrollment form and additional plan material. An enrollment letter and plan fact sheet will be provided as well. DBS will supply the Employer with claim forms and/or expense reporting kits as needed. TIlls section also includes establishing plan records on the flexible benefit plan software administration system, prelintinary plan compliance, election auditing, and other related in-house plan services. Under option B (2) the Employer may choose to have DBS Benefits Enrollers available for a limited period of time at various sites for individual employee enrollment sessions. The sites and schedule would be determined prior to the enrollment sessions. If option "B" Employer self-enrollment is selected and DBS provides limited enrollment with DBS enrollers then items (I) and (2) below will apply for fee calculation purposes. If no DBS enrollers are involved then item (I) below will apply for enrollment billing purposes c. Internet enrollment. DBS would provide the Employer with an enrollment instmction letter and plan information letter that would include system passwords for User name and PIN. TIlls would allow employees access to the DBS Web site enrollment system. Employees would receive an e-mail confmnation when submitting their election information. The Employer agrees to distribute the letter with instmctions to all eligible employees. DBS would provide the Employer with copies of completed enrolhnent forms for all plan participants. TIlls section also includes establishing plan records on the flexible benefit plan software administration system, prelintinary plan compliance, election auditing, and other related in-house plan services. Option A Fee: DBS full enrollment with benefit enrollers: $8.00 per eligible employee for each plan year. Option D Fee: (1) Employer self-enrollment: $3 .25/packet for each plan year (Minimum: $50) (2) Limited DBS emollment with benefit enrollers: $8.00 per enrolled participant for each plan year. (Minimum: $50) $100 setup plus $1.50/FSA participant (3) Self-enrollment using a DBS E-file Option C Fee: DBS, Inc. Online enrolhnent system: $100 annual setup fee plus $2.50 per FSA participant for each plan year. (Minimum: $50) ß\ Dl,;"ERSlFIED BENEFIT SER';"ICES, INC. - Dedicated to Excellence in Benefit Management Solution" , " Schedule A (continued) 4. Record-keeoin2. Claims orocessin2. and Plan Reoortin2 . process all claims from plan participants & issue reimbursement checks . employer aggregate plan reporting . Employee statements of accouot . one copy of the video group meeting tape as a training tape for use with new employees . process all family status changes for the Employer including new hires & termioations . reissuance of lost or stolen checks by employees . 800 toll free telephone number for Section 125/Flexible Benefit Plan questions . Periodic Section l25/Flexible Benefit Plan informational bulletins Plan Year Monthlv Fee Schedule 01/01/2004- 12/31/2004 01/01/2005- 12/31/2005 01/01/2006-12/31/2006 $ 2.S5/participant/month for service agreement year one $ 2. 95/participant/month for service agreement year two $ 2. 95/participant/month for service agreement year three The above month fee includes the following categories: Dependent Care Reimbursement Accouot, and/or the Medical Expense Reimbursement Accouot. Minimum Monthly Group Administration Fee: $30.00 MISCELLANEOUS COSTS FSA check supply, deposit slips, and related banking fees for account transactions, direct deposit bank transaction fees (if elected below), enrollment related costs such as travel, lodging, meals, (based on client facility locations), shipping & handling, and customized materials requested by the client. G) Packa2e Services (Circle the numher(s) for the services desired) All employer reports including transaction ledger, payments in excess of deposits, accouot summary, and check register sent to the Employer. There is no separate fee for this service, it is included in the section 4 of Schedule A above entitled "record keeping, claims processing, and reporting". Employee account statements and/or checks sent to employer unless package II or P.A.e.E. below is circled. (9 Statements / checks / direct deposit remittance mailed to employees: Postage reimbursement. Total banking accouot package. Includes FSA bank account setup with client bank, transfer of plan contributions (EFI'), audit of accouot, bank statement reconciliation, statement and/or checks mailed directly to employees: $30/month plus package II fees under 250 eligible employees; package II fees plus $50/month for 250 or more eligible. ~ FSA direct deposit: One time $2.50/participant set-up fee (waived). DBS fee is based on the number of eligible ~ employees and includes the bank fee: <100 - $15/mo.: 100 to 149 - $30/mo.; 150 to 199 - $35/mo.; 200 to 250 - $40/mo.; 251 to 499 - $45/mo.; >500 - $65/mo. Add package II remittance advice mailing fees. III. ~ Annnal 5500 & SAR Preparation. Includes data gathering, 5500 & SAR form preparation, answers to questions ~ regarding the form, related W2 questions: $250/year if required. On-line Packa2e Services (Circle the numher for the services desired) I. P.A.C.E. (participant Account Claim & Election system) & E-Clairns On-Line service: Premier subscriber: $45/month. 6 ß\ DI,;"ERSIFIED BENEFIT SER,;"ICES, INC. - Dedicated to Excellence in Benefit Management Svlotions