Salt Lake City Corporation
Request for Proposal, RFP No. RFP12017
EMPLOYEE LONG & SHORT TERM DISABILITY
INSURANCE ADMINISTRATION
DEPARTMENT OF HUMAN RESOURCES
Specification No. HR032, Contract No. 16-1-12-5656, Rev. January 23, 2012 /ts
INFORMATION & REQUIREMENTS
I.
OBJECTIVE Salt Lake City Corporation (the "City") is soliciting competitive sealed
proposals from interested and qualified Disability Administrators to provide a self-insured
Short Term Disability (STD) program for 2323 eligible employees and a self-insured Long
Term Disability (LTD) program for 2616 eligible employees effective on July 01, 2012.
Administration services for in-force STD and LTD plans: This shall include claims intake,
adjudication, medical review, claims reporting, policy and Summary Plan Description (SPD)
production, reserve calculations, return to work and rehabilitation services, and fraud
investigations. The City is also interested in a review of current funding levels, appropriateness
of self insuring vs. partially or fully insuring their risk.
II.
BACKGROUND
Salt Lake City is located in Northern Utah, and is the State Capitol and the Salt Lake County
seat. Currently there are approximately 200,000 residents of the City proper. Salt Lake City
Corporation’s NAIC Code is: 921120 and SIC Code is: 9111. Location of head office is: Salt
Lake City, Utah 84111.
The City provides an array of comprehensive benefit plans and programs to approximately
2,600 eligible employees plus their eligible dependents. Disability Insurance has been offered
to employees for 5 years. Currently there are two plans offered to employees, Short Term
Disability Insurance, and Long Term Disability Insurance. Both plans are 100% self funded by
the City. The City with the help of its Third Party Administrator calculates the reserves and
rates internally. Short Term Disability is self funded by the City and LTD is paid for by
employees with the exception of sworn Police Officers in which the City pays 100% of the
premium. Employees covered under the City’s benefit plans include administration employees,
maintenance workers, parks and recreation workers, sworn police officers, combat firefighters
and utility workers.
The City is committed to providing its employees with comprehensive, high quality and costeffective employee benefit plans and programs that provide optimum value to both the City and
its employees. Therefore in addition to requesting proposals on the administrative services for
their existing plan, the City is also interested in receiving proposals on funding alternatives
such as stop loss insurance, fully insured plans, and partially self funded plans. Should you
wish to offer a proposal on an alternative plan in addition to submitting on the administrative
services, please be sure that you clearly indicate what you are offering, and which if any
additional companies and services are included in your proposal.
Salt Lake City Corporation has retained FirstWest Benefit Solutions to aid in preparation of
these specifications, aid in proposal analysis, and offer recommendations for STD and LTD
plan marketing.
Salt Lake City Corporation does not pay a commission to a broker or agent for the
administration of the STD and LTD coverage. Therefore, all proposals shall consist of rates net
of commissions for the STD and LTD plans. Please do not include any broker compensation in
your proposals.
Reference documents available for download on BidSync, see Section V below.

Long Term Disability (LTD) Benefits Summary

Short Term Disability (STD) Benefits Summary

LTD Cost and Claim History

STD Cost and Claim History

LTD Eligible Police Sworn

LTD Eligible Non-Police Sworn

STD Eligible
III.
INSURANCE REQUIREMENTS
Offerors should review the required insurance coverage and notice of policy cancellation
requirements that will be part of the resulting contract(s). Such insurance information is
provided under Paragraph 4 of the Sample Agreement. Proposed pricing must include
associated insurance costs. The selected offeror will be required to provide insurance
certificates meeting all requirements at the time of notification of conditional award.
IV.
PROPOSAL SUBMISSION
 Sign and return the Proposal Response Cover Sheet (ATTACHMENT 1). The form must
be signed by a company representative authorized to bind the offeror contractually.

Submit all required information as outlined in the Proposal Content & Evaluation
Criteria section of ATTACHMENT 1.

Submit original proposal and five (5) proposal copies in a sealed envelope or other sealed
container.

Mark envelope or container with RFP Number and submission deadline date.

Submission Deadline: 3:00 pm, Wednesday, February 15, 2012. Proposals received
after the 3:00 pm deadline will be placed in the file unopened and will not be
considered.

Submit to the address shown on the Proposal Response Cover Sheet (ATTACHMENT 1).
NOTE: Proposals will be opened in a manner preventing disclosure of proposal
respondents and the contents of the submissions. Proposals will then be sent to the Cityappointed selection committee for evaluation.
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Even after an offeror is selected for award, no information regarding the proposals will
be made public until contract negotiations have been completed and a formal contract
has been awarded. When the formal contract has been awarded, the name of the
company awarded the contract will be listed on our website and can be accessed by
going to http://www.slcpurchasing.com, proceeding to the link to SLC Online Bids and
Proposal Request System, and then searching for the applicable RFP using the link
entitled Search For Bids and Proposal.
V.
ADDITIONAL INFORMATION
The City’s designated contact person for questions or additional information concerning the
services specified in this Request for Proposal, or for additional information concerning
Request for Proposal procedures and regulations (i.e., submission deadline, forms required,
etc.), or Americans with Disabilities (ADA) accommodations, is Tiffany Sorensen in the
Purchasing & Contracts Management Division: telephone (801) 535-6347; TDD (801) 5356021; FAX (801) 535-6656; e-mail (tiffany.sorensen@slcgov.com).
All questions requesting clarification or interpretation of any section or sections of this
specification can be submitted in writing on or before Wednesday, February 8, 2012.
Offerors are encouraged to submit questions on-line through BidSync.
(Access the RFP at www.slcpurchasing.com,
select “BidSync” link, click on the RFP name,
click on supplier log-in at the bottom of screen)
Questions received after the date above may not be considered or receive a written response. If
questions prompt the need for changes to the specification, the City will issue a written
addendum to the original specification.
Any Q & A information and/or written addendums issued by the City shall be available for
interested offerors to view and/or download within three (3) working days following the above
referenced deadline. Go to www.slcpurchasing.com and click on the BidSync link, then search
and click on the applicable RFP. All Q & A information and addendums will be contained in
the “Bid Packet”. It is the responsibility of the offeror to view and/or download Q & A
information and addendums prior to submission of their proposal.
VI.
REGISTER FOR NOTIFICATION OF RFP OR BID ADDENDA
It is the bidder/offeror’s responsibility to register for notification to receive any changes, corrections,
question/answer documents, and addendums issued for RFB (bid) or RFP (proposal) documents.
To receive notification of question/answer documents and addendums added to a current Bid or RFP
the bidder/offeror must complete a one-time registration by providing their company information
through BidSync at www.bidsync.com. Once registered, bidder/offeror can select (click on) any Bid
or RFP project listed on the City web site or the BidSync web site, log-in, download the project
documents, and request to be on the notification list for that project. Failure to register and log-in to
a Bid or RFP for documents and notifications constitutes an automatic waiver of bidder’s/offeror’s
right to receive a direct notification of any changes, corrections or addenda for a Bid or RFP.
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ATTACHMENT 1
Proposal Response Cover Sheet
RFP No. RFP12017
PROPOSAL FOR EMPLOYEE LONG & SHORT TERM
DISABILITY INSURANCE ADMINISTRATION
TO:
Use this address for all U.S. Postal Service:
Salt Lake City Corporation
Chief Procurement Officer
Purchasing & Contracts Division
P.O. Box 145455
Salt Lake City, Utah 84114-5455
For express courier or hand delivery, use:
Salt Lake City Corporation
Chief Procurement Officer
Purchasing & Contracts Division
451 South State Street - Room 238
Salt Lake City, Utah 84111
The undersigned, having carefully read and considered the Request for Proposal to provide
EMPLOYEE LONG & SHORT TERM DISABILITY INSURANCE ADMINISTRATION for
the DEPARTMENT OF HUMAN RESOURCES, does hereby offer to perform such services on behalf
of the City in the manner described and subject to the terms and conditions set forth in the attached
proposal. Services will be performed at the rates set forth in said proposal.
OFFEROR
Company Name: _________________________________________________________________
Doing business as: [ ] an individual [ ] a partnership [ ] a corporation [ ] a limited liability
company (mark appropriate box), duly organized under the laws of the State of _________________.
BY: ______________________________________
(Signature of authorized representative)
____________________________________
(Please Print or Type Name)
PRINCIPAL OFFICE ADDRESS:
Street Address _____________________________________________________________________
City ________________________________________________ County ______________________
State ________________________________________________ Zip Code____________________
Telephone (
)
FAX (
)
_
Email Address ____________________________________________________________________
TAXPAYER IDENTIFICATION NUMBER:
Employer I.D. No. ______________________
(Corporation or Partnership)
OR
Social Security No. _____________________
(Individual)
ALL PROPOSALS MUST INCLUDE THIS COVER SHEET & THE PROPOSAL
CONTENT & EVALUATION REQUIREMENTS LISTED ON THE NEXT PAGES
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PROPOSAL CONTENT & EVALUATION CRITERIA
EMPLOYEE LONG & SHORT TERM DISABILITY
INSURANCE ADMINISTRATION
The City is committed to offering STD/LTD programs which promote cost-effective services. The
City's primary selection criteria are listed below.
Net Cost Considerations

Competitive program costs, based upon expected claims and fees/premiums

Willing to accept meaningful performance penalties if superior service is not provided
Benefit Provisions

Ability to provide the requested benefit plan designs exactly as outlined in "Plan
Design" worksheets

Program design, including staffing, systems and other critical components, that
advances early return to work
Qualifications and Approach to Administrative Services






Proven claims management track record
Dedication to delivering superior member and customer service support
Satisfied clients of similar size and complexity to City
Utilizes best-in-practice disability management techniques
Utilizes best-in-practice disability duration guidelines
Facilitate return-to-work initiatives
Proposal Response
All information provided by offerors in their “RFP Response File” will be compiled and
assessed as it relates to the criteria above and will be used in the evaluation process.
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Proposal Content Instructions and Checklist
A.
B.
C.
Please submit proposal contents in the order listed below:
Complete and sign Attachment 1, “Proposal Response Cover Sheet” (Page 4) of
this RFP package and submit this as the first page of your submission.
Complete and attach this checklist as the 2nd page of your submission.
□
□
Download the “RFP Response File”, Excel file as provided at www.bidsyc.com
1.
Respond to all evaluation criteria as listed in this file which contains
worksheets 1 through 10. Type your response information directly into the
spaces provided in worksheets 2 through 10 of this electronic file.
2.
Print a hard copy of your completed worksheets 2 through 10 after all
responses have been added. Include this hard copy with your proposal
submission.
Copy your completed “RFP Response File” Excel file on to a CD and
include two (2) copies of the CD with your submission.
Exceptions. If you have any exceptions to this Request for Proposal and/or the
attached Sample Agreement they must be included as specified in Paragraph V of
Attachment 2, General Proposal Instructions & Information.
3.
D.
Check.
□
□
□
No Exceptions
-OR-
□
Exceptions
attached
E.
City Ethics Requirement.
Offeror acknowledges that they have read the paragraphs below and agree to
comply with their terms.
REPRESENTATION REGARDING ETHICAL STANDARDS FOR CITY
OFFICERS AND EMPLOYEES AND FORMER CITY OFFICERS AND
EMPLOYEES
The offeror represents that it has not: (1) provided an illegal gift or payoff to a City
officer or employee or former City officer or employee, or his or her relative or
business entity; (2) retained any person to solicit or secure this contract upon an
agreement or understanding for a commission, percentage, brokerage or contingent
fee, other than bona fide employees or bona fide commercial selling agencies for
the purpose of securing business; (3) knowingly breached any of the ethical
standards set forth in the City's conflict of interest ordinance, Chapter 2.44, Salt
Lake City Code; or (4) knowingly influenced, and hereby promises that it will not
knowingly influence, a City officer or employee or former City officer or
employee to breach any of the ethical standards set forth in the City's conflict of
interest ordinance, Chapter 2.44, Salt Lake City Code.
Pursuant to the foregoing, it is the City’s policy that City employees are prohibited
from personally accepting gifts, incentives, and marketing or promotional items
from suppliers and those suppliers shall not offer such items to City employees.
Such offers from suppliers are inappropriate and may result in suspension or
debarment of the supplier from the City's procurement processes.
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□
Yes we agree.
ORAL INTERVIEWS MAY BE CONDUCTED WITH ONE OR MORE PROSPECTIVE
CONTRACTORS. THE DECISION OF THE CITY'S SELECTION COMMITTEE SHALL
BE FINAL AND CONCLUSIVE.
PURSUANT TO REQUIREMENTS OF PARAGRAPH E ABOVE, PLEASE DO NOT SUBMIT
ANY GIFTS OR PROMOTIONAL ITEMS WITH YOUR PROPOSAL. CITY EMPLOYEES
ARE NOT ALLOWED TO ACCEPT SUCH ITEMS REGARDLESS OF THEIR VALUE.
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ATTACHMENT 2
General Proposal Instructions & Information
An electronic version of this document including all attachments and exhibits is available
for download from the Salt Lake City Purchasing & Contracts Division website:
http://www.slcpurchasing.com
I.
II.
AWARD BY WRITTEN AGREEMENT
The selected offeror shall be required to enter into a written agreement in substantially the form
as shown in the attached SAMPLE AGREEMENT (ATTACHMENT 3) which shall be the
basic form used to develop the final agreement.

Signature on the Proposal Cover Sheet acknowledges that the offeror is willing to enter into
the agreement if awarded the contract. Offerors are advised to read thoroughly the Sample
Agreement as the selected offeror will be required to comply with its requirements.

If offeror has any exceptions to the Sample Agreement, the offeror must follow the
procedures stated under Paragraph V, EXCEPTIONS TO PROPOSAL & SAMPLE
AGREEMENT.
PREPARATION OF PROPOSALS
A.
Failure to Read. Failure to read the Request for Proposal and these instructions will be
at the offeror's own risk.
B.
Cost Of Developing Proposals. All costs related to the preparation of the proposals and
any related activities are the sole responsibility of the offeror. The City assumes no
liability for any costs incurred by offerors throughout the entire selection process.
III.
SUBMISSION DEEMED AGREEMENT
Submission of a bid, proposal or other offer or submission constitutes the bidder's or offeror's
agreement to all of the terms, conditions and provisions of the bid or proposal package, or other
solicitation documents. In addition, submission of a bid, proposal or other offer or submission
by fax or E-mail constitutes a waiver of any claim to confidentiality, or any protest based on
such a claim. By the submission of any bid, proposal or other offer or submission, the bidder
or offeror represents that the matters stated therein are true and correct.
IV.
PROPOSAL INFORMATION
A.
Discussions With Offerors. The City reserves the right to enter into discussions with
the offeror(s) determined to be reasonably susceptible of being selected for award, or to
enter into exclusive discussions with the offeror whose proposal is deemed most
advantageous, whichever is in the City’s best interest, for the purpose of negotiation. In
the event that exclusive negotiations are conducted and an agreement is not reached, the
City reserves the right to enter into negotiations with the next highest ranked offeror
without the need to repeat the formal solicitation process.
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B.
Equal Opportunity. The City will make every effort to ensure that all offerors are
treated fairly and equally throughout the entire advertisement, review, and selection
process. The procedures established herein are designed to give all parties reasonable
access to the same basic information.
C.
Proposal Ownership. All proposals, including attachments, supplementary materials,
addenda, etc., shall become the property of the City and will not be returned to the
offeror.
D.
Rejection Of Proposals.
E.
V.

The City reserves the right to reject any or all proposals received. Furthermore, the
City shall have the right to waive any informality or technical defect in proposals
received when in the best interest of the City.

No proposal shall be accepted from, or contract awarded to, any person, firm or
corporation that is in arrears to the City upon a debt or contract or that is in default,
as surety or otherwise, upon any obligation to the City, or that may be deemed
irresponsible or unreliable by the Purchasing & Contracts Division. Offerors may
be required to submit satisfactory evidence that they have the necessary financial
resources to perform and complete the work outlined in this RFP.
Failure To Submit A Proposal. Failure to submit a proposal (or to advise the City
Purchasing & Contracts Division that future Requests for Proposal are desired) may
result in the removal of your firm from the prospective offerors list.
EXCEPTIONS TO PROPOSAL & SAMPLE AGREEMENT
If offeror takes exception to any term, condition, or requirement set forth in this Request for
Proposal or the Sample Agreement and any of its Exhibits and Attachments, said exceptions
must be clearly identified and included in the response to this RFP. Exceptions or deviations
to any of the terms, conditions, or requirements must not be added to the proposal pages
but must be submitted in a separate document accompanying offeror's proposal identified
as “Exceptions.” Such exceptions shall be considered in the evaluation and the award
processes. The City shall be the sole determiner of the acceptability of any exception.
If the City omits anything from this RFP that is necessary for a clear understanding of the work,
or if it appears that instructions are in conflict, then the offeror may request written clarifying
information from the Purchasing & Contracts Division at least forty-eight (48) hours before the
time and date of the proposal opening shown above.
VI.
CONFIDENTIALITY
All responses, inquiries, and correspondence relating to this RFP and all reports, charts,
displays, schedules, exhibits, and other documentation produced by the offeror that are
submitted to the City, as part of the proposal or otherwise, shall become the property of the
City when received by the City and may be considered public information under applicable
law. The City is subject to the disclosure requirements of the Government Records Access and
Management Act; Title 63G, Chapter 2, Utah Code Annotated (“GRAMA”). The City
Page 9 of 27
generally considers proposals and all accompanying material to be public and subject to
disclosure. Any material considered by the offeror to be proprietary must be
accompanied by a written claim of business confidentiality and a concise written
statement of reasons supporting the claim. Blanket claims that the entire RFP is
confidential will be denied. The City cannot guarantee that any information will be held
confidential. If the offeror makes a claim of business confidentiality, the City, upon receipt of
a request for disclosure, will determine whether the material should be classified as public or
nonpublic, and will notify the offeror of such determination. The offeror is entitled under
GRAMA to appeal an adverse determination. The City is not obligated to notify the offeror
of a request to see the offeror’s proposal, and will not consider a claim of confidentiality,
unless the offeror's claim of confidentiality is made in a timely basis and in accordance
with GRAMA.
VII.
GOVERNING CODE AND RULES
The City’s procurement processes, including this competitive solicitation, are governed by Salt
Lake City Code 3.24 and Salt Lake City Administrative Rules for Procurement.
Page 10 of 27
ATTACHMENT 3
SAMPLE AGREEMENT
The Sample Agreement will be subject to review and modification by the City
Attorney’s Office.
CONTRACT NO. 16-1-12-5656
Rev. /_
SAMPLE AGREEMENT
EMPLOYEE LONG & SHORT TERM DISABILITY
INSURANCE ADMINISTRATION
FOR THE SALT LAKE CITY DEPARTMENT OF HUMAN RESOURCES
THIS AGREEMENT is between SALT LAKE CITY CORPORATION, a Utah
municipal corporation (“City”), and Ø, a _ (“Contractor”) and is dated as of the date the City Recorder
attests the applicable City signature (which date shall be the recordation date).
RECITALS
1. Contractor desires to provide certain employee disability plan administration
services for City's Department of Human Resources.
2. City desires to engage Contractor for such services.
AGREEMENT
In consideration of the promises and covenants hereinafter contained, the parties agree
as follows:
1.
Contractor shall provide certain employee disability plan administration services
for City’s Department of Human Resources as described in Exhibit “A” for an initial term
commencing July 1, 2012 and continuing through June 30, 2015. City may extend this Agreement for
two (2) additional one-year terms, renewable on an annual basis, under the same terms and conditions.
Notice of term extensions shall be in writing served upon Contractor by regular mail at least thirty (30)
days before the expiration of the original term of this Agreement, or any renewal term, in order for
such extension to be effective. After all annual term extensions have been exercised, City shall have
the right to extend this Agreement for an additional term of up to four (4) months by giving Contractor
written notice at least ten (10) days before the expiration of the last annual extension, provided,
however, that City may terminate such additional term by giving Contractor at least five (5) days prior
written notice of such termination. This is a non-exclusive contract and City reserves the right to
acquire the services, at its discretion, from other sources during the term of this Agreement. All
financial commitments by City shall be subject to the appropriation of funds approved by the City
Council and the limitations on future budget commitments provided under applicable Utah law,
including the Utah Constitution.
Page 11 of 27
2.
For services provided to City, Contractor shall be paid as specified under
Exhibit “B” (Price Schedule).
3.
For such consideration, Contractor shall furnish all materials, supervision, labor,
and equipment to complete the requirements of this Agreement.
4.
The following insurance requirements apply to this Agreement:
A.
GENERAL INSURANCE REQUIREMENTS FOR ALL POLICIES.
(1)
Any insurance coverage required herein that is written on a
“claims made” form rather than on an “occurrence” form shall (i) provide full prior acts coverage or
have a retroactive date effective before the date of this Agreement, and (ii) be maintained for a period
of at least three (3) years following the end of the term of this Agreement or contain a comparable
“extended discovery” clause. Evidence of current extended discovery coverage and the purchase
options available upon policy termination shall be provided to City.
(2)
All policies of insurance shall be issued by insurance companies
licensed to do business in the state of Utah and either:
(a)
Currently rated A- or better by A.M. Best Company;
—OR—
(b)
Listed in the United States Treasury Department’s current
Listing of Approved Sureties (Department Circular 570), as amended.
(3)
Contractor shall furnish certificates of insurance, acceptable to
City, verifying the foregoing matters concurrent with the execution hereof and thereafter as required.
(4)
In the event any work is subcontracted, Contractor shall require
its subcontractor, at no cost to City, to secure and maintain all minimum insurance coverages required
of Contractor hereunder.
(5)
Contractor shall provide written notice to City of any
modification or cancellation of any insurance policy required by this Agreement at least thirty (30)
days prior to the effective date of such policy modification or cancellation.
B.
REQUIRED INSURANCE POLICIES. Contractor, at its own cost, shall
secure and maintain during the term of this Agreement, including all renewal terms, the following
minimum insurance coverage:
(1)
Worker's compensation and employer’s liability insurance
sufficient to cover all of Contractor’s employees pursuant to Utah law. This requirement includes
those who are doing business as an individual and/or as a sole proprietor as well as corporations and
partnerships. In the event any work is subcontracted, Contractor shall require its subcontractor(s)
similarly to provide worker’s compensation insurance for all of the latter’s employees, unless a waiver
of coverage is allowed and acquired pursuant to Utah law.
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(2)
Commercial general liability (CGL) insurance with City as an
additional insured, in the minimum amount of $1,000,000 per occurrence with a $2,000,000 general
aggregate and $2,000,000 products and completed operations aggregate. These limits can be covered
either under a CGL insurance policy alone, or a combination of a CGL insurance policy and an
umbrella insurance policy and/or a CGL insurance policy and an excess insurance policy. The policy
shall protect City, Contractor, and any subcontractor from claims for damages for personal injury,
including accidental death, and from claims for property damage that may arise from Contractor’s
operations under this Agreement, whether performed by Contractor itself, any subcontractor, or anyone
directly or indirectly employed by either of them. Such insurance shall provide coverage for premises
operations, acts of independent contractors, products and completed operations.
(3)
Professional liability insurance in the minimum amount of
$2,000,000 per occurrence with a $2,000,000 annual aggregate limit.
(4)
Commercial automobile liability insurance that provides
coverage for owned, hired, and non-owned automobiles used in connection with this Agreement in the
minimum amount of a combined single limit of $1,000,000 per occurrence or $500,000 Liability per
person, $1,000,000 Liability per occurrence, and $250,000 Property Damage. These limits can be
reached either with a commercial automobile liability insurance policy alone, or with a combination of
a commercial automobile liability insurance policy and an umbrella insurance policy and/or a
commercial automobile liability insurance policy and an excess insurance policy. If the policy only
covers certain vehicles or types of vehicles, such as scheduled autos or only hired and non-owned
autos, Contractor shall only use those vehicles that are covered by its policy in connection with any
work performed under this Agreement.
-OR- IF THERE WILL NOT BE ANY VEHICLE OPERATIONS—
(4)
Contractor shall not operate a vehicle in connection with any
services rendered under this Agreement. Inasmuch as Contractor agrees not to operate a vehicle in
connection with services rendered under this Agreement, City shall not require Contractor to provide
commercial automobile liability insurance.
5.
Contractor shall obey all federal, state, county, and municipal laws, ordinances,
regulations, and rules applicable to its operations. Said laws include, but are not limited to, the Equal
Employment Opportunity laws, the Fair Labor Standards Act, Occupational Safety & Health
Administration (OSHA) laws, Family Medical Leave Act (FMLA), the Americans with Disabilities
Act (ADA), and the Utah Immigration Accountability and Enforcement Act. Any violation of
applicable law shall constitute a breach of this Agreement and Contractor shall hold City harmless
from any and all liability arising out of, or in connection with, said violations including any attorney's
fees and costs incurred by City as a result of such violation.
6.
City may cancel this Agreement for any reason and without any liability
therefore, upon giving Contractor thirty (30) days prior written notice. Such notice shall be sent to the
last known address of Contractor.
7.
City may, without prejudice to any right or remedy, and without the necessity of
giving the thirty (30) day notice provided in paragraph 6 above, terminate this Agreement for cause in
the event Contractor fails to fulfill, in a timely or satisfactory manner, any of the terms and conditions
Page 13 of 27
set forth in this Agreement and fails to cure such failure within seven (7) days after written notice from
City of such failure.
8.
If this Agreement is canceled or terminated as provided herein, City shall pay
Contractor on the basis of actual services satisfactorily performed as calculated by City.
9.
Contractor, for itself, its successors and assigns, as part of the consideration
herefore, covenants that no person, solely on the grounds of race, color, national origin, age, sex,
religion, or non-job related disability, shall be excluded from participation in, denied the benefits of, or
be otherwise subject to discrimination in the furnishing of services hereunder, unless the characteristic
is a bona fide occupational qualification.
10.
Contractor shall indemnify, save harmless, and defend City, its officers and
employees, from and against all losses, claims, demands, actions, damages, costs, charges, and causes
of action of every kind or character, including attorney's fees, arising out of Contractor's intentionally
wrongful, reckless, or negligent performance hereunder. Contractor’s duty to defend City shall exist
regardless of whether City or Contractor may ultimately be found to be liable for anyone’s negligence
or other conduct. If City's tender of defense, based upon this indemnity provision, is rejected by
Contractor, and Contractor is later found by a court of competent jurisdiction to have been required to
indemnify City, then in addition to any other remedies City may have, Contractor shall pay City's
reasonable costs, expenses, and attorney's fees incurred in proving such indemnification, defending
itself, or enforcing this provision. Nothing herein shall be construed to require Contractor to
indemnify the indemnitee against the indemnitee's own negligence.
11.
REPRESENTATION REGARDING ETHICAL STANDARDS FOR CITY
OFFICERS AND EMPLOYEES AND FORMER CITY OFFICERS AND EMPLOYEES.
Contractor represents that it has not: (1) provided an illegal gift or payoff to a City officer or employee
or former City officer or employee, or his or her relative or business entity; (2) retained any person to
solicit or secure this contract upon an agreement or understanding for a commission, percentage, or
brokerage or contingent fee, other than bona fide employees or bona fide commercial selling agencies
for the purpose of securing business; (3) knowingly breached any of the ethical standards set forth in
City's conflict of interest ordinance, Chapter 2.44, Salt Lake City Code; or (4) knowingly influenced,
and hereby promises that it will not knowingly influence, a City officer or employee or former City
officer or employee to breach any of the ethical standards set forth in City's conflict of interest
ordinance, Chapter 2.44, Salt Lake City Code.
12.
GOVERNMENT RECORDS ACCESS AND MANAGEMENT ACT. City
is subject to the requirements of the Government Records Access and Management Act, Chapter 2,
Title 63G, Utah Code Annotated or its successor (“GRAMA”). All materials submitted by Contractor
pursuant to this Agreement are subject to disclosure unless such materials are exempt from disclosure
pursuant to GRAMA. The burden of claiming an exemption from disclosure shall rest solely with
Contractor. Any materials for which Contractor claims a privilege from disclosure shall be submitted
marked as “Business Confidential” and accompanied by a concise statement of reasons supporting
Contractor's claim of business confidentiality. City will make reasonable efforts to notify Contractor
of any requests made for disclosure of documents submitted under a claim of business confidentiality.
Contractor may, at Contractor’s sole expense, take any appropriate actions to prevent disclosure of
such material. Contractor specifically waives any claims against City related to disclosure of any
materials required by GRAMA.
Page 14 of 27
13.
Contractor is not an employee of City for any purpose whatsoever. Contractor is
an independent contractor at all times during the performance of the services specified herein.
14.
All notices shall be directed to the following addresses:
City:
Salt Lake City Corporation
Attn.: City Contracts Administrator, Purchasing
(For U.S. Postal Service delivery)
P.O. Box 145455
Salt Lake City, UT 84114-5455
-OR(For hand delivery or express courier delivery)
451 South State Street, Room 235
Salt Lake City, UT 84111
With a copy to:
City:
Contractor:
Salt Lake City Corporation
Department of Human Resources
Attn.: Employee Benefits Administrator
(For U.S. Postal Service delivery)
P.O. Box 145464
Salt Lake City, UT 84114-5464
-OR(For hand delivery or express courier delivery)
451 South State Street, Room 115
Salt Lake City, UT 84111
Ø
Attention:
_
_
15.
This Agreement may be assigned by either party but only with the prior written
consent of the other party.
16.
Contractor's obligations are solely to City and City’s obligations are solely to
Contractor. This Agreement shall confer no third party rights whatsoever.
17.
This Agreement embodies the entire Agreement between the parties relating to
the subject matter of this Agreement and shall not be altered except in writing signed by both an
authorized representative of Contractor and by City’s Mayor or the Mayor’s designee. The terms of
this Agreement shall supersede any additional or conflicting terms or provisions that may be set forth
or printed on Contractor’s work plans, cost estimate forms, receiving tickets, invoices, or any other
related standard forms or documents of Contractor that may subsequently be used to implement,
record, or invoice services hereunder from time to time, even if such standard forms or documents
have been signed or initialed by a representative of City. The intent of the parties is that the terms of
this Agreement shall prevail in any dispute between the terms of this Agreement and the terms printed
Page 15 of 27
on any such standard forms or documents, and such standard forms or documents shall not be
considered written amendments of this Agreement.
18.
This Agreement shall be enforced in and governed by the laws of the state of
Utah.
*********************************************************************************
(Balance of page left blank)
Page 16 of 27
The parties are signing this Agreement as of the date stated in the introductory clause.
SALT LAKE CITY CORPORATION
By _______________________________
Title ______________________________
ATTEST AND COUNTERSIGN:
_______________________
City Recorder
______________
Recordation Date
APPROVED AS TO FORM:
_______________________
Senior City Attorney
Ø
By ________________________________
Title _______________________________
ACKNOWLEDGMENT
State of _____________________
County of ___________________
)
:ss
)
The foregoing Agreement was acknowledged before me this _________ day of
__________________, 2012, by ________________________________, the
(Name of person signing Agreement)
__________________________ of Ø, a (state) (type of entity).
(Title of person signing Agreement)
___________________________________
NOTARY PUBLIC, residing in
___________________________________ County
My Commission Expires:_________________________
Page 17 of 27
CONTRACT NO. 16-1-12-5656
EXHIBIT “A”
SCOPE OF WORK
EMPLOYEE LONG & SHORT TERM DISABILITY
INSURANCE ADMINISTRATION
I.
GENERAL
A.
Contractor, if doing business under an assumed name, i.e. an individual, association,
partnership, corporation, or otherwise, shall be registered with the Utah State Division
of Corporations and Commercial Code.
NOTE: Forms and information on how to get registered may be obtained by calling
(801) 530-4849 or by accessing www.commerce.state.ut.us .
II.
B.
Contractor shall assume full responsibility for damage to City property caused by
Contractor's employees or equipment as determined by designated City personnel.
C.
Contractor shall be solely responsible for the safety of Contractor's employees and
others relative to Contractor's work, work procedures, material, equipment,
transportation, signage, and related activities and equipment.
D.
Contractor shall possess and keep in force all licenses and permits required to perform
services under this Agreement.
E.
No guarantee of the actual service requirement is implied or expressed by this
Agreement. Service requirements shall be determined by actual need.
RESPONSIBILITIES OF CONTRACTOR
NOTE: Subject to modification based on the proposal received from the selected offeror and
negotiations with City.
The responsibilities of Contractor include, but shall not be limited to, the following
A.
Contractor shall perform employee short-term disability (“STD”) and long-term
disability (“LTD”) plan administration services for City’s Department of Human
Resources by providing the services listed hereunder on behalf of City. These services
shall include, but shall not be limited to, the following.
1.
Contractor shall maintain claim adjudication and administration procedures and
practices that, at a minimum, adhere to the NAIC Model Unfair Claim
Settlement Practices Act, as described below in Section V, Claim Settlement
Practices.
2.
Contractor shall review, investigate, and administer the claims in accordance
with the terms of this Agreement.
Page 18 of 27
B.
III.
3.
Contractor shall provide City with monthly claim payment recommendations on
each of the active claims for which Contractor is responsible under this
Agreement. Contractor shall provide City with monthly status reports on each
pending claim for which Contractor is responsible for under this Agreement.
Each claim payment recommendation will be provided to City; whether in
writing or by electronic mail, not less than ten (10) days prior to each bi-weekly
or monthly claim payment date.
4.
Contractor shall provide City with its written recommendation with respect to
the approval, settlement, compromise, declination, termination, litigation, or
payment of each claim and shall provide City with all claim information it
requires.
5.
Contractor shall administer the claims in accordance with its approved
recommendation to City including preparing and sending all communications to
the claimants and others with a business need to know in order to fulfill the
purposes of this Agreement with respect to its review, investigation, and
administration of the claims. All such communications will be treated as
confidential information and safeguarded to prevent improper use or disclosure.
6.
Contractor shall meet at least once per month with City staff, in person or by
conference call, to report on and discuss progress and results. Contractor’s staff
will be available in its offices by telephone during City’s regular business hours
(8:00 am to 5:00 pm Mountain Time) Monday thru Friday or at any reasonable
time to discuss claims.
Contractor's Personnel
1.
Contractor shall provide sufficient personnel to accomplish the required services
as scheduled. All personnel shall be skilled in the various tasks assigned to
them.
2.
Contractor shall identify Contractors personnel who will be designated as the
main contact person for City. If the main contact person will be unavailable to
City for more than three (3) days, another person must respond to City within
two (2) business days.
REPORTING
A.
Contractor shall provide City with monthly and quarterly reports as requested by City
designee. Such reports shall be available no later than the end of the month following
the close of the period in question. These reports include, but are not limited to the
following:
1.
Monthly reporting of Short Term Disability claims by payroll department.
Report shall show the total benefit paid, all administrative fees charged, and the
diagnosis with the length of disability period anticipated and whether or not
employee is a candidate for light duty.
Page 19 of 27
2.
Quarterly reporting of Long Term Disability claims in the following two
categories. Both reports shall include the total benefit paid, all administrative
fees charged, the diagnosis, and length of anticipated disability period.
a.
b.
B.
Public Safety employee (taxed).
Regular employee claims (non-taxed).
Contractor shall provide City with the following reports on an annual basis within 90
days of the contract anniversary date.
1.
Annual accounting of each plan which shall include the total amount of paid
benefits and administrative fees charged.
2.
Annual calculation of the reserves and the premiums required for funding each
of the plans.
3.
Employee contested claims that were denied or partially denied, separated by
denial reason.
4.
A year-end financial accounting for the program.
IV.
PLAN DESCRIPTIONS
Contractor shall, upon request by City, redraft or create Summary Plan Descriptions (SPD’s)
for City’s Long and Short Term Disability products.
V.
CLAIM SETTLEMENT PRACTICES
Contractor will administer claims on behalf of City in accordance with the following Claims
Settlement Practices, which comply with standards found in the NAIC Model Unfair Claims
Settlement Practices Act, the NAIC Model Unfair Life, Accident and Health Claims Settlement
Practices Model Regulation, and the Federal Employee Retirement Income Security Act of
1974, as amended (ERISA):
A.
Contractor will thoroughly investigate all claims promptly and courteously.
B.
In all communications with claimants, Contractor will not knowingly misrepresent any
relevant facts or policy provisions relating to the claim.
C.
Contractor will acknowledge and respond within fifteen (15) days, or such shorter
minimum time period as required by Utah state law, to any written communications
relating to a pending claim.
D.
Contractor will acknowledge all pertinent communications relating to ongoing claims
from claimants or their authorized representatives with reasonable promptness.
E.
Contractor will follow reasonable standards for the prompt investigation and settlement
of claims. If a claim remains unresolved for thirty (30) days, Contractor will provide a
reasonable written explanation for the delay. If the claim remains unresolved,
Contractor will provide a reasonable written explanation at least once every thirty (30)
Page 20 of 27
days of the reason(s) for the delay and will provide a good faith estimate of the
additional time needed for the investigation.
VI.
F.
Contractor will attempt in good faith to effectuate prompt, fair, and equitable settlement
of each claim in which liability has become reasonably clear, and will recommend that
payment be made within thirty (30) days after liability has become reasonably clear.
Contractor will recommend a reasonable explanation of the computation of benefits in
connection with each recommendation from Contractor that a claim payment be made.
G.
Contractor will not refuse to pay any claim without first conducting a full, thorough,
and reasonable investigation of the claim.
H.
Contractor will affirm or deny coverage of each claim within a reasonable time after
completing its investigation of the claim.
I.
Contractor will not settle, or attempt to settle, a claim for less than the amount that a
reasonable person would believe the claimant is entitled to receive based on the terms of
the policy and the written advertising materials which accompanied or were made a part
of the claimant’s application for coverage.
CLAIM SETTLEMENTS PROCEDURE
Contractor will evaluate each claim on an ongoing basis to determine whether it would be
appropriate to explore a settlement of the claim. Contractor will evaluate each request from a
claimant for a settlement of his or her claim. All claim settlements will be conducted in
accordance with the following procedures:
A.
Contractor will notify City when Contractor determines that settlement options should
be explored for a claim and recommend a level of claim settlement authority for
Contractor to exercise on behalf of City in the claim settlement negotiations with the
claimant.
B.
Notwithstanding Section V, Paragraph G above, City will approve or disapprove the
recommendation from Contractor within ten (10) business days after receiving a
recommendation that settlement options be explored for a claim. City will be
considered to have approved the recommendation if City does not act on the
recommendation within ten (10) business days after it is received.
C.
Contractor and City agree that the authority of Contractor to engage in claim settlement
negotiations on behalf of City will be established specifically for each claim based on
the facts of the claim.
D.
Contractor and City agree that the claims settlement authority delegated by City is the
authority to negotiate in good faith with a claimant for the settlement of the claim on
behalf of City, but that the parties to the claim settlement agreement will be City and the
claimant, and that City must give final approval to each claim settlement. Contractor
will not be a party to the settlement agreement.
Page 21 of 27
VII.
E.
Contractor staff will explore claim settlement options with the claimant. Where
appropriate, Contractor may arrange for outside experts in structured settlements to
explore specific settlement options with a claimant.
F.
Contractor will recommend to the claimant that the claimant be represented by an
attorney and obtain appropriate financial counseling prior to negotiating any final
settlement agreement with the claimant. If a claimant declines to seek financial
counseling or representation by an attorney, Contractor may, at its discretion, require a
waiver from the claimant.
G.
When appropriate, taking into account the financial sophistication and mental capacity
of the claimant, Contractor may require that the claimant be represented by an attorney
prior to negotiating any final settlement agreement with the claimant.
H.
Each settlement agreement on a claim will be structured to comply with the laws and
regulations of the state where the claimant resides.
CLAIM DENIAL PROCEDURE
A.
Contractor will conduct a review and evaluation of each claim and prepare a written
notice to City of its recommended decision on each claim within a reasonable time after
receipt of the proof of ongoing loss submitted on the claim. If Contractor recommends
to City that all or a part of a claim be denied, the recommendation from Contractor will
comply with the following standards:
B.
C.
1.
Contractor will provide the reasons supporting the recommended denial of all or
any part of the claim.
2.
Contractor will refer to the wording of the insurance policy which is the basis
for the recommended denial of all or any part of the claim.
3.
Contractor will describe the additional information, documents, or proof of loss
that must be submitted to obtain disability benefits and explain why the
additional information is needed in order to pay the claim.
City will respond to each recommendation from Contractor that all or a part of the claim
is denied with one of the following options:
1.
City will affirm the recommendation from Contractor, in which case Contractor
will promptly notify the claimant of the claim decision, and the claim payment
from City will be stopped, withheld or modified accordingly; or
2.
City will notify Contractor that it disagrees with the recommendation from
Contractor as it applies to the pending claim payment, in which case City will
make the claim payment.
If City disagrees with the recommendation from Contractor on a claim, Contractor may,
at its option, administer such claims as directed by City or transfer responsibility for
administration of such claims to City. Similarly, City may, at its option, direct that
responsibility for administration of such claims be transferred to City.
Page 22 of 27
VIII. CLAIMANT APPEALS PROCEDURES
If City has affirmed a denial of all or a part of a claim, Contractor will provide a notice to the
claimant of the denial of all or a part of the claim. The notice will include the following notice
of the claimant’s right to a review of the claim denial:
You have the right to a review of any denial of all or any part of your claim. To obtain
a review, you should send a written request for review to us within sixty (60) days after
you receive notice of the denial. No special form is required. As a part of your request
for a review, you may submit issues and comments in writing and give us more
information, documents, and proof of loss in support of your claim. You may review
pertinent documents related to your request for review. We will review your claim
promptly after receiving your request for review. You will receive written notice of our
decision within sixty (60) days after your request for review is received.
If a claimant requests a review, Contractor will fully evaluate the request and submit the claim
decision for review by Contractor Claim Review Panel. Contractor Claim Review Panel will
provide City with a recommended action on the appeal within thirty (30) days after the appeal
is received. City retains the sole authority to affirm or reverse the denial of all or a part of the
claim, and will review the recommendation from Contractor and notify Contractor, at least ten
(10) calendar days prior to the end of the sixty (60) day period for notification to the claimant
of the decision on review, of City’s decision on the review.
IX.
CONTRACTOR CLAIM REVIEW PANEL
A.
Contractor Claim Review Panel will be composed of three or more members of
Contractor staff, including in each case:
1.
2.
3.
4.
A qualified actuary.
An attorney admitted to the practice of law in the state of Contractor’s physical
location.
A nurse or other qualified medical professional.
A claims analyst.
B.
Contractor Claim Review Panel will meet at least once a month during the term of this
Agreement to review recommendations that all or a part of a claim be denied and to
respond to requests for review from claimants who have requested review of claim
denials. In the event of a request for a review from a claimant, Contractor Claim
Review Panel will include a member of Contractor claims staff other than the claims
analyst who handled the initial claim denial.
C.
The purpose of Contractor Claim Review Panel is to provide a professional financial,
legal, and claims review and analysis of the claim in order to make a recommendation
to City. City has the final authority to make a decision on a recommendation from
Contractor that all or a part of a claim be denied or on the recommendation from
Contractor on the response to an appeal.
D.
City has the right, but not the responsibility, to send a representative to attend each
meeting of Contractor Claim Review Panel. Contractor will provide sufficient notice to
enable City’s participation in such meetings, either in person or by telephone.
Page 23 of 27
X.
XI.
CLAIM FILES
A.
All claim files (including, but not limited to, materials provided by City and
recommendations prepared by Contractor) will, during the term of this Agreement, be
the sole property of City. City grants to Contractor a nonexclusive, nontransferable,
fully paid license to use the claim files for the purpose of Contractor’s performance
under this Agreement. Such use shall be limited to those employees, members,
directors, officers, agents, assigns and successors of Contractor with a business need for
access to the claim files in order to fulfill their obligations under this Agreement.
B.
City and Contractor will each have the right at all reasonable times and for any
reasonable purpose to inspect at the office of the other all books, records, and
documents directly related to the claims.
C.
Upon the termination of this Agreement, Contractor will transfer all claim files to City
or to the person or firm designated by City, in accordance with a transition and file
transfer plan mutually agreed to by City and Contractor. City or the person or firm
designated by City must acknowledge receipt of the claim files in writing.
THIRD PARTY ADMINISTRATOR LAWS
Contractor and City agree that the Agreement between them includes the following standard
requirements found in the Third Party Administrator laws and/or regulations of one or more
states:
A.
Retention of Written Agreement. Contractor and City will retain the written Agreement
and all amendments to the Agreement as a part of the official records of each for the
duration of the Agreement and for not less than seven (7) years thereafter.
B.
Maintenance of Records and Information. Contractor will maintain and make available
to City complete books and records of all transactions performed on behalf of City.
Contractor will maintain the books and records in accordance with prudent standards of
insurance record keeping and will retain the books and records for not less than seven
(7) years after the date of their creation, except as follows: Upon the termination of this
Agreement, Contractor may, by written agreement with City, transfer all records to City
or to a new administrator, in which case City or the new administrator must
acknowledge that it is responsible for retaining the records of the prior administrator for
not less than seven (7) years after the date of their creation.
Contractor will grant access to the books and records to the commissioner of insurance
of Utah State with jurisdiction over City for the purposes of examination, audit, and
inspection.
C.
Approval of Advertising. Contractor will only use advertising pertaining to business
underwritten by City if the advertising has first been approved in writing by City.
D.
Responsibilities of City. City is responsible for determining the benefits, premium
rates, underwriting criteria, and claims payment procedures applicable to business
underwritten by City. It is the sole responsibility of City to provide for competent
administration of its programs. City will, at least semiannually, conduct a review of the
operations of Contractor.
Page 24 of 27
XII.
E.
Payments to Administrator. If Contractor receives any premiums or charges for
insurance from or on behalf of an insured individual for insurance coverage from City,
the payment received by Contractor will be deemed to have been received by City. If
City forwards any return of premium or claim payment to Contractor, the return
premium or claim payment will not be deemed to have been paid to the insured
individual or claimant until the return premium or claim payment is received by the
insured individual or claimant. Nothing in this provision limits any right City has
against Contractor resulting from the failure of Contractor to make payments to City,
insured individuals, or claimants.
F.
Compensation to the Administrator. The fees payable to Contractor under Exhibit “B”,
of this Agreement represents the sole compensation to Contractor under this Agreement.
City will not pay any compensation to Contractor which is contingent upon savings
affected in the adjustment, settlement, and payment of losses for the claims for which
City is liable.
G.
Disclosure of Charges and Fees. Contractor will not charge any service charges to an
insured individual or claimant. Contractor will disclose to City all charges, fees, and
commissions received in connection with the services performed for City, including
fees or commissions paid by any other insurer or reinsurer, if any.
REVIEW AND AUDIT
A.
City will have the right to conduct a semi-annual review of the claims operations of
Contractor performed on its behalf. City will have the right to conduct an annual onsite audit of the claims operations of Contractor performed on its behalf. Any such
review or audit will be conducted by City with its own personnel or by a third party
mutually acceptable to Contractor and City, and will be at the expense of City.
B.
Following each review or audit, City will provide Contractor with a copy of the report
of the results of the review or audit. City is solely responsible for the competent
administration of its programs and for determining the claims payment procedures and
rules relating to the review and investigation of the claims.
C.
City and Contractor acknowledge that the acts of Contractor are considered to be the
acts of City, and that the operations and records of Contractor with respect to the claims
may be examined by one or more state insurance commissioners as if Contractor were
the insurer. Contractor will cooperate fully with any such examination by a state
insurance commissioner, in accordance with instructions from City.
XIII. CONTRACTOR LOCATION AND HOURS OF OPERATION
NOTE: To be completed after award of contract.
Contractor maintains their corporate office in ________________. Contractor shall offer all
services from this location during the standard operation hours listed below. Contractor shall
maintain additional hours in order to meet specific client needs as agreed upon with City.
Service Center:
_________________________________
_________________________________
_________________________________
Page 25 of 27
Telephone:
Fax:
Standard Hours:
XIV.
XV.
_________________________________
_________________________________
_________________________________
RESPONSIBILITIES OF CITY
City shall perform the following duties and responsibilities with respect to the claims:
A.
City shall provide a Summary Plan Description to each employee to advise of the
identity of Contractor and the relationship between Contractor and City.
B.
City shall acknowledge receipt of each claim payment recommendation provided by
Contractor on the claims. The acknowledgement may be made by e-mail.
C.
City shall make all claim payments on the claims.
D.
City will make all claim payments on the claims in accordance with the
recommendations received from Contractor unless, prior to making the payment,
City notifies Contractor in writing of its determination that it will not follow
Contractors recommendation.
E.
Should City determine that it does not agree with the recommendation of Contractor
with respect to any other claim action, City will promptly notify Contractor. Failure
to notify Contractor within five (5) business days following receipt of written notice
with respect to such claims will be considered acceptance of Contractor
recommendation.
F.
City shall provide all required information to reinsurers and administer all
applicable reinsurance accounting and financial reporting requirements.
G.
City shall provide all required information to reinsurers and administer all
applicable reinsurance accounting and financial reporting requirements.
H.
City shall fulfill any claim related reporting requirements of the states.
I.
City shall provide system reports and system access or data transfer necessary for
Contractor to effectively and efficiently perform its responsibilities under this
Agreement. The specific reporting and access or data transfer requirements
afforded to Contractor will be mutually agreed to by Contractor and City.
DISCLOSURE OF CITY RECORDS
Because City shall own the documents generated by Contractor pursuant to this Agreement,
Contractor shall not, without written approval by City, disclose publicly said records.
Contractor understands that the information obtained in the performance of this Agreement is
confidential and may be shared with employees of City or others only on a need to know basis.
Page 26 of 27
CONTRACT NO. 16-1-12-5656
EXHIBIT “B”
PRICE SCHEDULE
EMPLOYEE LONG & SHORT TERM DISABILITY
INSURANCE ADMINISTRATION
NOTE: Subject to modification based on the proposal received from the selected offeror and
negotiations with City.
I.
GENERAL
A.
Prices stated include all costs associated with the performance of the services specified,
including materials, supervision, labor, insurance, transportation, delivery, fuel or other
surcharges, demurrage, and related costs. No other charges shall be allowed. All prices
and fees are stated in U.S. dollars.
B.
City is exempt from sales, use, and federal excise taxes on these products and services.
Exemption certificates shall be furnished upon request.
C.
Prices stated shall be firm for the initial term of this Agreement. Requests for price
adjustment thereafter shall follow the requirements specified in Paragraph III, Option
Renewal Period Price Adjustment. Any stated discount percentages shall be firm for
the full term of this Agreement, including any renewal terms.
II.
FEES NOTE: To be completed after award of contract.
III.
OPTION RENEWAL PERIOD PRICE ADJUSTMENT
Prices stated are firm for the initial term of this Agreement. If this Agreement is extended for
additional periods, price adjustments may be made; however, any request for a price adjustment
shall be made before the beginning date of the contract renewal period. Contractor may
calculate and make a written request to City that the prices for the next renewal year be
increased by the lesser of three percent (3%) or the percentage increase, if any, in the latest
published Consumer Price Index, All Urban Consumers (CPI-U), “US City Average” published
by the Bureau of Labor Statistics of the US Federal Government for the most recent twelve (12)
month period, and City shall respond to such request. If publication of said CPI index should
cease, such percentage increase shall be determined by reference to a similar index, or as
agreed upon by the parties.
IV.
INVOICING AND PAYMENT
City shall pay Contractor for all products and services provided by Contractor pursuant to this
Agreement. Contractor shall submit a written invoice, in duplicate, for services rendered and
City shall pay the invoiced fee within thirty (30) days after receipt of the invoice by City.
Invoices shall be submitted to:
Salt Lake City Corporation
Department of Human Resources
Attn.: Employee Benefits Administrator
P.O. Box 145464
Salt Lake City, UT 84114-5464
Page 27 of 27