Employer has asked isolved Benefit Services to assist it with satisfying Employer’s obligations to collect and forward premiums collected from benefit plan or other participants. This Service Appendix describes the rights and responsibilities of isolved Benefit Services and Employer with respect to benefit plan or other premium collection services provided by isolved Benefit Services. The rights and obligations outlined below apply only to the extent chosen by Employer on the Fees and Consideration Appendix. This Service Appendix is incorporated into and made a part of the Service Agreement (the “Agreement”). The effective date of this Service Appendix is the effective date of the Agreement or if later, the date assigned by isolved Benefit Services as defined in the isolved Benefit Services Client Welcome Letter. The responsibilities of the parties set forth in this Service Appendix are in addition to any responsibilities set forth in the Agreement. If there is a conflict between this Service Appendix and the Agreement, the Agreement controls.
A. Duties of isolved Benefit Services
- 1. General Administration. isolved Benefit Services will provide benefit plan or other premium billing and collection services for certain classes of participants (e.g. retirees, individuals on an FMLA or other leave of absence, short-term or long-term disability), including but not limited to the following:
- (a.) Premium rate table maintenance
- (b.) Participant enrollment communications
- (c.) Participant census management including reinstatement and termination processing
- (d.) Subsequent premium billing calculations, invoicing and collection of funds
- 2. Billing. isolved Benefit Services will be responsible for sending, in a timely fashion, premium billings via US mail to the enrolled employee participant incurred charges after receipt of the prior payment.
- 3. Collection. isolved Benefit Services will instruct participants to make timely premium payments to the order of isolved Benefit Services. isolved Benefit Services shall deposit all payments received from participants in a custodial account in the name of isolved Benefit Services that shall be separate from and not part of the general assets of isolved Benefit Services. isolved Benefit Services will forward all premiums collected in a month to Employer by the 15th business day of the next month.
- 4. Reporting. isolved Benefit Services will provide standard verification reports on a periodic basis to Employer (or as directed by Employer in writing), which will include information such as each participant’s paid-through date, the coverage period(s) paid for, and the plan(s) elected.
B. Duties of Employer
- 1. Employer Duties. Employer is responsible for providing all information necessary for isolved Benefit Services to send a premium billing as set forth above, including but not limited to, the premium amount, name and address of the participant and the date to cease sending a premium bill.
- 2. Verification. Employer is responsible for reviewing all standard verification reports set forth in A.4 above and reporting any discrepancies promptly to isolved Benefit Services.