2023/11/29 Council Agenda Packet

© Peak One Administration 2016 15 may apply to Client or the Benefit Plans. Consequently, PSP provides no warranty or representation regarding the compliance status of any documents or forms it provides to Client. 2. Salary Reduction Elections. All elections and changes to elections will be processed in accordance with the terms of the plan document adopted by Client and provided to PSP. PSP will also process Change of Status Elections consistent with Client’s instructions. PSP will also maintain on- going records of activity affecting each employee election. 3. Enrollment and Salary Election Services. PSP will process and maintain employee census and salary reduction and employer contribution information for the applicable Benefits Plans based on the information provided by Client, including initial enrollments in the Benefit Plans, annual enrollments and changes made to such payroll deductions in accordance with the terms of the plan document for applicable Benefit Plan. PSP will process initial enrollment forms, Change of Status Elections and revocation forms based on information provided by Client. PSP will provide forms to Client to use for communicating participant elections, terminations and changes. PSP will process and send Pay Cycle Contribution Billing Reports to Client confirming the deductions that should be taken for premiums, flexible spending accounts, and personal policy plans. PSP will, on an as requested basis, provide periodic re-enrollment services. On an annual basis, PSP will provide a Change of Status Report and renewal elections forms. 4. Processing of Reimbursements. PSP will process requests for reimbursements made by Participants in accordance with the terms of this Agreement, its standard operating procedures, and the particular plan. For HRA reimbursement claims, the participant must submit a voucher (on the form provided by PSP) stating that the amount claimed has not been, nor will be reimbursed under any other health plan or otherwise, along with written proof of the claim from a third party documenting the date incurred, the nature and the cost of the claim. For FSA reimbursement claims, the participant must submit a voucher (on the form provided by PSP) stating that the amount claimed has not been, nor will be reimbursed under any other health plan or otherwise, along with written proof of the claim from a third party documenting the date incurred, the nature and the cost of the claim. For DCAP reimbursement claims, the participant must submit a voucher (form provided) containing the following required information: dependent’s name; name, address and tax ID number of the dependent care provider; and the dates of services. Reimbursements under the 129 Plan are limited to the amount in the account. Unpaid portions of the DCAP voucher will be automatically paid during the check processing cycle after the next contribution has been posted to the account. 5. Participant Assistance. PSP will assist plan participants with general information pertaining to the Benefit Plans and answer routine questions concerning coverage status, claims status, complaint administration, and other general inquiries related to the Benefit Plans. Participants will have 24- hour access to their accounts balance, check history and voucher history for the current plan year via the internet and access to PSP’s call center during normal business hours. 6. Claims Processing. PSP will administer and process claims for benefits in accordance with the Plan Document and Summary Plan description. Based on the eligibility information provided by Client, PSP will initially determine if an individual is entitled to benefits under a Benefit Plan and will process submitted claims in its usual and customary manner for the service options elected by Client. PSP will have no duty or obligation with respect to claims processed prior to the Effective Date (“Prior Reimbursement Requests”), if any, and/or plan administration (or other) services arising prior to the Effective Date (“Prior Administration”), if any, regardless of whether such services were/are to be performed prior to or after the Effective Date.