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Healthcare Management Administrators (HMA) 2/20/2025
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Healthcare Management Administrators (HMA) 2/20/2025
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Last modified
3/5/2025 11:14:50 AM
Creation date
3/5/2025 11:13:13 AM
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Contracts
Contractor's Name
Healthcare Management Administrators (HMA)
Approval Date
2/20/2025
End Date
12/31/2025
Department
Human Resources
Department Project Manager
Chelsi Bardwell
Subject / Project Title
HMA 2025 Renewal
Tracking Number
0004705
Total Compensation
$372,032.00
Contract Type
Agreement
Contract Subtype
Professional Services (PSA)
Retention Period
6 Years Then Destroy
Imported from EPIC
No
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HMA TPA Agreement Page 15 4/22 <br /> <br />by any third-party contracts to which HMA is a signatory. Plan Sponsor hereby represents <br />and warrants that, to the extent any disclosed information contains Protected Health <br />Information (as defined by the Health Insurance Portability and Accountability Act of 1996, <br />as amended (“HIPAA”)) about a Participant, Plan Sponsor has the legal authority to have <br />access to such information. Plan Sponsor shall give HMA 60 days’ prior written notice of <br />its intent to perform such an audit and its need for such information and shall represent to <br />HMA that the information, which will be disclosed therein, is reasonably necessary for the <br />administration of the Plan. All audits and information disclosure shall occur at a reasonable <br />time and place and at the Plan Sponsor’s sole cost and expense. Prior to commencement <br />of any audit, all Auditors will be required to sign an HMA Auditor Agreement. <br />11. Overpayment or Improper Payment of Plan Benefits. If any payment is made <br />hereunder to an ineligible person, or if it is determined that an overpayment or improper <br />payment has been made to any party, HMA shall make reasonable efforts to recover the <br />overpayment or improper payment, but shall not be required to initiate court proceedings <br />for any such recovery. If HMA is unsuccessful, HMA shall notify Plan Sponsor in order that <br />Plan Sponsor may take such action as may be available to it. <br />12. Additional Payments to Claimants. Plan Sponsor may, by written notice to HMA signed <br />by an executive officer of the Plan Sponsor, instruct HMA to pay claims, which in HMA’s <br />opinion are not payable under the Plan, upon the condition that such instruction expressly <br />releases HMA from any liability in connection therewith. Plan Sponsor hereby <br />acknowledges that such payments will not qualify for credit toward excess or stop loss <br />insurance coverage, and as such, are considered “outside” the Plan, unless otherwise <br />agreed upon in writing by the Plan’s stop-loss carrier. Plan Sponsor retains all legal <br />requirements for such payment. <br />13. Cooperation in Defense of Claims. HMA and Plan Sponsor shall advise each other as <br />to matters which come to their respective attentions involving potential legal actions or <br />regulatory enforcement activity which involve the Plan or are related to the activities of <br />either party with respect to the Plan or this Agreement and shall promptly advise each <br />other of legal actions or administrative proceedings which have actually commenced. <br />14. Notice of Third Party Administrator’s Capacity. HMA shall notify all Participants in <br />writing of its identity and its relationship to the Plan and the Plan Sponsor in such form <br />and manner as approved by the Plan Sponsor. <br />15. Plan’s Compliance with Laws. Plan Sponsor represents and warrants that the Plan <br />presently complies with all applicable federal, state and local laws and regulations, <br />specifically including, but not limited to, ERISA, Mental Health Parity and Addiction Equity <br />Act (“MHPAEA”), Patient Protection and Affordable Care Act (“PPACA”) the Consolidated <br />Omnibus Budget Reconciliation Act of 1985, as amended (“COBRA”), HIPAA and HITECH, <br />the Consolidated Appropriations Act of 2021, and covenants and agrees that it will, at its <br />sole cost and expense, take all action necessary to cause the Plan’s continued compliance <br />with all applicable federal, state and local laws and regulations during the term of this <br />Agreement. Plan Sponsor is solely responsible for obtaining any actuarial analysis, non- <br />discrimination testing, or actuarial determinations required by the Plan. HMA’s services to <br />assist Plan Sponsor’s with their compliance obligations are limited to directly supporting <br />the services provided by HMA to the Plan Sponsor, and do not extend to any services that <br />the Plan Sponsor is receiving through external parties (i.e. PBM, benefit specific carve- <br />outs, advocacy services, etc.), unless otherwise agreed to in writing by a duly authorized <br />officer of HMA as an addendum to this Agreement, for which the Plan Sponsor remains <br />solely liable.
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