HomeMy WebLinkAboutAgreement A-22-572 with Navia Benefit Solutions Inc..pdf Agreement No. 22-572
1 AGREEMENT
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3 THIS AGREEMENT is made and entered into effective January 1, 2023, by and
4 between the COUNTY OF FRESNO, hereinafter referred to as "COUNTY", and Navia Benefit
5 Solutions, Inc., a Washington state corporation, hereinafter referred to as "CONTRACTOR".
6 WITNESSETH:
7 WHEREAS, the COUNTY desires to obtain certain health benefit administrative
8 services, including processing COUNTY retirees' enrollment, billing and reporting, for County
9 retirees that are 65 years of age or older (hereinafter "post-65 retirees:); and
10 WHEREAS, the COUNTY participates in health insurance programs for its employees
11 and retirees under the age of 65, offered through its participation in the San Joaquin Valley
12 Insurance Authority (SJVIA); and
13 WHEREAS, the SJVIA offers additional administrative services including consolidated
14 eligibility and billing services through its separate agreement with CONTRACTOR; and
15 WHEREAS, the COUNTY desires to ensure consistency and efficiency in health
16 benefit administrative services offered through the SJVIA by matching pricing and services for its
17 post-65 retirees; and
18 WHEREAS, the CONTRACTOR represents that it is willing and able to provide the
19 health benefit administrative services as set forth in this Agreement.
20 NOW, THEREFORE, in consideration of the mutual covenants, terms and conditions
21 herein contained, the parties hereto agree as follows:
22 1. OBLIGATIONS OF THE CONTRACTOR
23 A. The CONTRACTOR shall provide health benefit administrative services as
24 set forth in Exhibit A, attached hereto and incorporated herein by this reference.
25 B. The CONTRACTOR shall provide the COUNTY with general administrative
26 services that include, but are not limited to:
27 1. Furnishing necessary training to County personnel to assist the
28 COUNTY in utilizing the CONTRACTOR'S services.
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1 2. Furnishing the COUNTY with all available information from the
2 CONTRACTOR's records which the COUNTY, in its determination, may need and/or request.
3 3. Referral of participants to the COUNTY as reasonably necessary
4 for clarification of any enrollment or other service request made by any post-65 retiree.
5 The CONTRACTOR is responsible for compliance with the Internal Revenue
6 Code and other Federal, State or local laws applicable to the CONTRACTOR.
7 2. OBLIGATIONS OF THE COUNTY
8 A. The COUNTY is solely responsible for compliance with the Internal
9 Revenue Code and other Federal, State or local laws applicable to the COUNTY.
10 B. The COUNTY is solely responsible for the accuracy and integrity of
11 COUNTY data.
12 3. TERM
13 This Agreement shall become effective on the 1st day of January, 2023 and
14 shall terminate on the 31st day of December, 2023, unless otherwise terminated by COUNTY, as
15 provided herein.
16 4. TERMINATION
17 A. Non-Allocation of Funds - The terms of this Agreement, and the services to
18 be provided thereunder, are contingent on the approval of funds by the COUNTY. Should
19 sufficient funds not be allocated, the services provided may be modified, or this Agreement
20 terminated, at any time by giving the CONTRACTOR thirty (30) days advance written notice.
21 B. Breach of Contract - The COUNTY may immediately suspend or terminate
22 this Agreement in whole or in part, where in the determination of the COUNTY there is:
23 1. An illegal or improper use of funds;
24 2. A failure to comply with any term of this Agreement;
25 3. A substantially incorrect or incomplete report submitted to the
26 COUNTY;
27 4. Improperly performed service.
28 In no event shall any payment by the COUNTY constitute a waiver by the COUNTY
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1 of any breach of this Agreement or any default which may then exist on the part of the
2 CONTRACTOR. Neither shall such payment impair or prejudice any remedy available to the
3 COUNTY with respect to the breach or default. The COUNTY shall have the right to demand of
4 the CONTRACTOR the repayment to the COUNTY of any funds disbursed to the CONTRACTOR
5 under this Agreement, which in the judgment of the COUNTY were not expended in accordance
6 with the terms of this Agreement. The CONTRACTOR shall promptly refund any such funds upon
7 demand.
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9 C. Without Cause - Under circumstances other than those set forth above,
10 this Agreement may be terminated by COUNTY upon the giving of sixty (60) days advance written
11 notice of an intention to terminate to CONTRACTOR.
12 4. COMPENSATION: COUNTY agrees to pay CONTRACTOR and
13 CONTRACTOR agrees to receive compensation as follows: $2.00 Per Post-65 Retiree Per Month
14 (PRPM) paid monthly throughout the term of this Agreement per the compiled monthly
15 transmittals. The PRPM fee will be paid in arrears and is based on the actual number of eligible
16 Medicare retirees as determined by the COUNTY and as used for all eligibility purposes for the
17 specific contract month.
18 5. OWNERSHIP OF DATA: All data delivered by the COUNTY to
19 CONTRACTOR, or which is created by either party for the COUNTY in connection with the
20 performance of this Agreement, shall be the exclusive property of the COUNTY. CONTRACTOR
21 shall be the custodian of such data and will immediately make such data available to the COUNTY
22 upon request during normal working hours. CONTRACTOR shall return or destroy all
23 personnel/payroll raw data collected or generated in connection with the performance of the
24 Agreement within thirty (30) days of the termination of this Agreement upon written request of the
25 COUNTY and CONTRACTOR shall not access or use said data for any purpose other than in
26 connection with the performance of this Agreement or for CONTRACTOR'S administrative and
27 legal obligations.
28 6. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
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1 A. The parties to this Agreement shall be in strict conformance with all
2 applicable Federal and State of California laws and regulations, including but not limited to
3 Sections 5328, 10850, and 14100.2 et seq. of the Welfare and Institutions Code, Sections 2.1 and
4 431.300 et seq. of Title 42, Code of Federal Regulations (CFR), Section 56 et seq. of the
5 California Civil Code, Sections 11977 and 11812 of Title 22 of the California Code of Regulations,
6 and the Health Insurance Portability and Accountability Act (HIPAA), including but not limited to
7 Section 1320 D et seq. of Title 42, United States Code (USC) and its implementing regulations,
8 including, but not limited to Title 45, CFR, Sections 142, 160, 162, and 164, The Health
9 Information Technology for Economic and Clinical Health Act (HITECH) regarding the
10 confidentiality and security of patient information, and the Genetic Information Nondiscrimination
11 Act (GINA) of 2008 regarding the confidentiality of genetic information.
12 Except as otherwise provided in this Agreement, CONTRACTOR, as a
13 Business Associate of COUNTY, may use or disclose Protected Health Information (PHI) to
14 perform functions, activities or services for or on behalf of COUNTY, as specified in this
15 Agreement, provided that such use or disclosure shall not violate the Health Insurance Portability
16 and Accountability Act (HIPAA), 42 USC 1320d et seq. The uses and disclosures of PHI may not
17 be more expansive than those applicable to COUNTY, as the "Covered Entity" under the HIPAA
18 Privacy Rule (45 CFR 164.500 et seq.), except as authorized for management, administrative or
19 legal responsibilities of the Business Associate.
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1 B. CONTRACTOR, including its subcontractors and employees, shall protect,
2 from unauthorized access, use, or disclosure PHI and genetic information, concerning persons
3 receiving services pursuant to this Agreement, except where permitted in order to carry out data
4 aggregation purposes for health care operations [45 CFR Sections 164.504 (e)(2)(i), 164.504
5 (3)(2)(ii)(A), and 164.504 (e)(4)(i)] This pertains to any and all persons receiving services pursuant
6 to a COUNTY funded program. This requirement applies to electronic PHI. CONTRACTOR shall
7 not use PHI or genetic information for any purpose other than carrying out CONTRACTOR's
8 obligations under this Agreement.
9 C. CONTRACTOR, including its subcontractors and employees, shall not
10 disclose PHI or genetic information to any person or entity, except as otherwise specifically
11 permitted by this Agreement, authorized by Subpart E of 45 CFR Part 164 or other law, required
12 by the Secretary, or authorized by the client/patient in writing. In using or disclosing PHI that is
13 permitted by this Agreement or authorized by law, CONTRACTOR shall make reasonable efforts
14 to limit PHI to the minimum necessary to accomplish intended purpose of use, disclosure or
15 request.
16 D. For purposes of the above sections, genetic information shall include
17 genetic tests of family members of an individual or individual, manifestation of disease or disorder
18 of family members of an individual, or any request for or receipt of, genetic services by individual
19 or family members. Family member means a dependent or any person who is first, second, third,
20 or fourth degree relative.
21 E. CONTRACTOR shall provide access, at the request of COUNTY, and in
22 the time and manner designated by COUNTY, to PHI in a designated record set (as defined in 45
23 CFR Section 164.501), to an individual or to COUNTY in order to meet the requirements of 45
24 CFR Section 164.524 regarding access by individuals to their PHI. With respect to individual
25 requests, access shall be provided within thirty (30) days from request. Access may be extended
26 if CONTRACTOR cannot provide access and provides individual with the reasons for the delay
27 and the date when access may be granted. PHI shall be provided in the form and format
28 requested by the individual or COUNTY.
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1 CONTRACTOR shall make any amendment(s) to PHI in a designated record set at
2 the request of COUNTY or individual, and in the time and manner designated by COUNTY in
3 accordance with 45 CFR Section 164.526.
4 CONTRACTOR shall provide to COUNTY or to an individual, in a time and manner
5 designated by COUNTY, information collected in accordance with 45 CFR Section 164.528, to
6 permit COUNTY to respond to a request by the individual for an accounting of disclosures of PHI
7 in accordance with 45 CFR Section 164.528.
8 F. CONTRACTOR shall report to COUNTY, in writing, any knowledge or
9 reasonable belief that there has been unauthorized access, use, disclosure, security incident, or
10 breach of unsecured PHI not permitted by this Agreement of which it becomes aware, immediately
11 and without reasonable delay and in no case later than five (5) business days of discovery, unless
12 applicable law requires earlier or immediate notice. Immediate notification shall be made to
13 COUNTY's Information Security Officer and Privacy Officer and COUNTY's DPH HIPAA
14 Representative, within five (5) business days of discovery. The notification shall include, to the
15 extent possible, the identification of each individual whose unsecured PHI has been, or is
16 reasonably believed to have been, accessed, acquired, used, disclosed, or breached.
17 CONTRACTOR shall take prompt corrective action to cure any deficiencies and any action
18 pertaining to such unauthorized disclosure required by applicable Federal and State Laws and
19 regulations. CONTRACTOR shall investigate such breach and to the extent Contractor solely
20 caused the breach, Contractor is responsible for all notifications required by law and regulation or
21 deemed necessary by the Parties and shall provide a written report of the investigation and
22 reporting required to COUNTY's Information Security Officer and Privacy Officer and COUNTY's
23 DPH HIPAA Representative. If the breach is caused by County, County is responsible for all
24 notifications required by law and regulation or deemed necessary by the Parties. This written
25 investigation and description of any reporting necessary shall be postmarked within the thirty (30)
26 working days of the discovery of the breach to the addresses below:
27 County of Fresno County of Fresno County of Fresno
28 Dept. of Public Health Dept. of Public Health Dept. of Internal Services
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1 HIPAA Representative Privacy Officer Information Security Officer
2 (559) 600-6439 (559) 600-6405 (559) 600-5800
P.O. Box 11867 P.O. Box 11867 333 W. Pontiac Way
3 Fresno, CA 93775 Fresno, CA 93775 Clovis, CA 93612
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G. CONTRACTOR shall make its internal practices, books, and records
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relating to the use and disclosure of PHI received from COUNTY, or created or received by the
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CONTRACTOR on behalf of COUNTY, in compliance with HIPAA's Privacy Rule, including, but
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not limited to the requirements set forth in Title 45, CFR, Sections 160 and 164. CONTRACTOR
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shall make its internal practices, books, and records relating to the use and disclosure of PHI
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received from COUNTY, or created or received by the CONTRACTOR on behalf of COUNTY,
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available to the United States Department of Health and Human Services (Secretary) upon
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demand.
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CONTRACTOR shall cooperate with the compliance and investigation reviews
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conducted by the Secretary. PHI access to the Secretary must be provided during the
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CONTRACTOR's normal business hours, however, upon exigent circumstances access at any
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time must be granted. Upon the Secretary's compliance or investigation review, if PHI is
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unavailable to CONTRACTOR and in possession of a Subcontractor, it must certify efforts to
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obtain the information to the Secretary.
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H. Safeguards
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CONTRACTOR shall implement administrative, physical, and technical safeguards
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as required by the HIPAA Security Rule, Subpart C of 45 CFR 164, that reasonably and
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appropriately protect the confidentiality, integrity, and availability of PHI, including electronic PHI,
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that it creates, receives, maintains or transmits on behalf of COUNTY and to prevent unauthorized
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access, viewing, use, disclosure, or breach of PHI other than as provided for by this Agreement.
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CONTRACTOR shall conduct an accurate and thorough assessment of the potential risks and
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vulnerabilities to the confidential, integrity and availability of electronic PHI. CONTRACTOR shall
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develop and maintain a written information privacy and security program that includes
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administrative, technical and physical safeguards appropriate to the size and complexity of
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1 CONTRACTOR's operations and the nature and scope of its activities. Upon COUNTY's request,
2 CONTRACTOR shall provide COUNTY with information concerning such safeguards.
3 CONTRACTOR shall implement strong access controls and other security
4 safeguards and precautions in order to restrict logical and physical access to confidential,
5 personal (e.g., PHI) or sensitive data to authorized users only. Said safeguards and precautions
6 shall include the following administrative and technical password controls for all systems used to
7 process or store confidential, personal, or sensitive data:
8 1. Passwords must not be:
9 a. Shared or written down where they are accessible or recognizable by
10 anyone else; such as taped to computer screens, stored under keyboards,
11 or visible in a work area;
12 c. Stored in clear text
13 2. Passwords must be:
14 a. Eight (8) characters or more in length;
15 b. Changed immediately if revealed or compromised; and
16 c. Composed of characters from at least three (3) of the following four (4)
17 groups from the standard keyboard:
18 1) Upper case letters (A-Z);
19 2) Lowercase letters (a-z);
20 3) Arabic numerals (0 through 9); and
21 4) Non-alphanumeric characters (punctuation symbols).
22 CONTRACTOR shall implement the following security controls on each workstation
23 or portable computing device (e.g., laptop computer) containing confidential,
24 personal, or sensitive data:
25 1. Network-based firewall and/or personal firewall;
26 2. Continuously updated anti-virus software; and
27 3. Patch management process including installation of all operating
28 system/software vendor security patches.
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1 CONTRACTOR shall utilize a commercial encryption solution that has received
2 FIPS 140-2 validation to encrypt all confidential, personal, or sensitive data stored on portable
3 electronic media (including, but not limited to, compact disks and thumb drives) and on portable
4 computing devices (including, but not limited to, laptop and notebook computers).
5 CONTRACTOR shall not transmit confidential, personal, or sensitive data via e-mail
6 or other internet transport protocol unless the data is encrypted. CONTRACTOR must apply
7 appropriate sanctions against its employees who fail to comply with these safeguards.
8 CONTRACTOR must adopt procedures for terminating access to PHI when employment of
9 employee ends.
10 I. Mitigation of Harmful Effects
11 CONTRACTOR shall mitigate, to the extent practicable, any harmful effect that is
12 suspected or known to CONTRACTOR of an unauthorized access, viewing, use, disclosure, or
13 breach of PHI by CONTRACTOR or its subcontractors in violation of the requirements of these
14 provisions. CONTRACTOR must document suspected or known harmful effects and the
15 outcome.
16 J. CONTRACTOR's Subcontractors
17 CONTRACTOR shall ensure that any of its contractors, including subcontractors, if
18 applicable, to whom CONTRACTOR provides PHI received from or created or received by
19 CONTRACTOR on behalf of COUNTY, agree to the same restrictions, safeguards, and conditions
20 that apply to CONTRACTOR with respect to such PHI and to incorporate, when applicable, the
21 relevant provisions of these provisions into each subcontract or sub-award to such agents or
22 subcontractors.
23 K. Employee Training and Discipline
24 CONTRACTOR shall train and use reasonable measures to ensure compliance with
25 the requirements of these provisions by employees who assist in the performance of functions or
26 activities on behalf of COUNTY under this Agreement and use or disclose PHI and discipline such
27 employees who intentionally violate any provisions of these provisions, including termination of
28 employment.
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1 L. Termination for Cause
2 Upon COUNTY's knowledge of a material breach of these provisions by
3 CONTRACTOR, COUNTY shall either:
4 1. Provide an opportunity for CONTRACTOR to cure the breach or end the violation
5 and terminate this Agreement if CONTRACTOR does not cure the breach or end
6 the violation within the time specified by COUNTY; or
7 2. Immediately terminate this Agreement if CONTRACTOR has breached a material
8 term of these provisions and cure is not possible.
9 3. If neither cure nor termination is feasible, the COUNTY's Privacy Officer shall
10 report the violation to the Secretary of the U.S. Department of Health and Human
11 Services.
12 M. Judicial or Administrative Proceedings
13 COUNTY may terminate this Agreement in accordance with the terms and
14 conditions of this Agreement as written hereinabove, if: (1) CONTRACTOR is found guilty in a
15 criminal proceeding for a violation of the HIPAA Privacy or Security Laws or the HITECH Act; or
16 (2) there is a finding or stipulation that the CONTRACTOR has violated a privacy or security
17 standard or requirement of the HITECH Act, HIPAA or other security or privacy laws in an
18 administrative or civil proceeding in which the CONTRACTOR is a party.
19 N. Effect of Termination
20 Upon termination or expiration of this Agreement for any reason, CONTRACTOR
21 shall return or destroy all PHI received from COUNTY (or created or received by CONTRACTOR
22 on behalf of COUNTY) that CONTRACTOR still maintains in any form, and shall retain no copies
23 of such PHI. If return or destruction of PHI is not feasible, it shall continue to extend the
24 protections of these provisions to such information, and limit further use of such PHI to those
25 purposes that make the return or destruction of such PHI infeasible. This provision shall apply to
26 PHI that is in the possession of subcontractors or agents, if applicable, of CONTRACTOR. If
27 CONTRACTOR destroys the PHI data, a certification of date and time of destruction shall be
28 provided to the COUNTY by CONTRACTOR upon written request.
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1 O. Disclaimer
2 COUNTY makes no warranty or representation that compliance by CONTRACTOR
3 with these provisions, the HITECH Act, HIPAA or the HIPAA regulations will be adequate or
4 satisfactory for CONTRA CTOR's own purposes or that any information in CONTRACTOR's
5 possession or control, or transmitted or received by CONTRACTOR, is or will be secure from
6 unauthorized access, viewing, use, disclosure, or breach. CONTRACTOR is solely responsible
7 for all decisions made by CONTRACTOR regarding the safeguarding of PHI.
8 P. Amendment
9 The parties acknowledge that Federal and State laws relating to electronic data
10 security and privacy are rapidly evolving and that amendment of these provisions may be required
11 to provide for procedures to ensure compliance with such developments. The parties specifically
12 agree to take such action as is necessary to amend this agreement in order to implement the
13 standards and requirements of HIPAA, the HIPAA regulations, the HITECH Act and other
14 applicable laws relating to the security or privacy of PHI. COUNTY may terminate this Agreement
15 upon thirty (30) days written notice in the event that CONTRACTOR does not enter into an
16 amendment providing assurances regarding the safeguarding of PHI that COUNTY in its sole
17 discretion, deems sufficient to satisfy the standards and requirements of HIPAA, the HIPAA
18 regulations and the HITECH Act.
19 Q. No Third-Party Beneficiaries
20 Nothing express or implied in the terms and conditions of these provisions is intended to confer,
21 nor shall anything herein confer, upon any person other than COUNTY or CONTRACTOR and
22 their respective successors or assignees, any rights, remedies, obligations or liabilities
23 whatsoever.
24 R. Interpretation
25 The terms and conditions in these provisions shall be interpreted as broadly as
26 necessary to implement and comply with HIPAA, the HIPAA regulations and applicable State
27 laws. The parties agree that any ambiguity in the terms and conditions of these provisions shall be
28 resolved in favor of a meaning that complies and is consistent with HIPAA and the HIPAA
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1 regulations.
2 S. Regulatory References
3 A reference in the terms and conditions of these provisions to a section in the
4 HIPAA regulations means the section as in effect or as amended.
5 T. Survival
6 The respective rights and obligations of CONTRACTOR as stated in this Section
7 shall survive the termination or expiration of this Agreement.
8 U. No Waiver of Obligations
9 No change, waiver or discharge of any liability or obligation hereunder on any one or
10 more occasions shall be deemed a waiver of performance of any continuing or other obligation, or
11 shall prohibit enforcement of any obligation on any other occasion.
12 8. INDEPENDENT CONTRACTOR: In performance of the work, duties and
13 obligations assumed by CONTRACTOR under this Agreement, it is mutually understood and
14 agreed that CONTRACTOR, including any and all of the CONTRACTOR'S officers, agents, and
15 employees will at all times be acting and performing as an independent contractor, and shall act in
16 an independent capacity and not as an officer, agent, servant, employee, joint venturer, partner, or
17 associate of the COUNTY. Furthermore, COUNTY shall have no right to control or supervise or
18 direct the manner or method by which CONTRACTOR shall perform its work and function.
19 However, COUNTY shall retain the right to administer this Agreement so as to verify that
20 CONTRACTOR is performing its obligations in accordance with the terms and conditions thereof.
21 CONTRACTOR and COUNTY shall comply with all applicable provisions of
22 law and the rules and regulations, if any, of governmental authorities having jurisdiction over
23 matters the subject thereof.
24 Because of its status as an independent contractor, CONTRACTOR shall have
25 absolutely no right to employment rights and benefits available to COUNTY employees.
26 CONTRACTOR shall be solely liable and responsible for providing to, or on behalf of, its
27 employees all legally-required employee benefits. In addition, CONTRACTOR shall be solely
28 responsible and save COUNTY harmless from all matters relating to payment of
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1 CONTRACTOR'S employees, including compliance with Social Security withholding and all other
2 regulations governing such matters. It is acknowledged that during the term of this Agreement,
3 CONTRACTOR may be providing services to others unrelated to the COUNTY or to this
4 Agreement.
5 9. MODIFICATION: Any matters of this Agreement may be modified from time to
6 time by the written consent of all the parties without, in any way, affecting the remainder.
7 10. NON-ASSIGNMENT: Neither party may assign, transfer or sub-contract this
8 Agreement nor their rights or duties under this Agreement without the prior written consent of the
9 other party.
10 11. Indemnity. The CONTRACTOR shall indemnify and hold harmless and
11 defend the COUNTY (including its officers, agents, employees, and volunteers) against all
12 claims, demands, injuries, damages, costs, expenses (including attorney fees and costs), fines,
13 penalties, and liabilities of any kind incurred by the COUNTY that arise from or relate to the
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performance or breach of this Agreement by the CONTRACTOR (or any of its officers, agents,
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subcontractors, or employees). The COUNTY may conduct or participate in its own defense
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17 without affecting the CONTRACTOR's obligation to indemnify and hold harmless or defend the
18 County.
19 12. HOLD HARMLESS: CONTRACTOR agrees to indemnify, save, hold harmless,
20 and at COUNTY'S request, defend the COUNTY, its officers, agents, and employees from any and all
21 costs and expenses (including attorney's fees and costs), damages, liabilities, claims, and losses
22 occurring or resulting to COUNTY in connection with the performance, or failure to perform, by
23 CONTRACTOR, its officers, agents, or employees under this Agreement, and from any and all
24 costs and expenses (including attorney's fees and costs), damages, liabilities, claims, and losses
25 occurring or resulting to any person, firm, or corporation who may be injured or damaged by the
26 performance, or failure to perform, of CONTRACTOR, its officers, agents, or employees under
27 this Agreement.
28 13. INSURANCE
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1 A. Required Insurance
2 Without limiting the COUNTY's right to obtain indemnification from
3 CONTRACTOR or any third parties, CONTRACTOR, at its sole expense, shall maintain in full
4 force and effect, the following insurance policies or a program of self-insurance, including but not
5 limited to, an insurance pooling arrangement or Joint Powers Agreement (JPA) throughout the
6 term of the Agreement:
7 A. Commercial General Liability
8 Commercial General Liability Insurance with limits of not less than Two Million
9 Dollars ($2,000,000) per occurrence and an annual aggregate of Four Million Dollars
10 ($4,000,000). This policy shall be issued on a per occurrence basis.
11 B. Automobile Liability
12 Comprehensive Automobile Liability Insurance with limits of not less than One
13 Million Dollars ($1,000,000.00) per accident for bodily injury and for property damages. Coverage
14 should include any auto used in connection with this Agreement.
15 C. Professional Liability
16 CONTRACTOR shall maintain Professional Liability Insurance with limits of
17 not less than One Million Dollars ($1,000,000.00) per occurrence, Three Million Dollars
18 ($3,000,000.00) annual aggregate.
19 D. Worker's Compensation
20 A policy of Worker's Compensation insurance as may be required by the
21 California Labor Code.
22 E. Technology Professional Liability (Errors and Omissions)
23 Technology professional liability (errors and omissions) insurance with limits
24 of not less than Two Million Dollars ($2,000,000.00) per occurrence. Coverage shall
25 encompass all of the CONTRACTOR's duties and obligations that are the subject of this
26 Agreement. Coverage shall include, but not be limited to, any and all claims, damages, costs,
27 fees, regulatory fines and penalties, or forms of legal action involving Cyber Risks.
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1 F. Cyber Liability
2 Cyber liability insurance with limits of not less than Two Million Dollars
3 ($2,000,000.00) per occurrence. Coverage shall include, but not be limited to, any and all
4 claims, damages, costs, fees, regulatory fines and penalties, or forms of legal action involving
5 Cyber Risks. The cyber liability policy shall be endorsed to cover the full replacement value of,
6 damage to, alteration of, loss of, theft of, ransom of, or destruction of intangible property
7 (including but not limited to information or data) that is in the care, custody, or control of
8 CONTRACTOR.
9 For purposes of the technology professional liability insurance and the cyber liability
10 insurance required under this Agreement, Cyber Risks include, but are not limited to, (i) security
11 breaches, which include disclosure of, whether intentional or unintentional, information provided
12 by COUNTY, information provided by or obtained from any employee, or personal-identifying
13 information relating to any employee, to an unauthorized third party; (ii) breach of any of
14 CONTRACTOR's obligations under this Agreement relating to data security, protection,
15 preservation, usage, storage, transmission, and the like; (iii) infringement of intellectual property
16 including, but not limited to, infringement of copyright, trademark, and trade dress; (iv) invasion
17 of privacy, including any release of private information; (v) information theft by any person or
18 entity, whatsoever; (vi) damage to or destruction or alteration of electronic information; (vii)
19 extortion related to CONTRACTOR's obligations under this Agreement regarding electronic
20 information, including information provided by COUNTY, information provided by or obtained
21 from any employee, or personal-identifying information relating to any employee; (viii) network
22 security; (ix) data breach response costs, including security breach response costs; (x)
23 regulatory fines and penalties related to CONTRACTOR's obligations under this Agreement
24 regarding electronic information, including information provided by COUNTY, information
25 provided by or obtained from an employee, or personal-identifying information relating to any
26 employee; and (xi) credit monitoring expenses.
27 B. Additional Requirements Relating to Insurance
28 CONTRACTOR shall obtain endorsements to the Commercial General Liability
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1 insurance naming the COUNTY, its officers, agents, and employees, individually and collectively,
2 as additional insured, but only insofar as the operations under this Agreement are concerned.
3 Such coverage for additional insured shall apply as primary insurance and any other insurance, or
4 self-insurance, maintained by COUNTY, its officers, agents and employees shall be excess only
5 and not contributing with insurance provided under CONTRACTOR's policies herein. This
6 insurance shall not be cancelled or changed without a minimum of thirty (30) days advance written
7 notice given to COUNTY.
8 CONTRACTOR hereby waives its right to recover from COUNTY, its officers,
9 agents, and employees any amounts paid by the policy of worker's compensation insurance
10 required by this Agreement. CONTRACTOR is solely responsible to obtain any endorsement to
11 such policy that may be necessary to accomplish such waiver of subrogation, but
12 CONTRACTOR's waiver of subrogation under this paragraph is effective whether or not
13 CONTRACTOR obtains such an endorsement.
14 Within thirty (30) days from the date CONTRACTOR signs and executes this
15 Agreement, CONTRACTOR shall provide certificates of insurance and endorsement as stated
16 above for all of the foregoing policies, as required herein, to the COUNTY, (Paul Nerland, Director
17 of Human Resources, 2220 Tulare Street, 16t" Floor, Fresno, CA 93721), stating that such
18 insurance coverage have been obtained and are in full force; that the COUNTY, officers, agents
19 and employees will not be responsible for any premiums on the policies; that for such worker's
20 compensation insurance that CONTRACTOR has waived its right to recover from the COUNTY,
21 its officers, agents and employees any amounts paid under the insurance policy and that waiver
22 does not invalidate the insurance policy; that such Commercial General Liability insurance names
23 the COUNTY, its officers, agents and employees, individually and collectively, as additional
24 insured, but only insofar as the operations under this Agreement are concerned; that such
25 coverage for additional insured shall apply as primary insurance and any other insurance, or
26 self-insurance, maintained by COUNTY, its officers, agents and employees, shall be excess only
27 and not contributing with insurance provided under CONTRACTOR's policies herein; and that this
28 insurance shall not be cancelled or changed without a minimum of thirty (30) days advance,
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1 written notice given to COUNTY.
2 In the event CONTRACTOR fails to keep in effect at all times insurance
3 coverage as herein provided, the COUNTY may, in addition to other remedies it may have,
4 suspend or terminate this Agreement upon the occurrence of such event.
5 All policies shall be with admitted insurers licensed to do business in the State
6 of California. Insurance purchased shall be purchased from companies possessing a current A.M.
7 Best, Inc. rating of A FSC VII or better.
8 14. AUDITS AND INSPECTIONS: The CONTRACTOR shall at any time during
9 business hours, and as often as the COUNTY may deem necessary, make available to the
10 COUNTY for examination all of its records and data with respect to the matters covered by this
11 Agreement. The CONTRACTOR shall, upon request by the COUNTY, permit the COUNTY to
12 audit and inspect all of such records and data necessary to ensure CONTRACTOR'S compliance
13 with the terms of this Agreement.
14 If this Agreement exceeds ten thousand dollars ($10,000.00), CONTRACTOR
15 shall be subject to the examination and audit of the Auditor General for a period of three (3) years
16 after final payment under contract (Government Code Section 8546.7).
17 15. NOTICES: The persons and their addresses having authority to give and
18 receive notices under this Agreement include the following:
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COUNTY CONTRACTOR
20 Hollis Magill, Hilarie Aitken, CEO
Director of Human Resources Navia Benefit Solutions, Inc.
21 2220 Tulare Street, 16t" Floor 600 Naches Ave SW
Fresno, CA 93721 Renton, WA 98057
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All notices between the COUNTY and CONTRACTOR provided for or
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permitted under this Agreement must be in writing and delivered either by personal service, by
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first-class United States mail, by an overnight commercial courier service, or by telephonic
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facsimile transmission. A notice delivered by personal service is effective upon service to the
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recipient. A notice delivered by first-class United States mail is effective three COUNTY business
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1 days after deposit in the United States mail, postage prepaid, addressed to the recipient. A notice
2 delivered by an overnight commercial courier service is effective one COUNTY business day after
3 deposit with the overnight commercial courier service, delivery fees prepaid, with delivery
4 instructions given for next day delivery, addressed to the recipient. A notice delivered by
5 telephonic facsimile is effective when transmission to the recipient is completed (but, if such
6 transmission is completed outside of COUNTY business hours, then such delivery shall be
7 deemed to be effective at the next beginning of a COUNTY business day), provided that the
8 sender maintains a machine record of the completed transmission. For all claims arising out of or
9 related to this Agreement, nothing in this section establishes, waives, or modifies any claims
10 presentation requirements or procedures provided by law, including but not limited to the
11 Government Claims Act (Division 3.6 of Title 1 of the Government Code, beginning with section
12 810).
13 16. GOVERNING LAW: Venue for any action arising out of or related to this
14 Agreement shall only be in Fresno County, California.
15 The rights and obligations of the parties and all interpretation and performance
16 of this Agreement shall be governed in all respects by the laws of the State of California.
17 17. DISCLOSURE OF SELF-DEALING TRANSACTIONS: This provision is only
18 applicable if the CONTRACTOR is operating as a corporation (a for-profit or non-profit
19 corporation) or if during the term of the agreement, the CONTRACTOR changes its status to
20 operate as a corporation.
21 Members of the CONTRACTOR's Board of Directors shall disclose any self-
22 dealing transactions that they are a party to while CONTRACTOR is providing goods or
23 performing services under this agreement. A self-dealing transaction shall mean a transaction to
24 which the CONTRACTOR is a party and in which one or more of its directors has a material
25 financial interest. Members of the Board of Directors shall disclose any self-dealing transactions
26 that they are a party to by completing and signing a Self-Dealing Transaction Disclosure Form,
27 attached hereto as Exhibit B and incorporated herein by reference, and submitting it to the
28 COUNTY prior to commencing with the self-dealing transaction or immediately thereafter.
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1 18. ENTIRE AGREEMENT: This Agreement constitutes the entire agreement
2 between the CONTRACTOR and COUNTY with respect to the subject matter hereof and
3 supersedes all previous Agreement negotiations, proposals, commitments, writings,
4 advertisements, publications, and understanding of any nature whatsoever unless expressly
5 included in this Agreement.
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2 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the
day and year first hereinabove written.
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5 CO T OR Is COUNTY OF FRESNO
6 � _ ►'L
7 (Authorized Signature) Brian Pacheco,
Chairman of the Board of Supervisors of
8 the County of Fresno
Hilarie Aitken, CEO
9 Print Name & Title
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600 Naches Ave SW
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12 Renton, WA 98057
Mailing Address ATTEST:
13 Bernice E. Seidel
Clerk of the Board of Supervisors
14 County of Fresno, State of California
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16 By:
Deputy
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24 FOR ACCOUNTING USE ONLY:
25 Fund No: 1060
Subclass: 10000
26 ORG No: 89250200
27 Account No: 7185
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1 EXHIBIT A
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3 CONTRACTOR will provide the following Administrative Services for the COUNTY's
4 Medicare retirees (Post-65 retirees):
5 1. Process retirees' enrollment/billing paperwork once received from COUNTY;
6 2. Track benefits elected by retirees and covered family members;
7 3. Send retirees introductory letter containing payment options (e.g. payment coupons for
8 check or money order, ACH for auto-payment, credit cards);
9 4. Track and collect retirees' monthly premiums;
10 5. Remit premiums to COUNTY directly (CONTRACTOR does not send to carriers);
11 6. Notify COUNTY of all retiree terminations;
12 7. Store COUNTY benefit plan rules, including eligibility restrictions, waiting periods, volume
13 and age calculation frequencies;
14 8. Maintain standard reporting system, including various census, discrepancy, enrollment,
15 and audit reports.
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EXHIBIT "B"
SELF-DEALING TRANSACTION DISCLOSURE FORM
In order to conduct business with the County of Fresno (hereinafter referred to as "County"),
members of a contractor's board of directors (hereinafter referred to as "County Contractor"), must
disclose any self-dealing transactions that they are a party to while providing goods, performing
services, or both for the County. A self-dealing transaction is defined below:
"A self-dealing transaction means a transaction to which the corporation is a party and in which one
or more of its directors has a material financial interest"
The definition above will be utilized for purposes of completing this disclosure form.
INSTRUCTIONS
(1) Enter board member's name,job title (if applicable), and date this disclosure is being made.
(2) Enter the board member's company/agency name and address.
(3) Describe in detail the nature of the self-dealing transaction that is being disclosed to the
County.At a minimum, include a description of the following:
a. The name of the agency/company with which the corporation has the transaction; and
b. The nature of the material financial interest in the Corporation's transaction that the
board member has.
(4) Describe in detail why the self-dealing transaction is appropriate based on applicable
provisions of the Corporations Code.
(5) Form must be signed by the board member that is involved in the self-dealing transaction
described in Sections (3) and (4).
EXHIBIT "B"
(1)Company Board Member Information:
Name: N/A Date:
Job Title:
(2)Company/Agency Name and Address:
N/A
(3)Disclosure(Please describe the nature of the self-dealing transaction you are a party to):
N/A
(4) Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233(a):
N/A
(5)Authorized Signatur
Signature: Date:
12/06/2022