HomeMy WebLinkAboutLetter- RE TCCOG Health Care Status 2-12-2010.PDFAtt: Trustees
RE: TCCOG Health Care Status
From: Mayor Gilmore
Fellow Boardmembers,
At our 2/BMonday Noon board M
explain the key points of the TCCOG
to it, I'll now share the basics referri
questions for clarification on Tuesda
#1J The Municipal Cooperation Agre
progress for about a year. 17 munici
23 bargaining union units through th
review by Laurie fohnston, our I{eal
is nowwith the NYSID New York Stat
day now. The final version will go to
to sign it on or by February 25 which
its municipalities signing on by this
The Agreement gives the Village of
Member Municipalities one vote on t
the case where there's a tie vote, a w
possible stall in the managing the ent
employees will receive weighted vo
with smaller municipalities. These
occurred to date, as what's good for a
The VOCH Mayor by earlier Board Me
document on2/25/2010 at the regul
required, Randy or Norma should ad
TCC0G signing is anticipated.
#2) Financial Summary.."Jeff Silber wi
circled in the sheet you have dated 9/
anticipated for this new organization.
and the City of Ithaca's Controller Ste
the Health Consortium since each of t
the resources and staffing to oversee
Steve will report to the Health Care C
oversight. Extra consortium staffing
County under Dave Squire's direction.
The area under "Net Income". "Liabilit
building of resources for catastrophic
[page two/Health consortium financi summary continuedJ
Date 211,2/I0
ng it was nJy, Norma and Jeff Silber's intent to further
ealth Care Consortium situation. Since we didn,t get
to the material distributed. Please bring any
2 / L6' s evelring meeting.
ment dated 2/B/1,0 is in our packets; a work in
lities havd been involved in contract negotiation and
Health Consortium Board. The contract is under
care and Labor Relation's Attorney. This agreement
Insurance Department and likely to be approved any
urie |ohnston for her approval, and I would expect
ll officiall[z create the legal insurance entity with all
te.
ga Heights, a Labor Union Representative and all
Health Consortium Board issues going forward. In
ted voti4g model will be implemented to avoid any
. Municipalities with the greatest number of
, but in a manner that's intended to protect balance
ofconflicts are not expected, nor have they
y heaJth cg_pfortium membgr ig likq]y good_for all.
ber resolution has been authorized to execute this
r TCCOG Meeting. However, if a new Resolution is
se us of action required on Z/1.6 before the 2/25
I explain thfs in a more detail. The dollar amounts
4/09 is the Draft Health Consortium prrrloar
Tompkins County's Director of Finance Dave Squires
Thayer acft as the fiscal administrative officers for
ese entities have the lion's share of participants and
is $25 milllon do]lar annual operation. Dave and
sortium Board monthly as it relates to this financial
ill be hired administrativelv and housed within the
es", and "Ullencumbered Fund Balance" represents a
rticipant losses and long-term equity stabilization
of the consortium, allowing it to keep insurance prem
#3) VOCH Retiree Side by Side Compariso4 dated2/B
currentlv have verses what we anticipate for our Reti
as good as or better than our present health care cove
Participants and the Village for this coverage will be a
charged. It's expected this coverage will be ready to
explanation will go out to retirees as soon as the Villa
Support feels we are ready to move forwa4d.
Consortium Retiree Coverage was approved at the B
being appropriate, subject to Treasurer-Clerk and M
execution as required.
#4J VOCH Non-Bargaining Side-bir-Side Comparison d
currentlv have verses what we anticipate for our Non
designed to be as good as or better than orir present h
premiums to the Participants and the Village for this
than currently charged. It's expected this doverage wi
Treasurer, Clerk and Mayor will notify us, when in ou
coverage, assuming side-by-side comparisons continu
explanation will go out to Non-Bargaining Staff a mon
This coverage also represents a savings to V0CH, alth
finalized.
Non-Bargaining Consortium Insurance [#4J adoption
for administration to then take follow-up ;iction" It is s
#3  above) In both cases of coverage above, the
intimately involved in the detail of affirmirlg the cover
is brought forth to the employees"
This further explains the status of Consortium Health
Board's further support to keep this progressing. The
inching forward thanks to municipal-wide cooperatio
government, perhaps unheard of at the national level"
the 1st such Municipal Health Consortium greated in N
New York State Insurance Law.
I hope this helps and we can address any further ques
needed. Currently Mayor Gilmore sits on the Consorti
the official "Alternate" when the Mayor is unavailable.
Sincerely,Mayor jim Gilrnore
ums as low as nossible.
...This compares what coverage we
Participants. It is designed to be
ge. Insurance premiums to the
least 15% lower than currently
ke affect soon, and that letters of
Administration with Board
rd Level several month's ago, as
r's final review, approval and
ted2/8.... This comoares whatwe
argaining Participants. It is
Ith care coverage. Insurance
verage will be at least 15% lower
I be ready to take affect soon. Our
opinion we are ready to begin this
favorably. If so, letters of
before coverage would change.
ugh exact %o savings is being
believe still needs Board Approval
ll under review.
surer, Clerk and
and cost ofboth
Mayor will be
policies before it
nsurance, and our request for the
hole process has been slow but
that's a bit unique in local
If enacted, this organization will be
York State under Article 47 of
ons you all may have on 21L6 as
m Board and Trustee Kate Supron is
FT --
THIS AGREEMENT (the "") made effective as of 1" day of January 2010
(the "Effective Date"), by and among
(collectively, the "Participants").
of ttre signatory municipal corporations hereto
WHEREAS:
1. Article 5-G of the New Yprk General Municipal Law (the "General Municipal
Law") authorizes municipal corporationq to enter intq cooperative agreements for the
performance of those firnctions or activities in which they could engage individually;
2. Sections 92-aand 119-o the General Municipal Law authorize municipalities to
purchase a single health insurance po
body to administer a health plan;
enter into group health plans, and establish a joint
3. Article 47 of the New Y lnsurance Law (the "Insurance taw"), and the rules
and regulations of the New York State intendent of Insurance (the "Superintendent") set
forth certain requirements for governing
plans;
:insured municipal cooperative health insurance
4. Section 4702(t) of the I Law defines the term "municipal corporation" to
include a county, city, town, village,district, board of cooperative educational services,
public library (as defined in Section 253
defined in Section 119-n of the General
f the New York State Education Law) and district (as
unicipal Law); and
5. The Participants have to their individual satisfaction that furnishins
the health benefits (including, but not li ted to, medical, surgical, hospital, prescription drug,
dental, and/or vision) for their eligible o eligible employees (as defined by the Internal
Revenue Code of 1986" as amended. and Internal Revenue Service rules and. regulations),
of eligible officers, employees and retireeseligible retirees, and the eligibie
(eollectively, the "Enrollees") (such does not include independent contractors and/or
consultants) through a municipal is in their best interests as it is more cost- efflective
and efficient. Eligibility requirements be determined by each Participant's collective
bargaining agreements and/or their policies and procedures.
NOW, THEREFORE, the partie$ agree as follows:
A. P,rnrrcpaNrs.
1. The Participants hereby delignate themselves under this Agreement as the Greater
Tompkins County Municipal Health Insu{ance Consortium (the "Consortium") for the purpose of
providing heaith benefits (medical, surgic[], hospital, prescription drug, dental, and/or vision) to
those Enrollees that each Participant indi{idually elects to include in the Greater Tompkins
counf Municipal Health Insurance Conslrtium Medical Plan(s) (the "Plan(s)").
2. The followine shall comprise the initial membership of the
Consortium (a) County of Tompkins; (b)ity of Ithaca; (c) Town of Enfield; (d) Town of
Caroline; (e) Town of Ithaca; (f) Town Danby; (g) Town of Dryden; (h) Town of Ulysses; (i)
Village of Cayuga Heights; fi) Village of
{H1049320.1 1}
; (k) Village of Dryden; (1) Village of
nsortium may be offered to anY
f the County of Tompkins; Provided
), the applicant provides
same type of municipal corporation
as the initialParticipants. Notwithstanding anything to co set forth in this Agreement,
admission of new Participants shall not requiro of this Section A(2). MembershiP
Agreement, any amendments heretoshall be subiect to the terms'and conditions set forth in
and applicable law.
3. Participation in the Plan(s) by some, but all, collective bargaining units or
l not be permitted absent prior Board
which negotiates an alternative
tr-ealth insurance plan offering other than the Pfan o of the Consortium with a collective
charge as determined bY the Board"bargaining unit or employee group may be subject to a
4. Initial membership of additional shall become effective on the fust
the resolution to accept a municipal
agree to continue as a ParticiPant
5. The Board, by a two-thids (213) vote of entire Board, may elect to Permit a
ical or political boundaries of the
proof, as determined bY the
Trumansburg; (m) Town of Groton. Membership inthe C
municipal cJrporation within the geographical boundaries
however, in the sole discretion of the Board (as defined 1
satisfactory proof of its financial responsibility and is of
employee groups of a Participant is not encouiaged and
appioval. F,rthet, after obtaining approval, any Partici
day of the Plan Year following the adoption by the Bo.*d
corporation as a Participant. Such municipal oorporation
for a minimum of three (3) years upon entry.
municipal corporation which is not located in the geogl
County of Tompkins to become a Participant subject to
Board, of such municipal corporation's financial responsi
must agree to continue as a Participant for a minimum of
Participant, and which is otherwise eligible for membersl
entrv after a minimum of three (3) years has passed since
shali be"subjestto the approval of two-thirds (213) of the r
period may be waived by the approval of two'thirds Q/3)
(including medical, surgical, and hospital) provided ur
employees, retirees, and their dependents. Eaoh Partici
"premium" contribution to the Plan(s) as a petcentage of t
to the Plan(s), as is appropriate based on the nature of the
6. A municipal corporation that was previ a Participant, but is no longer a
Such municipal corPoration
(3) years upon entry.
in the Consortium, ffi&Y aPPIY for re-
was last a Participant. Such re-entry
or contribution.
Board. This re-en$ waiting
if the entife Board. In order to'rd:
inter the Consortium, a municipal corporation employer have satisfied in fullal1of its
outstanding financial obligations to the Consortium' A icipal corporation must agrce to
continue as a Participant for a minimum of three (3) years upon re-entry"
B. P.lnncrP.lNT LrABtr rrY"
1. The Participants shall share in Sre costs of,assume the liabilities for benefits
the Plan(s) to covered officers,
shall pay on demand such
Participant's share of any assessment or additional co
in Section L(4) of this Agreement" The pro rafa share
ion ordered by the Board, as set forth
be based on the Participant's relative
aggregate "premium" contribution
New Participants (each a "New Participant") who enter the Consortium may b3J. 6u LrVrPArlJ \vgvu * . t-'l
assessed a fee for additional financial costs atiove and bey]ond the premium contributions to the
plan(s). Any such additional financial obligafions and anJ' related 19"": and conditions
associated with membership in the Consortium shall be dgtermined by the Board, and shall be
disclosed to the New Participant prior to its admission.
{H1049320.11} 2
I
3. Each Participant shail be liable, on a pro rata basis, for any additional assessment
Insurancerequired in the event the Consortium
law as follows:
ing falls below those levels required by the
a. In the event the ium does not have admitted assets (as defined in
Insurance Law $ 107) atleast eq to the aggregate of its liabilities, reserves and
minimum surplus required by Insurance Law, the Board shall, within thirty (30) days,
order an assessment (an "nt Order") for the amount that will provide sufficient
funds to remove such impai and collect from each Participant a pro-rata share of
such assessed amount.
b" Each Particip_ant tfra! participated in the Consortium at any time during theffig (Zl year period prior to the ifsuing of an Assessment Order by the Board shall, if
notified of such Assessment , pay its pro rata share of such assessment within ninety
(90) days after the issuance of Assessment Order. This provision shall survive
termination of the Agreement of wal of a Participant.
c. Forpurposes of
assessment shall be determined
Section B(3), a Participant's pro-rata share of any
applying ttle ratio of the total assessment to the total
contributions or premium earned during the period covered by the assessrnent
on ali Participants subject to the to the contribution or premium equivalent
earned during such period attri le to suoh Participant.
C. Bo,l.nt or Drnncrons.
1. The governing board of Consortium, responsible for managsment, control and
administration of the Consortium and Plan(s), shall be referred to as the "Board of Directors"
authoriq'.to vote on any offisial aetion taken by the
Board (each a "Director"). Each Di , except the representative of the Labor-Management
in writing by the governing body of the Participant.Advisory Committee, shall be
2. If a Director desisnated a Participaril cannot fulfill hislher obligations, for any
reason, as set forth herein, and the desires to designate a new Director, it must notify
its selectiorr of a new designee to represent the
from the Consortium for their service and
December 31 (the "Plan Year").
No Director may more than one Participant.
No Director, or any me of a Director's immediate family shall be an owner,
officer, director, partner, or employee of contractor or agency retained by the Consortium,
including any third party contract
6" Except as otherwise provi in Section D of the Agreement, each Director shall
be entitled to one vote. A maioriff of the ire Board, not simply those present, is required for
the Board to take any official action.otherwise specified in this Agreement" The ooentire
(the "Board"). The voting members of
each Participant and one representative
forth in Section C(11)), who shall have
the Consortium's Chairperson in writing
Participant as a Director.
3. Directors shail receive no
shall serve a term from January 1 throus
Board", as used herein and elsewhere in
Directors when there are no vacancies.
Board shafl be composed of one representative of
the Labor-Management Advisory Committee (as set
Agreement, shall mean the total number of
aJ
4.
5.
{H1049320.1 1}
Board's meeting when its Director cannot attend. The altel
discussions at the Board meeting and will, if s9 designated
authorized to exercise the Participant's voting authority'
authority shall be counted toward a quofl'lm' The Labor-
an alternate Director as set forth in Section C(l1)'
simple majority (more than half) of the entire Board' A
con-duct any business. This quorl'Im requiremept is inde
basis at a time and place within the State ofNew York det
Board shall hold an annual meeting (the *Annual Meeting
any two (2) Directors. Whenever practicable, the person c
acted upon. In the event three (3) days notice cannot be
notice as is practicable under the circumstancEs'
10. In the event tbat a special meeting is
of any action which, in the opinion of the Chairperson, is
behalf of the Consortium, the Chairperson may send prol
number of written approvals, the Chairperson may act on
such approvals. Any actions taken by the Ch4frperson pr
obligations as all other Directors' The Labor-Manag
in writing an altemate Director to attend the Board's
RA -2t081
7"Each Participant may designate in writing alternate Director to attend the
Director may particiPate in the
in writing by the ParticiPa.nt, be
y alternate Directors with voting
Committee may designate
8. A majority of the Directors of ttie Board constitute a quonrm. A quorum is a
is required for the Board to
of the voting requirements set
forth in Section C(6). The Board shall meet on a regular is, but not less than on a quarterlY
nined by a vote of q" Board. The
between October 3'o and October
15m of each Plan Year.
g. Special meetings of the Board may be at any time by the ChairPerson or bY
persons calling such special meeting
shall give at least three (3) day notice to all of ttre other rs. Such notice shall set forth the
time ird place of the special meeting as well as a detailed of the matters proposed to be
each Director shall be given such
due to the nature and/or urgency
or advisable to be taken on
regarding said actions via
facsimile to each and all0f the Directors. Tho Directors y then fax their approval or
disapproval of said actions to the Chairpersonl Upon pt by the Chairperson of the requisite
of the Board in reliance uPon
to-this paragraph fhall be ratffigd
at the next scheduled meeting of the Board'
11. The Chafu of the Labor-Management Advi
K) shall serve as a Director (the "Labor Representative")
Committee (as defined in Section
shall have the same rights and
Advisory Committee may designate
when the Chair cannot attend.
The alternate Director may, if designated in'ryriting, be ized to exercise the Chair's voting
authority.
2. For purposes of this Section D; each Direcfor shall receive votes as follows:
D. WnrcnrnuVornvc.
1. Except as otherwise provided in this Agre$nent, any two or rnore Directors,
acting jointly, may iequire a weightid vote on 1ny mattel[hat may come before the Board. In
,"-rrZ"""t,irr" rrotitrg pto""dot" set forth in this Section { shall apply in lieu of any other voting
pru".d*., set forth ir tttir Agreement. Such weighted vo{ing procedures shall apply solely with
iespect to the matter then before the Board'
{H1049320.1 1}4
Enrollees shall be entitled to a n of votos equaling the total number of votes
avaiiable under subsection (a)one (1), divided evenly by the number of
a. each Director
Enrollees shall be entitled to
b. each Director
Participants eligible under this
number.
FT_2
ing a Participant with five hundred (500) or fewer
l) vote.
a Participant with more than five hundred (500)
bsection (b) and rounded down to the nearest whole
"2" of this Section.
c. the Labor Rep ive shall be entitled to one (1) vote.
3. Afiached as Addendum "" to this Agreement is an example of the application of
the voting formula contained in
4" Notwithstandins to the conhqry contained in this Agreement, any action
taken pursuant to this Section D shall
ofvotes, ifall votes had been cast.
E. Acrrons By rHE Bo.rnn.
ire the app4oval of two-thirds (2/3) of the total number
Subject to the voting and quorum req set fo4th in this Agreement, the Board is
authorized and/or required to take action the following matters:
f the officers of the Consortium.
place of regular Board meetings.
To approve an annual for the Cqnsortium, which Shall be prepared and
approved prior to October 15ft of each
to be paid by'each Participant for each
, and determine the annual premium equivalent rates
classification in the Plan on the basis of a
community rating methodology filed and approvpd by the Superintendent.
4.To audit receipts and di
independent audits, and periodic financ
5. To establish a joint fund or to finance all Consortium expenditures,
including claims, reserves, surplus,stop-loss insurance and other expenses.
6" To select and approve the fits provided by the Plan(s) including the plan
document(s), insurance certificate(s),summary plan description(s), a copy of the plan(s)
effective on the date of this Agreement is by reference into this Agreement.
7. To annually select a plan
Year, prior to October l't of each year.
sultant (the "Plan Consultant") for the upcoming plan
1.
2.
a
To fill any vacancy in any
To fix the frequency, time
sements of the Consortium and provide for
and operatiqnal reports to Participants.
8. To review consider and ac
Consultant.
9. To establish administrative
Consortium consistent with all applicable
{Hr049320.r1\
on any recommendations made by the Plan
idelines fqr the efficient operation of the plan.
10. To establish financial ions for thq entry of new Participants into the
requirements and this Agreement.
1 1. To contract with third parties, which may in{lude one or more Particrpants, for the
fumishing of all goods and services reasonably needed T t+" efficient operation and
administration ofthe Consortium, including, w[thout limita]tion, accounting services, legal
counsel, contract administration services, consulting servicfs, purchase of insurancel and
immedi# family shall be an owner, offrcer, director, partrler or employee.gf 9V contract
administrator retained by the Consortium; and (d) all such {Breements shall otherwise comply
with the requirements of Section 92-a(6) of the General Mr[nicipal Law'
actuarial services. Provided, however (a) the clrarges, fees and other compensation for any
contracted services shall be clearly stated in wilitten adminiltrative services contracts, as required
in Section 92-a(6)of the General ivtunlcipat L.aw; 9) payrnient for contracted services shall be
made only aftersuch services are rendered; (c) no Director or any mlmber of such Dir, ector's
the Consortium and determine each
stop- loss insurance coverage during
ihe next Plan Year, as required by Section 470V of t}lrel Law.
13. To determine and notifu each Participant to October 15ft of each Plan Year
durine the next Plan Year
12. To purchase stop-loss insurance on behalf
vear the insurance carrier or carriers who are to provide t
of the monthly premium equivalent for each enrollee
commencing the following January 1".
14. To designate the banks or trust oomparues which joint funds, including reserve
state, duly chartered under federalfunds, are to be deposited and which shall be located in
it Insurance Corporation, or anylaw or the laws of this state and insured by the Federal
successor thereto.
15. To designate annually a treasuror (the "T ") who may or may not be a
Director and who shall be the treasurer, or equivalent ial officer. for one of the
Participants. The Treasurer's duties shall be de[ermined by
he/she will report.
custody ofall reports, staternents and16. To designate .an Officer'or Director to ret
other documents of the Consortium and take minutes of Board meeting which shall be acted
on by the Board at a subsequent meeting.
17 " To choose the certified public abcountant
required by this Agreement and any applicabld law'
the actuary to provide the rePorts
18. To designate an attorney-in-facf to receive or other legal process in anY
action, suit or proceeding arising out ofany contract,nt or transaction involving the
Consortium. The Board designates John G. Powers, Esq'
fact"
the Consortium's initial attomey-in-
the Chief Fiscal Officer to whom
D. To take all necessary action to onsure that
Certificate of Authority in accordance with thb Insurance
20. To take all necessarY
administered in accordance with the
action to ensure the um is operated and
law of tho State ofN York.
21" To take any other action authorized by law
the purposes of this Agreement.
F. Exncurrvg Conanurrnn'
Consortium obtains and maintains a
{H1049320. I I }
deemed necessary to accomPlish
10
1. The Executive of the Consortium shall consist of the Chairperson, the
Vice-Chairperson, and the Chief Fiscal of the Consortium.
2. The Executive may meet at anytime between meetings of the Board,
at the discretion of the Chairperson.
the Board.
Executive Committee shall make recornmendations to
3" The Executive Committep shall manage the Consortium between meetings ofthe
subject to such approval by the FNoard as may be required by this Agreement.
Orrrcnns.
l. At the Annual Meeting,
Vice Chairperson, Chief Fiscal Officer,
or until their successors are elected and
filled at the next meeting of the Board.
Board shdll elect from its Directors a Chairperson,
2" Officers of the Consorti and employees of any third parry vendor, including
without limitation the officers and empl of any Participant, who assist or participate in the
operation of the Consortium, shall not deemed employees of the Consortium. Each third
parfy vendor shall provide for all services and materials pursuant to annual contracts
with the Consortium. The officers of Consortium shall serve without compensation from the
Consortium, but may be reimbursed for ble out-of-pocket expenses incurred in
connection with the performance of officers' duties.
3. Officers shall serve at the easure of the Board and may be removed or replaced
upon a two-thirds Ql3) vote of the entire This provision shall not be subject to the
weighted voting altemative set forth in
H. Cu.lrnpnnsox: Vrcn
The Chairperson shall be chief executive officer of the Consortium.
The Chairperson, or in absence of the Chairperson, the Vice Chairperson,
shall preside at all meetings of the Board
Secretary, who shall derve for a term of one (l) year
ified. At'ry vacancy in an officer's position shall be
Board,
G.
I.
.)
3. In the absence ofthe
related to that office.
Pr,,lN Aounrrrsrnaton.
The Board,by atwo-thirds (213) vote of
administrator and,/or insurance company
the Vice Chairperson shall perform all duties
entire Board, may annually designate an
the Plan (the "Flan Administrator") and the other
provider(s) who are deemed by the to be qualified to receive, investigate, and recommend
the charges, fees and other compensation for anyor make payment of claims, provided
contracted services shall be clearlv stated written administrative services and/or insurance
contracts and payment for such services shall be made only after such services are
rendered or are reasonably expected to
requirements of Section 92-a(6) ofthe
J. Cnrrr Frscar, Orrrcnn.
rendered. All such contracts shall conform to the
{H104e320.1r }
Municipal Law.
1. The Chief Fiscal Officer shall act as ttre financial administrator of the
shal bL a fiscal officer of a Participant. The Chief Fiscal shall receive no remuneration
from the Consortium. The Plan shall reimbursB the Partici that empioys the Chief Fiscal
Officer for reasonable and necessary out-of-pocket ex incurred by the Chief Fiscal Officer
Consortium and disbursing agent for all paymonts made
custody of all monies either received or expended by the
in connection with the performance of his or her duties
2. All monies collected by the Chi'ef Fiscal
be maintained and administered as a common lund' The
notwithstanding the provisions of the General Municipal
procedures developed by the Board and as deemed
3. The Chief Fiscal Officer shall be bonded
the Consortium, and shall have
ium. The Chief Fiscal Officer
relate to the Consortium.
relating to the Consortium, shall
Fiscal Offrcer shall,
, make payment in accordance with
le to the Superintendent.
all monies received from the
annually by the Consortium in such
Consortium's reserve firnds separate
accounting shall show:
the sale of investnents of the Plan's
of each payment from the reserve
balance and schedule of
and shall fumish to the Board,
the exclusive bargaining
the Superintendent:
Participants. The amount of such bond shall bo established
monies and principal amount as may be requirpd by the Su
connection with the Consortium shall be deposited in
Participant which regularly employs the Chief Fiscal
provisions of law governing the deposit of mupicipal
expenditure in the types of investments specified in the
investments or as otherwise expressly permitted by the
6. The Chief Fiscal Officer shall account for
and apart from all other funds of the Consortiqm, and suc
c. capital
reserve funds;
gains or losses rpsulting
d. the order, pulpose: date and
fund; and
e. the assets of the fund, ihdicating
investments.
7. The Chief Fiscal Officer shall cause to be
to participating municipal eorporations, to unlons which
accountant, of the financial condition, accounting
of the municipal cooperative health bqneflrt plan;
4. All monies collected from the Participants the Chief Fiscal Officer in
with the policies of the
and shall be subject to the
5. The Chief Fiscal Officer may invest not required for immediate
Municipal Law for temPorary
m.
the purpose, source.i date and of each sum paid into the fund;
b. the interest eamed bY such funds;
representatives of Enrollees, the Board's consultants, and
an annual audit, and oPinions by an independent certified public
{H1049320.11}
and internal control sYstems
b. an annual report {nd quarterly reports describing the Consortium's current
financial status; and
c" an annual indepe$dent actuarial opinion on the financial soundness of the
Consortium, including. the actua{ial soundne$s of contribution or premium equivalent
rates and reserves, both as paid iir the current Plan Year and projected for the^next plan
Year"
Within ninety (90) days r the end of each Plan Year, the Chief Fiscal Officer
K.Laron-M,c.NAGEMENT Anvrso Y COIVIIVIITTEE.
L There shall be a Labor-
shall furnish to the Board a detailed
reserve funds.
Management Members, an individual w
of the operations and condition of the Consortium's
tAdvisory Committee (the "Advisory
Committee"), which shall consist of (a)
the exclusive collective bargaining
by the Plan(s) (the "Union Members");(b) a reprpsentative of each Participant (the
"Management Members").Members may, but are not required to be, Directors.
2. The Advisory Committee I review all prospective Board actions in connection
with the benefit structure and desisn of Plan(s), and shall develop findings and
recommendations with respect to such
report such findings and recommendati
The Chair of the Advisory Committee shall
to the Boarrd at any regular or special meeting of the
tsoard. The Committee'sfindings will be to the Board in a timely manner, forconsideration by the Board, in
C o oper ativ e A. gr e e ment.
with the tineline described in the Municipal
3. The Advisory Committee I select (p) from among the Union Members, an
individual who shall serve as Chair of
representative of each collective bargaining unit that is
:ntative of any Enrollee or group of Enrollees covered
Advisory Committee; and (b) from among the
shall serve as Vice Chair of the Advisory Committee.
used for the development of the premium equivalent
'the approval of two-thirds (213) of the entire Board,
The Advisory Committee shall establish own parli4merfiary rules and procedures.
4. Each eligible union shall lish such procedures by which its representative to
the Advisory Committee is chosen and representative shall be designated in writing to the
Chairperson of the Board and the Chair o the Advisory Committee.
L. Pnnnrruivr C,c.Lcul,{rroNsi?A
1. The annual premium equi lent rates shall be established and approved by a
majority of the entire Board. The
rates may be changed from time to time
subject to review and approval by the S rintendent. The premium equivalent rates shall
consist ofsuch rates and catesories of as is se{ forth in the Plan[s] that is determined and
approved by the Board consistent with N York law.
in reserved and stop-loss insurance to the level and
directed !y the Superintendent.
2. The Consortium shall
extent required by the Insurance Law
{H1049320.1 I )
-2la8l
3. Each Participant's monthly premium equiv
be paid by the first day of each calendar month auline l|;
by enrollee classification, shall
Year" A late PaYment charge of
o"" p"t"."t (1%) of the monthly installment t{en au; witl charged by the Board for anY
payment not received by th9 first of.each month' :1ry-business day when the first falls on a
but*auy, Sunday, legai holiday or day observed as a legal liday by the ParticiPants.
The Consortium may waive the first penalty once Plan Year for each ParticiPant, but
to make timelY PaYments, including
justification for the exPulsion
4. The Board shall assess Participants for contributions, if actual and
, and reserve and surPlus
in Section B(3) above.
amounts in excess of reserves and
as an offset to amounts Projected
will strictly enforce the penalty thereafter' A ropeated fai
any applicable penalties, fl&Y be used by the Board as an
of the Participant from the Consortiirm'
anticipated losses due to benefits paid out, adrninistrative
requiiements exceed the amount in the joint fi4nds' as set
5. The Board, in its sole discretiorl' may re
strrplus, or retain such excess amounts and apply these
to be paid under the next Plan Year's budget'
M. EvrPr,oYgn CoxrnmurroNs"
If any Participant requires an Enrollee-9 contributionjol bfnefits nrovided by the Consortium'
the Participant shall coilect such contributions u1t":h tim{ and in sueh amounts as it requires'
However, the failure of a Participant to receive the Enrgll{e contribution on time shall not
diminish or delay the payment oittt" Participdnt's month{ premium equivalent to the
Consortium, as set forth in this Agreement"
N. Annrrroxu,Bnxnrrrs.
or enrollment eligibilitY other
xpense. This Agreement shall not be
rr enrollment eligibility, the additional
[ot later than one-hundred twenty (120)
r report with the SuPerintendent
ium, including an annual independent
he Board shall have PrePared a
ial soundness of the Plan, including the
Any'Partiiipant choosing to provide more benefits' covel
tnan tnat prlvided undeithe Plan(s), will do so at its sole
deemed to aimnistr such Participant's benefitp, coverages
benefits and the payment for such additional benefits'not be part of the Plan(s) and shall be
administered sollty uy ?trtd atthe expense of the Particinaft.
O. RrrontrNc.
The Board, through its offrcers, agents, or delegatees, shafl ensure that the follow reports are
prepared and submitted:
1" Annually after the close of the Plan Year'
days after the close of the Plan Year, t:"Boqd- shall file
showing the financial condition and affairs of the conso
financiil audit statement and independent actuarial opini n, as of the end of the Preceding Plan
year.
2" Annually after the close of the Plan Year' I
statement and independent actuarial opinion on the finanf
{Hro4e32o.r1} 10
contribution or premium equivalent
projected for the next Pian Year.
3. The Board shall file
then current financial status within
year.
FT-
and reservQs, both as paid in the current Plan year and
s with the Superintendent describing the Consortium,s
five (45) days of the end of each quarter during the plan
repo
forty
4. The Board shall provide e annual report to all Participants and all unions, which
madeare the exclusive collective bargaining r presentatives of Enrollees, which shall be
available for review to all Enrollees.
5. The Board shall submit td the Superintendent a report describing any material
changes in any information originally pr$vided i" ttte Certificate of Authority. iurft reports, in
addition to the reports described above,be in such form, and containing such additional
content, as may be required by the Su
P. Wrrgonawnr, orpanrrcrpANT
1. Withdrawal of a partici from the Consortium shall be effective onlv once
annually on the last day of the plan year
2. Notice of intention of a
Chairperson prior to October 3'd of each
automatically extend the Participant's ip and obligations under the Agreement for
another Plan Year, unless the Board shal
vote.
consent to 4n earlier withdrawal by a two-thirds (2/3)
3- Any withdrawin^g Partlcip{nt shait be responsible for its pro rata share of any plan
deficit that exists on the date of the withdfawal, subject io the provisions of subsecti on,,4,, of this
Section. The withdrawing Participant shafl be entitlld to any pro rata share of surplus that exists
on the date of the withdrawal, subject to th. provisions of subsecti orr" ".of this Section. The
Consortium swplus or deficit shall be baded on the surn of actual expenses and the estimated
liability of the Consortium as determined by the Board. These expenses and liabilities will be
determined one (1) year after the end of t{re Plan Year in which *ri narticipant last participated.
4- The surplus or deficit shail]include recognition and offset of any ciaims, expenses,
assets and./or penalties incurred at the tims of withdrawal, but not yet paid. Such pro rata slare
shall be based on the Participant's relative premium contribution to thi Consortium as a
percentage of the aggregate premium con{ibutions to the Consortium during the period of
participation. This percentage amount maJ' then be applied to the surplus orteficit which existed
on the date of the Participant's withdrawaf from the Consortium. Any pro rata surplus amount
due the Participant shall be paid to the Parfticipant one year after the effective date of the
withdrawal" Any pro rata deficit amount sfrall be billed to the Participant by the Consortium one
year after the effective date of the withdrafval and shall be due and payable within thirty (30)
days after the date of such bill.
a. DrssolurroN; RENEwAT,; Exrur,[rox.
1 . The Board at arry time, by { t*o-thira s Ql3) vote of the entire Board, may
determine that the Consortium shall be didsolved and terminated. If such determinationls made,
the Consortium shall be dissolved ninety (pO; days after written notice to the participants.
{H104e320.11} 1 1
cipant withdraw must be given in writing to the
m Year. Failure to give such notice shall
the Superintendent for approval a plan fo1 wind
orderly manner designed to result in tinoely pay
Participant until all Consortium benefits and other
satisfied. The Consortium's surplus or deficit shal
expenses will be determined oile year ater the end
Ajreement or the Consortium terminatps'
each Participant's relative premium corntribution to
aggregate piemium contributions to tho l.lan furin
Agreement, or any amendments or restatements thereto'
nfrfr (Str) anniversary of the Effective Date and on each
(each a "Review Date").
-2la8l
Upon determination to dissolve the um, the Board shall Provide
notice of its determination to the Superintendent'Board shall develoP and submit to
the Consortium's affairs in an
of all benefrts.
shall be responsible for its pro rata sharre of any de
or the Consortium, each Participant
:it or shall be entitled to any pro ratab. Upon termination of this
share of surplus that exists, after the affairs of the ium are closed. No Part of anY
funds of the-Consortium shall be subjeot to the clai of, general creditors of anY
ium obligations have been
be based on actual expenses. these
the Plan Year in which this
c. Any surplus or deficit shall include of any claims/exPenses
incurred at the time of termination, but not yet pai Such pro rata share shall be based on
Plan as a percentage of the
the period of particiPation. This
pii".tttugt amount would then be applied to the or deficit which exists at the time
of termination.
2.The continuation of the Consoritium under terms and conditions of the
be subject to Board review on the
(5th) anniversary date thereafter
a. At the annual meeting a Year Prior the Review Date, the Board shall
include as an agenda item a reminder of the Partici
terms and conditions of the Agreement"
' coming obligation to review thtl
b, During the calendar yedr preceding the Review bate, each ParticiPant
review of the terms and conditions of
a written resolution containing
any proposed modification or
Board on or before March 1*tpreceding the Revi
resolution shall be submitted to the
Date. Failwe to submit anY such
resolution shall be deemed as each Participant's and authori zatian to the
continuation of the Consortium until the next Revi w Date under the existing terms and
conditions of the Agreement.
c" As soon as Practicable after March ls. the Board shall circulate to all
Participants copies of all resolutions submitted by Participants. Subject to Section S
hereof, any resolutions relating to the modi amendment, or objection to the
Agreement submiued prior to each Review Date be considered and voted on bY the
Such special meeting shall be
d. Notwithstanding the foregoing or S hereof, if at the Annual
Meeting following any scheduled Review Date Board votes on and aPProves the
shall be responsible for independently conducting
the Agreernent and submitting to the Board of Dit
any objection to the existing terms and conditions
amendment to the existing Agreementi such writt(
Participants at a special meeting called for such
held on or before July l't preceding the Review
budget-and *trrrul asJessment for the hext year, ttJe Participants
[H1049320.11]t2
shall be deemed to have:
approved the continuation of the
Review Date.
of seventy-five percent (75%) ot
sixty (60) days to correct or cure
Upon the expiration of said sixty
Board may expel the Participant
the Participants (exclusive of the
warrants to each of the other Parti
ium under the existing Agreement until the next
that it may be3. The Participants
circumstances to expel a Participant
thzrt:
necessary in certain exhaordinary
In the event the Board determinesthe Consortium.
a. . a Participanthas {cted inconsibtently with the provisions of the Agreementin a way that t}reatens the financ[al well-beiag or legal validifu of the Consortium; or
b. a Participant has cted fraudulently or has otherwise acted in bad faith
with regards to the Consortium.r toward any individual Participant cpncerning matters
relating to the Consortium, the B ard may vote to conditionaliy terminate said
cnsortium. Upon such a finding by the affirmative voteParticipant's membership in the
Participeints, the offending Participant shall be given
alleged ryrongdoing to the satisfaction of the Board.
60) day period, an absent satisfactory cure, to the
an affirmative vote of seventy-five percent (75%) ot
rticipant Under consideration). This section shall not
Each
and r
be subject to the weighted voting vision provided in Section D.Any liabilities
associated with the Participant's
be determined by the procedures
frofn the Consortium under this provision shall
forth in Section P of this Asreement.
R RnrnnsrNTATroNS lxl W OFPARTICIPANTS.
Participant by its approval of the and conditions of this Agreement hereby represents
as follows:
1. The Participant and acknowledges that its participation in the
of this Agreempnt,is strictly voluntary and may beConsortium under the terms and condi_ ' .ll
ternrinated as set forth herein. at the di ion of the Participant.
2. The Participant and acknowledges that the duly authorized decisions
of the Board constitute the collective wil
the scope of the Agreement.
of each of the Participants as to those matters within
3. The Participant and aoknowledges that the decisions of the Board
made in the best interests of the Consorti
more of the individual Participants.
may on occasion temporarily disadvantage one or
4" The Participant represents
representative understands the terms and
wanants that its designated Director or authorized
onditions of this Agreement and is suitably
experienced to understand the principles which this Consortium operates.
5. The Participant and acknowledges that all Directors, or their
auth.oized representatives, are responsi for attending all scheduled meetings. Provided that
the quorum rules are satisfied,at any scheduled meeting is deemed acquiescence
by the absent Parficipant to any duly ized Board-approved action at the meeting. However,
a Participant that was absent from a meeti will not be presumed to have acquiesced in a
particular action taken at the meeting if,in fifteen (15) calendar days after leaming of such
action, the .L'articipant delivers written nc t
{H1049320.1 I }
ce to the Chairperson that it dissents from such action.
The Participant shall also notiff the other members of the
chairperson shall direct the secretary to file thp notice wi
6. The Participant understands and
Participant,s vote approving any Board action renders that
challenge by that ParticiPant.
chairperson and chief Fiscal officer. The consortium sh
than tirirty (30) days after its receipt thereof, and shall incl
Any change or amendment to this Agreement shall require
Participants, as authorizedby their respective legislative br
Rrcorus.
The Board shall have the custody of all records and including financial records,
associated with the operation of the consortium" Each Par
documents relative to their participation in the Consortium
ipant may request records and
providing a written request to the
I respond to each request no later
all information which can be
provided under aPPlicable law.
T. CnlNcrsroAGREEMENT.
of such dissent. The
the minutes of the Board.
that, absent bad faith or fraud, anY
action immune from later
the unanimous approval of the
waive any right that a covered person
of medical records and that such
CoxrmrxTrAlrrY.
Nothing contained in this Agreemenl shall be ponstrued to
porr.rt-"t under the Plan with respect to the confidentialiq
V.
iigttr will only be waived upon the written consent of covered person.
Ar.rnnnarrvr DTsPUTE REsoLUTIoN (trADR").
1. General. The Participants acknowledge agree that give; their budgeting and
fiscal constraints, it is imperative that any disputes arising of the operation of the Consortium
as quickly as possible.be limited and that any disputes which may arise be
forth in this Section V are intended to
. The Participants also
Participant is limiting its right to
ided.
Participant arising out of or
the Board, the Board's designated or any Participant has failed to
adhere to the terms and conditions of this
b. the Board, the Board's rilesignated
bad faith or fraudulently in undertaking any duty
or any Participant has acted in
action under the Agreement; or
c. any other dispute otherwise arising of or relatins to the terms or
conditions of this Agreement or requiring the i ion of this Agreement shall be
resolved exclusively through the ADR procedure
Accordingly, the Participants agree that the procedures
be the exClusive means through which disputos shall be
acknowledge and agree that by executing this Agreement
seek redress for certain 6/pes of disputes as hereinafter pr
2. Disputes sub-iect to ADR. Any dispute by
relating to a contention that:
{H1049320.1 1 )
forth in paragraph (3) below.
3. ADR Procedure. Any di subject to ADR, as described in subparagraph (2),
shall be resolved exclusively bv the fi ng procedure:
a.Co
dispute, the objecting parfy (the
to the Chairyerson specifying in
have been involved, the specific
il the nature of the dispute, the parties claimed to
Participant's objection, the speci
clairned, the basis under the Agreement for the
objectionable conduct to the
resolution of the dispute. A di shall be dbemed to have occurred on the date the
objecting party knew or y should have known of the basis for the dispute.
within
qn: Within ninety (90) days of the occurrence of any
Claimant") shall submit a written notice of the dispute
c qiury or damages claimed to have been caused by the
rt then ascertainable, and the requested action or
form a recofirmendation
and if so, recommend a
parby shall provide the with any reasonably requested information within
such party's control. The ive Committee shall present its recommendation
to the Board in writing,
upon which it is based,
(i0 Within (60) days of the submission of the Executive
resolution of the dispute, the Board shali convene in a
the dispute and the recommended resolution" The
Committee shall each be entitled to present any
Committee's
special meeting to
argument or material it
Executive Committee
Claimant, collect such
Claimant and the Executi
shall hold discussion and/
The Board's determinati
(60) days of the submission of the written notice, the
as nscessary, request further information from the
information from any other interested party or source,
to whether the Claimant has a valid objection or claim,
resolution of said claim" During such period, each
uding any underlying facts, conclusions or support
Lin such six,ty (60) day period.
m pertinent to the matter before the Board. The Board
debate as appropriate on the dispute and may
set forth in Section D shall not apply to this provision.
shall be deerned final subject to the Claimant's right to
question the Claimant or the Execrrrtive Committep on.their respective
strbntissions. Pursuant to i regular procedures, the Board shall vote on whether
the Claimant has a valid im, and if so, what the fair resolution should be. The
weighted voting
arbitrate as set forth
b. Arbitration. The may challenge any Board decision under
subparagraph (V)(3)(a)(ii) by fili a demand for arbitration with the American
Arbihation As sociation within (30) days ofthe Board's vote (a "Demand"). In the
event a Claimant shall fail to file Demand within thirry (30) days, the Board's decision
shail automatrcally be deemed fi
timely Demand, the arbitrator or
and conclusive. In the event the Participant files a
itration panel may consider the claim:
provided however;
(i) in no event the arbitrator review any action taken by the
Board that occurred three 3) or more )lears prior to when the Chairperson
received notice of the clai
(ii) in no event the arbitrator award damages for any period that
precedes the date the
{H1049320.rr}
twenty-four (24) months.
15
receirved notice of the claim by more than
RA
w.
c. The ParticiPants agree that the set forth in this Section V shall
constitute their exclusive remedy for disputes wi
Mrscrr,r,.LNEous Pnovrsroxs.
the scope of this Section.
1. This instrument constitutes the entire of the ParticiPants with resPect
to the subject matter hereof, and contains the sole of the operating rules of the
3"'":"ilffi:'tirfrt]rt*"nt supersedes any qte"ious Ag{eement' whether oral or written'
&1H:;1H".,i'i; ft;;;i;'ul 1'.. 11a "rg,1flshau
not be invaridated or rendered
i[egat or unenforcJi;;;;,h;*ir" affected by such nofOins or adjudication'
4. This Agreement shall be governed by an! po3:ty:.U in a1o-1d111ewith the laws
of the State of New YIrk. Any claims *-ud. undgr S.-tli+ V(3Xb) except to the extent
otherwise limited therein, shall be governed by New Yo$ substantive law'
5. A11 notices to any party hereunder shall in writing, signed by the parfy giving
or certified mail, retum receiPt
it, shall be sufficiently given or served if sent by regi
requested, hand delivery, 9t ov.gtettJ joy""1 t:T]:",to the parties at the address
alrig"ut"i by each party inwriting' Notice shall be given when transmitted.
rnore counterparts each of whi-c-h - ,
stitute the same Agreement and shall
Agreement.
3" If any article, section, subdivision,_paragraph, sentence, clause, Phrase, provision
or portion of this Agreement shall for *y r.urorr-u" h"ta fr adjudged to be invalid or illegal or
trnenforceable by any court of competeni juripdiction' sucfr article' section' subdivision'
paragraph, sentence, clause, phrase, provision or portion {o adjudged invalid, illegal or
unenforceable shall be deemed separate' Jittin"t alld indepeid:."t*9'h" t1ffT1t:-"-*:-^^
shallbedeemedtobeanoriginalbutallofrdlrichshall
become binding upon the undersigned upon dellv9V to
this Agreement together with a certified copy of the
this Alreement and authorizing its execution'
7 . The provisions of Section V shall survive
withdrawal or expuision of a Participant, and/or dissolut
Chairperson ofan executed coPY of
ion of the legislative body approving
termination of this Agreement,
of the Consortium.
are included for reference onlY8. Article and section headings ln this
and shall not constitute part of this Agreement'
X. Appnov.q'r-, Rl'tmIclrroN, AND ExECUTToN'
1. As a condition precedent to execution ofttiis Municipal coopelltive Agreement
and membership in the Consortium, each ellgible municinal corporation desiring to be
participant shalr obtain legisrative apprwal Jrtrr" terms and conditions of this Agreement by the
municipality' s governing bodY'
z. prior to execution of this Agreement uy a farticipant, the Participant shall provide
the Chairperson with the resolution apprivihg the muni{ipatity's particlnaJion in this
consortium *a ."pr.rrlf upprouirrg til" t.it"'r ana con{iiions of this Municipal cooperative
{Hro4932o,r 1} L6
Agreement. Each presented resolution
Asreement.
3. By executing this
with the approval and ratification
bind the participating municipal
{H1049320.11}
be attaghed to and considered a paxt of this
each sigr{atory warrants that he/she has complied
ents here[n and is otherwise properly authorized to
to the tprms and conditions of this Agreement.
ature Pageq Followl
IN WITNESS WHEREOF, the undersigned has
By:
By:
as of the day and year first above written'
CrrvorIrruc.L
Mayor
CouNrv or TovrPxnvs
Chair of the CountY Legislature
Towx or CAnor,nln
By:
Town Supervisor
TowNorD.lr.rnY
Town Supervisor
TowN orUr.Yssrs
By:
Town Supervisor
Vn r,a,cn or C.lYuclllBrcnrs
By:
Mayor
Vrr,r,,c.cn on Tnulr.c.NSBURG
By:
Mayor
By:
{H1049320.r 1}
this Agreement to be executed
onENrmr,p
Supervisor
or GnoroN
Supervisor
or Irmcl
Supervisor
wN oF DnvonN
Supervisor
TLLAGE or GnoroN
ILLAGE or DnvlrBx
Mayor
By:
Example of W
If 10 Participants have 500 or fewer
enrollees each, under subparagraph ..a"
large Participants get 4 votes each, whi
subparagraph "a" [10] subtacting l, di
subsection 'ob" V1, and rounding the rer
Labor Representative shall have 1 vote.
{Hr049320.11}
Voting Formula under Section D(2)
llees each and? Participants have more than 500
e 10 each get 1 vote" Under subparagraph..b,, the 2
is calculated by taking the total number of votes und^er
ing by the number of eligible participants under
t [4.5] doram to the nearest whole number [a]. The
ive of the votes available to the Participants.