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Home My WebLink About20232729.tiffRESOLUTION RE: APPROVE GROUP MASTER APPLICATION AND THIRD -PARTY DATA SHARING AUTHORIZATION FORM FOR 2024 EMPLOYEE BENEFIT PLAN AND AUTHORIZE CHAIR TO SIGN ELECTRONICALLY - CONTINENTAL AMERICAN INSURANCE COMPANY, DBA AFLAC WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Group Master Application and Third -Party Data Sharing Authorization Form for a 2024 Employee Benefit Plan between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Resources, and Continental American Insurance Company, dba Aflac, with further terms and conditions being as stated in said application and form, and WHEREAS, after review, the Board deems it advisable to approve said application and form, copies of which are attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Group Master Application and Third -Party Data Sharing Authorization Form for a 2024 Employee Benefit Plan between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Resources, and Continental American Insurance Company, dba Aflac, be, and hereby are, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to electronically sign said application and form. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 20th day of September, A.D., 2023. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: ddttvs) C.1 `�; Weld County Clerk to the Board e . Deputy Clerk to the Board County Attorney I Date of signature: ` �3 Cc:PE(ss/510) 1O loci /2.3 2023-2729 PE0035 CorrfrocH Dihso5 BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS -AROUND TITLE: 2024 Aflac Plans DEPARTMENT: Human Resources DATE: 07/19/2023 PERSON REQUESTING: Staci Datteri-Frey, Jill Scott Brief description of the problem/issue: Weld County Human Resources - Benefits Team is requesting to update the three Aflac products that are currently offered to employees. The updated plans will allow for plan enhancements and the opportunity to electronically enroll in the new Workday platform in 2024. What options exist for the Board? (include consequences, impacts, costs, etc. of options): Approve plans and provisions. No cost to the County as these plans are all employee paid only. Sunset all Aflac plans for the upcoming year. Recommendation: Staff recommendation is to approve the updated Aflac plans. These plans are enhanced and easier to enroll in for new and existing employees. Approve Perry L. Buck, Pro-Tem Mike Freeman, Chair Scott K. James Kevin D. Ross Lori Saine Schedule Work Session Other/Comments: je‘r:lill :4* 47,0 zid.11)) 2023-2729 q/ZO 0035 GROUP MASTER APPLICATION Application is hereby made to: Afac. CONTINENTAL AMERICAN INSURANCE COMPANY P.O. Box 427, Columbia, SC 29202 HEALTH COVERAGES: THIS IS A LIMITED BENEFIT HEALTH COVERAGE POLICY AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMUM ESSENTIAL COVERAGE) MAY RESULT IN AN ADDITIONAL PAYMENT WITH YOUR TAXES. By Weld County Full Legal Name of Proposed Policyholder Of Greeley, CO Including (if applicable) City and State in which the Master Policy will be Issued (situs state) (Any Subsidiaries/Affiliates/Divisions) REPRESENTATIONS ARE MADE AS FOLLOWS: General Employee Requirements BA full-time Employee is one who works 20 hours or more per week. An Employee must be Actively at Work on the date he applies for coverage and on the date his Certificate of Insurance becomes effective. An Employee must complete 1O of the month following date of hire (0) days of continuous service to be eligible for coverage. 0Number of eligible Employees: 1800 IOJ The minimum number of enrolled Employees necessary to keep the Group Policy in force*:25 *See separate Hospital Indemnity requirement below HEALTH COVERAGES: If this coverage will replace any existing Aflac individual policy, please be aware that it may be in the insureds' best interest to maintain their individual guaranteed -renewable policy with Aflac via direct bill. Insureds may contact Aflac for an explanation of their options for both continuation or cancellation of any existing coverage. COVERAGE REQUESTED OGROUP ACCIDENT Series 70000 024 Hour Application Reason: 0 New Policy Iji; Change to Existing Policy # Class of Eligible Employees: ®Regular full-time Employees at least age 18 tOSpouses of eligible Employees at least age 18 Plan: Optional Features: 0 Initial Accident Treatment Category (Base Plan) 0 High OHospitalization Category OHigh OAfter Care Category 0 High O Life Change Events Category 0 High OGunshot Wound Rider B $5,000 OWellness Rider 0 High -LT O Organized Athletic Activity Rider 0 Accidental Death Rider The requested Effective Date is 1/1/2024. Rates are guaranteed for 2 year(s) from the Group Policy Effective Date. Premium Contributions: Percentage to be paid by Employee100% Percentage to be paid by Employer0% Will this Group Accident Policy replace any existing Group Accident Policy? Yes❑ No❑ If yes, provide carrier and policy number.' ®GROUP CRITICAL ILLNESS Series 21000 Application Reason: LI New Policy 6t Change to Existing Policy it 11 (0 11 l 0 Other Class of Eligible Employees: ®Regular full-time Employees at least age 18 C02204CO Page 1 of 2 ®Spouses of eligible Employees at least age 18 Optional Features: With Cancer 0 yes Non -Invasive Cancer Benefit Dyes Skin Cancer Benefit: Oyes With Health Screening Benefit: 0 yes TIA: 0 yes Waiver of Premium: Dyes OHeart Event Rider OProgressive Diseases Rider 0 Optional Benefits Rider O Specified Disease Rider 0 Additional Benefits Rider The requested Effective Date is 1/1/2024. Rates are guaranteed for 2 year(s) from the Group Policy Effective Date. Premium Contributions: Percentage to be paid by Employee100% Percentage to be paid by Employer 0% Will this Group Critical Illness Policy replace any existing Group Critical Illness Policy? Yes❑ No❑ If yes, provide carrier and policy number. ISGROUP HOSPITAL INDEMNITY Series 80000 Plan Application Reason: ❑ New Policy X Change to Existing Policy # Class of Eligible Employees: ISRegular full-time Employees at least age 18 ISSpouses of eligible Employees at least age 18 Optional Features: t R€tl Hospitalization (Base Plan) OHigh OHealth Screening Benefit 0 Yes ODependent Child Rider ODependent Spouse Rider ODependent Child Neonatal and Pediatric ICU Rider 0 Other: HSA Compatible The requested Effective Date is 1/1/2024. The minimum number of enrolled Employees necessary to keep the Group Hospital Indemnity Policy in force: 25 Rates are guaranteed for 2 year(s) from the Group Policy Effective Date. Premium Contributions: Percentage to be paid by Employee100% Percentage to be paid by Employer0% Will this Group Hospital Indemnity Policy replace any existing Group Hospital Indemnity Policy? Yes No❑ If yes, provide carrier and policy number: 11 ti) 1 GENERAL AGREEMENT The applicant agrees to transmit the total premiums under the group policy to Continental American Insurance Company at its Home Office when due. The applicant agrees to accept the terms and provisions of the group policy, including its exhibits, riders, endorsements or amendments, if any. No agent or other person except an officer of the Company can make or change any contract or agreement on behalf of Continental American Insurance Company. It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado division of insurance within the department of regulatory agencies. Representative � of the Policyholder Mike Freeman (Prin. Name) (Signature) Date SEP 2 0 2023 Title Board of Weld County Commissioners, Chair State of Signature Colorado C02204CO Page 2 of 2 ,.off - .1a7 THIRD PARTY DATA SHARING AUTHORIZATION This ENROLLMENT INFORMATION AUTHORIZATION (the "Agreement") is effective as of the signature date below, between Weld County (CO) including its affiliates and/or subsidiaries (the "Employer"), and CONTINENTAL AMERICAN INSURANCE COMPANY ("Aflac Group") (collectively the "Parties"). Employer has made Aflac Group insurance products available to its employees that are outlined in the Master Application (the "Products"). Employer has contracted with a third party enrollment platform, Workday ("Vendor"), to act as its agent to facilitate offering the Products to its employees. In doing so, Employer acknowledges that it has contracted with Vendor to serve as its enrollment agent and that Vendor will transmit to Aflac Group certain employee census, enrollment, and/or premium submission information (the "Enrollment Information"). All capitalized terms herein, that are not otherwise defined, shall be defined consistent with HIPAA. In consideration of and reliance upon the below acknowledgements from Employer, Aflac Group agrees to accept the Enrollment Information from Vendor as Employer's enrollment agent. 1. Employer directs Aflac Group to communicate with Vendor on Employer's behalf as Employer's enrollment agent. Employer maintains that such Enrollment Information will not be protected health information ("PHI"), as that term is defined by the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). The Enrollment Information will constitute personally identifiable information ("PII"), as that term is defined by the Gramm -Leach -Bliley Act (GLBA). Employer agrees that if any portion of the Enrollment Information provided to Vendor by Employer should constitute PHI, Employer will enter into a Business Associate Agreement with Vendor, as required under HIPAA. 2. Employer agrees to notify, via e-mail, Aflac Group's Privacy Office (aflacgroupprivacyoffice@aflac.com) immediately, but in no event more than thirty (30) calendar days, after Employer discovers any unauthorized use or disclosure of the Enrollment Information, or if applicable, any HIPAA Breach or Security Incident that impacts the Enrollment Information. Employer agrees to reasonably assist Aflac Group in any resulting investigation. To the extent the Enrollment Information is the subject of the unauthorized use or disclosure, or Breach, or Security Incident, Aflac Group will make any required customer notifications, and report to any federal and state agencies as required by law. 3. Each Party disclaims all liability for claims, damages, losses, lawsuits, settlements, judgments, costs, penalties, and expenses arising out of the other Party's 1) breach of the Agreement, or 2) release or disclosure of the Enrollment Information that was not authorized or violates any law, regulation or practice. This provision shall survive the expiration or termination of this Agreement. 4. This Agreement shall be governed by the laws of the State of Colorado. Aflac Croup 01/2021 Page 1 of 2 5. This Agreement may be executed in the original or by facsimile or other electronic means in any number of counterparts, each of which shall be deemed an original, and all of which together shall constitute one and the same instrument. In consideration of the mutual obligations contained in this Agreement, the sufficiency of which is hereby acknowledged, the Parties agree to the terns and conditions herein. Each of the undersigned represents, warrants, and covenants that he or she has the authority and the right to enter into this Agreement binding the Party on whose behalf the Agreement is executed: Weld County (CO) Mike Freeman op ;' : 5 Signature: Name: Mike Freeman Address: 1150 "O" Street Title: BOCC Chair city/State/Zip: Greeley, CO 80534 9/20/23 970.400.4200 Date: Phone Number: CONTINENTAL AMERICAN INSURANCE COMPANY r3'4 Signature: Name: Robert Ruff SVP, Group Voluntary Benefits Title: Date: Oct 3, 2023 Atlas Group 0I/202I Page 2 of 2 2023 -A7,21 GROUP MASTER APPLICATION AND THIRD -PARTY DATA SHARING AUTHORIZATION FORM FOR 2024 EMPLOYEE BENEFIT PLAN - CONTINENTAL AMERICAN INSURANCE COMPANY, DBA AFLAC APPROVED AS TO SUBSTANCE: Elect d Off <I i ' :'yep. rtment Head APPRO D AS TO FUNDING: e)04 Chief Financial Officer, or Controller APPROVED AS TO FORM: County Attorney New Contract Request Entity Information Entity Name AFLAC INSURANCE Entity ID* @00020465 Contract Name 2024 AFLAC EMPLOYEE BENEFITS PLANS Contract Status CTB REVIEW Contract ID 7305 Contract Lead * MRAIMER [J New Entity? Parent Contract ID Requires Board Approval YES Contract Lead Email mraimer@co.weld.co.us Department Project # Contract Description * HUMAN RESOURCES BENEFITS TEAM IS REQUESTING UPDATES TO THREE AFLAC PRODUCTS TO ALLOW FOR PLAN ENHANCEMENTS AND THE OPPORTUNITY TO ELECTRONICALLY ENROLL WITH WORKDAY APPLICATION PLATFORM IN 2024. Contract Description 2 THERE IS NO COUNTY COST AS THESE PLANS ARE EMPLOYEE PAID. NOTE ATTACHED SIGNED 7/19/23 PASS AROUND. Contract Type * Department Requested BOCC Agenda Due Date APPLICATION HUMAN RESOURCES Date* 09/09/2023 09/13/2023 Amount* Department Email 00.00 CM- Will a work session with BOCC be required?* HumanResources@weld HAD Renewable" gov.com YES Does Contract require Purchasing Dept. to be Department Head Email included? Automatic Renewal CM-HumanResources- NO YES DeptHead@weldgov.com Grant IGA County Attorney GENERAL COUNTY ATTORNEY EMAIL County Attorney Email CM- COUNTYATTORNEY@WE LDGOV.COM If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Termination Notice Period Contact Information Review Date 08/05/2024 Renewal Date* 09/16/2024 Committed Delivery Date Expiration Date Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date Approval Process Department Head Finance Approver Legal Counsel JILL SCOTT CHERYL PATTELLI BRUCE BARKER DH Approved Date Finance Approved Date Legal Counsel Approved Date 09/20/2023 09/20/2023 09/22/2023 Final Approval BOCC Approved Tyler Ref # YES CTB TEMP BOCC Signed Date 09/20/2023 BOCC Agenda Date 09/20/2023 Originator MRAIMER Hello