Employer shall notify Anthem monthly of the Subscribers, dependents, or other individuals that will be or
have become ineligible for benefits under the Plan. Upon receipt of such notice, Anthem shall terminate
coverage effective as of the date specified in the Benefits Booklet. Employer shall give Anthem advance
notice, if possible, of any Member's expected termination and/or retirement. Anthem reserves the right to
limit retroactive terminations to a maximum of 60 days prior to the date notice is received. Anthem shall
credit Employer Administrative Services Fees for such retroactive terminations as indicated in Section 3(A)
of Schedule A.
If Anthem has paid Claims for persons no longer eligible for reasons including, but not limited to, Anthem
having been provided inaccurate eligibility information, or Anthem having received notice of a retroactive
change to enrollment, then Employer shall reimburse Anthem for all unrecovered Paid Claim amounts to
the extent that the amounts have not already been paid by Employer.
b. Employer acknowledges that it or its designee(s) serves as the "plan sponsor, "plan administrator" and
“named fiduciary" as those terms are defined in ERISA. Employer has the discretionary authority and
control over the management of the Plan, and all discretionary authority and responsibility for the
administration of the Plan except as delegated to Anthem in Article 2(c) of this Agreement. Anthem does
not serve as "plan sponsor", "plan administrator" or as the Plan's "named fiduciary". Employer retains all
final authority and responsibility for the Plan and its operation and Anthem is empowered to act on behalf of
Employer in connection with the Plan only as expressly stated in this Agreement or as otherwise agreed to
by the Parties in writing.
Cc. It is understood and agreed that the provision of any notice, election form, or communication and the
collection of any applicable premium or fees required by or associated with Title X of the Consolidated
Omnibus Budget Reconciliation Act of 1985, as amended ("COBRA’), or any other applicable law governing
continuation of health care coverage, shall be the sole responsibility of Employer and not Anthem, except
as otherwise agreed to in a written agreement between the Parties.
d. Employer is solely responsible for compliance with the Family and Medical Leave Act ("FMLA") and, to the
extent applicable to Employers' wellness program(s), for compliance with the Americans with Disabilities
Act, the Internal Revenue Code, federal and state nondiscrimination laws, and other federal and state laws
and regulations governing wellness programs.
e. Employer agrees to and shall collect those contributions from Subscribers that are required by Employer for
participation in the Plan. If Employer elects Anthem's stop loss coverage, Employer shall abide by
Anthem's participation and contribution guidelines.
f. Unless otherwise agreed to by the Parties in writing, Employer shall prepare and distribute SPDs, summary
annual reports, and all notices or summaries of changes or material modifications to the Plan. Employer
shall ensure that when it or its designee prepares the SPD, such SPD will accurately reflect the terms of the
Benefits Booklet.
g. To the extent that Medicare, Medicaid, the Veterans Administration or any other federal or state agency or
entity asserts a reimbursement right against Employer, the Plan, or Anthem pursuant to that agency's or
entity's rights under applicable law with respect to Claims processed by Anthem under this Agreement, the
Employer shall be responsible for reimbursing Anthem any such amounts determined to be owed.
h. Employer shall give notice to Anthem of the expected occurrence of any of the following events (including a
description of the event), with such notice to be given at least 30 days prior to the effective date of the
event, unless such advance notice is prohibited by law or contract in which case, notice will be provided as
soon as practicable:
1. Change of Employer's name;
2. Any merger between or consolidation with another entity where, after such merger or
consolidation, Employer is not the controlling entity;
3. The sale or other transfer of all or substantially all of the assets of either Employer or any
Employer Affiliates or the sale or other transfer of the equity of Employer or any Employer
Affiliates, or:
Enterprise Administrative Services Agreement — Octaber 2012 Master Template 7
City of Nashua 06/17/2013
