12-30-2008 HUCMRegular Meeting
December 30, 2008
Members present: President Donald H. Walser; Vice President David Wetterling,
Secretary Dwight Bordson; Commissioner Craig Lenz; Attorney Marc Sebora; General
Manager Michael Kumm.
Member absent: Commissioner Robert Hantge
President Walser called the meeting to order at 3:00 p.m.
The minutes of the November 25, 2008 regular meeting were reviewed. A motion was
made by Commissioner Lenz, seconded by Vice President Wetterling to approve the
minutes with changes to New Business: “President Walser appointed himselfVice
President Wetterling and Secretary Bordson to a committee to look into compensation
issues.” Motion was unanimously carried.
The minutes of the December 30, 2008 special meeting were reviewed. A motion was
made by Vice President Wetterling, seconded by Secretary Bordson to approve the
minutes as written. Motion was unanimously carried.
GM Kumm presented the November 2008 payables. After discussion, a motion was
made by Secretary Bordson, seconded by Vice President Wetterling to ratify the
November 2008 payables in the amount of $2,960,753.63 (detailed listing in payables
book). Motion was unanimously carried.
GM Kumm presented the November 2008 financial statements/budget year-to-date.
After discussion, a motion was made by Vice President Wetterling, seconded by
Commissioner Lenz to approve the November 2008 financial statements/budget year-
to-date. Motion was unanimously carried.
A resolution to the comp time issue was presented. A motion was made by
Commissioner Lenz, seconded by Vice President Wetterling to approve the following
changes to the overtime provision of the exempt employee handbook:
“Exempt employees may earn compensatory time on an hour-for-hour basis for all
hours worked in excess of 40 hours per week. Exempt employees must use their
compensatory time by December 31 of the year in which it is earned or it will be
forfeited. Accrued compensatory time shall not be paid out to exempt employees upon
separation from employment.”
After further discussion, and to settle current comp time issues for certain employees,
the following was presented:
GM Kumm, electric division director Steve Lancaster, and gas division director
John Webster would be paid for 50% of their accumulated comp time hours.
They could elect to receive payment in 2008, or in 2009, or split the amount
between the two years. We will need to split GM Kumm’s payment in order to
stay within the salary cap.
These three employees would carry over the other 50% of the comp time. That
comp time, and any comp time accruing in 2009, would have to be used by
December 31, 2009, or lost.
Other salaried employees will carry over all accumulated comp time to be used
by December 31, 2009.
In the fall of 2009, we will review the history of comp time taken and used in 2009
to determine whether there is a need for hiring another employee to alleviate the
problem of these three employees not being able to use their comp time.
Motion was made by Vice President Wetterling, seconded by Secretary Bordson
resolving comp time issues and amending the exempt employee handbook. Motion was
unanimously carried with exception for 2009 pursuant to previous motion.
President Walser discussed GM Kumm’s performance review. The board congratulated
Mike on his positive attitude and on how he has advanced the utilities forward. Mike
thanked the board for their professionalism in working with each of them and for the
cooperation in working with the employees of Hutchinson Utilities. A motion was made
by Commissioner Lenz, seconded by Secretary Bordson to approve the performance
review and to approve the salary recommendation. Motion was unanimously carried.
As per our policy review schedule, we need to rescind the budget payment policy
update from February 27, 2002 as this is a part of the policies and requirements
booklet. A motion was made by Commissioner Lenz, seconded by Secretary Bordson to
rescind budget payment policy update from February 27, 2002. Motion was
unanimously carried.
Changes to the budget payment plan were presented. A motion was made by Vice
President Wetterling, seconded by Secretary Bordson to approve changes to budget
payment plan section of the policies and requirements booklet. Motion was unanimously
carried.
As per our policy review schedule, we also need to rescind automatic payment plan
from August 27, 2003 as this a part of the policies and requirements booklet. A motion
was made by Secretary Bordson, seconded by Vice President Wetterling, to rescind
automatic payment plan from August 27, 2003. Motion was unanimously carried.
Changes to the automatic bill payment plan were presented. After discussion, a motion
was made by Vice President Wetterling, seconded by Secretary Bordson to approve the
changes to the automatic bill payment plan section of the policies and requirements
booklet with the suggested changes made by the board. Motion was unanimously
carried.
Business Manager Jan Sifferath presented the Medica contracts. There are two
contracts for approval. One is for the new HSA contract and one is the current contract.
A motion was made by Commissioner Lenz, seconded by Secretary Bordson to
approve the Medica contracts subject to asking for a change to Article 2, Section 2.1:
Term and Renewal. Motion was unanimously carried.
Jan also presented the Midwest Dental Benefits contract. There are no adjustments to
the contract and the administrative fee will be waived. A motion was made
Commissioner Lenz, seconded by Secretary Bordson to approve the Midwest Dental
Benefits contract with Medica. Motion was unanimously carried.
GM Kumm presented changes to the By-Laws. After discussion, a motion was made by
Vice President Wetterling, seconded by Secretary Bordson to change wording only in
Article III: Section 10 – Terms of Commissioners. The word ‘except’ will be added to the
second sentence so that it will read: “Each Commissioner’s term shall expire on
st
except
December 31 of the last year of that Commissioner’s appointed term,
Commissioner shall continue in office until their successor has been appointed and
qualified.” Motion was unanimously carried.
Advertisement for bids for directional drilling contractor for 2009 – 2010 was presented.
This is a labor contract and we obtain bids every two years. A motion was made by
Commissioner Lenz, seconded by Secretary Bordson to approve the advertisement for
bids for directional drilling contractor for 2009 – 2010. Motion was unanimously carried.
The agreement for professional services with Power System Engineering, Inc for
Advanced Metering Infrastructure Services was presented. Discussion was held
regarding the terms and conditions for risk allocation and ownership of documents. After
discussion, a motion was made by Secretary Bordson, seconded by Vice President
Wetterling to table the agreement and look into changing the risk allocation number as
well as changing the ownership of documents. Motion was unanimously carried.
Division reports
Business – Jan Sifferath
The long-term supplier agreement with Border States to provide street
light pole is not yet complete. We’ll continue to follow current procedure
and go out for bids as needed.
League of MN Cities to settle claim by end of week on the new inventory
building. KC Companies to start rebuilding January 12, 2009.
Electric – Steve Lancaster
Finished with 2008 projects – will be working on 2009 projects.
More of the downtown plant beautification project to start in 2009
Gas – John Webster
Finished with 2008 projects – will be working on 2009 projects
GM Kumm reported:
Utilities Plus will no longer provide HUC with a base load contract as of
December of 2009. We will look into acquiring a different base load in
March.
Possible dates for the joint meeting: January 13, 26, 27, & 29. Will contact
Gary Plotz to determine City Council availability.
Will visit with Sue Winter on her comp hours and will resolve any issues so
she does not lose any hours worked.
Legal Update
Nothing to report
Unfinished Business
JoMax claim – This issue has been completed.
New Business
None
There being no further business, a motion was made by Secretary Bordson, seconded
by Vice President Wetterling to adjourn the meeting at 4:41 p.m. Motion was
unanimously carried.
______________________________
Dwight Bordson, Secretary
ATTEST: ___________________________
Donald H. Walser, President
Regular Meeting
December 30, 2008
Members present: President Donald H. Walser; Vice President David Wetterling,
Secretary Dwight Bordson; Commissioner Craig Lenz; Attorney Marc Sebora; General
Manager Michael Kumm.
Member absent: Commissioner Robert Hantge
President Walser called the meeting to order at 3:00 p.m.
The minutes of the November 25, 2008 regular meeting were reviewed. A motion was
made by Commissioner Lenz, seconded by Vice President Wetterling to approve the
minutes with changes to New Business: "President Walser appointed himself -Vise
President Wetterhnq and Secretary Bordson to a committee to look into compensation
issues." Motion was unanimously carried.
The minutes of the December 30, 2008 special meeting were reviewed. A motion was
made by Vice President Wetterling, seconded by Secretary Bordson to approve the
minutes as written. Motion was unanimously carried.
GM Kumm presented the November 2008 payables. After discussion, a motion was
made by Secretary Bordson, seconded by Vice President Wetterling to ratify the
November 2008 payables in the amount of $2,960,753.63 (detailed listing in payables
book). Motion was unanimously carried.
GM Kumm presented the November 2008 financial statements /budget year -to -date.
After discussion, a motion was made by Vice President Wetterling, seconded by
Commissioner Lenz to approve the November 2008 financial statements /budget year -
to -date. Motion was unanimously carried.
A resolution to the comp time issue was presented. A motion was made by
Commissioner Lenz, seconded by Vice President Wetterling to approve the following
changes to the overtime provision of the exempt employee handbook:
"Exempt employees may earn compensatory time on an hour - for -hour basis for all
hours worked in excess of 40 hours per week. Exempt employees must use their
compensatory time by December 31 of the year in which it is earned or it will be
forfeited. Accrued compensatory time shall not be paid out to exempt employees upon
separation from employment."
After further discussion, and to settle current comp time issues for certain employees,
the following was presented:
• GM Kumm, electric division director Steve Lancaster, and gas division director
John Webster would be paid for 50% of their accumulated comp time hours.
They could elect to receive payment in 2008, or in 2009, or split the amount
between the two years. We will need to split GM Kumm's payment in order to
stay within the salary cap.
• These three employees would carry over the other 50% of the comp time. That
comp time, and any comp time accruing in 2009, would have to be used by
December 31, 2009, or lost.
• Other salaried employees will carry over all accumulated comp time to be used
by December 31, 2009.
• In the fall of 2009, we will review the history of comp time taken and used in 2009
to determine whether there is a need for hiring another employee to alleviate the
problem of these three employees not being able to use their comp time.
Motion was made by Vice President Wetterling, seconded by Secretary Bordson
resolving comp time issues and amending the exempt employee handbook. Motion was
unanimously carried with exception for 2009 pursuant to previous motion.
President Walser discussed GM Kumm's performance review. The board congratulated
Mike on his positive attitude and on how he has advanced the utilities forward. Mike
thanked the board for their professionalism in working with each of them and for the
cooperation in working with the employees of Hutchinson Utilities. A motion was made
by Commissioner Lenz, seconded by Secretary Bordson to approve the performance
review and to approve the salary recommendation. Motion was unanimously carried.
As per our policy review schedule, we need to rescind the budget payment policy
update from February 27, 2002 as this is a part of the policies and requirements
booklet. A motion was made by Commissioner Lenz, seconded by Secretary Bordson to
rescind budget payment policy update from February 27, 2002. Motion was
unanimously carried.
Changes to the budget payment plan were presented. A motion was made by Vice
President Wetterling, seconded by Secretary Bordson to approve changes to budget
payment plan section of the policies and requirements booklet. Motion was unanimously
carried.
As per our policy review schedule, we also need to rescind automatic payment plan
from August 27, 2003 as this a part of the policies and requirements booklet. A motion
was made by Secretary Bordson, seconded by Vice President Wetterling, to rescind
automatic payment plan from August 27, 2003. Motion was unanimously carried.
Changes to the automatic bill payment plan were presented. After discussion, a motion
was made by Vice President Wetterling, seconded by Secretary Bordson to approve the
changes to the automatic bill payment plan section of the policies and requirements
booklet with the suggested changes made by the board. Motion was unanimously
carried.
Business Manager Jan Sifferath presented the Medica contracts. There are two
contracts for approval. One is for the new HSA contract and one is the current contract.
A motion was made by Commissioner Lenz, seconded by Secretary Bordson to
approve the Medica contracts subject to asking for a change to Article 2, Section 2.1:
Term and Renewal. Motion was unanimously carried.
Jan also presented the Midwest Dental Benefits contract. There are no adjustments to
the contract and the administrative fee will be waived. A motion was made
Commissioner Lenz, seconded by Secretary Bordson to approve the Midwest Dental
Benefits contract with Medica. Motion was unanimously carried.
GM Kumm presented changes to the By -Laws. After discussion, a motion was made by
Vice President Wetterling, seconded by Secretary Bordson to change wording only in
Article III: Section 10 — Terms of Commissioners. The word `except' will be added to the
second sentence so that it will read: "Each Commissioner's term shall expire on
December 31St of the last year of that Commissioner's appointed term, except
Commissioner shall continue in office until their successor has been appointed and
qualified." Motion was unanimously carried.
Advertisement for bids for directional drilling contractor for 2009 — 2010 was presented.
This is a labor contract and we obtain bids every two years. A motion was made by
Commissioner Lenz, seconded by Secretary Bordson to approve the advertisement for
bids for directional drilling contractor for 2009 — 2010. Motion was unanimously carried.
The agreement for professional services with Power System Engineering, Inc for
Advanced Metering Infrastructure Services was presented. Discussion was held
regarding the terms and conditions for risk allocation and ownership of documents. After
discussion, a motion was made by Secretary Bordson, seconded by Vice President
Wetterling to table the agreement and look into changing the risk allocation number as
well as changing the ownership of documents. Motion was unanimously carried.
Division reports
Business — Jan Sifferath
• The long -term supplier agreement with Border States to provide street
light pole is not yet complete. We'll continue to follow current procedure
and go out for bids as needed.
• League of MN Cities to settle claim by end of week on the new inventory
building. KC Companies to start rebuilding January 12, 2009.
Electric — Steve Lancaster
• Finished with 2008 projects — will be working on 2009 projects.
• More of the downtown plant beautification project to start in 2009
Gas — John Webster
• Finished with 2008 projects — will be working on 2009 projects
GM Kumm reported:
• Utilities Plus will no longer provide HUC with a base load contract as of
December of 2009. We will look into acquiring a different base load in
March.
• Possible dates for the joint meeting: January 13, 26, 27, & 29. Will contact
Gary Plotz to determine City Council availability.
• Will visit with Sue Winter on her comp hours and will resolve any issues so
she does not lose any hours worked.
Legal Update
Nothing to report
Unfinished Business
JoMax claim — This issue has been completed.
New Business
None
There being no further business, a motion was made by Secretary Bordson, seconded
by Vice President Wetterling to adjourn the meeting at 4:41 p.m. Motion was
unanimously carried.
Dwight Bordson, Secretary
ATTEST:
Donald H. Walser, President
1
C
!J
Business Manager Spethman presented budget payment policy update.
Budgets will be reviewed annually and Business Manager Spethman was
given proxy to increase /decrease budget amount if customer's balance is
two or more times the current budget.
General Manager Kadrmas salary was discussed. Commissioner Ackland
made a motion to approve a 3% increase for General Manager Kadrmas,
contingent upon acceptance of exemption filed with the State of
Minnesota. Vice President Lenz seconded the motion and it passed
unanimously. Commissioner Gilmer made a motion to approve a 1 %
merit increase for General Manager Kadrmas, contingent upon
acceptance of exemption filed with the State of Minnesota. Secretary
Walser seconded the motion and it passed unanimously.
There being no further business, the meeting was adjourned.
ATTEST
Donald H. Walser, Secretary
etterling, President
C% L V
Overtime
Exempt employees may earn compensatory time on an hour - for -hour basis for all hours worked
in excess of 40 hours per week, and all hours worked on a weekend except on holidays, for
which compensatory time shall be earned at a rate of 1 and '/z times the base pay rate for each
hour worked. Exempt employees must use their compensatory time within 6 months of earning it
or it will be forfeited. Accrued compensatory time shall not be paid out to exempt employees
upon separation from employment.
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iJ
BUDGET PAYMENT PLAN
A budget payment plan is available for residential customers. The budget amount +ho+
wall be paid eaGh menth is based on the average bull for the previous 12 menths. The
budget arnount is reviewed o - . qg basis and adjustments made by the HIJG-
. Procedures are in place for setting up and reviewing the
budget payment plan calculation. Changes are made at the discretion of the customer
service department based on the customer's average bill from the previous 12 months.
Customers will be notified of any changes. The budget plan and automatic bank
payment plan can be done at the same time.
1
1
1
Adopted March 28, 1994
Amended August 27, 2003
Hutchinson Utilities Commission
Policies
Automatic Payment Plan
Customer must fill out an Authorization for Automatic Payment form. Customer
will receive their monthly utility billing statement showing the payment that will
be made. Customer's utility payment will be made automatically from
customer's checking or savings account on the due date.
A service charge of $30 is added to customer's account for each non - sufficient
funds occurrence. If customer has non - sufficient funds for two consecutive
months, customer will be removed from automatic payment plan.
AUTOMATIC BILL PAYMENT PLAN
Payments may be made directly from withdrawals out of a checking or savings account.
These payments are withdrawn on the date the bill is due. The customer must fill out an
Authorization for Automatic Payment form supplied at by HUC's Business Office. The
customer will receive their monthly utility billing statement showing the payment amount
to be withdrawn. The customer may contact our Customer Service Department before
the amount is withdrawn if they don't agree with the billing or have any questions. The
customer will have approximately 10 days to review their bill before the money is
withdrawn.
If a customer's payment is dishonored has non suffir-aie ^t. f--- vs for two consecutive
months, that customer will be removed from the automatic payment plan. A service
charge of $30 is assessed to customer's account for each dishonored payment
occurrence.
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MASTER GROUP CONTRACT
BETWEEN
HUTCHINSON UTILITIES
AND
MEDICA INSURANCE COMPANY
�/ S,4
MEDICA INSURANCE COMPANY ( "MIC ") CHOICE
MASTER GROUP CONTRACT
ARTICLE 1
INTRODUCTION
This Master Group Contract ( "Contract ") is entered into by and between Medica Insurance Company
( "MIC ") and the employer group identified in Exhibit 1 ( "Employer "). This Contract includes Exhibit 1,
Exhibit 2, the Certificate of Coverage ( "Certificate ") and any Amendments. This Contract is delivered
in the state of Minnesota.
The capitalized terms used in this Contract have the same meanings given those terms defined in the
Certificate, unless otherwise specifically defined in this Contract.
If this Contract is purchased by Employer to provide benefits under an employee welfare benefit plan
governed by the Employee Retirement Income Security Act, 29 U.S.C. 1001, et seq. ("ERISA"), this
Contract is governed by ERISA and, to the extent state law applies, the laws of the State of
Minnesota. If this Contract is not governed by ERISA, it is governed by the laws of the State of
Minnesota. If this Contract is governed by ERISA, any legal action arising out of or relating to this
Contract shall be brought in the federal district court for the district of Minnesota. If this Contract is
not governed by ERISA, any legal action arising out of or relating to this Contract shall be brought in
state court in Hennepin County, Minnesota.
In consideration of payment of the Premiums by the Employer and payment of applicable Deductibles,
Copayments and Coinsurance by or for Members, MIC will provide coverage for the Benefits set forth
in the Certificate and any amendments, subject to all terms and conditions, including limitations and
exclusions, in this Contract.
This Contract replaces and supersedes any previous agreements between Employer and MIC relating
to Benefits.
MIC shall not be deemed or construed to be an employer for any purpose with respect to the
administration or provision of benefits under Employer's welfare benefit plan. MIC shall not be
responsible for fulfilling any duties or obligations of Employer with respect to Employer's benefit plan.
ARTICLE 2
TERM OF CONTRACT
Section 2.1 Term and Renewal. The initial Term of this Contract is set forth in Exhibit 1.
At least 30 days before each Expiration Date, as set forth in Exhibit 1, MIC shall notify Employer of
any modifications to this Contract, including Premiums and Benefits for the next term of this Contract
( "Renewal Terms "). If Employer accepts the Renewal Terms or if Employer and MIC agree on
different Renewal Terms, this Contract is renewed for the additional term, unless MIC terminates this
Contract pursuant to Section 2.2.
1
MIC MGC 05 (8/05)
it
Section 2.2 Termination of This Contract. Employer may terminate this Contract after at least 30
days written notice to MIC. This Contract is guaranteed renewable and will not be terminated by MIC
except for the following reasons and will be effective as stated below. Terminations for the reasons
stated below require at least 30 days written notice from MIC:
(a) Upon notice to an authorized representative of the Employer that Employer failed to pay the
required Premium when due, provided, however, that this Contract can be reinstated pursuant
to Section 5.2. If Employer fails to pay the required Premium within the grace period
described in Section 5.2, the Contract will be terminated, subject to a 30 -day advance written
notice of termination by MIC to Employer. The date of the termination shall be retroactive to
not more than 30 days prior to the effective date of the notice of termination;
(b) On the date specified by MIC because Employer provided MIC with false information material
to the execution of this Contract or to the provision of Benefits under this Contract. MIC has
the right to rescind this Contract back to the effective date;
(c) On the date specified by MIC due to Employer's violation of the participation or contribution
rules as determined by MIC;
(d) Automatically on the date Employer ceases to do business pursuant to 11 U.S.C. Chapter 7;
(e) Automatically on the date Employer ceases to do business for any reason;
(f) On the date specified by MIC, after at least 90 days prior written notice to Employer, that this
Contract is terminated because MIC will no longer issue this particular type of group health
benefit plan within the applicable employer market;
(g) On the date specified by MIC, after at least 180 days prior written notice to the applicable state
authority and Employer, that this Contract will be terminated because MIC will no longer renew
or issue any employer health benefit plan within the applicable employer market;
(h) If this Contract is made available to Employer only through one or more bona fide
associations, on the date specified by MIC after Employer's membership in the association
ceases;
(i) Automatically on the date that Employer fails to maintain any active employees who are
Subscribers;
(j) Any other reasons or grounds permitted by the licensing laws and regulations governing MIC.
Notwithstanding the above, MIC may modify the Premium rate and /or the coverage at renewal.
Nonrenewal of coverage as a result of failure of MIC and the Employer to reach agreement with
respect to modifications in the Premium rate or coverage shall not be considered a failure of MIC to
provide coverage on a guaranteed renewable basis.
MIC MGC 05 (8/05)
Section 2.3 Notice of Termination.
MIC will notify Employer in writing if MIC terminates this Contract for any reason.
In accordance with applicable law, MIC will notify Subscribers in writing if MIC terminates this Contract
pursuant to Section 2.2(a), (d), (f) or (g).
Employer will provide timely written notification to Subscribers in all circumstances for which MIC does
not provide written notification to Subscribers.
Section 2.4 Effect of Termination. In the event of termination of this Contract:
(a) All Benefits under this Contract will end at 12:00 midnight Central Time on the effective date of
termination;
(b) MIC will not be responsible for any Claims for health services received by Members after the
effective date of the termination; and
(c) Employer shall be and shall remain liable to MIC for the payment of any and all Premiums that
are unpaid at the time of termination.
ARTICLE 3
ENROLLMENT AND ELIGIBILITY
Section 3.1 Eligibility. The Eligibility conditions stated in Exhibit 1 of this Contract govern who is
eligible to enroll under this Contract. The eligibility conditions stated in Exhibit 1 are in addition to
those specified in the Certificate.
Section 3.2 Enrollment. The Certificate governs when eligible employees and eligible dependents
may enroll for coverage under this Contract, including the Initial Enrollment Period, Open Enrollment
Period and any applicable Special Enrollment Periods. Employer shall conduct the Initial Enrollment
Period and Open Enrollment Period. Employer shall cooperate with MIC to ensure appropriate
enrollment of Members under the Contract.
Section 3.3 Qualified Medical Child Support Orders. Employer will establish, maintain and
enforce all written procedures for determining whether a child support order is a qualified medical
child support order as defined by ERISA. Employer will provide MIC with notice of such determination
and a copy of the order, along with an application for coverage, within the greater of 30 days after
issuance of the order or the time in which Employer provides notice of its determination to the persons
specified in the order.
When and if Employer receives notice that the child has designated a representative, or of the
existence of a legal guardian or custodial parent of the child, Employer shall promptly notify MIC of
such person(s).
MIC shall have no responsibility for:
(i) establishing, maintaining or enforcing the procedures described above;
(ii) determining whether a support order is qualified; or
MGC 05 (8105)
(iii) providing required notices to the child or the designated representative.
Section 3.4 Eligibility and Enrollment Decisions. Subject to applicable law and the terms of this
Contract, Employer has discretion to determine whether employees and their dependents are eligible
to enroll for coverage under this Contract. MIC shall rely upon Employer's determination regarding an
employee's and /or dependent's eligibility to enroll for coverage under this Contract. The Employer will
be responsible for maintaining information verifying its continuing eligibility and the continuing
eligibility of its eligible Subscribers and eligible Dependents. This information shall be provided to
MIC as reasonably requested by MIC. The Employer shall also maintain written documentation of a
waiver of coverage by an eligible Subscriber or eligible Dependent and provide this documentation to
MIC upon reasonable request.
Section 3.5 Notification. The Employer must notify MIC within 30 days of the effective date of the
Member's initial enrollment application, changes to the Member's name or address, or changes to
enrollment, including if a Member is no longer eligible for coverage.
ARTICLE 4
ELECTRONIC DELIVERY OF INSURANCE DOCUMENTS
The Employer agrees to deliver, as MIC's agent, insurance documents required by law to be furnished
to Subscribers. These documents shall be furnished by MIC to the Employer for delivery to
Subscribers. The Employer shall not modify these documents in any way. The Employer agrees to
deliver such documents electronically to the extent permissible under Title 1 of the Employee
Retirement Income Security Act of 1974, Department of Labor Regulation § 2520.104b -1(c), and
Minn. Stat. § 72A.20, subd. 37. Such documents shall be delivered electronically only to Subscribers
who meet the following requirements: (a) has the ability to access an electronic document effectively
at any location where the Subscriber is reasonably expected to perform his or her duties as an
employee, and (b) with respect to whom access to the plan sponsor's electronic information system is
an integral part of those duties.
The Employer shall implement procedures that ensure actual receipt of these documents and notify
Subscribers of the significance of the materials at the time of delivery. In addition, the Employer shall
inform the recipient of his or her right to request a paper version of these documents, and an
expedient process for doing so. Upon such a request, Employer shall furnish the recipient with paper
copies supplied by MIC. Employer shall inform MIC of individuals who do not qualify for electronic
delivery because they do not meet the requirements regarding access to a computer, or they are not
in the workplace, including but not limited to those on continuation coverage, on retiree coverage, or
covered pursuant to a qualified medical child support order. Employer shall provide the individual's
mailing information to MIC so that MIC can provide the documents.
ARTICLE 5
PREMIUMS
Section 5.1 Monthly Premiums.
The monthly Premiums for this Contract are: set forth in Exhibit 2.
The Premiums are due on the first day of each calendar month. Employer shall pay the Premiums to
MIC at the billing address stated in the Acceptance of Contract.
MIC MGC 05 (8/05)
Employer shall notify MIC in writing:
(a) each month of any changes in the coverage classification of any Subscriber; and
(b) within 30 days after the effective date of enrollments, terminations or other changes regarding
Members.
Section 5.2 Grace Period and Reinstatement. Employer has a grace period of 10 days after the
due date stated in Section 5.1 to pay the monthly Premiums. If Employer fails to pay the Premium,
the Contract will be terminated in accordance with Section 2.2(a). This Contract will be reinstated if
Employer pays all of the Premiums owed on or before the end of the grace period. In the event this
Contract is not reinstated pursuant to this Section, MIC shall not be responsible for any Claims for
health services received by Members after the effective date of the termination.
Section 5.3 Premium Calculation. The monthly Premiums owed by Employer shall be calculated
by MIC using the number of Subscribers in each coverage classification according to MIC's records at
the time of the calculation. Employer may make adjustments to its payment of Premiums for any
additions or terminations of Members submitted by Employer but not yet reflected in MIC's
calculations.
A full calenda{hmonth's Premiums shall be charged for Members whose effective date falls on or
before the 15 day of that clhendar month. No Premium shall be charged for Members whose
effective date falls after the 15 day of that calendar month. With the exception of termination of
coverage due to a Member's death, a Member's coverage may be terminated only at the end of a
calendar month and a full Premium rate for that month will apply. In the case of a Member's death,
that Member's coverage will be terminated on the date of death.
Section 5.4 Retroactive Adjustments. In accordance with applicable law, retroactive adjustments
may be made for any additions or terminations of Members or changes in coverage classifications not
reflected in MIC's records at the time the monthly Premiums were calculated by MIC. However, no
retroactive credit will be granted for any month in which a Member received Benefits. No retroactive
adjustments to enrollment or Premium refund shall be granted for any change occurring more than 60
days prior to the date MIC received notification of the change from Employer.
Notwithstanding the foregoing, Employer shall pay a Premium for any month during which a Member
received Benefits.
Section 5.5 Premium Changes. MIC may change the Premiums after 30 days prior written notice to
Employer.
Section 5.6 Employer Fees. MIC may charge Employer:
(a) a late payment charge in the form of a finance charge of 12% per annum for any Premiums
not received by the due date; and
(b) a service charge for any non - sufficient -fund check received in payment of the Premiums.
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MIC MGC 05 (8/05)
ARTICLE 6
INDEMNIFICATION
MIC will hold harmless and indemnify Employer against any and all claims, liabilities, damages or
judgments asserted against, imposed upon or incurred by Employer, including reasonable attorney
fees and costs, that arise out of MIC's negligent acts or omissions in the discharge of its
responsibilities to a Member.
Employer will hold harmless and indemnify MIC against any and all claims, liabilities, damages or
judgments asserted against, imposed upon or incurred by MIC, including reasonable attorney fees
and costs, that arise out of Employer's or Employer's employees', agents', and representatives'
negligent acts or omissions in the discharge of its or their responsibilities under this Contract.
Employer and MIC shall promptly notify the other of any potential or actual claim for which the other
party may be responsible under this Article 6.
ARTICLE 7
ADMINISTRATIVE SERVICES
The services necessary to administer this Contract and the Benefits provided under it will be provided
in accordance with MIC's or its designee's standard administrative procedures. If Employer requests
such administrative services be provided in a manner other than in accordance with these standard
procedures, including requests for non - standard reports, and if MIC agrees to provide such non-
standard administrative services, Employer shall pay for such services or reports at MIC's or its
designee's then - current charges for such services or reports.
ARTICLE 8
CLERICAL ERROR
A Member will not be deprived of coverage under the Contract because of a clerical error.
Furthermore, a Member will not be eligible for coverage beyond the scheduled termination date
because of a failure to record the termination.
ARTICLE 9
ERISA
When this Contract is entered into by Employer to provide benefits under an employee welfare benefit
plan governed by ERISA, MIC shall not be named as and shall not be the plan administrator of the
employee welfare benefit plan, as that term is used in ERISA. MIC shall only be considered a named
fiduciary for purposes of claims adjudication.
The parties agree that MIC has sole, final, and exclusive discretion to:
(a) interpret and construe the Benefits under the Contract;
(b) interpret and construe the other terms, conditions, limitations and exclusions set out in the
Contract;
(c) change, interpret, modify, withdraw or add Benefits without approval by Members; and
MIC MGC 05 (8/05) 6
(d) make factual determinations related to the Contract and the Benefits.
For purposes of overall cost savings or efficiency, MIC may, in its sole discretion, provide services
that would otherwise not be Benefits. The fact that MIC does so in any particular case shall not in any
way be deemed to require it to do so in other similar cases.
MIC may, from time to time, delegate discretionary authority to other persons or entities providing
services under this Contract.
ARTICLE 10
DATA OWNERSHIP AND USE
Information and data acquired, developed, generated, or maintained by MIC in the course of
performing under this Contract shall be MIC's sole property. Except as this Contract or applicable law
requires otherwise, MIC shall have no obligation to release such information or data to Employer.
MIC may, in its sole discretion, release such information or data to Employer, but only to the extent
permitted by law and subject to any restrictions determined by MIC.
ARTICLE 11
CONTINUATION OF COVERAGE
MIC shall provide coverage under this Contract to those Members who are eligible to continue
coverage under federal or state law.
MIC will not provide any administrative duties with respect to Employer's compliance with federal or
state continuation of coverage laws. All duties of the Employer, including, but not limited to, notifying
Members regarding federal and state law continuation rights and Premium billing and collection,
remain Employer's sole responsibility.
ARTICLE 12
CERTIFICATION OF QUALIFYING COVERAGE FORMS
As required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), MIC will
produce Certification of Qualifying Coverage forms for Members whose coverage under this Contract
terminates or upon request by Members. The Certification of Qualifying Coverage forms will be based
on the eligibility and termination data Employer provides to MIC. Employer shall provide all necessary
eligibility and termination data to MIC in accordance with MIC's data specifications. The Certification
of Qualifying Coverage forms will only include periods of coverage MIC administers under this
Contract.
I
MIC MGC 05 (8/05)
1
ARTICLE 13
AMENDMENTS AND ALTERATIONS
Section 13.1 Standard Amendments. Except as provided in Section 13.2, amendments to this
Contract are effective 30 days after MIC sends Employer a written amendment. Unless regulatory
authorities direct otherwise, Employer's signature will not be required. No MIC agent or broker has
authority to change this Contract or to waive any of its provisions.
Section 13.2 Regulatory Amendment. MIC may amend this Contract to comply with requirements
of state and federal law ( "Regulatory Amendment ") and shall issue to Employer such Regulatory
Amendment and give Employer notice of its effective date. The Regulatory Amendment will not
require Employer's consent and, unless regulatory authorities direct otherwise, Employer's signature
will not be required. Any provision of this Contract that conflicts with the terms of applicable federal or
state laws is deemed amended to conform to the minimum requirements of such laws.
ARTICLE 14
ASSIGNMENT
Neither party shall have the right to assign any of its rights and responsibilities under the Contract to
any person, corporation or entity without the prior written consent of the other party; provided,
however, that MIC may, without the prior written consent of the Employer, assign the Contract to any
entity that controls MIC, is controlled by MIC, or is under common control with MIC. In the event of
assignment, the Contract shall be binding upon and inure to the benefit of each party's successors
and assigns.
ARTICLE 15
DISPUTE RESOLUTION
In the event that any dispute, claim or controversy of any kind or nature relating to this Contract arises
between the parties, the parties agree to meet and make a good faith effort to resolve the dispute.
The party requesting the meeting shall provide the other, in advance of the meeting, with written
notice of the claimed dispute. Upon receipt of the written notice, representatives for each party shall
meet promptly to attempt to resolve the dispute. If a mutually agreeable resolution is not reached
within thirty (30) days following receipt of the written notice, either party may pursue legal action in
accordance with the terms of this Contract. The parties may mutually agree to waive the informal
dispute resolution process set forth herein. Any such waiver must be in writing and executed by both
parties.
MIC MGC 05 (8/05)
ARTICLE 16
TIME LIMIT ON CERTAIN DEFENSES
No statement made by Employer, except a fraudulent statement, shall be used to void this Contract
after it has been in force for a period of 2 years.
ARTICLE 17
RELATIONSHIP BETWEEN PARTIES
The relationship between Employer and any Member is that of Employer and Subscriber, Dependent
or other coverage classification as defined in this Contract.
The relationships between MIC and Network Providers and the relationship between MIC and
Employer are solely contractual relationships between independent contractors. Network Providers
and Employer are not agents or employees of MIC. MIC and its employees are not agents or
employees of Network Providers or Employer.
The relationship between a Network Provider and any Member is that of provider and patient and the
Network Provider is solely responsible for the services provided to any Member.
ARTICLE 18
EMPLOYER RECORDS
Employer shall furnish MIC with all information and proofs that MIC may reasonably require with
regard to any matters pertaining to this Contract. MIC may at any reasonable time inspect all
documents furnished to Employer by an individual in connection with the Benefits, Employer's payroll
records, and any other records pertinent to the Benefits under this Contract.
Unless Employer provides the appropriate written assurances required by 45 CFR 164.504, MIC will
only provide Employer with summary health information (for the purposes of obtaining premium bids
or for modifying, amending or terminating the group health plan only) and information on whether
individuals are participating in the group health plan, or is enrolled in or has disenrolled from the
health plan as provided in 45 CFR 164.504 (f)(1) and the minimum necessary information for
purposes of auditing MIC's operations or services.
ARTICLE 19
NOTICE
Except as provided in Article 2, notice given by MIC to an authorized representative of Employer will
be deemed notice to all Members.
All notices to MIC shall be sent to the address stated in the Acceptance of Contract. All notices to
Employer shall be sent to the persons and addresses stated in the Group Application. All notices to
MIC and Employer shall be deemed delivered:
(a) if delivered in person, on the date delivered in person;
(b) if delivered by a courier, on the date stated by the courier;
MIC MGC 05 (8/05)
1
1
(c) if delivered by an express mail service, on the date stated by the mail service vendor; or
(d) if delivered by United States mail, 3 business days after date of mailing.
A party can change its address for receiving notices by providing the other party a written notice of the
change.
ARTICLE 20
COMMON LAW
No language contained in the Contract constitutes a waiver of MIC's rights under common law.
MIC MGC 05 (8/05) 10
ACCEPTANCE OF CONTRACT
This Contract is deemed accepted by Employer upon the earlier of MIC's receipt of Employer's first
payment of the Premium or upon Employer's execution of this Contract by its duly authorized
representative. This Contract is deemed accepted by MIC upon MIC's deposit of Employer's first
payment of the Premium. Such acceptance renders all terms and provisions herein binding on MIC
and the Employer.
IN WITNESS WHEREOF, MIC has caused this Contract to be executed on this November 11, 2008,
to take effect on the Effective Date stated in Exhibit 1 to this Contract.
MEDICA HEALTH PLANS
MEDICA INSURANCE COMPANY
401 Carlson Parkway
Minnetonka, MN 55305
(952) 992 -2200
Billing Address:
NW 7105
P.O. Box 1450
Minneapolis, MN 55485 -7105
Mailing Address:
P.O. Box 9310
Minneapolis, MN 55440
By:
Tom Henke
Senior Vice President, Commercial Markets
By:
James P. Jacobson
Senior Vice President and Assistant Secretary
MIC MGC 05 (8 /05)
EMPLOYER
Hutchinson Utilities
Address: 225 Michigan Street Southeast
Hutchinson, MN 55350
Telephone: (320) 587 -4746
By:
Title:
Employer Representative:
Jan Sifferath
Date:
i
n
1
IEXHIBIT 1
J
1. Parties. The parties to this Master Group Contract ( "Contract') are Medica Insurance
Company ( "MIC ") and the employer group Hutchinson Utilities ( "Employer "), employer group
number(s) 58506, an employer under Minnesota law and other applicable law.
2. Effective Date and Expiration Date of this Contract. This Contract is effective 01/01/2009
( "Effective Date ") to 12/31/2009 ( "Expiration Date "). All coverage under this Contract begins
at 12:01 a.m. Central Time.
3. Contract Number: MIC CHOICE MN HSA 2500 -100% BPL #: 20106
4. Amendment(s) Number: Calendar Year
5. Eligibility. The following conditions are in addition to those specified in the Certificate:
5.1 Eligibility to Enroll.
A Subscriber, and his or her Dependents who satisfies the eligibility conditions stated in this
Contract are eligible to enroll for coverage under this Contract. Any person who does not
satisfy the definition of Subscriber or Dependent is not eligible for coverage under this
Contract.
A Subscriber and his or her Dependents must meet the eligibility requirements described
below and in the entire Contract.
5.2 Subscriber Definition.
The term "Subscriber" as used in the Contract will include the types of employees and
conditions identified below:
Classifications Applicable Waiting Periods and Effective Dates
1. Employees: Full -time employees New Hires: First of the month following date of hire
working a minimum of 40
hours /week Status Change: First of the month following date of
change
Return: First of the month following date of return
MIC MGC 05 (8/05) Exhibit 1
Page 1
EXHIBIT 2
Premiums
The monthly Premiums for this Contract are:
Subscriber Classifications
Monthly
Premium Rate
Class I
(Single)
MIC Choice
$359.96
Class IV
(Family)
MIC Choice
$912.60
MIC MGC 05 (8/05) Exhibit 2
Page 1
G
1
1
MASTER GROUP CONTRACT
BETWEEN
HUTCHINSON UTILITIES
AND
MEDICA INSURANCE COMPANY
1
1
CU /rz,�-�
MEDICA INSURANCE COMPANY ( "MIC ") CHOICE
MASTER GROUP CONTRACT
ARTICLE 1
INTRODUCTION
This Master Group Contract ( "Contract ") is entered into by and between Medica Insurance Company
( "MIC ") and the employer group identified in Exhibit 1 ( "Employer "). This Contract includes Exhibit 1,
Exhibit 2, the Certificate of Coverage ( "Certificate ") and any Amendments. This Contract is delivered
in the state of Minnesota.
The capitalized terms used in this Contract have the same meanings given those terms defined in the
Certificate, unless otherwise specifically defined in this Contract.
If this Contract is purchased by Employer to provide benefits under an employee welfare benefit plan
governed by the Employee Retirement Income Security Act, 29 U.S.C. 1001, et seq. ( "ERISA"), this
Contract is governed by ERISA and, to the extent state law applies, the laws of the State of
Minnesota. If this Contract is not governed by ERISA, it is governed by the laws of the State of
Minnesota. If this Contract is governed by ERISA, any legal action arising out of or relating to this
Contract shall be brought in the federal district court for the district of Minnesota. If this Contract is
not governed by ERISA, any legal action arising out of or relating to this Contract shall be brought in
state court in Hennepin County, Minnesota.
In consideration of payment of the Premiums by the Employer and payment of applicable Deductibles,
Copayments and Coinsurance by or for Members, MIC will provide coverage for the Benefits set forth
in the Certificate and any amendments, subject to all terms and conditions, including limitations and
exclusions, in this Contract.
This Contract replaces and supersedes any previous agreements between Employer and MIC relating
to Benefits.
MIC shall not be deemed or construed to be an employer for any purpose with respect to the
administration or provision of benefits under Employer's welfare benefit plan. MIC shall not be
responsible for fulfilling any duties or obligations of Employer with respect to Employer's benefit plan.
ARTICLE 2
TERM OF CONTRACT
Section 2.1 Term and Renewal. The initial Term of this Contract is set forth in Exhibit 1.
At least 30 days before each Expiration Date, as set forth in Exhibit 1, MIC shall notify Employer of
any modifications to this Contract, including Premiums and Benefits for the next term of this Contract
( "Renewal Terms "). If Employer accepts the Renewal Terms or if Employer and MIC agree on
different Renewal Terms, this Contract is renewed for the additional term, unless MIC terminates this
Contract pursuant to Section 2.2.
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MIC MGC 05 (8/05)
1
Section 2.2 Termination of This Contract. Employer may terminate this Contract after at least 30
days written notice to MIC. This Contract is guaranteed renewable and will not be terminated by MIC
except for the following reasons and will be effective as stated below. Terminations for the reasons
stated below require at least 30 days written notice from MIC:
(a) Upon notice to an authorized representative of the Employer that Employer failed to pay the
required Premium when due, provided, however, that this Contract can be reinstated pursuant
to Section 5.2. If Employer fails to pay the required Premium within the grace period
described in Section 5.2, the Contract will be terminated, subject to a 30 -day advance written
notice of termination by MIC to Employer. The date of the termination shall be retroactive to
not more than 30 days prior to the effective date of the notice of termination;
(b) On the date specified by MIC because Employer provided MIC with false information material
to the execution of this Contract or to the provision of Benefits under this Contract. MIC has
the right to rescind this Contract back to the effective date;
(c) On the date specified by MIC due to Employer's violation of the participation or contribution
rules as determined by MIC;
(d) Automatically on the date Employer ceases to do business pursuant to 11 U.S.C. Chapter 7;
(e) Automatically on the date Employer ceases to do business for any reason;
(f) On the date specified by MIC, after at least 90 days prior written notice to Employer, that this
Contract is terminated because MIC will no longer issue this particular type of group health
benefit plan within the applicable employer market;
(g) On the date specified by MIC, after at least 180 days prior written notice to the applicable state
authority and Employer, that this Contract will be terminated because MIC will no longer renew
or issue any employer health benefit plan within the applicable employer market;
(h) If this Contract is made available to Employer only through one or more bona fide
associations, on the date specified by MIC after Employer's membership in the association
ceases;
(i) Automatically on the date that Employer fails to maintain any active employees who are
Subscribers;
0) Any other reasons or grounds permitted by the licensing laws and regulations governing MIC.
Notwithstanding the above, MIC may modify the Premium rate and /or the coverage at renewal.
Nonrenewal of coverage as a result of failure of MIC and the Employer to reach agreement with
respect to modifications in the Premium rate or coverage shall not be considered a failure of MIC to
provide coverage on a guaranteed renewable basis.
MIC MGC 05 (8/05)
Section 2.3 Notice of Termination.
MIC will notify Employer in writing if MIC terminates this Contract for any reason.
In accordance with applicable law, MIC will notify Subscribers in writing if MIC terminates this Contract
pursuant to Section 2.2(a), (d), (f) or (g).
Employer will provide timely written notification to Subscribers in all circumstances for which MIC does
not provide written notification to Subscribers.
Section 2.4 Effect of Termination. In the event of termination of this Contract:
(a) All Benefits under this Contract will end at 12:00 midnight Central Time on the effective date of
termination;
(b) MIC will not be responsible for any Claims for health services received by Members after the
effective date of the termination; and
(c) Employer shall be and shall remain liable to MIC for the payment of any and all Premiums that
are unpaid at the time of termination.
ARTICLE 3
ENROLLMENT AND ELIGIBILITY
Section 3.1 Eligibility. The Eligibility conditions stated in Exhibit 1 of this Contract govern who is
eligible to enroll under this Contract. The eligibility conditions stated in Exhibit 1 are in addition to
those specified in the Certificate.
Section 3.2 Enrollment. The Certificate governs when eligible employees and eligible dependents
may enroll for coverage under this Contract, including the Initial Enrollment Period, Open Enrollment
Period and any applicable Special Enrollment Periods. Employer shall conduct the Initial Enrollment
Period and Open Enrollment Period. Employer shall cooperate with MIC to ensure appropriate
enrollment of Members under the Contract.
Section 3.3 Qualified Medical Child Support Orders. Employer will establish, maintain and
enforce all written procedures for determining whether a child support order is a qualified medical
child support order as defined by ERISA. Employer will provide MIC with notice of such determination
and a copy of the order, along with an application for coverage, within the greater of 30 days after
issuance of the order or the time in which Employer provides notice of its determination to the persons
specified in the order.
When and if Employer receives notice that the child has designated a representative, or of the
existence of a legal guardian or custodial parent of the child, Employer shall promptly notify MIC of
such person(s).
MIC shall have no responsibility for:
(i) establishing, maintaining or enforcing the procedures described above;
(ii) determining whether a support order is qualified; or
MIC MGC 05 (8/05)
(iii) providing required notices to the child or the designated representative.
Section 3.4 Eligibility and Enrollment Decisions. Subject to applicable law and the terms of this
Contract, Employer has discretion to determine whether employees and their dependents are eligible
to enroll for coverage under this Contract. MIC shall rely upon Employer's determination regarding an
employee's and /or dependent's eligibility to enroll for coverage under this Contract. The Employer will
be responsible for maintaining information verifying its continuing eligibility and the continuing
eligibility of its eligible Subscribers and eligible Dependents. This information shall be provided to
MIC as reasonably requested by MIC. The Employer shall also maintain written documentation of a
waiver of coverage by an eligible Subscriber or eligible Dependent and provide this documentation to
MIC upon reasonable request.
Section 3.5 Notification. The Employer must notify MIC within 30 days of the effective date of the
Member's initial enrollment application, changes to the Member's name or address, or changes to
enrollment, including if a Member is no longer eligible for coverage.
ARTICLE 4
ELECTRONIC DELIVERY OF INSURANCE DOCUMENTS
The Employer agrees to deliver, as MIC's agent, insurance documents required by law to be furnished
to Subscribers. These documents shall be furnished by MIC to the Employer for delivery to
Subscribers. The Employer shall not modify these documents in any way. The Employer agrees to
deliver such documents electronically to the extent permissible under Title I of the Employee
Retirement Income Security Act of 1974, Department of Labor Regulation § 2520.104b -1(c), and
Minn. Stat. § 72A.20, subd. 37. Such documents shall be delivered electronically only to Subscribers
who meet the following requirements: (a) has the ability to access an electronic document effectively
at any location where the Subscriber is reasonably expected to perform his or her duties as an
employee, and (b) with respect to whom access to the plan sponsor's electronic information system is
an integral part of those duties.
The Employer shall implement procedures that ensure actual receipt of these documents and notify
Subscribers of the significance of the materials at the time of delivery. In addition, the Employer shall
inform the recipient of his or her right to request a paper version of these documents, and an
expedient process for doing so. Upon such a request, Employer shall furnish the recipient with paper
copies supplied by MIC. Employer shall inform MIC of individuals who do not qualify for electronic
delivery because they do not meet the requirements regarding access to a computer, or they are not
in the workplace, including but not limited to those on continuation coverage, on retiree coverage, or
covered pursuant to a qualified medical child support order. Employer shall provide the individual's
mailing information to MIC so that MIC can provide the documents.
ARTICLE 5
PREMIUMS
Section 5.1 Monthly Premiums.
The monthly Premiums for this Contract are: set forth in Exhibit 2.
The Premiums are due on the first day of each calendar month. Employer shall pay the Premiums to
MIC at the billing address stated in the Acceptance of Contract.
MIC MGC 05 (8/05) 4
Employer shall notify MIC in writing:
(a) each month of any changes in the coverage classification of any Subscriber; and
(b) within 30 days after the effective date of enrollments, terminations or other changes regarding
Members.
Section 5.2 Grace Period and Reinstatement. Employer has a grace period of 10 days after the
due date stated in Section 5.1 to pay the monthly Premiums. If Employer fails to pay the Premium,
the Contract will be terminated in accordance with Section 2.2(a). This Contract will be reinstated if
Employer pays all of the Premiums owed on or before the end of the grace period. In the event this
Contract is not reinstated pursuant to this Section, MIC shall not be responsible for any Claims for
health services received by Members after the effective date of the termination.
Section 5.3 Premium Calculation. The monthly Premiums owed by Employer shall be calculated
by MIC using the number of Subscribers in each coverage classification according to MIC's records at
the time of the calculation. Employer may make adjustments to its payment of Premiums for any
additions or terminations of Members submitted by Employer but not yet reflected in MIC's
calculations.
A full calends {h month's Premiums shall be charged for Members whose effective date falls on or
before the 15 day of that cEendar month. No Premium shall be charged for Members whose
effective date falls after the 15 day of that calendar month. With the exception of termination of
coverage due to a Member's death, a Member's coverage may be terminated only at the end of a
calendar month and a full Premium rate for that month will apply. In the case of a Member's death,
that Member's coverage will be terminated on the date of death.
Section 5.4 Retroactive Adjustments. In accordance with applicable law, retroactive adjustments
may be made for any additions or terminations of Members or changes in coverage classifications not
reflected in MIC's records at the time the monthly Premiums were calculated by MIC. However, no
retroactive credit will be granted for any month in which a Member received Benefits. No retroactive
adjustments to enrollment or Premium refund shall be granted for any change occurring more than 60
days prior to the date MIC received notification of the change from Employer.
Notwithstanding the foregoing, Employer shall pay a Premium for any month during which a Member
received Benefits.
Section 5.5 Premium Changes. MIC may change the Premiums after 30 days prior written notice to
Employer.
Section 5.6 Employer Fees. MIC may charge Employer:
(a) a late payment charge in the form of a finance charge of 12% per annum for any Premiums
not received by the due date; and
(b) a service charge for any non - sufficient -fund check received in payment of the Premiums.
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MIC MGC 05 (8105)
ARTICLE 6
INDEMNIFICATION
MIC will hold harmless and indemnify Employer against any and all claims, liabilities, damages or
judgments asserted against, imposed upon or incurred by Employer, including reasonable attorney
fees and costs, that arise out of MIC's negligent acts or omissions in the discharge of its
responsibilities to a Member.
Employer will hold harmless and indemnify MIC against any and all claims, liabilities, damages or
judgments asserted against, imposed upon or incurred by MIC, including reasonable attorney fees
and costs, that arise out of Employer's or Employer's employees', agents', and representatives'
negligent acts or omissions in the discharge of its or their responsibilities under this Contract.
Employer and MIC shall promptly notify the other of any potential or actual claim for which the other
party may be responsible under this Article 6.
ARTICLE 7
ADMINISTRATIVE SERVICES
The services necessary to administer this Contract and the Benefits provided under it will be provided
in accordance with MIC's or its designee's standard administrative procedures. If Employer requests
such administrative services be provided in a manner other than in accordance with these standard
procedures, including requests for non - standard reports, and if MIC agrees to provide such non-
standard administrative services, Employer shall pay for such services or reports at MIC's or its
designee's then - current charges for such services or reports.
ARTICLE 8
CLERICAL ERROR
A Member will not be deprived of coverage under the Contract because of a clerical error.
Furthermore, a Member will not be eligible for coverage beyond the scheduled termination date
because of a failure to record the termination.
ARTICLE 9
ERISA
When this Contract is entered into by Employer to provide benefits under an employee welfare benefit
plan governed by ERISA, MIC shall not be named as and shall not be the plan administrator of the
employee welfare benefit plan, as that term is used in ERISA. MIC shall only be considered a named
fiduciary for purposes of claims adjudication.
The parties agree that MIC has sole, final, and exclusive discretion to:
(a) interpret and construe the Benefits under the Contract;
(b) interpret and construe the other terms, conditions, limitations and exclusions set out in the
Contract;
(c) change, interpret, modify, withdraw or add Benefits without approval by Members; and
05(8/05)
(d) make factual determinations related to the Contract and the Benefits
For purposes of overall cost savings or efficiency, MIC may, in its sole discretion, provide services
that would otherwise not be Benefits. The fact that MIC does so in any particular case shall not in any
way be deemed to require it to do so in other similar cases.
MIC may, from time to time, delegate discretionary authority to other persons or entities providing
services under this Contract.
ARTICLE 10
DATA OWNERSHIP AND USE
Information and data acquired, developed, generated, or maintained by MIC in the course of
performing under this Contract shall be MIC's sole property. Except as this Contract or applicable law
requires otherwise, MIC shall have no obligation to release such information or data to Employer.
MIC may, in its sole discretion, release such information or data to Employer, but only to the extent
permitted by law and subject to any restrictions determined by MIC.
ARTICLE 11
CONTINUATION OF COVERAGE
MIC shall provide coverage under this Contract to those Members who are eligible to continue
coverage under federal or state law.
MIC will not provide any administrative duties with respect to Employer's compliance with federal or
state continuation of coverage laws. All duties of the Employer, including, but not limited to, notifying
Members regarding federal and state law continuation rights and Premium billing and collection,
remain Employer's sole responsibility.
ARTICLE 12
CERTIFICATION OF QUALIFYING COVERAGE FORMS
As required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), MIC will
produce Certification of Qualifying Coverage forms for Members whose coverage under this Contract
terminates or upon request by Members. The Certification of Qualifying Coverage forms will be based
on the eligibility and termination data Employer provides to MIC. Employer shall provide all necessary
eligibility and termination data to MIC in accordance with MIC's data specifications. The Certification
of Qualifying Coverage forms will only include periods of coverage MIC administers under this
Contract.
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MIC MGC 05 (8/05)
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ARTICLE 13
AMENDMENTS AND ALTERATIONS
Section 13.1 Standard Amendments. Except as provided in Section 13.2, amendments to this
Contract are effective 30 days after MIC sends Employer a written amendment. Unless regulatory
authorities direct otherwise, Employer's signature will not be required. No MIC agent or broker has
authority to change this Contract or to waive any of its provisions.
Section 13.2 Regulatory Amendment. MIC may amend this Contract to comply with requirements
of state and federal law ( "Regulatory Amendment ") and shall issue to Employer such Regulatory
Amendment and give Employer notice of its effective date. The Regulatory Amendment will not
require Employer's consent and, unless regulatory authorities direct otherwise, Employer's signature
will not be required. Any provision of this Contract that conflicts with the terms of applicable federal or
state laws is deemed amended to conform to the minimum requirements of such laws.
ARTICLE 14
ASSIGNMENT
Neither party shall have the right to assign any of its rights and responsibilities under the Contract to
any person, corporation or entity without the prior written consent of the other party; provided,
however, that MIC may, without the prior written consent of the Employer, assign the Contract to any
entity that controls MIC, is controlled by MIC, or is under common control with MIC. In the event of
assignment, the Contract shall be binding upon and inure to the benefit of each party's successors
and assigns.
ARTICLE 15
DISPUTE RESOLUTION
In the event that any dispute, claim or controversy of any kind or nature relating to this Contract arises
between the parties, the parties agree to meet and make a good faith effort to resolve the dispute.
The party requesting the meeting shall provide the other, in advance of the meeting, with written
notice of the claimed dispute. Upon receipt of the written notice, representatives for each party shall
meet promptly to attempt to resolve the dispute. If a mutually agreeable resolution is not reached
within thirty (30) days following receipt of the written notice, either party may pursue legal action in
accordance with the terms of this Contract. The parties may mutually agree to waive the informal
dispute resolution process set forth herein. Any such waiver must be in writing and executed by both
parties.
MIC MGC 05 (8/05)
ARTICLE 16
TIME LIMIT ON CERTAIN DEFENSES
No statement made by Employer, except a fraudulent statement, shall be used to void this Contract
after it has been in force for a period of 2 years.
ARTICLE 17
RELATIONSHIP BETWEEN PARTIES
The relationship between Employer and any Member is that of Employer and Subscriber, Dependent
or other coverage classification as defined in this Contract.
The relationships between MIC and Network Providers and the relationship between MIC and
Employer are solely contractual relationships between independent contractors. Network Providers
and Employer are not agents or employees of MIC. MIC and its employees are not agents or
employees of Network Providers or Employer.
The relationship between a Network Provider and any Member is that of provider and patient and the
Network Provider is solely responsible for the services provided to any Member.
ARTICLE 18
EMPLOYER RECORDS
Employer shall furnish MIC with all information and proofs that MIC may reasonably require with
regard to any matters pertaining to this Contract. MIC may at any reasonable time inspect all
documents furnished to Employer by an individual in connection with the Benefits, Employer's payroll
records, and any other records pertinent to the Benefits under this Contract.
Unless Employer provides the appropriate written assurances required by 45 CFR 164.504, MIC will
only provide Employer with summary health information (for the purposes of obtaining premium bids
or for modifying, amending or terminating the group health plan only) and information on whether
individuals are participating in the group health plan, or is enrolled in or has disenrolled from the
health plan as provided in 45 CFR 164.504 (f)(1) and the minimum necessary information for
purposes of auditing MIC's operations or services.
ARTICLE 19
NOTICE
Except as provided in Article 2, notice given by MIC to an authorized representative of Employer will
be deemed notice to all Members.
All notices to MIC shall be sent to the address stated in the Acceptance of Contract. All notices to
Employer shall be sent to the persons and addresses stated in the Group Application. All notices to
MIC and Employer shall be deemed delivered:
(a) if delivered in person, on the date delivered in person;
(b) if delivered by a courier, on the date stated by the courier;
MIC MGC 05 (8/05) 9
1
n
(c) if delivered by an express mail service, on the date stated by the mail service vendor; or
(d) if delivered by United States mail, 3 business days after date of mailing.
A party can change its address for receiving notices by providing the other party a written notice of the
change.
ARTICLE 20
COMMON LAW
No language contained in the Contract constitutes a waiver of MIC's rights under common law.
MIC MGC 05 (8105) 10
ACCEPTANCE OF CONTRACT
This Contract is deemed accepted by Employer upon the earlier of MIC's receipt of Employer's first
payment of the Premium or upon Employer's execution of this Contract by its duly authorized
representative. This Contract is deemed accepted by MIC upon MIC's deposit of Employer's first
payment of the Premium. Such acceptance renders all terms and provisions herein binding on MIC
and the Employer.
IN WITNESS WHEREOF, MIC has caused this Contract to be executed on this November 11, 2008,
to take effect on the Effective Date stated in Exhibit 1 to this Contract.
MEDICA HEALTH PLANS
MEDICA INSURANCE COMPANY
401 Carlson Parkway
Minnetonka, MN 55305
(952) 992 -2200
Billing Address:
NW 7105
P.O. Box 1450
Minneapolis, MN 55485 -7105
Mailing Address:
P.O. Box 9310
Minneapolis, MN 55440
By:
X�
Tom Henke
Senior Vice President, Commercial Markets
By:
James P. Jacobson
Senior Vice President and Assistant Secretary
EMPLOYER
Hutchinson Utilities
Address: 225 Michigan Street Southeast
Hutchinson, MN 55350
Telephone: (320) 587 -4746
By: _Ljpc W,
Title: vnLz�
Employer Representative:
Jan Sifferath
Date:
MIC MGC 05 (8105) 11
1
1
1
IEXHIBIT 1
1
1. Parties. The parties to this Master Group Contract ( "Contract ") are Medica Insurance
Company ( "MIC ") and the employer group Hutchinson Utilities ( "Employer "), employer group
number(s) 48963, an employer under Minnesota law and other applicable law.
2. Effective Date and Expiration Date of this Contract. This Contract is effective 01/01/2009
( "Effective Date ") to 12/31/2009 ( "Expiration Date "). All coverage under this Contract begins
at 12:01 a.m. Central Time.
3. Contract Number: MIC CHOICE MN 300 -15 BPL #: 35574
4. Amendment(s) Number: Amendments attached as applicable for benefit package log (BPL)
as listed above
5. Eligibility. The following conditions are in addition to those specified in the Certificate:
5.1 Eligibility to Enroll.
A Subscriber, and his or her Dependents who satisfies the eligibility conditions stated in this
Contract are eligible to enroll for coverage under this Contract. Any person who does not
satisfy the definition of Subscriber or Dependent is not eligible for coverage under this
Contract.
A Subscriber and his or her Dependents must meet the eligibility requirements described
below and in the entire Contract.
5.2 Subscriber Definition.
The term "Subscriber" as used in the Contract will include the types of employees and
conditions identified below:
Classifications
1. Employees: Full -time employees
working a minimum of 40
hours /week
Applicable Waiting Periods and Effective Dates
New Hires: First of the month following date of hire
Status Change: First of the month following date of
change
Return: First of the month following date of return
MIC MGC 05 (8/05) Exhibit 1
Page 1
EXHIBIT 2
Premiums
The monthly Premiums for this Contract are:
Subscriber Classifications
Monthly
Premium Rate
Class I
(Single)
MIC Choice
$567.73
Class IV
(Family)
MIC Choice
$1,439.37
MIC MGC 05 (8/05) Exhibit 2
Page 1
1
1
1
MASTER GROUP CONTRACT
BETWEEN
HUTCHINSON UTILITIES
AND
MEDICA INSURANCE COMPANY
J
i�
C U /\� r�� �-
MEDICA INSURANCE COMPANY ( "MIC ") CHOICE
MASTER GROUP CONTRACT
ARTICLE 1
INTRODUCTION
This Master Group Contract ( "Contract ") is entered into by and between Medica Insurance Company
( "MIC ") and the employer group identified in Exhibit 1 ( "Employer "). This Contract includes Exhibit 1,
Exhibit 2, the Certificate of Coverage ( "Certificate ") and any Amendments. This Contract is delivered
in the state of Minnesota.
The capitalized terms used in this Contract have the same meanings given those terms defined in the
Certificate, unless otherwise specifically defined in this Contract.
If this Contract is purchased by Employer to provide benefits under an employee welfare benefit plan
governed by the Employee Retirement Income Security Act, 29 U.S.C. 1001, et seq. ( "ERISA "), this
Contract is governed by ERISA and, to the extent state law applies, the laws of the State of
Minnesota. If this Contract is not governed by ERISA, it is governed by the laws of the State of
Minnesota. If this Contract is governed by ERISA, any legal action arising out of or relating to this
Contract shall be brought in the federal district court for the district of Minnesota. If this Contract is
not governed by ERISA, any legal action arising out of or relating to this Contract shall be brought in
state court in Hennepin County, Minnesota.
In consideration of payment of the Premiums by the Employer and payment of applicable Deductibles,
Copayments and Coinsurance by or for Members, MIC will provide coverage for the Benefits set forth
in the Certificate and any amendments, subject to all terms and conditions, including limitations and
exclusions, in this Contract.
This Contract replaces and supersedes any previous agreements between Employer and MIC relating
to Benefits.
MIC shall not be deemed or construed to be an employer for any purpose with respect to the
administration or provision of benefits under Employer's welfare benefit plan. MIC shall not be
responsible for fulfilling any duties or obligations of Employer with respect to Employer's benefit plan.
ARTICLE 2
TERM OF CONTRACT
Section 2.1 Term and Renewal. The initial Term of this Contract is set forth in Exhibit 1.
At least 30 days before each Expiration Date, as set forth in Exhibit 1, MIC shall notify Employer of
any modifications to this Contract, including Premiums and Benefits for the next term of this Contract
( "Renewal Terms "). If Employer accepts the Renewal Terms or if Employer and MIC agree on
different Renewal Terms, this Contract is renewed for the additional term, unless MIC terminates this
Contract pursuant to Section 2.2.
MIC MGC 05 (8/05) 1
1
Section 2.2 Termination of This Contract. Employer may terminate this Contract after at least 30
days written notice to MIC. This Contract is guaranteed renewable and will not be terminated by MIC
except for the following reasons and will be effective as stated below. Terminations for the reasons
stated below require at least 30 days written notice from MIC:
(a) Upon notice to an authorized representative of the Employer that Employer failed to pay the
required Premium when due, provided, however, that this Contract can be reinstated pursuant
to Section 5.2. If Employer fails to pay the required Premium within the grace period
described in Section 5.2, the Contract will be terminated, subject to a 30 -day advance written
notice of termination by MIC to Employer. The date of the termination shall be retroactive to
not more than 30 days prior to the effective date of the notice of termination;
(b) On the date specified by MIC because Employer provided MIC with false information material
to the execution of this Contract or to the provision of Benefits under this Contract. MIC has
the right to rescind this Contract back to the effective date;
(c) On the date specified by MIC due to Employer's violation of the participation or contribution
rules as determined by MIC;
(d) Automatically on the date Employer ceases to do business pursuant to 11 U.S.C. Chapter 7;
(e) Automatically on the date Employer ceases to do business for any reason;
(f) On the date specified by MIC, after at least 90 days prior written notice to Employer, that this
Contract is terminated because MIC will no longer issue this particular type of group health
benefit plan within the applicable employer market;
(g) On the date specified by MIC, after at least 180 days prior written notice to the applicable state
authority and Employer, that this Contract will be terminated because MIC will no longer renew
or issue any employer health benefit plan within the applicable employer market;
(h) If this Contract is made available to Employer only through one or more bona fide
associations, on the date specified by MIC after Employer's membership in the association
ceases;
(i) Automatically on the date that Employer fails to maintain any active employees who are
Subscribers;
(j) Any other reasons or grounds permitted by the licensing laws and regulations governing MIC.
Notwithstanding the above, MIC may modify the Premium rate and /or the coverage at renewal.
Nonrenewal of coverage as a result of failure of MIC and the Employer to reach agreement with
respect to modifications in the Premium rate or coverage shall not be considered a failure of MIC to
provide coverage on a guaranteed renewable basis.
MIC MGC 05 (8/05) 2
Section 2.3 Notice of Termination.
MIC will notify Employer in writing if MIC terminates this Contract for any reason.
In accordance with applicable law, MIC will notify Subscribers in writing if MIC terminates this Contract
pursuant to Section 2.2(a), (d), (f) or (g).
Employer will provide timely written notification to Subscribers in all circumstances for which MIC does
not provide written notification to Subscribers.
Section 2.4 Effect of Termination. In the event of termination of this Contract:
(a) All Benefits under this Contract will end at 12:00 midnight Central Time on the effective date of
termination;
(b) MIC will not be responsible for any Claims for health services received by Members after the
effective date of the termination; and
(c) Employer shall be and shall remain liable to MIC for the payment of any and all Premiums that
are unpaid at the time of termination.
ARTICLE 3
ENROLLMENT AND ELIGIBILITY
Section 3.1 Eligibility. The Eligibility conditions stated in Exhibit 1 of this Contract govern who is
eligible to enroll under this Contract. The eligibility conditions stated in Exhibit 1 are in addition to
those specified in the Certificate.
Section 3.2 Enrollment. The Certificate governs when eligible employees and eligible dependents
may enroll for coverage under this Contract, including the Initial Enrollment Period, Open Enrollment
Period and any applicable Special Enrollment Periods. Employer shall conduct the Initial Enrollment
Period and Open Enrollment Period. Employer shall cooperate with MIC to ensure appropriate
enrollment of Members under the Contract.
Section 3.3 Qualified Medical Child Support Orders. Employer will establish, maintain and
enforce all written procedures for determining whether a child support order is a qualified medical
child support order as defined by ERISA. Employer will provide MIC with notice of such determination
and a copy of the order, along with an application for coverage, within the greater of 30 days after
issuance of the order or the time in which Employer provides notice of its determination to the persons
specified in the order.
When and if Employer receives notice that the child has designated a representative, or of the
existence of a legal guardian or custodial parent of the child, Employer shall promptly notify MIC of
such person(s).
MIC shall have no responsibility for:
(i) establishing, maintaining or enforcing the procedures described above;
(ii) determining whether a support order is qualified; or
MIC MGC 05 (8/05)
(iii) providing required notices to the child or the designated representative.
Section 3.4 Eligibility and Enrollment Decisions. Subject to applicable law and the terms of this
Contract, Employer has discretion to determine whether employees and their dependents are eligible
to enroll for coverage under this Contract. MIC shall rely upon Employer's determination regarding an
employee's and /or dependent's eligibility to enroll for coverage under this Contract. The Employer will
be responsible for maintaining information verifying its continuing eligibility and the continuing
eligibility of its eligible Subscribers and eligible Dependents. This information shall be provided to
MIC as reasonably requested by MIC. The Employer shall also maintain written documentation of a
waiver of coverage by an eligible Subscriber or eligible Dependent and provide this documentation to
MIC upon reasonable request.
Section 3.5 Notification. The Employer must notify MIC within 30 days of the effective date of the
Member's initial enrollment application, changes to the Member's name or address, or changes to
enrollment, including if a Member is no longer eligible for coverage.
ARTICLE 4
ELECTRONIC DELIVERY OF INSURANCE DOCUMENTS
The Employer agrees to deliver, as MIC's agent, insurance documents required by law to be furnished
to Subscribers. These documents shall be furnished by MIC to the Employer for delivery to
Subscribers. The Employer shall not modify these documents in any way. The Employer agrees to
deliver such documents electronically to the extent permissible under Title I of the Employee
Retirement Income Security Act of 1974, Department of Labor Regulation § 2520.104b -1(c), and
Minn. Stat. § 72A.20, subd. 37. Such documents shall be delivered electronically only to Subscribers
who meet the following requirements: (a) has the ability to access an electronic document effectively
at any location where the Subscriber is reasonably expected to perform his or her duties as an
employee, and (b) with respect to whom access to the plan sponsor's electronic information system is
an integral part of those duties.
The Employer shall implement procedures that ensure actual receipt of these documents and notify
Subscribers of the significance of the materials at the time of delivery. In addition, the Employer shall
inform the recipient of his or her right to request a paper version of these documents, and an
expedient process for doing so. Upon such a request, Employer shall furnish the recipient with paper
copies supplied by MIC. Employer shall inform MIC of individuals who do not qualify for electronic
delivery because they do not meet the requirements regarding access to a computer, or they are not
in the workplace, including but not limited to those on continuation coverage, on retiree coverage, or
covered pursuant to a qualified medical child support order. Employer shall provide the individual's
mailing information to MIC so that MIC can provide the documents.
ARTICLE 5
PREMIUMS
Section 5.1 Monthly Premiums.
The monthly Premiums for this Contract are: set forth in Exhibit 2.
The Premiums are due on the first day of each calendar month. Employer shall pay the Premiums to
MIC at the billing address stated in the Acceptance of Contract.
MIC MGC 05 (8/05)
Employer shall notify MIC in writing:
(a) each month of any changes in the coverage classification of any Subscriber; and
(b) within 30 days after the effective date of enrollments, terminations or other changes regarding
Members.
Section 5.2 Grace Period and Reinstatement. Employer has a grace period of 10 days after the
due date stated in Section 5.1 to pay the monthly Premiums. If Employer fails to pay the Premium,
the Contract will be terminated in accordance with Section 2.2(a). This Contract will be reinstated if
Employer pays all of the Premiums owed on or before the end of the grace period. In the event this
Contract is not reinstated pursuant to this Section, MIC shall not be responsible for any Claims for
health services received by Members after the effective date of the termination.
Section 5.3 Premium Calculation. The monthly Premiums owed by Employer shall be calculated
by MIC using the number of Subscribers in each coverage classification according to MIC's records at
the time of the calculation. Employer may make adjustments to its payment of Premiums for any
additions or terminations of Members submitted by Employer but not yet reflected in MIC's
calculations.
A full calend %1h month's Premiums shall be charged for Members whose effective date falls on or
before the 15 day of that calendar month. No Premium shall be charged for Members whose
effective date falls after the 15 day of that calendar month. With the exception of termination of
coverage due to a Member's death, a Member's coverage may be terminated only at the end of a
calendar month and a full Premium rate for that month will apply. In the case of a Member's death,
that Member's coverage will be terminated on the date of death.
Section 5.4 Retroactive Adjustments. In accordance with applicable law, retroactive adjustments
may be made for any additions or terminations of Members or changes in coverage classifications not
reflected in MIC's records at the time the monthly Premiums were calculated by MIC. However, no
retroactive credit will be granted for any month in which a Member received Benefits. No retroactive
adjustments to enrollment or Premium refund shall be granted for any change occurring more than 60
days prior to the date MIC received notification of the change from Employer.
Notwithstanding the foregoing, Employer shall pay a Premium for any month during which a Member
received Benefits.
Section 5.5 Premium Changes. MIC may change the Premiums after 30 days prior written notice to
Employer.
Section 5.6 Employer Fees. MIC may charge Employer:
(a) a late payment charge in the form of a finance charge of 12% per annum for any Premiums
not received by the due date; and
(b) a service charge for any non - sufficient -fund check received in payment of the Premiums.
1
MIC MGC 05 (8/05) 5
ARTICLE 6
INDEMNIFICATION
MIC will hold harmless and indemnify Employer against any and all claims, liabilities, damages or
judgments asserted against, imposed upon or incurred by Employer, including reasonable attorney
fees and costs, that arise out of MIC's negligent acts or omissions in the discharge of its
responsibilities to a Member.
Employer will hold harmless and indemnify MIC against any and all claims, liabilities, damages or
judgments asserted against, imposed upon or incurred by MIC, including reasonable attorney fees
and costs, that arise out of Employer's or Employer's employees', agents', and representatives'
negligent acts or omissions in the discharge of its or their responsibilities under this Contract.
Employer and MIC shall promptly notify the other of any potential or actual claim for which the other
party may be responsible under this Article 6.
ARTICLE 7
ADMINISTRATIVE SERVICES
The services necessary to administer this Contract and the Benefits provided under it will be provided
in accordance with MIC's or its designee's standard administrative procedures. If Employer requests
such administrative services be provided in a manner other than in accordance with these standard
procedures, including requests for non - standard reports, and if MIC agrees to provide such non-
standard administrative services, Employer shall pay for such services or reports at MIC's or its
designee's then - current charges for such services or reports.
ARTICLE 8
CLERICAL ERROR
A Member will not be deprived of coverage under the Contract because of a clerical error.
Furthermore, a Member will not be eligible for coverage beyond the scheduled termination date
because of a failure to record the termination.
ARTICLE 9
ERISA
When this Contract is entered into by Employer to provide benefits under an employee welfare benefit
plan governed by ERISA, MIC shall not be named as and shall not be the plan administrator of the
employee welfare benefit plan, as that term is used in ERISA. MIC shall only be considered a named
fiduciary for purposes of claims adjudication.
The parties agree that MIC has sole, final, and exclusive discretion to:
(a) interpret and construe the Benefits under the Contract;
(b) interpret and construe the other terms, conditions, limitations and exclusions set out in the
Contract;
(c) change, interpret, modify, withdraw or add Benefits without approval by Members; and
MIC MGC 05 (8/05) 6
(d) make factual determinations related to the Contract and the Benefits
For purposes of overall cost savings or efficiency, MIC may, in its sole discretion, provide services
that would otherwise not be Benefits. The fact that MIC does so in any particular case shall not in any
way be deemed to require it to do so in other similar cases.
MIC may, from time to time, delegate discretionary authority to other persons or entities providing
services under this Contract.
ARTICLE 10
DATA OWNERSHIP AND USE
Information and data acquired, developed, generated, or maintained by MIC in the course of
performing under this Contract shall be MIC's sole property. Except as this Contract or applicable law
requires otherwise, MIC shall have no obligation to release such information or data to Employer.
MIC may, in its sole discretion, release such information or data to Employer, but only to the extent
permitted by law and subject to any restrictions determined by MIC.
ARTICLE 11
CONTINUATION OF COVERAGE
MIC shall provide coverage under this Contract to those Members who are eligible to continue
coverage under federal or state law.
MIC will not provide any administrative duties with respect to Employer's compliance with federal or
state continuation of coverage laws. All duties of the Employer, including, but not limited to, notifying
Members regarding federal and state law continuation rights and Premium billing and collection,
remain Employer's sole responsibility.
ARTICLE 12
CERTIFICATION OF QUALIFYING COVERAGE FORMS
As required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), MIC will
produce Certification of Qualifying Coverage forms for Members whose coverage under this Contract
terminates or upon request by Members. The Certification of Qualifying Coverage forms will be based
on the eligibility and termination data Employer provides to MIC. Employer shall provide all necessary
eligibility and termination data to MIC in accordance with MIC's data specifications. The Certification
of Qualifying Coverage forms will only include periods of coverage MIC administers under this
Contract.
1
MIC MGC 05 (8/05) 7
1
ARTICLE 13
AMENDMENTS AND ALTERATIONS
Section 13.1 Standard Amendments. Except as provided in Section 13.2, amendments to this
Contract are effective 30 days after MIC sends Employer a written amendment. Unless regulatory
authorities direct otherwise, Employer's signature will not be required. No MIC agent or broker has
authority to change this Contract or to waive any of its provisions.
Section 13.2 Regulatory Amendment. MIC may amend this Contract to comply with requirements
of state and federal law ( "Regulatory Amendment ") and shall issue to Employer such Regulatory
Amendment and give Employer notice of its effective date. The Regulatory Amendment will not
require Employer's consent and, unless regulatory authorities direct otherwise, Employer's signature
will not be required. Any provision of this Contract that conflicts with the terms of applicable federal or
state laws is deemed amended to conform to the minimum requirements of such laws.
ARTICLE 14
ASSIGNMENT
Neither party shall have the right to assign any of its rights and responsibilities under the Contract to
any person, corporation or entity without the prior written consent of the other party; provided,
however, that MIC may, without the prior written consent of the Employer, assign the Contract to any
entity that controls MIC, is controlled by MIC, or is under common control with MIC. In the event of
assignment, the Contract shall be binding upon and inure to the benefit of each party's successors
and assigns.
ARTICLE 15
DISPUTE RESOLUTION
In the event that any dispute, claim or controversy of any kind or nature relating to this Contract arises
between the parties, the parties agree to meet and make a good faith effort to resolve the dispute.
The party requesting the meeting shall provide the other, in advance of the meeting, with written
notice of the claimed dispute. Upon receipt of the written notice, representatives for each party shall
meet promptly to attempt to resolve the dispute. If a mutually agreeable resolution is not reached
within thirty (30) days following receipt of the written notice, either party may pursue legal action in
accordance with the terms of this Contract. The parties may mutually agree to waive the informal
dispute resolution process set forth herein. Any such waiver must be in writing and executed by both
parties.
MIC MGC 05 (8/05)
ARTICLE 16
TIME LIMIT ON CERTAIN DEFENSES
No statement made by Employer, except a fraudulent statement, shall be used to void this Contract
after it has been in force for a period of 2 years.
ARTICLE 17
RELATIONSHIP BETWEEN PARTIES
The relationship between Employer and any Member is that of Employer and Subscriber, Dependent
or other coverage classification as defined in this Contract.
The relationships between MIC and Network Providers and the relationship between MIC and
Employer are solely contractual relationships between independent contractors. Network Providers
and Employer are not agents or employees of MIC. MIC and its employees are not agents or
employees of Network Providers or Employer.
The relationship between a Network Provider and any Member is that of provider and patient and the
Network Provider is solely responsible for the services provided to any Member.
ARTICLE 18
EMPLOYER RECORDS
Employer shall furnish MIC with all information and proofs that MIC may reasonably require with
regard to any matters pertaining to this Contract. MIC may at any reasonable time inspect all
documents furnished to Employer by an individual in connection with the Benefits, Employer's payroll
records, and any other records pertinent to the Benefits under this Contract.
Unless Employer provides the appropriate written assurances required by 45 CFR 164.504, MIC will
only provide Employer with summary health information (for the purposes of obtaining premium bids
or for modifying, amending or terminating the group health plan only) and information on whether
individuals are participating in the group health plan, or is enrolled in or has disenrolled from the
health plan as provided in 45 CFR 164.504 (f)(1) and the minimum necessary information for
purposes of auditing MIC's operations or services.
ARTICLE 19
NOTICE
Except as provided in Article 2, notice given by MIC to an authorized representative of Employer will
be deemed notice to all Members.
All notices to MIC shall be sent to the address stated in the Acceptance of Contract. All notices to
Employer shall be sent to the persons and addresses stated in the Group Application. All notices to
MIC and Employer shall be deemed delivered:
(a) if delivered in person, on the date delivered in person;
(b) if delivered by a courier, on the date stated by the courier;
MIC MGC 05 (8/05)
1
(c) if delivered by an express mail service, on the date stated by the mail service vendor; or
(d) if delivered by United States mail, 3 business days after date of mailing.
A party can change its address for receiving notices by providing the other party a written notice of the
change.
ARTICLE 20
COMMON LAW
No language contained in the Contract constitutes a waiver of MIC's rights under common law.
MIC MGC 05 (8/05) 10
ACCEPTANCE OF CONTRACT
This Contract is deemed accepted by Employer upon the earlier of MIC's receipt of Employer's first
payment of the Premium or upon Employer's execution of this Contract by its duly authorized
representative. This Contract is deemed accepted by MIC upon MIC's deposit of Employer's first
payment of the Premium. Such acceptance renders all terms and provisions herein binding on MIC
and the Employer.
IN WITNESS WHEREOF, MIC has caused this Contract to be executed on this November 11, 2008,
to take effect on the Effective Date stated in Exhibit 1 to this Contract.
MEDICA HEALTH PLANS
MEDICA INSURANCE COMPANY
401 Carlson Parkway
Minnetonka, MN 55305
(952) 992 -2200
Billing Address:
NW 7105
P.O. Box 1450
Minneapolis, MN 55485 -7105
Mailing Address:
P.O. Box 9310
Minneapolis, MN 55440
By:
Tom Henke
Senior Vice President, Commercial Markets
By:
James P. Jacobson
Senior Vice President and Assistant Secretary
MIC MGC 05 (8/05)
EMPLOYER
Hutchinson Utilities
Address: 225 Michigan Street Southeast
Hutchinson, MN 55350
Telephone: (320) 587 -4746
By:
Title:
Employer Representative:
Jan Sifferath
Date:
1
L.
1
1
EXHIBIT 1
1. Parties. The parties to this Master Group Contract ( "Contract ") are Medica Insurance
Company ( "MIC ") and the employer group Hutchinson Utilities ( "Employer "), employer group
number(s) 48963, an employer under Minnesota law and other applicable law.
2. Effective Date and Expiration Date of this Contract. This Contract is effective 01/01/2009
( "Effective Date ") to 12/31/2009 ( "Expiration Date "). All coverage under this Contract begins
at 12:01 a.m. Central Time.
3. Contract Number: MIC CHOICE MN 300 -15 BPL #: 35574
4. Amendment(s) Number: Amendments attached as applicable for benefit package log (BPL)
as listed above
5. Eligibility. The following conditions are in addition to those specified in the Certificate:
5.1 Eligibility to Enroll.
A Subscriber, and his or her Dependents who satisfies the eligibility conditions stated in this
Contract are eligible to enroll for coverage under this Contract. Any person who does not
satisfy the definition of Subscriber or Dependent is not eligible for coverage under this
Contract.
A Subscriber and his or her Dependents must meet the eligibility requirements described
below and in the entire Contract.
5.2 Subscriber Definition.
The term "Subscriber" as used in the Contract will include the types of employees and
conditions identified below:
Classifications
1. Employees: Full -time employees
working a minimum of 40
hours /week
Applicable Waiting Periods and Effective Dates
New Hires: First of the month following date of hire
Status Change: First of the month following date of
change
Return: First of the month following date of return
MIC MGC 05 (8/05) Exhibit 1
Page 1
EXHIBIT 2
Premiums
The monthly Premiums for this Contract are:
Subscriber Classifications
Monthly
Premium Rate
Class I
(Single)
MIC Choice
$567.73
Class IV
(Family)
MIC Choice
$1,439.37
MIC MGC 05 (8/05) Exhibit 2
Page 1
�J
1
12/29/2008 04:04 6127679200 MDB PAGE 02
�l
November 3, 2008
Jan Sifferath
Hutchinson Utilities
225 Michigan Street SE
Hutchinson, MN 55350
RE: Hutchinson Utilities
MD13 Group Number 308
Contract Term: January 1, 2009 — December 31, 2009
Dear Jan:
Midwest Dental Benefits has been pleased to provide dental benefits to your employees for this
past coverage year. We look forward to the renewal of your dental program for the above noted
Contract Effective Date.
In reviewing Hutchinson Utilities experience for this past year, we have determined the budget
projections currently established do not need to be adjusted for the next contract year. Using the
most recent 12 months of paid claims experience (through September 2008) we are projecting
paid claims of $40,591.00 for 2009. The corresponding funding rates may remain at the current
$30.50 for single coverage and $74.70 for family coverage. Midwest Dental Benefits appreciates
your business and will waive any increase in administrative fee for the next contract year. Your
Administrative Fee will remain at the current $3.65 per employee per month. Any changes made
to rates or plan design will become effective on January 1, 2009.
If you would like to renew your contract with Midwest Dental Benefits for the next contract
year, please sign and date below. If you would like to take a look at changing your current plan
design, please give me a call and we can discuss some options. We thank you for your business
and look forward to servicing the fine employees of Hutchinson Utilities for the next contract
period.
Sincerely, App ved by:
Deborah Loder, � 3 � � N Director of Operations Dated: i
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ARTICLE III
Commissioners, Officers and Employees
SECTION - 9 ELECTION AND TENURE The Commission shall
annually elect the officers of the commission at its January
meeting. Such elected officers will assume their offices the
first day of February. Each officer shall hold office for a one-
year term and until such officer's successor is elected. There
shall be a limit of two successive terms that an officer may
serve.
SECTION - 10 TERMS OF COMMISSIONERS The appointment and
length of service of each Commissioner shall be set forth in the
Hutchinson City Charter. Each Commissioner's term shall expire
on December 31St of the last year of that Commissioner's
appointed term, except Commissioners shall continue in office
until their successor has been appointed and qualified.
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Advertisement for Bids
for
DIRECTIONAL DRILLING CONTRACTOR FOR 2009 - 2010
Hutchinson Utilities Commission
Hutchinson, Minnesota
Notice is hereby given that the Hutchinson Utilities Commission of the City of
Hutchinson, Hutchinson, Minnesota, hereinafter referred to as the Owner, will receive
sealed Bids at the Hutchinson Utilities office until 2:00 p.m. on the 27th day of January
2009, and will publicly open and read aloud such Bids on the following work:
"DIRECTIONAL DRILLING CONTRACTOR FOR 2009 - 2010"
Proposals shall be properly endorsed and delivered in an envelope marked,
"DIRECTIONAL DRILLING CONTRACTOR FOR 2009 - 2010" and shall be addressed to:
Hutchinson Utilities Commission of the City of Hutchinson, 225 Michigan Street SE,
Hutchinson, Minnesota 55350.
All proposals shall be submitted in duplicate on the Bidder's own letterhead in
facsimile of the Proposal Form enclosed in the Specifications, or by utilizing the Proposal
Form enclosed with the Specifications by typing the official name of the Bidder at the top of
the form.
Each proposal should be accompanied by a Bid Bond, made payable to the
Hutchinson Utilities Commission of the City of Hutchinson, Hutchinson, Minnesota, in the
amount of $10,000 as a guarantee that the Bidder will enter into the proposed Contract.
The successful Bidder shall furnish a Certificate of Insurance and proof that
Contractor complies with all parts of DOT 49 CFR Part 199, drug and alcohol testing.
Contractor must also provide Hutchinson Utilities a copy of the contractor's drug and
alcohol program that complies with DOT 49 CFR Part 199 as well as proof that all
employees that will be subcontracted to Hutchinson Utilities are currently covered under
this program.
No Bidder may withdraw his Bid or Proposal for a Period of thirty (30) days after
date of opening of Bids.
At the aforementioned time and place, or at such later time and Place as the Owner
then may fix, the Owner will act upon Proposals received and with its sole discretion may
award Contract(s) for the furnishing of said labor.
The work shall be started by May 1" 2009, on an as needed basis.
Specifications for bids are available at the Office of the Hutchinson Utilities, 225
Michigan Street, Hutchinson, Minnesota 55350.
The Hutchinson Utilities Commission of the City of Hutchinson, Hutchinson,
Minnesota reserves the right to reject any and all bids, or bid irregularities.
By A::�- 0J,
DONALD H WALSER , President
Date
ATTESTED
By
CR - LENZ
COMMISSIONER
Date DECEMBER 30, 2008
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