#18-7409 (Matrix Absence Management, Inc.) SII► /
MATRIX
ABSENCE MANAGEMENT
A MEMBER OF THE TO IO MARINE GROUP
AGREEMENT FOR SERVICES
(Client's Agreement #18-7409)
Client:Board of County Commissioners/Collier County
Government (hereinafter "Client")
Effective Date: January 1st, 2019
Services:
✓ Family Medical Leave Act ("FMLA")
ler Short Term Disability ("STD")
✓ Americans with Disabilities Act ("ADA")
Service Agreement 2018 1 q)
THIS AGREEMENT is made as of the Effective Date set forth on the face page hereof by and
between the Client set forth on the face page hereof and Matrix Absence Management, Inc., a
corporation organized and existing under the laws of the State of Delaware ("Matrix").
RECITALS
WHEREAS, Client is an employer that maintains certain benefit programs for its employees; and
WHEREAS, Matrix offers absence and disability management services to employers;and
WHEREAS, Client desires to utilize Matrix's absence and disability management services; with
respect to the benefit programs checked on the face page hereof(collectively the "Plans");
THEREFORE, in accordance with the terms and conditions contained herein, acknowledged to be
good and sufficient consideration,the parties agree as follows:
I DEFINITIONS
"Allocated Loss Adjustment Expenses" means all costs, charges or expenses incurred by Matrix, its
agents or its employees which are properly chargeable to a Claim including, without limitation,
medical records costs, court costs, fees and expenses of IME's, attorneys, independent adjusters,
investigators, appraisers, medical cost containment service providers, experts and witnesses, and
fees for obtaining diagrams, reports, documents and photographs, language translation costs and
any other items which are deemed necessary or appropriate to process a Claim, but do not include
the fees for services performed by Matrix employees.
"Agreement Period" means the one year period beginning on the Effective Date and ending on the
first anniversary of the Effective Date, and each subsequent one year period there after, for so long
as the Agreement is in effect.
"Claimant" means anyone filing a claim under the Plan(s).
"Claim" means a claim made under, and pursuant to the terms of the Plan(s).
"Claim Appeal Brief" documentation of Matrix review and notifications with respect to Claimant
appeal of an initial Claim decision.
"Effective Date" means, the date upon which this Agreement shall be effective and the services
described herein shall begin to be delivered, as set forth on the face page hereof.
"Eligible Pay" means the compensation of a Participant that is eligible to be considered for the
purpose of determining benefits as set forth in the applicable plan document.
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"Employee" means an employee of Client as determined by Client's human resource policies.
"ERISA" means the Employee Retirement Income Security Act of 1974, as amended from time to
time, and the regulations promulgated thereunder. The Plans may not be subject to ERISA. To the
extent that a Plan is not subject to ERISA,all references to ERISA hereunder shall be deemed as having
no effect.
"FMLA" means the Family Medical Leave Act.
"FMLA Services" means, collectively, the services, functions, duties and responsibilities related to
the administration of Client's FMLA Plan, including the administration, management and
adjudication of intermittent and stand-alone claims under FMLA, and claims that run concurrently
with claims under the STD Plan or under one of the Statutory Plans; the tracking of leaves; co-
ordination with Client's systems and managers; co-ordination with workers compensation carriers
and long-term disability providers as required.
"IME" means independent medical examination.
"Participant" means an Employee of Client who Client determines is eligible for,and who is enrolled
in, and covered by the Plans.
"Plan(s)" means the Program(s), to which this Agreement applies as set forth on the face page
hereof, and as described in the applicable plan documents.
"Plan Description" means documents provided to Participants describing the terms and conditions
of coverage offered under the Plans.
"Plan Document(s)" means a written description of the Plan benefits and Plan provisions.
"Proprietary Business information"means information about Client's business or Matrix's business
that is confidential, proprietary, trade secret or is not readily available to the general public; or,
information that has been designated by Client or Matrix as confidential or proprietary.
"Requirements Document" means the document(s) listing the specifications and requirements of
the Services, including the manner in which the Services will be provided,as such document(s) may
be amended or supplemented from time to time.
"Return to Work"or"RTW" means a transition process for return to active work of those Employees
or Participants who are (1) receiving short-term disability benefits or long-term disability benefits,
and/or(2) absent from work due to an approved leave,and who have a medical release to return to
work at modified duty or with restrictions.
"Service Period" The billing period in which Matrix provides Administrative Services to the Client.
"Services" means, collectively, the services, functions, duties and responsibilities related to certain
claims and other leave administrative management services under the Programs to be performed by
Matrix as described in more detail in the Requirements Documents in the Attached Addendums.
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"Self-Fund"or"Self-Funded" means that Client has the sole responsibility to pay,and provide funds,
for all covered Plan benefits and applicable payroll taxes during the term of this Agreement,
excluding administrative expenses.
"Tax" or"Taxes" means taxes, assessments and all other federal, state, local or other governmental
charges.
II. OBLIGATIONS OF MATRIX
A. Compliance with Laws. Matrix represents and warrants that it will remain, throughout the
period in which this Agreement is effective, in compliance with all laws, rules, and regulations
that are now or hereafter promulgated by any governmental authority or agency that govern or
apply to the operation and/or use of the services described herein or that otherwise govern or
apply to Matrix. This includes Florida Statute § 501.171. Security of Confidential Personal
Information.
B. Public Records Compliance. By executing and entering into this Agreement, Matrix
("Contractor") is formally acknowledging without exception or stipulation that it agrees to
comply, at its own expense, with all federal, state and local laws, codes, statutes, ordinances,
rules, regulations and requirements applicable to this Agreement, including but not limited to
those dealing with the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324,
et seq. and regulations relating thereto, as either may be amended; taxation, workers'
compensation, equal employment and safety and the Florida Public Records Law Chapter 119,
including specifically those contractual requirements at F.S. § 119.0701(2)(a)-(b) as stated as
follows:
IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119,
FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBUC RECORDS RELATING
TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBUC RECORDS AT:
Communication and Customer Relations Division
3299 Tamiami Trail East,Suite 102
Naples, FL 34112-5746
Telephone: (239)252-8383
The Contractor must specifically comply with the Florida Public Records Law to:
1. Keep and maintain public records required by the public agency to perform the service.
2. Upon request from the public agency's custodian of public records,provide the public agency
with a copy of the requested records or allow the records to be inspected or copied within a
reasonable time at a cost that does not exceed the cost provided in this chapter or as
otherwise provided by law.
3. Ensure that public records that are exempt or confidential and exempt from public records
disclosure requirements are not disclosed except as authorized by law for the duration of the
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contract term and following completion of the contract if the Contractor does not transfer
the records to the public agency.
4. Upon completion of the contract,transfer, at no cost,to the public agency all public records
in possession of the Contractor or keep and maintain public records required by the public
agency to perform the service. If the Contractor transfers all public records to the public
agency upon completion of the contract, the Contractor shall destroy any duplicate public
records that are exempt or confidential and exempt from public records disclosure
requirements. If the Contractor keeps and maintains public records upon completion of the
contract,the Contractor shall meet all applicable requirements for retaining public records.
All records stored electronically must be provided to the public agency, upon request from
the public agency's custodian of public records, in a format that is compatible with the
information technology systems of the public agency.
If Contractor observes that the Contract Documents are at variance therewith,it shall promptly notify
the County in writing. Failure by the Contractor to comply with the laws referenced herein shall
constitute a breach of this agreement and the County shall have the discretion to unilaterally
terminate this agreement immediately.
C. Privacy. Matrix represents and warrants that it will remain, throughout the period in which
this agreement is effective, in compliance with applicable federal privacy laws and
regulations.
D. Other Obligations of Matrix. Matrix agrees to discharge its duties with respect to this
Agreement with the care, skill, prudence, and diligence under the circumstances then
prevailing as would a prudent person, acting in a like capacity and familiar with such matters
in accordance with, and pursuant to,the provisions of the Plan. Matrix further agrees that it
will remain, throughout the period in which this Agreement is effective, in compliance with
all laws, rules, and regulations that are now or hereafter promulgated by any government
authority or agency that govern or apply to the services described herein or that are
otherwise provided by Matrix to Client.
Ill. OBUGATIONS OF CUENT
A. Responsibility for the Plan. Except to the extent this Agreement specifically requires Matrix
to have the responsibility for a Plan's administrative function, Client is responsible for the
Plan. Matrix is not the plan administrator of the Plan(s).
B. Enrollment Services for the Plan. Client shall be responsible for determining the eligibility of
Employees to be Participants. Client or its designated third-party benefits administrator shall
provide, and Matrix shall accept in an agreed upon format, eligibility information
electronically or otherwise on a weekly basis or as needed.
Matrix shall be entitled to rely on the most current information provided by Client regarding
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4.1)
eligibility of Participants in paying Plan benefits and providing other services under this
Agreement.
C. Description of the Plan. Client will give Matrix a written description of the Plan benefits and
Plan provisions in a timely manner, so that Matrix will be able to provide its services under
this Agreement on the effective date.
D. Plan Documents. Client will provide Matrix with copies of Plan documents and Employee
communications. Client will provide to Matrix any documentation which Matrix reasonably
requests for review.
E. Plan Changes. Client will notify Matrix in writing if Client intends to change relevant Plan
benefits or other relevant Plan provisions, including termination of the Plan, within a
reasonable period of time but no less than thirty (30) days prior to the change becoming
effective.
F. Compliance with Laws. Client represents and warrants that it will remain, throughout the
period in which this Agreement is effective,in compliance with all laws,rules,and regulations
that are now or hereafter promulgated by any governmental authority or agency that govern
or apply to the operation and/or use of the services described herein or that otherwise govern
or apply to Client. Client acknowledges that while Matrix may, from time to time, advise
client of regulatory changes that it becomes aware of which may affect the Plans, it is the
Client's sole responsibility to maintain awareness of all regulatory changes,and to make such
modifications to the Plans as may be required.
G. Responsibility for Employment Decisions—Client is and shall remain solely responsible for
all determinations of the employment status of employees of Client,including but not limited
to eligibility and qualification for leave of absence, and any extensions thereof, pursuant to
Client's employment policies. in addition, Client shall remain solely responsible for all
determinations regarding accommodations requested by employees in their employment,
including without limitation extension of any leave of absence or reduced work schedules.
Matrix shall direct any employee who submits such a request to Matrix to submit the request
directly to the Client and Matrix shall notify a designated person at the Client of any such
requests that it receives.
IV. COMPENSATION TO Matrix
Client shall pay Matrix the fees set forth in Exhibit A. Any expenses or fees for products or services
not specified in this Agreement,must be agreed to and approved in writing by Client and Matrix prior
to commencement of such products or services.
A. Due Dates. Payments.and Penalties. Matrix's charges for its Administrative Services under
this Agreement are set forth in Exhibit A attached to and made a part of this Agreement, as
may be changed from time to time by written agreement between Matrix and Client.
Payments are due upon receipt of a proper invoice and in compliance with Chapter 218, Fla.
Stats., otherwise known as the "Local Government Prompt Payment Act." Any late interest
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Stats., otherwise known as the "Local Government Prompt Payment Act." Any late interest
fees shall be pursuant to Section 218.74, Fla. Stat.
B. Changes in Service Fees. The service fees are subject to change: (1) at anytime after the end
of each Agreement Period, subject to any rate guarantees specifically set forth in Exhibit A;
(2) any time there are changes made to this Agreement or the Plans, which materially affect
the Services; (3) when there are changes to laws or regulations which materially affect the
Services; or (4) if Client's actual claims activity exceeds the threshold outlined in Exhibit A.
Matrix will provide Client with sixty(60) days prior written notice of the revised service fees
for subsequent Agreement Periods, and for service fee adjustments. Client shall have the
option to accept or reject the revised service fees. If Client accepts the revised service fees,
the revised service fees will become effective at the end of the 60 day notice period. If the
Client rejects the revised service fees, then this Agreement shall terminate at the end of the
60 day notice period.
V. CLAIMS PAYMENT ADVANCES&TAXES
A. Claims Payment Advances. Under no circumstances shall Matrix be required to advance
funds to pay for benefits administered under this Agreement.
B. Taxes. Collier County, Florida as a political subdivision of the State of Florida, is exempt from
the payment of Florida sales tax to its Contractors under Chapter 212, Florida Statutes,
Certificate of Exemption#85-8015966531C-1.
C. Allocated Lost Adjustment Expenses. Client shall be responsible for the payment of
Allocated Loss Adjustment Expenses.
D. Termination of Agreement. When this Agreement terminates, the method of providing
funds for Plan benefits shall remain in place for the period of time as agreed to by the parties.
VI. INSURANCE
A. Fidelity Bond. Matrix, at its sole cost, shall procure and maintain in force during the term of
this Agreement a fidelity bond in the amount of not less than one million dollars($1,000,000)
covering all employees of Matrix.
B. Insurance.Matrix,at its sole cost,shall maintain commercial general liability and professional
liability insurance (errors and omissions liability) policies (or self-insurance programs) with a
minimum limit of two million dollars ($2,000,000) per occurrence and annual aggregate, to
insure against claims arising out of services performed under this Agreement. The general
liability insurance policy should also include personal injury and contractual liability.
The General Liability Policy maintained by Matrix shall name Collier County, Florida (Collier
County Board of County Commissioners, or Board of Collier County Commissioners,
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or Collier County Government, or Collier County), as an additional insured for any work
performed on behalf of Collier County and shall contain a severability of interests clause.
Matrix shall also maintain Workers'Compensation coverage for its employees in accordance
with the statutory Limits of Florida Statutes, Chapter 440 and all Federal Government
statutory limits and requirements. Evidence of Workers' Compensation coverage or a
Certificate of Exemption issued by the State of Florida shall be provided to the Client.
Matrix and/or its insurance carrier shall provide thirty (30) days written notice to the Client
of policy cancellation or non-renewal on the part of the insurance carrier or Matrix. Matrix
shall also notify the Client, in a like manner, within twenty-four (24) hours after receipt, of
any notices of expiration,cancellation, non-renewal or material change in coverage or limits
received by Matrix from its insurer and nothing contained herein shall relieve Matrix of this
requirement to provide notice.
VII. LITIGATION AND INDEMNIFICATION
A. Indemnification of Client, To the maximum extent permitted by Florida law, Matrix shall
indemnify and hold harmless and defend Collier County, its officers and employees from any
and all liabilities,damages,losses and costs,including,but not limited to, reasonable attorneys'
fees and paralegals'fees,to the extent caused by the negligence, recklessness,or intentionally
wrongful conduct of Matrix. This indemnification obligation shall not be construed to negate,
abridge or reduce any other rights or remedies which otherwise may be available to an
indemnified party or person described in this paragraph. This section does not pertain to any
incident arising from the negligence or willful misconduct of Collier County.
B. Limitation of Liability Neither party shall be liable to the other for any indirect, special,
incidental, exemplary, reliance or punitive or consequential damages arising out of or related
to this agreement,even if advised of the possibility thereof.
C. Plan Benefits Litigation. Subject to the Indemnification provisions above, if a demand is
asserted or litigation proceedings or arbitration is commenced by a Participant or any other
person to recover benefits("Plan Benefits Litigation")against Matrix,Client or any combination
of the parties, the defense of that action will be borne by Client at its sole cost. Matrix will
cooperate with Client in any defense of any action. In seeking any recovery under this
Agreement, Matrix will not be required to take legal action on behalf of the Plan, but will
consult with and defer to Client who will have the sole discretion and authority to compromise,
settle, or both, any claim for recovery by the Plan. Under no circumstances will Matrix be
responsible to pay any underlying Plan benefits. The Client's foregoing indemnification shall
not constitute a waiver of sovereign immunity beyond the limits set forth in section 768.28,
Florida Statutes, and is limited as otherwise provided by law.
D. Employment Litigation. Subject to Section VILA,Client agrees to hold Matrix harmless,defend
and indemnify Matrix from and against any and all claims, liability, loss, obligation, suit,
judgment, damage, expenses and costs, induding reasonable attorneys' fees and cost of
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defense, which may be asserted against or incurred by Matrix, which arise out of or in
connection with Client's decisions about the employment status of any employee of Client,
except to the extent that the claim arises from Matrix's negligent acts or omissions. The Client's
foregoing indemnification shall not constitute a waiver of sovereign immunity beyond the limits
set forth in section 768.28, Florida Statutes, and is limited as otherwise provided by law.
VIII. AUDITS
The parties shall have the mutual right to inspect,audit and copy, upon no less than thirty(30) days
prior written notice to the other party and during normal business hours or at such other times as
may be agreed upon, said relevant books and records as they pertain to this Agreement. Such
information shall be provided to each party hereto pursuant to procedures designed to protect the
confidentiality of patient health care records in accordance with applicable legal requirements and
recognized standards of professional practice. This right shall continue to be provided for a period
of three (3) years after the termination of this Agreement. Matrix reserves the right to defer any
requested audit for up to 60 additional days based upon then current business requirements.
IX. DISPUTE RESOLUTION
All disputes arising directly under the express terms of this Agreement or the grounds for termination
thereof shall be resolved as follows: Prior to the initiation of any action or proceeding permitted by
this Agreement to resolve disputes between the parties,the parties shall make a good faith effort to
resolve any such disputes by negotiation. The negotiation shall be attended by representatives of
Matrix with full decision-making authority and by Client's staff person who would make the
presentation of any settlement reached during negotiations to Client for approval. Failing resolution,
and prior to the commencement of depositions in any litigation between the parties arising out of
this Agreement,the parties shall attempt to resolve the dispute through Mediation before an agreed-
upon Circuit Court Mediator certified by the State of Florida. The mediation shall be attended by
representatives of Matrix with full decision-making authority and by Client's staff person who would
make the presentation of any settlement reached at mediation to Client's Board for approval. Should
either party fail to submit to mediation as required hereunder, the other party may obtain a court
order requiring mediation under section 44.102, Fla.Stat.
X. RECORDS
A. Maintenance. Matrix shall keep all books and records necessary to reflect accurately the
business it transacts with respect to this Agreement and to determine the respective rights
of the parties under this Agreement. Such books and records shall be kept at such location
as shall be disclosed in writing. All records will be maintained for a period of at least seven
(7) years after the date they are first prepared or for such longer period as may be required
by law.
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B. Confidentiality. The parties each acknowledge and agree that each has developed certain
trade secrets,client lists,software,knowledge,data,tools, methodologies, processes, plans,
procedures, techniques, manuals, treatment protocols, clinical indicators, case rates,
provider payment structure information, underwriting methodology, proprietary rating
plans, provider practice data,Employee-outcomes data,audit reports,actuarial analyses and
other proprietary information (collectively"Confidential Information"). For purposes of this
Agreement, the party that has developed Confidential Information to which the other has
access is referred to as the "Protected Party." Except with the express written consent of the
Protected Party, or as provided herein,the other party shall not disclose to others or take or
use for such other party's own purposes or the purposes of others at any time, any
Confidential Information of the Protected Party not otherwise in the public domain that may
have been or may be obtained by the other party by reason of its relationship with the
Protected Party. The parties further agree that this provision shall also be applied to all
information that is designated as confidential or proprietary in writing by the Protected Party,
whether by letter or by use of a stamp or legend before or at the time any such information
is disclosed or delivered to the other party. Notwithstanding the foregoing, the parties
recognize that patient's medical records are confidential and are not to be disclosed to third
parties without the consent of the patient, unless otherwise permitted or required by
applicable law. Confidentiality of information contained in this agreement is subject to the
requirements of the Florida Public Records Act, Chapter 119, Fla. Stat., and the Florida
Sunshine Law, Chapter 286, Fla. Stat.
XI. INDEPENDENT CONTRACTORS/SUBCONTRACTING
A. Independent Contractors. Matrix and Client are independent legal entities. Nothing in this
Agreement shall be construed or be deemed to create a relationship of joint ventures,
principal and agent, or employer and employee. Unless otherwise specifically authorized by
Client in writing, Matrix shall have no authority to enter into contracts or otherwise deal with
third parties on behalf of, or as agent for, Client. Although Matrix may hire its own
independent contractors, agents, or employees to supply data processing, accounting,
printing, and other services to it in connection with its performance of services for Client, it
is expressly understood and agreed that such independent contractors, agents, and
employees are those of Matrix and not of Client, and Client shall have no responsibility or
obligation,financial or otherwise,to such independent contractors,agents,or employees.
B. Assignment. Neither party can assign this Agreement or any rights or obligations under this
Agreement to anyone without the other party's written consent, which shall not be
unreasonably withheld.Any attempted assignment in violation of this Article shall be void.
C. Data Transfer to Third Parties. It is acknowledged that it may be necessary from time to time
for Matrix, in performing its duties hereunder,to make available to independent contractors,
agents, or employees documents belonging to Client and/or containing data belonging to
Client. Matrix agrees to secure from any such third parties their agreement to maintain the
confidentiality of such documents and information.
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D. Subcontractors. Matrix can use its affiliates or other subcontractors to perform Matrix's
services under this Agreement. However, Matrix will be responsible for those services to the
same extent that Matrix would have been had it performed those services without the use of
an affiliate or subcontractor.
XII. PROPRIETARY RIGHTS
Each of the parties reserves the right to control the use of any of their symbols, trademarks,
computer programs, and service marks currently existing or hereafter established. Both parties
agree that they will not use such computer programs,work, symbols,trademarks, service marks, or
other devices of the other in advertising, promotional materials, or otherwise and will not advertise
or display such devices without the prior written consent of the other party. In addition,both parties
further agree that any such signs, displays, literature, computer programs, or material furnished to
the other shall remain the property of the other party and shall be returned upon demand upon the
termination of this Agreement.
XIII.TERM AND TERMINATION
A. Term. This initial term of this Agreement shall commence on the Effective Date and end on
the first anniversary of the Effective Date. This Agreement may renew for successive one
year terms,for four(4)additional years unless either party shall give the other party written
notice of its intention to terminate at least 60 days prior to the end of the then current term.
B. Termination. Except as provided for in XIII.A above, this Agreement may be terminated as
provided below.
1. Either of the parties may terminate the Agreement at any time in the event of a
material breach by the other which is not cured within thirty (30) days after written
notice to the other. The termination shall be effective, without further notice,thirty
(30) days after the initial written notice of the breach is given. Any and all
performance or other penalties provided for in this Agreement shall be in addition to,
and not in lieu of, any legal or equitable remedies either party may have in the event
of a material breach of the Agreement by the other.
2. Either party may terminate this Agreement for convenience with a ninety (90) day
written notice.
3. Notwithstanding any other provision in this Agreement, if Client fails to make funds
available to pay claims or administrative fees as required under this Agreement within
fifteen (15)days after Matrix gives Client written notice that Client has failed to do so,
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Matrix may terminate the Agreement. Such termination shall be effective as of the
end of the fifteen (15) day notice period.
4. If any state or other jurisdiction penalizes a party for administering the Plans under
the terms of this Agreement, the affected party may immediately discontinue the
Agreement's application in such state or jurisdiction. Notice must be given promptly
to the other party. The Agreement will continue to apply in all other states or
jurisdictions.
5. If a party receives written notice of proven fraud or abandonment, that party may
terminate immediately upon receipt of such written notice.
6. By either of the parties, immediately upon written notice, if the other party shall be
adjudged bankrupt, become insolvent, have a receiver of its assets or property
appointed, make a general assignment for the benefit of creditors, or institute or
cause to be instituted any procedure for reorganization or rearrangement of its
affairs.
7. As set forth in Article IV.B. (Changes in Service Fees).
C. Prior Obligations. Termination of this Agreement for any reason shall not relieve any party
of any obligation incurred by it prior to such termination.
D. Runout Claims Processing. Matrix shall continue to provide claims administration for a
period of three (3) months or (6) months after the termination of this Agreement for open
claims reported by Participants to Matrix prior to the termination date. Client agrees to pay
Matrix a fee for claims administration services during this Run-Out Period and as specified in
Exhibit A. This fee shall be due and payable at the time of termination.
E. Return of Records. Upon termination, Matrix will return all Client claim and other data
stored electronically upon 60 days of written request by Client in Matrix's standard data
format at no charge. Any physical files will be returned upon 60 days written request by
Client. The Client will prepay for the cost of transportation (UPS or similar) from Matrix's
office,or prepay the cost to have files moved from our Offsite Storage Facility. If Matrix does
not have explicit instructions for disposition within 60 days of termination, we will ship all
documents to the Client's last address Prepaid or COD. If the Client opts for us to destroy
physical files on their behalf, Matrix will charge for actual retrieval and destruction costs at
prevailing rates. Fees associated for the physical return of documents may include retrieval
costs from the Matrix Offsite storage, packaging,shipping and insurance at prevailing rates.
XIV. GENERAL PROVISIONS
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A. Amendments. This Agreement may be amended from time to time by mutual agreement
between the parties, which amendment shall be in writing and executed by an authorized
representative of each party.
B. Entire Agreement. This Agreement,including the exhibits and schedules supersedes any and
all other agreements,either oral or in writing,between the parties with respect to the subject
matter hereof, and contains all of the covenants and agreements between the parties with
respect to such matters. Any inducements, promises, or agreements, oral or otherwise that
have been made by any party, or anyone acting on behalf of any party, which are not
embodied herein, shall not be valid or binding. This Agreement shall be binding upon the
parties,their successors and permitted assigns.
C. Applicable Law. This Agreement shall be governed by and construed in accordance with the
laws of the State of Florida and any action to enforce the terms of this Agreement shall be in
the State and Federal Courts for Collier County, Florida.
D. Waiver of Breach. Nothing in this Agreement is considered to be waived by any party unless
the party claiming the waiver receives the waiver in writing. Waiver of a breach of any
provision of this Agreement shall not be deemed a waiver of any other breach of the same or
a different provision.
E. Severability. In the event any portion of this Agreement is rendered invalid or unenforceable,
the remainder of the provisions of this Agreement shall remain in full force and effect.
F. Headings. The headings of articles and sections contained in this Agreement are for
reference purposes only and shall not affect in any way the meaning or interpretation of this
Agreement.
G. Notices. Any notices required to be given pursuant to the terms and provisions of this
Agreement shall be in writing, postage prepaid, and shall be sent by certified mail, return
receipt requested, to the parties at the addresses below. The notices shall be effective on
the date indicated on the return receipt.
To: Jeff Walker
Director of Risk Management Division
Collier County Government
3311 E. Tamiami Trail
Naples, FL 34112
To:
Matrix Absence Management, Inc.
2421 W. Peoria Ave. Suite 200
Phoenix,AZ 85029-4944
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With a Copy To:
Matrix Absence Management, Inc.
Attention:General Counsel
2001 Market Street,Suite 1500
Philadelphia, PA 19103
H. Counterparts. This Agreement may be executed in more than one counterpart,each of which
shall be deemed to be an original and all of which, when taken together, shall constitute a
single instrument.
Information Exchange. Each party shall be responsible for liabilities arising from errors or
omissions made by it in the transmission of information to the other party, and each party
shall be entitled to assume the accuracy of all information transmitted to it by the other party
and to rely on such information for all purposes under this Agreement.
J. Force Maleure. Neither party shall be liable to the other for any failure of (or delay in
performance of)its obligations hereunder due to any cause or circumstance which is beyond
its reasonable control including, but without limiting the generality of the foregoing, any
failure or delay caused by fire, explosion, shipwreck, act of God or the public enemy, war,
riot, interference by the military or governmental authorities, act(s) of terrorism or
compliance with the laws of the United States or with the laws or orders of any other
government or regulatory authority. Each party agrees to consult, cooperate with and assist
the other as reasonably necessary in the performance of its obligations under this Agreement.
K. Representations and Warranties. In addition to other representations and warranties
throughout this Agreement,each party represents and warrants that this Agreement and the
transactions and activities contemplated hereby (i) are within its corporate powers; (ii) have
been duly authorized by all of its necessary corporate action;(iii)constitute its legal,valid and
binding obligations, enforceable against it in accordance with its terms; and (iv) do not and
will not conflict with or result in a breach of any of the provisions of, or constitute a default
under the provisions of any law, regulation, licensing requirement,charter provision, by-law
or other instrument applicable to it or its employees or to which it is a party or by which it
may be bound.
XV. SYSTEM ACCESS
A. System Access. Subject to the terms of any applicable E-services Agreement, Matrix grants
Client the nonexclusive,nontransferable right to access and use the functionalities contained
within the web based systems Matrix makes available to the Client for the purpose of
accessing Client's data and reports,under the terms set forth in this Agreement.Client agrees
that all rights,title and interest in the systems and all rights in patents,copyrights,trademarks
and trade secrets encompassed in the systems will remain Matrix's. Client shall not(a)access
Service Agreement 2018 14
mop
systems or use, copy, reproduce, modify, or excerpt any of the systems documentation
provided by Matrix in order to access or utilize systems,for purposes other than as expressly
permitted under this Agreement; or (b) share, transfer or lease Client's right to access and
use systems,to any other person or entity which is not a party to this Agreement. Upon prior
written consent by Matrix, Client may designate any third party to access systems on Client's
behalf, provided the third party agrees to these terms.
B. Security Procedures. It is Client's responsibility to ensure that Client employees who are
provided access to eServices do not share or misuse the information.Client shall notify Matrix
immediately if non-authorized access to eServices has occurred.
C. System Access Suspension/Termination. Matrix reserves the right to suspend Client's
system access (a) on the date Client fails to accept the hardware, software and browser
requirements provided by Matrix, including any amendments thereto or (b) immediately on
the date Matrix reasonably determines that Client has breached, or allowed a breach of, any
applicable provision of this Agreement or any applicalble E-Services Agreement. Such access
shall be restored on the date that Matrix determines, in its sole discretion, that Client has
cured the deficiency or breach cited above. Upon termination of this Agreement, Client's
system access will be terminated. Client agrees to cease all use of systems, and Matrix shall
deactivate Client's identification numbers and passwords and access to the system.
Service Agreement 2018 15
.
IN WITNESS WHEREOF, authorized representatives of the parties have confirmed the Agreement of the
parties to the foregoing terms by affixing their signatures below:
I
ATTEST: BOARD 0 0U COMM .*• •
CRYSTAL K.KINZtL, •,. /
INTERIM C - o COLLIE' COU • ,
,
•
' i Andy Solis,Chairman
Dated: I U \ - ) ' �p . I
(SEAL) );` "
est eta Chairman'
•
Contractor's Wltneg nature o►tly.
Matrix Absence Management, Inc.
By: 111/14444ttiovvv.0
Contra 7 • fitness Signature
I ,.
u dice Askins CFO
�
A � 'i
N..I 61A4N
I 'Type/print signature and title'
1 Typ: • int witness namet
tractor's Second Witn s
i ...______
trype/print witness namet
Ap oveds to F n Legality;
10.5County Attorney,.‘
G? d , L
Print Name
Service Agreement 2018 16 44
I,
Exhibit A
Service Fees
Service Assumed Number of 'Rate Per Ernr31. - - rtsilmated Annual Fee
Covered Lives* Per Month „
FMLA (State/Federal) 2232 $1.75 $46,872.0*
STD 2232
$1.72 $46,068.48
ADA 2232 $0.88 $23,569.92
If ADA
incidence exceeds 2%
an additional fee of
$275.00 per event will
apply.
Payroll Tax Service $2,750.00 Annually.
One-Time
implementation fee
(applicable only to
FMLA offering
Orie-Time $3,500.00
implementation fee
(applicable only to
ADA offering)
ff at any time during the life of the agreement, the FMLA/LOA incidence rate for Collier County Government
exceeds 10% Matrix reserves the right to review,and f necessary, revise the pricing reflected above. Client
shall be provided 60 days' notice of such revision as set forth in Article IV (B) (4). For purposes of this
calculation the FMLA/LOA incidence rate shall be the total
number of annual claims divided by the total
number of billed lives.
*Assumed Number of Covered Lives will be invoiced based upon headcount as reported from client supplied
data eligibility feeds.
Service Agreement 2018 17
Terms and Conditions:
• All fees outlined above in Exhibit A will be paid in Monthly installments beginning upon agreement
and written notice to the County.
• The above rates are guaranteed from January 1,2019 through December 31, 2021. Matrix will
provide the County written notice in advance of any price increases after the December 31, 2021
term.
• Administration fees are inclusive of all standard services as outlined above.
• Run-out Services are not included as part of this proposal and are priced separately below.
• All non-standard fees or unallocated expenses associated with the routine management of claims
(i.e. Specialty Exams,Attorney Fees etc.) are invoiced at cost.
O. .onal Value Added Services& Expenses:
Premium Billing Services
Priced separately
Takeover of existing STD Claims
-$265 per claim
Run Out of Claims at Termination
-$265 per claim for 3 months period
-$350 per claim for 6 months period
Takeover of existing FMLA Claims/Run Out of Claims at Termination
-$165 per claim
STD Appeal
$370 per appeal
Banking Services
$2,750 annually
Payroll Services(if Matrix issues checks)
$2,750 annually
Non-Standard Billing,Administrative Fee
Billing that requires filtering and manipulating data from the detailed data feed, as
opposed to billing using the totals provided on the summary data feed
$40 per invoice
Benefit Deduction Service(if Matrix issues checks)
Post tax only—included with Payroll Services
Service Agreement 2018 18
eServices Access
Up to 25 users included. Additional users available in blocks of 10 users @$2,500 per
block
Data Feeds-Including but not limited to:Custom Payroll Feeds& "Reverse Feeds'
$200/hour plus$200 per exception
Changes to Data Feeds-$5,000
Ad Hoc Reporting Services
(Customized Programming and Reporting);
• An Ad Hoc report writing tool is provided to all our clients free of charge, this gives access to all major
data elements and allows users to generate their own reports.
• Reports that require complex logic, scheduling, distribution or data encryption will be custom
developed after sign off by the client on a report specification. This specification will be produced by
Matrix/Reliance Standard in conjunction with client representatives. Such reports shall be subject
to a fee mutually agreed upon by the parties.
LOA Data File Transfer Fee
File transfer, upon termination. One-time transfer in Matrix standard format-No charge.
Customization and/or increased frequency-At Cost
Service Agreement 2018 19
Exhibit B
Requirements Document
A. General Obligations
Matrix shall administer the Plans in accordance with the terms and conditions of the Plans
and this Agreement. In carrying out its responsibilities under this Agreement, Matrix shall
provide the following general administrative services:
(a) When requested by Client, Matrix shall use commercially reasonable efforts to assist
Client with respect to its Plan on issues of program design, including benefits and
eligibility and other related administrative services.
(b) Matrix shall design communication materials subject to prior approval by Client as
related to the Plans implementation process. Client agrees to cooperate in the review
and approval of such materials in a timely manner. It is the Client's responsibility to
distribute implementation materials to Employees and Participants.
(c) Matrix is responsible for maintaining and training adequate levels of staff and
providing a toll-free customer service telephone number for responding promptly to
inquiries from Client, Client's administrative staff, Employees,former Employees that
have or have had an active claim under the Plan, Participants and providers
concerning the Plans.
(d) Matrix shall provide assistance to Client's staff during the Plan's implementation
process. Ongoing assistance with training as reasonably requested by Client upon
mutual agreement of the parties will be provided at a fee to cover associated
expenses.
(e) Matrix shall provide assistance with review of the Summary Plan Descriptions
developed by Client for each product line. Client is responsible for the costs of printing
and distributing the Plan, Summary Plan Description and related documents to its
participants.
(f) Matrix shall prepare and distribute to Participants, as appropriate,forms and related
materials required for processing claims.
(g) Matrix shall provide information as permitted by law to assist Client in preparing
reports required to be furnished to governmental entities regarding the Plans.
(h) Matrix agrees to provide standard web based reports that are available without
modification. Customized reports may be available by mutual agreement at an
additional charge.
(i) Non-Standard and Custom reports will be produced upon mutual agreement for an
additional charge as set forth in Exhibit A.
(J) Use of web-based services shall be subject to the current terms and conditions as
posted on the Matrix web site.
Service Agreement 2018 20
,r)
("3‘4
B. Disability claim Management Services
Matrix shall provide the following services with respect to the claims submitted under the
Plan:
(a) Matrix will evaluate each disability claim and provide clinical duration management
advice that conforms to Matrix and industry standards and practices Matrix will
recommend the disability duration and will provide appropriate information to Client
to facilitate RTW.
(b) Matrix will make disability determinations regarding claims presented under the Plan
to facilitate the issuance of benefits in accordance with the Plan.
(c) During the term of this Agreement and any renewals thereof, all initial requests for
claims under the Plan will be made by the Participant through the toll—free number
provided or on the Matrix website.
(d) Matrix will obtain all necessary medical information from the Participant and the
appropriate medical provider(s)and advise Client as to the continued disability status
of Participants. Client and Matrix will distribute the necessary "release of medical
information" authorizations to the Participant.
(e) Matrix will provide assistance to Participants regarding eligibility and application for
Social Security Disability benefits, as appropriate.
(f) At Client's expense, Matrix will arrange special investigative services, IMEs,
rehabilitative services, or any other services constituting Allocated Loss Adjustment
Expenses as an allocated expense to the Plan.
(g) As per the fees outlined in Exhibit A, and with Client's advance approval, Matrix will
administer the Claims Appeals Briefs. All initial claims shall be reviewed by Matrix.
Matrix shall respond to such claims within a reasonable period of time, but not later
than 45 days after the claim is submitted, provided that this period may be extended
by up to 30 days if Matrix determines that such an extension is necessary due to
matters beyond the control of the Plan and Matrix notifies the Claimant and Client of
the extension before the expiration of the initial 45-day period. If before the end of
the 30-day extension period, Matrix determines that due to matters beyond the
control of the Plan,a decision cannot be rendered within the extension period, Matrix
may extend the period for up to an additional 30 days, provided that Matrix notifies
the Claimant and Client of the extension before the end of the first 30-day extension
period. All such initial claim reviews and notifications shall be performed by Matrix in
a manner consistent with the Plan document.
(h) Matrix shall process claims for covered benefits under the Plan for Participants.Claims
for Plan benefits must be submitted in a form that is satisfactory to Matrix. Matrix will
use claim procedures and standards that Matrix develops for claim benefit
determination. Client delegates to Matrix the discretion and authority to use such
procedures and standards.
Service Agreement 2018 21
(i) Client delegates to Matrix the discretionary authority to determine the validity of
claims under the Plan. This delegation is subject to Client's retention of full
responsibility as Plan Administrator for the final review of claims, and Client has the
discretionary authority to administer, construe and interpret the terms of the Plans
and to make final, binding determinations concerning the availability of Plan benefits.
(j) It is expressly agreed by the parties that Client will be the Plan Administrator and
named fiduciary of the Plan, as those terms are defined by ERISA or any similar or
successor law(collectively referred to as ERISA)with the exclusive authority to control
and manage the operation of the Plan and that Matrix will be a fiduciary with respect
to the Plan solely for purposes of,and to the extent that,its services relating to claims
processing and review of appeals are considered fiduciary functions under ERISA and
Matrix will have no other fiduciary obligations under the Plan on account of this
Agreement. In reviewing and making decisions on claims for benefits,Matrix will have
the discretionary authority to interpret the terms of the Plan and to make factual
determinations, including determining eligibility for benefits and validity of charges
submitted for reimbursement subject to Client's responsibility as Plan Administrator
as set forth in Section (i)above.
(k) Matrix shall determine Participant benefits payable, if any, for each claim and shall
notify the Participant of the payment or if there is a denial or partial denial in
accordance with the provisions of the Plan. Where no benefits are payable, Matrix
shall notify the participant of the denial and any right to appeal the denial as
prescribed in the Plans, set forth in the Summary Plan Descriptions, this Agreement
and/or which are required under applicable law. This notification will be designed to
comply with the ERISA requirements for claim denial notices.
In processing claims under this Agreement, Matrix shall adhere to the Plan provisions relating to third party
liability for such claims, including without limitation non-duplication of benefits, Worker's Compensation,
and subrogation.
Service Agreement 2018 22
0.Ar)
Exhibit C
FMLA Management Services
Matrix shall provide the following services with respect to the Leave of Absence claims
submitted under the Plan for the Federal and State Leave laws and Employer Policies Identified
in the Business Process Document to be completed during implementation:
(a) Accept and receive all Leave of Absence requests under the Policy.
(b) Provide necessary forms to Employees.
(c) Examine all Leave of Absence requests and follow-up information, as appropriate.
(d) Adhere to the U.S. Department of Labor's federal regulations including regulations for
FMLA.
(e) Obtain additional information, as needed, by correspondence with Claimants,
physicians and others.
(f) Determine an Employee's eligibility for leave and amount in accordance with the
Client's Policy and information provided by Client and the Employee.
(g) Send pending notice of Leave of Absence to Client designated contacts within two (2)
days of notice.
(h) Send formal FMLA approval letter and all follow up notices and FMLA letters to
Employee during duration of Leave of Absence.
(I) Evaluation and notification of approvals or denials of FMLA Leave of Absence
Requests, within 2 business days.
(j) Calculation of Leave of Absence duration.
(k) Provide Notice of eligibility for Leave of Absence Requests.
(I) Provide adequate notice to Client on Leave of Absence Requests.
(m) Continue to provide documentation on Employee Leave of Absence Requests to Client
until FMLA leave duration ceases.
(n) Maintain complete and accurate tracking for purposes of establishing Employee
eligibility for a Leave of Absence and records and files on each Leave of Absence
Request in accordance with applicable statutory requirements.
(o) Give timely written notice to Employee of any denial of a Leave of Absence Request
in accordance with applicable law.
(p) Maintain records of family and medical leave utilization.
(q) Coordinate Return-to-Work dates with Employee and Client, five (5) days prior to
Service Agreement 2018 23
•
scheduled return and on the Employee date of return.
(r) Accumulate and store in database all applicable leave of absence time in accordance
with FMLA regulations.
(s) Notify Employee and Client when FMLA leave of absence duration is exhausted.
(t) Provide support for FMLA conflict resolution process.
(u) Provide contact with Employee by phone or letter to establish/re-assess the Leave of
Absence Request and for Employee inquiries concerning leave request status with
copies of all written communication.
(v) Assign a leave coordinator to act on behalf of Employee by responding directly to all
FMLA requests.
(w) Standardize forms to assist in managing FMLA policy.
(x) Completion,distribution and coordination of all standard forms. Matrix is responsible
for the recording,tracking,and reporting of employee absences from various sources
as reported through the toll-free number or any other approved media.
(y) At Client's request and expense, Matrix will arrange special investigative services,
2nd and 3nd FMLA Medical opinions,or any other requested services as an allocated
expense to the Plan.
Service Agreement 2018 24
APPLICABLE x NOT APPUCABLE
Exhibit D
Payroll Tax Service
(I) Matrix Payroll Services, Inc. is a wholly owned subsidiary of Matrix Absence Management,
Inc. The Client is provided IRS Form 2678, Employer Appointment of Agent, authorizing
Matrix Payroll Services to act as agent on Client's behalf.
(II) Once an executed copy of this form is received, Matrix will send it to the proper IRS office.
(III) Matrix will insure the withholding of Federal Income Taxes, Social Security Taxes, and
Medicare Taxes from Disability payments administered by Matrix.
(IV) Matrix will deduct these amounts from Client's Account, including the employer portion of
the Social Security and Medicare taxes, and transmit the funds to the IRS by EFT.
(V) Matrix will prepare the quarterly Form 941 and annual W2's.
(VI) All reporting is done under the Matrix Payroll Services FEIN.
Service Agreement 2018 25
01.31
APPUCABLE x NOT APPUCABLE
Exhibit E
ADA Management Services
Matrix shall provide the following services with respect to all workplace accommodation requests
submitted to Matrix for handling on behalf of the Client under the Americans with Disabilities Act
("ADA"):
(a) Client launches the non-leave related ADA accommodation request through Matrix's
Web Portal, MatrixAbsence.com.
(b) Matrixassigns an ADA Specialist to manage employee Workplace Accommodation
requests.
(c) Matrix provides forms and letters to assist the Client in managing Workplace
Accommodations and documenting its compliance with the ADA and applicable state
laws.
(d) Matrix provides Employees who request accommodation(s)with,where applicable, a
form to provide Client and Matrix a specific written request for accommodation(s)
sought, a release for the Employee to execute to enable Matrix to obtain clarification
or supporting medical documentation and,the certification form to be completed by
the Employee's treating provider to support his or her request for accommodation(s).
Matrix will include job description for the Employee's position, if the Client has
provided one to Matrix.
(e) Matrix and Client agree that all employee requests for accommodation shall be
processed in accordance with current EEOC regulations, federal and applicable state
law.
(f) Matrix provides Client with online access to Matrix's ADA management system for
purposes of entering information, including but not limited to: detailed job
descriptions that describe the essential functions of the employee's position,whether
or not the Client accepts the employee's request for accommodation, or if the
employer would like more information or for the assigned ADA Specialist to arrange
and facilitate an interactive discussion. Client shall also be responsible for keeping
Matrix and the assigned ADA Specialist apprised of all relevant information they learn
which will assist the handling of the employee's request for accommodation(s).
(g) Matrix gathers, reviews, and clarifies information, as needed, from Employees and
their treating providers, regarding: the nature, severity, and duration of the
employee's impairment; the activity or activities which the impairment limits; and
substantiates why the requested accommodation is needed.
(h) Matrix provides information to Client for review and use in Interactive Process with
Service Agreement 2018 26
Employees for the purpose of the Client determining approval or denial of requests
for Workplace Accommodation under ADA.
(I) Matrix coordinates and participates in,as needed,Interactive Process with Employees
and Client.
0) Matrix sends employer's approval/denial decision in a letter to employee.
(k) Matrix enters approval or denial letter into system.
(I) Matrix follows up on accommodations to determine effectiveness.
(m) Matrix assists Client in identifying alternative accommodations that might be
reasonable and effective.
(n) Matrix maintains complete and accurate tracking of actions taken and
communications on each Workplace Accommodation.
(o) Matrix maintains records of Workplace Accommodations.
Service Agreement 2018 27
OA°