AgdaPkt 2005-06-27 - Laserfiche WebLink

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. 6. /(/-6 " MtiN WITH A MIND .YOUR AMENDMENT TO mE EMPLOYEE ASSISTANCE PROGRAM SERVICES AGREEMENT BETWEEN MANAGED HEALTH NETWORK AND CITY OF REDWOOD CITY GROUP # 5213 The Employee Assistance Program Services Agreement effective January 1, 2003, ("Agreement") by and between MANAGED HEALTH NETWORK ("MHN"), a California corporation and CITY OF REDWOOD CITY ("Client") is hereby amended by both Parties (hereinafter referred to as "Amendment"). . RECITALS WHEREAS, in order to continue their existing relationship, the Parties desire to amend the Agreement; NOW THEREFORE, in consideration of the premises, terms, and conditions set forth herein, the Panies agree to amend the Agreement as follows: 1. Section I, "Definitions", the following paragraph shall be added: "1.13 "Combined Evidence of Coverage and Disclosure Form (Evidence of Coverage)" - A document issued by MHN to a Covered Person that describes the specific Covered Services available to that Covered'Person under a specific Employee Assistance Program Services Agreement." 2. Section I.3 "Dependent", paragraph 4 shall be deleted in its entirety. 3. Section II, "Duties of MHN", paragraph 2.3, "Employee Assistance Program", subparagraph c) shall be deleted and replaced with: "C) MHN will respond to CISDs as set forth in Exhibit 2.3 relating to a distressing and traumatic event occurring in the Client's workplace on an unlimited basis, except in the case of catastrophic events. A "catastrophic event" is defined as an incident requiring more than twenty (20) hours of counseling. In such an event, beginning with the ~ 151 hour. MHN shall bill Client at the rate of $250.00 per hour, or the rate in effect at the time of service in MHN's T raIning & Consulting Schedule, as well as for any travel expenses, including without limitation, practitioner professional fees for travel time, incurred by MHN." 4. Section 3 ,I "Dissemination of Information", shall be deleted and replaced with the following paragraph: "3.1 Dissemination of Information. Client shall infonn all its employees who are Covered Persons of the services provided pursuant to this Agreement, Client shall also provide to Covered Persons information as to the existence and tenns of this Agreement and shall annually distribute to Covered Persons copies of the MHN Combined Evidence of Coverage and Disclosure Fonn and any other appropriate MHN infonnation materials periodically as MHN may request. Except with respect to materials prepared solely by MHN and distributed in accordance with MHN's instructions, MHN shall have no responsibility for the correctness of any infonnation disseminated by Client or compliance with applicable laws. rules, or regulations, Client, as plan fiduciary, understands and agrees that it shan be fuUy responsible for Plan compliance with all relevant provisions of the Employee Retirement Income Security Act of 1974 (ERISA), as amended, including, but not limited to, any disclosures required to be given to Covered Persons under applicable Department of Labor regulations and/or other legal and regulatory requirements. The Client acknowledges that any designated Plan Administrator shall be responsible for Plan compliance including, but not limited to, the following: a) preparation and filing of Fonns 5500 and/or 990; b) preparation, review and distribution of a Summary Plan Description as required by ERISA; and c) filing Summary Plan Description with U.S. Department of Labor." ." I ) !1:f"J'.004 Page I of5