Stop Loss Confidentiality Agreement with Cigna Health and Life Insurance Company 20/6—°Z9cl7y
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Cigna®
STOP LOSS CONFIDENTIALITY AGREEMENT
THIS AGREEMENT, effective as of October 1, 2016 is between and among
Symetra Life Insurance Company ("Stop Loss Carrier"), Cigna Health and Life Insurance
Company ("Cigna"), and City of Miami Beach ("Employer").
WHEREAS, Cigna furnishes claim administration services to Employer with respect to
Employer's self-funded employee benefit plan (the "Plan"); and
WHEREAS, Employer has requested that Cigna furnish its standard third party stop loss
reporting package (the "Confidential Information") to Stop Loss Carrier from time to time,
related to the claim processing services that are provided by Stop Loss Carrier with
respect to the stop loss policy (the "Stop Loss Policy") provided to Employer by Stop
Loss Carrier with respect to the Plan, and
WHEREAS, Employer and Stop Loss Carrier understand and acknowledge that any and
all individually identifiable information contained in such Confidential Information is
confidential; and
WHEREAS, Cigna is willing to make the Confidential Information available to Stop Loss
Carrier in accordance with the request of Employer, upon the condition that Employer
and Stop Loss Carrier provide proper assurances, including assurances of protection
against claims or liability arising out of Cigna release of the Confidential Information to
Stop Loss Carrier,
NOW, THEREFORE, in light of the foregoing and in partial consideration to Cigna for
providing the Confidential Information, Cigna, Employer and Stop Loss Carrier agree as
follows:
1. Cigna agrees to release the Confidential Information to Stop Loss Carrier as
requested by Employer. Consistent with the Employer's Administrative Services
Only agreement which stipulates only standard reports based upon paid claims
data will be provided, the release of Confidential information shall be limited to
Cigna's standard third party reporting package and will not include clinical notes,
case management notes or prognosis information. Cigna makes no warranty,
express or implied, with regard to the content of its standard reporting and does
not guarantee its accuracy or, completeness. Cigna will not be liable for any
damages arising directly or indirectly from the use of(or failure to use), reliance
upon or provision of this report even if Cigna has been advised that such
damages may arise.
2. Employer and Stop Loss Carrier agree that all Confidential Information regarding
persons covered under the Plan and obtained from Cigna shall be used or
disclosed only (i) for purposes of making eligibility and payment determinations
under the Stop Loss Policy, or (ii) as may otherwise be necessary in connection
with administering the Stop Loss Policy, or (iii) as required by law;
3. Employer and Stop Loss Carrier agree to take all necessary precautions to
ensure that all Confidential Information regarding persons covered under the
Plan which is obtained by Employer or by Stop Loss Carrier from Cigna is
disclosed only to those persons who need to know such information for a
purpose described in paragraph 2 above;
4. Employer and Stop Loss Carrier agree that Cigna is not responsible for
reviewing, monitoring, or complying with any disclosure or underwriting
requirements which may be part of the stop loss coverage agreement between
Employer and Stop Loss Carrier. Employer is solely responsible for ensuring
that all underwriting and other requirements for coverage are performed.
5. Stop Loss Carrier agrees to indemnify and hold Cigna harmless from and against
any and all claims, suits, expenses (including reasonable attorneys' fees and
court costs), liabilities or damages (whether resulting from settlement, judgment,
arbitration or otherwise) arising directly or indirectly from Cigna's provision of the
Confidential Information to Employer or to Stop Loss Carrier, or relating directly
or indirectly to the use of Confidential Information by the Employer or the Stop
Loss Carrier, their officers, agents, directors, employees or designees except to
the extent Cigna provided the Confidential Information to an unauthorized party.
6. Employer agrees to waive, release and fully and forever discharge Cigna, its
affiliates and their directors, officers, employees and agents from any and all
injuries, losses, damages, expenses or claims or causes of action whether
known now or hereafter arising relating thereto (including reasonable attorneys'
fees and court costs that they may incur) resulting directly or indirectly from
Cigna's provision of the Confidential Information to the Stop Loss Carrier, or
relating directly or indirectly to the use by the Stop Loss Carrier of Confidential
Information provided by the Stop Loss Carrier, it officers, agents, directors,
employees or designees, except to the extent Cigna provided the Confidential
Information to an unauthorized party.
7. In the event litigation is instituted by a third party against Cigna concerning any
matter under this Agreement, each party shall have sole authority to select legal
counsel of its choice.
IN WITNESS WHEREOF, the parties hereto have caused this Agreement,.• be signed
in triplicate by their duly authorized officers1�..a%" It
Dated at 2�� v''��� QTY' F. l IkBE• H
Attest Ba \°9a t ,�„ . .
Rafael o, City Clerk rwAx � `.
3 day of 201 7,4 .'....` ..•• , 4. /`.
This y tab. , � iy .9 �v. i/
Dated at Y°ild—i ', ° SYMETRA LIFE INSURANCE COMPANY
This �/�� day of IA 41 v'-) , 201? By ii,01.'l
Its Duly Authorized
Dated at Bloomfield, Connecticut CI '.HE• T 'ND LIFE
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This day of 201_ By \••�`��`- \‘ A
APPROVED AS TO .�”
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