Appendix_C_-_Minimum_Insurance_Req.pdf

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Attached to
Health Reimbursement Arrangement (HRA) Plan currently called County of Sacramento Retiree Health Savings Plan (RHSP). Record-keeper RFP
Solicitation number
HRA_RHSP05022022
Issued by
Sacramento County, San Francisco City, California

About this file

This document is Appendix C - Insurance Requirements for a Retiree Health Plan Administrator contract with the County of Sacramento, California. The appendix details comprehensive insurance coverage requirements for a contractor providing health plan administration services, specifying multiple types of mandatory insurance including General Liability, Automobile Liability, Workers' Compensation, Professional Liability, Crime Policy, and Cyber Liability. The document outlines specific minimum insurance limits for each coverage type, with General Liability set at $2,000,000 per occurrence and aggregate, Professional Liability at $3,000,000 per claim and aggregate, and Cyber Liability at $2,000,000 per claim and aggregate.

The insurance requirements are designed to protect the County of Sacramento from potential risks associated with the health plan administration services, with provisions for insurers to have a minimum A.M. Best's rating of A-: VII. The contractor must maintain all insurance coverages continuously, provide evidence of renewal within 10 days of each policy's anniversary, and immediately notify the county of any potential changes or cancellations in coverage. Additional requirements include endorsing the County of Sacramento and its representatives as additional insureds, maintaining primary insurance status, and providing waiver of subrogation for workers' compensation. The detailed specifications reflect a comprehensive risk management approach typical of large public sector health benefit administration contracts.

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Appendix C - COUNTY OF SACRAMENTO

INSURANCE REQUIREMENTS FOR

RETIREE HEALTH PLAN ADMINISTRATOR

Without limiting CONTRACTOR'S indemnification, CONTRACTOR shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the Agreement by CONTRACTOR, its agents, representatives, or employees. The County of Sacramento shall retain the right at any time to review the coverage, form, and amount of the insurance required hereby. If in the opinion of The County Risk Manager, insurance provisions in these requirements do not provide adequate protection for the County and for members of the public, the County may require CONTRACTOR to obtain insurance sufficient in coverage, form and amount to provide adequate protection. The County’s requirements shall be reasonable but shall be imposed to assure protection from and against the kind and extent of risks that exist at the time a change in insurance is required.

1. Verification of Coverage

CONTRACTOR shall furnish the County with certificates evidencing coverage required below. Copies of required endorsements must be attached to certificates provided. The County Risk Manager may approve self-insurance programs in lieu of required policies of insurance if, in the opinion of the Risk Manager, the interests of the County of Sacramento and general public are adequately protected. All certificates, evidences of self-insurance, and additional insured endorsements are to be received and approved by the County before performance commences.

The County reserves the right to require that CONTRACTOR provide complete copies of any policy of insurance including endorsements offered in compliance with these specifications.

2. Minimum Scope of Insurance

Coverage shall be at least as broad as:

GENERAL LIABILITY: Insurance Services Office’s Commercial General Liability occurrence coverage form CG 0001. Including, but not limited to Premises/Operations, Products/Completed Operations, Contractual, and Personal & Advertising Injury, without additional exclusions or limitations, unless approved by the County- Risk Manager.

AUTOMOBILE LIABILITY: Insurance Services Office’s Commercial Automobile Liability coverage form CA 0001. Commercial Automobile Liability: auto coverage symbol “1” (any auto) for corporate/business owned vehicles. If there are no owned or leased vehicles, symbols 8 and 9 for non-owned and hired autos shall apply. Personal Lines automobile insurance shall apply if vehicles are individually owned.

WORKERS’ COMPENSATION: Statutory requirements of the State of California and Employer's Liability Insurance.

PROFESSIONAL LIABILITY or Errors and Omissions Liability insurance appropriate to CONTRACTOR'S profession.

CRIME POLICY: To cover CONTRACTOR and its agents for dishonest and fraudulent acts by employees including theft of money, securities or property or by using computers to transfer covered property.

CYBER LIABILITY, including identity theft, information security and privacy injury.

1. Third party injury or damage (including loss or corruption of data) arising from a negligent act, error or omission or a data breach.

2. Defense, indemnity and legal costs associated with regulatory breach, (including HIPAA) negligence or where a covered event results in a breach of contract.

3. Administrative expenses for forensic expenses and legal services

4. Crisis management expenses for printing, advertising, mailing of materials and travel costs of crisis management firm, including notification expenses.

5. Identity event service expenses for identify theft education, assistance, credit file monitoring to mitigate effects of personal identity event, post event services.

UMBRELLA or Excess Liability policies are acceptable where the need for higher liability limits is noted in the Minimum Limits of Insurance and shall provide liability coverages that at least follow form over the underlying insurance requirements where necessary for Commercial General Liability, Commercial Automobile Liability, Employers’

Liability, and any other liability coverage (other than Professional Liability) designated under the Minimum Scope of Insurance.

3. Minimum Limits of Insurance

CONTRACTOR shall maintain limits no less than:

General Liability shall be on an Occurrence basis (as opposed to Claims Made basis). Minimum limits and structure shall be:

General Aggregate: $2,000,000

Products Comp/Op Aggregate: $2,000,000

Personal & Adv. Injury: $2,000,000

Each Occurrence: $2,000,000

Automobile Liability:

A. Commercial Automobile Liability for Corporate/business owned vehicles including non-owned and hired, $1,000,000 Combined Single Limit.

B. Personal Lines Automobile Liability for Individually owned vehicles, $250,000 per person, $500,000 each accident, $100,000 property damage.

Workers' Compensation: Statutory.

Employer's Liability: $1,000,000 per accident for bodily injury or disease.

Professional Liability or Errors and Omissions Liability: $3,000,000 per claim and aggregate.

Crime Policy: $5,000,000 single loss limit of liability.

Cyber Liability: $2,000,000 per claim and aggregate.

4. Deductibles and Self-Insured Retention

Any deductible or self-insured retention that apply to any insurance required by this Agreement must be declared and approved by the County.

5. Claims Made Professional Liability Insurance

If professional liability coverage is written on a Claims Made form:

A. The "Retro Date" must be shown, and must be on or before the date of the Agreement or the beginning of Agreement performance by

CONTRACTOR.

B. Insurance must be maintained and evidence of insurance must be provided for at least two (2) years after completion of the Agreement.

C. If coverage is cancelled or non-renewed, and not replaced with another claims made policy form with a "Retro Date" prior to the contract effective date, CONTRACTOR must purchase "extended reporting" coverage for a minimum of two (2) years after completion of the Agreement.

6. Other Insurance Provisions

The insurance policies required in this Agreement are to contain, or be endorsed to contain, as applicable, the following provisions:

7. All Policies:

a. ACCEPTABILITY OF INSURERS: Insurance is to be placed with insurers with a current A.M. Best's rating of no less than A-: VII.

County Risk Manager may waive or alter this requirement, or accept self-insurance in lieu of any required policy of insurance if, in the opinion of the Risk Manager, the interests of the County and the general public are adequately protected.

b. MAINTENANCE OF INSURANCE COVERAGE: The CONTRACTOR shall maintain all insurance coverages and limits in place at all times and provide the County with evidence of each policy's renewal within ten (10) days after its anniversary date. CONTRACTOR is required by this Agreement to immediately notify the County if they receive a communication from their insurance carrier or agent that any required insurance is to be canceled, non-renewed, reduced in scope or limits or otherwise materially changed. CONTRACTOR shall provide evidence that such cancelled or non-renewed or otherwise materially changed insurance has been replaced or its cancellation notice withdrawn without any interruption in coverage, scope, or limits. Failure to maintain required insurance in force shall be considered a material breach of the Agreement.

c.If CONTRACTOR maintains higher limits than the minimums shown above, whether on a primary or excess basis, County requires and shall be entitled to coverage with the higher limits maintained by Concessionaire. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverages shall be available to the Additional Insured Parties.

8. Commercial General Liability and/or Commercial Automobile

Liability:

a. ADDITIONAL INSURED STATUS: The County of Sacramento, and its governing Board, officers, directors, officials, employees, and authorized agents and volunteers (each an “Additional Insured Party,” and collectively “Additional Insured Parties”), are to be endorsed as additional insureds as respects: liability arising out of activities performed by or on behalf of CONTRACTOR; products and completed operations of CONTRACTOR; premises owned, occupied or used by CONTRACTOR; or automobiles owned, leased, hired or borrowed by CONTRACTOR. The coverage shall contain no endorsed limitations on the scope of protection afforded to the Additional Insured Parties.

b. PRIMARY INSURANCE: For any claims related to this agreement, CONTRACTOR'S insurance coverage shall be endorsed to be primary insurance as respects the Additional Insured Parties. Any insurance or self-insurance maintained by the Additional Insured Parties shall be excess of CONTRACTOR'S insurance and shall not contribute with it.

c. SEVERABILITY OF INTEREST: CONTRACTOR'S insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability.

d. SUBCONTRACTORS: CONTRACTOR shall be responsible for the acts and omissions of all its subcontractors and additional insured endorsements as provided by CONTRACTOR’S subcontractor.

9. Professional Liability:

PROFESSIONAL LIABILITY PROVISION: Any professional liability or errors and omissions policy required hereunder shall apply to any claims, losses, liabilities, or damages, demands, and actions arising out of or resulting from professional services provided under this Agreement.

10. Workers’ Compensation:

WORKERS’ COMPENSATION WAIVER OF SUBROGATION: The workers' compensation policy required hereunder shall be endorsed to state that the workers' compensation carrier waives its right of subrogation against the County of Sacramento, its governing Board, officers, directors, officials, employees, authorized agents and volunteers, which might arise by reason of payment under such policy in connection with performance under this Agreement by CONTRACTOR. Should CONTRACTOR be self-insured for workers' compensation, CONTRACTOR hereby agrees to waive its right of subrogation against the County of Sacramento, its governing Board, officers, directors, officials, employees, and authorized agents and volunteers.

11. Notification of Claim

If any claim for damages is filed with CONTRACTOR or if any lawsuit is instituted against CONTRACTOR, that arise out of or are in any way connected with CONTRACTOR’S performance under this Agreement and that in any way, directly or indirectly, contingently or otherwise, affect or might reasonably affect the County of Sacramento, CONTRACTOR shall give prompt and timely notice thereof to the County. Notice shall be prompt and timely if given within thirty (30) days following the date of receipt of a claim or ten (10) days following the date of service of process of a lawsuit.

1. Verification of Coverage
CONTRACTOR shall furnish the County with certificates evidencing coverage required below. Copies of required endorsements must be attached to certificates provided. The County Risk Manager may approve self-insurance programs in lieu of required polici...
2. Minimum Scope of Insurance
Coverage shall be at least as broad as:
GENERAL LIABILITY: Insurance Services Office’s Commercial General Liability occurrence coverage form CG 0001. Including, but not limited to Premises/Operations, Products/Completed Operations, Contractual, and Personal & Advertising Injury, without a...
AUTOMOBILE LIABILITY: Insurance Services Office’s Commercial Automobile Liability coverage form CA 0001. Commercial Automobile Liability: auto coverage symbol “1” (any auto) for corporate/business owned vehicles. If there are no owned or leased v...
WORKERS’ COMPENSATION: Statutory requirements of the State of California and Employer's Liability Insurance.
PROFESSIONAL LIABILITY or Errors and Omissions Liability insurance appropriate to CONTRACTOR'S profession.
UMBRELLA or Excess Liability policies are acceptable where the need for higher liability limits is noted in the Minimum Limits of Insurance and shall provide liability coverages that at least follow form over the underlying insurance requirements wher...
3. Minimum Limits of Insurance
CONTRACTOR shall maintain limits no less than:
General Liability shall be on an Occurrence basis (as opposed to Claims Made basis). Minimum limits and structure shall be:
General Aggregate: $2,000,000
Products Comp/Op Aggregate: $2,000,000
Personal & Adv. Injury: $2,000,000
Each Occurrence: $2,000,000
Automobile Liability:
Workers' Compensation: Statutory.
Employer's Liability: $1,000,000 per accident for bodily injury or disease.
Professional Liability or Errors and Omissions Liability: $3,000,000 per claim and aggregate.
4. Deductibles and Self-Insured Retention
Any deductible or self-insured retention that apply to any insurance required by this Agreement must be declared and approved by the County.
5. Claims Made Professional Liability Insurance
If professional liability coverage is written on a Claims Made form:
6. Other Insurance Provisions
The insurance policies required in this Agreement are to contain, or be endorsed to contain, as applicable, the following provisions:
7. All Policies:
9. Professional Liability:
PROFESSIONAL LIABILITY PROVISION: Any professional liability or errors and omissions policy required hereunder shall apply to any claims, losses, liabilities, or damages, demands, and actions arising out of or resulting from professional services pro...
10. Workers’ Compensation:
WORKERS’ COMPENSATION WAIVER OF SUBROGATION: The workers' compensation policy required hereunder shall be endorsed to state that the workers' compensation carrier waives its right of subrogation against the County of Sacramento, its governing Board, ...
11. Notification of Claim

If any claim for damages is filed with CONTRACTOR or if any lawsuit is instituted against CONTRACTOR, that arise out of or are in any way connected with CONTRACTOR’S performance under this Agreement and that in any way, directly or indirectly, conting...

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