{"component": "clause", "props": {"groups": [{"snippet": "The Plan Administrator has engaged certain third party administrators (TPA) to assist in the administration of the Plan. Under these TPA arrangements, the Employer has agreed to provide the following information to you (in compliance with the Third Party Administrator Act (e.g. MCL 550.901 et seq): This Basic SPD and Plan document, the Adoption Agreement, and the applicable Benefits Guides, describe your benefits under each benefit program and whether such benefits are self-funded through the general assets of the Employer or fully- insured through an insurance company. If a benefit program is self-funded from the general assets of the Employer (and not fully insured), and in the event such self-funded program or the Employer does not ultimately pay medical expenses that are eligible for payment under the benefit program for any reason, the individuals covered by the Plan may be liable for those expenses. The TPA merely processes claims and does not insure that any medical expenses of individuals covered by the benefit program will be paid. Complete and proper claims for benefits made by individuals covered by the Plan will be promptly processed but that in the event there are delays in processing claims, the individuals covered by the benefit program shall have no greater rights to interest or other remedies against the TPA than as otherwise afforded them by law.", "snippet_links": [{"key": "the-plan-administrator", "type": "clause", "offset": [0, 22]}, {"key": "to-assist", "type": "clause", "offset": [76, 85]}, {"key": "administration-of-the-plan", "type": "clause", "offset": [93, 119]}, {"key": "the-employer", "type": "definition", "offset": [151, 163]}, {"key": "provide-the", "type": "clause", "offset": [178, 189]}, {"key": "the-third-party", "type": "definition", "offset": [239, 254]}, {"key": "plan-document", "type": "clause", "offset": [319, 332]}, {"key": "adoption-agreement", "type": "clause", "offset": [338, 356]}, {"key": "applicable-benefits", "type": "definition", "offset": [366, 385]}, {"key": "your-benefits", "type": "clause", "offset": [403, 416]}, {"key": "benefit-program", "type": "definition", "offset": [428, 443]}, {"key": "general-assets", "type": "definition", "offset": [498, 512]}, {"key": "insurance-company", "type": "definition", "offset": [558, 575]}, {"key": "fully-insured", "type": "definition", "offset": [662, 675]}, {"key": "in-the-event", "type": "clause", "offset": [682, 694]}, {"key": "funded-program", "type": "definition", "offset": [705, 719]}, {"key": "medical-expenses", "type": "clause", "offset": [760, 776]}, {"key": "for-payment", "type": "clause", "offset": [795, 806]}, {"key": "the-benefit", "type": "definition", "offset": [813, 824]}, {"key": "for-any-reason", "type": "clause", "offset": [833, 847]}, {"key": "covered-by", "type": "definition", "offset": [865, 875]}, {"key": "processes-claims", "type": "definition", "offset": [934, 950]}, {"key": "expenses-of", "type": "clause", "offset": [988, 999]}, {"key": "claims-for-benefits", "type": "clause", "offset": [1077, 1096]}, {"key": "processing-claims", "type": "clause", "offset": [1206, 1223]}, {"key": "rights-to-interest", "type": "clause", "offset": [1294, 1312]}, {"key": "other-remedies", "type": "clause", "offset": [1316, 1330]}], "size": 2, "samples": [{"hash": "aAMLbk1Abmd", "uri": "/contracts/aAMLbk1Abmd#third-party-administrators", "label": "Adoption Agreement", "score": 30.7433069188, "published": true}, {"hash": "8LevSIISpH5", "uri": "/contracts/8LevSIISpH5#third-party-administrators", "label": "Adoption Agreement", "score": 23.0602327173, "published": true}], "hash": "106ed9512d5be8bbd699dea8bc47f0e1", "id": 1}, {"snippet": "1.2.1 Each party will transmit Documents directly through State of Ohio Electronic Commerce Center (ECC) a third party administrator (\"Agent\").\n1.2.2 ODA shall be responsible for the costs of the Agent with which it contracts.\n1.2.3 Each party shall be responsible for the acts or omissions of the Agent while transmitting, receiving, storing or handling Documents or performing related activities for such party. As both parties will be using the same Agent to effect the transmission and receipt of a Document, the originating party shall be responsible for the acts or omissions of such Agent relative to such Document.", "snippet_links": [{"key": "each-party-will", "type": "clause", "offset": [6, 21]}, {"key": "state-of-ohio", "type": "definition", "offset": [58, 71]}, {"key": "electronic-commerce", "type": "clause", "offset": [72, 91]}, {"key": "third-party-administrator", "type": "definition", "offset": [107, 132]}, {"key": "responsible-for", "type": "clause", "offset": [163, 178]}, {"key": "costs-of", "type": "clause", "offset": [183, 191]}, {"key": "the-agent", "type": "clause", "offset": [192, 201]}, {"key": "it-contracts", "type": "definition", "offset": [213, 225]}, {"key": "acts-or-omissions", "type": "definition", "offset": [273, 290]}, {"key": "related-activities", "type": "clause", "offset": [379, 397]}, {"key": "such-party", "type": "clause", "offset": [402, 412]}, {"key": "both-parties-will", "type": "clause", "offset": [417, 434]}, {"key": "the-transmission", "type": "clause", "offset": [469, 485]}, {"key": "receipt-of", "type": "clause", "offset": [490, 500]}, {"key": "originating-party", "type": "definition", "offset": [517, 534]}], "size": 2, "samples": [{"hash": "dcDQROJvkI4", "uri": "/contracts/dcDQROJvkI4#third-party-administrators", "label": "Electronic Data Interchange Trading Partner Agreement", "score": 25.7994524298, "published": true}, {"hash": "8lM8f5T17DK", "uri": "/contracts/8lM8f5T17DK#third-party-administrators", "label": "Electronic Data Interchange Trading Partner Agreement", "score": 25.7994524298, "published": true}], "hash": "8d24555a68ae370e20554a8a3b759df1", "id": 2}, {"snippet": "(a) To the Knowledge of SALIC, from January 1, 2014 to the date hereof, each third- party administrator that managed or administered insurance business for the SALIC Group Companies, at the time such Person managed or administered such business, was duly licensed or registered as required by Applicable Law (for the type of business managed or administered on behalf of the Scottish Insurance Companies), and to the Knowledge of SALIC, no such third- party administrator is in violation (or with or without notice or lapse of time or both, would be in violation) of any term or provision of any Applicable Law related to the administration or management of insurance business for the Scottish Insurance Companies, except for such failures to be licensed or such violations which have been cured, resolved or settled through agreements with applicable Governmental Authorities or are barred by an applicable statute of limitations or, individually or in the aggregate, are not material.", "snippet_links": [{"key": "knowledge-of", "type": "clause", "offset": [11, 23]}, {"key": "date-hereof", "type": "clause", "offset": [59, 70]}, {"key": "insurance-business", "type": "clause", "offset": [133, 151]}, {"key": "group-companies", "type": "clause", "offset": [166, 181]}, {"key": "at-the-time", "type": "clause", "offset": [183, 194]}, {"key": "duly-licensed", "type": "clause", "offset": [250, 263]}, {"key": "as-required-by", "type": "clause", "offset": [278, 292]}, {"key": "applicable-law", "type": "clause", "offset": [293, 307]}, {"key": "type-of-business", "type": "clause", "offset": [317, 333]}, {"key": "on-behalf-of", "type": "clause", "offset": [358, 370]}, {"key": "insurance-companies", "type": "definition", "offset": [384, 403]}, {"key": "in-violation", "type": "definition", "offset": [475, 487]}, {"key": "without-notice", "type": "definition", "offset": [500, 514]}, {"key": "lapse-of-time", "type": "clause", "offset": [518, 531]}, {"key": "provision-of", "type": "clause", "offset": [579, 591]}, {"key": "related-to", "type": "clause", "offset": [611, 621]}, {"key": "the-administration", "type": "clause", "offset": [622, 640]}, {"key": "management-of", "type": "clause", "offset": [644, 657]}, {"key": "applicable-governmental-authorities", "type": "definition", "offset": [841, 876]}, {"key": "statute-of-limitations", "type": "definition", "offset": [908, 930]}, {"key": "in-the-aggregate", "type": "definition", "offset": [951, 967]}, {"key": "not-material", "type": "clause", "offset": [973, 985]}], "size": 2, "samples": [{"hash": "2fS7znpRDN8", "uri": "/contracts/2fS7znpRDN8#third-party-administrators", "label": "Stock Purchase Agreement", "score": 29.1600927564, "published": true}], "hash": "cf13120222938ddf0dcd8783d3e212e7", "id": 3}, {"snippet": "Since the IPO Date, each third-party administrator, insurance claims adjuster or managing general agent that managed, adjusted or administered the business for the Insurance Subsidiaries (whether or not Affiliates thereof) at the time such person managed, adjusted or administered the business, to the Knowledge of the Company, was duly licensed as required by applicable Insurance Law (for the type of business managed or administered on behalf of the Insurance Subsidiaries), and to the Knowledge of the Company, no such third-party administrator, adjuster or managing general agent has been since the IPO Date, or is, in violation (or with or without notice or lapse of time or both, would be in violation) of any term or provision of any applicable Insurance Law applicable to the administration, adjusting or management of insurance business for the Insurance Subsidiaries, except as is not, or would not reasonably be expected to be, material to the Company and its Subsidiaries, taken as a whole.", "snippet_links": [{"key": "ipo-date", "type": "definition", "offset": [10, 18]}, {"key": "claims-adjuster", "type": "definition", "offset": [62, 77]}, {"key": "managing-general-agent", "type": "definition", "offset": [81, 103]}, {"key": "the-business", "type": "clause", "offset": [143, 155]}, {"key": "insurance-subsidiaries", "type": "definition", "offset": [164, 186]}, {"key": "at-the-time", "type": "clause", "offset": [223, 234]}, {"key": "knowledge-of-the-company", "type": "clause", "offset": [302, 326]}, {"key": "duly-licensed", "type": "clause", "offset": [332, 345]}, {"key": "as-required-by", "type": "clause", "offset": [346, 360]}, {"key": "applicable-insurance-law", "type": "definition", "offset": [361, 385]}, {"key": "type-of-business", "type": "clause", "offset": [395, 411]}, {"key": "on-behalf-of", "type": "clause", "offset": [436, 448]}, {"key": "in-violation", "type": "definition", "offset": [621, 633]}, {"key": "without-notice", "type": "definition", "offset": [646, 660]}, {"key": "lapse-of-time", "type": "clause", "offset": [664, 677]}, {"key": "provision-of", "type": "clause", "offset": [725, 737]}, {"key": "applicable-to", "type": "clause", "offset": [767, 780]}, {"key": "the-administration", "type": "clause", "offset": [781, 799]}, {"key": "management-of", "type": "clause", "offset": [814, 827]}, {"key": "insurance-business", "type": "clause", "offset": [828, 846]}, {"key": "the-company-and-its-subsidiaries", "type": "clause", "offset": [952, 984]}, {"key": "taken-as-a-whole", "type": "clause", "offset": [986, 1002]}], "size": 1, "samples": [{"hash": "cL7p2Py3fn6", "uri": "/contracts/cL7p2Py3fn6#third-party-administrators", "label": "Merger Agreement (ProSight Global, Inc.)", "score": 32.5893223819, "published": true}], "hash": "3be4ca787ad3f2496fd3d037a78ecfa7", "id": 4}, {"snippet": "The Company may transfer the Participant\u2019s Personal Data to the Company's Affiliates outside of the United States of America, who assists the Company with the implementation, administration and management of the Plan, including the Affiliates payroll provider. In the future, the Company may share the Participant\u2019s personal data with another company that serves in a similar manner. The Participant may be asked to agree to the terms and data processing practices with the Affiliate or the Affiliate's payroll provider, which is a condition to the Participant\u2019s ability to participate in the Plan. c. International Data Transfers. The Company is based in the United States of America. The Participant should note that the Participant\u2019s country of residence may have enacted data privacy laws that are different from the United States of America. The Company\u2019s legal basis for the transfer of the Participant\u2019s Personal Data to the United States of America is the Participant\u2019s consent. d. Voluntariness and Consequences of Consent Denial or Withdrawal. The Participant\u2019s participation in the Plan and his or her grant of consent is purely voluntary. The Participant may deny or withdraw his or her consent at any time. If the Participant does not consent, or if the Participant later withdraws his or her consent, the Participant may be unable to participate in the Plan. This would not affect the Participant\u2019s existing employment or salary; instead, the Participant merely may forfeit the opportunities associated with the Plan. e.", "snippet_links": [{"key": "the-participant", "type": "clause", "offset": [25, 40]}, {"key": "personal-data", "type": "clause", "offset": [43, 56]}, {"key": "to-the-company", "type": "clause", "offset": [57, 71]}, {"key": "the-united-states-of-america", "type": "clause", "offset": [96, 124]}, {"key": "management-of-the", "type": "clause", "offset": [194, 211]}, {"key": "payroll-provider", "type": "definition", "offset": [243, 259]}, {"key": "the-future", "type": "clause", "offset": [264, 274]}, {"key": "agree-to", "type": "clause", "offset": [416, 424]}, {"key": "terms-and", "type": "clause", "offset": [429, 438]}, {"key": "processing-practices", "type": "definition", "offset": [444, 464]}, {"key": "the-affiliate", "type": "clause", "offset": [470, 483]}, {"key": "ability-to", "type": "definition", "offset": [563, 573]}, {"key": "participate-in", "type": "definition", "offset": [574, 588]}, {"key": "international-data-transfers", "type": "clause", "offset": [602, 630]}, {"key": "in-the-united-states", "type": "clause", "offset": [653, 673]}, {"key": "country-of-residence", "type": "definition", "offset": [737, 757]}, {"key": "data-privacy-laws", "type": "clause", "offset": [775, 792]}, {"key": "legal-basis", "type": "definition", "offset": [861, 872]}, {"key": "transfer-of-the", "type": "clause", "offset": [881, 896]}, {"key": "voluntariness-and-consequences-of-consent-denial-or-withdrawal", "type": "clause", "offset": [990, 1052]}, {"key": "participation-in-the-plan", "type": "clause", "offset": [1072, 1097]}, {"key": "grant-of-consent", "type": "clause", "offset": [1113, 1129]}, {"key": "at-any-time", "type": "clause", "offset": [1207, 1218]}, {"key": "associated-with", "type": "definition", "offset": [1506, 1521]}], "size": 1, "samples": [{"hash": "7Hm7jduaLet", "uri": "/contracts/7Hm7jduaLet#third-party-administrators", "label": "Restricted Cash Award Agreement (Interpublic Group of Companies, Inc.)", "score": 30.1430527036, "published": true}], "hash": "80248b769c2fd4f0a543bf41dc77b25d", "id": 5}, {"snippet": "The parties agree that the BOE shall have the sole authority to select and contract with a Third-Party Administrator to manage and administrate the Section 125 Plan.", "snippet_links": [{"key": "the-parties-agree-that", "type": "clause", "offset": [0, 22]}, {"key": "authority-to", "type": "clause", "offset": [51, 63]}, {"key": "section-125-plan", "type": "clause", "offset": [148, 164]}], "size": 1, "samples": [{"hash": "7gmYuwYPxFO", "uri": "/contracts/7gmYuwYPxFO#third-party-administrators", "label": "Collective Bargaining Agreement", "score": 21.7618069815, "published": true}], "hash": "6aabe44b507b34b4c93ad771b1a02e60", "id": 6}, {"snippet": "1.2.1 Each party will transmit Documents directly or through a third party administrator (\"Agent\"), as will be specified by the party in the MACSIS claims testing process. Either party may modify its election to use, not use, or change an Agent upon thirty days prior written notice to the other party.\n1.2.2 Each party shall be responsible for the costs of any Agent with which it contracts.\n1.2.3 Each party shall be responsible for the acts or omissions of its Agent while transmitting, receiving, storing or handling Documents or performing related activities for such party. If both parties use the same Agent to effect the transmission and receipt of a Document, the originating party shall be responsible for the acts or omissions of such Agent relative to such Document.", "snippet_links": [{"key": "each-party-will", "type": "clause", "offset": [6, 21]}, {"key": "third-party-administrator", "type": "definition", "offset": [63, 88]}, {"key": "the-party", "type": "clause", "offset": [124, 133]}, {"key": "testing-process", "type": "definition", "offset": [155, 170]}, {"key": "either-party", "type": "definition", "offset": [172, 184]}, {"key": "an-agent", "type": "clause", "offset": [236, 244]}, {"key": "notice-to-the", "type": "clause", "offset": [276, 289]}, {"key": "other-party", "type": "definition", "offset": [290, 301]}, {"key": "responsible-for", "type": "clause", "offset": [329, 344]}, {"key": "costs-of", "type": "clause", "offset": [349, 357]}, {"key": "it-contracts", "type": "definition", "offset": [379, 391]}, {"key": "acts-or-omissions", "type": "definition", "offset": [439, 456]}, {"key": "related-activities", "type": "clause", "offset": [545, 563]}, {"key": "such-party", "type": "clause", "offset": [568, 578]}, {"key": "both-parties", "type": "clause", "offset": [583, 595]}, {"key": "the-transmission", "type": "clause", "offset": [625, 641]}, {"key": "receipt-of", "type": "clause", "offset": [646, 656]}, {"key": "originating-party", "type": "definition", "offset": [673, 690]}], "size": 1, "samples": [{"hash": "24feJSnhf7p", "uri": "/contracts/24feJSnhf7p#third-party-administrators", "label": "Trading Partner and Business Associate Agreement", "score": 21.0, "published": true}], "hash": "d891b3184caeffc180c5f269de802209", "id": 7}, {"snippet": "Unless it obtains the prior written consent of the Company, the Reinsurer shall not use the services of any third-party administrators in connection with the administration and servicing of the Policies.", "snippet_links": [{"key": "consent-of-the-company", "type": "clause", "offset": [36, 58]}, {"key": "the-reinsurer", "type": "clause", "offset": [60, 73]}, {"key": "the-services", "type": "definition", "offset": [88, 100]}, {"key": "in-connection-with", "type": "clause", "offset": [135, 153]}, {"key": "the-policies", "type": "clause", "offset": [190, 202]}], "size": 1, "samples": [{"hash": "crBtrPv437d", "uri": "/contracts/crBtrPv437d#third-party-administrators", "label": "Coinsurance and Servicing Agreement (Kansas City Life Insurance Co)", "score": 18.0, "published": true}], "hash": "dfa4d5395274e91071b39487297fc7ec", "id": 8}, {"snippet": "Neither the Ceding Company nor any of its Affiliates (a) is party to a contract with a third party administrator pursuant to which such third party administrator administers or otherwise provides services in respect of the Business or the Reinsured Liabilities (a \u201cThird Party Administrator\u201d) or (b) owes any amount to a Third Party Administrator in respect of the Business or the Reinsured Liabilities.", "snippet_links": [{"key": "the-ceding-company", "type": "clause", "offset": [8, 26]}, {"key": "third-party-administrator", "type": "definition", "offset": [87, 112]}, {"key": "pursuant-to", "type": "definition", "offset": [113, 124]}, {"key": "in-respect-of", "type": "clause", "offset": [205, 218]}, {"key": "the-business", "type": "clause", "offset": [219, 231]}, {"key": "reinsured-liabilities", "type": "definition", "offset": [239, 260]}], "size": 1, "samples": [{"hash": "bkWQ4KC8jds", "uri": "/contracts/bkWQ4KC8jds#third-party-administrators", "label": "Master Transaction Agreement (Cna Financial Corp)", "score": 31.9979466119, "published": true}], "hash": "47e3878e7541a6f74ae70ad2c44204dd", "id": 9}, {"snippet": "Except as set forth in Section 5.21 of the Seller Disclosure Schedule, to the Knowledge of Seller, since January 1, 2017, each third party administrator that managed or administered insurance business for the Company, the Company Subsidiary or, with respect to the Reinsured Business, ELIC, at the time such Person managed or administered such business, was duly licensed as required by applicable Law (for the type of business managed or administered on behalf of such entity), and to the Knowledge of Seller, no such third party administrator has been since January 1, 2017 or is in violation (or with or without notice or lapse of time or both, would be in violation) of any term or provision of any applicable Law applicable to the administration or management of insurance business for the Company, the Company Subsidiary or, with respect to the Reinsured Business, ELIC, except for such failures to be licensed or such violations that, individually or in the aggregate, have not had, and would not reasonably be expected to have, a Business Material Adverse Effect.", "snippet_links": [{"key": "seller-disclosure-schedule", "type": "definition", "offset": [43, 69]}, {"key": "knowledge-of-seller", "type": "clause", "offset": [78, 97]}, {"key": "third-party-administrator", "type": "definition", "offset": [127, 152]}, {"key": "insurance-business", "type": "clause", "offset": [182, 200]}, {"key": "for-the-company", "type": "clause", "offset": [201, 216]}, {"key": "company-subsidiary", "type": "clause", "offset": [222, 240]}, {"key": "with-respect-to", "type": "clause", "offset": [245, 260]}, {"key": "reinsured-business", "type": "definition", "offset": [265, 283]}, {"key": "at-the-time", "type": "clause", "offset": [291, 302]}, {"key": "duly-licensed", "type": "clause", "offset": [358, 371]}, {"key": "as-required-by", "type": "clause", "offset": [372, 386]}, {"key": "applicable-law", "type": "clause", "offset": [387, 401]}, {"key": "type-of-business", "type": "clause", "offset": [411, 427]}, {"key": "on-behalf-of", "type": "clause", "offset": [452, 464]}, {"key": "in-violation", "type": "definition", "offset": [582, 594]}, {"key": "without-notice", "type": "definition", "offset": [607, 621]}, {"key": "lapse-of-time", "type": 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["health-benefit-claims", "Health Benefit Claims"], ["workforce-of-the-plan", "Workforce of the Plan"], ["claims-for-benefits", "Claims for Benefits"], ["urgent-care", "Urgent Care"]], "parents": [["miscellaneous", "Miscellaneous"], ["representations-and-warranties-of-salic", "REPRESENTATIONS AND WARRANTIES OF SALIC"], ["representations-and-warranties-of-the-company-parties", "REPRESENTATIONS AND WARRANTIES OF THE COMPANY PARTIES"], ["scope-of-services", "SCOPE OF SERVICES"], ["duration-and-recapture", "DURATION AND RECAPTURE"]], "id": "third-party-administrators", "related": [["third-party-administrators-for-defined-contribution-plans", "Third Party Administrators for Defined Contribution Plans", "<strong>Third Party Administrators</strong> for Defined Contribution Plans"], ["pay-administration", "PAY ADMINISTRATION", "PAY ADMINISTRATION"], ["regulatory-administration-services", "REGULATORY ADMINISTRATION SERVICES", "REGULATORY ADMINISTRATION SERVICES"], ["policy-administration", "Policy Administration", "Policy Administration"], ["salary-administration", "Salary Administration", "Salary Administration"]], "related_snippets": [], "updated": "2025-07-07T12:35:11+00:00", "also_ask": ["What key qualifications and oversight mechanisms should be mandated for third party administrators?", "How can liability and indemnification provisions be structured to minimize client risk?", "What are the most common negotiation pitfalls when defining third party administrator roles?", "How do third party administrator clauses differ across jurisdictions or industry standards?", "What factors most often determine enforceability of third party administrator obligations in court?"], "drafting_tip": "Specify the TPA's authority and responsibilities to prevent scope disputes; require compliance with applicable laws to ensure enforceability; mandate regular reporting to maintain transparency.", "explanation": "The Third Party Administrators clause defines the rights and responsibilities related to the use of external organizations or individuals to manage certain administrative functions on behalf of a party to the contract. Typically, this clause outlines which tasks may be delegated, such as claims processing or benefits administration, and may set standards for the selection, oversight, and accountability of the third party administrator. Its core practical function is to clarify the scope and limits of outsourcing administrative duties, ensuring that both parties understand how such arrangements will be managed and who remains ultimately responsible for compliance and performance."}, "json": true, "cursor": ""}}