2010-06-07_(2).pdf - 19318.8K - BridgeportCT.gov

Customer Name Bridgeport City
BOE
Administrative Services Only Agreement
Exhibit C
Claim Audit Agreement Sample
A WHEREAS Connecticut General Life Insurance Company Connecticut General desires to
cooperate with requests by A Employer
to
permit an audit for the
purposes set forth below and
B WHEREAS the Auditor has been retained by Employer for the purpose of
performing an audit Audit ofclaims administered by
Connecticut General
C
WHEREAS the Auditor and the Employer recognize Connecticut General s legitimate
interests
in maintaining the confidentiality of its claim information protecting its business reputation
avoiding unnecessary disruption
of its claim administration
NOW THEREFORE IN CONSIDERATION ofthe premises and the mutual promises contained
herein Connecticut General the Employer and the Auditor hereby agree
1 Audit Specifications
as follows
The Auditor will specifY to Connecticut General in writing at least forty five 45 days
prior to the commencement ofthe Audit the following Audit Specifications
a
b
c
d
e
f
g
the name title and professional qualifications of individual Auditors
the Claim Office locations if any
to be audited
the Audit objectives
the scope
ofthe Audit time period lines of coverage and number ofclaims
the process by which claims will be selected for audit
the records information required by the Auditor for purposes
the length oftime contemplated as necessary to complete
the Audit
ofthe Audit and
2 Reviewof Specifications
Connecticut General will have the right to review the Audit Specifications and to require
any changes in or conditions on the Audit Specifications which may be necessary to
protect Connecticut Generals legal and business interests identified in paragraph C above
except that such audit may not be limited by Connecticut General for purposes
of
shielding it from legal liability
3 Access to Information
Connecticut General will make the records information called for in the Audit
Specifications available to the Auditor at a mutually acceptable time and place
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