Specifications include, but are not limited to: 1. Recommend changes to the Plan document to keep the Plan Document up to date and compliant. Recommend reasonable policies, procedures, rules and interpretations to promote orderly and efficient administration of this Agreement and the Plan. 2. Provide claims administrative services for Plan Sponsor with respect to claims presented for payment during the term of this Agreement. 3. Provide information and assistance to Plan participants concerning claims for benefits under the Plan. Provide explanation of benefits for payments made and for denial of benefits. Provide claim forms and debit cards as needed. 4. Receive and process claims received after the Effective Date and pay or deny such claims for benefits in accordance with the terms of the Plan Document. 5. Claims payments will be made by the Contractor from an account established by the Contractor. 6. Share information with the State’s health plans and dental plans and coordinate claims for the Health Savings Account participants. 7. If a Plan participant files a written request to the Contractor for a review of any claim processed by the Contractor, the following procedure shall be implemented : a. The Contractor will investigate the request and provide an appropriate written response to the participant within thirty (30) days after date of receipt of the request. Such response will include notification of a right of appeal. b. In the event participant appeals to the Contractor, the Contractor will administer those appeals, subject to the State’s final authority to determine issues which arise under the plan. 8. Maintain records of coverage and claims histories of the Plan participants