a. The Contractor, upon request by the State, shall review and comment on benefit provisions in the Plan. When so requested, the Contractor shall comment in regard to: 1) industry practices; and/or 2) the general financial impact to premium rates plus Plan and Member costs if future changes were made to the Benefits of the Plan. b. The Contractor shall provide assistance and information (not legal advice) to the State regarding applicable existing and proposed Federal and State laws, court holdings and regulations affecting the Plan, and other Plan related matters as needed. c. The Contractor shall provide assistance with questions and issues raised by the State, individual employees/retirees, former and current Members and others identified by the State. The Contractor shall log escalated questions (other than general routine questions identified by the State In Writing) and issues and submit the log to the State as specified in Contract Attachment C, #19. d. The Contractor shall refer calls regarding eligibility and premium payment issues to the State. e. The Contractor shall respond to all inquiries In Writing from the State within two (2) Business Days after receipt of said inquiry. In cases where additional information to answer the State’s inquiry is required, the Contractor shall notify the Statewithin one (1) Business Days as to when the response can be furnished to the State. For matters designated as urgent by the State, the Contractor shall provide a response to the State on the same business day. During non-business hours, the Contractor shall provide a response to urgent matters to the State on the next business day. Staff members, from the applicable business unit, with final decision-making authority shall provide responses. Said responses may be communicated through the account manager...
