New York Laws
Article 5 - Powers, Limitations and Liabilities
92-A - Medical, Surgical and Hospital Services or Insurance for Officers, Employees and Retired Officers and Employees of Public Corporations and Their Famil

(b) In order to authorize the payment of claims for benefits audited
and approved by a contract administrator or other service provider, an
agreement entered into pursuant to this subdivision may provide that
after claims have been audited by the contract administrator or other
service provider, the contract administrator or other service provider
shall periodically inform the public corporation of the total amount
payable in satisfaction of the audited and approved claims, together
with such other supporting information as the public corporation may
require, and the public corporation may transfer moneys in that amount
to the contract administrator or other service provider for disbursement
to the claimants entitled thereto. Any such agreement shall provide that
if a check issued by the contract administrator or other service
provider in satisfaction of a claim remains unpaid after one hundred
eighty days, the moneys payable in satisfaction of that claim shall be
returned to the public corporation.
(c) Any agreement entered into pursuant to this subdivision shall
contain, at a minimum, the following:
(i) a clear statement of the charges, fees or other compensation for
the services provided under the agreement;
(ii) a statement that payment for the services provided under the
agreement shall be made only after the services are rendered;
(iii) a provision stating that the contract administrator or other
service provider to which functions are delegated shall be liable to the
public corporation for all loss or damage that may result from any
failure by the contract administrator or other service provider to
discharge their duties, or from any improper or incorrect discharge of
those duties, and a provision that expressly reserves to the public
corporation all legal rights of set-off. The contract administrator or
service provider shall save the public corporation free and harmless

from any and all loss occasioned by or incurred in the performance of
services under an agreement pursuant to this subdivision;
(iv) a provision requiring the contract administrator or other service
provider to furnish a surety bond, irrevocable letter of credit or
equivalent security, in a form and amount acceptable to the governing
board of the public corporation, to secure the contract administrator's
or other service provider's performance under the agreement;
(v) a provision requiring the contract administrator or service
provider to establish, maintain and retain for a specified period
complete and accurate books, records, documents, accounts and other
evidence pertinent to performance under the agreement, and to submit
quarterly and annual reports, in a form acceptable to the governing
board of the public corporation, detailing the payment of claims and
other activities of the contract administrator or other service provider
during the relevant period. The auditing body or official of the public
corporation shall have access to and may examine such books, records,
documents, accounts and other evidence pertinent to performance under
the agreement upon reasonable notice to the contract administrator or
service provider;
(vi) a provision requiring an annual audit, and opinions thereon, by
an independent certified public accountant, of the accounting procedures
and internal control procedures of the contract administrator or other
service provider;
(vii) a provision by which the contract administrator or other service
provider agrees to maintain the confidentiality of medical records in
its possession and that such confidentiality may only be waived upon the
written consent of the covered person; and
(viii) a provision by which the contract administrator or other
service provider acknowledges that those records maintained on behalf of
the public corporation are subject to the provisions of article six of
the public officers law.
(d) A contract entered into pursuant to this section shall be for a
term not to exceed five years, except that it shall be subject to
cancellation by the municipal corporation at any time upon thirty days'
notice.
7. The provisions of this section shall permit a public corporation to
provide coverage for volunteer firefighters, as defined in section three
of the volunteer firefighters' benefit law, and volunteer ambulance
workers, as defined in subdivision one of section three of the volunteer
ambulance workers' benefit law, provided however, that the total cost of
participation by such volunteers and their families shall be borne by
such volunteers.

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