Niural Legal

Benefits Administration Services Additional Terms

Last updated: Dec 20, 2023

The "Benefits Administration Services Additional Terms" (referred to as "Benefits Administration Additional Terms'') form an integral part of the Niural Customer Terms of Service and are incorporated into it by reference. They can be accessed at https:// www.niural.com/terms-of-service.

Any capitalized terms used in these Benefits Administration Additional Terms, not explicitly defined herein, carry the meanings as defined in the Terms of Service.

These Benefits Administration Additional Terms specify the additional conditions under which Niural will deliver certain benefits administration services, such as "Federal COBRA Administration Services," "ACA Administration Services," and "Flex Benefits Administration Services" (collectively referred to as the "Benefits Administration Services," further detailed below) to the Customer. All provisions within the Niural Terms of Service Agreement, encompassing disclaimers, liability limitations, agreements, and indemnities, are applicable to these Benefits Administration Service Additional Terms.

THOROUGHLY REVIEW THESE BENEFITS ADMINISTRATION ADDITIONAL TERMS. BY ACCEPTING THESE TERMS OR UTILIZING THE BENEFITS ADMINISTRATION SERVICES, YOU ARE AGREEING TO THIS AGREEMENT, INCLUDING THESE BENEFITS ADMINISTRATION ADDITIONAL TERMS WITH NIURAL, AND TO THE COLLECTION AND USAGE OF YOUR INFORMATION AS OUTLINED IN THE NIURAL PRIVACY POLICY, WHICH FORMS A PART OF THIS AGREEMENT.

1. Benefits Administration Services

1.1 Users of Benefits Administration Services.

(a) Entity or Organization Users. 

Niural will grant the Account Administrator and/or an Authorized Representative—authorized to select and oversee Insurance Policies or Benefit Plans (as defined below) on behalf of an entity or organization (referred to as the “Benefits Administrator”)—access to specific administrative and managerial facets of the Benefits Administration Services outlined here. These services will be directly accessible to the Customer or facilitated through the Customer's chosen broker of record, which may or may not be associated with Niural’s digital insurance agency, Niural Insurance Services, Inc. In the event that the Customer has designated Niural Insurance as its broker of record, the Broker Services will be governed by the Broker Services Additional Terms, accessible at https://www.niural.com/broker-terms.

(b) Individual Users.

The Benefits Administration Services for Individual Users will be constrained according to the service descriptions provided below.

1.2 Benefits Administration Services

(a) Entity or Organization Users. 

Niural offers comprehensive services to Benefits Administrators. This includes assistance in:

  • Selecting and managing group health insurance policies from various Benefits Providers.
  • Setting up and overseeing Benefit Plans.
  • Handling specific ERISA-related documents.
  • Optionally assisting with benefits-related payroll data management.

(b) Individual Users.

Niural provides more streamlined services for Individual Users, focusing on:

  • Managing enrollment and disenrollment during specified periods.
  • Providing necessary insurance policy documents and Benefits Provider certificates.
  • By using Niural's Benefits Administration Services, Users agree to abide by the Terms of Service outlined herein.

1.3 Federal COBRA Administration Services

(a) Entity or Organization Users. 

Niural offers services designed to aid Benefits Administrators in complying with federal group health plan continuation coverage regulations (commonly referred to as “COBRA”) as stipulated in Section 4980B of the Internal Revenue Code of 1986 (“Code”), and Sections 601 - 609 of the Employee Retirement Income Security Act of 1974, as amended over time (“ERISA”). Specifically, Niural facilitates the enrollment of Former Employees and their eligible dependents into health insurance coverage as per COBRA continuation provisions, provided the Customer is actively using Benefits Administration Services. The Customer agrees that (i) COBRA administration will occur electronically, (ii) All employees, Former Employees, and their COBRA-eligible dependents have consented to electronic receipt of COBRA-related materials, (iii) These consents comply with prevailing IRS and DOL guidelines.

The Customer acknowledges that if an Individual User (including a Former Employee) or their COBRA-eligible dependents: (i) Request COBRA information or notices via mail, (ii) Attempt to pay COBRA premiums using cash or check.

The Customer becomes immediately responsible for all COBRA administration, payment processing, notices, and related documentation or services for such individuals. Niural may, at its discretion, develop and offer supplementary COBRA administration capabilities, including physical mail notices. Niural does not currently provide state continuation administration services, and compliance with any state health care continuation laws remains the Customer's sole responsibility.

(b) Individual Users.

Individual Users who are Former Employees can utilize Niural's Benefits Administration Service to enroll in COBRA. Former employees who are entitled to state continuation coverage can access their accounts; however, Niural does not guarantee that the Benefits Administration Service will reflect their state COBRA continuation coverage enrollment information.

1.4 ACA Administration Services.

(a) Entity or Organization Users.

Niural provides tailored services for Benefits Administrators to fulfill their year-end reporting duties under the Affordable Care Act (“ACA”). This encompasses the submission of year-end filings associated with ACA compliance, along with the calculation and reporting of specific eligibility criteria. It's crucial to understand that Niural does not currently offer comprehensive ACA compliance services. The responsibility for ACA compliance, including the tracking of eligible part-time employees, remains solely with the Customer.

(b) Individual Users.

Niural's ACA Reporting Services cater to Individual Users by focusing solely on the preparation, distribution, and filing of ACA year-end compliance documents. Specifically designed for Individual Users, these services aim to streamline and support their ACA compliance needs.

1.5 Flex Benefits Administration Services. 

1.6 Limitations on Benefits Administration Information.

Within the scope of the Benefits Administration Service, Niural may furnish oral or written summaries and descriptions of Insurance Policies (referred to as 'Benefits Information'). Should a conflict arise between the Benefits Information and details within Insurance Policy documents or Benefits Provider certificates issued by the Benefits Providers, the information documented in the Insurance Policy documents or Benefits Provider certificates shall take precedence. Niural explicitly disclaims providing legal, tax, or accounting advice. By utilizing the Benefits Administration Service, you acknowledge and consent to understanding that Niural does not offer such advice, and you are advised to seek counsel from your independent legal and tax advisors concerning your utilization of the Benefits Administration Service.

1.7 Niural is not a Benefits Provider or Adviser.

Niural neither serves as a plan sponsor nor a plan administrator for the Insurance Policies or Benefit Plans and does not possess the authority to create, modify, or terminate any of the Insurance Policies or Benefit Plans offered or recommended within the Benefits Administration Service. Additionally, Niural does not engage in claims processing, decision-making, or the establishment of eligibility criteria for specific Insurance Policies or Benefit Plans. While Niural may relay enrollment information to a Benefits Provider, it does not assure or validate that all enrollment details have been processed and approved by the Benefits Provider. It is recommended that you directly engage with the relevant Benefits Provider for inquiries related to eligibility, enrollment, or other pertinent matters within their jurisdiction. Your insurance broker may furnish recommendations and pricing details for Insurance Policies or Benefit Plans from relevant Benefits Providers as part of the Benefits Administration Service. However, the ultimate decision to accept any such Insurance Policy or Benefit Plan solely rests with you.

1.8 Fiduciary Responsibility.

You agree that Niural does not function in a fiduciary role under this agreement, explicitly excluding any representation as a named fiduciary as defined in ERISA section 402(a)(2), or as a "plan administrator" or "plan sponsor" as described in ERISA sections 3(16)(A) and 3(16)(B) respectively. Niural explicitly disclaims any fiduciary status concerning you or any Insurance Policy or Benefit Plan and does not handle claims determinations under ERISA. You acknowledge your continued fiduciary responsibility for all Insurance Policies and Benefit Plans managed or acquired through the Benefits Administration Service. Additionally, it is your responsibility to thoroughly review and ensure the accuracy of all communications, notifications, and invoices directly received from your Benefits Provider.

1.9 Compliance ERISA

Your obligations under ERISA concerning Insurance Policies and Benefit Plans are essential. Niural may support meeting these obligations by providing draft copies of necessary documents like summary plan descriptions and material modifications (referred to as "ERISA Documents"). Additionally, Niural might offer template documents for various Benefit Plans—like Health FSA, Dependent Care FSA, Commuter Plan, and facilitate pre-tax contributions to Health Savings Accounts (HSA)—benefiting your eligible employees (referred to as "Plan Participants"). Despite Niural’s initial provision of these drafts, you acknowledge that you hold complete responsibility for accuracy, legal compliance, completeness, and timely submission of ERISA Documents and Benefit Plan documents. You confirm either: (i) your legal counsel has reviewed these documents or (ii) despite advice, you've chosen not to seek legal counsel for review. Consequently, any penalties, failures, fees, or expenses resulting from these documents will solely be your responsibility.

1.10 Benefit Plan Funding Responsibility

As the sole party responsible for funding benefits under the applicable Benefit Plan, you accept full responsibility. You acknowledge that Niural holds no financial liability or obligation for payment of any Benefit Plan benefits or claims. Should you opt for a Health FSA, Dependent Care FSA, or Commuter Plan, you agree to establish one or more general asset bank accounts in your name and grant Niural Insurance (or its designee) check-writing authority for the designated account. Niural bears no liability for any errors in HSA crediting, including over-crediting, arising from inaccurate or false information provided by you or your employees. While Niural will exert commercially reasonable efforts to facilitate reversals from HSAs, any costs or expenses resulting from crediting errors will be your responsibility.

1.11 ERISA Documents and Benefit Plan Management

Niural retains the right to amend, adjust, or discontinue initial drafts of ERISA Documents or Benefit Plans. While we will notify you of any identified issues or inaccuracies in the ERISA Documents and Benefit Plans, should we become aware, we are not accountable for the design, implementation, amendment, or termination of any Benefit Plan. You agree to inform Niural at least 45 days before the effective date should you amend, modify, or significantly alter any Benefit Plan document. By making amendments or alterations to such documents, you acknowledge full responsibility for ensuring compatibility with the Niural Benefits Administration Services. Niural reserves the right to decline the administration of your modified Benefit Plan document.

2. Additional Responsibilities

2.1 Accuracy of User Representations

To facilitate the Benefit Administration Service effectively, Niural relies on the accuracy, completeness, and timeliness of information provided by you (including your employees and Benefits Administrators) (referred to as "User Representations"). You acknowledge that our service necessitates accurate and reliable User Representations, allowing Niural to conclusively rely on them. It remains your responsibility to confirm carrier enrollments on behalf of your employees. Niural holds no obligation to verify, correct, or ensure the accuracy or quality of User Representations, absolving itself from liability for errors, penalties, or losses resulting from inaccurate or incomplete User Representations submitted by you, an Account Administrator, or an Authorized Representative.

2.2 Electronic Notices

Consent to electronic notice, delivery, payment, debit, and/or communication of all materials related to the Benefits Administration Service is implied from your employees' agreement.

2.3 Error Handling and Notification

Upon becoming aware of any failures, investigations, or penalties related to Benefits Administration Services, you commit to promptly informing Niural in writing and cooperating in resolving such issues. While Niural may attempt to correct errors at your request, it isn't obligated to do so. Niural disclaims liability for any claims or consequences arising directly or indirectly from its attempts to rectify or failure to correct such errors.

2.4 Adherence to Legal Requirements

You solely bear the responsibility for complying with all relevant laws, including but not limited to the Code and ERISA, for each Benefit Plan. Additionally, Niural and Niural Insurance hold no liability if a Plan Participant exceeds contribution limits established by applicable law. Protected health information within 45 C.F.R. Section 160.103 should not be provided to Niural, except regarding Flex Benefits Administration Services.

3. Broker Services Exclusion

The Benefits Administration Services, accessible via your insurance broker as an Authorized Representative, don't encompass broker benefit services within their scope. Niural doesn't partake in activities typical of insurance brokers, such as managing Insurance Policy renewals, submitting enrollment forms to carriers, or confirming carrier enrollments. Fees for utilizing the BeneAdmin Services are your responsibility, even if covered through your broker.

4. Fees for Benefits Administration Services

Niural might waive Benefits Administration Services fees if Customer receives Broker Services from Niural Insurance or its affiliates. If the Client revokes the status of Niural Insurance or a Niural Partner as broker of record, prevailing rates for Benefits Administration Services and any additional carrier fees shall apply.

5. Liability Limitation

In addition to the limitations outlined in the Niural Terms of Service, you acknowledge that nothing herein guarantees health insurance coverage or a specific insurance policy/service. Benefits Providers define policy requirements, and Niural assumes no liability for any damages or losses arising from your use of any Benefits Provider’s insurance policy or your own insurance broker’s insurance policy.