c)1.3 Relationship of the Parties

c)1.3 Relationship of the Parties

b) Subcontractors. Contractor shall require any subcontractor or assignee to comply with applicable requirements in this Agreement. Nothing in this Agreement shall limit Contractor’s ability to hold subcontractor liable for performance under a contract between Contractor and its subcontractor(s). Contractor’s obligations pursuant to this Agreement and applicable laws, rules or regulations shall not be waived or released if Contractor subcontracts or otherwise delegates services of this contract. Contractor shall exercise due diligence in the selection of subcontractors and monitor services provided by subcontractors for compliance with the terms of this Agreement and applicable laws, rules or regulatory requirements or orders.

d)1.4 General Duties of the Exchange

a) Certification of QHP Issuers (45 C.F.R. Part 155, Subpart K);

b) Consultation with stakeholders (45 C.F.R. §155.130);

c) Consumer assistance tools and programs, including but not limited to operation of a toll-free call center (45 U.S.C. §18031 (d) and 45 C.F.R. §155.205);

d) Eligibility and enrollment determinations, as well as exemption determinations in the Individual Exchange and Covered California for Small Business (45 C.F.R. Part 155, Subparts D, E, H, I);

e) Financial support for continued operation of the Exchange (45 C.F.R. §155.160);

f) Navigator program standards, in accordance with Federal rules, designed to raise awareness of the Exchange by providing consumer access to education and other resources regarding eligibility, enrollment, and program specifications (45 C.F.R. §155.210);

g) Non-interference with Federal law and nondiscrimination standards (45 C.F.R. §155.120);

h) Notices to Enrollees (45 C.F.R. §155.230);

i) Oversight, financial and quality activities (45 C.F.R. §155.200);

j) Participation of brokers to enroll qQualified iIndividuals or employers in QHPs (45 C.F.R. §155.220);

k) Ensuring that individuals can pay premiums owed directly to qualified health plan issuers and ensuring compliance with related Federal requirements (45 C.F.R. §155.240);

l) Privacy and security of personally identifiable information (45 C.F.R. § 155.260);

m) Use of standards and protocols for electronic transactions (45 C.F.R. § 155.270);

n) Establishment of Covered California for Small Business to assist employers and facilitate enrollment of eEmployees into QHPs (45 C.F.R. Subpart H, §155.700 et seq.);

o) Operation and management of CalHEERS. The Exchange also has a duty, as part of its management of CalHEERS, to determine, how CalHEERS presents information about cost, quality and provider availability for consumers to inform their selection of issuer and benefit design in the Exchange. The Exchange shall solicit comment from Contractor on the design but retains final authority to make design and presentation decisions in its sole discretion; and

p) The Exchange agrees to provide a dedicated team member responsible for working with Contractor to resolve any and all issues that arise from implementation of the Exchange.

1.4.1 Confidentiality of Contractor Documents

e)1.5 General Duties of the Contractor

Contractor shall maintain the organization and administrative capacity to support and ensure implementation and operation of this Agreement. This requirement includes the following:

a) Contractor maintains the legal capacity to contract with the Exchange and complies with the requirements for participation in the Exchange pursuant to this Agreement and applicable Federal and State laws, rules and regulations;

b) A dedicated liaison is available as the primary contact person to coordinate and cooperate with the Exchange in the implementation of this Agreement and the contact person and/or other personnel are available to the Exchange as needed to fulfill Contractor’s duties under this Agreement;

c) Qualified Health Plans identified in Attachment 1 are offered in accordance with the terms; conditions of the agreement and compliance with the Affordable Care Act and the California Affordable Care Act and implementing regulations, and with applicable Federal and State laws, rules and regulations as may be amended from time to time as required under applicable laws, rules and regulations or as otherwise authorized under this Agreement;

d) Notify the Exchange of any material concerns identified by Contractor or by a regulatory agency that may impact Contractor’s performance under this Agreement;

e) Participate in quarterly in-person meetings between the Exchange and Contractor at the Exchange headquarters to report and review program performance results, including all Services and components of the program, i.e., clinical, financial, contractual reporting requirements, customer service, appeals and any other program recommendations.