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2015-025D
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2015-025D
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Last modified
4/2/2018 3:40:21 PM
Creation date
4/26/2016 11:52:47 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
02/17/2015
Control Number
2015-025D
Agenda Item Number
8.G.
Entity Name
Blue Cross and Blue Shield of Florida
Subject
Administrative Services Agreement
Financial Arrangements
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EXHIBIT "B" <br />to the <br />ADMINISTRATIVE SERVICES AGREEMENT <br />between <br />BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. DIBIA FLORIDA BLUE <br />and <br />INDIAN RIVER COUNTY BOARD OF COUNTY COMMISSIONERS <br />FINANCIAL ARRANGEMENTS <br />Banking Arrangement <br />I. Effective Date. <br />The effective date of this Exhibit is October 1, 2015. <br />II. Bank Account. <br />The Employer agrees to establish a bank account prior to the effective date <br />of this Agreement, in its own name, at the bank designated by Florida Blue. <br />The Employer authorizes Florida Blue to write checks on the bank account <br />in order to pay claims pursuant to this Agreement. The Employer agrees to <br />maintain the bank account and the reserve amount as set forth below. The <br />Employer shall be responsible for the reconciliation of its bank account, <br />based on information and reports provided by Florida Blue and the bank. <br />III. Special Banking Information. <br />A. Name of Employer (as it is to appear on the checks) - no more than <br />25 characters: <br />R. <br />INDIAN RIVER COUNTY <br />Employer Bank Account Reference Number - 5 characters: <br />10047 <br />C. Reserve Requirement: $108,000 <br />D. Funding Frequency: Daily <br />E. Method of Funding: ACH <br />-1- <br />
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