Laserfiche WebLink
S. COBRA <br /> You are solely responsible for determining when individuals are eligible for coverage under a <br /> Medicare Plan pursuant to the Consolidated Omnibus Budget Reconciliation Act ("COBRA"). <br /> You will notify us promptly of any COBRA elections. For more information on your COBRA <br /> responsibilities refer to the Benefit Administrator Guide. <br /> In consideration of the payment of Premiums when due and subject to all of the terms of this <br /> ` Agreement, Blue Cross Blue Shield of Florida, Inc. hereby agrees to provide each enrollee of <br /> Indian River County BOCC the benefits of this Agreement as set forth in the attached <br /> Evidence of Coverage beginning on each enrollee's effective date. <br /> The Group has selected the following plan and premium: <br /> BlueMedicare Group <br /> PPO*Plan 1 ---$379.99 <br /> The Group's Agreement is effective as of October 1, 2014. <br /> IN WITNESS WHEREOF, the parties have executed this Agreement as of <br /> Blue Cross Blue Shield of Florida, Inc. Indian River County BOCC <br /> By: By: <br /> (Signature) (Signature) <br /> Name: Lynn Esposito Name: A . <br /> i r <br /> (Please Print or Type) (Ple se int or TAd <br /> i) <br /> Title: Vice President, Sales Operations Title: Y fo <br /> APPROVED AS TO FORM <br /> AND LEGAL SUFFICIENCY <br /> 13 BY <br /> DYLAN REINGOLD <br /> COUNTY ATTORNEY <br /> I <br />