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2017-099A
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2017-099A
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Last modified
11/20/2017 4:23:58 PM
Creation date
10/25/2017 10:48:49 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
07/18/2017
Control Number
2017-099A
Agenda Item Number
8.H.
Entity Name
Blue Cross Blue Shield of Florida
Subject
Bluemedicare group master agreement
Medicare Plan coverage
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This Agreement sets forth the exclusive and entire understanding and agreement between the parties and <br /> shall be binding upon the Covered Persons, the parties, and any of their subsidiaries, affiliates, <br /> successors, heirs, and permitted assigns. All prior negotiations, agreements, and understandings are <br /> superseded hereby. No oral statements, representations, or understanding by any person can change, <br /> alter, delete, add or otherwise modify the express written terms of this Agreement, which includes the <br /> terms of coverage and/or benefits set forth in the Evidence of Coverage, the Schedule of Benefits, and <br /> any other attachments, amendments or riders. <br /> J. Financial Responsibilities of the Group <br /> We reserve the right to recover any benefit payments made to or on behalf of any individual whose <br /> coverage has been terminated. Our recovery efforts may relate to benefit payments made for health care <br /> services rendered subsequent to the Covered Person's termination date and prior to the date notice of <br /> coverage termination is required to be made by you. Your cooperation with and support such recovery <br /> efforts is required. <br /> In the event that you do not comply with the notice requirements set forth in Subsection 5.A (Monthly <br /> Invoice), you shall be solely liable to us for Premium due until the effective date established by CMS for <br /> a Covered Person's disenrollment. <br /> K. Indemnification <br /> You shall hold harmless and indemnify Florida Blue, against all claims, demands, liabilities, or expenses <br /> (including reasonable attorney fees and court costs), which are related to, arise out of, or are in <br /> connection with any of your acts or omissions, or acts or omissions of any of your employees, retirees or <br /> agents, in the performance of your obligations under this Agreement. We are not your agent, nor are you <br /> our agent, for any purpose. This paragraph shall only apply to the extent and limits allowed under <br /> Florida Statutes § 768.28. <br /> L. Representations on the Group Application and the Enrollment Forms <br /> We rely on the information you and your Eligible Retirees provide to determine whether to issue <br /> coverage; the appropriate Premium and financing method; and eligibility for coverage. All such <br /> information must be accurate, truthful, and complete. Statements made on the Enrollment Forms are <br /> representations and not warranties. <br /> We may cancel, terminate, or void this Agreement if the information which you provide is fraudulent, or <br /> if you make an intentional misrepresentation. <br /> M. Reservation of Right to Contract <br /> We reserve the right to contract with any individuals, corporations, associations, partnerships, or other <br /> entities for assistance with the servicing of coverage and benefits to be provided by us or obligations <br /> due, under this Agreement. <br /> N. Service Mark <br /> You, on behalf of the Group and its Covered Retirees, hereby expressly acknowledge your <br /> understanding that this Agreement constitutes a contract solely between you and Florida Blue. We are an <br /> 10 <br />
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