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Florida <br />Blue V <br />BLUEMEDICARE GROUP MASTER AGREEMENT <br />SECTION 1: INTRODUCTION <br />This BlueMedicare Group Master Agreement (this "Agreement") describes the rights and <br />obligations which you and Blue Cross and Blue Shield of Florida, Inc. ("Florida Blue") have <br />with respect to the group Medicare Advantage, Medicare Advantage Prescription Drug Plan, <br />and/or standalone Medicare Prescription Drug Plan (hereinafter, "Medicare Plan(s)") coverage to <br />be provided by us to your Covered Retirees and Covered Dependents. <br />References to "we", "us", "our," and Florida Blue throughout this Agreement refer to Blue Cross <br />and Blue Shield of Florida, Inc. In exchange for your payment of the Premium, we agree to <br />provide the coverage and/or benefits specified in the Evidence of Coverage for the Medicare <br />Plan(s) ("Evidence of Coverage"), a copy of which is attached to this Agreement. The coverage <br />to be provided by us under the Group Plan which you have established is described in the <br />Evidence of Coverage. <br />SECTION 2: DEFINITIONS <br />Certain terms defined in the Agreement are also used and defined (for the convenience of <br />Covered Persons) in the Evidence of Coverage. If a word or phrase starts with a capital letter, it <br />is either the first word in a sentence, a proper name, a title, or a defined term. The following <br />defined terms apply to this Agreement: <br />Anniversary Date means the date one year after the Effective Date of coverage and subsequent <br />annual anniversaries or such other date as mutually agreed to in writing by the parties. <br />Appeal means a request submitted by or on behalf of a Covered Person for a review of our <br />decision to deny a request for coverage of health care services or prescription drugs or payment <br />for services or drugs. <br />CMS means the Centers for Medicare and Medicaid Services. <br />CMS Requirements means the provisions of Parts C and D of Title XVIII of the Social Security <br />Act, CMS Medicare Part C and D regulations at 42 C.F.R. Parts 422 and 423, the CMS Managed <br />Care and Prescription Drug Benefit Manuals, other CMS instructions and guidance and the <br />provisions of Florida Blue's contracts with CMS to offer the Medicare Plans. <br />88 <br />