Laserfiche WebLink
the Medicare Advantage Program policies then in effect. The Medicare Advantage Program <br />available to Covered Persons under this Agreement is described generally below. <br />B. Covered Persons Liability Calculation <br />The cost of the service on which the Covered Person's liability is based, will be either: <br />1. The Medicare allowable amount for covered services; or <br />2. The amount we negotiate with the provider of the Host Blue negotiates with its provider <br />on behalf of our Covered Persons, if applicable. The amount negotiated may be either <br />higher than, lower than, or equal to the Medicare allowable amount. <br />SECTION 7: GENERAL PROVISIONS <br />A. Administration and Record Retention <br />You must provide us with any information we need to administer the coverage and/or benefits to <br />be provided or needed to compute the Premium due. While this coverage is in force, we have the <br />right, at any reasonable time, to examine your records on any issues necessary to verify <br />information provided by you. You must retain all records relating to this Agreement, including <br />but not limited to those relating to LIS administration, for the current calendar year plus an <br />additional ten (10) years. <br />B. Assignment and Delegation <br />You may not assign, delegate or otherwise transfer this Agreement and the obligations hereunder <br />without our written consent. Any assignment, delegation, or transfer made in violation of this <br />provision shall be void. We may assign, delegate, or otherwise transfer this Agreement to our <br />successor in interest or an affiliated entity without your consent at any time. <br />C. Authorization <br />Where this Agreement requires that an act involving the administration of coverage and/or <br />benefits be authorized or approved by us, such authorization or approval shall be considered <br />given when provided in writing by a duly authorized officer of Florida Blue or his or her <br />designee. <br />D. Evidence of Coverage <br />We will provide an Evidence of Coverage and ID Card for each Covered Retiree. The Evidence <br />of Coverage will describe the coverage and benefits to be provided to Covered Persons by us. <br />You agree that, if requested by us, you will distribute the Evidence of Coverage (and any <br />Endorsements to it) and other coverage materials to Covered Persons. <br />9 <br />96 <br />