My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2018-170
CBCC
>
Official Documents
>
2010's
>
2018
>
2018-170
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
1/4/2021 11:21:35 AM
Creation date
9/19/2018 1:21:19 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
09/11/2018
Control Number
2018-170
Agenda Item Number
8.AA.
Entity Name
Blue Cross and Blue Shield of Florida, Inc.
Florida Blue
Subject
Blue Medicare Advantage Plan Renewal
BlueMedicare Master Agreement
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
19
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
F,& <br />B&e 0V <br />In the pursuit of health' <br />BLUEMEDICARE GROUP MASTER AGREEMENT <br />SECTION 1: INTRODUCTION <br />This B1ueMedicare Group Master Agreement (this "Agreement") describes the rights and obligations <br />which you and Blue Cross and Blue Shield of Florida, Inc. ("Florida Blue") have with respect to the group <br />Medicare Advantage, Medicare Advantage Prescription Drug Plan, and/or standalone Medicare <br />Prescription Drug Plan (hereinafter, "Medicare Plan(s)") coverage to be provided by us to your Covered <br />Retirees and Covered Dependents. <br />References to "we", "us", "our," and Florida Blue throughout this Agreement refer to Blue Cross and Blue <br />Shield of Florida, Inc. In exchange for your payment of the Premium, we agree to provide the coverage <br />and/or benefits specified in the Evidence of Coverage for the Medicare Plan(s) ("Evidence of Coverage"), <br />a copy of which is attached to this Agreement. The coverage to be provided by us under the Group Plan <br />which you have established is described in the Evidence of Coverage. <br />SECTION 2: DEFINITIONS <br />Certain terms defined in the Agreement are also used and defined (for the convenience of Covered <br />Persons) in the Evidence of Coverage. If a word or phrase starts with a capital letter, it is either the first <br />word in a sentence, a proper name, a title, or a defined term. The following defined terms apply to this <br />Agreement: <br />Anniversary Date means the date one year after the Effective Date of coverage and subsequent annual <br />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 decision to <br />deny a request for coverage of health care services or prescription drugs or payment 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 Act, <br />CMS Medicare Part C and D regulations at 42 C.F.R. Parts 422 and 423, the CMS Managed Care and <br />Prescription Drug Benefit Manuals, other CMS instructions and guidance and the provisions of Florida <br />Blue's contracts with CMS to offer the Medicare Plans. <br />Covered Dependent means an Eligible Dependent who continues to meet all applicable eligibility <br />requirements described in the Evidence of Coverage and who is enrolled, and actually covered, under the <br />Agreement other than as a Covered Retiree. <br />Covered Person means a Covered Retiree or a Covered Dependent. <br />Covered Retiree means an Eligible Retiree, who continues to meet all applicable eligibility requirements <br />described in the Evidence of Coverage and who is enrolled, and actually covered, under the Agreement <br />other than as a Covered Dependent. <br />
The URL can be used to link to this page
Your browser does not support the video tag.