2022-117A - Laserfiche WebLink

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$49.55 per enrolled employee per month from October 1, 2023 through September 30, 2024. $51.04 per enrolled employee per month from October 1, 2024 through September 30, 2026. B. Florida Blue will pay Employer a $75,000 wellness contribution upon the Board's approval of renewing this Agreement, and $50,000 per year, each year for four years upon renewing this Agreement for any wellness related initiatives or activities. C. Administrative fees after the termination of the Agreement: 15% of claims paid. D. Access fees of up to 2.11% (2022) of Network Savings for PPO provider claims and 3.79% of Network savings for Traditional provider claims may be assessed for claims incurred in states under the BlueCard program as explained in more detail under the Section InterPlan Arrangements. This access fee will not exceed two thousand dollars ($2,000) for any one claim and will not apply in Florida, South Carolina or in Consortium Plan Service Areas which is the geographic area where enrolled members reside as long as enrollment continues to be equal to or greater than one thousand (1,000) contracts. On the first anniversary date after enrollment falls below one thousand (1,000) contracts, access fees will apply in those Consortium Plan service areas where enrolled members reside and Consortium fees were not previously established. Access fees will also apply in Consortium Plan service areas where no enrolled members reside. A determination of the Consortium Plan service areas that will not apply access fees for services rendered to members will be made on the basis of enrollment on each subsequent anniversary of this Agreement's effective date. Access fees will be applied on the basis of where the service was incurred, and not where the member resides. Network Savings is defined as the total of the amounts computed by subtracting each "allowed amount" for a particular service under the terms of a participating provider's written agreement from each "billed amount" for such service. In no event shall the term "Network Savings" include duplicate charges or billed amounts for services or supplies not covered under the Employer's Plan. The term "allowed amount" means the amount received as payment in full by a participating provider, under that provider's written agreement, from both Florida Blue and covered individuals under Employer's Plan for claims submitted to, and paid by Florida Blue for a particular covered service, and the term "billed amount' means the amount which would be received by such provider for the same covered service -2-