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2022-117A
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2022-117A
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Last modified
8/2/2022 2:22:57 PM
Creation date
8/2/2022 2:14:59 PM
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Template:
Official Documents
Official Document Type
Amendment
Approved Date
06/07/2022
Control Number
2022-117A
Agenda Item Number
12.D.1.
Entity Name
Blue Cross and Blue Shield of Florida, Inc. dba Florida Blue
Subject
Amendment to Administrative Services Agreement
for Group Insurance for Plan Year 2022/2023
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utilizing that provider's charges. The Allowed Amount for Emergency <br />Services provided by Non -Participating or Non -Contracting Providers will <br />pay in accordance with the definition of Maximum Payment in the Plan of <br />Benefits. <br />V. Late Payment Penalty <br />A. A daily charge of .00038 times the amount of overdue administrative fees. <br />VI. Expected Enrollment <br />A. The administrative fees and reserve requirement referenced above are based <br />on an expected enrollment of: 1,650. <br />B. If the actual enrollment is materially different from this expected enrollment, <br />Florida Blue reserves the right to adjust the administrative fees and the reserve <br />requirement as set forth in the Agreement. <br />-3- <br />
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