2023-098B - Laserfiche WebLink

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(10) Coordination of Benefits: Except for the standard processes that BCBSF has in place for questioning members regarding other health coverage (which may be subject to change from time to time, but which currently includes sending out a questionnaire to the member when BCBSF deems appropriate), BCBSF shall not be required to determine the existence of any other employee welfare benefit plan or amount of benefits payable under any such other employee welfare benefit plan. The payment of Benefits will only be affected by the benefits that would be payable under any other employee welfare benefit plan and only to the extent that BCBSF receives written information relative to such other employee welfare benefit plans. (11) Account Management: BCBSF shall provide account management services including account transition, implementation and the relationship management and issue resolution for the Employer and its designated consulting firm. (12) Customer Service: BCBSF shall provide customer service administration including providing a toll-free telephone line. (13) Identification Cards ("ID cards"): BCBSF shall provide standard ID cards to persons participating under the Plan. At Employer's expense, Employer may (within guidelines) personalize the standard cards furnished by BCBSF. BCBSF reserves the right to charge for reissuing identification cards as a result of an independent action caused by Employer. At Employer's request, BCBSF will mail cards directly to members. (14) Plan of Benefits: a. BCBSF shall prepare and deliver to the Employer, for the distribution to persons who are participating or eligible to participate in the Plan, the Plan of Benefits which will describe the benefits and such other conditions of the Plan as are agreed to by BCBSF and the Employer. b. The Plan of Benefits means the attached document and is the document attached as Exhibit A, which is not the Summary Plan Description as defined by applicable law, unless so designated by the Employer or Plan Administrator, and which describes the terms and benefits to be provided to members. Revision of the Plan of Benefits shall be prepared whenever required by revisions in the Plan under this Agreement. The Plan of Benefits include the Schedule of Benefits and all endorsements, amendments, riders or addenda and Employer agrees that the Plan of Benefits will at a minimum be incorporated as Part of the Employer's Group Health Plan. c. The Summary Plan Description is a document, as required by ERISA, which is prepared by the Employer, Plan Administrator or their designee, and which, among other things, describes the eligibility requirements for participation in the Plan, the benefits to be administered by BCBSF, identification of fiduciaries, and information on members' rights. The preparation and distribution of the SPD remain solely the responsibility of the Employer. d. Employer is responsible for: (i) reviewing the Plan of Benefits, (ii) determining whether the Plan of Benefits meets all of Employer's legal and business obligations 11