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2023-098B
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2023-098B
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Last modified
3/18/2024 12:03:39 PM
Creation date
3/18/2024 11:53:00 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
05/16/2023
Control Number
2023-098B
Agenda Item Number
12.D.2.
Entity Name
Blue Cross and Blue Shield
Subject
Shield Transition Health Plan Administrative Services from
Blue Cross Shield of Florida Inc.(Florida Blue)
to Blue Cross Blue Shield National Alliance effective 10/01/2023 thru 9/30/2026
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ADMINISTRATIVE SERVICES AGREEMENT <br />between <br />INDIAN RIVER BOARD OF COUNTY COMMISSIONERS <br />and <br />BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. <br />This Administrative Services Agreement, including Exhibits, the Employer Application, Benefits <br />Checklist, Plan of Benefits, Schedule of Benefits, Schedule A and all endorsements, <br />amendments, riders or addenda thereto (hereinafter referred to as the "Agreement"), is entered <br />into and effective October 1, 2023 between Blue Cross Blue Shield of Florida, Inc., a Florida <br />corporation having its principal place of business at 4800 Deerwood Campus Parkway, <br />Jacksonville, Florida 32246 (hereinafter referred to as "BCBSF") and Indian River Board of <br />County Commissioners. At 1800 27th St, Vero Beach, FL 32960. (hereinafter referred to as the <br />"IRBOCC") on behalf of itself and its Group Health Plan(s). <br />The term for this Agreement shall be Three (3) years from the Effective Date ("Initial Term"). <br />The Agreement shall automatically renew for successive one (1) year terms (each, a "Renewal <br />Term") on the day immediately following the expiration date of the Initial Term and each <br />subsequent Renewal Term thereafter, unless terminated sooner in accordance with Section IV. <br />WHEREAS, the Employer has established and currently sponsors a self-funded employee welfare <br />benefit plan, to provide certain benefits (attached hereto as Exhibit A and hereinafter referred to <br />as the "Plan") and <br />WHEREAS, the Employer is or has designated a Plan Administrator. The Plan Administrator <br />and the Employer may be the same; however, the Plan Administrator shall not be BCBSF; and <br />WHEREAS, the Employer, on behalf of itself and the Plan Administrator, has requested that <br />BCBSF furnish services as defined in this Agreement. <br />WHEREAS, it is the purpose of this Agreement to establish an agency relationship whereby <br />BCBSF will undertake to act as an agent for the Employer in (1) receiving and processing claims <br />for benefits under the Plan, (2) disbursing claim payments under the Plan, and (3) performing <br />such additional duties as set forth herein. <br />WHEREAS, it is understood and agreed that BCBSF may contract with other entities to perform <br />certain functions and/or services in the administration of this Agreement. <br />NOW, THEREFORE, in consideration of the mutual agreements and conditions contained <br />herein, the parties, intending to be legally bound hereby, agree as follows. <br />
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