2023-098B - Laserfiche WebLink

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EXHIBIT B Financial Arrangement It is mutually understood and agreed that Exhibit B of the Administrative Services Agreement between BCBSF and the Employer becomes a part of said Agreement for the period beginning 10/1/2023and ending on 9/30/2026 with all other terms of said Agreement remaining in full force and effect. This Exhibit applies to the method of payment for services for all benefits payable under this Agreement. I. While this Agreement is in effect services will be furnished in connection with the Plan including claims processing and payments of the amount due with respect to claims incurred on or after 10/1/2023, that qualify under the Employer's Plan. The Designated Agent shall be fully reimbursed for the payment of such claims by the Employer as specified in this Exhibit. II. The Administrative Fees applicable to this Agreement include a base Administrative Fee and Administrative Fees for other services as described in Sections A and B directly below. A. The base Administrative Fees are as follows for the Employer's Plan. Year 1: $46.74 per employee per month Year 2: $48.14 per employee per month Year 3: $48.14 per employee per month B. In addition to the base Administrative Fee, the charges for the listed additional services will be as stated below. These charges, together with the base Administrative Fee will be called the "Administrative Fees" under this Agreement. Charges listed in this paragraph II. B. apply for three years and may change for subsequent years. Radiology Management IA No Additional Fee Stop Loss Packets to non -Blue vendors No Additional Fee Teladoc General Medical (claims costs also apply) No Additional Fee Teladoc Dermatology (claims costs also apply) No Additional Fee Additional Fees: Coordination of Benefits Recovery 30% of recovered amount Retroactive Termination Recoveries 30% of recovered amount 25