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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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Section I: Responsibilities of the Employer <br />A. The Employer shall have the obligation to furnish any information required in accordance with <br />the Exhibits to this Agreement. Such information shall include, but is not limited to, member <br />social security numbers in order to comply with Medicare secondary payer provisions of <br />federal law. <br />B. BCBSF and/or their Designated Agent's performance of the services will require prompt <br />discharge by the Employer of such obligation. Therefore, BCBSF shall not be considered to <br />have failed to perform obligations under this Agreement if any delay or non-performance is <br />due, in whole or in part, to the Employer's failure to promptly discharge such obligations. <br />BCBSF's Designated Agent is an entity that has contracted with BCBSF to perform a <br />function and/or service in the administration of this Agreement. <br />C. The Employer shall provide BCBSF with the names of individuals, together with the scope of <br />their authority, authorized to act for the Employer in connection with this Agreement. <br />D. The Employer shall fund the Plan and pay all claims in accordance with its terms and as <br />provided in Exhibit B. <br />E. The Employer, BCBSF, and their Designated Agent shall comply with all material Federal or <br />State laws applicable to the Plan and Employer shall comply with such reporting and <br />disclosure laws as may be applicable thereto. <br />F. Employer is responsible for the Group Health Plan's compliance with all applicable federal and <br />state laws and regulations, including amending the Group Health Plan documents as necessary <br />to comply with applicable law changes. Employer further acknowledges that BCBSF is not <br />providing tax or legal advice and that Employer shall be solely responsible for determining the <br />legal and tax status of the Group Health Plan <br />G. Employer retains all authority, responsibility, and liability for its Group Health Plan and its <br />operation, and BCBSF is only authorized to act on behalf of Employer as expressly stated in <br />this Agreement or the Plan of Benefits or as may be mutually agreed to in writing by BCBSF <br />and Employer. Employer has advised BCBSF to place its members on a do -not -call list with <br />respect to surveys conducted by third parties. Notwithstanding the preceding, BCBSF may <br />conduct outbound calling campaigns as part of its regular health Plan administrative activities <br />pursuant to this Agreement. <br />H. The parties will comply with all state and federal laws applicable to the performance of their <br />respective obligations under this Agreement. <br />I. Employer represents and warrants it is not a Multiple Employer Welfare Arrangement <br />(MEWA). <br />J. Member Information. <br />The Employer shall provide BCBSF, in a format reasonably acceptable to BCBSF, the member <br />information. Such information will include, but is not limited to, member social security <br />numbers in order to comply with Medicare Secondary payor provisions of federal law. <br />Employer will notify BCBSF as soon as possible of a change of a member's eligibility <br />
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