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deductibles, copayments and/or coinsurance for covered items and services provided by non -participating or non -contracting providers described in this Agreement will be calculated as if the item or service was furnished by a participating or contracting provider, and based on the Recognized Amount, which may differ from the Allowed Amount. "Recognized Amount" means, in accordance with federal law, the lesser of the non- participating or non -contracting provider's billed amount or BCBSF's or its Designated Agent's median contracted rate for participating or contracting providers for the same or similar item or service furnished in the same or similar specialty in the same geographic region; provided that, except in connection with air ambulance services, if there is a recognized amount specified for this purpose under an applicable All -Payer Model Agreement under Section 1115A of the Social Security Act, or if not, under applicable state law, then such amount, as applicable, will instead serve as the Recognized Amount. (3) Timing of submission of claims: If BCBSF or its Designated Agent determines that benefits are payable, but the provider does not participate in the participating or contracting provider network, BCBSF or its Designated Agent may (in BCBSF's or its Designated Agent's sole discretion, or as required by law) make payment to the member or to the provider. No one may assign a member's right to the payment of benefits without BCBSF's or its Designated Agent's express written consent. Claims will be processed in the order received by BCBSF and will not be reprocessed due to out of sequence dates of services. Claims will be processed in the timeframes set forth in the Plan of Benefits without regard to Stop -Loss Insurance. Employer retains the sole discretion to determine whether a claim was timely submitted or whether the timely submission of a claim was reasonably possible. Claims will be paid in accordance with information supplied by Employer and received by BCBSF. BCBSF shall be entitled to rely upon information supplied by Employer. BCBSF shall not pay any claim if this Agreement has terminated except for the term that BCBSF is providing Retention Services; or the Employer has directed BCBSF to withhold payment. (4) Plan of Benefits: Based on the Plan of Benefits express terms or Employer's written authorization and subject to the terms of this Agreement, BCBSF shall determine the extent of the Benefits (if any) to which any member is entitled. In the event that Employer determines that BCBSF has misinterpreted the Plan of Benefits and so informs BCBSF in writing, unless notified otherwise by BCBSF, BCBSF shall begin processing and paying claims in accordance with Employer's corrected interpretation as set forth in such writing, to the extent practicable, within thirty (30) days after receipt of such notice or as soon thereafter as reasonably possible. BCBSF shall not reprocess claims submitted prior to Employer's notification and shall have no liability to Employer or member for such claims. Notwithstanding any determination made by Employer under this Section H. A (4), BCBSF shall have no liability to a member or Employer (and Employer shall indemnify BCBSF against any such liability pursuant to Section V for withholding payments as directed by Employer, for alleged or actual misinterpretations of the Plan of Benefits or for claims that were denied prior to Employer's determination and written notification to BCBSF. (5) Recovery of Claims Amounts: In the event of retroactive addition or termination of members, BCBSF shall not be responsible for denials of claims under Employer's Stop Loss Insurance. BCBSF will not be responsible for collection of claims amounts paid to providers or members prior to notification of a member's termination. Any such recovered 9