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2015-185
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2015-185
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Last modified
3/30/2017 4:46:27 PM
Creation date
10/8/2015 2:33:17 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
09/22/2015
Control Number
2015-185
Agenda Item Number
8.L
Entity Name
Bluemedicare Group
Florida Blue
Blue Cross and Blue Shield
Subject
Master Agreement
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H. Errors or Delays <br />Clerical errors or delays by us in maintaining enrollment records regarding Covered Persons will not <br />invalidate coverage which would otherwise be validly in force or continue coverage which would <br />otherwise be validly terminated, provided you have furnished us with timely and accurate enrollment <br />information. Errors or delays by you in furnishing accurate enrollment information to us will not affect <br />our right to strictly enforce any and all eligibility requirements. <br />I. Entire Agreement <br />This Agreement sets forth the exclusive and entire understanding and agreement between the parties and <br />shall be binding upon the Covered Persons, the parties, and any of their subsidiaries, affiliates, <br />successors, heirs, and permitted assigns. All prior negotiations, agreements, and understandings are <br />superseded hereby. No oral statements, representations, or understanding by any person can change, <br />alter, delete, add or otherwise modify the express written terms of this Agreement, which includes the <br />terms of coverage and/or benefits set forth in the Evidence of Coverage, the Schedule of Benefits, and <br />any other attachments, amendments or riders. <br />J. Financial Responsibilities of the Group <br />We reserve the right to recover any benefit payments made to or on behalf of any individual whose <br />coverage has been terminated. Our recovery efforts may relate to benefit payments made for health care <br />services rendered subsequent to the Covered Person's termination date and prior to the date notice of <br />coverage termination is required to be made by you. Your cooperation with and support such recovery <br />efforts is required. <br />In the event that you do not comply with the notice requirements set forth in Subsection 5.A (Monthly <br />Invoice), you shall be solely liable to us for Premium due until the effective date established by CMS for <br />a Covered Person's disenrollment. <br />K. Indemnification <br />You shall hold harmless and indemnify Florida Blue, against all claims, demands, liabilities, or expenses <br />(including reasonable attorney fees and court costs), which are related to, arise out of, or are in <br />connection with any of your acts or omissions, or acts or omissions of any of your employees, retirees or <br />agents, in the performance of your obligations under this Agreement. We are not your agent, nor are you <br />our agent, for any purpose. This paragraph shall only apply to the extent allowed under Florida Statutes <br />§ 768.28. <br />L. Representations on the Group Application and the Enrollment Forms <br />We rely on the information you and your Eligible Retirees provide to determine whether to issue <br />coverage; the appropriate Premium and financing method; and eligibility for coverage. All such <br />information must be accurate, truthful, and complete. Statements made on the Enrollment Forms are <br />representations and not warranties. <br />We may cancel, terminate, or void this Agreement if the information which you provide is fraudulent, or <br />if you make an intentional misrepresentation. <br />10 <br />
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