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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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B. Termination by Group <br />The Group may cancel this Agreement on its Anniversary Date by giving written notice to us at least <br />sixty (60) calendar days in advance, unless we have initiated a termination for any of the reasons stated <br />below. <br />C. Termination by Florida Blue <br />We may terminate this Agreement or refuse to renew for the following reasons: <br />1 Failure to Pay Premiums. You do not pay Premiums in accordance with its terms or we have <br />not received timely Premium payments prior to the end of the Grace Period. Termination of this <br />Agreement for failure to pay premiums shall be effective as of the end of the Grace Period. In the <br />event of such termination, you are obligated to pay the following: <br />a. Any portion of the Premium due for coverage provided by us prior to termination; and <br />b. Any amounts otherwise due us. <br />2. Fraud or Intentional Misrepresentation of Material Fact. You perform an act, or engage in <br />any practice, that constitutes fraud or make an intentional misrepresentation of material fact. <br />3. Group Contribution and Participation and CMS Rules. You do not comply with: (1) a <br />material provision which relates to rules for Group contributions or Covered Person <br />participation; or (2) any provision in this Agreement which relates to LIS or other CMS <br />Requirements. <br />4. Service Area. There is no longer any Covered Person who lives, resides, or works in the Service <br />Area. <br />5. Termination or Non -renewal of the CMS Contract. We will provide you with at least ninety <br />(90) calendar days' notice upon termination or non -renewal of our contract with CMS. <br />Except as specifically provided in this Subsection 4.C, if we decide to terminate or not renew the <br />Agreement based on one or more of the circumstances mentioned above, we will give you at least forty- <br />five (45) calendar days advance written notice. <br />D. Notification of Termination to Covered Retirees <br />It is your obligation to immediately notify each Covered Person of any such termination of this <br />Agreement for any reason, consistent with the requirements of Section 3 of this Agreement. <br />E. Representations Made By, and Obligations of, the Group <br />In agreeing to provide coverage in accordance with the terms of this Agreement, we rely on the <br />representations you made when you applied for coverage with us and your representation that you have <br />authority to act on behalf of all Covered Persons with respect to this Agreement. Consequently, every <br />act by, agreement with, or notice given to, you will be binding on all Covered Persons. You agree that <br />5 <br />
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