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R2024-342 Resolution Authorizing Agreement and Amendment with BlueCross BlueShield of Ilinois for Administration of the City Group Health Benefit Plan for Calendar Year 2025
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R2024-342 Resolution Authorizing Agreement and Amendment with BlueCross BlueShield of Ilinois for Administration of the City Group Health Benefit Plan for Calendar Year 2025
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11/6/2024 4:59:41 PM
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11/6/2024 4:59:39 PM
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Resolution/Ordinance
Res Ord Num
R2024-342
Res Ord Title
R2024-342 Resolution Authorizing Agreement and Amendment with BlueCross BlueShield of Ilinois for Administration of the City Group Health Benefit Plan for Calendar Year 2025
Department
Finance
Approved Date
11/4/2024
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7. Independent Dispute Resolution Process: <br /> Employer authorizes and directs Claim Administrator to offer an amount not to exceed the greater of the Qualifying <br /> Payment Amount(QPA)or the amount allowed on the initial notice of payment or denial of a claim on behalf of the <br /> Employer during negotiations under the federal [DR process. <br /> 8. Volume-Based Discount: The administrative charges shown in this BPA reflect a volume-based discount in an <br /> amount up to$3 PEPM for the twelve-month period beginning on the Contract Effective Date. If any of the qualifying <br /> ancillary coverage(BlueCare Dental,Basic Life,Short-Term Disability, Long-Term Disability,Accident,Critical Illness, <br /> Hospital Indemnity and/or Vision product(s)) lapses during this twelve-month period, BCBSIL reserves the right to <br /> remove the volume-based discount attributable to the lapsed product on medical administrative fee. in such event, <br /> upon sixty (60) days prior written notice to Employer, the administrative fee payment will be adjusted to reflect the <br /> removal of the discount attributable to the lapsed product. <br /> Additional Provisions: _Renewal effective 01/01/2025 with the following changes: <br /> Medical benefits: <br /> BA 12: HSA increase deductible to$1.650 Individual/$3,300 Family <br /> RX benefits: <br /> Adding 90 Day at Retail ESN <br /> Adding coverage for Weight Loss/GLP-1 Weight Management drugs with prior authorization <br /> Adding New to Therapy NTT for both Diabetes and Weight Management <br /> Proprietary and Confidential Information of Claim Administrator <br /> Not for use or disclosure outside Claim Administrator,Employer,their respective affiliated companies and third-party representatives,except <br /> with written permission of Claim Administrator. <br /> IL GEN ASO VSD BPA(Rev.06.24)Blue Cross and Blue Shield of Illinois,a Division of Health Care Service Corporation,a Mutual <br /> Legal Reserve Company,an Independent Licensee of the Blue Cross and Blue Shield Association 12 <br />
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