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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2 BlueCross Blue5hield ® of Illinois AMENDMENT TWO TO THE ADMINISTRATIVE SERVICES AGREEMENT THIS AMENDMENT to the Administrative Services Agreement is effective as of January 1, 2025, and is attached to and made part of the Administrative Services Agreement by and between Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (hereinafter referred to as the "Claim Administrator"), and CITY OF DECATUR (hereinafter referred to as the"Employer"),WITNESSETH AS FOLLOWS: WHEREAS, the Claim Administrator and the Employer have entered into an Administrative Services Agreement(hereinafter referred to as the"Agreement")which was effective January 1,2023, WHEREAS,the Parties desire to amend the Agreement as described herein; NOW, THEREFORE, in consideration of these premises and the mutual promises and agreements hereinafter set forth,and for other good and valuable consideration,the receipt and sufficiency of which are hereby acknowledged, Employer and Claim Administrator hereby agree to amend the Agreement as follows: 1. Section 4.12 `Transparency and Surprise Billing Procedures", b. 1. "Qualifying Payment Amount"is deleted in its entirety and replaced with the following: "1. Qualifying Payment Amount. As it pertains to Employer's self-funded plans, Employer acknowledges that NSA requires,among other things,that member cost-share for certain items and services the Plan covers are calculated based on the lesser of the Provider's billed charge or the NSA's"Qualifying Payment Amount"("QPA"). Up and until October 31, 2024,with respect to the calculation of QPA, Employer elects to use and adopts the QPA calculated by Claim Administrator based on Claim Administrator's self-funded business. Employer acknowledges litigation is pending over various regulatory provisions that govern QPA.The referenced litigation(or agency rulemaking or guidance related to the litigation) could require changes to how QPA is calculated for Employers'self-funded plans.Pursuant to Claim Administrator's understanding of previous agency guidance, Claim Administrator calculates QPA for self-funded plans based on all of Claim Administrator's self-funded business, i.e., QPAs are not calculated specific to each Employer's self-funded plan(s). It may be infeasible or impracticable for Claim Administrator to make certain changes to how such calculations are made, maintained,and/or used in processing Claims for Employer's Pians on or after November 1, 2024. To illustrate, such limitations could include, but are not limited to, the following: Claim Administrator does not have access to contracts or contracted rates of other claim administrators; and Claim Administrator's current capabilities and the fees and expenses charged to Employer herein do not support calculating, maintaining, and/or processing Claims with Employer- or Plan-specific QPA calculations. If the litigation (or agency rulemaking or guidance related to the litigation) requires changes to how QPAs are calculated for self-funded plans, and Claim Administrator agrees such changes to QPA calculations are practicable and feasible for Claim Administrator to make, maintain, and use in processing Claims, and Claim Administrator opts not charge additional fees or expenses for any such changes, Claim IL Gen Med-CF Non-ERISA ASA Amendment Rev.724 1 Proprietary and Confidential Information of Claim Administrator Not for use or disclosure outside Claim Administrator,Employer,their respective affiliated companies,and third-party representatives,except with written permission of Claim Administrator. Blue Cross Blue Shield of Illinois,a Division of Health Care Service Corporation,a Mutual Legal Reserve Company, An Independent Licensee of the Blue Cross and Blue Shield Association