R2011-04 AUTHORIZING AGREEMENT - Laserfiche WebLink

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B. Data Required for ERR Proqram Reimbursement Pavments. 1. Responsibilitv for Compilina and Submittina Data. Employer, or a third party designated by Employer, shall be responsible for submitting data to HHS. Employer will provide HCSC with Employer's appropriate List of Early Retirees determined consistent with ERR Program Requirements in sufficient time for HCSC to determine the applicable Claims for each Early Retiree. Upon receipt of Employer's List of Early Retirees, HCSC will compile and submit to Employer the following data for each listed Early Retiree quarterly or more frequently if Group has incurred $5,000 or more in Claims (which shall not be more frequent than monthly) or otherwise at the time(s) specified by ERR Program Requirements: a. Early Retiree Claim Costs, including: i. The actual costs of Claims (net of any known Negotiated Price Concessions) Incurred and paid by the Group Health Plan with all documentation details required by 45 C.F.R. §149.2 and §149.335; ii. To the extent available in HCSC's claims processing system, prima facie evidence of the portion of Claim costs paid by an Early Retiree, consistent with 45 C.F.R. §149.100(b); iii. Documentation of those costs in the form and manner specified by HHS; and iv. Any other information specified in the definition of a Claim under 45 C.F.R. §149.2 or related guidance from HHS. b. For Reported Claims that have previously been provided to Employer for submission to HHS, the amount of any subsequent payment reversals and additional Post-Point-of-Sale Negotiated Price Concessions (including Prescription Drug Rebates) to the extent required by ERR Program Requirements and that are known to HCSC that were received but not accounted for in the Employer's previously submitted Claims, as well as any other updated, corrected data known to HCSC. HCSC shall submit all data to Employer or Employer's designee, for each individual Early Retiree identified on Employer's List of Early Retirees for the pertinent reporting period. 2. Receipt of ERR Proqram Pavments. Employer shall receive all ERR Program payments from the United States government directly, and HCSC shall have no reponsibility for claiming, receiving or handling such payments. C. Reporting of Updates, Inaccuracies and Corrections. Should HCSC learn that any data provided by either party to this Agreement or by any third party is or was inaccurate, that Employer is receiving or has received ERR Program overpayments, or that Employer's ERR Program application, Claims cost data, or any submission to HHS fail to comply with ERR Program Requirements, it shall notify Employer, and Employer shall have the sole responsibility for making necessary corrections, filings and communications to HHS. D. Emplover's Third Partv Consultant and/or Vendor. In the event Employer directs HCSC to provide data directly to its third party consultant and/or vendor, the Employer acknowledges and agrees, and will cause its third party consultant and/or vendor to acknowledge and agree: -4-