R2007-236 AUTHORIZING AGREEMENT WITH BLUE CROSS BLUE SHIELD OF ILLINOIS

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�. . �, , ; certain employers may offer group health care coverage to Medicare-eligible employees,their spouses and,in some cases, depcndent children. (Sec Section 1( 01' ihis Txhibil titled "MI�DICART SrCONDA1tY PAYI;R ("MSl'") D�1'A MATCI I.") 2.5 "Run-Off'Claim"means a Claim incurred prior to the termination o1'the Agreement that is suhmitted i'or payment during the Run-Ofi Period. 2.G "Run-Off'Period" means the time period immediately following termination of the Agreement,as specified in the most current Fee Schedule specifications oi'this Exhibit, during which the Claim Administrator will accept Run-01'f Claims submitted for payment. 2.7 ""I'ermination Administr�tive Ch�rge" means the consideration that is required by the Claim Administrator upon ter- mination ol the Agreement, including any services that may be performed by the Claim Administrator during the Run-Off Period. 2.8 "Transfer PaymenN'means a payment in the amount ouNined in Section 5 of this Exhibit,via wire,draft,electronic fund transfer (EF�or such other method as mutually agreed to by the parties in writing. S�CTION 3: COMP�NSA1'ION 1'O CLAIM ADMINISTI2A1'Olt 3.1 Intent of seri�ice clzarges. The Employer will pay service charges to the Claim Administrator, in accordance with the most cunent Fee Schedule specifications of Section ] of this Exhibit,as compensation for the processing of Claims and administrative and other services provided to the Employer. 3.2 Detei•mining sen�ice charges. "I'he service charges, which are guaranteed for the ree Schedule Period indi�ated in the most current Pee Schedule specifications of Section l of'this Exhibit, have been detennined in accordance wit;h the Claim Administra�or's current regulatory status and the Gmployer's existing benefit program. 3.3 Chaaging sen�ice chnrges. '1'he service charges shall be subject to change by the Claim Administrator as follows: �. At the end of�he Fee Schedule 1'eriod indicated in the most current Fee Schedule specifications of Section 1 of this Exhibit, provided that sixty (60) days prior written notice is given by the Claim Administrator; b. On the effective date of any changes or benefit variances in the Plan,its administration,or the level 01�ben�fit valua- tion which would increase the Claim Administrator's cost of administration; c. On any date changes imposed by governmental entities increase expenses incurred by the Claim Administrator,pro- vided that such ina�eases shall be limited to an amount sufficient to recover such increase in expenses; d. On any date that the number of Covered Employees enrolled in the Plan changes by an amount equal to ten percent (10%)or more of total enrollment over a one (1)month period or twenty-five percent(25%)or more of total enroll- ment over a three (3) month period; or e. On any date an affiliate, subsidiary, or other business entity is added or dropped by the Employer. 3.4 Service clzarges upon tei•mination. In the event the Agreement is terminated in accordance with the"TERM AND TER- MINATION"provisions of the Agreement,the Employer will Timely pay the Claim Administrator the Termination Ad- ministrative Charge indicated in the most cun�ent Fee Schedule specifications of Section 1 of this Exhibit. 3.5 Additional sen�ice cha��es. In addition to the amounts due and payable each month in accordance with the most current Fee Schedule specifications of Section 1 of this rxhibit, the Claim Administrator may charge the Employer for: a. Any applicable Supplemental Charge(s); b. Reasonable fees for�he reproduction or return of Claim records requested by the Employer,a governmental agency or pursuant lo a court order, and/or c. Any other fees that may be assessed by third parties for services rendered lo lhe �mployer and/or any other fees for services muUially agreed upon by the parties in writing. 3.6 Effecl of Plau enroUnaeiil. Administrative Charges will be paid based upon informalion the Claim AdminisU�ator re- ceives regarding current Plan enrollment as of the 1�irst day of each month. Appropriate adjustments will be made for en- rollment variances or corrections. II('SC'It,nSA Rev.G/07 -?1-