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

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� r, � . up �o lhe date of ihe Final SettlemenL The difi�erence shall be paid or applied as sel forth in Section 6 of this Txhibit. 1Iuwever, il�ihe"I'ransier Yaymenis exceed the Claim Settlement"Ibtals for all Run-01f Claims paid u��10 the I�inal SctUe- ment, the Claim Administrator shall pay such di11'erence to the Gmployer alter applying the diii�erence against amounts, if any, then owed to the Claim Administralor by the L'mployer. SrC'I'ION 9: I2rQUIItGD DISCLOSURC YI20VISIONS "Thc l�mployer represents that i� acicnowledges and has communicated the provisions stated in each o1'the following sections of this Txhibit 2 to its Covered Persons. S�CTION 10: YAPM�N1'OF CLAIMS AND ASSIGNMCNT OP'I3GN�FI7'S: 101 Clainz paynaent assign►nent. All payments by the Claim Administrator for the benefit of any Covered Person may be made directly to any Provider furnishing Covered Services for which such payment is due,and the Claim Administrator is authorized by such Covered Person to make such payments directly to such Providers. However,the Claim Administra- tor reserves the right in its sole discretion to pay any benefits that are payable under the terms of the Plan directly to the Covered Person or Provider t'urnishing Covered Services.All benefits payable to the Covered Person which remain un- paid at the time of the death of the Covered Person wil] be paid to the estate of the Covered Person. 10.2 Claim dispute. Once Covered Services are rendered by a Provider,the Covered Person has no right to request the Claim Administrator not to pay the Claim submitted by such Provider and no such request by a Covered Person or his agent will be given effect. rurthermore, the Claim Administrator will have no liability to the Covered Person or any ather person because o1'its rejection of such request. 10.3 Plan coverage ussignnaent. Neither the Plan nor a Covered Nerson's claims for payment of benefits under the Plan are assignable in whole or in part to any person or entity at any time. Coverage under the Plan is expressly non-�ssignable or non-transferable and will be forfeited it�a Covered Person attempts to assign or transTer coverage or aids or attempts to aid any other person in fraudulently obtaining coverage under the Plan. However, if the Claim Administrator makes payment because of a person's wrongfu] use of the identification card of a Covered Person,such payment will be consid- ered a proper payment and die Claim Administrator will have no obligation to pursue recovery of such payment. SEC'I70N 11: COV�R�D YGRSON/PROVID�R R�LATIONSHIP ll1 Choosing a Proviclen The choice of a Provider is solely the choice of the Covered Person and the Claim Administrator will not interfere with the Covered Person's relationship with any Provider. 11.2 Cluim Administratoi•'s ro[e. It is expressly understood that the Claim Administrator does not itself undertake ro furnish hospital, medical or dental service,but solely to make payment to a Provider for the Covered Services received by Cov- ered Persons.The Claim Administrator is not in any event liable for any act or omission of any Provider or the agent or employee of such Provider, including, bul not limited to, the failure or refusal to render services to a Covered Person. Yrofessional services which can only be legally perfonned by a Provider are not provided by the Claim Administrator. Any contractual relationship between a Provider and the Claim Administrator shall not be construed to mean that the Claim Administrator is providing professional service. 11.3 If point-of-ser��ice coi�ernge app[ies. If coverage under a Network point-of-service managed care health benefit program is applicable to the Nlan w�der the Agreement, the following apply: :►. Physician Selection. A Covered Person shall be entitled to selecl a Primary Care Physician through the Ylan to acl as the Covered Person's principal care giver and to provide or arrange for the provision of inedical care. b. Cliaizgi�zg Physician Selection. Both the Covered Person and the Primary Care Physician may request �� change from one Primary Care Physician to another by notifying the Claim Administra�or of the desire to change; provided, however,such a reyuest by a Pri- i Ic'sc�ii,ns�Ite�-.��io� -24-