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

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� s , ' � 2.18"Primary Care Physician"means a physician who is a Netwark Provider at the time Covered Services are rendered under the Claim Administrator's point-of-service managed care health benefit coverage program, if applicable to the Plan under this Agreement,and who is selected by or assigned to a Covered Person to coardinate and arrange for the Covered Person's medical care and who approves and makes medically appropriate refenals for any non-Primary Care Physician services and who provides medical care within the scope of a license permitting him/her to legally practice medicine in the recognized areas of pediatrics,obstetrics and gynecology,internal medicine and family practice. 2.19"Provider"means any hospital,health care facility,laboratory,person or entity duly licensed to render Covered Services to a Covered Person or any other provider of inedical or dental services,products or supplies which are Covered Services. 2.20 "Provider's Eligible Charge" means (a) in the case of a Provider which has a written agreement with the Claim Administrator to provide care to Covered Persons at the time Covered Services are rendered,such Provider's Claim Charge for Covered Services and (b) in the case of a Provider which does not have a written agreement with the Claim Administrator to provide care to Covered Persons at the time Covered Services are rendered,such Provider's Claim Charge for Covered Services,not to exceed the reasonable charge therefor as reasonably determined by the Claim Administrator. 2.21 "Supplemental Charge" means a charge for costs due and payable to the Claim Administrator by the Employer that is separate and apart from the service charges detailed in Exhibit 2 of this Agreement.A Supplemental Charge may be applied for any customized reports, forms or other materials or for any additional services or supplies not documented in the most current Fee Schedule of Exhibit 2. Such services and/or supplies and any applicable Supplemental Charge(s) are to be agreed upon by the parties in writing prior to the Claim Administrator's performance and/or provision of such. 2.22 "Surcharges"means state or federal taxes,surcharges or other fees, including,but not limited to World Access Fees,paid by the Claim Administrator which are imposed upon or resulting from this Agreement. 2.23"Timely"means the following,unless an alternative standard is specified in this Agreement or is mutually agreed to by the parties in writing: a. With respect to all payments due the Claim Administrator by the Employer under this Agreement,within ten (10)calendar days of notification of the Employer by the Claim Administrator;or b. With respect to all information due the Claim Administrator by the Employer concerning Covered Persons,within thirty-one(31)calendar days of a Covered Person's effective date of coverage or change in coverage status under the Plan;or c. With respect to all Plan information due the Claim Administrator by the Employer,upon the effective date of this Agreement and at least ninety(90)calendar days prior to the effective date of change or amendment to the Plan thereafter. 2.24 ��World Access Fee" means the Surcharge imposed upon the Claim Administrator under the B1ueCardA Worldwide program for the administration of an international Claim. SECTION 3: SERVICES TO BE PROVIDED BY THE CLAIM ADMINISTRATOR 3.1 Subcontractors. During the continuance of this Agreement,the Claim Administrator will perform such services as set forth in Exhibit 1 of this Agreement,attached hereto and made a part hereo£The Claim Administrator,at its sole discretion,may contract with other entities for performance of any of the services to be performed by the Claim Administrator hereunder; provided,however,the Claim Administrator shall remain fully responsible and liable for performance of any such services to be performed by the Claim Administrator but delegated to other entities. 3.2 Subsidiaries. Further, any of the services to be performed by the Claim Administrator under this Agreement may be performed by the Claim Administrator,or any of its subsidiaries(including any successor corporation,whether by merger, consolidation,or reorganization), without prior written approval by the Employer. Any reference in this Agreement to the Claim Administrator shall include its directors, officers and employees as well as the directors, officers and employees of any of its subsidiaries and the Claim Administrator shall be responsible and liable for all performance or failure to perform by such subsidiaries in connection with this Agreement. SECTION 4: CERTAIN RESPONSIBILITIES OF THE EMPLOYER AND THE CLAIM ADMINISTRATOR 4.1 Employer Responsibility.The Employer retains full and final authority and responsibility for the Plan and its operation.The Claim Administrator is empowered to act on behalf of the Employer in connection with the Plan only as expressly stated in this Agreement or as mutually agreed to in writing by the parties hereto. -7-