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R2007-236 AUTHORIZING AGREEMENT WITH BLUE CROSS BLUE SHIELD OF ILLINOIS
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R2007-236 AUTHORIZING AGREEMENT WITH BLUE CROSS BLUE SHIELD OF ILLINOIS
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10/23/2015 3:29:59 PM
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Resolution/Ordinance
Res Ord Num
R2007-236
Res Ord Title
AUTHORIZING AGREEMENT WITH BLUE CROSS BLUE SHIELD OF ILLINOIS - ADMINISTRATIVE SERVICES AGREEMENT
Approved Date
12/26/2007
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�. <br /> � <br /> , r <br /> 4.2 Claim Administrator Responsibility.The Claim Administrator shall have no responsibility for or liability with respect to the <br /> compliance or non-compliance of the Plan with any applicable federal, state and local rules, laws and regulations; and the <br /> Employer shall have the sole responsibility for and shall bear the entire cost of compliance with all federal,state and local <br /> rules, laws and regulations, including, but not limited to, any licensing, filing, reporting, modification requirements and <br /> disclosure requirements as may apply to the Plan,and all costs,expenses and fees relating thereto;provided,however,the <br /> Claim Administrator shall have the responsibility far and bear the cost of compliance with any federal,state ar local laws as <br /> may apply to the Claim Administrator in connection with the performance of its obligations under this Agreement. <br /> 4.3 Litigation. Each party shall,to the extent possible, advise the other party of any legal actions against it or the other party <br /> which involve the Plan or the obligations of either party under the Plan or this Agreement.The Employer shall undertake the <br /> defense of such action and be responsible for the costs of defense;provided, however, that the Claim Administrator shall <br /> have the option,at its sole discretion,to employ attorneys selected by it to defend any such action,the costs and expenses of , <br /> which shall be the responsibility of the Claim Administrator. It is further agreed that each party(provided no conflicts of ' <br /> interest exist)shall fully cooperate with the other party in the defense of any action arising out of matters related to the Plan 'i <br /> or this Agreement. I <br /> 4.4 Claim overpayments. The Employer acknowledges that unintentional administrative errors may occur. When the Claim I <br /> Administrator becomes aware of a Claim overpayment,the Claim Administrator will make a diligent attempt to recover any <br /> such payment. The Claim Administrator,however, will not be required to enter into litigation to obtain a recovery,unless <br /> specifically provided for elsewhere in this Agreement,nor will the Claim Administrator be required to reimburse the Plan, <br /> except for negligence or intentional acts by the Claim Administrator. <br /> 4.5 Required Plan information. The Employer shall furnish on a Timely basis to the Claim Administrator certain information <br /> concerning the Plan and Covered Persons as may from time to time be required by the Claim Administrator for the <br /> performance of its duties including,but not limited to,the following: <br /> a. All documents by which the Plan is established and any amendments or changes to the Plan. <br /> b. All data as may be required by the Claim Administrator regarding Covered Persons who are to be covered <br /> under this Agreement. <br /> It is the Employer's obligation to Timely notify the Claim Administrator of any change in a Covered Person's status under <br /> this Agreement.All such notifications by the Employer to the Claim Administrator(including,but not limited to,forms and <br /> tapes)must be furnished in a format mutually agreed to by the parties and must include all information reasonably required <br /> by the Claim Administrator to effect such changes. <br /> 4.6 Plan eligibility errors. Clerical errors in keeping or reporting data relative to coverage under this Agreement will not <br /> invalidate coverage that would otherwise be validly in force or continue coverage which would otherwise validly terminate. <br /> Such errors will be corrected by the Claim Administrator subject to the terms and conditions of this Agreement and the <br /> Claim Administrator's reasonable administrative practices in the administration of the Plan including,but not limited to, <br /> those related to Timely notification of a change in a Covered Person's status.The Employer is liable to Claim Administrator <br /> for any benefits paid for a terminated Covered Person until the Employer has notified the Claim Administrator of such <br /> Covered Person's termination. <br /> 4.7 Claim information disclosure. The Claim Administrator will disclose Claim information in accordance with HIPAA <br /> privacy regulations and the Business Associate Agreement entered into by the parties. <br /> 4.8 Electronic exchange of information. In the event the Employer and the Claim Administrator exchange various data and <br /> information electronically,the Employer agrees to transfer on a Timely basis all required data to the Claim Administrator <br /> via electronic transmission on the intranet and/or internet or otherwise, in a format mutually agreed to by the parties. <br /> Further,the Employer is responsible for maintaining any enrollment applications and change forms completed by Covered <br /> Persons and to allow the Claim Administrator reasonable access to this information as needed for administrative purposes. <br /> The Employer authorizes the Claim Administrator to submit reports,data and other information to the Employer in the electronic <br /> format mutually agreed to by the parties.In the event the Employer is unable or unwilling to transfer data in the electronic format <br /> mutually agreed to by the parties,the Claim Administrator is under no obligation to receive or transmit data in any other format. <br /> -8- <br />
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