R2000-207 AUTHORIZING APPLICATIONS

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B1ueCross B1ueShield A I?ivision of Health Caze Service Corporation, . � a Mutual Legal Reserve Company, . ' Of Ill11101S An Independent Licensee of the � Blue Cross and Blue Shield Association � m ADMINISTRATIVE SERVICES AGREEMENT This Agreement made as of November 1,2000 by and between Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutuai Legal Reserve Company (hereinafter re- ferred to as the "Claim Administrator"), and City of Decatur (hereinafter referred to as the"Employer"), Employer Group Number(s) P06856 and 992844, WITNESSETH AS FOLLOWS: � WHEREAS,the Employer has executed a Benefit Program Application and the Claim Administrator here- ! ' by accepts such Benefit Program Application attached hereto as Exhibit I; and , WHEREAS,the Employer has established and adopted an employee welfare benefit plan ("Plan") as de- 'I scribed in the Plan Document attached hereto as Exhibit A; and, I, WHEREAS,the benefit programs offered under the Plan by the Employer to eligible employees and their I eligible dependents include a comprehensive major medical program and a preferred provider option pro- � gram; and, WHEREAS,the Claim Administrator has established and maintains a Comprehensive Major Medical Pro- gram ("CMM") and a preferred provider option network known as the Blue Cross and Blue Shield Partici- pating Provider Option ("PPO'�; and, WHEREAS, the Employer desires to retain the Claim Administrator to establish and maintain the CMM and the PPO under the Plan offered by the Employer to eligible employees and their eligible dependents and provide certain administrative services with respect to the attached Plan; and, WHEREAS, it is desirable to set forth more fully the obligations, duties, rights and liabilities of the Claim Administrator and the Employer in respect to the Plan; NOW,THEREFORE, in consideration of these premises and the mutual promises and agreements here- inafter set forth, the parties hereby agree as follows: I. APPOINTMENT The Employer hereby retains and appoints the Claim Administrator to provide services as herein- after described in connection with the administration of the Plan. II. SERVICES TO BE PROVIDED BY THE CLAIM ADMINISTRATOR During the continuance of this Agreement, the Claim Administrator will manage, operate and ad- minister its CMM and PPO and will perform such services as are set forth in Exhibit II, attached hereto and made a part hereof,with respectto benefits provided underthe Plan.The ClaimAdmin- istrator,at its sole discretion, may contract with other entities for performance of any of the services to be performed bythe 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. III. CERTAIN RESPONSIBILITIES OF THE EMPLOYER AND THE CLAIM ADMINISTRATOR A. 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 - 1 -