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V. REPRESENTATIONS AND WARRANTIES <br /> The Claim Administrator hereby represents and warrants to Employer as of the date hereof as fol- <br /> lows: <br /> A. The Claim Administrator has established and maintains its PPO for the provision of In-Net- <br /> work Services to Covered Persons under the Plan. The PPO Providers are available in the <br /> geographic areas specified by Employer and include sufficient numbers to readily provide ac- <br /> cess to Covered Persons. <br /> B. The Claim Administrator has established and maintains written agreements with PPO Provid- <br /> ers which require such Providers to cooperate with utilization review programs. <br /> C. The Claim Administrator has established and maintains written agreements with PPO Provid- <br /> ers which encourage such Providers to make referrals to other PPO Providers. <br /> VI. CERTIFICATE OF CREDITABLE COVERAGE <br /> A. The Claim Administrator, at the written direction of the Employer, shall issue to individuals, <br /> whose coverage under the Plan terminates during the term of this Agreement, a Certificate <br /> of Creditable Coverage, based upon coverage under this Agreement and information pro- <br /> vided by the Employer to the Claim Administrator, in a form acceptable to the Claim Adminis- <br /> trator, regarding the individual's eligibility and termination of coverage under this Agreement. <br /> A Certificate of Creditable Coverage will be issued subsequent to the following events: <br /> 1. A�the time an individuaPs coverage under the Agreement is terminated during the term <br /> of this Agreement; I <br /> 2. At the time an individual ceases to be covered under COBRA; and ' <br /> 3. At the request of such individual within finrenty-four(24) months after the date of termina- � <br /> tion of coverage under this Agreement or continuance. <br /> B. A Certificate of Creditable Coverage shall include, without limitation, either (a) a statement I <br /> thatthe individual has at least 18 months of coverage,or(b)the date anywaiting period began I <br /> and the date Creditable Coverage began and the date Creditable Coverage ended, unless I, <br /> Creditable Coverage is continuing at the time a Certificate is issued. I <br /> VII. COMPENSATION TO CLAIM ADMINISTRATOR ', <br /> A. The Employer will pay service charges to the Claim Administrator as compensation for the II <br /> processing of Claims and administrative and other services provided to the Employer.These <br /> service charges will be the following percentage(s) and/or amount(s) and will be applied in <br /> accordance with the provisions of this Agreement: <br /> 1. Administrative Fee: <br /> $38.00 per Covered Employee per month for all Claim Payments <br /> $1.65 per Covered Employee per month for the Administration of the Medical Services <br /> Advisory Program <br /> 2. Claim Administrator's Provider Access Fee: <br /> 25% of Average Discount Percentage (ADP) savings for Group Number P06856 <br /> 50% of Average Discount Percentage (ADP) savings for Group Number 992844 <br /> � 3. Reimbursement Fee: <br /> The Claim Administrator shall be compensated for its administration of the Reimburse- <br /> ment Provision by retaining 15% of net recoveries made on behalf of the Employer after <br /> attorneys' fees have been deducted. <br /> - 4 - <br />