R99-108 AUTHORIZING APPLICATIONS

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B. Any reasonable determination by the Claim Administrator in adjudicating a Claim under the � Agreement that a Covered Person is entitled to a Net Claim Payment is conclusive evidence of the liability of the Employer to the Claim Administrator for such Net Claim Payment pursuant to section above entitled "Claim Settlements." C. During the term of the Agreement and within one hundred eighty(180)days after the termination ofthe Agreement,the Employer may,upon at leastthirty(30)days priorwritten notice to the Claim Administrator, conduct reasonable audits of the Claim Administrator's records in regard to Claim Payments and Net Claim Payments calculated on the basis of Claim Payments made under the Agreement. All such audits shall be subject to the Claim Administrator's external review proce- dures and guidelines, a copy of which shall be furnished to the Employer upon written request to the Claim Administrator. D. Any errors identified in Claim Payments and Net Claim Payments will be promptly corrected by the Claim Administrator subject to the terms and conditions of the Agreement.The Employer will assist and cooperate with the Claim Administrator in recovering errors in benefit payments made to Covered Persons but the res onsibili for such errors in Claim Pa ments and Net Claim Pa - P tY Y Y ments calculated on the basis of Claim Payments shall ultimately be the Claim Administrator's, limited to the Claim Administrator's making an equitable adjustment to the Employer's account. However,the Claim Administrator shall be responsible only for the correction of errors identified in specific Claim Payments and Net Claim Payments and shall not be responsible for errors calcu- lated to exist in a population of Claim Payments and Net Claim Payments on the basis of a sample drawn from that population. Further,the Claim Administrator has the right to implement reason- able administrative practices in the administration of the Agreement. Minor deviations in Claim Payments and Net Claim Payments from the provisions of the Agreement as a result of such rea- sonable administrative practices shall not be considered errors. � XI. PAYMENT OF CLAIMS AND ASSIGNMENT OF BENEFITS A. All payments by the Claim Administrator for the benefit of any Covered Person may be made di- rectly 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 directlyto such Pro- viders. However,the Claim Administrator reserves the right in its sole discretion to pay any bene- fits that are payable under the terms of this Plan directly to the Covered Person or Provider fur- nishing Covered Services. All benefits payable to the Covered Person which remain unpaid at the time of the death of the Covered Person will be paid to the estate of the Covered Person. B. 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. Furthermore, the Claim Administrator will have no liability to the Covered Person or any other person because of its rejection of such re- quest. C. Neither the Plan nor a Covered Person's claims for payment of benefits under the Plan are as- signable in whole or in part to any person or entity at any time. Coverage under the Plan is ex- pressly non-assignable or non-transferable and will be forfeited if a Covered Person attempts to assign or transfer 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 per- son's wrongful use of the identification card of a Covered Person, such payment will be consid- ered a proper payment and the Claim Administrator will have no obligation to pursue recovery of such payment. The Employer represents that it has included the provision stated in this Section XI. in its Plan . Document. XII. LATE PAYMENTS AND REMEDIES - 6 -