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R96-148 AUTHORIZING APPLICATIONS
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R96-148 AUTHORIZING APPLICATIONS
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5/3/2016 2:11:16 PM
Creation date
5/3/2016 2:11:07 PM
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Resolution/Ordinance
Res Ord Num
R96-148
Res Ord Title
AUTHORIZING APPLICATIONS FOR GROUP HEALTH INSURANCE COVERAGE
Approved Date
10/21/1996
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• XII. AMENDMENTS <br /> This Agreement may be amended by mutual agreement of the parties hereto at any time, but, to be <br /> effective, any amendment hereto must be in writing and signed by an authorized representative of <br /> each party. <br /> XIII.LIMITATIONS <br /> No civil action shall be brought to recover under this Agreement after the expiration of three (3)years <br /> from the date the cause of action accrued, except to the extent that a later date is permitted under <br /> Section 413 of ERISA. <br /> XIV.NOTICES <br /> All notices,directions or requests under this Agreement shall be in writing and shall either be delivered <br /> or mailed, Certified or Registered Mail, to the other addressed as follows: <br /> If to the Claim Administrator: <br /> Health Care Service Corporation <br /> a Mutual Legal Reserve Company <br /> 233 North Michigan Avenue <br /> Chicago, Illinois 60601-5655 <br /> Attention: David Underkoffler <br /> If to the Employer: <br /> City of Decatur <br /> � #1 Civic Center Plaza <br /> Decatur, Illinois 62523 <br /> Attention: Mr. Jerry Bauer <br /> XV. CLAIM ADMINISTRATOR'S SEPARATE FINANCIAL ARRANGEMENTS WITH PROVIDERS <br /> All amounts payable to the Claim Administrator by the Employer for Claim Payments provided by the <br /> Claim Administrator and applicable service charges pursuant to the terms of this Agreement and all <br /> required deductible and Coinsurance amounts under this Agreement shall be calculated on the basis <br /> of the Provider's Eligible Charge less the ADP, unless otherwise directed in writing by the Employer, <br /> for Covered Services rendered to a Covered Person, irrespective of any separate financial arrange- <br /> ment between any Administrator Provider or the Employer and the Claim Administrator. <br /> The Employer acknowledges that the Claim Administrator has contracts with certain Providers ("Ad- <br /> ministrator Providers") for the provision of, and payment for, health care services to all persons en- <br /> titled to health care benefits under individual certificates, agreements and contracts to which the <br /> Claim Administrator is a party, including the Covered Persons under this Agreement, and that pur- <br /> suant to the Claim Administrator's contracts with Administrator Providers, under certain circum- <br /> stances described therein, the Claim Administrator may receive substantial payments from Adminis- <br /> trator Providers with respect to services rendered to all such persons for which the Claim <br /> Administrator was obligated to pay Administrator Providers, or the Claim Administrator may pay Ad- <br /> ministrator Providers less than their Claim Charges for services, by discounts or otherwise, or may <br /> receive from Administrator Providers other allowances under the Claim Administrator's contracts with <br /> them.The Employer acknowledges that in negotiating the service charges set forth in this Agreement, <br /> � it has taken into consideration that the Claim Administrator may receive such payments, discounts <br /> and/or other allowances during the term of this Agreement and that the service charges specified in <br /> this Agreement reflect the amount of additional consideration expected to be received by the Claim <br /> - 7 - <br />
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