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R2016-136 BlueCross BlueShield Administration of Group Health Benefit Plan 2017
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R2016-136 BlueCross BlueShield Administration of Group Health Benefit Plan 2017
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2/8/2017 4:44:36 PM
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Resolution/Ordinance
Res Ord Num
R2016-136
Res Ord Title
Agreement with BlueCross BlueShield for Administration of Group Health Benefit Plan 2017
Department
Finance
Approved Date
11/21/2016
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and procedures, a copy of which shall be furnished to Employer upon request to Claim Administrator. The <br /> audit period will be limited to the current Agreement year and the immediately preceding Agreement year. No <br /> more than one(1)audit shall be conducted during a twelve(12)consecutive-month period, except as required <br /> by state or federal government agency or regulation. Employer and such agent that have access to the <br /> information and files maintained by Claim Administrator will agree not to disclose any proprietary information, <br /> and to hold harmless and indemnify Claim Administrator in writing of any liability from disclosure of such <br /> information by executing an Audit Agreement with Claim Administrator that sets forth the terms and conditions <br /> of the audit. Claim Administrator has the right to implement reasonable administrative practices in the <br /> administration of Claims. <br /> 7.2 Claim Administrator audits Employer. During the term of this Agreement and within one hundred eighty <br /> (180) days after its termination, Claim Administrator may, upon at least thirty(30) days prior written notice to <br /> Employer, conduct reasonable audits of Employer's membership records with respect to eligibility. <br /> SECTION 8: TERM AND TERMINATION OF AGREEMENT <br /> 8.1 Term. This Agreement will continue in full force and effect from the effective date and continue from year to <br /> year unless terminated as provided herein. <br /> 8.2 Termination. This Agreement may be terminated as follows: <br /> a. By either party at the end of any month after the end of the Fee Schedule Period indicated in the Fee <br /> Schedule specifications of the most current ASO BPA with ninety(90)days prior written notice to the other <br /> party; or <br /> b. By both parties on any date mutually agreed to in writing; or <br /> c. By either party, in the event of conduct by the other party constituting fraud, misrepresentation of material <br /> fact or material breach of the terms of this Agreement, upon written notice as provided under Section 16 <br /> below; or <br /> d. By Claim Administrator, upon Employer's failure to pay Timely all amounts due under this Agreement <br /> including, but not limited to, all amounts pursuant to and in accordance with the specifications of the Fee <br /> Schedule of the most current ASO BPA. <br /> 8.3 Notice of termination to Covered Employees. If this Agreement is terminated pursuant to this Section 8, <br /> Employer agrees to notify all Covered Employees. The parties agree that Employer will give such notice <br /> because Employer maintains direct and ongoing communication with,and maintains current addresses for,all <br /> such Covered Employees. <br /> SECTION 9: RELATIONSHIP OF PARTIES <br /> 9.1 Regarding the parties. Claim Administrator is an independent contractor with respect to Employer. Neither <br /> party shall be construed, represented or held to be an agent, partner, associate,joint venturer nor employee <br /> of the other. <br /> Further, nothing in this Agreement shall create or be construed to create the relationship of employer and <br /> employee between Claim Administrator and Employer; nor shall Employer's agents, officers or employees be <br /> considered or construed to be employees of Claim Administrator for any purpose whatsoever. <br /> 9.2 Regarding non—parties. It is understood and agreed that nothing contained in this Agreement shall confer <br /> or be construed to confer any benefit on persons who are not parties to this Agreement including, but not <br /> limited to, employees of Employer and their dependents. <br /> 9.3 Exclusivity.Employer agrees not to perform or engage any other party to perform the same services as Claim <br /> Administrator's Services while this Agreement is in effect, unless Employer gives notice of termination <br /> pursuant to the terms of this Agreement. <br /> 9.4 Assignment. Except as otherwise permitted by Section 2 of this Agreement, no part of this Agreement, or <br /> any rights, duties or obligations described herein, shall be assigned or delegated without the prior express <br /> written consent of both parties.Any such attempted assignment in the absence of the prior written consent of <br /> the parties shall be null and void. Claim Administrator's contractual arrangements for the acquisition and use <br /> HCSC IL Gen ASA Med Non ERISA REG Rev.8.16 8 <br /> Proprietary and Confidential Information of Claim Administrator <br /> Not for use or disclosure outside Claim Administrator,Employer,their respective affiliated companies and third party <br /> representatives,except with written permission of Claim Administrator. <br />
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