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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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11.3 Infringement Claim Administrator agrees not to infringe upon, dilute or harm Employer's rights in its <br /> Proprietary Marks. Employer agrees not to infringe upon, dilute or harm the Blue Cross and Blue Shield <br /> Association's ownership rights or Claim Administrator's rights as a licensee in the Proprietary Marks. <br /> 11.4 Disclosures in Account Contracts. Employer on behalf of itself and its Covered Persons hereby expressly <br /> acknowledges its understanding this Agreement constitutes a contract solely between Employer and Claim <br /> Administrator, which is an independent corporation operating under a license from the Blue Cross and Blue <br /> Shield Association, an association of independent Blue Cross and Blue Shield Plans, (the "Association") <br /> permitting Claim Administrator to use the Blue Cross and Blue Shield Service Mark, and that Claim <br /> Administrator is not contracting as the agent of the Association. Employer on behalf of itself and its Covered <br /> Persons further acknowledges and agrees that it has not entered into this Agreement based upon <br /> representations by any person other than Claim Administrator and that no person, entity, or organization other <br /> than Claim Administrator shall be held accountable or liable to Employer for any of Claim Administrator's <br /> obligations to Employer created under this Agreement. This subsection shall not create any additional <br /> obligations whatsoever on the part of Claim Administrator other than those obligations created under other <br /> provisions of this Agreement. <br /> 11.5 Administrative Services Only, Network Only. Claim Administrator must disclose that it does not underwrite <br /> or assume any financial risk with respect to claims liability; and disclose the nature of the services and/or <br /> network access Claim Administrator is providing. Such disclosures must be made to Employer, Employer's <br /> Covered Persons, and Providers and must include, at a minimum, disclosure on identification cards, benefit <br /> booklets, Employer contracts and explanation of benefits documentation. <br /> SECTION 12: ELECTRONIC DOCUMENTS <br /> Employer's consent/responsibilities. Employer consents that any documents exchanged between the parties <br /> that describe the benefits under,or the administration of,the Plan (including but not limited to benefit booklets)may <br /> be in the format of an electronic file or access to an electronic file. Employer further acknowledges and agrees that <br /> if Claim Administrator provides Employer,at Employer's request,an electronic file that describes the benefits under, <br /> or the administration of, the Plan, Employer will provide Covered Persons access, via the intranet, internet, or <br /> otherwise, to only the most current version of that electronic file. Employer also acknowledges and agrees that, in <br /> all instances, Claim Administrator may rely on the fact that the most current version of the electronic file Claim <br /> Administrator provides to Employer is the authorized document that governs administration of Employer's Plan <br /> under this Agreement and will prevail in the event of any conflict between such electronic file and any other <br /> electronic or paper file. Employer is solely responsible for any and all claims for loss, liability or damages, arising <br /> either directly or indirectly from Employer's use or posting of the electronic file on the intranet and/or internet. <br /> SECTION 13: RECORDS <br /> All Claim determination records, excluding any and all of the Business Confidential Information of Claim <br /> Administrator, other Blue Cross and/or Blue Shield companies, or Claim Administrator's subsidiaries, affiliates, and <br /> vendors, in the possession of Claim Administrator are and shall remain the property of Employer upon termination <br /> of this Agreement. Claim Administrator shall return a copy of such property upon request in a form as agreed upon <br /> by the parties with the cost of preparing such property for transmittal to be borne by Employer. All such Claim <br /> records shall be retained by Claim Administrator until Claim Administrator receives a request from Employer for <br /> transmittal or for a period of eleven (11)years from the date of a Claim's adjudication,whichever occurs first. <br /> SECTION 14: APPLICABLE LAW <br /> This Agreement shall be governed by, and shall be construed in accordance with, the laws of the state of Illinois <br /> without regard to any state choice—of—law statutes, and any applicable federal law.All disputes between Employer <br /> and Claim Administrator arising out of or related to this Agreement will be resolved in Chicago, Illinois. Changes in <br /> state or federal law or regulations or interpretations thereof may change the terms and conditions of the Services. <br /> HCSC IL Gen ASA Med Non ERISA REG Rev.8.16 10 <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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