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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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H. Within thirty(30) days of receiving verification from Claim Administrator as to <br /> the provider the Covered Person used, Vitals shall determine if an Incentive <br /> Reward Payment is owed. Within thirty (30) days of determining an Incentive <br /> Reward Payment is owed, Vitals shall mail the Incentive Reward Payment to the <br /> Covered Person. Vitals shall verify the Covered Person's qualification for an <br /> Incentive Reward Payment by confirming through claims payment information <br /> from Claim Administrator that a request for payment from the provider for the <br /> specific service in question was received and processed. <br /> 1. Vitals shall generate and mail all Incentive Reward Payments to Covered Persons <br /> as stated in Section 4 of this Agreement. <br /> J. Employer shall make the Program available to Covered Persons for such period of <br /> time and in connection with such procedures as Employer, in its sole discretion <br /> and in its capacity as the settlor of the Plan may determine. <br /> K. Employer's participation in the Program is not intended to,nor shall it,change the <br /> scope and type of benefits offered by the Plan or alter or revise in any manner <br /> either the Employer's or Covered Person's respective contributory or any other <br /> obligations in connection with Plan. <br /> L The Program is not intended to and will not limit the choice of providers available <br /> under the Plan for selection by Covered Persons. <br /> M. The Program is not intended to and will not affect or alter in any manner the <br /> copay, coinsurance,deductibles, benefit limits or any aspect of the Plan affecting <br /> the cost of benefits to Covered Persons under the Plan documents. <br /> N. Vitals has no responsibility or authority of any kind to determine whether claims <br /> for health care services provided to Covered Persons are to be covered. <br /> 2 <br />
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