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January 13,2017 <br /> Dear Linda: <br /> Thank you for being a valued customer of Blue Cross and Blue Shield of IL.We appreciate your business <br /> and are committed to providing you with a superior customer experience. In an effort to anticipate your <br /> needs and to help streamline our renewal process,we are pleased to provide you with the attached <br /> Administrative Services Agreement that details our administrative services.If you have not yet received <br /> the rest of your renewal packet,it will follow shortly. <br /> A Guide to Key Forms <br /> We understand that we provide a number of forms to you as part of our renewal process and want to make <br /> sure you understand what we are providing to you and why it is important to us—and to you—that you <br /> review and sign. <br /> • Administrative Services Agreement(ASA)—this is your detailed contract that outlines services <br /> and provisions with us.We update this document annually to keep it current. <br /> • Benefit Program Application (BPA)-this document is focused on making sure that the <br /> administrative services and fees are clearly outlined and it becomes an exhibit to your ASA <br /> needed to complete your renewal. The BPA will be an exhibit to your group's ASA and must also <br /> be signed and returned. <br /> Please Be Aware <br /> • If you change or modify services or products,then a new ASA,ASA Amendment or BPA may be <br /> required. <br /> On Signing Our Forms <br /> • In order to make sure there are no delays in applying any plan changes to your group, it is <br /> important to promptly return the ASA signed by an authorized officer within the next two weeks <br /> to facilitate a smooth implementation. <br /> • If signing electronically through DocuSign, you will receive a confirmation email upon signature <br /> with a copy of the executed contract.If signing manually,please send a PDF of the executed <br /> contract in an email to myself and then send the hardcopy to the address listed below. <br /> • As with any contract form,we do encourage you to retain a copy for your own files. <br /> • For your convenience,the ASA and BPA can be signed in any order.But both must be signed <br /> before the effective date. <br /> • If you already signed your BPA, we thank you. <br /> Again,thank you for being a valued customer of Blue Cross and Blue Shield of IL. We look forward to <br /> continuing to work with you and for your members.Please let me know if you have any questions about <br /> the Agreement. <br /> Sincerely, <br /> Holly Little <br /> Holly A Little@bcbsil.com <br /> 2787 McFarland Rd. <br /> Rockford,IL 61107 <br />