Common use of Administrative Operations Clause in Contracts

Administrative Operations. The Plan shall conduct the day-to-day administrative operations of the Benefit Programs, including but not limited to: setting premiums; establishing new and revising existing Benefit Programs; making benefit determinations, claims adjudication and any other functions that are necessary and appropriate for the proper administration and support of the arrangement for Covered Services to be provided to Members.

Appears in 2 contracts

Sources: Participating Provider Agreement, Participating Provider Agreement