BlueCard Program Fees and Compensation. Employer understands and agrees to reimburse Claim Administrator for certain fees and compensation which Claim Administrator is obligated under the BlueCard Program to pay to the Host Blues, to the Association, and/or to vendors of the BlueCard Program-related services. The specific BlueCard Program fees and compensation that are charged to Employer are set forth in the most current ASO BPA. The specific BlueCard Program fees and compensation may be revised from time to time as described in Section 4.9 below. Claim Administrator will charge these fees as follows:
BlueCard Program Fees and Compensation. Group understands and agrees to reimburse BCN for certain fees and compensation which we are obligated under the BlueCard Program to pay to the Host Blues, to the Blue Cross and Blue Shield Association (BCBSA), or to BlueCard Program vendors, as described below. Fees and compensation under the BlueCard Program may be revised in accordance with the Program’s standard procedures for revising such fees and compensation, which do not provide for prior approval by any Group. Such revisions typically are made annually as a result of Program policy changes and/or vendor negotiations. These revisions may occur at any time during the course of a given calendar year, and they do not necessarily coincide with Group’s benefit period. Only the BlueCard Program access fee may be charged separately each time a claim is processed through the BlueCard program. If one is charged, it will be a percentage of the discount/differential BCN receives from the Host Blue, based on the current rate in accordance with the Program’s standard procedures for establishing the access fee rate. The access fee will not exceed $2,000 for any claim. All other BlueCard Program-related fees are included in BCN’s administrative fee. A BlueCard Program access fee may be charged only if the Host Blue’s arrangement with its healthcare provider prohibits billing members for amounts in excess of the negotiated payment. However, a healthcare provider may xxxx for non-covered healthcare services and for member cost sharing (for example, deductibles, copayments, and/or coinsurance) related to a particular claim. Instances may occur in which the claim payment is zero or BCN pays only a small amount because the amounts eligible for payment were applied to patient cost sharing (such as a deductible or coinsurance). In these instances, BCN will pay the Host Blue’s access fee and pass it along to Group as stated above even though you paid little or had no claim liability.
BlueCard Program Fees and Compensation. Employer understands and agrees to reimburse BlueCross for certain fees and compensation which BlueCross is obligated under the BlueCard Program to pay to the Host Blues, to the Association and/or to vendors of BlueCard Program-related services. The specific BlueCard Program fees and compensation that are charged to Employer are set forth in Exhibit B. BlueCard Program Fees and compensation may be revised from time to time as described in section 1.7 below.
