Common use of Electronic Enrollment Eligibility File Clause in Contracts

Electronic Enrollment Eligibility File. Upon request from GROUP, BCBSRI may accept an electronic enrollment eligibility file (“eligibility file”) from GROUP through an on-line electronic enrollment tool, whether administered by BCBSRI or by an intermediary, including private exchanges. Upon acceptance by BCBSRI, the eligibility file will provide BCBSRI with GROUP’s determinations as to when an Eligible Employee, Eligible Dependent or Eligible Retiree is to become an Enrolled Member and when an individual is no longer an Enrolled Member under GROUP’s Health Care Coverage (“Eligibility Determinations”). GROUP agrees that BCBSRI and not GROUP will be responsible for making eligibility determinations for disabled dependents over the age of twenty-six (26). The date BCBSRI accepts the GROUP’s first eligibility file shall be deemed the effective date of GROUP’s responsibility to conduct Eligibility Determinations. Subsequent to this effective date, BCBSRI will refer all individuals inquiring about eligibility to GROUP. BCBSRI will, at the direction of GROUP, enroll or disenroll any employee, dependent or retiree based on the eligibility file provided by GROUP. GROUP shall have sole responsibility for (1) establishing standards governing the eligibility of individuals to participate in GROUP Health Care Coverage, (2) determining whether an individual is eligible to participate in GROUP Health Care Coverage, and (3) resolving all disputes relating to eligibility. BCBSRI shall have no liability to GROUP or to any individual for any Eligibility Determination made by GROUP. GROUP agrees to indemnify, defend, and hold harmless BCBSRI against all claims, actions, liabilities, damages, costs and expenses, including attorneys’ fees, arising out of GROUP’s Eligibility Determinations, including without limitation, negligence, willful misconduct, or failure to notify BCBSRI of such Eligibility Determinations, except to the extent such claims, actions, liabilities, damages, costs or expenses are proximately caused by the negligent acts or omissions of BCBSRI.

Electronic Enrollment Eligibility File. Upon request from GROUP, BCBSRI may accept an electronic enrollment eligibility file (“eligibility file”) from GROUP through an on-line electronic enrollment tool, whether administered by BCBSRI or by an intermediary, including private exchanges. Upon acceptance by BCBSRI, the eligibility file will provide BCBSRI with the GROUP’s determinations as to when an Eligible Employee, Eligible Dependent or Eligible Retiree is to become an Enrolled Member and when an individual is no longer an Enrolled Member under the GROUP’s Health Care Healthcare Coverage (“Eligibility Determinations”). GROUP agrees that BCBSRI and not GROUP will be responsible for making eligibility determinations for disabled dependents over the age of twenty-six (26). The date BCBSRI accepts the GROUP’s first eligibility file shall be deemed the effective date of GROUP’s responsibility to conduct Eligibility Determinations. Subsequent to this effective date, BCBSRI will refer all individuals inquiring about eligibility to GROUP. BCBSRI will, at the direction of GROUP, enroll or disenroll any employee, dependent or retiree based on the eligibility file provided by GROUP. GROUP shall have sole responsibility for (1) establishing standards governing the eligibility of individuals to participate in the GROUP Health Care Healthcare Coverage, (2) determining whether an individual is eligible to participate in the GROUP Health Care Healthcare Coverage, and (3) resolving all disputes relating to eligibility. BCBSRI shall have no liability to GROUP or to any individual for any Eligibility Determination made by GROUP. GROUP agrees to indemnify, defend, and hold harmless BCBSRI against all claims, actions, liabilities, damages, costs and expenses, including attorneys’ fees, arising out of GROUP’s Eligibility Determinations, including without limitation, negligence, willful misconduct, or failure to notify BCBSRI of such Eligibility Determinationseligibility determinations, except to the extent such claims, actions, liabilities, damages, costs or expenses are proximately caused by the negligent acts or omissions of BCBSRI.

Electronic Enrollment Eligibility File. Upon request from GROUP, BCBSRI may accept an electronic enrollment eligibility file (“eligibility file”) from GROUP through an on-line electronic enrollment tool, whether administered by BCBSRI or by an intermediary, including private exchanges. Upon acceptance by BCBSRI, the eligibility file will provide BCBSRI with the GROUP’s determinations as to when an Eligible Employee, Eligible Dependent or Eligible Retiree is to become an Enrolled Member and when an individual is no longer an Enrolled Member under the GROUP’s Health Care Coverage (“Eligibility Determinations”). GROUP agrees that BCBSRI and not GROUP will be responsible for making eligibility determinations for disabled dependents over the age of twenty-six (26). The date BCBSRI accepts the GROUP’s first eligibility file shall be deemed the effective date of GROUP’s responsibility to conduct Eligibility Determinations. Subsequent to this effective date, BCBSRI will refer all individuals inquiring about eligibility to GROUP. BCBSRI will, at the direction of GROUP, enroll or disenroll any employee, dependent or retiree based on the eligibility file provided by GROUP. GROUP shall have sole responsibility for (1) establishing standards governing the eligibility of individuals to participate in the GROUP Health Care Coverage, (2) determining whether an individual is eligible to participate in the GROUP Health Care Coverage, and (3) resolving all disputes relating to eligibility. BCBSRI shall have no liability to GROUP or to any individual for any Eligibility Determination made by GROUP. GROUP agrees to indemnify, defend, and hold harmless BCBSRI against all claims, actions, liabilities, damages, costs and expenses, including attorneys’ fees, arising out of GROUP’s Eligibility Determinations, including without limitation, negligence, willful misconduct, or failure to notify BCBSRI of such Eligibility Determinationseligibility determinations, except to the extent such claims, actions, liabilities, damages, costs or expenses are proximately caused by the negligent acts or omissions of BCBSRI.