ADMINISTRATIVE SERVICES AGREEMENT GROUP NO. XXXXXNetwork Service Agreement • May 9th, 2016 • Wisconsin
Contract Type FiledMay 9th, 2016 JurisdictionThis Agreement is made and entered into as of this day of , 20 17 (“Effective Date”) by and between (Group Name) (hereinafter referred to as “Employer”) and Allied Benefit Systems, Inc. (hereinafter referred to as “TPA”). The purpose of this Agreement is to detail the responsibilities and obligations of the parties with respect to the Employer's program of providing medical and/or other benefits for employees and their dependents (hereinafter referred to as “Benefit Plan”).