Blues Plan definition

Blues Plan means any health insurance company that (a) has been licensed by the Blue Cross Blue Shield Association to use the Blue Cross and/or Blue Shield marks and (b) is not Blue Cross Blue Shield of North Carolina.
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Examples of Blues Plan in a sentence

  • Notwithstanding Section 6.9.1 and with the exception of this Agreement and its associated Reimbursement Exhibit(s), you agree that: (i) any documents, information, or data from the Blue Cross and Blue Shield Association or other Blues Plan, (ii) any of our programs, policies, or data, and (iii) our trade secret information shall be and remain confidential.

  • During the Term, the parties agree that they will not provide, or have any interest, whether as an employee, officer, director, shareholder, partner, contractor, consultant or advisor, in any person or entity that provides, Specialty Physician Management Services, whether or not compensated, to any Blues Plan except pursuant to this Agreement.

  • The Contracting Party shall receive Capitation Payments for the benefit of Allied, CareAdvantage and physicians who render specialty health care services to Blues Plan enrollees and, accordingly, shall have contractual and fiduciary obligations to manage Capitation Payments in accordance with this Agreement.

  • If written notice is not provided to Allied as set forth herein, CareAdvantage shall be deemed to have waived its option with respect to such Blues Plan.

  • The parties acknowledge that disbursement of Capitation Payments in a timely manner is essential in order to, among other things, compensate physicians who render specialty health care services to Blues Plan enrollees.

  • CareAdvantage may exercise its option by providing written notice to Allied no later than ten business days prior to the effective date of any contract for Specialty Management Services with any such Blues Plan.

  • The remainder of the Capitation Payments shall be allocated to physicians who rendered specialty health care services to Blues Plan enrolls during the prior month, as a part of the Back Room Services.

  • The parties shall allocate, on a contract by contract basis, an agreed upon percentage of the Capitation Payments as payment for Specialty Physician Management Services (the "Service Fee"); provided, however, that in no event shall the Service Fee for any Blues Plan be less than 9% of the Capitation Payments.

  • The employee shall be responsible for paying towards the annual deductible of the Health Savings Account (HSA) underwritten by Blue Cross Blue Shield (BCBS) of Michigan Flexible Blues Plan 2 the amount which shall not exceed $720.00 annually towards the cost of the Health Saving Account deductible.

  • Allied and CareAdvantage will mutually agree on whether Allied, CareAdvantage or some other jointly controlled entity should be the appropriate party to any contract to provide Specialty Physician Management Services to any Blues Plan.