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Agmt23 AETNA
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Agmt23 AETNA
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Last modified
3/28/2023 11:20:48 AM
Creation date
3/28/2023 11:19:57 AM
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Agreement
PROJECT NAME
AETNA Resources for Living -
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<br /> EAP Services Agreement <br />8 <br />change in Periodic Fees and/or Benefits shall be consistent with the requirements in Sections 1374.21 <br />and 1374.22 of the California Health and Safety Code. <br /> <br />B. Member Consent. By this Agreement, Group makes Benefits available to Members. However, this <br />Agreement shall be subject to amendment, modification or termination, in accordance with the <br />provisions hereof, or by mutual agreement between Plan and Group, without the consent or <br />concurrence of Members. By electing Benefits pursuant to this Agreement, or accepting Benefits <br />hereunder, all Members legally capable of contracting, and the legal representatives of all Members <br />incapable of contracting, agree to all terms, conditions and provisions hereof. <br />C. Entitlement to Benefits. To be entitled to receive Benefits under this Agreement, a person must be a <br />Member on whose behalf Periodic Fees have been paid. Any person receiving Benefits to which he <br />or she is not then entitled pursuant to the provisions of this Agreement shall be responsible for payment <br />therefore. <br /> <br />D. Notice of Certain Events. Plan shall give Group written notice within a reasonable time of any <br />termination or breach of contract by, or inability to perform of an EAP Provider, or any person with <br />whom Plan has a contract to provide Benefits hereunder, if Group can be materially and adversely <br />affected thereby. <br /> <br />E. Liability of Plan. In the event Plan fails to pay EAP Providers for Benefits provided to Members, <br />Members shall not be liable to EAP Providers for any sums owed by Plan. <br />F. Member's Liability to Non-Plan Providers. Except with respect to Benefits rendered in an emergency, <br />in the event Plan fails to pay non-EAP Providers, Members may be liable to such non-EAP Providers <br />for the cost of services rendered. <br /> <br />G. Plan Referrals to Members. When EAP Providers refer Members for further treatment, EAP <br />Providers, to the best of their ability, will inform Members of the insurance deductibles and <br />co-payments that Members will be liable for as a result of the referral. Members will be informed they <br />are fully liable for all costs of treatment subsequent to the Benefits provided herein. <br /> <br />H. Plan's Policies. Plan may adopt reasonable policies, procedures, rules and interpretations to promote <br />orderly and efficient administration of this Agreement. <br /> <br />I. Entire Agreement. This Agreement, including its Exhibits, constitutes the entire understanding <br />between the parties with respect to the subject matter hereof and, as of the effective date hereof, <br />supersedes all other agreements between the parties with respect to such subject matter. If any part of <br />this Agreement is deemed unenforceable, the remaining parts shall remain in full force and effect. <br /> <br />J. Amendments. No agent or other person, except an authorized representative of Plan, has authority to <br />waive any condition or restriction of this Agreement, to extend the time for making a payment, or to <br />bind Plan by making any promise or representation or by giving or receiving any information. No <br />change in this Agreement shall be valid unless evidenced by an endorsement to it signed by the <br />aforesaid representative, or by an amendment to it signed by Group and such representative of Plan. <br />The above notwithstanding, this Agreement shall be deemed automatically amended to comply with <br />the provisions of the Act and the Regulations. <br />REV: 03-10-23 MI <br />ATTY/AGR.2023.039/Aetna (EAP Services Agreement) (Page 9 of 42)
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