Administrative Operations. EmblemHealth shall conduct the day-to-day administrative operations of the Benefit Programs, including but not limited to: setting premiums; establishing new and revising existing Benefit Plans; making benefit determinations, claims adjudication and any other functions that are necessary and appropriate for the proper administration and support of the arrangement for Covered Services to be provided to Members.
Appears in 2 contracts
Sources: Participating Practitioner Agreement, Participating Practitioner Agreement