Intermediary Contracts Clause Samples
The Intermediary Contracts clause defines the terms and conditions under which an intermediary, such as an agent or broker, may enter into agreements on behalf of one or more parties. This clause typically outlines the intermediary’s authority, the scope of their responsibilities, and any limitations on their ability to bind the principal to contractual obligations. For example, it may specify that the intermediary can only negotiate certain types of contracts or must obtain prior written approval before finalizing agreements. The core function of this clause is to clarify the intermediary’s role and prevent unauthorized commitments, thereby reducing the risk of disputes and ensuring all parties understand the extent of the intermediary’s powers.
Intermediary Contracts. Unless Provider is a health delivery network contracting solely with self-insured employers, any subcontract between Provider and a provider or health care facility shall contain all of the following:
(i) the requirements provided in Sections 1-13 of this Appendix;
(ii) an acknowledgement that UBH is a third party beneficiary; and
(iii) an acknowledgement of UBH’s role in approving participation of the provider or health care facility as required this Section.
Intermediary Contracts. If Provider is an Intermediary as defined by C.R.S.A. § 10-16- 102(25.5) and 3 Colo. Code of Regs. § 4.2-15(IV)(B), or any other applicable law, Provider as an Intermediary agrees to the following:
(a) If contracted to perform utilization management, utilization review, provider credentialing, administration of health insurance benefits, setting or negotiation of reimbursement rates, payment to providers, network development, disease management programs, or any other program subject to Section 10-16-705(6.5) C.R.S., Intermediary shall comply with the same standards, guidelines, medical policies, and benefit terms as Cigna.
(b) If contracted to perform utilization management, utilization review, provider credentialing, administration of health insurance benefits, setting or negotiation of reimbursement rates, payment to providers, network development, disease management programs, or any other program subject to Section 10-16-705(10.5)(a) C.R.S., Intermediary shall indicate the name of Intermediary and the company for which it is conducting the work when making any payment to a health care provider on behalf of Cigna.
(c) Intermediary will comply, and shall require Subcontracted Providers to comply, with all of the applicable requirements of Section ▇▇-▇▇-▇▇▇, C.R.S.
(d) Cigna is responsible for ensuring that Subcontracted Providers have the capacity and legal authority to furnish Covered Services.
(e) Cigna has the right to approve or disapprove participation status of Subcontracted Providers in its own or a contracted network for the purpose of delivering Covered Services to its Participants.
(f) Intermediary shall provide Cigna with copies of Subcontracted Providers’ contracts in accordance with Applicable Law and Cigna shall maintain copies of all such contracts.