Option 1
Plan’s liability for payment of claims for Participants covered under Self-Insured Groups is limited to the funds Plan receives from the Group for disbursement to Hospital pursuant to Plan’s contract with the Group. Hospital hereby acknowledges that it is accepting risk of non-payment from Plan in the event a Group fails to meet its obligations under the contract between Plan and Group, regardless of whether such failure is a result of insolvency or for other reasons. In the event a Self-Insured Group fails to make payment for Covered Services, Hospital shall, upon notice to Plan, cease to be bound by this Agreement with respect to servicing Self-Insured Groups, and may pursue payment for unsatisfied claims directly from said Group Participants. This Article shall not operate nor be construed to allow Hospital to seek or recover more than what is due under the terms and conditions of this Agreement for services provided prior to notice to Plan. Plan shall provide Hospital with the necessary information to implement this Article upon request by Hospital.

Option 2
Plan grants to the Provider the right to selectively Terminate from the contract those Payer Groups that rent the network and demonstrate the inability to adhere to the provisions of the contract. Plan agrees to work with the Payer and Provider to resolve issues of non-payment within 30 days. Should Payer fail to pay, Provider has the right to bill the Member.