2002 NS Revenue- Blue Cross and Blue Shield of North Carolina Ambulance Service Contract

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3 AMBULANCE SERVICES AGREEMENT THIS AMBULANCE SERVICES AGREEMENT(the"Agreement")is entered into effective as of the Effective Date set forth hereafter in this Agreement,by and between Blue Cross and Blue Shield of North Carolina,an independent licensee of the Blue Cross and Blue Shield Association,and ,an ambulance services provider,(`Provider"),(hereafter referred to collectively as the"parties"); WHEREAS BCBSNC is a hospital,medical and dental service corporation licensed by the State of North Carolina and/or by such other jurisdictions as may be required by law or regulation to meet the obligations set forth in this Agreement;and WHEREAS Provider is a provider of ambulance services and is duly licensed,registered, certified,or otherwise authorized as required by law and regulation,to provide ambulance services in each jurisdiction in which such services are to be provided under this Agreement;and WHEREAS the parties to this Agreement seek to facilitate the efficient and cost-effective delivery of quality ambulance services to individuals covered under health benefit plans or otherwise entitled to provider network services made available or otherwise administered by BCBSNC; NOW THEREFORE,the parties,in consideration of the mutual covenants and agreements set forth herein,do hereby agree as follows: 1. GENERAL DEFINITIONS. 1.1 "BCBSNC"means,as applicable,any one or more of the following: (i)Blue Cross and Blue Shield of North Carolina; (ii)Personal Care Plan of North Carolina,Inc.("PCP-NC"); (iii)any corporate parent,subsidiary or affiliate of BCBSNC and/or PCP-NC;and/or a joint venture(r)with BCBSNC and/or PCP-NC;and/or (iv)any other Blue Cross and Blue Shield plan for purposes of the Blue Card program or other program coordinated with BCBSNC. 1.2 "Group"means any party that has entered into a contract for health care and/or workers' compensation coverage and/or the administration of benefits and/or the provision of provider network services to eligible Members with any of the following: (i)BCBSNC; (ii)another Blue Cross and/or Blue Shield plan or corporate parent,subsidiary or affiliate thereof;and/or (iii)another health plan which has a reciprocity or other agreement with BCBSNC. 1.3 "Member"means an individual designated by a Group or by BCBSNC,as the case may be,to be eligible for health benefit plan coverage and/or benefits and/or provider network services under BCBSNC's contracts with Groups. 2. PROVIDER'S SERVICES AND OBLIGATIONS. Provider agrees to provide the services and carry out the obligations set forth as follows: 2.1 Member Services. Provider agrees to provide ambulance services for the transport of Members in accordance with: (i)all applicable local,state and federal laws and regulations; (ii)accepted industry standards;and (iii)the terms and conditions set forth in this Agreement. 2.2 Vehicles,Equipment and Supplies. Provider agrees that all vehicles,equipment, supplies or other goods used by Provider in carrying out Provider's services and obligations under this agreement shall be: (i)properly serviced and maintained; (ii)titled,licensed,insured,bonded,registered, certified,or otherwise authorized as required by each jurisdiction in which services are provided under this Agreement,to provide ambulance services to Members.