Qualifying Payment Amount. As it pertains to Employer’s self-funded plans, Employer acknowledges that NSA requires, among other things, that member cost-share for certain items and services the Plan covers are calculated based on the lesser of the Provider’s billed charge or the NSA’s “Qualifying Payment Amount” (“QPA”). With respect to the calculation of QPA, Employer elects to use and adopts the QPA calculated by Claim Administrator based on Claim Administrator’s self-funded business and not a QPA customized for Employer’s Plan(s).
