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R89-148 AUTHORIZING APPLICATIONS FOR GROUP HEALTH INSURANCE COVERAGES
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R89-148 AUTHORIZING APPLICATIONS FOR GROUP HEALTH INSURANCE COVERAGES
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8/5/2016 3:15:57 PM
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Resolution/Ordinance
Res Ord Num
R89-148
Res Ord Title
AUTHORIZING APPLICATIONS FOR GROUP HEALTH INSURANCE COVERAGES
Approved Date
10/30/1989
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competent jurisdiction that the liability therefor was <br /> the direct consequence of dishonest or criminal conduct, <br /> or fraud on the part of the Claim Administrator or any <br /> of its directors, officers or employees. <br /> F. If it is determined that any payment has been made under <br /> this Agreement to an ineligible employee or dependent, <br /> or if it is determined that more or less than the cor- <br /> rect amount of any payment hereunder has been paid by <br /> the Claim Administrator, the Claim Administrator will <br /> make a diligent attempt to recover any such payment made , <br /> to an ineligible person or overpayment, or the Claim Ad- <br /> ministrator will adjust the underpayment, but the Claim <br /> Administrator will not be required to initiate court <br /> proceedings for any such recovery. <br /> G. The Employer shall furnish on a timely basis to the <br /> Claim Administrator certain information concerning the <br /> Plan and employees and dependents covered under the Plan <br /> ( "Covered Persons" ) as may from time to time be required <br /> by the Claim Administrator for the performance of its <br /> duties including, but not limited to, the following: <br /> 1 . All documents by which the Plan is established and <br /> any amendments or ehanges to the Plan as may from <br /> time to time be adopted. <br /> 2 . All data as may be required by the Claim Adminis- <br /> trator reqarding the Covered Persons who are to be <br /> covered under this Agreement. <br /> a. Such data may include, without limitation, a <br /> list of Covered Persons who are to be covered <br /> under the Agreement and completed application <br /> cards. It is the Employer� s obligation to <br /> notify the Claim Administrator no later than <br /> thirty-one ( 31 ) days after the effective date <br /> of any change in a Covered Person� s status un- <br /> der this Agreement. Clerical errors or delays <br /> in keeping or reporting data relative to cov- <br /> erage under this Agreement will not invalidate <br /> coverage which would otherwise be validly in <br /> force or continue coverage which would other- <br /> wise validly terminate . However, the Employer <br /> is liable for any benefits paid for a termi- <br /> nated Covered Person if the Employer had not <br /> timely notified the Claim Administrator of <br /> such Covered Person' s termination. <br /> b. All such notifications by the Employer to the <br /> Claim Administrator must be furnished on forms <br /> or in a format approved by the Claim Adminis- <br /> trator and must include all information rea- <br /> sonably required by the Claim Administrator to <br /> effect such changes. <br /> -3- <br />
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