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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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. � <br /> the Claim Administrator and/or for failure to perform any <br /> other obligation, duty or act required by this Agreement, <br /> the Employer agrees to notify all Covered Employees. The <br /> Employer and the Claim Administrator agree that the Em- <br /> ployer will give such notice because the Employer main- <br /> tains direct and ongoinq communication with, and main- <br /> tains current addresses for all such Covered Employees. <br /> The Employer will indemnify and hold the Claim Admini- <br /> strator harmless from any and all claims, cost and ex- <br /> penses, including but not limited to, reasonable attor- <br /> ney' s fees in connection with such default, arising from <br /> the Claim Administrator' s termination of this Agreement <br /> or denial of Claims pursuant to this Agreement. <br /> F. Notwithstanding any provision to the contrary, if the <br /> Employer has failed to pay when due any amount owed the <br /> Claim Administrator, the Claim Administrator shall be <br /> under no obligation to make any further Claim Payments <br /> until such default is cured. <br /> IX. TERM AND TERMINATION OF AGREEMENT <br /> A. This Agreement shall continue in full force and effect <br /> for one ( 1 ) year from the Effective Date, and from year <br /> to year thereafter, but may be cancelled at the end of <br /> any month after the first year by either the Employer or <br /> the Claim Administrator upon ninety ( 90 ) days prior <br /> written notice to the other party. in the event of such <br /> termination, the Employer agrees to notify all Covered <br /> Employees in accordance with the provisions of Article <br /> VIII . E. above. <br /> B. The Employer hereby acknowledges that on the date of <br /> termination of this Agreement in accordance with the <br /> provisions of either Article VIII , or Article IX, of this <br /> Agreement, there may be an undetermined but substantial <br /> number of Claims for services rendered or Eurnished prior <br /> to that date which have not been submitted to the Claim <br /> Administrator for reimbursement and also an undetermined <br /> but substantial number of Claims submitted for reimburse- <br /> ment which have not been paid by the Claim Administrator . <br /> The Employer shall be responsible for the payment of all <br /> Claim Payments for services rendered or furnished to a <br /> Covered Person prior to the date of termination, whether <br /> or not Claims for such services have been submitted, or <br /> Claim Payments for such services have been made by the <br /> Claim Administrator, as of the date of termination, and <br /> for the payment of the Service Charge( s) in effect on the <br /> date of termination. Further, if a Covered Person is an <br /> Inpatient at the time his coverage under the Plan termin- <br /> ates, the Plan shall provide benefits for Covered Ser- <br /> vices which are provided by and regularly charged for by <br /> a Hospital or other facility Provider until the Covered <br /> Person is discharged or until the end of the Covered <br /> -8- <br />
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