NOTICES AND OTHER INFORMATION. Any notices, documents, or other information under the Contract may be sent by United States Mail, postage prepaid, addressed as follows: If to Us: To Our last address on record with the Contractholder. If to the Contractholder: To the last address provided by the Contractholder on an enrollment or change of address form actually delivered to Us. If to a [Member]: To the last address provided by the [Member] on an enrollment or change of address form actually delivered to Us. We are only required to provide benefits to the extent stated in this Contract, its riders and attachments. We have no other liability. Services and supplies are to be provided in the most cost-effective manner practicable as Determined by Us. We reserve the right to use Our subsidiaries or appropriate employees or companies in administering this Contract. We reserve the right to modify or replace an erroneously issued Contract. Information in a Contractholder's application may not be used by Us to void this Contract or in any legal action unless the application or a duplicate of it is attached to this Contract or has been furnished to the Contractholder for attachment to this Contract. Information in a [Member's] application may not be used by Us to void his or her coverage under this Contract or in any legal action unless the application or a duplicate of it is attached to the Evidence of Coverage issued to a [Member], or has been mailed to a [Member] for attachment to his or her Evidence of Coverage. PARTICIPATION REQUIREMENTS At least [75%] of the Employees eligible for insurance must be enrolled for coverage. If an eligible Employee is not covered by this Contract because: the Employee is covered as a Dependent under a spouse's coverage, other than individual coverage; the Employee is covered under any fully-insured Health Benefits Plan [issued by the same carrier] offered by the Contractholder; the Employee is covered under Medicare; the Employee is covered under Medicaid or NJ FamilyCare; the Employee is covered under Tricare; or
Appears in 3 contracts
Samples: Hmo Plan Contract, Hmo Plan Contract, Hmo Plan Contract
NOTICES AND OTHER INFORMATION. Any notices, documents, or other information under the Contract may be sent by United States Mail, postage prepaid, addressed as follows: If to Us: To Our last address on record with the Contractholder. If to the Contractholder: To the last address provided by the Contractholder on an enrollment or change of address form actually delivered to Us. If to a [Member]: To the last address provided by the [Member] on an enrollment or change of address form actually delivered to Us. We are only required to provide benefits to the extent stated in this Contract, its riders and attachments. We have no other liability. Services and supplies are to be provided in the most cost-effective manner practicable as Determined by Us. We reserve the right to use Our subsidiaries or appropriate employees or companies in administering this Contract. We reserve the right to modify or replace an erroneously issued Contract. Information in a Contractholder's application may not be used by Us to void this Contract or in any legal action unless the application or a duplicate of it is attached to this Contract or has been furnished to the Contractholder for attachment to this Contract. Information in a [Member's] application may not be used by Us to void his or her coverage under this Contract or in any legal action unless the application or a duplicate of it is attached to the Evidence of Coverage issued to a [Member], or has been mailed to a [Member] for attachment to his or her Evidence of Coverage. PARTICIPATION REQUIREMENTS At least [75%] of the Employees eligible for insurance must be enrolled for coverage. If an Employee eligible Employee for insurance is not covered by this Contract because: the Employee is covered as a Dependent under a spouse's coverage, other than individual coverage; the Employee is covered under any fully-insured Health Benefits Plan [issued by the same carrier] offered by the Contractholder; the Employee is covered under Medicare; the Employee is covered under Medicaid or NJ FamilyCare; the Employee is covered under Tricare; or
Appears in 1 contract
Samples: Hmo Plan Contract