Common use of Responsibility for Distribution and Notification Requirements Clause in Contracts

Responsibility for Distribution and Notification Requirements. Please see this section for important timelines for distribution of information. It is agreed that this application supersedes any previous application for this Contract. Dated at (City, State) this day of 20 By Title Inquiries concerning any problems that may develop in the administration of this Contract should be directed to Blue Shield of California at the address provided on page GC-1. 000 00xx Xxxxxx California Physicians' Service dba Blue Shield of California a not-for-profit corporation In consideration of the applications and the timely payment of Premiums, Blue Shield agrees to provide Benefits of this Contract to covered Employees and their covered Dependents. This Contract shall be effective as of [Effective Date], for a term of 12 months, subject to the provisions entitled, “Changes: Entire Contract”.

Responsibility for Distribution and Notification Requirements. Please see this section for important timelines for distribution of information. It is agreed that this application supersedes any previous application for this Contract. Dated at (City, State) this day of 20 By Title Inquiries concerning any problems that may develop in the administration of this Contract should be directed to Blue Shield of California at the address provided on page GC-1. 000 00xx Xxxxxx California Physicians' Service dba Blue Shield of California a not-for-profit corporation In consideration of the applications and the timely payment of PremiumsDues, Blue Shield agrees to provide Benefits of this Contract to covered Employees and their covered Dependents. This Contract shall be effective as of [Effective Date]January 1, 2021, for a term of 12 months, subject to the provisions entitled, “Changes: Entire Contract”.. Group Number: W0071883-M0025379 Original Effective Date: January 1, 2021 GC-1

Responsibility for Distribution and Notification Requirements. Please see this section for important timelines for distribution of information. It is agreed that this application supersedes any previous application for this Contract. Dated at (City, State) this day of 20 By Title Inquiries concerning any problems that may develop in the administration of this Contract should be directed to Blue Shield of California at the address provided on page GC-1. 000 00xx Xxxxxx California Physicians' Service dba Blue Shield of California a not-for-profit corporation In consideration of the applications and the timely payment of PremiumsDues, Blue Shield agrees to provide Benefits of this Contract to covered Employees and their covered Dependents. This Contract shall be effective as of [Effective Date]January 1, 2021, for a term of 12 months, subject to the provisions entitled, “Changes: Entire Contract”.. Group Number: W0070519-M0023808 Original Effective Date: January 1, 2020 GC-1

Responsibility for Distribution and Notification Requirements. Please see this section for important timelines for distribution of information. It is agreed that this application supersedes any previous application for this Contract. Dated at (City, State) this day of 20 By Title Inquiries concerning any problems that may develop in the administration of this Contract should be directed to Blue Shield of California at the address provided on page GC-1. 000 00xx Xxxxxx California Physicians' Service dba Blue Shield of California a not-for-profit corporation In consideration of the applications and the timely payment of PremiumsDues, Blue Shield agrees to provide Benefits of this Contract to covered Employees and their covered Dependents. This Contract shall be effective as of [Effective Date]January 1, 2022, for a term of 12 months, subject to the provisions entitled, “Changes: Entire Contract”.. Group Number: W0071883-M0026322 Original Effective Date: January 1, 2021 GC-1

Responsibility for Distribution and Notification Requirements. Please see this section for important timelines for distribution of information. It is agreed that this application supersedes any previous application for this Contract. Dated at (City, State) this day of 20 By Title Inquiries concerning any problems that may develop in the administration of this Contract should be directed to Blue Shield of California at the address provided on page GC-1. 000 00xx Xxxxxx California Physicians' Service dba Blue Shield of California a not-for-profit corporation In consideration of the applications and the timely payment of PremiumsDues, Blue Shield agrees to provide Benefits of this Contract to covered Employees and their covered Dependents. This Contract shall be effective as of [Effective Date]July 1, 2021, for a term of 12 9 months, subject to the provisions entitled, “Changes: Entire Contract”.. Group Number: W0069784-M0026707 Original Effective Date: October 1, 2019 GC-1

Responsibility for Distribution and Notification Requirements. Please see this section for important timelines for distribution of information. It is agreed that this application supersedes any previous application for this Contract. Dated at (City, State) this day of 20 By Title Inquiries concerning any problems that may develop in the administration of this Contract should be directed to Blue Shield of California at the address provided on page GC-1. 000 00xx Xxxxxx California Physicians' Service dba Blue Shield of California a not-for-profit corporation In consideration of the applications and the timely payment of PremiumsDues, Blue Shield agrees to provide Benefits of this Contract to covered Employees and their covered Dependents. This Contract shall be effective as of [Effective Date]January 1, 2024, for a term of 12 months, subject to the provisions entitled, “Changes: Entire Contract”.. Group Number: W8002402-M0035422 Original Effective Date: January 1, 2023 GC-1

Responsibility for Distribution and Notification Requirements. Please see this section for important timelines for distribution of information. It is agreed that this application supersedes any previous application for this Contract. Dated at (City, State) this day of 20 By Title Inquiries concerning any problems that may develop in the administration of this Contract should be directed to Blue Shield of California at the address provided on page GC-1. 000 00xx Xxxxxx California Physicians' Service dba Blue Shield of California a not-for-profit corporation In consideration of the applications and the timely payment of PremiumsDues, Blue Shield agrees to provide Benefits of this Contract to covered Employees and their covered Dependents. This Contract shall be effective as of [Effective Date]January 1, 2021, for a term of 12 months, subject to the provisions entitled, “Changes: Entire Contract”.. Group Number: W0064034-M0024739 Original Effective Date: January 1, 2017 GC-1

Responsibility for Distribution and Notification Requirements. Please see this section for important timelines for distribution of information. It is agreed that this application supersedes any previous application for this Contract. Dated at (City, State) this day of 20 By Title Inquiries concerning any problems that may develop in the administration of this Contract should be directed to Blue Shield of California at the address provided on page GC-1. 000 00xx Xxxxxx California Physicians' Service dba Blue Shield of California a not-for-profit corporation In consideration of the applications and the timely payment of PremiumsDues, Blue Shield agrees to provide Benefits of this Contract to covered Employees and their covered Dependents. This Contract shall be effective as of [Effective Date]January 1, 2022, for a term of 12 months, subject to the provisions entitled, “Changes: Entire Contract”.. Group Number: W0053649-M0029012 Original Effective Date: January 1, 2015 GC-1

Responsibility for Distribution and Notification Requirements. Please see this section for important timelines for distribution of information. It is agreed that this application supersedes any previous application for this Contract. Dated at (City, State) this day of 20 By Title Inquiries concerning any problems that may develop in the administration of this Contract should be directed to Blue Shield of California at the address provided on page GC-1. 000 00xx Xxxxxx California Physicians' Service dba Blue Shield of California a not-for-profit corporation In consideration of the applications and the timely payment of PremiumsDues, Blue Shield agrees to provide Benefits of this Contract to covered Employees and their covered Dependents. This Contract shall be effective as of [Effective Date]January 1, 2021, for a term of 12 months, subject to the provisions entitled, “Changes: Entire Contract”.. Group Number: W0064034-M0024738 Original Effective Date: January 1, 2017 GC-1

Responsibility for Distribution and Notification Requirements. Please see this section for important timelines for distribution of information. It is agreed that this application supersedes any previous application for this Contract. Dated at (City, State) this day of 20 By Title Inquiries concerning any problems that may develop in the administration of this Contract should be directed to Blue Shield of California at the address provided on page GC-1. 000 00xx Xxxxxx California Physicians' Service dba Blue Shield of California a not-for-profit corporation In consideration of the applications and the timely payment of PremiumsDues, Blue Shield agrees to provide Benefits of this Contract to covered Employees and their covered Dependents. This Contract shall be effective as of [Effective Date]January 1, 2021, for a term of 12 months, subject to the provisions entitled, “Changes: Entire Contract”.. Group Number: W0070519-M0023040 Original Effective Date: January 1, 2020 GC-1