Terms of Insurance Policies to Govern. The extent of coverage under the insurance plan documents (including HMO or PPO plans) referred to in this Agreement shall be governed by the terms and conditions set forth in those policies. Any questions or disputes concerning such insurance documents, or benefits under them, shall be resolved in accordance with the terms and conditions set forth in the policies and shall not be subject to the grievance and arbitration procedures set forth in this Agreement. The failure of any insurance carrier(s) or organization(s) to provide any benefit for which it has contracted or is obligated shall result in no liability to the City, nor shall such failure be considered a breach by the City of any obligation under this Agreement. However, nothing in this Agreement shall be construed to relieve any insurance carrier(s) or organization(s) from any liability it may have to the City, City employee or beneficiary of any City employee.
Terms of Insurance Policies to Govern. The extent of coverage under the insurance policies (including self-insured plans) referred to in this Agreement shall be governed by the terms and conditions set forth in said policies or plans. Any questions or disputes concerning an employee's claim for benefits under said insurance policies or plans shall be resolved in accordance with the terms and conditions set forth in said policies or plans, including the claims appeal process available through the insurance company or third party administrator, and shall not be subject to the grievance procedure set forth in this Agreement unless in the context of a self-insured plan, the City either (1) assumes the role of directly administering the terms of the plan without a third-party administrator or (2) overrides the decision of the City's third-party administrator inconsistent with the terms of the plan regarding specific claims for coverage. The failure of any insurance carrier(s) or plan administrator(s) to provide any benefit for which it has contracted or is obligated shall result in no liability to the City, nor shall such failure be considered a breach by the City of any obligation undertaken under this or any other Agreement. However, nothing in this Agreement shall be construed to relieve any insurance carrier(s) or plan administrator(s) from any liability it may have to the City, employee or beneficiary of any employee.
Terms of Insurance Policies to Govern. The extent of coverage under the insurance plan documents referred to in this Agreement shall be governed by the terms and conditions set forth in those policies. Any questions or disputes concerning such insurance documents, or benefits under them, shall be resolved in accordance with the terms and conditions set forth in the policies and shall not be subject to the grievance and arbitration procedures set forth in this Agreement. The failure of any insurance carrier(s) or organization(s) to provide any benefit for which it has contracted or is obligated shall result in no liability to the Village, nor shall such failure be considered a breach by the Village of any obligation under this Agreement. However, nothing in this Agreement shall be construed to relieve any insurance carrier(s) or organization(s) from any liability it may have to the Village, Village employee or beneficiary of any Village employee.
Terms of Insurance Policies to Govern. The extent of coverage under any insurance policies and/or benefit plan descriptions referred to in this Agreement shall be governed by the terms and conditions set forth in such policies and/or benefit plan descriptions. Any questions or disputes concerning said insurance policies and/or benefit plan descriptions or benefits therein under shall be resolved in accordance with the terms and conditions set forth in said policies and/or benefit descriptions and shall not be subject to the grievance and arbitration procedure set forth in this Agreement. The failure of any insurance carrier(s) to provide any benefit for which it has contracted or is obligated shall result in no liability to the Village, nor shall such failure be considered a breach by the Village of any obligation undertaken under this or any other Agreement. However, nothing in this Agreement shall be construed to relieve any insurance carrier(s) from any liability it may have to the Village, employee or beneficiary of any Village employee, by reason of said insurance policy.
Terms of Insurance Policies to Govern. The scope of coverage under any insurance policies or plans (including Point of Service (POS), Health Maintenance Organizations (HMO), Consumer Driven and self‐insured plans) that the Town of Auburn may provide shall be governed by the terms and conditions set forth in said policies or plans. Any questions or disputes concerning said insurance policies or plans or benefits thereunder shall be resolved in accordance with the terms and conditions set forth in said policies or plans and shall not be subject to the grievance procedure established in this Agreement. The failure of any insurance carrier(s) or plan administrator(s) to provide any benefits for which it has contracted or is obligated shall result in no liability to the Town, nor shall such failure be considered a breach by the Town of any obligation under this Agreement. Nothing in this Agreement shall be construed to relieve any insurance carrier(s) or plan administrator(s) from any liability it may have to the Town, employee or beneficiary of any employee.
Terms of Insurance Policies to Govern. The extent of coverage under any or all of the insurance policies (including HMO and self-insurance plans) referred to in this Agreement, shall be governed exclusively by the terms and conditions set forth in said policies or plans. Any questions, concerns and disputes concerning said insurance policies, plans or benefits thereunder shall be resolved in accordance with the terms and conditions set forth in said policies or plans and shall not be subject to any grievance, arbitration, fact-finding or mediation procedures set forth in this Agreement or elsewhere. The failure of any insurance carrier(s) or plan administrator(s) to provide any benefit for which it has contracted or is obligated, shall result in no liability to the Town, nor shall such failure be considered a breach by the Town of any obligation undertaken under this or any other Agreement. Nothing in this Agreement shall be construed to relieve any insurance carrier(s) or plan administrator(s) from any liability it may have to the Town, its Employees or the beneficiaries of any Employee.
Terms of Insurance Policies to Govern. The extent of coverage under the insurance plan documents (including HMO or PPO plans) applicable to employees shall be governed by the terms and conditions as set forth in those policies. Any questions or disputes concerning insurance documents, or benefits under them, shall be resolved in accordance with the terms and conditions set forth in the policies and shall not be subject to the grievance and arbitration procedures set forth in this Agreement.
Terms of Insurance Policies to Govern. The extent of coverage under the insurance policies referred to in Sections 1, 1.B and 3 of this Article shall be governed by the terms and conditions set forth in said policies. Any questions concerning coverage shall be resolved in accordance with the terms and conditions in said policy and shall not be subject to the grievance procedures set forth in this Agreement. The failure of any insurance carrier or plan administrator to provide any benefit for which it is contracted or is obligated shall result in no liability to the Village, nor shall such failure be considered a breach by the Village of any obligation undertaken under this or any other agreement. Nothing in this Agreement shall be construed to relieve any insurance carrier or plan administrator from any liability it may have to the Village, employee, or beneficiary of any employee, and nothing in this Section shall relieve the Village of its obligation to provide the coverages as specified in this Agreement.
Terms of Insurance Policies to Govern. The extent of coverage under the insurance plan documents (including HMO, PPO plans or State of Illinois insurance exchanges offered under the Affordable Care Act) applicable to employees shall be governed by the terms and conditions as set forth in those policies. Any questions or disputes concerning insurance documents, or benefits under them, shall be resolved in accordance with the terms and conditions set forth in the policies and shall not be subject to the grievance and arbitration procedures set forth in this Agreement.
Terms of Insurance Policies to Govern. The extent of coverage under the insurance policies referred to above shall be governed by the terms and conditions set forth in said insurance contracts. Any question concerning coverage shall be resolved in accordance with the terms and conditions in said policy and the administrative review procedures provided therein and shall not be subject to the grievance procedure set forth in this Agreement.
