Common use of Waiver Agreement Clause in Contracts

Waiver Agreement. I understand the explanation I have received regarding my decision to waive Health Plan coverage, and I hereby waive my participation for myself and/or dependents in Juniata College’s health plan. I understand that a qualified change in Family Status or Loss of coverage (Special Enrollment) will be required to enroll at a later date other than open enrollment. Signature Date

Waiver Agreement. I understand the explanation I have received regarding my decision to waive Health Plan coverage, and I hereby waive my participation for myself and/or dependents in Juniata College’s health plan. I understand that a qualified change in Family Status or Loss of coverage (Special Enrollment) will be required to enroll at a later date other than open enrollment. Signature Date.