Common Contracts

1 similar Massachusetts Care Self contracts

Membership Application & Indemnity Agreement
Massachusetts Care Self • January 30th, 2024

THIS APPLICATION AND INDEMNITY AGREEMENT (the “Agreement”), dated effective as of the date of acceptance by the administrator as set forth below, is made by and between Massachusetts Care Self-Insurance Group, Inc., a Massachusetts nonprofit corporation, (the “Group”), and the undersigned employer located in the Commonwealth of Massachusetts, (the “Member”).

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