Common Contracts
3 similar null contracts
Group Enrollment and Coverage Agreement (Part A, B & C)Michigan • June 14th, 2010
Enrollment forms (ECOS) for all enrolling employees. Forms must be complete. Please ensure that dates of hire and signatures are included. Medicare and COBRA fields must be completed if applicable.
Group Enrollment and Coverage Agreement (Part A, B & C)Michigan • June 14th, 2010
Enrollment forms (ECOS) for all enrolling employees. Forms must be complete. Please ensure that dates of hire and signatures are included. Medicare and COBRA fields must be completed if applicable.
Group Enrollment and Coverage AgreementMichigan • June 14th, 2010
Blue Cross Blue Shield of Michigan (BCBSM) will provide health care coverage to Members, i.e., eligible persons enrolled through the group identified below (Group) and participating in Group's employee welfare benefit plan providing health benefits (Group Health Plan or GHP), subject to the terms of applicable certificates and riders (Certificates and Riders), BCBSM's administrative and underwriting requirements, the Group Administrative Guide (Guide) and the following terms and conditions of the Group Enrollment & Coverage Agreement consisting of Part A-Terms and Conditions, Part B-Group Information, and Part C-Coverage Selection (Agreement):
