Plan Name] CONTRACTHOLDER: [ABC Company] GROUP CONTRACT NUMBER GOVERNING JURISDICTION [G-12345] NEW JERSEY EFFECTIVE DATE OF CONTRACT: [January 1, 2014] CONTRACT ANNIVERSARIES: [January 1st of each year, beginning in 2015 ] PREMIUM DUE DATES:...New Jersey • April 24th, 2015
Jurisdiction FiledApril 24th, 2015This Contract takes effect on the Effective Date, if it is duly attested below. It continues as long as the required premiums are paid, unless it ends as described in its General Provisions.