Common Contracts

1 similar Reimbursement Agreement contracts

MID-AMERICA CARPENTERS REGIONAL COUNCIL HEALTH FUND REIMBURSEMENT AGREEMENT FOR THIRD-PARTY CAUSATION
Reimbursement Agreement • April 2nd, 2024

This Reimbursement Agreement (“RA”) between the undersigned Covered Individual and the Mid- America Carpenters Regional Council Health Fund (“Fund”) is entered into to compel the Fund to advance payment for medical treatment and/or disability benefits that are incurred as a result of the injury or illness sustained on the date-of-injury indicated below (“Injury”), which may have been caused, contributed to, or aggravated under circumstances that may permit the Covered Individual to obtain compensation from a third party, or any other source of coverage (“Third Party”). The Fund provides no benefits to a Covered Individual that are related to any injury or illness that is caused by third-parties or is the responsibility of any other entity or other source of coverage, but the Fund may advance benefits that may be related to the Injury in exchange for the Covered Individual’s agreement to the terms contained herein. The rights of the Fund listed herein are not exhaustive, and the plan do

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