Evidence of Coverage Sample Contracts

AGREEMENT AND CONSIDERATION
Evidence of Coverage • June 24th, 2024

This document along with the corresponding Schedule of Benefits and the enrollment application is your contract and it is a legal document. It is the agreement under which benefits will be provided and paid. In consideration of your application and timely payment of premiums, we will provide health care benefits to you, the member, for covered services as outlined in this contract. Benefits are subject to contract definitions, provisions, limitations and exclusions.

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Celtic Insurance Company Ambetter from Sunshine Health
Evidence of Coverage • October 20th, 2018

In this contract, the terms "you," "your" or “yours” will refer to the member or any dependents enrolled in this contract. The terms "we," "our," or "us" will refer to Celtic Insurance Company or Ambetter from Sunshine Health.

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