GROUP BENEFIT AGREEMENTGroup Benefit Agreement • January 21st, 2016 • California
This agreement has been approved by the officers of Anthem to become effective at 12:01 A.M. Pacific Standard Time on the Agreement Effective Date shown above. Payment of the first monthly subscription charges indicates the group’s acceptance of this agreement. It continues from month to month as long as the required subscription charges are paid, unless it is terminated as described in GENERAL PROVISIONS: CANCELLATION.
COMBINED EVIDENCE OF COVERAGE AND DISCLOSURE FORMGroup Benefit Agreement • July 24th, 2013
This Combined Evidence of Coverage and Disclosure Form (Evidence of Coverage) constitutes only a summary of the health plan. The Agreement, of which this Evidence of Coverage is a part, must be consulted to determine the exact terms and conditions of coverage. If you have special health care needs, you should read those sections of the Evidence of Coverage that apply to those needs. However, this statement of benefits, exclusions and limitations in this Evidence of Coverage is complete and is incorporated by reference into the Agreement.
GROUP BENEFIT AGREEMENTGroup Benefit Agreement • December 18th, 2012 • California
This agreement has been approved by the officers of Anthem to become effective at 12:01 A.M. Pacific Standard Time on the Agreement Effective Date shown above. Payment of the first monthly subscription charges indicates the group’s acceptance of this agreement. It continues from month to month as long as the required subscription charges are paid, unless it is terminated as described in GENERAL PROVISIONS: CANCELLATION.
