Health Plan Sample Contracts

CONTRACT AND EVIDENCE OF COVERAGE
Health Plan • January 9th, 2022

This Consumer Choice of Benefits Health Maintenance Organization health care plan, either in whole or in part, does not provide state-mandated health benefits normally required in evidences of coverage in Texas. This standard health benefit plan may provide a more affordable health plan for you although, at the same time, it may provide you with fewer health plan benefits than those normally included as state-mandated health benefits in Texas.

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HEALTH PLAN and HOSPITAL ADDENDUM TO PPO AGREEMENT
Health Plan • January 7th, 2016

THIS BUNDLED PAYMENT ADDENDUM (this “Addendum”) is made and entered into by and between , a (“Plan”), and , a California (“Provider”), as of , 20 . (Plan and Provider are referred to herein individually as a “Party” and collectively as the “Parties”).

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