Insurance Coverage Agreement Sample Contracts

Reformed Benefits Association
Insurance Coverage Agreement • October 23rd, 2018

Option 1 Partial Coverage: enroll all current and future full-time staff members, according to the Terms of Participation, in one of the group Basic Life plans offered by Reformed Benefits Association. The employer may also offer additional voluntary benefits (excluding Medical, Dental and Vision) to eligible staff.

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Contract
Insurance Coverage Agreement • May 11th, 2017

The council/consistory /board of directors of , a Christian Reformed Church in North America or Reformed Church in America church, institution or agency, located in , , hereby agrees to enroll all current and future full-time staff members according to the Terms of Participation in the group Medical and Basic Life insurance offered by Reformed Benefits Association. We understand other benefit offerings are optional. We have read and understand the attached Terms of Participation and agree to abide by the criteria as outlined. We have listed the names of all paid staff members in the section below (add additional names on a separate page if necessary):

Reformed Benefits Association
Insurance Coverage Agreement • September 21st, 2023

Option 1 Partial Coverage: enroll all current and future full-time staff members, according to the Terms of Participation, in one of the group Basic Life plans offered by Reformed Benefits Association. The employer may also offer additional voluntary benefits (excluding Medical, Dental and Vision) to eligible staff.

INSURANCE COVERAGE AGREEMENT
Insurance Coverage Agreement • October 23rd, 2018

The Contractor shall provide, procure, and maintain all applicable insurance coverage for the purpose of performing the work/services (Scope of Work) specified in the ☐ Request for Proposal, ☐ Invitation for Bid.

Patient Insurance Coverage Agreement
Insurance Coverage Agreement • November 26th, 2020

We have verified your commercial insurance and would like to make sure you fully understand your benefits. Please take a moment to review the following information:

PATIENT INSURANCE COVERAGE AGREEMENT
Insurance Coverage Agreement • June 23rd, 2020

We have verified your commercial insurance and would like to make sure you fully understand your benefits. Please take a moment to review the following information:

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