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Reso 2010-1529
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Reso 2010-1529
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Last modified
4/24/2012 11:44:38 AM
Creation date
2/26/2010 10:54:59 AM
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CityClerk-Resolutions
Resolution Type
Resolution
Resolution Number
2010-1529
Date (mm/dd/yyyy)
02/18/2010
Description
Health Insurance Renewal Agmts w/AvMed, Lincoln Financial Group & EyeMed
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<br />) <br /> <br />17.02 Assignment. This Contract, and all rights and benefits related thereto, may not be assigned by the <br />Subscribing Group or the Members without written consent of AvMed. <br /> <br />17.03 Certificate of Coverage. AvMed shall provide a copy of the Certificate of Coverage for each Subscriber. <br />No changes or amendments to this Contract shall be valid unless approved by an executive officer of <br />AvMed and endorsed herein or attached hereto. No agent has authority to change this Contract or to <br />waive any of its provisions. <br /> <br />17.04 Circumstances not reasonably within the control of AvMed. In the event of circumstances not <br />reasonably within the control of AvMed, including major disasters and under such circumstances as <br />complete or partial destruction of facilities, an act of God, war, riot, civil insurrection, disability of a <br />significant part of Hospital or participating medical personnel or similar causes, if the rendition of <br />Medical Services and Hospital Services provided under this Contract is delayed or rendered impractical, <br />neither AvMed, Participating Providers, nor any physician shall have any liability or obligation on <br />account of such delay or failure to provide services; however, AvMed shall make a good faith effort to <br />arrange for the timely provision of covered services during such event. <br /> <br />17.05 Clerical errors. Clerical errors shall neither deprive any individual Member of any benefits or coverage <br />provided under this Group Contract nor shall such errors act as authorization of benefits or coverage for <br />the Mernber that is not otherwise validly in force. Retroactive adjustments in-coverage, for clerical <br />errors or otherwise will only be done for up to a 60 day period from the date of notification. Refunds of <br />premiums are done for up to a 60 day period frorn the date of notification. Refunds of prerniums are <br />limited to a total of 60 days from the date of notification of the event, provided there are no Claims <br />incurred subsequent to the effective date of such event. <br /> <br />17.06 Contracting parties. By executing this Contract, Subscribing Group and AvMed agree to make the <br />Medical Services and Hospital Services specified herein available to persons who are eligible under the <br />provisions of Part IV. However, the delivery of benefits and services covered in this Contract shall be <br />subject to the provisions, Limitations, and Exclusions set forth herein and any amendments, <br />modifications, and Contract termination provisions specified herein and by the mutual agreement <br />between AvMed and Subscribing Group, without the consent or concurrence of the Members. By <br />electing or accepting Medical Services and Hospital or other benefits hereunder, all Members legally <br />capable of contracting and the legal representatives of all Members incapable of contracting, agree to all <br />terms, conditions, and provisions hereof. <br /> <br />17.07 Contract review. Subscribing Group may, if this Contract is not satisfactory for any reason, return this <br />Contract within 3 days after receipt and receive a full refund of the deposit paid, if any, unless the <br />services of AvMed were utilized during the 3 days. If this Contract is not returned within 3 days after <br />receipt, then this Contract shall be deemed to have heen accepted. <br /> <br />17.08 Entirety of Contract. This Agreement and all applicable schedules, exhibits, riders, amendments and <br />any other attachments and endorsernents, constitute the entire Contract between the Subscribing Group <br />and AvMed. No modification (or oral representation) of this Group Contract shall be of any force or <br />effect unless it is in writing and signed by both parties. <br /> <br />17.09 ERlSA. When this Contract is purchased by the Subscribing Group to provide benefits under a welfare <br />plan governed by ERlSA, AvMed shall be considered a fiduciary to the extent that it perfonns any <br />discretionary functions on behalf ofthe Plan. If a Member has questions about the group's welfare plan, <br />the Mernber should contact the Subscribing Group. <br /> <br />17.10 Gender. Whenever used, the singular shall include the plural and the plural the singular and the use of <br />any gender shall include all genders. <br /> <br />17.11 Identification cards. Cards issued by AvMed to Members pursuant to this Contract are for purposes of <br />identification only. Possession of an AvMed identification card confers no right to health services or <br /> <br />) <br /> <br />) <br /> <br />) <br /> <br />45 <br /> <br />A V -0100-2009 <br />MP-5319 (10/09) <br />
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