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2014-318 HR - UnitedHealthCare for United HealthCare Application for Excess Loss Insurance Policy $1,625,322
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2014-318 HR - UnitedHealthCare for United HealthCare Application for Excess Loss Insurance Policy $1,625,322
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Last modified
5/16/2017 3:32:16 PM
Creation date
8/8/2014 11:38:20 AM
Metadata
Fields
Template:
BOCC
Date
9/17/2013
Meeting Type
Regular Meeting
Document Type
Others
Agenda Item
09/17/2013
Amount
$1,625,322.00
Document Relationships
2015-141-E County Manager - UnitedHealthCare of NC - Amendment to Excess Loss Insurance Policy $635,758
(Linked From)
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\Board of County Commissioners\Contracts and Agreements\General Contracts and Agreements\2010's\2015
R 2014-318 HR - UnitedHealthCare for application for Excess Loss Insurance Policy
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Path:
\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2014
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REIMBURSEMENT PROVISIONS <br /> NOTICE OF COVERED EXPENSE The Policyholder authorizes the Administrator to file claims on its <br /> behalf under this Policy. The Policyholder authorizes the Company to reimburse Covered Expenses to the <br /> Administrator for deposit into the bank account maintained by the Policyholder for the funding of benefits <br /> under the Plan. <br /> PAYMENT BY PLAN While the determination of benefits under the Plan is the sole responsibility of the <br /> Policyholder,the Company reserves the right to interpret the terms and conditions of the Plan Document as <br /> it applies to this Policy. The Company will have the sole authority to reimburse or deny reimbursement <br /> under this Policy. <br /> SPECIFIC EXCESS LOSS INSURANCE <br /> The Schedule of Benefits indicates whether Specific Excess Loss Insurance is provided under this Policy. <br /> If, while this Policy is in effect, the Covered Expenses for a Covered Person for the applicable Benefit <br /> Period exceed the Specific Deductible,the Company will reimburse the Policyholder, subject to the terms <br /> and conditions of this Policy including the limits set forth in the Schedule of Benefits. <br /> The amount of the reimbursement will be equal to the Specific Percentage Reimbursable times the amount <br /> by which Covered Expenses exceed the Specific Deductible amount, but will not exceed the Maximum <br /> Specific Benefit.For purposes of determining whether such Maximum Specific Benefit has been exceeded, <br /> Covered Expenses Incurred or Paid in any other Policy Period under this policy are included. <br /> Covered Expenses for any Covered Person during the Policy Period will be determined according to the <br /> Benefit Period described in the Schedule of Benefits. <br /> If Specific Excess Loss Insurance terminates before the end of the Policy Period,the Specific Deductible <br /> will not be reduced. <br /> AGGREGATE EXCESS LOSS INSURANCE <br /> The Schedule of Benefits indicates whether Aggregate Excess Loss Insurance is provided under this Policy. <br /> If the Covered Expenses for the applicable Benefit Period exceed the Annual Aggregate Deductible for the <br /> Policy Period, the Company will reimburse the Policyholder, subject to the terms and conditions of this <br /> Policy including the limits set forth in the Schedule of Benefits. <br /> The amount of the reimbursement will be equal to the Aggregate Percentage Reimbursable times the <br /> amount by which Covered Expenses exceed the Annual Aggregate Deductible amount,but will not exceed <br /> the Maximum Aggregate Benefit. <br /> Covered Expenses will not include any amounts reimbursed by the Company under any other provision of <br /> this Policy.If the Policyholder's coverage terminates before the end of the Policy Period,the greater of the <br /> Accumulated Annual Aggregate Deductible or the Minimum Annual Aggregate Deductible will apply.The <br /> Minimum Aggregate Deductible will not be reduced. <br /> UHIELIP-NC(07/06) 5 REIM <br />
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