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2005-040
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2005-040
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Last modified
7/7/2016 10:57:11 AM
Creation date
9/30/2015 7:45:12 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
02/01/2005
Control Number
2005-040
Agenda Item Number
7.S.
Entity Name
SAFECO Life Insurance Company
Subject
Excell Loss Insurance Policy Participation Agreement
Archived Roll/Disk#
4000
Supplemental fields
SmeadsoftID
3876
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- _ CLAIMS PROVISIONS <br /> EMPLOYEE BENEFIT PLAN 'S CLAIMS ADMINISTRATION <br /> The Participating Employer must retain a Claims Administrator at all times . All Claims Administrator(s) <br /> must be approved by SAFECO . The Claims Administrator performs as the Participating Employer's agent, <br /> and SAFECO will not be held liable for any act or omission of the Claims Administrator. <br /> SAFECO will only reimburse the Participating Employer for claims paid by the Claims Administrator(s ) , <br /> The Claims Administrator will : <br /> a . supervise the administration and adjustment of all claims and verify the accuracy and computation <br /> of all claims in accordance with the terms of the Employee Benefit Plan ; <br /> b , maintain accurate records of all claim payments ; <br /> c . maintain separate records of expenses not covered ; and <br /> d . provide SAFECO with the following data for the preceding Policy Month on or before the 30th day <br /> of each succeeding Policy Month : <br /> 1 . number of Covered Units ; <br /> 2 . notice of claims that reach 50 % of the Individual Deductible ; and <br /> 3 . total amount of claims paid . <br /> MANAGEMENT OF LARGE CLAIMS AND POTENTIAL LARGE CLAIMS <br /> Notice of Large Claim The Participating Employer or the Participating Employer's Claims <br /> Administrator(s ) must notify SAFECO in writing within 10 business days of receiving information indicating <br /> that Covered Expenses qualify as a Large Claim . <br /> If the Participating Employer receives information that any claim may be or become a Large Claim , the <br /> Participating Employer will immediately notify the Participating Employer's Claims Administrator. <br /> Notice of Potential Large Claim The Participating Employer or the Participating Employer's Claims <br /> Administrator must notify SAFECO of any Potential Large Claim in writing within 10 business days <br /> of receiving any information indicating that the claim qualifies as a Potential Large Claim . See the List of <br /> Potential Large Claims below. <br /> If the Participating Employer receives information that any claim may be or become a Potential Large <br /> Claim , the Participating Employer will immediately notify the Participating Employer's Claims <br /> Administrator. <br /> LGC 8815 03/02 1 <br />
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