EMPLOYER INFORMATION |
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The Contour Group Medical Plan is a surplus lines product underwritten by
Certain underwriters at Lloyd’s, London. It is distributed, managed and administered, as
agent for and on behalf of certain underwriters at Lloyd’s, London, by Azimuth Risk
Solutions, LLC SM . |
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EMPLOYEE WAITING PERIOD |
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EMPLOYEE ELIGIBILITY |
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Employer Contribution |
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BENEFIT OPTION |
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Please make the initial payment check payable to: Azimuth Risk Solutions, LLC. Azimuth Risk Solutions, LLC is recognized as a managing underwriter/ authorized agent and representative on behalf of certain underwriters at Lloyd’s of London.
Enclosed is payment of 1/12th of the estimated annual premium as initial payment and deposit. Employer understands that no coverage shall be effective unless and until notified in writing by Azimuth that Employer’s application has been accepted by Azimuth for and on behalf of the Underwriters. Employer understands that any such acceptance is at the sole discretion of Azimuth. If Employer’s application is accepted, the enclosed deposit will be applied toward payment of the first monthly premium. If Employer’s application is not accepted, Azimuth’s and the Underwriter’s sole obligation will be to return the deposit to Employer. Employer understands that, as an employer employing persons in foreign jurisdictions, Employer may be subject to foreign laws with respect to the provision of medical benefits and/or the insurance of those benefits. Employer understands and agrees that neither Azimuth nor Underwriters have investigated whether or how the purchase of this insurance complies with the laws of any foreign jurisdiction. Employer further understands and agrees that Employer is solely responsible for compliance with all applicable foreign laws. |
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