55A - HARTFORD INSURNACE - Laserfiche WebLink

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POLICY PROVISIONS Certificate(s) of Insurance The Company will give individual Certificate(s) of Insurance to: 1) the Policyholder; or 2) any other person according to a mutual agreement among the other person, the Policyholder, and The Company; for delivery to persons covered under The Policy and which will explain the important features of The Policy. Data To Be Furnished The Policyholder, or any other person designated by the Policyholder, will give The Company all information The Company needs regarding matters pertaining to the insurance. At any reasonable time while The Policy is in force and for 12 months after that, The Company may inspect any of the Policyholder's documents, books, or records which may affect the insurance or premiums of The Policy. The Policyholder will, upon our request, give The Company: 1) the names of all persons initially eligible for coverage; 2) the names of all additional persons who become eligible for coverage; 3) the names of all persons whose amount of insurance is to be changed; 4) the names of all persons whose eligibility or insurance is terminated; and 5) any data necessary to administer the insurance provided by The Policy. If the Policyholder gives The Company any incorrect information, the relevant facts will be determined to establish if insurance is in effect and in what amount. No person will be deprived of insurance to which he is otherwise entitled or have insurance to which he is not entitled, because of any misstatement of fact by the Policyholder. Any required adjustment may be made in premiums or benefits. Right to Audit The Company reserves the right to audit, once every 2 years, the Policyholder's billing records and premium accounting practices. If The Company discovers: 1) an underpayment of premium by the Policyholder, the Policyholder will be obligated to remit, in a timely manner, the underpayment amount; or 2) an overpayment of premium, The Company will return any overpayment amount in a timely manner; for the previous 2 year period. Not in Lieu of Worker's Compensation This Policy does not satisfy any requirement for worker's compensation insurance. Time Period All periods begin and end at 12:01 A.M., standard time, at the Policyholder's address. Disclosure of Fees The Company may reduce or adjust premiums, rates, fees and/or other expenses for programs under The Policy. Disclosure of Services In addition to the insurance coverage, The Company may offer noninsurance benefits and services to Active Employees. Form GB13-1000 A (10/08) (CA) 9 55A-14