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KAISER FOUNDATION HEALTH PLAN
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KAISER FOUNDATION HEALTH PLAN
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Last modified
6/30/2022 3:20:00 PM
Creation date
6/30/2022 3:19:13 PM
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Contracts
Company Name
KAISER FOUNDATION HEALTH PLAN
Contract #
N-2022-182
Agency
Human Resources
Expiration Date
7/19/2022
Insurance Exp Date
1/1/2023
Destruction Year
2026
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0456 00 0113 (XWC) <br />ENDORSEMENT <br />BLANKET WAIVER OF SUBROGATION <br />Effective 12:01 A.M., Local Time, January 01, 2022 <br />In consideration of the payment of premium and adherence by both parties to the terms of this Agreement, it is <br />hereby understood and agreed that the Recovery From Others section of this Agreement is amended to include <br />the following additional language: <br />The CORPORATION has the right to pursue subrogation recoveries from anyone liable for an <br />injury covered by this Agreement_ The CORPORATION will not enforce its right against any <br />person or organization for whom the EMPLOYER performs work under a written contract that <br />requires the EMPLOYER to obtain this agreement from the CORPORATION. <br />All other terms, conditions, agreements and stipulations remain unchanged. <br />Attached to and forming a part of Excess Workers' Compensation and Employers' Liability Insurance Agreement <br />No. SP 4066154, issued by SAFETY NATIONAL CASUALTY CORPORATION of St. Louis, Missouri to KAISER <br />FOUNDATION HEALTH PLAN, INC_, ET AL, dated January 01, 2022. Endorsement No. 0456 00 0113 (XWC) <br />SAFETY NATIONAL CASUALTY CORPORATION <br />.a..s'n�Jtcc�_ <br />d+f�dJ/JSecretary <br />Risk MawgemadDW[bo t <br />RE Ewm & APPRav® BY: <br />faa� R. VLU.cWt <br />�' R6k Management Malpt <br />
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