№ lp_1_17450
File format: docx
Character count: 48459
File size: 154 KB
Structured form for prospective insured entities to provide detailed information necessary for underwriting various liability coverages including professional, general, and managed care organization errors and omissions insurance.
Note:
Year
Type of Document:
Insurance Application
Organization / Institution:
Chubb
Intended Audience:
Prospective insured entities
Coverage Types:
Professional Liability, General Liability, Managed Care Errors & Omissions, Employee Benefits Liability, Excess Liability
Required Information:
Applicant details, retroactive dates, subsidiaries, additional insureds, accreditation status, coverage specifications, loss experience, exposures
Price: 8 / 10 USD
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
1998
Region / City:
United States
Topic:
Health Insurance, Legal Rights
Document Type:
Legal Notice
Organ / Institution:
Federal Government
Author:
Not specified
Target Audience:
Individuals with health coverage
Period of Validity:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2023
Region / City:
Victoria, Australia
Theme:
Gender equality in sports media, women’s sports coverage
Document Type:
Research study
Organization / Institution:
Victorian Government
Author:
N/A
Target Audience:
General public, media professionals, sports enthusiasts
Period of validity:
2023
Approval Date:
N/A
Date of Changes:
N/A
Note:
Year
Region / City:
Ottawa
Subject:
Health Insurance Coverage
Document Type:
Contractual Agreement
Organ / Institution:
Embassy of Italy
Target Audience:
Economic Operators
Period of Validity:
Five years
Note:
Year
Topic:
Medical Treatment Request
Document Type:
Letter
Author:
[Insert Healthcare Provider’s Name]
Target Audience:
Insurance Company
Coverage period:
01/01/2025–12/31/2025
Plan name:
Plan Option 1
Plan type:
PPO
Coverage level:
Family
Insurance company:
Insurance Company 1
Document type:
Summary of Benefits and Coverage
Overall deductible:
$500 individual / $1,000 family
Out-of-pocket limit:
$2,500 individual / $5,000 family (network); $4,000 individual / $8,000 family (out-of-network)
Referral requirement:
Required for specialist visits
Prescription drug coverage:
Included with tiered cost sharing
Preventive services coverage:
Covered before deductible
Note:
Year
Theme:
Adoption Assistance
Document Type:
Annual Assurance Form
Agency / Organization:
Ohio Department of Children and Youth
Target Audience:
Adoptive Parents, Eligibility Determiners
Year:
2026
Region / City:
Not specified
Theme:
Health Insurance Coverage
Document Type:
Summary of Benefits
Organ / Institution:
Not specified
Author:
Not specified
Target Audience:
Individuals seeking health insurance information
Effective Period:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2026
Type of Document:
Health insurance summary
Organization:
UMR
Target Audience:
Health plan members
Coverage Details:
In-network and out-of-network services
Deductible:
$1,000 individual / $2,000 family in-network, $2,000 individual / $4,000 family out-of-network
Out-of-Pocket Limit:
$2,500 individual / $5,000 family in-network, $5,000 individual / $10,000 family out-of-network
Copayment and Coinsurance:
Specified per service type
Services Covered:
Preventive care, primary and specialist care, diagnostic tests, imaging, prescription drugs, outpatient and inpatient care, mental health, maternity, home health
Provider Network:
Yes
Referral Requirement:
No for specialists
Glossary Reference:
www.umr.com
Note:
or 1-800-207-3172
Period of Validity:
Annual coverage period
Year:
March 2024
Region / City:
USA
Subject:
Reimbursement, Healthcare Economics
Document Type:
Guide
Organization / Institution:
Abbott
Author:
Abbott
Target Audience:
Healthcare providers, medical professionals
Effective Period:
March 2024 and ongoing
Approval Date:
March 2024
Year:
2024
Region / City:
Athens, Greece
Topic:
Coverage enhancement for NR NTN
Document Type:
Discussion Document
Organization:
3GPP TSG RAN WG1
Author:
Moderator (NTT DOCOMO, INC.)
Target Audience:
3GPP members and related stakeholders
Period of Validity:
N/A
Approval Date:
N/A
Amendment Date:
N/A
Year:
1985
Region / city:
United States
Topic:
COBRA continuation coverage
Document type:
Notice
Organization / institution:
U.S. Department of Labor
Author:
U.S. Department of Labor
Target audience:
Employees, former employees, and their families
Effective period:
Until the date of coverage termination
Approval date:
Not specified
Date of revisions:
Not specified
Note:
Year
Community Support Team (CST) Clinical Coverage Policy 8A-6 State-Funded MH/SA/DD Service Definitions
Note:
Year
Contextual Description:
A policy document detailing eligibility criteria and administrative review procedures for clinical coverage within state-funded mental health, substance abuse, and developmental disabilities services.
Year:
2020
Region / City:
Global
Topic:
5G NR coverage enhancements
Document Type:
Email discussion
Organization / Institution:
3GPP
Author:
Moderator (China Telecom)
Target Audience:
Telecom professionals, 3GPP members
Validity Period:
May 25th – June 5th, 2020
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2026
Region / City:
United States
Subject:
Individual coverage health reimbursement arrangements (HRAs)
Document Type:
Instruction Manual
Organization / Institution:
U.S. Departments of the Treasury, Labor, and Health and Human Services
Author:
U.S. Departments of the Treasury, Labor, and Health and Human Services
Target Audience:
Employers, plan sponsors, and individuals using individual coverage HRAs
Effective Period:
Ongoing
Approval Date:
N/A
Amendment Date:
N/A
Year:
2023
County:
[County Name]
Club:
[Club Name]
Location of Activity:
[Location Name]
Date of Activity:
[Date]
Participant Name:
[Participant Name]
Participant Age:
[Participant Age]
Participant is a 4-H member:
Yes/No
Participant is NOT a 4-H member:
Yes/No
Participant knows how to swim and can swim at least one length of the pool:
Yes/No
Participant does NOT know how to swim:
Yes/No
Participant does NOT have permission to participate in water activities:
Yes/No
Governing Law:
Iowa
Program:
[Program Name]
Health Requirements:
Participant must be healthy and reasonably fit to participate safely
Inherent Risks:
Climbing, Ropes Course, Swimming
Emergency Contact:
[Emergency Contact Name]
Signature of Parent or Guardian:
[Signature]
Date:
[Date]
Signature of Participant:
[Signature]
Year:
2023
Region / City:
Bemidji
Topic:
Liability Waiver, Sports Facility
Document Type:
Legal Agreement
Organization / Institution:
Bemidji Indoor Sports Commission
Author:
Not specified
Target Audience:
Participants of the Neilson Fieldhouse, parents/legal guardians of minors
Period of validity:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2026
Region / City:
Zambia
Topic:
Insurance, Procurement, Health Organization
Document Type:
Request for Proposal (RFP)
Organization / Institution:
Amref Health Africa
Author:
Amref Health Africa
Target Audience:
Insurance companies, brokers
Period of Validity:
1 January 2026 to 31 December 2026
Approval Date:
Not specified
Date of Changes:
Not specified
Context:
A formal request for proposals for insurance and equipment coverage for Amref Health Africa’s Zambia operations, detailing technical specifications and requirements for various insurance services.
Year:
2025
Region / City:
United Kingdom
Topic:
Insurance, Product Oversight and Governance
Document Type:
Product Passport
Organization:
Convex Insurance (UK) Limited
Author:
Convex Insurance (UK) Limited
Target Audience:
SME and Large UK commercial entities
Effective Date:
22/05/2025
Date of Last Review:
22/05/2025
Exclusions:
Abuse, Asbestos, Cyber Data Loss, Data Protection, Bodily Injury or Property Damage, Liquidated Damages, Nuclear, Communicable Disease, War, Terrorism, Sanctions, US/Canada Pollution, PFA
Policy Length:
Variable but usually annual
Policy Structure:
Individual insureds
Risk:
No material risks associated with the target market
Target Market Complexity:
Suitable for commercial clients
Unsuitable Market:
Not suitable for consumers (natural persons acting outside trade or profession)
Year:
Not specified
Region / City:
Not specified
Subject:
Business agreements and operations of a Limited Liability Company
Document type:
Operating Agreement
Organization / Institution:
Not specified
Author:
Not specified
Target audience:
Members of the Company
Effective period:
Not specified
Approval date:
Not specified
Amendment date:
Not specified