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UTAH SMALL EMPLOYER HEALTH INSURANCE APPLICATION OFFICE USE ONLY Policy / Group No. Effective Date PEC New Hire Waiting Period REASON FOR ENROLLMENT (mark all that apply) New Group Newborn Loss of
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(18 mos. For small group) Employee Deductible: 1,250 Employee COBRA Premium: 5,000 Employee Deductible (including additional amounts for self-only or dependent coverage): 2,000 Employers COBRA Premium: 5,000 Employers Deductibles: 2,000 (per person per enrollment day) Coverage Options: Basic Health Plan, Family Life Plan, and Life and Accident Only Plan; Coverage is not in effect unless Employer decides to take or not to take this option.
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What we're going to go over here today is the cord 126 which is the general liability application mm-hmm with that being said what I have up here in front again I used a court advantage to get this application, but this is the Accord 126 the general liability section and as we discussed last time on the 125 you would complete this application any time that you need liability coverage on commercial lines, and you just fill this out along with the 125 that you fill out each time so without further ado let's go ahead and just kind of get clicking through here so hmm first off we just start with the easy stuff today's date and then if it's access plus you would leave this information up here blank agency and carrier and that sort of thing you can fill this in if you're sending it in through your own office however we do want to put down what date you would like this policy to be effective, so we're just going to say it's due on the 15th of March, and again we need to put down the policy applicants first name insured and as we discussed last time if it's a sole proprietor we would just put down the sole proprietors name doing business as whatever the business is or if it's in court of a corporation an LLC we would actually put down the name of the LLC or corporation because that would be the entity okay so depending on what the name insurer it is that's how that would be and then and if anyone has questions on that to be happy to help them um nix down here on the commercial general liability section um we're gonna obviously check that I don't know why they put that there we check it every time, and then we have a decision to make either we're going to write this policy as a claims-made basis or as an occurrence basis okay now we get into some fun stuff um most policies are written on an occurrence basis okay claims made an occurrence the difference between the two is basically on a claims-made policy the policy in force at the time the claim is made is the policy that pays the claim on an occurrence based policy the policy in effect at the time the occurrence happened is what policy pays the claim so let's take a school for example let's say back when I was in high school the band room that I was in I'm pretty sure the ceiling was made out of pure asbestos and whenever it rained and asbestos particles would drip in maybe the powder would get in my lungs or something well down the road let's say I develop some sort of condition and I decide to sue the school because it was the asbestos that caused this lung condition that I have now if the school is written on an occurrence policy which most policies are written that way what that means is that if I sue them and the occurrence happened back in like 1985 or something like that then the 1985 policy is the policy that would pay because that's when the occurrence happened okay so if there are limits we'll lower back then which I'm sure they were back in 1985, and we'll say this happens 10 years in the...