Application and Adoption Agreement Sample Contracts

This APPLICATION AND ADOPTION AGREEMENT FOR ASSOCIATION HEALTH PLAN
Application and Adoption Agreement • December 9th, 2019

EMPLOYER GROUP ENROLLMENT (“Agreement”) in the association health plan program provided by Hometown Health Providers Insurance Company, Inc. and Hometown Health Plan, Inc. (collectively referred to as “Hometown Health”) and Better Business Bureau (BBB) Northern Nevada and Utah

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Groups that are new to this Association must complete this entire application.
Application and Adoption Agreement • November 4th, 2021

ENROLLMENT (“Agreement”) in the association health plan program provided by Hometown Health Providers Insurance Company, Inc. and Hometown Health Plan, Inc. (collectively referred to as “Hometown Health”) and Builders Association of Northern Nevada Benefit Trust Fund (“Association”) is hereby submitted by the following Employer Group:

Application and Adoption Agreement
Application and Adoption Agreement • April 26th, 2017

⇒ Place all trash bags used during collection of litter adjacent to the Adopt A Street sign supports for pickup by and disposal by the City

Groups that are new to this Association must complete this entire application.
Application and Adoption Agreement • November 4th, 2021

ENROLLMENT (“Agreement”) in the association health plan program provided by Hometown Health Providers Insurance Company, Inc. and Hometown Health Plan, Inc. (collectively referred to as “Hometown Health”) and Builders Association of Northern Nevada Benefit Trust Fund (“Association”) is hereby submitted by the following Employer Group:

Groups that are new to this Association must complete this entire application.
Application and Adoption Agreement • February 9th, 2021

EMPLOYER GROUP ENROLLMENT (“Agreement”) in the association health plan program provided by Hometown Health Providers Insurance Company, Inc. and Hometown Health Plan, Inc. (collectively referred to as “Hometown Health”) and Builders Association of Northern Nevada Benefit Trust Fund

Groups that are new to this Association must complete this entire application.
Application and Adoption Agreement • November 4th, 2021

ENROLLMENT (“Agreement”) in the association health plan program provided by Hometown Health Providers Insurance Company, Inc. and Hometown Health Plan, Inc. (collectively referred to as “Hometown Health”) and Builders Association of Northern Nevada Benefit Trust Fund (“Association”) is hereby submitted by the following Employer Group:

Groups that are new to this Association must complete this entire application.
Application and Adoption Agreement • November 4th, 2021

ENROLLMENT (“Agreement”) in the association health plan program provided by Hometown Health Providers Insurance Company, Inc. and Hometown Health Plan, Inc. (collectively referred to as “Hometown Health”) and Builders Association of Northern Nevada Benefit Trust Fund (“Association”) is hereby submitted by the following Employer Group:

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