Examples of Evidence of coverage in a sentence
Agreement — this Evidence of Coverage and Health Service Agreement, any endorsements is- sued by Blue Shield of California to this Agree- ment, and the Subscriber's application.
If the grievance involves a Non-Participating Provider, the Subscriber should contact the ap- propriate Blue Shield of California Customer Service Department shown on the last page of this Evidence of Coverage and Health Service Agreement.
Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this Evidence of Coverage may be used or may pertain, the coverages afforded by the Memorandum of Coverages described herein are subject to all the terms, exclusions, and conditions of such Memorandum of Coverages.
Authorized Signature per Board Resolution Name (Please Type or Print) Date Signed EVIDENCE OF COVERAGE DATE (MM/DD/YYYY) 3/11/2024 This Evidence of Coverage is used as a matter of information only and confers no rights upon the Certificate Holder.
This Evidence of Coverage does not amend, extend, or alter the coverage afforded by the memoranda listed below.