I understand by entering this agreement, I am appointing Clearwater Benefits, LLC as my insurance broker and agent for the purposes of obtaining the insurance services, products, and other health care products I request.
As my broker of record, Clearwater is authorized to make changes to or modify my plan and can upgrade/adjust my plan during the term so long as the cost to me and my benefits either stay essentially the same or are improved (lower cost and better benefits). I authorize and appoint Clearwater Benefits, LLC as my agent to give Clearwater the right to, in their sole and exclusive discretion, change or modify and adjust the specific provisions of the plan on my behalf, including switching carriers or providers.
As my appointed broker of record and agent, I hereby authorize and empower Clearwater Benefits, LLC, or its officers, employees, or agents, to change or modify my payment forms or authorizations (including ACH authorizations) on my behalf to reflect to a new carrier or provider, so long as the cost and terms of the payment remain the same or better and so long as I am notified of such changes.
I acknowledge that I am free to terminate this appointment and the authorization created by it by notifying Clearwater Benefits, LLC in writing of my desire to terminate this appointment. Any such termination of authority to act as my broker of record and agent shall be effective ten days after receiving such written termination.
If I am a current member of Planstin and/or Zion’s health plans as of 7/15/2022, I give Clearwater Benefits, LLC permission to transfer my plan/s starting 8/1/2022, so long as the benefits and monthly cost are the same or better.
