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Home My WebLink AboutContract 28042� �I ..� . ,�7 . � 7EXASLi�E�INSURANC� COMPANY A ]vletLife� Company TERMIMATION Founn: 135fi R03/00 �- �J� 111CN '�+•ny �il�� LI� PY�� i�� A�T . o�� l�ORIJi�Yo�RI� LI�E l�oyuntary Payroll Deduc#ion �mployer Agreemenfi Texfts Life Insurance Campany and C' �� f � �d�� (Employer), a�*,ree to prnvide for the Eznpioyer's eligible amployees a Paproll Ileduction Prngram for payment af premiums on Texas I.ife°s ��° '�� a �� ; Progx'am. The amployer wiil deduct from the saSary or wages of all participating emplayees �he preminms on their and/or their faznily mernbers policies and will remit the amount so deducted to '�exas Life In- surance Company at its Home Office in Waco, e as, on the Carnmon Due Datesis}, (as defined t�e- low). The eznployer will give prampt nptice ta � �►`� n�' ��' ��G`f' �a.� , .Agent, or ta the Home QfFice af the Company, of tl�e name(s) and policy number(s) of any participant who leaves its employ, changes or withdraws a payroll deduction autharization, dies, or for whom payro�l deductians will no longer 6e raade for any reasan. Eligible employees v�rili he those who have laeen employed for the mini.�num tame raquired far the paqrol3 d�duction gragram selected at enrollment date and (Other Requirements, ii anq) � _ t� L�6� � a 1+ rc _,��-�i" r 1 �� 'I`he Common Due Date foar this Program is the � day af each month anc} the first Common Due Date for this I'rogram will bp 1 � 1 I� E�anth, Day, YeaT). Texas Life witl turxxish to the Employer as pari of each biil a detailed statemant showing the indi- vidual and total amounts dne and any current changes, according to iis records at biIling date. This agreement miay be t�:rxninated at any iinne by the Employer ar by' Texas Life Insuranr.e Com- pany upon furnishing 90 $ays written notice. I£ this agreement is terminated, the Employer wixl l�e respansible only for the rem,ittance to Texas Life of any fi�l premiams deducted priar to the termi- nation date. In the event deductians for any particular poliey ara to be diseontinued on ather than a Commnn Due Date, the amaunts already withileld from pay, if any, aare ta he refunded to the em- ployee, and'J.'exas Life is to be notified as provided above. Executed �his �� day of �� , � Texas Life Insurance Company, Waco, Texas Employ r ��` By: BY' � � �� Ge rg��ller,'Vice President Print Namp' Titlw� � �� V�t� � � Af►�D LE�17Y: �� ty At me� ate . � : ..._. ��.�� r�.� �-� � � ,;. �..�.., _ _ . , � - _ .. ._ `j edfl��G� �r��hoziza��a� C�p�� tiyh5H1�JGTOiV AVF I P�Si PFFICE BOX HjO I WACO, TE%AS']6]Q3-68�f1 I$00-28j"9�33 �54-75z_65z1 � wuvw.texaslife.com f —�'-' ' , dl,_ �� D�� .'_ - �