1973-007- Approving Kaiser Foundation Health planRESOLUTION N0. I973-7
A RESOLUTION AUTHORIZING AMENDMENT TO
AGREEMENTWITH KAISER FOUNDATION
HEALTH PLAN.
RESOLVED by the Town Council o£ the Town o£ Los Gatos,
County of Santa Clara, State of California, that the Town of
Los Gatos enter into that Amendment to Agrnement with I(AISER
FOUNDATION HEALTH PLAN, a copy o£ which is attached hereto.,
and that the May oris authorized and she is hereby directed to
execute said Amendment to Agreement in the name and in behalf
o£ the Town of Los Gatos.
PASSED AND ADOPTED at a regular meeting o£
the Town Council of the Town of Los Gatos held on the 2nd
day a£ January 1973, by the following vote:
AYES: COUNCILMEN Lha rl es E. De Frei tas
Mark B. DiDU Ca
Egon Jensen
John B. Lochner
Ruth Cannon
NOES: COUNCILMEN None.
ABSENT: COUNCILMEN None.
SIGNED: MAYOR OP THE TOWN OF LOS GATOS
ATTEST:
CLERK p,F' 'THE T`OWN.'rOF LQS GATOS
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FJd=,~dLTH hwB_e~IV, ffNe:.
A Nonprofit Corporation GROUP Ct~EC.7ECAL. AfVC7 NgSPITAL SERVICE AGREEPliE1UT
Northern California Regio^ AM EN L)Ni EN7
Cro~~n No. 931
The Group Medical and Hospital Sarvico F1.greement between Kaiser Foundation Health Plan, inn. and the Group~namedbelow
is amended as folfaws:
Tho following subsection ds added to 5erfion 0. of the 3arvica A,grecment:
"C. Ewnomia Stabilization Hules. No amountotherwise payable under this agreement shall be payable 40 the
extent that it is not payable by virtue of the L'conomic Stabilization Act of 1970, or any extension or amend-
ment ehereof, or any other law of similar or related pw pose or import, or any rule, regulation, order or decision
issued thereunder. Any such amount actually paid to Health Plan shall be refunded."
Coverage and Periodic Payments: This table shows the coverages and periodic payments under this Agreement.
If the Subscriber has: -No Pan,ily Dependents, the periodic payment is the amount u, Colwm, A;
-One family I'iependeut, the periodic payment is the sum of the amounts in Columns A and B;
-Two or more Family Dependents, the periodic payment is the sum. of the amounts in Columns A,B and C
Member Under Covera e
~RAge 65 ~~ Periodic PaJ%menY _~
Both Parts Cover
Member Age Periodic
65 or Older of Medicare
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titl
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e
o
.an
Benefits Under: __
One Part or Nom Coverag
Part of Medicare' periodic
Accepted.-^_ January 2 1973 _
's'own of Los Gatos
P. 0. ]3ax 949
hos Gatos, Ca.liforria 95030
M
IIl
n
A B C
Subscriber First Dependent All Other Dependents
- ~ ~ --B B
- B I Medicare PA-~ B
P;xecuted at: Oakland, California to take effect
as of March 1, 1973
December 1II, 1972"
ICAISl,R FOUIJDATION IIliAhTH PLAN, INC.,
A California nonprofit corporation
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By' - ~ - `~~ ----
Authorixcd c cscntntivc, Norihrm California
By:_.~ _______ -_._..
Ruth Cannon, Mayor
Isy: