Some Test
EclecticGeek, a body corporate, incorporated under the laws of the province / territory of Province Name, (hereinafter referred to as the "Employer")
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Brian Sweeney, an individual employed by the Employer, (hereinafter referred to as the "Employee")
Having regard to the tenure of the Employee and his contribution to the success of the business in his employment capacity, the Employer agrees to provide a Private Health Services Plan for the Employee, whereby the Employer agrees to pay for eligible medical expenses of the Employee, subject to the terms and conditions as set forth in the document "EclecticGeek Private Health Services Plan (PHSP) for Employees" (hereinafter referred to as the "Plan").
The Employee has indicated below, his / her intention to participate or not participate in the Plan. (Please check one of the boxes below)
I will participate in the Plan and, and agree to abide by the terms and conditions of the Plan. I consent to the Employer's collection, use and disclosure of Personal Medical Information provided by me for the purposes of administering the Plan, as governed by the Privacy Policy of the Plan.
I will not participate in the Plan. I can at a future date choose to participate in the Plan by providing written notice to the Employer, and completing a new copy of this Agreement.
IN WITNESS WHEREOF the parties hereto have executed this Agreement as of the day and year first above written.