Common use of Application for Coverage Clause in Contracts

Application for Coverage. When coverage is purchased through the SHOP, applications, changes, and terminations must be made through the SHOP. The SHOP will determine and verify eligibility to enroll in this Contract and establish an Effective Date for coverage. Application for enrollment must be made through the SHOP during the Group’s annual Open Enrollment Period each year, which will be at least 30 days in length. After the initial Open Enrollment Period, qualified persons generally may enroll in or change coverage only during subsequent Open Enrollment Periods or, if an individual becomes eligible outside the annual Open Enrollment Period, he may apply for coverage beginning on the date he becomes eligible. A qualified individual may also enroll in coverage during a Special Enrollment Period available after certain trigger events occur. When coverage is purchased from Company Off-SHOP, applications, changes and terminations must be made to Company. Company will determine and verify eligibility to enroll in this Benefit Plan and establish an Effective Date for coverage. Application for enrollment must be made to Company during the Group’s annual Open Enrollment Period each year. After the initial Open Enrollment Period, qualified persons generally may enroll in or change coverage only during subsequent Open Enrollment Periods or if an individual becomes eligible outside the annual Open Enrollment Period, he may apply for coverage beginning on the date he becomes eligible. A qualified individual may also enroll in coverage during a Special Enrollment Period available after certain trigger events occur. Every Eligible Person may enroll for coverage under this Benefit Plan and may include any Eligible Dependents on such enrollment form. The Group will submit any such enrollment forms to the Company as a prerequisite to coverage under this Benefit Plan. No person will be covered under this Benefit Plan unless the Company has accepted the enrollment form and has been issued an identification card or other written notice of acceptance. Payment of premiums to the Company for any person will not effectuate coverage unless and until the Company's identification card or other written acceptance has been issued, and in the absence of such issuance, the Company's liability will be limited to refund of the amount of premiums paid. This Group dental Benefit Plan and coverage under it will not be issued or renewed unless the percentage of Eligible Persons specified in the Application for Group Coverage is enrolled.

Application for Coverage. When coverage is purchased through the SHOP, applications, changes, and terminations must be made through the SHOP. The SHOP will determine and verify eligibility to enroll in this Contract and establish an Effective Date for coverage. Application for enrollment must be made through the SHOP during the Group’s annual Open Enrollment Period each year, which will be at least 30 days in length. After the initial Open Enrollment Period, qualified persons generally may enroll in or change coverage only during subsequent Open Enrollment Periods or, if an individual becomes eligible outside the annual Open Enrollment Period, he may apply for coverage beginning on the date he becomes eligible. A qualified individual may also enroll in coverage during a Special Enrollment Period available after certain trigger events occur. When coverage is purchased from Company Off-SHOP, applications, changes and terminations must be made to Company. Company will determine and verify eligibility to enroll in this Benefit Plan and establish an Effective Date for coverage. Application for enrollment must be made to Company during the Group’s annual Open Enrollment Period each year. After the initial Open Enrollment Period, qualified persons generally may enroll in or change coverage only during subsequent Open Enrollment Periods or if an individual becomes eligible outside the annual Open Enrollment Period, he may apply for coverage beginning on the date he becomes eligible. A qualified individual may also enroll in coverage during a Special Enrollment Period available after certain trigger events occur. Every Eligible Person may enroll for coverage under this Benefit Plan and may include any Eligible Dependents on such enrollment form. The Group will submit any such enrollment forms to the Company as a prerequisite to coverage under this Benefit Plan. Plan.‌‌ No person will be covered under this Benefit Plan unless the Company has accepted the enrollment form and has been issued an identification card or other written notice of acceptance. Payment of premiums to the Company for any person will not effectuate coverage unless and until the Company's identification card or other written acceptance has been issued, and in the absence of such issuance, the Company's liability will be limited to refund of the amount of premiums paid. This Group dental vision Benefit Plan and coverage under it will not be issued or renewed unless the percentage of Eligible Persons specified in the Application for Group Coverage is enrolled. Available Classes of Coverage as Selected by the Group Subscriber Only coverage means coverage for the Subscriber only. Subscriber and Spouse coverage means coverage for the Subscriber and his Spouse. Subscriber and Family coverage means coverage for the Subscriber, his Spouse, and one or more Dependent children. Subscriber and Child(ren) coverage means coverage for the Subscriber and one or more Dependent children. Subscriber and Dependent coverage means coverage for the Subscriber and one Dependent. Effective Date When an enrollment form has been accepted and any premiums for coverage have been paid, coverage will begin on the following applicable Effective Date, subject to any Eligibility Waiting Period: If a person is an Eligible Person on the Group's Benefit Plan Date and enrolls for coverage for self or for self and any eligible Dependent(s) on or before such date, this Group's Benefit Plan Date will be the Effective Date of coverage. If a person becomes an Eligible Person after this Group's Benefit Plan Date, and enrolls for coverage for self or for self and any eligible Dependent(s) and the enrollment form is received by the Company within thirty (30) days of the eligibility date, the Effective Date of coverage will be the eligibility date. If an Eligible Person’s application for coverage for self or for self and any eligible Dependent(s) is not received by Us within thirty (30) days of the eligibility date or Special Enrollment Period as described below, the request for enrollment will be denied. The Eligible Person shall be eligible to enroll for coverage during the next Open Enrollment Period. If a child is born to a Subscriber holding coverage which includes Dependent children (Subscriber and Family coverage or Subscriber and Child(ren) coverage), and the enrollment form is received by the Company within one hundred eighty (180) days of the date of birth, the Effective Date of coverage will be the date of birth.

Application for Coverage. When coverage is purchased through the SHOP, applications, changes, and terminations must be made through the SHOP. The SHOP will determine and verify eligibility to enroll in this Contract and establish an Effective Date for coverage. Application for enrollment must be made through the SHOP during the Group’s annual Open Enrollment Period each year, which will be at least 30 days in length. After the initial Open Enrollment Period, qualified persons generally may enroll in or change coverage only during subsequent Open Enrollment Periods or, if an individual becomes eligible outside the annual Open Enrollment Period, he may apply for coverage beginning on the date he becomes eligible. A qualified individual may also enroll in coverage during a Special Enrollment Period available after certain trigger events occur. When coverage is purchased from Company Off-SHOP, applications, changes and terminations must be made to Company. Company will determine and verify eligibility to enroll in this Benefit Plan and establish an Effective Date for coverage. Application for enrollment must be made to Company during the Group’s annual Open Enrollment Period each year. After the initial Open Enrollment Period, qualified persons generally may enroll in or change coverage only during subsequent Open Enrollment Periods or if an individual becomes eligible outside the annual Open Enrollment Period, he may apply for coverage beginning on the date he becomes eligible. A qualified individual may also enroll in coverage during a Special Enrollment Period available after certain trigger events occur. Every Eligible Person may enroll for coverage under this Benefit Plan and may include any Eligible eligible Dependents on such enrollment form. The Group will submit any such enrollment forms to the Company as a prerequisite to coverage under this Benefit Plan. No person will be covered under this Benefit Plan unless the Company has accepted the enrollment form and has been issued an identification card or other written notice of acceptance. Payment of premiums to the Company for any person will not effectuate coverage unless and until the Company's identification card or other written acceptance has been issued, and in the absence of such issuance, the Company's liability will be limited to refund of the amount of premiums paid. This Group dental Benefit Plan and coverage under it will not be issued or renewed unless the percentage of Eligible Persons specified in the Application for Group Coverage is enrolled.