Applying for Coverage. This Section gives an overview of how to apply for coverage under this Contract, through the Marketplace, or directly with AvMed. Rules for enrolling during specific enrollment periods, for changing coverage, and for adding eligible dependents are described in Sections 4.3 Enrollment Periods and 4.4
Applying for Coverage. You may apply for dental coverage for yourself and/or your Dependents. No eligibility rules or variations in premium will be imposed based upon your health status, dental condition, claims experience, receipt of health care, dental history, genetic information, evidence of insurability, disability, or any other health status related factor. You will not be discriminated against for coverage under this Plan on the basis of race, color, national origin, disability, age, sex, gender identity, or sexual orientation. Variations in the administration, processes or Benefits of this Contract that are based on clinically indicated, reasonable dental management practices, or are part of permitted wellness incentives, disincentives and/or other programs do not constitute discrimination. You may enroll in or change dental coverage for yourself and/or your Dependents during one of the following enrollment periods. Your and/or your Dependents’ Effective Date will be determined by the Plan and the Exchange, as appropriate, depending upon the date your application is received, payment of the initial premiums no later than the day before the Effective Date of coverage, and other determining factors. The Plan and the Exchange, as appropriate, may require acceptable proof (such as copies of legal adoption or legal guardianship papers, or court orders) that an individual qualifies as a Dependent under this Contract. You may apply for or change dental coverage for yourself and/or your Dependents during the annual open enrollment period designated by the Exchange and/or the Plan, as appropriate. When you enroll during the annual open enrollment period, your and/or your Dependents’ Effective Date will be the following January 1, unless otherwise designated by the Exchange and/or the Plan, as appropriate. This section “Annual Open Enrollment Periods/Effective Date of Coverage” is subject to change by the Exchange, the Plan and/or applicable law, as appropriate. Special enrollment periods have been designated during which you may change dental coverage for yourself and/or your Dependents. You must apply for dental coverage within 60 days from the date of a Special Enrollment Event detailed below. Except as otherwise provided below, if you apply between the 1st day and the 15th day of the month, your Effective Date will be no later than the 1st day of the following month, or if you apply between the 16th day and the end of the month, your and/or your Dependents’ Effective Date will...
Applying for Coverage. An applicant may apply for coverage in a Qualified Health Plan (QHP) through the Exchange for himself/herself and/or any eligible Dependents (see below) by submitting the application(s) for individual medical insurance form, along with any exhibits, appendices, addenda and/or other required information (“application(s)”) to Blue Cross and Blue Shield of Montana and the Exchange, as appropriate. The application(s) for coverage may or may not be accepted. No eligibility rules or variations in premium will be imposed based on health status, medical condition, claims experience, receipt of healthcare, medical history, genetic information, evidence of insurability, disability, or any other health status related factor. Applicants will not be discriminated against for coverage under this Plan on the basis of race, color, national origin, disability, age, sex, gender identity, or sexual orientation. Variation in the administration, processes or Benefits of this policy that are based on clinically indicated, reasonable medical management practices, or are part of permitted wellness incentives, disincentives and/or other programs do not constitute discrimination. An applicant may enroll in or change a QHP for himself/herself and/or any eligible Dependents during one of the Initial and Annual Enrollment Periods as set by the Exchange. The Effective Date will be determined by Blue Cross and Blue Shield of Montana and the Exchange, as appropriate, depending upon the date the application is received, payment of the initial premiums no later than the day before the Effective Date of coverage (unless any Advance Premium Tax Credit is greater than the initial premium), and other determining factors. Special Enrollment Events
Applying for Coverage. This Section gives an overview of how to apply for coverage under this Contract, through the Marketplace, or directly with AvMed. Rules for enrolling during specific enrollment periods, for changing coverage, and for adding eligible dependents are described in Sections 4.3 Enrollment Periods and 4.4 Qualifying Events, SEPs and Effective Dates of Coverage.
a. To apply for coverage under this Contract through the Marketplace, you must:
i. Create a Marketplace account on XxxxxxXxxx.xxx;
ii. Fill out and submit an online application or download and complete a paper application. You can also apply by phone or in-person with an assister;
iii. You will receive a notice in the mail or in an email that tells you what coverage you are eligible for. Review and save this notice.
iv. If you are eligible, shop for an AvMed Marketplace plan and enroll on behalf of yourself and/or your eligible dependents you want to cover; and
v. Send your first Premium payment to us.
b. To apply for coverage under this Contract directly through AvMed, outside of the Marketplace, you must:
i. Complete an online application, or download and complete a paper application, and submit it to us on behalf of yourself and/or your eligible dependents you want to cover;
ii. Provide information needed to determine eligibility, as requested; and
iii. Pay the required Premium.
c. By submitting an Application, you represent that you have permission from all of the people whose information is on the Application to both submit their information to us or the Marketplace and receive any communications about their eligibility and enrollment.
