Common use of Contribution and Participation Requirements Clause in Contracts

Contribution and Participation Requirements. HEALTH PLAN and GROUP understand and agree to the following contribution and participation requirements for the provision of services pursuant to the Agreement. 1. For medical coverage, GROUP must contribute a minimum of the equivalent of fifty percent (50%) of the Premium cost of the Employee-only rate in the reference plan selected by the Employer. 2. For medical coverage, GROUP must have a minimum of seventy percent (70%) of Eligible Employees enroll in a QHP through the SHOP. If the Group pays 100 percent of its Qualified Employees' QHP premiums, then all Eligible Employees must enroll in health insurance coverage through the SHOP. For purposes of participation, Eligible Employees do not include an employee who is enrolled in coverage through another employer, an employee’s union, Medicaid, Medicare, or any other federal or state health coverage programs –other than coverage through a QHP sold in the Individual Exchange at the time GROUP initially contracts with HEALTH PLAN 3. If GROUP does not meet such minimum contribution and minimum participation requirements, GROUP may only enroll with HEALTHPLAN through SHOP from November 15th through December 15th of each year.

Appears in 2 contracts

Samples: Group Subscriber Agreement, Group Subscriber Agreement

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Contribution and Participation Requirements. HEALTH PLAN and GROUP understand and agree to the following contribution and participation requirements for the provision of services pursuant to the Agreement. 1. For medical coverage, GROUP must contribute a minimum of the equivalent of fifty percent (50%) of the Premium cost of the Employee-only rate in the reference plan selected by the Employer. 2. For medical coverage, GROUP must have a minimum of seventy percent (70%) of Eligible Employees enroll in a QHP through the SHOP. If the Group pays 100 percent of its Qualified Employees' QHP premiums, then all Eligible Employees must enroll in health insurance coverage through the SHOP. For purposes of participation, Eligible Employees do not include an employee who is enrolled in coverage through another employer, an employee’s union, Medicaid, Medicare, or any other federal or state health coverage programs –other than coverage through a QHP sold in the Individual Exchange at the time GROUP initially contracts with HEALTH PLAN. 3. If GROUP does not meet such minimum contribution and minimum participation requirements, GROUP may only enroll with HEALTHPLAN through SHOP from November 15th through December 15th of each year.

Appears in 1 contract

Samples: Group Subscriber Agreement

Contribution and Participation Requirements. HEALTH PLAN and GROUP understand and agree to the following contribution and participation requirements for the provision of services pursuant to the Agreement. 1. For medical coverage, GROUP must contribute a minimum of the equivalent of fifty percent (50%) of the Premium cost of the Employee-only rate in the reference plan selected by the Employer. 2. For medical coverage, GROUP must have a minimum of seventy percent (70%) of Eligible Employees enroll in a QHP through the SHOP. If the Group pays 100 percent of its Qualified Employees' QHP premiums, then all Eligible Employees must enroll in health insurance coverage through the SHOP. For purposes of participation, Eligible Employees do not include an employee who is enrolled in coverage through another employer, an employee’s union, Medicaid, Medicare, or any other federal or state health coverage programs –other than coverage through a QHP sold in the Individual Exchange at the time GROUP initially contracts with HEALTH PLAN 3. If GROUP does not meet such minimum contribution and minimum participation requirements, GROUP may only enroll with HEALTHPLAN through SHOP from November 15th through December 15th of each year. III. ELIGIBILITY AND ENROLLMENT A. Eligibility and Enrollment for Open Enrollment

Appears in 1 contract

Samples: Medical and Hospital Service Agreement

Contribution and Participation Requirements. HEALTH PLAN and GROUP understand and agree to the following contribution and participation requirements for the provision of services pursuant to the Agreement. 1. For medical coverage, GROUP must contribute a minimum of the equivalent of fifty percent (50%) of the Premium cost of the Employee-only rate in the reference plan selected by the Employer. 2. For medical coverage, GROUP must have a minimum of seventy percent (70%) of Eligible Employees enroll in a QHP through the SHOP. If the Group pays 100 percent of its Qualified Employees' QHP premiums, then all Eligible Employees must enroll in health insurance coverage through the SHOP. For purposes of participation, Eligible Employees do not include an employee who is enrolled in coverage through another employer, an employee’s union, Medicaid, Medicare, or any other federal or state health coverage programs other than coverage through a QHP sold in the Individual Exchange at the time GROUP initially contracts with HEALTH PLAN. 3. If GROUP does not meet such minimum contribution and minimum participation requirements, GROUP may only enroll with HEALTHPLAN HEALTH PLAN through SHOP from November 15th through December 15th of each year. III. ELIGIBILITY AND ENROLLMENT A. Eligibility and Enrollment for Open Enrollment

Appears in 1 contract

Samples: Group Agreement

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Contribution and Participation Requirements. HEALTH PLAN and GROUP understand and agree to the following contribution and participation requirements for the provision of services pursuant to the Agreement. 1. For medical coverage, GROUP must contribute a minimum of the equivalent of fifty percent (50%) of the Premium cost of the Employee-only rate in the reference plan selected by the Employer. 2. For medical coverage, GROUP must have a minimum of seventy percent (70%) of Eligible Employees enroll in a QHP through the SHOP. If the Group pays 100 percent of its Qualified Employees' QHP premiums, then all Eligible Employees must enroll in health insurance coverage through the SHOP. For purposes of participation, Eligible Employees do not include an employee who is enrolled in coverage through another employer, an employee’s union, Medicaid, Medicare, or any other federal or state health coverage programs other than coverage through a QHP sold in the Individual Exchange at the time GROUP initially contracts with HEALTH PLAN 3. If GROUP does not meet such minimum contribution and minimum participation requirements, GROUP may only enroll with HEALTHPLAN through SHOP from November 15th through December 15th of each year.

Appears in 1 contract

Samples: Group Subscriber Agreement

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