Common use of Coverage Following Termination and Decertification Clause in Contracts

Coverage Following Termination and Decertification. (a) Upon the termination of the Agreement or decertification of one or more of Contractor’s QDPs, Contractor shall cooperate fully with Covered California in order to effect an orderly transition of Enrollees to another QDP as directed by Covered California. This cooperation shall include (i) attending post- termination meetings, (ii) providing or arranging for the provision of Specialized Health Care Services as may be deemed necessary by Participating Providers to assure the appropriate continuity of care, and (iii) communicating with affected Enrollees in cooperation with Covered California and the succeeding contractor as applicable, as reasonably requested by Covered California. (b) In the event the termination or expiration of the Agreement requires the transfer of some or all Enrollees into any other dental plan, the terms of coverage under Contractor’s QDP shall not be carried over to the replacement QDP but rather the transferred Enrollees shall be entitled only to the extent of coverage offered through the replacement QDP as of the effective date of transfer to the new QDP.

Appears in 7 contracts

Samples: Qualified Dental Plan Issuer Contract, Qualified Dental Plan Issuer Contract, Qualified Dental Plan Issuer Contract

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Coverage Following Termination and Decertification. (a) Upon the termination of the Agreement or decertification of one or more of Contractor’s QDPs, Contractor shall cooperate fully with Covered California in order to effect an orderly transition of Covered California Enrollees to another QDP as directed by Covered California. This cooperation shall include (i) attending post- post-termination meetings, (ii) providing or arranging for the provision of Specialized Health Care Covered Services as may be deemed necessary by Participating Providers to assure the appropriate continuity of care, and (iii) communicating with affected Covered California Enrollees in cooperation with Covered California and the succeeding contractor as applicable, as reasonably requested by Covered California. (b) In the event the termination or expiration of the Agreement requires the transfer of some or all Covered California Enrollees into any other dental plan, the terms of coverage under Contractor’s QDP shall not be carried over to the replacement QDP but rather the transferred Covered California Enrollees shall be entitled only to the extent of coverage offered through the replacement QDP as of the effective date of transfer to the new QDP.

Appears in 5 contracts

Samples: Covered California Qualified Dental Plan Issuer Contract, Covered California Qualified Dental Plan Issuer Contract, Qualified Dental Plan Issuer Contract

Coverage Following Termination and Decertification. (a) Upon the termination of the Agreement or decertification of one or more of Contractor’s QDPsQHPs, Contractor shall cooperate fully with Covered California in order to effect an orderly transition of Covered California Enrollees to another QDP QHP as directed by Covered California. This cooperation shall include include: (i) attending post- post-termination meetings, (ii) providing or arranging for the provision of Specialized Health Care Covered Services as may be deemed necessary by Participating Providers to assure the appropriate continuity of care, and (iii) communicating with affected Covered California Enrollees in cooperation with Covered California and the succeeding contractor as applicable, as reasonably requested by Covered California. (b) In the event the termination or expiration of the Agreement requires the transfer of some or all Covered California Enrollees into any other dental health plan, the terms of coverage under Contractor’s QDP QHP shall not be carried over to the replacement QDP QHP, but rather the transferred Covered California Enrollees shall be entitled only to the extent of coverage offered through the replacement QDP QHP as of the effective date of transfer to the new QDPQHP.

Appears in 2 contracts

Samples: Qualified Health Plan Issuer Contract, Qualified Health Plan Issuer Contract

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Coverage Following Termination and Decertification. (a) Upon the termination of the Agreement or decertification of one or more of Contractor’s QDPs, Contractor shall cooperate fully with Covered California in order to effect an orderly transition of Covered California Enrollees to another QDP as directed by Covered California. This cooperation shall include (i) attending post- post-termination meetings, (ii) providing or arranging for the provision of Specialized Health Care Services as may be deemed necessary by Participating Providers to assure the appropriate continuity of care, and (iii) communicating with affected Covered California Enrollees in cooperation with Covered California and the succeeding contractor as applicable, as reasonably requested by Covered California. (b) In the event the termination or expiration of the Agreement requires the transfer of some or all Covered California Enrollees into any other dental plan, the terms of coverage under Contractor’s QDP shall not be carried over to the replacement QDP but rather the transferred Covered California Enrollees shall be entitled only to the extent of coverage offered through the replacement QDP as of the effective date of transfer to the new QDP.

Appears in 1 contract

Samples: Qualified Dental Plan Issuer Contract

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