Covered California for Small Business Terminations of Coverage. Contractor acknowledges and agrees that Covered California shall be responsible for the aggregation and administration of premiums for Covered California for Small Business. Covered California shall be responsible for: (1) the submission of bills to each Employer on a monthly basis in a form that identifies Employer and Employee contributions and the total amount due, (2) collecting the amounts due from each Employer, and (3) making payments to Contractor for Enrollees in Contractor’s QDPs on a monthly basis or such other intervals as mutually agreed upon by Covered California and Contractor. In no event shall Covered California be liable to Contractor with respect to any interest or other charges relating to premium funds received by Covered California that are not yet disbursed by Covered California to QDP Issuers. The specific terms and conditions relating to terminations, including Contractor’s right to terminate an Employer in connection with the receipt of non-payment or partial payments from Employers, shall be established by Covered California in accordance with applicable laws, rules and regulations. Except as otherwise required under applicable laws, rules or regulations, an Employee’s enrollment through Employer may be terminated in connection with the termination of Employer’s coverage and/or with respect to the events described in Section 2.2.4. With respect to an Employee, his or her eligibility shall cease at such time as he or she is no longer a qualified Employee to whom Employer has offered coverage. Covered California will notify Contractor within five (5) business days of any Employer or Employee termination. Contractor shall request termination of an enrollee for fraud or mis-representation through the Carrier Referral Process (posted on the Contractor’s extranet website provided by Covered California (Data Home, Contractor’s folder, Fraud Referral folder)) and provide Covered California with supporting documentation for each request to terminate. Contractor shall not terminate for fraud or misrepresentation without prior approval from Covered California.
Covered California for Small Business Terminations of Coverage. Contractor acknowledges and agrees that the Exchange shall be responsible for the aggregation and administration of premiums for Covered California for Small Business. The Exchange shall be responsible for: (1) the submission of bills to each Employer on a monthly basis in a form that identifies Employer and Employee contributions and the total amount due, (2) collecting the amounts due from each Employer, and (3) making payments to Contractor for Enrollees in Contractor’s QDPs on a monthly basis or such other intervals as mutually agreed upon by the Exchange and Contractor. In no event shall the Exchange be liable to Contractor with respect to any interest or other charges relating to premium funds received by the Exchange that are not yet disbursed by the Exchange to QDP Issuers. The specific terms and conditions relating to terminations, including Contractor’s right to terminate an Employer in connection with the receipt of non-payment or partial payments from Employers, shall be established by the Exchange in accordance with applicable laws, rules and regulations. Except as otherwise required under applicable laws, rules or regulations, an Employee’s enrollment through Employer may be terminated in connection with the termination of Employer’s coverage and/or with respect to the events described in Section 2.2.4. With respect to an Employee, his or her eligibility shall cease at such time as he or she is no longer a qualified Employee to whom Employer has offered coverage. The Exchange will notify Contractor within five (5) business days of any Employer or Employee termination.
Covered California for Small Business Terminations of Coverage. Contractor acknowledges and agrees that Covered California shall be responsible for the aggregation and administration of premiums for Covered California for Small Business. Covered California shall be responsible for: (1) the submission of bills to each Employer on a monthly basis in a form that identifies Employer and Employee contributions and the total amount due, (2) collecting the amounts due from each Employer, and (3) making payments to Contractor for Covered California Enrollees in Contractor’s QDPs on a monthly basis or such other intervals as mutually agreed upon by Covered California and Contractor. In no event shall Covered California be liable to Contractor with respect to any interest or other charges relating to premium funds received by Covered California that are not yet disbursed by Covered California to QDP Issuers. The specific terms and conditions relating to terminations, including Contractor’s right to terminate an Employer in connection with the receipt of non-payment or partial payments from Employers, shall be established by Covered California in accordance with applicable laws, rules and regulations.
