Common use of Covered California for the Individual Market Coverage Effective Dates Clause in Contracts

Covered California for the Individual Market Coverage Effective Dates. Contractor shall ensure coverage effective dates for the Covered California Enrollee consistent with applicable State law. Covered California and Contractor shall require payment of premium in accordance with the premium payment due dates specified in 10 CCR § 6410 and the premium payment process specified in 10 CCR § 6500 and other applicable State law. Contractor shall provide Covered California with information necessary to confirm Contractor’s receipt of premium payment from a Covered California Enrollee that is required to commence coverage. Covered California shall establish the specific terms and conditions relating to commencement of coverage, including the administration of a state financial assistance program, advance payments of the premium tax credit and cost sharing reductions, and cancellation or postponement of the effective date of coverage in the event of nonpayment or partial payment of an initial premium, in accordance with applicable laws, rules and regulations. The first premium binder payment shall be either paid directly to the Contractor or processed through a third-party administrator and deposited into an account owned by the third-party administrator and settled by the third-party administrator to the Contractor’s own bank account.

Appears in 3 contracts

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

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Covered California for the Individual Market Coverage Effective Dates. Contractor shall ensure coverage effective dates for the Covered California Enrollee consistent with applicable State law. Covered California and Contractor shall require payment of premium in accordance with the premium payment due dates specified in 10 CCR § 6410 and the premium payment process specified in 10 CCR § 6500 and other applicable State law. Contractor shall provide Covered California with information necessary to confirm Contractor’s receipt of premium payment from a Covered California Enrollee that is required to commence coverage. Covered California shall establish the The specific terms and conditions relating to commencement of coverage, including the administration of a state financial assistance program, advance payments of the premium tax credit and cost sharing reductions, and cancellation or postponement of the effective date of coverage in the event of nonpayment or partial payment of an initial premium, shall be established by Covered California in accordance with applicable laws, rules and regulations. The first premium binder payment shall be either paid directly to the Contractor or processed through a third-party administrator and deposited into an account owned by the third-party administrator and settled by the third-party administrator to the Contractor’s own bank account.

Appears in 3 contracts

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

Covered California for the Individual Market Coverage Effective Dates. Contractor shall ensure coverage effective dates for the Covered California Enrollee consistent with applicable State law. Covered California and Contractor shall require payment of premium in accordance with the premium payment due dates specified in 10 10 CCR CCR § § 6410 and the premium payment process specified in 10 CCR § 6500 and other applicable State law. Contractor shall provide Covered California with information necessary to confirm Contractor’s receipt of premium payment from a Covered California Enrollee that is required to commence coverage. Covered California shall establish the specific terms and conditions relating to commencement of coverage, including the administration of a state financial advance premium assistance programsubsidy, advance payments of the premium tax credit and cost sharing reductions, and cancellation or postponement of the effective date of coverage in the event of nonpayment or partial payment of an initial premium, in accordance with applicable laws, rules and regulations. The first premium binder payment shall be either paid directly to the Contractor or processed through a third-party administrator and deposited into an account owned by the third-party administrator and settled by the third-party administrator to the Contractor’s own bank account.

Appears in 2 contracts

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

Covered California for the Individual Market Coverage Effective Dates. Contractor shall ensure coverage effective dates for the Covered California Enrollee consistent with applicable State law. Covered California and Contractor shall require payment of premium in accordance with the premium payment due dates specified in 10 CCR § 6410 and the premium payment process specified in 10 CCR § 6500 and other applicable State law. Contractor shall provide Covered California with information necessary to confirm Contractor’s receipt of premium payment from a Covered California Enrollee that is required to commence coverage. Covered California shall establish the specific terms and conditions relating to commencement of coverage, including the administration of a state financial advance premiumfinancial assistance programsubsidyprogram, advance payments of the premium tax credit and cost sharing reductions, and cancellation or postponement of the effective date of coverage in the event of nonpayment or partial payment of an initial premium, in accordance with applicable laws, rules and regulations. The first premium binder payment shall be either paid directly to the Contractor or processed through a third-party administrator and deposited into an account owned by the third-party administrator and settled by the third-party administrator to the Contractor’s own bank account.

Appears in 1 contract

Samples: Qualified Health Plan Issuer Contract

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Covered California for the Individual Market Coverage Effective Dates. Contractor shall ensure coverage effective dates for the Covered California Enrollee consistent with applicable State law. Covered California and Contractor shall require payment of premium in accordance with the premium payment due dates specified in 10 CCR § 6410 and the premium payment process specified in 10 CCR § 6500 and other applicable State law. Contractor shall provide Covered California with information necessary to confirm Contractor’s receipt of premium payment from a Covered California Enrollee that is required to commence coverage. Covered California shall establish the specific terms and conditions relating to commencement of coverage, including the administration of a state financial advance premium assistance programsubsidy, advance payments of the premium tax credit and cost sharing reductions, and cancellation or postponement of the effective date of coverage in the event of nonpayment or partial payment of an initial premium, in accordance with applicable laws, rules and regulations. The first premium binder payment shall be either paid directly to the Contractor or processed through a third-party administrator and deposited into an account owned by the third-party administrator and settled by the third-party administrator to the Contractor’s own bank account.

Appears in 1 contract

Samples: Qualified Health Plan Issuer Contract

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