Common use of Customer Protection Clause in Contracts

Customer Protection. Subcontractor agrees, and shall require Participating Providers to agree, that in no event, including but not limited to, non-payment by Subcontractor, MA Organization or an intermediary, insolvency of Subcontractor, MA Organization or an intermediary, or breach of the Agreement, shall Subcontractor or Participating Providers bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against any MA Customer or person (other than MA Organization or an intermediary) acting on behalf of the MA Customer for Covered Services provided pursuant to the Agreement, or for any other fees that are the legal obligation of MA Organization under the CMS Contract. This provision does not prohibit a Participating Provider from collecting from MA Customers allowable Cost Sharing. This provision also does not prohibit a Participating Provider and an MA Customer from agreeing to the provision of services solely at the expense of the MA Customer, as long as the Participating Provider has clearly informed the MA Customer, in accordance with applicable law, that the MA Customer’s Benefit Plan may not cover or continue to cover a specific service or services. In the event of MA Organization’s or an intermediary’s insolvency or other cessation of operations or termination of MA Organization’s contract with CMS, Subcontractor shall require Participating Providers to continue to provide Covered Services to an MA Customer through the later of the period for which premium has been paid to MA Organization on behalf of the MA Customer, or, in the case of MA Customers who are hospitalized as of such period or date, the MA Customer’s discharge. This provision shall be construed in favor of the MA Customer, shall survive the termination of the Agreement regardless of the reason for termination, including MA Organization’s insolvency, and shall supersede any contrary agreement, oral or written, between Subcontractor or Participating Providers and an MA Customer or the representative of an MA Customer if the contrary agreement is inconsistent with this provision. For the purpose of this provision, an “intermediary” is a person or entity authorized to negotiate and execute the Agreement on behalf of Participating Providers or on behalf of a network through which Participating Providers elect to participate.

Customer Protection. Subcontractor agrees, and shall require Participating Providers to agree, Ancillary Provider agrees that in no event, including but not limited to, non-payment by Subcontractor, MA Organization United or an intermediary, insolvency of Subcontractor, MA Organization United or an intermediary, or breach by United of the Agreement, shall Subcontractor or Participating Providers billAncillary Provider xxxx, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against any MA Customer or person (other than MA Organization United or an intermediary) acting on behalf of the MA Customer for Covered Services provided pursuant to the Agreement, or for any other fees that are the legal obligation of MA Organization under the CMS Contract. This provision does not prohibit a Participating Ancillary Provider from collecting from MA Customers allowable Cost Sharingcopayments, coinsurance, or fees for services not covered under the Customer’s Benefit Plan and delivered on a fee-for-service basis to the Customer. This provision also does not prohibit a Participating Ancillary Provider and an MA a Customer from agreeing to the provision of continue services solely at the expense of the MA Customer, as long as the Participating Ancillary Provider has clearly informed the MA Customer, in accordance with applicable law, Customer that the MA Customer’s Benefit Plan may not cover or continue to cover a specific service or services. In the event of MA OrganizationUnited’s or an intermediary’s insolvency or other cessation of operations or termination of MA OrganizationUnited’s contract with CMS, Subcontractor Ancillary Provider shall require Participating Providers to continue to provide Covered Services to an MA a Customer through the later of the period for which premium has been paid to MA Organization United on behalf of the MA Customer, or, in the case of MA Customers who are hospitalized as of such period or date, until the MA Customer’s discharge. Covered Services for a Customer confined in an inpatient facility on the date of insolvency or other cessation of operations shall continue until the Customer’s continued confinement in an inpatient facility is no longer medically necessary. This provision shall be construed in favor of the MA Customer, shall survive the termination of the Agreement regardless of the reason for termination, including MA OrganizationUnited’s insolvency, and shall supersede any contrary agreement, oral or written, * Confidential Treatment Requested by Celera Corporation* written contrary agreement between Subcontractor or Participating Providers Ancillary Provider and an MA a Customer or the representative of an MA a Customer if the contrary agreement is inconsistent with this provision. For the purpose of this provision, an “intermediary” is a person or entity authorized to negotiate and execute the Agreement on behalf of Participating Providers Ancillary Provider or on behalf of a network through which Participating Providers elect Ancillary Provider elects to participate.

Customer Protection. Subcontractor agrees, and shall require Participating Providers to agree, Ancillary Provider agrees that in no event, including but not limited to, non-payment by Subcontractor, MA Organization United or an intermediary, insolvency of Subcontractor, MA Organization United or an intermediary, or breach by United of the Agreement, shall Subcontractor or Participating Providers billAncillary Provider xxxx, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against any MA Customer or person (other than MA Organization United or an intermediary) acting on behalf of the MA Customer for Covered Services provided pursuant to the Agreement, or for any other fees that are the legal obligation of MA Organization under the CMS Contract. This provision does not prohibit a Participating Ancillary Provider from collecting from MA Customers allowable Cost Sharingcopayments, coinsurance, or fees for services not covered under the Customer’s Benefit Plan and delivered on a fee-for-service basis to the Customer. This provision also does not prohibit a Participating Ancillary Provider and an MA a Customer from agreeing to the provision of continue services solely at the expense of the MA Customer, as long as the Participating Ancillary Provider has clearly informed the MA Customer, in accordance with applicable law, Customer that the MA Customer’s Benefit Plan may not cover or continue to cover a specific service or services. In the event of MA OrganizationUnited’s or an intermediary’s insolvency or other cessation of operations or termination of MA OrganizationUnited’s contract with CMS, Subcontractor Ancillary Provider shall require Participating Providers to continue to provide Covered Services to an MA a Customer through the later of the period for which premium has been paid to MA Organization United on behalf of the MA Customer, or, in the case of MA Customers who are hospitalized as of such period or date, until the MA Customer’s discharge. Covered Services for a Customer confined in an inpatient facility on the date of insolvency or other cessation of operations shall continue until the Customer’s continued confinement in an inpatient facility is no longer medically necessary. This provision shall be construed in favor of the MA Customer, shall survive the termination of the Agreement regardless of the reason for termination, including MA OrganizationUnited’s insolvency, and shall supersede any contrary agreement, oral or written, [***] indicates material that has been omitted pursuant to a request for confidential treatment. The omitted material has been filed separately with the Securities and Exchange Commission. written contrary agreement between Subcontractor or Participating Providers Ancillary Provider and an MA a Customer or the representative of an MA a Customer if the contrary agreement is inconsistent with this provision. For the purpose of this provision, an “intermediary” is a person or entity authorized to negotiate and execute the Agreement on behalf of Participating Providers Ancillary Provider or on behalf of a network through which Participating Providers elect Ancillary Provider elects to participate.