Common use of Duties of the Exchange Clause in Contracts

Duties of the Exchange. The Exchange is approved by the United States Department of Health Services (“DHHS”) pursuant to 45 C.F.R. § 155.105 and shall perform its duties in accordance with the terms and conditions required of this Agreement pursuant to applicable laws, rules and regulations, including the California Affordable Care Act and the Federal Affordable Care Act. The duties of the Exchange shall include: (a) Certification of QDP Issuers (45 C.F.R. Part 155, Subpart K and 45 C.F.R. 155.1065); (b) Consultation with stakeholders (45 C.F.R. § 155.130); (c) Consumer assistance tools and programs, including but not limited to operation of a toll- free call center and Internet website (45 C.F.R. § 155.205 and 45 U.S.C. § 18031(d)); (d) Eligibility and enrollment in the Individual Exchange and Covered California for Small Business (45 C.F.R. Part 155, Subparts D, E, H, I); (e) Financial support for continued operations of the Exchange (45 C.F.R. § 155.160); (f) Navigator program standards designed to raise awareness of the Exchange by, among other items, providing consumer access to education and other resources regarding eligibility, enrollment, and program specifications (45 C.F.R. § 155.210); (g) Non-interference with Federal law and nondiscrimination standards (45 C.F.R. § 155.120); (h) Notices to Enrollees (45 C.F.R. § 155.230); (i) Oversight, financial and quality activities (45 C.F.R. § 155.200); (j) Participation of agents to enroll Qualified Individuals or employers in QDPs (45 C.F.R. § 155.220); (k) Allowance for the payment of premiums (45 C.F.R. § 155.240); (l) Xxxxxxx and security of personally identifiable information (45 C.F.R. § 155.260); (m) Use of standards and protocols for electronic transactions (45 C.F.R. § 155.270); (n) The Exchange also has a duty, as part of its management of CalHEERS, to determine how information about the cost, quality and provider availability is presented to consumers to inform their selection of a Family Dental Plan and benefit design in the Exchange. The Exchange shall solicit comment from Contractor on the designs, but shall make design and presentation decisions at its sole discretion; and (o) The Exchange agrees to provide a dedicated team member responsible for working with Contractor to resolve any and all issues that arise from implementation of the Exchange.

Appears in 2 contracts

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

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Duties of the Exchange. The Exchange is approved by the United States Department of Health and Human Services (“DHHS”) pursuant to 45 C.F.R. § 155.105 and shall perform its duties in accordance with the terms and conditions required of this Agreement pursuant to applicable laws, rules and regulations, including the California Affordable Care Act and the Federal Affordable Care Act. The duties of the Exchange shall include: (a) Certification of QDP Issuers (45 C.F.R. Part 155, Subpart K and 45 C.F.R. § 155.1065); (b) Consultation with stakeholders (45 C.F.R. § 155.130); (c) Consumer assistance tools and programs, including but not limited to operation of a toll- free call center and Internet website (45 C.F.R. § 155.205 and 45 U.S.C. § 18031(d)); (d) Eligibility and enrollment in the Individual Exchange and Covered California for Small Business (45 C.F.R. Part 155, Subparts D, E, H, I); (e) Financial support for continued operations of the Exchange (45 C.F.R. § 155.160); (f) Navigator program standards designed to raise awareness of the Exchange by, among other items, providing consumer access to education and other resources regarding eligibility, enrollment, and program specifications (45 C.F.R. § 155.210); (g) Non-interference with Federal law and nondiscrimination standards (45 C.F.R. § 155.120); (h) Notices to Enrollees (45 C.F.R. § 155.230); (i) Oversight, financial financial, and quality activities (45 C.F.R. § 155.200); (j) Participation of agents to enroll Qualified Individuals or employers Employers in QDPs (45 C.F.R. § 155.220); (k) Allowance for the payment of premiums (45 C.F.R. § 155.240); (l) Xxxxxxx and security of personally identifiable information (45 C.F.R. § 155.260); (m) Use of standards and protocols for electronic transactions (45 C.F.R. § 155.270); (n) The Exchange also has a duty, as part of its management of CalHEERS, to determine how information about the cost, quality and provider availability is presented to consumers to inform their selection of a Family Dental Plan and benefit design in the Exchange. The Exchange shall solicit comment from Contractor on the designs, but shall make design and presentation decisions at its sole discretion; and (o) The Exchange agrees to provide a dedicated team member responsible for working with Contractor to resolve any and all issues that arise from implementation of the Exchange.

Appears in 2 contracts

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

Duties of the Exchange. The Exchange is approved by the United States Department of Health Services (“DHHS”) pursuant to 45 C.F.R. § 155.105 and shall perform its duties in accordance with the terms and conditions required of this Agreement pursuant to applicable laws, rules and regulations, including including, the California Affordable Care Act and the Federal Affordable Care Act. The duties of the Exchange shall include: (a) Certification of QDP Issuers (45 C.F.R. Part 155, Subpart K and 45 C.F.R. CFR 155.1065); (b) Consultation with stakeholders (45 C.F.R. § 155.130); (c) Consumer assistance tools and programs, including including, but not limited to operation of a toll- free call center and Internet website (45 C.F.R. § 155.205 and 45 U.S.C. § 18031(d)); (d) Eligibility and enrollment enrollment, as well as exemption determinations in the Individual Exchange and Covered California for Small Business (45 C.F.R. Part 155, Subparts D, E, H, I); (e) Financial support for continued operations of the Exchange (45 C.F.R. § 155.160); (f) Navigator program standards designed to raise awareness of the Exchange by, among other items, providing consumer access to education and other resources regarding eligibility, enrollment, and program specifications (45 C.F.R. § 155.210); (g) Non-interference with Federal law and nondiscrimination standards (45 C.F.R. § 155.120); (h) Notices to Enrollees (45 C.F.R. § 155.230); (i) Oversight, financial and quality activities (45 C.F.R. § 155.200); (j) Participation of agents brokers to enroll Qualified Individuals qualified individuals or employers in QDPs (45 C.F.R. § 155.220); (k) Allowance for the payment Payment of premiums (45 C.F.R. § 155.240); (l) Xxxxxxx and security of personally identifiable information (45 C.F.R. § 155.260); (m) Use of standards and protocols for electronic transactions (45 C.F.R. § 155.270); (n) The Exchange also has a duty, as part of its management of CalHEERS, to determine how information about the cost, quality and provider availability is presented to consumers to inform their selection of a Family Dental Plan and benefit design in the Exchange. The Exchange shall solicit comment from Contractor on the designs, but shall make design and presentation decisions at its sole discretion; and (o) The Exchange agrees to provide a dedicated team member responsible for working with Contractor to resolve any and all issues that arise from implementation of the Exchange.

Appears in 1 contract

Samples: Qualified Dental Plan Issuer Contract

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Duties of the Exchange. The Exchange is approved by the United States Department of Health Services (“DHHS”) pursuant to 45 C.F.R. § 155.105 and shall perform its duties in accordance with the terms and conditions required of this Agreement pursuant to applicable laws, rules and regulations, including,including the California Affordable Care Act and the Federal Affordable Care Act. The duties of the Exchange shall include: (a) : Certification of QDP Issuers (45 C.F.R. Part 155, Subpart K and 45 C.F.R. CFR 155.1065); (b) ; Consultation with stakeholders (45 C.F.R. § 155.130); (c) ; Consumer assistance tools and programs, including,including but not limited to operation of a toll- toll-free call center and Internet website (45 C.F.R. § 155.205 and 45 U.S.C. § 18031(d)); (d) ; Eligibility and enrollment enrollment, as well as exemption determinations in the Individual Exchange and Covered California for Small Business (45 C.F.R. Part 155, Subparts D, E, H, I); (e) ; Financial support for continued operations of the Exchange (45 C.F.R. § 155.160); (f) ; Navigator program standards designed to raise awareness of the Exchange by, among other items, providing consumer access to education and other resources regarding eligibility, enrollment, and program specifications (45 C.F.R. § 155.210); (g) ; Non-interference with Federal law and nondiscrimination standards (45 C.F.R. § 155.120); (h) ; Notices to Enrollees (45 C.F.R. § 155.230); (i) ; Oversight, financial and quality activities (45 C.F.R. § 155.200); (j) ; Participation of agents brokers to enroll Qualified Individuals qQualified iIndividuals or employers in QDPs (45 C.F.R. § 155.220); (k) Allowance for the payment ; Payment of premiums (45 C.F.R. § 155.240); (l) ; Xxxxxxx and security of personally identifiable information (45 C.F.R. § 155.260); (m) ; Use of standards and protocols for electronic transactions (45 C.F.R. § 155.270); (n) ; The Exchange also has a duty, as part of its management of CalHEERS, to determine how information about the cost, quality and provider availability is presented to consumers to inform their selection of a Family Dental Plan and benefit design in the Exchange. The Exchange shall solicit comment from Contractor on the designs, but shall make design and presentation decisions at its sole discretion; and (o) and The Exchange agrees to provide a dedicated team member responsible for working with Contractor to resolve any and all issues that arise from implementation of the Exchange.

Appears in 1 contract

Samples: Qualified Dental Plan Issuer Contract

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