Common use of Explanation of Benefits Clause in Contracts

Explanation of Benefits. (EOB) – A statement sent from the Contractor to an Enrollee listing services provided, amount billed, eligible expenses and payment made by the Plan. Explanation of Payment (EOP) – A statement sent from the Contractor to Providers detailing payments made for Covered Services. Formulary – A list of outpatient prescription drugs, selected by the Plan(s) and revised periodically, which are available to Enrollees in a specific QHP. General Agent - A licensed insurance brokerage firm, qualified and operating under the laws of the state of California, with a network of affiliated Agents in the state of California, that is contracted with Covered California. Grace Period – A specified time following the premium due date during which coverage remains in force and an Enrollee or Employer or other authorized person or entity may pay the premium without penalty.