Fraud or Abusive Conduct Sample Clauses

Fraud or Abusive Conduct. 1. If Covered California reasonably suspects that an Agency may have engaged in fraud, abusive conduct, or any behavior that may cause imminent or ongoing consumer harm using personally identifiable information of Covered California enrollee or applicant or in connection with an enrollment or application, Covered California may temporarily suspend this Agreement for up to ninety (90) calendar days. Suspension will be effective on the date of the notice that Covered California sends to the Agency advising of the suspension. 2. Agency may submit evidence in a form and manner to be specified by Covered California, to rebut the allegation during this ninety (90)-day period. If the Agency submits such evidence during the suspension period, Covered California will review the evidence and make a determination whether to lift the suspension within thirty (30) calendar days of receipt of such evidence. If the rebuttal evidence does not persuade Covered California to lift the suspension, or if the Agency fails to submit rebuttal evidence during the suspension period, Covered California may terminate this Agreement for cause under Section G of Exhibit C. a. If there is a finding or determination by Covered California or any federal or state entity that an Agency engaged in fraud, abusive conduct, or any behavior which may result in imminent or ongoing consumer harm, using personally identifiable information of enrollees or applicants or in connection with an enrollment or application, Covered California will terminate this Agreement under Section G of Exhibit C. The termination will be effective starting on the date of the notice that Covered California sends to the Agency advising of the termination. b. During the suspension period and following termination of this Agreement, Agency will not be permitted to assist with or facilitate enrollment of Qualified Individuals, Qualified Employers, or Qualified Employees in coverage in a manner that constitutes enrollment through Covered California. Agency must continue to protect any personally identifiable information accessed during the term of this Agreement