Monthly Premium Payment. On or before the first day of each month for which coverage is sought, Subscribing Group or its designated agent will remit to AvMed, on behalf of each Subscriber and his Covered Dependents, the monthly Premium based on the Rate Letter (as defined in Part XVII. GENERAL PROVISIONS), and the Group Master Application. Only Members for whom the stipulated payment is actually received by AvMed will be entitled to the Health Care Services covered under this Contract and then only for the period for which such payment is applicable.
Monthly Premium Payment. ODM will remit payment to the MCP via an electronic funds transfer (EFT), or at the discretion of ODM, by paper warrant.
a. ODM will confirm all premium payments paid to the MCP during the month via a monthly remittance advice (RA).
b. ODM or its designated entity will provide a record of each recipient detail level payment via HIPAA compliant 820 transactions. ODM or its designee will keep a record of the MCP’s Accounts Payable (i.e. Pay 4 Performance, Primary Care Rate Increase, and Health Insurance Provider Fee) and Accounts Receivable (i.e. Penalty, Credit Balance) transaction on the MITS Provider Portal Report Tab.
Monthly Premium Payment. The amount of your initial monthly Premium is indicated on the front cover of this Contract.
a. Your Premium will automatically change if you change contractual underwriting requirements, such as moving to a different geographic area, or if the number of individuals covered under this Contract changes. We will not change your Premium because of Claims filed or due to a change in your health since becoming a Member. Renewal Premiums may be based on your original Premium, age, area of residence, tobacco use, and the type of health benefit plan you select. Your Premium may increase each year on the Contract renewal date due to the increase in any Member’s age. We will notify you 30 days in advance of any change in your Premium.
b. If we accept the Premium for a Covered Dependent for a period of time beyond the date, age, or event specified for termination of the Covered Dependent’s coverage, that coverage will continue during the Grace Period for which an identifiable Premium was accepted, unless we accepted the Premium because of a misstatement of age, tobacco use or residence.
Monthly Premium Payment. ODM will remit monthly premium payment to the MCOP via an electronic funds transfer (EFT), or at the discretion of ODM, by paper warrant.
a. ODM will confirm all premium payments paid to the MCOP during the month via a monthly remittance advice (RA).
b. ODM or its designated entity will provide a record of each recipient detail level payment via HIPAA compliant 820 transactions. ODM or its designee will keep a record of the MCOP’s Accounts Payable (e.g. Pay 4 Performance, and Health Insurance Provider Fee) and Accounts Receivable (e.g. Penalty, Credit Balance) transaction on the MITS Provider Portal Report Tab.
Monthly Premium Payment. The amount of the Contractholder's initial monthly Premium is indicated on the front cover of this Contract.
a. The Premium will automatically change if the Contractholder changes contractual underwriting requirements, such as moving to a different geographic area, or if the number of individuals covered under this Contract changes. We will not change your Premium because of Claims filed or due to a change in your health since becoming a Member. Renewal Premiums may be based on your original Premium, age, area of residence, tobacco use, and the type of health benefit plan you select. Additionally, the Premium may increase each year on the anniversary date due to the increase in the age of any Member. We will provide 30-day notice of any such change in Premium.
b. If we accept the Premium for a Covered Dependent for a period extending beyond the date, age, or event specified for termination of such Covered Dependent, such coverage will continue during the grace period for which an identifiable Premium was accepted, unless such acceptance resulted from a misstatement of age, tobacco use or residence.
Monthly Premium Payment. ODM will remit payment to the MCP via an electronic funds transfer (EFT), or at the discretion of ODM, by paper warrant.
a. ODM will confirm all premium payments paid to the MCP during the month via a monthly remittance advice (RA). ODM or its designated entity will provide a record of each recipient detail level payment via HIPAA 820 compliant transactions. ODM or its designee will keep a record of the MCP’s Accounts Payable (i.e. Pay 4 Performance, Primary Care Rate Increase, and Health Insurance Provider Fee) and Accounts Receivable (i.e. Penalty, Credit Balance) transaction on the MITS Provider Portal Report Tab.
b. ODM will make available a website which includes current program information.
c. ODM will regularly provide information to the MCP regarding different aspects of the MCP’s performance including, but not limited to, information on MCP-specific and statewide external quality review organization surveys, focused clinical quality of care studies, consumer satisfaction surveys and provider profiles.
Monthly Premium Payment. This Contract is not enforceable until the Contractholder's application for coverage has been received by us, is acceptable to us, and we have received the Contractholder's first Premium payment. All subsequent Premium payments are payable in advance or within the Grace Period. The amount of the Contractholder's initial monthly Premium is indicated on the front cover of this Contract. Failure on our part, for whatever reason, to provide the Contractholder with a notice of payment due does not justify the Contractholder's non-payment of Premiums. It is the Contractholder's responsibility to submit the indicated Premium by the end of the Grace Period or to notify us that a billing was not received.
a. The Premium will automatically change if the Contractholder changes contractual underwriting requirements, such as moving to a different geographic area, or if the number of individuals covered under this Contract changes. We will not change your Premium because of claims filed or due to a change in your health since becoming a Member. Renewal Premiums may be based on your original Premium, age, area of residence, tobacco use, and the type of health benefit plan you select. Additionally, the Premium may increase each year on the anniversary date due to the increase in the age of any Member. We will provide 30-day notice of any such change in Premium.
b. If we accept the Premium for coverage of a Covered Dependent for a period extending beyond the date, age, or event specified for termination of such Covered Dependent, then coverage for such a Covered Dependent shall continue during the Grace Period for which an identifiable Premium was accepted, except if such acceptance resulted from a misstatement of age, tobacco use or residence.
