Network Disruptions. If Contractor experiences any network hospital with a pending contract termination, including any hospitals that may experience a break in maintaining a continuous contract, Contractor shall provide prior notice to Covered California as defined in 3.3.
Network Disruptions. If Contractor experiences provider network disruptions or other similar circumstances that make it necessary for Enrollees to change QHPs or Participating Providers, Contractor agrees to provide prior notice to the Exchange and Health Insurance Regulator, in accordance with advance notice, meeting, and other requirements set forth in applicable laws, rules and regulations, including Insurance Code § 10199.1 and Health and Safety Code § 1367.23 and § 1366.1.
Network Disruptions. If Contractor experiences provider network disruptions or other similar circumstances that make it necessary for Enrollees to change QHPs or Participating Providers, Contractor agrees to provide prior notice to Covered California and State Regulators, in accordance with advance notice, meeting, and other requirements set forth in applicable laws, rules and regulations, including Insurance Code § 10199.1 and Health and Safety Code § 1367.23 and 1366.1.
Network Disruptions. If Contractor experiences provider network disruptions or similar circumstances that make it necessary for the higher of either 100 Enrollees or 10% of Enrollees residing within any county of an affected region to change Participating Providers, as detailed in the QDP Network Disruption Reporting Template, Contractor agrees to provide prior notice to Covered California as defined in 4.3.3 (b) i., in accordance with advance notice, meeting, and other requirements set forth in applicable laws, rules, and regulations, including Insurance Code § 10199.1 and Health and Safety Code §§ 1367.23 and 1366.1.
i. Contractor shall notify Covered California with respect to changes in its provider network as follows:
1. Contractor shall notify Covered California of any pending change in the composition of its provider network, as defined in 4.3.3 (b), within any of the regions it covers, or its participating provider contracts, of and throughout the term of this Agreement at least sixty (60) Days prior to any change or immediately upon Contractor’s knowledge of the change if knowledge is acquired less than sixty (60) Days prior to the change, and cooperate with Covered California in planning for the orderly transfer of plan members; and
2. Contractor shall ensure that Covered California Enrollees have access to care when there are changes in the provider network, including mid-year contract terminations between Contractor and Participating Providers. Contractor shall ensure that Covered California Enrollees have access to care when there are changes in the provider network, including mid-year contract terminations between Contractor and Participating Providers.
Network Disruptions. If Contractor experiences provider network disruptions or similar circumstances that make it necessary for 10% of Enrollees residing within any county of an affected region to change Participating Providers, as detailed in the QDP Network Disruption Reporting Template, Contractor agrees to provide prior notice to Covered California as defined in 4.3.3 (b) i., in accordance with advance notice, meeting, and other requirements set forth in applicable laws, rules, and regulations, including Insurance
i. Contractor shall notify Covered California with respect to changes in its provider network as follows:
1. Contractor shall notify Covered California of any pending change in the composition of its provider network, as defined in 4.3.3 (b), within any of the regions it covers, or its participating provider contracts, of and throughout the term of this Agreement at least sixty (60) Days prior to any change or immediately upon Contractor’s knowledge of the change if knowledge is acquired less than sixty (60) Days prior to the change, and cooperate with Covered California in planning for the orderly transfer of plan members; and
2. Contractor shall ensure that Covered California Enrollees have access to care when there are changes in the provider network, including mid-year contract terminations between Contractor and Participating Providers. Contractor shall ensure that Covered California Enrollees have access to care when there are changes in the provider network, including mid-year contract terminations between Contractor and Participating Providers.
Network Disruptions. If Contractor experiences any network hospital with a pending contract termination, including any hospitals that may experience a break in maintaining a continuous contract, Contractor shall provide prior notice to Covered California and State Regulators as defined in 3.3.3c)
i. If Contractor experiences any other provider network disruptions or other similar circumstances that make it necessary for 10% of Enrollees residing within any county of an affected region to change Participating Providers or QHPs, Contractor agrees to provide prior notice to Covered California and State Regulators as defined 3.3.3c)i., in accordance with advance notice, meeting, and other requirements set forth in applicable laws, rules, and regulations, including Insurance Code § 10199.1 and Health and Safety Code §§ 1367.23 and 1366.
i. Contractor shall notify Covered California with respect to changes in its provider network as follows:
1. Contractor shall notify Covered California of any pending change in the composition of its provider network, as defined in 3.3.3c), within any of the regions it covers, or its participating provider contracts, of and throughout the term of this Agreement at least 60 days prior to any change or immediately upon Contractor’s knowledge of the change if knowledge is acquired less than 60 days prior to the change, and cooperate with Covered California in planning for the orderly transfer of plan members; and
2. Contractor shall ensure that Covered California Enrollees have access to care when there are changes in the provider network, including mid-year contract terminations between Contractor and Participating Providers.
