Notice to Provider Regarding Enrollee’s Grace Period Status Sample Clauses

Notice to Provider Regarding Enrollee’s Grace Period Status. (a) In the event of nonpayment of premium by an individual Exchange enrollee who is receiving a federal health insurance subsidy, Contractor shall provide written or telephonic notice to its network providers within 15 calendar days of the start of the second month of the grace period of an individual Exchange enrollee who is receiving a federal health insurance subsidy required pursuant 45 C.F.R. § 156.270(d). This notice shall inform the network provider possibility of pended claims enrollee is in the second and third month of the enrollee’s grace period if premium remains unpaid at the exhaustion of the grace period. This notice obligation only attaches to network providers who have submitted claims to the QHP within the previous two months and any provider who is an assigned Primary Care Provider for that enrollee..
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Notice to Provider Regarding Enrollee’s Grace Period Status. (a) In the event of nonpayment of premium by an individual Exchange enrollee who is receiving a federal health insurance subsidy, Contractor shall provide written or telephonic notice to its network providers within 15 calendar days of the start of the second month of the grace period of an individual Exchange enrollee who is receiving a federal health insurance subsidy required pursuant 45 C.F.R. § 156.270(d), of an individual Exchange enrollee who is receiving advance payments of the premium tax credit. This notice shall inform the network provider possibility of pended claimsthat this enrollee’s claims may be pended during the enrollee is in the second and third month of the enrollee’s grace period if premium remains unpaid at the exhaustion of the grace period. This notice obligation only attaches to network providers who have submitted claims to the QHP within the previous two months and any provider who is an assigned Primary Care Provider for that enrollee. This notice obligation does not relieve the QHP issuer from compliance with existing state laws governing claims payment.
Sample 1
Notice to Provider Regarding Enrollee’s Grace Period Status. (a) In the event of nonpayment of premium by an individual Exchange enrollee who is receiving a federal health insurance subsidy that applies to the Stand-Alone Dental Plan, Contractor shall provide written or telephonic notice to its network providers within 15 calendar days of the start of the second month of the grace period of an individual Exchange enrollee who is receiving a federal health insurance subsidy required pursuant to 45 C.F.R. § 156.270(d). This notice shall inform the network provider of the possibility of pended claims when enrollee is in the second and third month of the enrollee’s grace period if premium remains unpaid at the exhaustion of the grace period. This notice obligation only attaches to network providers who have submitted claims to the SADP within the previous two months and any provider who is an assigned dental care provider for that enrollee. This notice obligation does not relieve the SADP issuer from compliance with existing state laws governing claims payment.
Sample 1
Notice to Provider Regarding Enrollee’s Grace Period Status a) In the event of nonpayment of premium by an individual Covered California Enrollee receiving advance payments of the premium tax credit or state advance premium assistance subsidy, or both, Contractor shall provide notice to its network providers in accordance with the applicable state and federal law.
Sample 1
Notice to Provider Regarding Enrollee’s Grace Period Status. (a) In the event of nonpayment of premium by an individual Exchange enrollee who is receiving a federal health insurance subsidy that applies to the Stand-Alone Dental Plan, Contractor shall provide written or telephonic notice to its network providers within 15 calendar days of the start of the second month of the grace period of an individual Exchange enrollee who is receiving a federal health insurance subsidy required pursuant to 45 C.F.R. § 156.270(d). This notice shall inform the network provider of the possibility of pended claims when enrollee is in the second and third month of the enrollee’s grace period if premium remains unpaid at the exhaustion of the grace period. This notice obligation only attaches to network providers who have submitted claims to the SADP within the previous two months and any provider who is an assigned dental care provider for that enrollee.
Sample 1
Notice to Provider Regarding Enrollee’s Grace Period Status. (a) In the event of nonpayment of premium by an individual Exchange enrollee who is receiving a federal health insurance subsidy, Contractor shall provide written or telephonic notice to its network providers within 15 calendar days of the start of the second month of the grace period of an individual Exchange enrollee who is receiving a federal health insurance subsidy required pursuant 45 C.F.R. § 156.270(d). This notice shall inform the network provider possibility of pended claims enrollee is in the second and third month of the enrollee’s grace period if premium remains unpaid at the exhaustion of the grace period. This notice obligation only attaches to network providers who have submitted claims to the QHP within the previous two months and any provider who is an assigned Primary Care Provider for that enrollee. This notice obligation does not relieve the QHP issuer from compliance with existing state laws governing claims payment.
Sample 1
Notice to Provider Regarding Enrollee’s Grace Period Status. (a) In the event of nonpayment of premium by an individual Exchange enrollee who is receiving a federal health insurance subsidy, Contractor shall provide written or telephonic notice to its network providers within 15 calendar days of the start of the second month of the grace period of an individual Exchange enrollee who is receiving a federal health insurance subsidy required pursuant 45 C.F.R. § 156.270(d). This notice shall inform the network provider of the enrollee’s suspension of coverage during the second and third months of the enrollee’s grace period, and shall include any other information required under applicable state and federal law. This notice obligation only attaches to network providers who have submitted claims to the QHP within the previous two months and any provider who is an assigned Primary Care Provider for that enrollee.
Sample 1
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Notice to Provider Regarding Enrollee’s Grace Period Status. Covered California – Final HealthFinal SADP Plan Contract – May 6August 190, 2013 17
Sample 1

Related to Notice to Provider Regarding Enrollee’s Grace Period Status

  • Statement of Grievance The grievance shall contain a statement of:

  • Certification Regarding Debarment, Suspension, and Other Responsibility Matters – Primary Covered Transactions The Firm certifies to the best of its knowledge and belief, that it and its principals:

  • Certification Regarding Business with Certain Countries and Organizations Pursuant to Subchapter F, Chapter 2252, Texas Government Code, PROVIDER certifies it is not engaged in business with Iran, Sudan, or a foreign terrorist organization. PROVIDER acknowledges this Purchase Order may be terminated if this certification is or becomes inaccurate.

  • CERTIFICATION REGARDING BOYCOTTING CERTAIN ENERGY COMPANIES (Texas law as of September 1, 2021) By submitting a proposal to this Solicitation, you certify that you agree, when it is applicable, to the following required by Texas law as of September 1, 2021: If (a) company is not a sole proprietorship; (b) company has ten (10) or more full-time employees; and (c) this contract has a value of $100,000 or more that is to be paid wholly or partly from public funds, the following certification shall apply; otherwise, this certification is not required. Pursuant to Tex. Gov’t Code Ch. 2274 of SB 13 (87th session), the company hereby certifies and verifies that the company, or any wholly owned subsidiary, majority-owned subsidiary, parent company, or affiliate of these entities or business associations, if any, does not boycott energy companies and will not boycott energy companies during the term of the contract. For purposes of this contract, the term “company” shall mean an organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, or limited liability company, that exists to make a profit. The term “boycott energy company” shall mean “without an ordinary business purpose, refusing to deal with, terminating business activities with, or otherwise taking any action intended to penalize, inflict economic harm on, or limit commercial relations with a company because the company (a) engages in the exploration, production, utilization, transportation, sale, or manufacturing of fossil fuel-based energy and does not commit or pledge to meet environmental standards beyond applicable federal and state law, or (b) does business with a company described by paragraph (a).” See Tex. Gov’t Code § 809.001(1).

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