Notify Covered California of Sample Clauses

Notify Covered California of i. all routine or non-routine surveys and audits conducted by State and Federal Regulators concerning Contractor’s Covered California lines of business; ii. any material concerns identified by Contractor or by State and Federal Regulators that may impact Contractor’s performance under this Agreement; and
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Notify Covered California of i. all routine or non-routine surveys and audits conducted by a State and Federal Regulators concerning Contractor’s Covered California lines of business; ii. any material concerns identified by Contractor or material concerns, including any enforcement actions resulting in monetary penalties equal to or exceeding $10,000, identified by State and Federal Regulators that may impact Contractor’s performance under this Agreement within ten (10) Days following Contractor’s knowledge of such concern; iii. Contractor’s Dental Loss Ratio (DLR), as calculated and submitted to Contractor’s State Regulator annually, and Contractor’s DLR for dental plans offered through Covered California, calculated separately by market and product type. If the difference between Contractor’s DLR as submitted to Contractor’s State Regulator and Contractor’s DLR for dental plans offered through Covered California is equal to or greater than five percent (5%), Contractor’s notice to Covered California shall include a justification for the difference, including supporting documentation as applicable.
Sample 1Sample 2Sample 3See All (4)
Notify Covered California of i. all routine or non-routine surveys and audits conducted by State and Federal Regulators concerning Contractor’s Covered California lines of business; ii. any material concerns identified by Contractor or material concerns, including any enforcement actions resulting in monetary penalties equal to or exceeding $100,000, identified by State and Federal Regulators that may impact Contractor’s performance under this Agreement; iii. In the event Contractor fails to meet Medical Loss Ratio (MLR) minimum standards in the individual or small group market, Contractor shall notify Covered California of such failure on or before the date on which Contractor reports MLR rebate information to the U.S. Department of Health and Human Services pursuant to 45 C.F.R. § 158.260. The notice to Covered California shall include: (1) Contractor’s MLR, (2) the number of subscribers in the individual and small group markets to whom issuer will pay a MLR rebate directly and the number of small group policy holders receiving a MLR rebate on behalf of enrollees, (3) the amount of rebates provided as a premium credit, (4) the amount of rebates provided in lump sum, and (5) the amount of rebates that were de minimis and the number of enrollees and policyholders who did not receive a rebate because it was de minimis; and.
Sample 1Sample 2See All (4)
Notify Covered California of i. all routine or non-routine surveys and audits conducted by State and Federal Regulators concerning Contractor’s Covered California lines of business; ii. any material concerns identified by Contractor or by State and Federal Regulators that may impact Contractor’s performance under this Agreement; and iii. In the event Contractor fails to meet Medical Loss Ratio (MLR) minimum standards in the individual or small group market, Contractor shall notify Covered California of such failure on or before the date on which Contractor reports MLR rebate information to the U.S. Department of Health and Human Services pursuant to 45 C.F.R. § 158.260. The notice to Covered California shall include: (1) Contractor’s MLR, (2) the number of subscribers in the individual and small group markets to whom issuer will pay a MLR rebate directly and the number of small group policy holders receiving a MLR rebate on behalf of enrollees, (3) the amount of rebates provided as a premium credit, (4) the amount of rebates provided in lump sum, and (5) the amount of rebates that were de minimis and the number of enrollees and policyholders who did not receive a rebate because it was de minimis; and
Sample 1
Notify Covered California of i. all routine or non-routine surveys and audits conducted by State and Federal Regulators concerning Contractor’s Covered California lines of business; ii. any material concerns identified by Contractor or material concerns, including any enforcement actions resulting in monetary penalties equal to or exceeding $100,000, identified by State and Federal Regulators that may impact Contractor’s performance under this Agreement; within ten (10) Days following Contractor’s knowledge of such concern; iii. In the event Contractor fails to meet Medical Loss Ratio (MLR) minimum standards in the individual market, Contractor shall notify Covered California of such failure on or before the date on which Contractor reports MLR rebate information to the U.S. Department of Health and Human Services pursuant to 45 C.F.R. § 158.260. The notice to Covered California shall include: (1) Contractor’s MLR, (2) the number of subscribers in the individual market to whom issuer will pay a MLR rebate directly, (3) the amount of rebates provided as a premium credit, (4) the amount of rebates provided in lump sum, and (5) the amount of rebates that were de minimis and the number of enrollees and policyholders who did not receive a rebate because it was de minimis.
Sample 1

Related to Notify Covered California of

  • Waiver of California Civil Code Section 1542 Borrower acknowledges that there is a risk that subsequent to the execution of this Agreement it may incur or suffer losses, damages or injuries which are in some way caused by the transactions referred to in the Loan Documents or this Agreement, but which are unknown and unanticipated at the time this Agreement is executed. Borrower does hereby assume the above mentioned risks and agree that this Agreement shall apply to all unknown or unanticipated results of the transactions and occurrences described herein, as well as those known and anticipated, and upon advice of counsel, Borrower does hereby knowingly waive any and all rights and protections under California Civil Code Section 1542 which section has been duly explained and reads as follows: “A general release does not extend to claims that the creditor or releasing party does not know or suspect to exist in his or her favor at the time of executing the release and that, if known by him or her, would have materially affected his or her settlement with the debtor or released party.”

  • Labor Code Notice 2.6.1 All A-E and subcontractors must comply with the requirements of California Labor Code 1770 et seq. if the work performed is considered a “public works” under California Labor Code 1720 et seq. A-E is encouraged to contact the California Department of Industrial Relations for clarification if the A-E is unsure if some or any of the work performed under this CONTRACT qualifies as “public works”.

  • Permissible Requests by Covered Entity Covered Entity shall not request Business Associate to use or disclose PHI in any manner that would not be permissible under the HIPAA Standards if done by the Covered Entity, except that Business Associate may use and disclose PHI for data aggregation, and management and administrative activities of Business Associate, as permitted under this Section of the Contract.

  • Claims Subject to Elective Arbitration 13.6.2.1 Claims will be subject to elective arbitration pursuant to Section 13.7 below, if, and only if, the claim is not settled through informal Dispute Resolution and both Parties agree to arbitration. If both Parties do not agree to arbitration, then either Party may proceed with any remedy available to it pursuant to law, equity or agency mechanism.

  • California Civil Code Section 1542 Executive acknowledges that he has been advised to consult with legal counsel and is familiar with the provisions of California Civil Code Section 1542, a statute that otherwise prohibits the release of unknown claims, which provides as follows: A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE CREDITOR DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE, WHICH IF KNOWN BY HIM OR HER MUST HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR. Executive, being aware of said code section, agrees to expressly waive any rights he may have thereunder, as well as under any other statute or common law principles of similar effect.

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