Common use of Payment of Premium Clause in Contracts

Payment of Premium. This Agreement has a regular grace period of thirty (30) days. This means that if a payment is not made on or before the date it is due, it may be paid during the grace period. During the grace period the Agreement will stay in force, unless prior to the date payment was due, the Subscriber gave timely written notice to the HMO that the Agreement is to be cancelled. If the Subscriber does not make payment during the grace period, the Agreement will be cancelled effective on the last day of the grace period and the HMO will have no liability for services which are incurred after the grace period. The HMO has the right to collect all outstanding premiums, including the premium for the grace period, from the Subscriber. If premiums are delinquent for a Member who receives a Subsidy and at least one month’s premium has been paid in full during the calendar year, coverage shall remain in effect during a ninety (90 day) grace period. If premiums have not been paid in full by the end of the grace period, the HMO shall terminate coverage effective as of the last day of the first month of the grace period. Inpatient Provision When this Agreement is terminated, except for termination for incorrect information or material misrepresentation, and a Member is receiving inpatient services billed by a hospital or skilled nursing facility on the date of termination, benefits will continue to be provided only up to the date of discharge or up to the expiration of eligible benefit days, whichever occurs first. This provision does not apply to services rendered by a second facility provider if the Member is transferred from one facility provider to another if the first facility provider is able to treat the Member’s condition at the appropriate level. Totally Disabled If a Member is Totally Disabled at the date of termination of coverage, the Benefits of this Agreement shall be furnished for Benefits directly related to the condition causing such Total Disability and for no other condition, illness, disease or injury. Benefits under this provision for Total Disability shall be provided:

Payment of Premium. This Agreement has a regular grace period of thirty (30) days. This means that if a payment is not made on or before the date it is due, it may be paid during the grace period. During the grace period the Agreement will stay in force, unless prior to the date payment was due, the Subscriber gave timely written notice to the HMO that the Agreement is to be cancelled. If the Subscriber does not make payment during the grace period, the Agreement will be cancelled effective on the last day of the grace period and the HMO will have no liability for services which are incurred after the grace period. The HMO has the right to collect all outstanding premiums, including the premium for the grace period, from the Subscriber. If premiums are delinquent for a Member who receives a Subsidy and at least one month’s premium has been paid in full during the calendar year, coverage shall remain in effect during a ninety (90 day) grace period. If premiums have not been paid in full by the end of the grace period, the HMO shall terminate coverage effective as of the last day of the first month of the grace period. Inpatient Provision When this Agreement is terminated, except for termination for incorrect information or material misrepresentation, and a Member is receiving inpatient services billed by a hospital or skilled nursing facility on the date of termination, benefits will continue to be provided only up to the date of discharge or up to the expiration of eligible benefit days, whichever occurs first. This provision does not apply to services rendered by a second facility provider if the Member is transferred from one facility provider to another if the first facility provider is able to treat the Member’s condition at the appropriate level. Totally Disabled If a Member is Totally Disabled at the date of termination of coverage, the Benefits of this Agreement shall be furnished for Benefits directly related to the condition causing such Total Disability and for no other condition, illness, disease or injury. Benefits under this provision for Total Disability shall be provided: