Common use of Premium Processing Clause in Contracts

Premium Processing. Except as otherwise set forth herein, the State shall have no payment obligations to the Contractor, and the Contractor shall have no recourse to the State, for Premium payments. The State shall be responsible for the aggregation and administration of Premiums for Qualified Employers and Qualified Individuals purchasing insurance through VHC. The State shall be responsible for: (1) the submission of bills to each Employer on a monthly basis in a form that identifies Employer and Employee contributions and the total amount due; (2) collecting the amounts due from each Employer; (3) determining that portion of collected premiums which is payable to Contractor; and (4) making payments to Contractor for Enrollees in Contractor’s Certified QHPs within timeframes identified in the Payment ICD and Companion Guide attached to the Trading Partner Agreement between the parties; and (5) promptly processing non-payment termination transactions transmitted to the State by Contractor. In no event shall the State be liable to Contractor with respect to any interest or other charges relating to Premium payments received by the State that are not yet disbursed by the State to the Contractor; provided, however, the State shall be liable to the extent of its own negligent acts or omissions or intentional misconduct which results in the failure to distribute Premium payments to Contractor which are owing for coverage provided pursuant to the QHPs attached hereto in Exhibit 1. In no event shall Contractor be liable for the negligent acts or omissions or intentional misconduct of the State, including billing errors attributable to the State and, to the extent Contractor has provided coverage for Premiums received, Contractor shall not be required to rescind such coverage.

Premium Processing. Except as otherwise set forth herein, the State shall have no payment obligations to the Contractor, and the Contractor shall have no recourse to the State, for Premium payments. The State shall be responsible for the aggregation and administration of Premiums for Qualified Employers and Qualified Individuals purchasing insurance through VHC. The State shall be responsible for: (1) the submission of bills to each Employer on a monthly basis in a form that identifies Employer and Employee contributions and the total amount due; (2) collecting the amounts due from each Employer; (3) determining that portion of collected premiums which is payable to Contractor; and (4) making payments to Contractor for Enrollees in Contractor’s Certified QHPs within timeframes identified in the Payment ICD and Companion Guide attached to the Trading Partner Agreement between the parties; and (5) promptly processing non-payment termination transactions transmitted to the State by Contractor. In no event shall the State be liable to Contractor with respect to any interest or other charges relating to Premium payments received by the State that are not yet disbursed by the State to the Contractor; provided, however, the State shall be liable to the extent of its own negligent acts or omissions or intentional misconduct which results in the failure to distribute Premium payments to Contractor which are owing for coverage provided pursuant to the QHPs attached hereto in Exhibit 1is certification letter. In no event shall Contractor be liable for the negligent acts or omissions or intentional misconduct of the State, including billing errors attributable to the State and, to the extent Contractor has provided coverage for Premiums received, Contractor shall not be required to rescind such coverage.