Premium Rebates. If Insurance Company is required by law to provide a premium rebate to Group’s Members and former Subscribers, Insurance Company will choose one of the following methods of distribution, as allowed by law:
a. Insurance Company will distribute the required rebate to Group and Group will distribute the rebate to its Members and former Subscribers any in such a manner as to comply with applicable laws.
b. Group will provide Insurance Company with any information that is necessary for Insurance Company to pay the rebates to Members and former Subscribers in accordancewith applicable law, including, but not limited to information relating to premium contribution amounts and contact information. If Group fails to provide Insurance Company with premium contribution information that is necessary to calculate a rebate to Members and former Subscribers on a pro rata basis based on the percentage of premium paid, Insurance Company will distribute 100% of the rebate for Group’s coverage to Members and former Subscribers, without regard to the pro-rata share of the premium contribution made by Group and Group waives any claim it has to a share of the rebate.
Premium Rebates. If state or federal law requires the Health Plan to rebate Premium from this or any earlier contract year and the Health Plan rebates Premium to the Group, those responsible to represent that the Group will use that rebate for the benefit of Members, in a manner consistent with the requirements of the Public Health Service Act, the Affordable Care Act, and the obligations of a fiduciary under the Employee Retirement Income Security Act (ERISA).
Premium Rebates. If state or federal law requires SHP to rebate premiums from this or any earlier contract year and SHP rebates premiums to Group, Group represents that Group will use that rebate for the benefit of Members, in a manner consistent with the requirements of the Public Health Service Act, the Affordable Care Act, and the obligations of a fiduciary under ERISA.
Premium Rebates. If Insurance Company is required by law to provide a premium rebate to Group’s Members, and former Subscribers, Insurance Company, in its sole discretion, will choose one of the following methods of distribution, as allowed by law:
a. Insurance Company will distribute the required rebate to Group and Group will distribute the rebate to its Members and former Subscribers and in such a manner as to comply with applicable laws.
b. Group will provide Insurance Company with any information that is necessary for Insurance Company to pay the rebates to Members and former Subscribers in accordance with applicable law, including, but not limited to information relating to premium contribution amounts and contact information. If Group fails to provide Insurance Company with premium contribution information that is necessary to calculate a rebate to Members and former Subscribers on a pro rata basis based on the percentage of premium paid, Insurance Company will distribute 100% of the rebate for Group’s coverage to Members and former Subscribers, without regard to the pro-rata share of the premium contribution made by Group and Group waives any claim it has to a share of the rebate. To the extent applicable, if Group is a non-ERISA and a non-governmental plan, Group shall distribute the employee contribution portion of any MLR rebate to employees in a method consistent with applicable laws and Federal regulations or guidance. If Group decides to use or distribute the rebate in a different manner than the one agreed to above, Group shall notify Insurance Company of such decision, in writing, and any MLR rebate due to the Group will be paid directly to Subscribers instead, as required by PPACA and other applicable laws.
Premium Rebates. This Section applies if CareFirst BlueChoice is required under federal or state law or regulation to rebate any portion of a Premium paid under the [In-Network] Group Contract by the Group or any Subscribers (a “Rebate”).
Premium Rebates. If Insurance Company is required by law to provide a premium rebate to Group’s Members and former Subscribers, Insurance Company, in its sole discretion, will as allowed by law:
a. Group will provide Insurance Company with any information that is necessary for Insurance Company to pay the rebates to Members in accordance with applicable law, including, but not limited to information relating to premium contribution amounts and contact information.
b. If Group fails to provide Insurance Company with premium contribution information that is necessary to calculate a rebate to Members on a pro rata basis based on the percentage of premium paid, Insurance Company will distribute 100% of the rebate for Group’s coverage to Members, without regard to the pro-rata share of the premium contribution made by Group and Group waives any claim it has to a share of the rebate.
Premium Rebates. In the event federal or state law requires Wellmark to pay Account or Plan Members a rebate for a portion of the annual premium payment, Wellmark will pay the Account the total rebate amount applicable to Account. In accordance with applicable law, the Account shall use the portion of the rebates attributable to the amount of premiums paid by Plan Members, if any, for the exclusive benefit of Plan Members so that the Plan Members receive the benefit of the rebates. The Plan Member portion of the rebates may be used to reduce the Plan Members' portion of the premiums in subsequent years or provided as a cash refund or, if the Plan is subject to ERISA, for other permissible Plan purposes. Account shall develop and retain records and documentation evidencing its use of the rebates and shall provide such records to Wellmark upon request. If the Plan is neither a governmental plan nor a plan subject to ERISA, the Account agrees that it has provided or will provide Wellmark with written assurance that any rebates received by Account will be used to benefit current Plan Members.
Premium Rebates. The employee’s portion of the reduced premiums resulting from registration of the Sickness and Accident Benefit Plans under the Employment Insurance Act will continue to be directed toward employee benefit plans.
Premium Rebates. Premium Rebates are contingent upon: County's adoption, without deviation, of Contractor’s Formulary and Formulary exclusions, as well as any changes Contractor makes to its Formulary and Formulary exclusions; and the implementation of the step therapies required by Contractor, as well as any changes Contractor makes to its Formulary and formulary exclusions; and the implementation of the step therapies required by Contractor, as well as any changes Contractor makes to its utilization management programs.
Premium Rebates. If Insurance Company is required by law to provide a premium rebate to Group’s Members and former Subscribers, Insurance Company will choose one of the following methods of distribution, as allowed by law:
a) Insurance Company will distribute the required rebate to Group and Group will distribute the rebate to its Members and former Subscribers any in such a manner as to comply with applicable laws.
b) Group will provide Insurance Company with any information that is necessary for Insurance Company to pay the rebates to Members andformer Subscribers in accordance with applicable law, including, but not limited to information relating to premium contribution amounts and contact information. If Group fails to provide Insurance Company with premium contribution information that is necessary to calculate a rebate to Members and former Subscribers on a pro rata basis based on the percentage of premium paid, Insurance Company will distribute 100% of the rebate for Group’s coverage to Members and former Subscribers, without regard to the pro-rata share of the premium contribution made by Group and Group waives any claim it has to a share of the rebate. To the extent applicable, if Group is a non-ERISA and a non-governmental benefit Insurance Company, Group shall distribute the employee contribution portion of any MLR rebate to employees in a method consistent with applicable laws and Federal regulations or guidance. If Group decides to use or distribute the rebate in a different manner than the one agreed to above, Group shall notify Insurance Company of such decision, in writing, and any MLR rebate due Group will be paid directly to Subscribers instead, as required by PPACA and other applicable laws.
