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Common use of Premium Rebates Clause in Contracts

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.

Appears in 2 contracts

Samples: Group Insurance Policy, Group Insurance Policy

Premium Rebates. If Insurance Company is required by law to provide a premium rebate to Group’s Members, Members and former Subscribers, Insurance Company, in its sole discretion, will choose one of the following methods of distribution, as allowed by law: a. 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. 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.

Appears in 1 contract

Samples: Group Insurance Policy

Premium Rebates. If Insurance Company is required by law to provide a premium rebate to Group’s Members, Members and former Subscribers, Insurance Company, in its sole discretion, will choose one of the following methods of distribution, as allowed by law: a. i. 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. ii. 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 iii. To the extent applicable, if Group is a non-ERISA and a non-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.

Appears in 1 contract

Samples: Group Insurance Policy