PREMIUM SUBSIDIZATION. The Group may subsidize premium amounts charged to Eligible Enrollees in accordance with CMS requirements. The Group represents and warrants that premium subsidization may vary for different classes of Enrollees provided such classes are reasonable and based on objective business criteria, but cannot be based on eligibility for Medicare Part D Prescription Drug Low Income Subsidy (LIS). The Group agrees that the premium cannot vary for individuals within a given class of Enrollees. The Group also agrees that if it provides Medicare Advantage Prescription Drug coverage, the Group cannot charge an Enrollee more than the sum of the monthly premium attributable to the Medicare Part D Prescription Drug coverage and 100% of the monthly premium attributable to non- Medicare Part D Prescription Drug benefits if applicable. The Group is required to pass through any direct subsidy payments received from CMS to reduce the amount that the Enrollee pays.
PREMIUM SUBSIDIZATION. You may subsidize Premium amounts charged to Eligible Retirees. You are responsible for compliance with all applicable laws and regulations relating to your subsidy of Premiums, including ERISA and CMS Requirements, as applicable. You acknowledge and agree that Premium subsidization may vary for different classes of Eligible Retirees only if such classes are reasonable and based on objective business criteria. You represent and warrant that you will not vary Premium subsidization based on any Covered Person’s eligibility for LIS. Further, you will not vary Premium subsidization for individuals within a given class of Eligible Retirees. In no case will you charge an Eligible Retiree more than the sum of the monthly Premium that we charge you for the Medicare Plan benefits.
