Premiums and Grace Sample Clauses

Premiums and Grace. Period This contract is issued in consideration of an accepted application or notification of enrollment through The Exchange and the payment of the required premiums. Premiums are not accepted from third party payers including employers, providers, non-profit or government agencies, except as required by law. Federal Government Assistance with Premiums If the federal government is paying a portion of your premium as an advance payment of the premium tax credit, you have a different grace period to pay your portion of the premiums. If we receive an advance payment of premium tax credit from the government for you, you have up to a three-month grace period to pay all outstanding premiums. • For the first month of the three-month grace period, we will continue to process and pay claims for covered services under this plan. • Beginning on the first day of the second month and through the last day of the third month, we will pend all your claims. If we have not received all outstanding premiums by the last day of the third month, this contract will, without further notice, terminate as of the last day of the first month of the grace period. We will also deny all pended claims for services you received in the second and third months of the grace period. Note that providers can then seek reimbursement directly from you for those services, and they would not be considered covered under this plan. If after termination you wish to re-enroll on an individual plan offered by us or one of our related companies, we reserve the right to require you to pay any unpaid premiums that were due during the 12-month period prior to your re-application for coverage. No Federal Government Assistance with Premiums For members whose premiums are not subsidized by the federal government, you have a 1-month grace period to pay subsequent premiums. If a payment is not received by the end of the grace period, your coverage will terminate as of the last day of the period for which premiums were paid. Claims for services received after the termination date will be denied. Providers can seek reimbursement directly from you for those services. Consistent with state law, we reserve the right to revise premiums annually upon written notice. See Notice. Such notice will be provided to the subscriber. Such changes will become effective on the date stated in the notice, and payment of the revised premiums will constitute acceptance of the change. Premiums will also be revised in the following s...

Premiums and Grace. Period Premiums