Common use of Service Area Eligibility Clause in Contracts

Service Area Eligibility. In order to facilitate the Exchange’s compliance with State and Federal law, Contractor shall monitor information it receives directly, or indirectly or through its subcontractors to assure continued compliance with eligibility requirements related to participation of Qualified Individuals in the Individual Exchange, including requirements related to residency in the Contractor’s service area. Contractor shall notify the Exchange if it becomes aware that an individual Enrollee enrolled in a QHP of Contractor no longer meets the requirements for eligibility, based on place of residence. The Exchange will evaluate, or cause CalHEERS to evaluate, such information to determine Enrollee’s continuing enrollment in the Contractor’s Service Area under the Exchange’s policies which shall be established in accordance with applicable laws, rules and regulations.