SHOP. In the event that Contractor continues to offer small group coverage in the State following the Notice of Non-Recertification Election, Contractor shall comply with applicable laws, rules and regulations relating to the discontinuation of a benefit package, including those set forth at Section 1365 of the Health and Safety Code and Section 10713 of the Insurance Code. The termination of the Agreement shall occur upon the termination of coverage which shall be determined as follows:
SHOP. With respect to SHOP, Contractor acknowledges that (i) the Exchange is responsible for collecting premiums from Employers and Employees, and (ii) the Exchange will remit applicable Employer and Employee premiums collected by the Exchange to Contractor, net of (1) Participation Fees computed in accordance with the Participation Methodology - SHOP, and (2) agent commissions determined in accordance with the terms set forth at Section 3.29. The Exchange shall transfer funds to Contractor on a monthly basis or such other intervals as mutually agreed upon by the Exchange and Contractor and shall establish a process to resolve any disagreements on premium amounts due in a timely manner and prior to transfer of funds to Contractor as required under this Section.
SHOP. (i) SHOP will be responsible for collection of premiums, including delinquent payments. Premium charged in SHOP includes the assessment of the participation fee, agent and general agent commissions (see Section 5.03 Participation Fee).
SHOP. The Participation Fee payable to the Exchange during each month of this Agreement shall be equal to a per member per month (“PMPM”) rate of $18.90 multiplied by the number of Enrollees in Contractor’s QHPs for such month plus additional fees as necessary to pay agent commissions. This Participation fee is based on the Exchange’s estimates of the revenue required to support the transition of the Exchange to being self-sufficient beginning in 2015. This Participation fee is based on a rate equivalent to approximately four percent (4%) of the estimated aggregate premiums relating to all QHP products and policies sold through SHOP. The Participation Fee will be assessed by the Exchange and payable monthly by Contractor based on enrollment in Contractor's QHPs sold through the SHOP Exchange in 2014.
SHOP. HBEPD has facilitated numerous stakeholder forums and targeted workgroups aimed at fostering discussion and gathering information from the individuals and groups who will be most impacted by the development of the Exchange. Based on expressed concern that employers would drop coverage after Exchanges are introduced, our Exchange Planning Policy Consultant from the Arkansas Center for Health Improvement (ACHI) prepared a policy brief in August, 2011, titled, “Will Employers Drop, Keep, or Add Health Insurance in 2014?” (Link to full article: xxxx://xxx.xxxx.xxx/HCR%20Docs/110808%20ISSUE%20BRIEF%20EMPLOYER%20RESPONSE.pdf). It reviewed factors that suggest employers will drop, keep, or add coverage and reviewed five national studies (Mercer, McKinsey, Congressional Budget Office, RAND, and Urban Institute). The report concluded that the overall availability of employer-sponsored insurance is not likely to change much after 2014. Our Exchange Planning Steering Committee recommended a targeted outreach education effort in the fall of 2011 to small businesses. This was needed to counteract negative messages aimed at business owners. The HBEPD entered into a contract with ACHI/UAMS to design an education program targeting small business owners. The design work is complete and catchy, positive radio and print media ads were to be launched in October 2011 using Exchange Planning funds. However, the ads were delayed due to Legislative objection. We are now planning to run the ads in the fall of 2012 using already awarded Level One funds. Since hiring the Plan Management Specialist, HBEPD has been actively engaged with CCIIO and CMS to ensure a successful implementation of the SHOP program with the federal government. Currently, Arkansas is waiting for additional regulations and answers to questions from CCIIO related to what roles and responsibilities Partnership states will assume within the SHOP program. It is our understanding that the individual and SHOP markets will be separate as part of the FFE Partnership Model. We await guidance on Agent/Broker training and FFE “certification” requirements for the SHOP. PROPOSAL TO MEET PROGRAM REQUIREMENTS Building on the work of the last almost two years and using funds provided by our Planning Grant (awarded 9/30/10 with Administrative Supplement awarded 3/8/12) and Level One Grant (awarded 2/22/12), the HBEPD is making steady progress toward implementing the FFE-Partnership model for Arkansas. Some activities (primarily...
SHOP. The Small Business Health Options Program described in Government Code 100502(m).
SHOP. All those employees who are presently members of the Union or who are eligible for membership in the Union shall, as a condition of continued employment, maintain such membership or become a member of the Union immediately upon the signing of this agreement. All employees hired on or after the date of signing this agreement shall, as a condition of employment, become members of the Union and maintain such membership.
SHOP. The Participation Fee payable to the Exchange during each month of this Agreement shall be equal to a per member per month (“PMPM”) rate of $.83 multiplied by the number of Enrollees in Contractor’s QDPs for such month plus additional fees as necessary to pay agent commissions. This Participation fee is based on the Exchange’s estimates of the revenue required to support the transition of the Exchange to being self-sufficient beginning in 2015. The Participation Fee will be assessed by the Exchange and payable monthly by Contractor based on enrollment in Contractor's QDPs sold through the SHOP Exchange in 2015.
SHOP. The shop shown in the schedule (including private dwelling rooms and its outbuildings on the same premises), the structure of the shop (including private dwelling rooms and its outbuildings on the same premises) being brick, stone, or concrete built, and roofed with slate, tile, concrete, metal, asbestos or any other non combustible material (unless otherwise agreed with us and noted in the statement of facts). Territorial limits In respect of Sections one to seven and nine:
