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. AHCD 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 Marketplace. Based on expressed concern that employers would drop coverage after Marketplaces are introduced, ACHI prepared a policy brief in August, 2011, titled, “Will Employers Drop, Keep, or Add Health Insurance in 2014 xxxx://xxx.xxxx.xxx/HCR%20Docs/110808%20ISSUE%20BRIEF%20EMPLOYER%20RESPONSE.pdf.The brief 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. Since hiring the Plan Management Specialist, AHCD has been actively engaged with CCIIO and CMS to ensure a successful implementation of the SHOP program with the federal government. The individual and SHOP markets will be separate as part of the SPM model. As the result of federal changes, employers in 2014 will choose one plan for their employees as they do now. AHCD has contracted with the University of Arkansas at Little Rock Arkansas Small Business and Technology Development Center (ASBTDC) for outreach to the small business community, with emphasis on SHOP. ASBTDC will work closely with the Small Business Administration regional office and the state and local xxxxxxxx of commerce. PROPOSAL TO MEET PROGRAM REQUIREMENTS Building on the work of the last two-plus years funded by our Planning Grant (awarded September 2010 with Administrative Supplement awarded March 2012), Level One A grant (awarded February 2012), Level One B grant (awarded September 2012), and Level One C grant (awarded April 2013), ACHD is making systematic, steady progress toward implementing the State Partnership Marketplace (SPM) model for Arkansas. Early and on-going research coupled with guidance from CMS and our CCIIO state officer has supported our efforts as well as helped us plan for the future. Arkansas chose the SPM model because it allows local development and oversight of the functions that most directly interact with Arkansans, and the insurance issuers and producers who do business in our state. From the onset of our planning efforts, we devoted much of our energy and resources to interaction with a wide-range of stakeholders and consumer groups. As we ...
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 $18.60 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. 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 2015.
SHOP. Each Employer shall maintain an established shop with the necessary equipment to carry on business and each Employer shall employ not less than two (2) Pipe Fitters for a period of ten (10) months of each calendar year in order to qualify as an operating Employer.
