Common use of SHOP Clause in Contracts

SHOP. The provisions of this Section 3.21(b) shall apply with respect to the SHOP. (i) Contractor shall coordinate and cooperate with Exchange to the extent necessary during the Exchange’s enrollment process that shall commence following the Exchange’s acceptance of the single employer and single employee application forms. Contractor shall provide Services as may be required to support the Exchange during the enrollment process conducted by the Exchange in accordance with the Exchange’s responsibilities under 45 C.F.R. § 155.720 and other applicable laws, rules and regulations. Such Services shall include support of the Exchange’s performance of the following activities that must occur before the effective date of coverage: (i) determination of Employer eligibility, (ii) selection of Contractor’s QHPs coverage levels by Employers and Employees, and (iii) verification of Employee’s eligibility. Upon verification of eligibility and selection of Contractor’s QHP, the Exchange shall (1) process enrollment of Employees into Contractor’s QHPs, (2) establish effective dates of Employee coverage, and (3) transmit enrollment information for Employees to Contractor and Contractor shall notify Employee of the effective date of coverage. (ii) Coverage shall commence on the first (1st) day of a month or such other date as may be established by the Exchange under its enrollment timeline and processes in accordance with the requirements set forth at 45 C.F.R. § 155.720(b)(7). (iii) The specific terms and conditions relating to commencement of coverage, including, cancellation or postponement of the effective date of coverage in the event of nonpayment or partial payment of an initial premium will be determined in accordance with applicable laws, rules and regulations.

SHOP. The provisions of this Section 3.21(b3.2119(b) shall apply with respect to the SHOP. (i) Contractor shall coordinate and cooperate with Exchange to the extent necessary during the Exchange’s enrollment process that shall commence following the Exchange’s acceptance of the single employer and single employee application forms. Contractor shall provide Services as may be required to support the Exchange during the enrollment process conducted by the Exchange in accordance with the Exchange’s responsibilities under 45 C.F.R. § 155.720 and other applicable laws, rules and regulations. Such Services shall include support of the Exchange’s performance of the following activities that must occur before the effective date of coverage: (i) determination of Employer eligibility, (ii) selection of Contractor’s QHPs SADPs coverage levels by Employers and Employees, and (iii) verification of Employee’s eligibility. Upon verification of eligibility and selection of Contractor’s QHPSADP, the Exchange shall (1) process enrollment of Employees into Contractor’s QHPsSADPs, (2) establish effective dates of Employee coverage, and (3) transmit enrollment information for Employees to Contractor and Contractor shall notify Employee of the effective date of coverage. (ii) Coverage shall commence on the first (1st) day of a month or such other date as may be established by the Exchange under its enrollment timeline and processes in accordance with the requirements set forth at 45 C.F.R. § 155.720(b)(7). (iii) The specific terms and conditions relating to commencement of coverage, including, cancellation or postponement of the effective date of coverage in the event of nonpayment or partial payment of an initial premium will be determined in accordance with applicable laws, rules and regulations.

SHOP. The provisions of this Section 3.21(b) shall apply with respect to the SHOP. (i) Contractor shall coordinate and cooperate with Exchange to the extent necessary during the Exchange’s enrollment process that shall commence following the Exchange’s acceptance of the single employer and single employee application forms. Contractor shall provide Services as may be required to support the Exchange during the enrollment process conducted by the Exchange in accordance with the Exchange’s responsibilities under 45 C.F.R. § 155.720 and other applicable laws, rules and regulations. Such Services shall include support of the Exchange’s performance of the following activities that must occur before the effective date of coverage: (i) determination of Employer eligibility, (ii) selection of Contractor’s QHPs SADPs coverage levels by Employers and Employees, and (iii) verification of Employee’s eligibility. Upon verification of eligibility and selection of Contractor’s QHPSADP, the Exchange shall (1) process enrollment of Employees into Contractor’s QHPsSADPs, (2) establish effective dates of Employee coverage, and (3) transmit enrollment information for Employees to Contractor and Contractor shall notify Employee of the effective date of coverage. (ii) Coverage shall commence on the first (1st) day of a month or such other date as may be established by the Exchange under its enrollment timeline and processes in accordance with the requirements set forth at 45 C.F.R. § 155.720(b)(7). (iii) The specific terms and conditions relating to commencement of coverage, including, cancellation or postponement of the effective date of coverage in the event of nonpayment or partial payment of an initial premium will be determined in accordance with applicable laws, rules and regulations.

SHOP. The provisions of this Section 3.21(b3.23(b) shall apply with respect to the SHOP. (i) Contractor shall coordinate and cooperate with Exchange to the extent necessary during the Exchange’s enrollment process that shall commence following the Exchange’s acceptance of the single employer and single employee application forms. Contractor shall provide Services as may be required to support the Exchange during the enrollment process conducted by the Exchange in accordance with the Exchange’s responsibilities under 45 C.F.R. § 155.720 and other applicable laws, rules and regulations. Such Services shall include support of the Exchange’s performance of the following activities that must occur before the effective date of coverage: (i) determination of Employer eligibility, (ii) selection of Contractor’s QHPs coverage levels by Employers and Employees, and (iii) verification of Employee’s eligibility. Upon verification of eligibility and selection of Contractor’s QHP, the Exchange shall (1) process enrollment of Employees into Contractor’s QHPs, (2) establish effective dates of Employee coverage, and (3) transmit enrollment information for Employees to Contractor and Contractor shall notify Employee of the effective date of coverage. (ii) Coverage shall commence on the first (1st) day of a month or such other date as may be established by the Exchange under its enrollment timeline and processes in accordance with the requirements set forth at 45 C.F.R. § 155.720(b)(7). (iii) The specific terms and conditions relating to commencement of coverage, including, cancellation or postponement of the effective date of coverage in the event of nonpayment or partial payment of an initial premium will be determined in accordance with applicable laws, rules and regulations.

SHOP. The provisions of this Section 3.21(b3.19(b) shall apply with respect to the SHOP. (i) Contractor shall coordinate and cooperate with Exchange to the extent necessary during the Exchange’s enrollment process that shall commence following the Exchange’s acceptance of the single employer and single employee application forms. Contractor shall provide Services as may be required to support the Exchange during the enrollment process conducted by the Exchange in accordance with the Exchange’s responsibilities under 45 C.F.R. § 155.720 and other applicable laws, rules and regulations. Such Services shall include support of the Exchange’s performance of the following activities that must occur before the effective date of coverage: (i) determination of Employer eligibility, (ii) selection of Contractor’s QHPs SADPs coverage levels by Employers and Employees, and (iii) verification of Employee’s eligibility. Upon verification of eligibility and selection of Contractor’s QHPSADP, the Exchange shall (1) process enrollment of Employees into Contractor’s QHPsSADPs, (2) establish effective dates of Employee coverage, and (3) transmit enrollment information for Employees to Contractor and Contractor shall notify Employee of the effective date of coverage. (ii) Coverage shall commence on the first (1st) day of a month or such other date as may be established by the Exchange under its enrollment timeline and processes in accordance with the requirements set forth at 45 C.F.R. § 155.720(b)(7). (iii) The specific terms and conditions relating to commencement of coverage, including, cancellation or postponement of the effective date of coverage in the event of nonpayment or partial payment of an initial premium will be determined in accordance with applicable laws, rules and regulations.