TERMINATION/CANCELLATION, REINSTATEMENT, AND SUSPENSION OF THE AGREEMENT. No Subscriber shall be terminated individually by Blue Shield for any cause other than as provided in this section I.B. This Agreement may be rescinded or terminated, as follows: 1. Termination by the Subscriber A Subscriber desiring to terminate this Agree- ment shall give Blue Shield 30-days notice. 2. Rescission by Blue Shield By signing the enrollment application, you rep- resented that all responses contained in your application for coverage were true, complete and accurate, to the best of your knowledge, and you were advised regarding the conse- quences of intentionally submitting materially false or incomplete information to Blue Shield in your application for coverage, which in- cluded rescission of this Agreement. For underwritten plans (not guaranteed ac- ceptance) - To determine whether or not you would be offered enrollment through this Agreement, Blue Shield reviewed your medi- cal history based upon the information you pro- vided in your enrollment application, including the health history portion of your enrollment application and any supplemental information that Blue Shield determined was necessary to evaluate your medical history and status. This process is called underwriting. Blue Shield has the right to rescind this Agree- ment if the information contained in the appli- cation or otherwise provided to Blue Shield by you or anyone acting on your behalf in connec- tion with the application was intentionally and materially inaccurate or incomplete. This Agreement also may be rescinded if you or an- yone acting on your behalf failed to disclose to Blue Shield any new or changed facts arising after the application was submitted but before this Agreement was issued, when those facts pertained to matters inquired about in the ap- plication. However, after 24 months following the issuance of the Agreement, Blue Shield of California will not rescind the Agreement for any reason. If after enrollment, Blue Shield investigates your application information, we will not re- scind this Agreement without first notifying you of the investigation and offering you an op- portunity to respond. If this Agreement is rescinded, it means that the Agreement is voided retroactive to its inception as if it never existed. This means that you will lose coverage back to the original Effective Date. If the Agreement is properly rescinded, Blue Shield will refund any dues payments you made, but, to the extent permitted by applicable law, may reduce that refund by the amount of any medical expenses that Blue Shield paid un- der the Agreement or is otherwise obligated to pay. In addition, Blue Shield may, to the extent permitted by California law, be entitled to re- coup from you all amounts paid by Blue Shield under the Agreement. If this Agreement is rescinded, Blue Shield will provide a 30 day advance written notice that will: (a) explain the basis of the decision and your appeal rights, including your right to re- quest assistance from the California Depart- ment of Managed Health Care; (b) clarify that, in the case of a qualifying applicant utilizing the Household Savings Program whose appli- cation information was not false or incomplete is entitled to new coverage without medical un- derwriting and will explain how that individual may obtain this coverage; and (c) explain that the monthly Dues for that individual will be de- termined based on that individual’s age. 3. Termination by Blue Shield if Subscriber is No Longer Enrolled in Medicare This Agreement shall terminate on the date the Subscriber is no longer enrolled under Parts A and B or Medicare. Blue Shield shall refund the prepaid dues, if any, that Blue Shield deter- mines will not have been earned as of the ter- mination date. Blue Shield reserves the right to subtract from any such dues refund any amounts paid by Blue Shield for benefits paid or payable by Blue Shield prior to the termina- tion date. 4. Cancellation of the Agreement for Nonpay- ment of Dues Blue Shield may cancel this Agreement for failure to pay the required Dues. If the Agree- ment is being cancelled because you failed to pay the required Dues when owed, the Plan will send a Notice of Start of Grace Period and will terminate the day following the 30-day grace period. You will be liable for all Dues accrued while this Agreement continues in force in- cluding those accrued during this 30 day grace period. Within five (5) business days of canceling or not renewing the Agreement, Blue Shield will mail you a Notice of End of Coverage, which will inform you of the following: a. That the Agreement has been cancelled, and the reasons for cancellation; b. The specific date and time when coverage for you ended. 5. Reinstatement of the Agreement after Cancel- lation If the Agreement is cancelled for nonpayment of dues, Blue Shield will permit reinstatement of the Agreement or coverage twice during any twelve-month period, without a change in dues and without consideration of your medical con- dition, if the amounts owed are paid within 15 days of the date the Notice of End of Coverage is mailed to you. If your request for reinstate- ment and payment of all outstanding amounts is not received within the required 15 days, or if the Agreement is cancelled for nonpayment of dues more than twice during the preceding twelve-month period, then Blue Shield is not required to reinstate your coverage, and you will need to reapply for coverage.
Appears in 6 contracts
Samples: Evidence of Coverage and Health Service Agreement, Evidence of Coverage and Health Service Agreement, Medicare Supplement Plan G
TERMINATION/CANCELLATION, REINSTATEMENT, AND SUSPENSION OF THE AGREEMENT. No Subscriber shall be terminated individually by Blue Shield for any cause other than as provided in this section I.B. This Agreement may be rescinded or terminated, as follows:
1. Termination by the Subscriber A Subscriber desiring to terminate this Agree- ment Agreement shall give Blue Shield 30-days noticeno- xxxx.
2. Rescission by Blue Shield By signing the enrollment application, you rep- resented represented that all responses contained in your application for coverage were true, complete com- plete and accurate, to the best of your knowledge, and you were advised regarding the conse- quences consequences of intentionally submitting materially false or incomplete information to Blue Shield in your application for coverage, which in- cluded included rescission of this Agreement. For underwritten plans (not guaranteed ac- ceptance) - To determine whether or not you would be offered enrollment through this Agreement, Blue Shield reviewed your medi- cal history based upon the information you pro- vided provided in your enrollment application, including in- cluding the health history portion of your enrollment en- rollment application and any supplemental information in- formation that Blue Shield determined was necessary to evaluate your medical history and status. This process is called underwriting. Blue Shield has the right to rescind this Agree- ment Agreement if the information contained in the appli- cation application or otherwise provided to Blue Shield by you or anyone acting on your behalf be- half in connec- tion connection with the application was intentionally and materially inaccurate or incompletein- complete. This Agreement also may be rescinded re- scinded if you or an- yone anyone acting on your behalf failed to disclose to Blue Shield any new or changed facts arising after the application applica- tion was submitted but before this Agreement was issued, when those facts pertained to matters inquired about in the ap- plicationapplication. However, after 24 months following the issuance issu- ance of the Agreement, Blue Shield of California Cali- fornia will not rescind the Agreement for any reason. If after enrollment, Blue Shield investigates your application information, we will not re- scind this Agreement without first notifying you of the investigation and offering you an op- portunity opportunity to respond. If this Agreement is rescinded, it means that the Agreement is voided retroactive to its inception in- ception as if it never existed. This means that you will lose coverage back to the original Effective Ef- fective Date. If the Agreement is properly rescindedre- scinded, Blue Shield will refund any dues payments you made, but, to the extent permitted permit- xxx by applicable law, may reduce that refund by the amount of any medical expenses that Blue Shield paid un- der under the Agreement or is otherwise obligated to pay. In addition, Blue Shield may, to the extent permitted by California Cali- fornia law, be entitled to re- coup recoup from you all amounts paid by Blue Shield under the Agreement. . If this Agreement is rescinded, Blue Shield will provide a 30 day advance written notice that will: (a) explain the basis of the decision and your appeal rights, including your right to re- quest request assistance from the California Depart- ment De- partment of Managed Health Care; (b) clarify that, in the case of a qualifying applicant utilizing uti- lizing the Household Savings Program whose appli- cation application information was not false or incomplete in- complete is entitled to new coverage without medical un- derwriting underwriting and will explain how that individual may obtain this coverage; and (c) explain that the monthly Dues for that individual will be de- termined based on that individual’s age.
3. Termination by Blue Shield if Subscriber is No Longer Enrolled in Medicare This Agreement shall terminate on the date the Subscriber is no longer enrolled under Parts A and B or Medicare. Blue Shield shall refund the prepaid dues, if any, that Blue Shield deter- mines will not have been earned as of the ter- mination date. Blue Shield reserves the right to subtract from any such dues refund any amounts paid by Blue Shield for benefits paid or payable by Blue Shield prior to the termina- tion date.
4. Cancellation of the Agreement for Nonpay- ment of Dues Blue Shield may cancel this Agreement for failure to pay the required Dues. If the Agree- ment is being cancelled because you failed to pay the required Dues when owed, the Plan will send a Notice of Start of Grace Period and will terminate the day following the 30-day grace period. You will be liable for all Dues accrued while this Agreement continues in force in- cluding those accrued during this 30 day grace period. Within five (5) business days of canceling or not renewing the Agreement, Blue Shield will mail you a Notice of End of Coverage, which will inform you of the following:
a. That the Agreement has been cancelled, and the reasons for cancellation;
b. The specific date and time when coverage for you ended.
5. Reinstatement of the Agreement after Cancel- lation If the Agreement is cancelled for nonpayment of dues, Blue Shield will permit reinstatement of the Agreement or coverage twice during any twelve-month period, without a change in dues and without consideration of your medical con- dition, if the amounts owed are paid within 15 days of the date the Notice of End of Coverage is mailed to you. If your request for reinstate- ment and payment of all outstanding amounts is not received within the required 15 days, or if the Agreement is cancelled for nonpayment of dues more than twice during the preceding twelve-month period, then Blue Shield is not required to reinstate your coverage, and you will need to reapply for coverage.and
Appears in 3 contracts
Samples: Medicare Supplement Plan G, Medicare Supplement Plan C, Medicare Supplement Plan G
TERMINATION/CANCELLATION, REINSTATEMENT, AND SUSPENSION OF THE AGREEMENT. No Subscriber shall be terminated individually by Blue Shield for any cause other than as provided in this section I.B. This Agreement may be rescinded or terminated, as follows:
1. Termination by the Subscriber A Subscriber desiring to terminate this Agree- ment shall give Blue Shield 30-days notice.
2. Rescission by Blue Shield By signing the enrollment application, you rep- resented that all responses contained in your application for coverage were true, complete and accurate, to the best of your knowledge, and you were advised regarding the conse- quences of intentionally submitting materially false or incomplete information to Blue Shield in your application for coverage, which in- cluded rescission of this Agreement. For underwritten plans (not guaranteed ac- ceptance) - To determine whether or not you would be offered enrollment through this Agreement, Blue Shield reviewed your medi- cal history based upon the information you pro- vided in your enrollment application, including the health history portion of your enrollment application and any supplemental information that Blue Shield determined was necessary to evaluate your medical history and status. This process is called underwriting. Blue Shield has the right to rescind this Agree- ment if the information contained in the appli- cation or otherwise provided to Blue Shield by you or anyone acting on your behalf in connec- tion with the application was intentionally and materially inaccurate or incomplete. This Agreement also may be rescinded if you or an- yone acting on your behalf failed to disclose to Blue Shield any new or changed facts arising after the application was submitted but before this Agreement was issued, when those facts pertained to matters inquired about in the ap- plication. However, after 24 months following the issuance of the Agreement, Blue Shield of California will not rescind the Agreement for any reason. If after enrollment, Blue Shield investigates your application information, we will not re- scind this Agreement without first notifying you of the investigation and offering you an op- portunity to respond. If this Agreement is rescinded, it means that the Agreement is voided retroactive to its inception as if it never existed. This means that you will lose coverage back to the original Effective Date. If the Agreement is properly rescinded, Blue Shield will refund any dues payments you made, but, to the extent permitted by applicable law, may reduce that refund by the amount of any medical expenses that Blue Shield paid un- der the Agreement or is otherwise obligated to pay. In addition, Blue Shield may, to the extent permitted by California law, be entitled to re- coup from you all amounts paid by Blue Shield under the Agreement. If this Agreement is rescinded, Blue Shield will provide a 30 day advance written notice that will: (a) explain the basis of the decision and your appeal rights, including your right to re- quest assistance from the California Depart- ment of Managed Health Care; (b) clarify that, in the case of a qualifying applicant utilizing the Household Savings Program whose appli- cation information was not false or incomplete is entitled to new coverage without medical un- derwriting and will explain how that individual may obtain this coverage; and (c) explain that the monthly Dues for that individual will be de- termined based on that individual’s age.
3. Termination by Blue Shield if Subscriber is No Longer Enrolled in Medicare This Agreement shall terminate on the date the Subscriber is no longer enrolled under Parts A and B or Medicare. Blue Shield shall refund the prepaid dues, if any, that Blue Shield deter- mines will not have been earned as of the ter- mination date. Blue Shield reserves the right to subtract from any such dues refund any amounts paid by Blue Shield for benefits paid or payable by Blue Shield prior to the termina- tion date.
4. Cancellation of the Agreement for Nonpay- ment of Dues Blue Shield may cancel this Agreement for failure to pay the required Dues. If the Agree- ment is being cancelled because you failed to pay the required Dues when owed, the Plan will send a Notice of Start of Grace Period and will terminate the day following the 30-day grace period. You will be liable for all Dues accrued while this Agreement continues in force in- cluding those accrued during this 30 day grace period. Within five (5) business days of canceling or not renewing the Agreement, Blue Shield will mail you a Notice of End of Coverage, which will inform you of the following:
a. That the Agreement has been cancelled, and the reasons for cancellation;
b. The specific date and time when coverage for you ended.
5. Reinstatement of the Agreement after Cancel- lation If the Agreement is cancelled for nonpayment of dues, Blue Shield will permit reinstatement of the Agreement or coverage twice during any twelve-month period, without a change in dues and without consideration of your medical con- dition, if the amounts owed are paid within 15 days of the date the Notice of End of Coverage is mailed to you. If your request for reinstate- ment and payment of all outstanding amounts is not received within the required 15 days, or if the Agreement is cancelled for nonpayment of dues more than twice during the preceding twelve-month period, then Blue Shield is not required to reinstate your coverage, and you will need to reapply for coverage.
Appears in 2 contracts
Samples: Medicare Supplement Plan K, Medicare Supplement High Deductible Plan F
TERMINATION/CANCELLATION, REINSTATEMENT, AND SUSPENSION OF THE AGREEMENT. No Subscriber shall be terminated individually by Blue Shield for any cause other than as provided in this section I.B. This Agreement may be rescinded or terminated, as follows:
1. Termination by the Subscriber A Subscriber desiring to terminate this Agree- ment shall give Blue Shield 30-days notice.
2. Rescission by Blue Shield By signing the enrollment application, you rep- resented that all responses contained in your application for coverage were true, complete and accurate, to the best of your knowledge, and you were advised regarding the conse- quences of intentionally submitting materially false or incomplete information to Blue Shield in your application for coverage, which in- cluded rescission of this Agreement. For underwritten plans (not guaranteed ac- ceptance) - To determine whether or not you would be offered enrollment through this Agreement, Blue Shield reviewed your medi- cal history based upon the information you pro- vided in your enrollment application, including the health history portion of your enrollment application and any supplemental information that Blue Shield determined was necessary to evaluate your medical history and status. This process is called underwriting. Blue Shield has the right to rescind this Agree- ment if the information contained in the appli- cation or otherwise provided to Blue Shield by you or anyone acting on your behalf in connec- tion with the application was intentionally and materially inaccurate or incomplete. This Agreement also may be rescinded if you or an- yone acting on your behalf failed to disclose to Blue Shield any new or changed facts arising after the application was submitted but before this Agreement was issued, when those facts pertained to matters inquired about in the ap- plication. However, after 24 months following the issuance of the Agreement, Blue Shield of California will not rescind the Agreement for any reason. If after enrollment, Blue Shield investigates your application information, we will not re- scind this Agreement without first notifying you of the investigation and offering you an op- portunity to respond. If this Agreement is rescinded, it means that the Agreement is voided retroactive to its inception as if it never existed. This means that you will lose coverage back to the original Effective Date. If the Agreement is properly rescinded, Blue Shield will refund any dues payments you made, but, to the extent permitted by applicable law, may reduce that refund by the amount of any medical expenses that Blue Shield paid un- der the Agreement or is otherwise obligated to pay. In addition, Blue Shield may, to the extent permitted by California law, be entitled to re- coup from you all amounts paid by Blue Shield under the Agreement. . If this Agreement is rescinded, Blue Shield will provide a 30 day advance written notice that will: (a) explain the basis of the decision and your appeal rights, including your right to re- quest assistance from the California Depart- ment of Managed Health Care; (b) clarify that, in the case of a qualifying applicant utilizing the Household Savings Program whose appli- cation information was not false or incomplete is entitled to new coverage without medical un- derwriting and will explain how that individual may obtain this coverage; and (c) explain that the monthly Dues for that individual will be de- termined based on that individual’s age.
3. Termination by Blue Shield if Subscriber is No Longer Enrolled in Medicare This Agreement shall terminate on the date the Subscriber is no longer enrolled under Parts A and B or Medicare. Blue Shield shall refund the prepaid dues, if any, that Blue Shield deter- mines will not have been earned as of the ter- mination date. Blue Shield reserves the right to subtract from any such dues refund any amounts paid by Blue Shield for benefits paid or payable by Blue Shield prior to the termina- tion date.
4. Cancellation of the Agreement for Nonpay- ment of Dues Blue Shield may cancel this Agreement for failure to pay the required Dues. If the Agree- ment is being cancelled because you failed to pay the required Dues when owed, the Plan will send a Notice of Start of Grace Period and will terminate the day following the 30-day grace period. You will be liable for all Dues accrued while this Agreement continues in force in- cluding those accrued during this 30 30-day grace period. Within five (5) business days of canceling or not renewing the Agreement, Blue Shield will mail you a Notice of End of Coverage, which will inform you of the following:
a. That the Agreement has been cancelled, and the reasons for cancellation;
b. The specific date and time when coverage for you ended.
5. Reinstatement of the Agreement after Cancel- lation If the Agreement is cancelled for nonpayment of dues, Blue Shield will permit reinstatement of the Agreement or coverage twice during any twelve-month period, without a change in dues and without consideration of your medical con- dition, if the amounts owed are paid within 15 days of the date the Notice of End of Coverage is mailed to you. If your request for reinstate- ment and payment of all outstanding amounts is not received within the required 15 days, or if the Agreement is cancelled for nonpayment of dues more than twice during the preceding twelve-month period, then Blue Shield is not required to reinstate your coverage, and you will need to reapply for coverage.
Appears in 2 contracts
Samples: Medicare Supplement Plan F Extra, Medicare Supplement Plan F Extra
TERMINATION/CANCELLATION, REINSTATEMENT, AND SUSPENSION OF THE AGREEMENT. No Subscriber shall be terminated individually by Blue Shield for any cause other than as provided in this section I.B. This Agreement may be rescinded or terminated, as follows:
1. Termination by the Subscriber A Subscriber desiring to terminate this Agree- ment Agreement shall give Blue Shield 30-days noticeno- xxxx.
2. Rescission by Blue Shield By signing the enrollment application, you rep- resented represented that all responses contained in your application for coverage were true, complete com- plete and accurate, to the best of your knowledge, and you were advised regarding the conse- quences consequences of intentionally submitting materially false or incomplete information to Blue Shield in your application for coverage, which in- cluded included rescission of this Agreement. For underwritten plans (not guaranteed ac- ceptance) - To determine whether or not you would be offered enrollment through this Agreement, Blue Shield reviewed your medi- cal history based upon the information you pro- vided provided in your enrollment application, including in- cluding the health history portion of your enrollment en- rollment application and any supplemental information in- formation that Blue Shield determined was necessary to evaluate your medical history and status. This process is called underwriting. Blue Shield has the right to rescind this Agree- ment Agreement if the information contained in the appli- cation application or otherwise provided to Blue Shield by you or anyone acting on your behalf be- half in connec- tion connection with the application was intentionally and materially inaccurate or incompletein- complete. This Agreement also may be rescinded re- scinded if you or an- yone anyone acting on your behalf failed to disclose to Blue Shield any new or changed facts arising after the application applica- tion was submitted but before this Agreement was issued, when those facts pertained to matters inquired about in the ap- plicationapplication. However, after 24 months following the issuance issu- ance of the Agreement, Blue Shield of California Cali- fornia will not rescind the Agreement for any reason. If after enrollment, Blue Shield investigates your application information, we will not re- scind this Agreement without first notifying you of the investigation and offering you an op- portunity opportunity to respond. If this Agreement is rescinded, it means that the Agreement is voided retroactive to its inception in- ception as if it never existed. This means that you will lose coverage back to the original Effective Ef- fective Date. If the Agreement is properly rescindedre- scinded, Blue Shield will refund any dues payments you made, but, to the extent permitted permit- xxx by applicable law, may reduce that refund by the amount of any medical expenses that Blue Shield paid un- der under the Agreement or is otherwise obligated to pay. In addition, Blue Shield may, to the extent permitted by California Cali- fornia law, be entitled to re- coup recoup from you all amounts paid by Blue Shield under the Agreement. If this Agreement is rescinded, Blue Shield will provide a 30 day advance written notice that will: (a) explain the basis of the decision and your appeal rights, including your right to re- quest assistance from the California Depart- ment of Managed Health Care; (b) clarify that, in the case of a qualifying applicant utilizing the Household Savings Program whose appli- cation information was not false or incomplete is entitled to new coverage without medical un- derwriting and will explain how that individual may obtain this coverage; and (c) explain that the monthly Dues for that individual will be de- termined based on that individual’s age.
3. Termination by Blue Shield if Subscriber is No Longer Enrolled in Medicare This Agreement shall terminate on the date the Subscriber is no longer enrolled under Parts A and B or Medicare. Blue Shield shall refund the prepaid dues, if any, that Blue Shield deter- mines determines will not have been earned as of the ter- mination termination date. Blue Shield reserves re- serves the right to subtract from any such dues refund any amounts paid by Blue Shield for benefits paid or payable by Blue Shield prior to the termina- tion termination date.
4. Cancellation of the Agreement for Nonpay- ment of Dues Blue Shield may cancel this Agreement for failure to pay the required Dues. If the Agree- ment Agreement is being cancelled because you failed to pay the required Dues when owed, the Plan will send a Notice of Start of Grace Period and will terminate the day following the 30-day grace period. You will be liable for all Dues accrued while this Agreement continues con- tinues in force in- cluding including those accrued during this 30 day grace period. Within five (5) business days of canceling or not renewing the Agreement, Blue Shield will mail you a Notice of End of Coverage, which will inform you of the following:
a. That the Agreement has been cancelled, and the reasons for cancellation;
b. The specific date and time when coverage for you ended.
5. Reinstatement of the Agreement after Cancel- lation If the Agreement is cancelled for nonpayment of dues, Blue Shield will permit reinstatement of the Agreement or coverage twice during any twelve-month period, without a change in dues and without consideration of your medical con- ditionmedi- cal condition, if the amounts owed are paid within 15 days of the date the Notice of End of Coverage is mailed to you. If your request for reinstate- ment reinstatement and payment of all outstanding outstand- ing amounts is not received within the required re- quired 15 days, or if the Agreement is cancelled for nonpayment of dues more than twice during the preceding twelve-month periodpe- riod, then Blue Shield is not required to reinstate rein- state your coverage, and you will need to reapply for coverage.
Appears in 2 contracts
Samples: Medicare Supplement Plan A, Medicare Supplement Plan A
TERMINATION/CANCELLATION, REINSTATEMENT, AND SUSPENSION OF THE AGREEMENT. No Subscriber shall be terminated individually by Blue Shield for any cause other than as provided in this section I.B. This Agreement may be rescinded or terminated, as follows:
1. Termination by the Subscriber A Subscriber desiring to terminate this Agree- ment Agreement shall give Blue Shield 30-days noticeno- xxxx.
2. Rescission by Blue Shield By signing the enrollment application, you rep- resented represented that all responses contained in your application for coverage were true, complete com- plete and accurate, to the best of your knowledge, and you were advised regarding the conse- quences consequences of intentionally submitting materially false or incomplete information to Blue Shield in your application for coverage, which in- cluded included rescission of this Agreement. For underwritten plans (not guaranteed ac- ceptance) - To determine whether or not you would be offered enrollment through this Agreement, Blue Shield reviewed your medi- cal history based upon the information you pro- vided provided in your enrollment application, including in- cluding the health history portion of your enrollment en- rollment application and any supplemental information that Blue Shield determined was necessary to evaluate your medical history and status. This process is called underwriting. Blue Shield has the right to rescind this Agree- ment Agreement if the information contained in the appli- cation application or otherwise provided to Blue Shield by you or anyone acting on your behalf be- half in connec- tion connection with the application was intentionally and materially inaccurate or incompletein- complete. This Agreement also may be rescinded re- scinded if you or an- yone anyone acting on your behalf failed to disclose to Blue Shield any new or changed facts arising after the application applica- tion was submitted but before this Agreement was issued, when those facts pertained to matters inquired about in the ap- plicationapplication. However, after 24 months following the issuance issu- ance of the Agreement, Blue Shield of California Cali- fornia will not rescind the Agreement for any reason. If after enrollment, Blue Shield investigates your application information, we will not re- scind this Agreement without first notifying you of the investigation and offering you an op- portunity opportunity to respond. If this Agreement is rescinded, it means that the Agreement is voided retroactive to its inception in- ception as if it never existed. This means that you will lose coverage back to the original Effective Ef- fective Date. If the Agreement is properly rescindedre- scinded, Blue Shield will refund any dues payments you made, but, to the extent permitted permit- xxx by applicable law, may reduce that refund by the amount of any medical expenses that Blue Shield paid un- der under the Agreement or is otherwise obligated to pay. In addition, Blue Shield may, to the extent permitted by California Cali- fornia law, be entitled to re- coup recoup from you all amounts paid by Blue Shield under the Agreement. . If this Agreement is rescinded, Blue Shield will provide a 30 day advance written notice that will: (a) explain the basis of the decision and your appeal rights, including your right to re- quest request assistance from the California Depart- ment De- partment of Managed Health Care; (b) clarify that, in the case of a qualifying applicant utilizing uti- lizing the Household Savings Program whose appli- cation application information was not false or incomplete in- complete is entitled to new coverage without medical un- derwriting underwriting and will explain how that individual may obtain this coverage; and (c) explain that the monthly Dues for that individual will be de- termined based on that individual’s age.
3. Termination by Blue Shield if Subscriber is No Longer Enrolled in Medicare This Agreement shall terminate on the date the Subscriber is no longer enrolled under Parts A and B or Medicare. Blue Shield shall refund the prepaid dues, if any, that Blue Shield deter- mines will not have been earned as of the ter- mination date. Blue Shield reserves the right to subtract from any such dues refund any amounts paid by Blue Shield for benefits paid or payable by Blue Shield prior to the termina- tion date.
4. Cancellation of the Agreement for Nonpay- ment of Dues Blue Shield may cancel this Agreement for failure to pay the required Dues. If the Agree- ment is being cancelled because you failed to pay the required Dues when owed, the Plan will send a Notice of Start of Grace Period and will terminate the day following the 30-day grace period. You will be liable for all Dues accrued while this Agreement continues in force in- cluding those accrued during this 30 day grace period. Within five (5) business days of canceling or not renewing the Agreement, Blue Shield will mail you a Notice of End of Coverage, which will inform you of the following:
a. That the Agreement has been cancelled, and the reasons for cancellation;
b. The specific date and time when coverage for you ended.
5. Reinstatement of the Agreement after Cancel- lation If the Agreement is cancelled for nonpayment of dues, Blue Shield will permit reinstatement of the Agreement or coverage twice during any twelve-month period, without a change in dues and without consideration of your medical con- dition, if the amounts owed are paid within 15 days of the date the Notice of End of Coverage is mailed to you. If your request for reinstate- ment and payment of all outstanding amounts is not received within the required 15 days, or if the Agreement is cancelled for nonpayment of dues more than twice during the preceding twelve-month period, then Blue Shield is not required to reinstate your coverage, and you will need to reapply for coverage.and
Appears in 2 contracts
Samples: Medicare Supplement Plan N, Medicare Supplement Plan N
TERMINATION/CANCELLATION, REINSTATEMENT, AND SUSPENSION OF THE AGREEMENT. No Subscriber shall be terminated individually by Blue Shield for any cause other than as provided in this section I.B. This Agreement may be rescinded or terminated, as follows:
1. Termination by the Subscriber A Subscriber desiring to terminate this Agree- ment shall give Blue Shield 30-days notice.
2. Rescission by Blue Shield By signing the enrollment application, you rep- resented that all responses contained in your application for coverage were true, complete and accurate, to the best of your knowledge, and you were advised regarding the conse- quences of intentionally submitting materially false or incomplete information to Blue Shield in your application for coverage, which in- cluded rescission of this Agreement. For underwritten plans (not guaranteed ac- ceptance) - To determine whether or not you would be offered enrollment through this Agreement, Blue Shield reviewed your medi- cal history based upon the information you pro- vided in your enrollment application, including the health history portion of your enrollment application and any supplemental information that Blue Shield determined was necessary to evaluate your medical history and status. This process is called underwriting. Blue Shield has the right to rescind this Agree- ment if the information contained in the appli- cation or otherwise provided to Blue Shield by you or anyone acting on your behalf in connec- tion with the application was intentionally and materially inaccurate or incomplete. This Agreement also may be rescinded if you or an- yone acting on your behalf failed to disclose to Blue Shield any new or changed facts arising after the application was submitted but before this Agreement was issued, when those facts pertained to matters inquired about in the ap- plication. However, after 24 months following the issuance of the Agreement, Blue Shield of California will not rescind the Agreement for any reason. If after enrollment, Blue Shield investigates your application information, we will not re- scind this Agreement without first notifying you of the investigation and offering you an op- portunity to respond. If this Agreement is rescinded, it means that the Agreement is voided retroactive to its inception as if it never existed. This means that you will lose coverage back to the original Effective Date. If the Agreement is properly rescinded, Blue Shield will refund any dues payments you made, but, to the extent permitted by applicable law, may reduce that refund by the amount of any medical expenses that Blue Shield paid un- der the Agreement or is otherwise obligated to pay. In addition, Blue Shield may, to the extent permitted by California law, be entitled to re- coup from you all amounts paid by Blue Shield under the Agreement. . If this Agreement is rescinded, Blue Shield will provide a 30 day advance written notice that will: (a) explain the basis of the decision and your appeal rights, including your right to re- quest assistance from the California Depart- ment of Managed Health Care; (b) clarify that, in the case of a qualifying applicant utilizing the Household Savings Program whose appli- cation information was not false or incomplete is entitled to new coverage without medical un- derwriting underwriting and will explain how that individual individ- ual may obtain this coverage; and (c) explain that the monthly Dues for that individual will be de- termined determined based on that individual’s age.
3. Termination by Blue Shield if Subscriber is No Longer Enrolled in Medicare This Agreement shall terminate on the date the Subscriber is no longer enrolled under Parts A and B or Medicare. Blue Shield shall refund the prepaid dues, if any, that Blue Shield deter- mines will not have been earned as of the ter- mination date. Blue Shield reserves the right to subtract from any such dues refund any amounts paid by Blue Shield for benefits paid or payable by Blue Shield prior to the termina- tion date.
4. Cancellation of the Agreement for Nonpay- ment of Dues Blue Shield may cancel this Agreement for failure to pay the required Dues. If the Agree- ment is being cancelled because you failed to pay the required Dues when owed, the Plan will send a Notice of Start of Grace Period and will terminate the day following the 30-day grace period. You will be liable for all Dues accrued while this Agreement continues in force in- cluding those accrued during this 30 day grace period. Within five (5) business days of canceling or not renewing the Agreement, Blue Shield will mail you a Notice of End of Coverage, which will inform you of the following:
a. That the Agreement has been cancelled, and the reasons for cancellation;
b. The specific date and time when coverage for you ended.
5. Reinstatement of the Agreement after Cancel- lation If the Agreement is cancelled for nonpayment of dues, Blue Shield will permit reinstatement of the Agreement or coverage twice during any twelve-month period, without a change in dues and without consideration of your medical con- dition, if the amounts owed are paid within 15 days of the date the Notice of End of Coverage is mailed to you. If your request for reinstate- ment reinstatement and payment of all outstanding amounts is not received within the required 15 days, or if the Agreement is cancelled for nonpayment non- payment of dues more than twice during the preceding twelve-month period, then Blue Shield is not required to reinstate your coveragecover- age, and you will need to reapply for coverage.
Appears in 1 contract
Samples: Medicare Supplement Plan F
TERMINATION/CANCELLATION, REINSTATEMENT, AND SUSPENSION OF THE AGREEMENT. No Subscriber shall be terminated individually by Blue Shield for any cause other than as provided in this section I.B. This Agreement may be rescinded or terminated, as follows:
1. Termination by the Subscriber A Subscriber desiring to terminate this Agree- ment Agreement shall give Blue Shield 30-days written notice.
2. Rescission by Blue Shield By signing the enrollment application, you rep- resented represented that all responses contained in your application for coverage were true, complete com- plete and accurate, to the best of your knowledge, and you were advised regarding the conse- quences consequences of intentionally submitting materially false or incomplete information to Blue Shield in your application for coverage, which in- cluded included rescission of this Agreement. For underwritten plans (not guaranteed ac- ceptance) - To determine whether or not you would be offered enrollment through this Agreement, Blue Shield reviewed your medi- cal history based upon the information you pro- vided provided in your enrollment application, including in- cluding the health history portion of your enrollment en- rollment application and any supplemental information that Blue Shield determined was necessary to evaluate your medical history and status. This process is called underwriting. Blue Shield has the right to rescind this Agree- ment Agreement if the information contained in the appli- cation application or otherwise provided to Blue Shield by you or anyone acting on your behalf in connec- tion connection with the application was intentionally inten- tionally and materially inaccurate or incompleteincom- plete. This Agreement also may be rescinded if you or an- yone anyone acting on your behalf failed to disclose to Blue Shield any new or changed facts arising after the application was submitted submit- xxx but before this Agreement was issued, when those facts pertained to matters inquired about in the ap- plicationapplication. However, after 24 months following the issuance of the AgreementAgree- ment, Blue Shield of California will not rescind re- scind the Agreement for any reason. If after enrollment, Blue Shield investigates your application information, we will not re- scind this Agreement without first notifying you of the investigation and offering you an op- portunity opportunity to respond. If this Agreement is rescinded, it means that the Agreement is voided retroactive to its inception in- ception as if it never existed. This means that you will lose coverage back to the original Effective Ef- fective Date. If the Agreement is properly rescindedre- scinded, Blue Shield will refund any dues payments you made, but, to the extent permitted permit- xxx by applicable law, may reduce that refund by the amount of any medical expenses that Blue Shield paid un- der under the Agreement or is otherwise obligated to pay. In addition, Blue Shield may, to the extent permitted by California Cali- fornia law, be entitled to re- coup recoup from you all amounts paid by Blue Shield under the Agreement. If this Agreement is rescinded, Blue Shield will provide a 30 day advance written notice that will: (a) explain the basis of the decision and your appeal rights, including your right to re- quest request assistance from the California Depart- ment De- partment of Managed Health Care; (b) clarify that, in the case of a qualifying applicant utilizing two-party agreement, the Household Savings Program Subscriber or Dependent whose appli- cation application information was not false or incomplete is entitled en- titled to new coverage without medical un- derwriting and will explain how that individual may obtain this coverage; and (c) explain that the monthly Dues for that individual indi- vidual will be de- termined determined based on that individualindi- vidual’s age.
3. Termination by Blue Shield if Subscriber is No Longer Enrolled in Medicare This Agreement shall terminate on the date the Subscriber is no longer enrolled under Parts A and B or Medicare. Blue Shield shall refund the prepaid dues, if any, that Blue Shield deter- mines determines will not have been earned as of the ter- mination termination date. Blue Shield reserves re- serves the right to subtract from any such dues refund any amounts paid by Blue Shield for benefits paid or payable by Blue Shield prior to the termina- tion termination date.
4. Cancellation of the Agreement for Nonpay- ment of Dues Blue Shield may cancel this Agreement for failure to pay the required Dues. If the Agree- ment Agreement is being cancelled because you failed to pay the required Dues when owed, then coverage will end 30 days after the Plan will send a Notice of Start of Grace Period and will terminate date for which the day following the 30-day grace periodDues are due. You will be liable lia- ble for all Dues accrued while this Agreement continues in force in- cluding including those accrued during this 30 day grace period. Within five (5) business days of canceling or not renewing the Agreement, Blue Shield will mail you a Notice of End Confirming Termination of Coverage, which will inform you of the followingfol- lowing:
a. That the Agreement has been cancelled, and the reasons for cancellation;
b. The specific date and time when coverage for you ended.
5. Reinstatement of the Agreement after Cancel- lation If the Agreement is cancelled for nonpayment of dues, Blue Shield will permit reinstatement of the Agreement or coverage twice during any twelve-month period, without a change in dues and without consideration of your medical con- ditionmedi- cal condition, if the amounts owed are paid within 15 days of the date the Notice of End Con- firming Termination of Coverage is mailed to you. If your request for reinstate- ment reinstatement and payment of all outstanding amounts is not received re- ceived within the required 15 days, or if the Agreement is cancelled for nonpayment of dues more than twice during the preceding twelve-month period, then Blue Shield is not required to reinstate your coverage, and you will need to reapply for coverage.
Appears in 1 contract
Samples: Medicare Supplement Agreement
TERMINATION/CANCELLATION, REINSTATEMENT, AND SUSPENSION OF THE AGREEMENT. No Subscriber shall be terminated individually by Blue Shield for any cause other than as provided in this section I.B. This Agreement may be rescinded or terminated, as follows:
1. Termination by the Subscriber A Subscriber desiring to terminate this Agree- ment shall give Blue Shield 30-days noticewritten no- xxxx.
2. Rescission by Blue Shield By signing the enrollment application, you rep- resented that all responses contained in your application for coverage were true, complete and accurate, to the best of your knowledge, and you were advised regarding the conse- quences of intentionally submitting materially false or incomplete information to Blue Shield in your application for coverage, which in- cluded rescission of this Agreement. For underwritten plans (not guaranteed ac- ceptance) - To determine whether or not you would be offered enrollment through this Agreement, Blue Shield reviewed your medi- cal history based upon the information you pro- vided in your enrollment application, including the health history portion of your enrollment application and any supplemental information that Blue Shield determined was necessary to evaluate your medical history and status. This process is called underwriting. Blue Shield has the right to rescind this Agree- ment if the information contained in the appli- cation or otherwise provided to Blue Shield by you or anyone acting on your behalf in connec- tion with the application was intentionally and materially inaccurate or incomplete. This Agreement also may be rescinded if you or an- yone acting on your behalf failed to disclose to Blue Shield any new or changed facts arising after the application was submitted but before this Agreement was issued, when those facts pertained to matters inquired about in the ap- plication. However, after 24 months following the issuance of the Agreement, Blue Shield of California will not rescind the Agreement for any reason. If after enrollment, Blue Shield investigates your application information, we will not re- scind this Agreement without first notifying you of the investigation and offering you an op- portunity to respond. If this Agreement is rescinded, it means that the Agreement is voided retroactive to its inception as if it never existed. This means that you will lose coverage back to the original Effective Date. If the Agreement is properly rescinded, Blue Shield will refund any dues payments you made, but, to the extent permitted by applicable law, may reduce that refund by the amount of any medical expenses that Blue Shield paid un- der the Agreement or is otherwise obligated to pay. In addition, Blue Shield may, to the extent permitted by California law, be entitled to re- coup from you all amounts paid by Blue Shield under the Agreement. . If this Agreement is rescinded, Blue Shield will provide a 30 day advance written notice that will: (a) explain the basis of the decision and your appeal rights, including your right to re- quest assistance from the California Depart- ment of Managed Health Care; (b) clarify that, in the case of a qualifying applicant utilizing the Household Savings Program whose appli- cation information was not false or incomplete is entitled to new coverage without medical un- derwriting underwriting and will explain how that individual individ- ual may obtain this coverage; and (c) explain that the monthly Dues for that individual will be de- termined determined based on that individual’s age.
3. Termination by Blue Shield if Subscriber is No Longer Enrolled in Medicare This Agreement shall terminate on the date the Subscriber is no longer enrolled under Parts A and B or Medicare. Blue Shield shall refund the prepaid dues, if any, that Blue Shield deter- mines will not have been earned as of the ter- mination date. Blue Shield reserves the right to subtract from any such dues refund any amounts paid by Blue Shield for benefits paid or payable by Blue Shield prior to the termina- tion date.
4. Cancellation of the Agreement for Nonpay- ment of Dues Blue Shield may cancel this Agreement for failure to pay the required Dues. If the Agree- ment is being cancelled because you failed to pay the required Dues when owed, the Plan will send a Notice provide written notice of Start of Grace Period non-payment and will terminate coverage no sooner than 30 days af- ter the day following date of the 30-day grace periodwritten notice. You will be liable for all Dues accrued while this Agreement Agree- ment continues in force in- cluding including those accrued ac- crued during this 30 day grace period. Within five (5) business days of canceling or not renewing the Agreement, Blue Shield will mail you a Notice of End Confirming Termination of Coverage, which will inform you of the followingfollow- ing:
a. That the Agreement has been cancelled, and the reasons for cancellation;
b. The specific date and time when coverage for you ended.
5. Reinstatement of the Agreement after Cancel- lation If the Agreement is cancelled for nonpayment of dues, Blue Shield will permit reinstatement of the Agreement or coverage twice during any twelve-month period, without a change in dues and without consideration of your medical con- dition, if the amounts owed are paid within 15 days of the date the Notice of End Confirming Ter- mination of Coverage is mailed to you. If your request for reinstate- ment reinstatement and payment of all outstanding amounts is not received within the required 15 days, or if the Agreement is cancelled can- celled for nonpayment of dues more than twice during the preceding twelve-month period, then Blue Shield is not required to reinstate your coverage, and you will need to reapply for coverage.
Appears in 1 contract
Samples: Medicare Supplement Plan F
TERMINATION/CANCELLATION, REINSTATEMENT, AND SUSPENSION OF THE AGREEMENT. No Subscriber shall be terminated individually by Blue Shield for any cause other than as provided in this section I.B. This Agreement may be rescinded or terminated, as follows:
1. Termination by the Subscriber A Subscriber desiring to terminate this Agree- ment Agreement shall give Blue Shield 30-days written notice.
2. Rescission by Blue Shield By signing the enrollment application, you rep- resented represented that all responses contained in your application for coverage were true, complete com- plete and accurate, to the best of your knowledge, and you were advised regarding the conse- quences consequences of intentionally submitting materially false or incomplete information to Blue Shield in your application for coverage, which in- cluded included rescission of this Agreement. For underwritten plans (not guaranteed ac- ceptance) - To determine whether or not you would be offered enrollment through this Agreement, Blue Shield reviewed your medi- cal history based upon the information you pro- vided provided in your enrollment application, including in- cluding the health history portion of your enrollment en- rollment application and any supplemental information in- formation that Blue Shield determined was necessary to evaluate your medical history and status. This process is called underwriting. Blue Shield has the right to rescind this Agree- ment Agreement if the information contained in the appli- cation application or otherwise provided to Blue Shield by you or anyone acting on your behalf be- half in connec- tion connection with the application was intentionally and materially inaccurate or incompletein- complete. This Agreement also may be rescinded re- scinded if you or an- yone anyone acting on your behalf failed to disclose to Blue Shield any new or changed facts arising after the application applica- tion was submitted but before this Agreement was issued, when those facts pertained to matters inquired about in the ap- plicationapplication. However, after 24 months following the issuance issu- ance of the Agreement, Blue Shield of California Cali- fornia will not rescind the Agreement for any reason. If after enrollment, Blue Shield investigates your application information, we will not re- scind this Agreement without first notifying you of the investigation and offering you an op- portunity opportunity to respond. If this Agreement is rescinded, it means that the Agreement is voided retroactive to its inception in- ception as if it never existed. This means that you will lose coverage back to the original Effective Ef- fective Date. If the Agreement is properly rescindedre- scinded, Blue Shield will refund any dues payments you made, but, to the extent permitted permit- xxx by applicable law, may reduce that refund by the amount of any medical expenses that Blue Shield paid un- der under the Agreement or is otherwise obligated to pay. In addition, Blue Shield may, to the extent permitted by California Cali- fornia law, be entitled to re- coup recoup from you all amounts paid by Blue Shield under the Agreement. . If this Agreement is rescinded, Blue Shield will provide a 30 day advance written notice that will: (a) explain the basis of the decision and your appeal rights, including your right to re- quest request assistance from the California Depart- ment De- partment of Managed Health Care; (b) clarify that, in the case of a qualifying applicant utilizing uti- lizing the Household Savings Program whose appli- cation application information was not false or incomplete in- complete is entitled to new coverage without medical un- derwriting underwriting and will explain how that individual may obtain this coverage; and (c) explain that the monthly Dues for that individual will be de- termined based on that individual’s age.
3. Termination by Blue Shield if Subscriber is No Longer Enrolled in Medicare This Agreement shall terminate on the date the Subscriber is no longer enrolled under Parts A and B or Medicare. Blue Shield shall refund the prepaid dues, if any, that Blue Shield deter- mines will not have been earned as of the ter- mination date. Blue Shield reserves the right to subtract from any such dues refund any amounts paid by Blue Shield for benefits paid or payable by Blue Shield prior to the termina- tion date.
4. Cancellation of the Agreement for Nonpay- ment of Dues Blue Shield may cancel this Agreement for failure to pay the required Dues. If the Agree- ment is being cancelled because you failed to pay the required Dues when owed, the Plan will send a Notice of Start of Grace Period and will terminate the day following the 30-day grace period. You will be liable for all Dues accrued while this Agreement continues in force in- cluding those accrued during this 30 day grace period. Within five (5) business days of canceling or not renewing the Agreement, Blue Shield will mail you a Notice of End of Coverage, which will inform you of the following:
a. That the Agreement has been cancelled, and the reasons for cancellation;
b. The specific date and time when coverage for you ended.
5. Reinstatement of the Agreement after Cancel- lation If the Agreement is cancelled for nonpayment of dues, Blue Shield will permit reinstatement of the Agreement or coverage twice during any twelve-month period, without a change in dues and without consideration of your medical con- dition, if the amounts owed are paid within 15 days of the date the Notice of End of Coverage is mailed to you. If your request for reinstate- ment and payment of all outstanding amounts is not received within the required 15 days, or if the Agreement is cancelled for nonpayment of dues more than twice during the preceding twelve-month period, then Blue Shield is not required to reinstate your coverage, and you will need to reapply for coverage.and
Appears in 1 contract
Samples: Medicare Supplement Plan C
