Common use of Termination of a Members Coverage Clause in Contracts

Termination of a Members Coverage. The Company may choose to rescind coverage or terminate a Member’s coverage if a Member performs an act or practice that constitutes fraud or makes an intentional misrepresentation of material fact under the terms of this Benefit Plan. The issuance of this coverage is conditioned on the representations and statements contained at application and enrollment. All representations made are material to the issuance of this coverage. Any information provided on the application or enrollment form or intentionally omitted therefrom, as to any proposed Subscriber or covered Member, shall constitute an intentional misrepresentation of material fact. A Member’s coverage may be rescinded retroactively to the Effective Date of coverage or terminated within three (3) years of the Member’s Effective Date, for fraud or intentional misrepresentation of material fact. Company will give the Member sixty (60) days advance written notice prior to rescinding or terminating coverage under this section. If Members are enrolled that are not eligible for coverage, it will be considered an act of fraud or intentional misrepresentation of material fact. Unless COBRA or other type of continuation of coverage is available and selected as provided in this Benefit Plan, a Member's coverage terminates as provided below: The Subscriber’s coverage and that of all his Dependents automatically, and without notice, terminates at the end of the period in which the Subscriber ceases to be eligible. The coverage of the Subscriber's Spouse will terminate automatically, and without notice, at the end of the period for which premiums have been paid at the time of the entry of a final decree of divorce or other legal termination of marriage. The coverage of a Dependent will terminate automatically, and without notice, at the end of the billing cycle in which the Dependent reaches the maximum age for coverage or otherwise ceases to be an eligible Dependent, if premiums have been paid through that period.‌‌‌ Upon the death of a Subscriber, the coverage of all of his surviving Dependents will terminate automatically and without notice at the end of the month that death occurred if premiums have been paid through that month. However, a surviving Spouse or Dependent may be able to elect COBRA or other type of continuation of coverage as described elsewhere in this Benefit Plan. In the event the Group cancels this Benefit Plan or Company or SHOP terminates this Benefit Plan for nonpayment of the appropriate payment when due or because the for the Group fails to perform any obligation required by this Benefit Plan, such cancellation or termination alone will operate to end all rights of the Member to Benefits under this Benefit Plan as of the Effective Date of such cancellation or termination. The Group shall have the obligation to notify its Members, participants, and beneficiaries of such cancellation or termination. Company has no such obligation to notify at the Member level. Except as otherwise provided in this Benefit Plan, no Benefits are available to a Member for Covered Services rendered after the date of cancellation or termination of a Member's coverage. When Members on the policy change, Company reserves the right to change Subscriber’s class of coverage and bill appropriate premium to reflect the Members covered. Cancellation or termination will be effective at midnight on the last day of the billing cycle. When the Group’s coverage ends because the plan ceases to exist or COBRA is exhausted, Members may apply for individual coverage to Company or to the Exchange.

Termination of a Members Coverage. The Company may choose to rescind coverage or terminate a Member’s coverage if a Member performs an act or practice that constitutes fraud fraud, or makes an intentional misrepresentation of material fact under the terms of this Benefit Plan. The issuance of this coverage is conditioned on the representations and statements contained at application and enrollment. All representations made are material to the issuance of this coverage. Any information provided on the application or enrollment form or intentionally omitted therefrom, as to any proposed Subscriber or covered Member, shall constitute an intentional misrepresentation of material fact. A Member’s coverage may be rescinded retroactively to the Effective Date of coverage or terminated within three (3) years of the Member’s Effective Date, for fraud or intentional misrepresentation of material fact. Company will give the Member sixty (60) days advance written notice prior to rescinding or terminating coverage under this section. If Members are enrolled that are not eligible for coverage, it will be considered an act of fraud or intentional misrepresentation of material fact. Unless COBRA or other type of continuation of coverage is available and selected as provided in this Benefit Plan, a Member's coverage terminates as provided below: The Subscriber’s coverage and that of all his Dependents automatically, and without notice, terminates at the end of the period in which the Subscriber ceases to be eligible. The coverage of the Subscriber's Spouse will terminate automatically, and without notice, at the end of the period for which premiums have been paid at the time of the entry of a final decree of divorce divorc e or other legal termination of marriage. The coverage of a Dependent will terminate automatically, and without notice, at the end of the billing cycle in which the Dependent reaches the maximum age for coverage or otherwise ceases to be an eligible Dependent, if premiums have been paid through that period.‌‌‌ period. Upon the death of a Subscriber, the coverage of all of his surviving Dependents will terminate automatically and without notice at the end of the month that death occurred if premiums have been paid through that month. However, a surviving Spouse or Dependent may be able to elect COBRA or other type of continuation of coverage as described elsewhere in this Benefit Plan. In the event the Group cancels this Benefit Plan or Company or SHOP terminates this Benefit Plan for nonpayment of the appropriate payment when due or because the for the Group fails to perform any obligation required by this Benefit Plan, such cancellation or termination alone will operate to end all rights of the Member to Benefits under this Benefit Plan as of the Effective Date of such cancellation or termination. The Group shall have the obligation to notify its Members, participants, and beneficiaries of such cancellation or termination. Company has no such obligation to notify at the Member Memb er level. Except as otherwise provided in this Benefit Plan, no Benefits are available to a Member for Covered Services rendered after the date of cancellation or termination of a Member's coverage. When Members on the policy change, Company reserves the right r ight to change Subscriber’s class of coverage and bill appropriate premium to reflect the Members covered. Cancellation or termination will be effective at midnight on the last day of the billing cycle. When the Group’s coverage ends because the plan ceases to exist or COBRA is exhausted, Members may apply for individual coverage to Company or to the Exchange.. Filing of Claims‌‌‌‌‌ You must file all Claims within ninety (90) days from the date services were rendered, unless it is not reasonably possible to do so. In no event may any Claim be filed later than fifteen (15) months from the date services were rendered. J.

Termination of a Members Coverage. The Company may choose to rescind coverage or terminate a Member’s coverage if a Member performs an act or practice that constitutes fraud or makes an intentional misrepresentation of material fact under the terms of this Benefit Plan. The issuance of this coverage is conditioned on the representations and statements contained at application and enrollment. All representations made are material to the issuance of this coverage. Any information provided on the application or enrollment form or intentionally omitted therefrom, as to any proposed Subscriber or covered Member, shall constitute an intentional misrepresentation of material fact. A Member’s coverage may be rescinded retroactively to the Effective Date of coverage or terminated within three (3) years of the Member’s Effective Date, for fraud or intentional misrepresentation of material fact. Company will give the Member sixty (60) days advance written notice prior to rescinding or terminating coverage under this section. If Members are enrolled that are not eligible for coverage, it will be considered an act of fraud or intentional misrepresentation of material fact. Unless COBRA or other type of continuation of coverage is available and selected as provided in this Benefit Plan, a Member's coverage terminates as provided below: below:‌‌ The Subscriber’s coverage and that of all his Dependents automatically, and without notice, terminates at the end of the period in which the Subscriber ceases to be eligible. The coverage of the Subscriber's Spouse will terminate automatically, and without notice, at the end of the period for which premiums have been paid at the time of the entry of a final decree of divorce or other legal termination of marriage. The coverage of a Dependent will terminate automatically, and without notice, at the end of the billing cycle in which the Dependent reaches the maximum age for coverage or otherwise ceases to be an eligible Dependent, if premiums have been paid through that period.‌‌‌ period. Upon the death of a Subscriber, the coverage of all of his surviving Dependents will terminate automatically and without notice at the end of the month that death occurred if premiums have been paid through that month. However, a surviving Spouse or Dependent may be able to elect COBRA or other type of continuation of coverage as described elsewhere in this Benefit Plan. In the event the Group cancels this Benefit Plan or Company or SHOP terminates this Benefit Plan for nonpayment of the appropriate payment when due or because the for the Group fails to perform any obligation required by this Benefit Plan, such cancellation or termination alone will operate to end all rights of the Member to Benefits under this Benefit Plan as of the Effective Date of such cancellation or termination. The Group shall have the obligation to notify its Members, participants, and beneficiaries of such cancellation or termination. Company has no such obligation to notify at the Member level. Except as otherwise provided in this Benefit Plan, no Benefits are available to a Member for Covered Cover ed Services rendered after the date of cancellation or termination of a Member's coverage. When Members on the policy change, Company reserves the right to change Subscriber’s class of coverage and bill appropriate premium to reflect the Members covered. Cancellation or termination will be effective at midnight on the last day of the billing cycle. When the Group’s coverage ends because the plan ceases to exist or COBRA is exhausted, Members may apply for individual coverage to Company or to the Exchange.

Termination of a Members Coverage. The Company may choose to rescind coverage or terminate a Member’s coverage if a Member performs an act or practice that constitutes fraud fraud, or makes an intentional misrepresentation of material fact under the terms of this Benefit Plan. The issuance of this coverage is conditioned on the representations and statements contained at application and enrollment. All representations made are material to the issuance of this coverage. Any information provided on the application or enrollment form or intentionally omitted therefrom, as to any proposed Subscriber or covered Member, shall constitute an intentional misrepresentation of material fact. A Member’s coverage may be rescinded retroactively to the Effective Date of coverage or terminated within three (3) years of the Member’s Effective Date, for fraud or intentional misrepresentation of material fact. Company will give the Member sixty (60) days advance written notice prior to rescinding or terminating coverage under this section. If Members are enrolled that are not eligible for coverage, it will be considered an act of fraud or intentional misrepresentation of material fact. Unless COBRA or other type of continuation of coverage is available and selected as provided in this Benefit Plan, a Member's coverage terminates as provided below: The Subscriber’s coverage and that of all his Dependents automatically, and without notice, terminates at the end of the period in which the Subscriber ceases to be eligible. The coverage of the Subscriber's Spouse will terminate automatically, and without notice, at the end of the period for which premiums have been paid at the time of the entry of a final decree of divorce or other legal termination of marriage. The coverage of a Dependent will terminate automatically, and without notice, at the end of the billing cycle in which the Dependent reaches the maximum age for coverage or otherwise ceases to be an eligible Dependent, if premiums have been paid through that period.‌‌‌ period. Upon the death of a Subscriber, the coverage of all of his surviving Dependents will terminate automatically and without notice at the end of the month that death occurred if premiums have been paid through that month. However, a surviving Spouse or Dependent may be able to elect COBRA or other type of continuation of coverage as described elsewhere in this Benefit Plan. In the event the Group cancels this Benefit Plan or Company or SHOP terminates this Benefit Plan for nonpayment of the appropriate payment when due or because the for the Group fails to perform any obligation required by this Benefit Plan, such cancellation or termination alone will operate to end all rights of the Member to Benefits under this Benefit Plan as of the Effective Date of such cancellation or termination. The Group shall have the obligation to notify its Members, participants, and beneficiaries of such cancellation or termination. Company has no such obligation to notify at the Member level. Except as otherwise provided in this Benefit Plan, no Benefits are available to a Member for Covered Services rendered after the date of cancellation or termination of a Member's coverage. coverage.‌‌‌‌ When Members on the policy change, Company reserves the right to change Subscriber’s class of coverage and bill xxxx appropriate premium to reflect the Members covered. Cancellation or termination will be effective at midnight on the last day of the billing cycle. When the Group’s coverage ends because the plan ceases to exist or COBRA is exhausted, Members may apply for individual coverage to Company or to the Exchange.

Termination of a Members Coverage. The Company may choose to rescind coverage or terminate a Member’s coverage if a Member performs an act or practice that constitutes fraud fraud, or makes an intentional misrepresentation of material fact under the terms of this Benefit Plan. The issuance of this coverage is conditioned on the representations and statements contained at application and enrollment. All representations made are material to the issuance of this coverage. Any information provided on the application or enrollment form or intentionally omitted therefrom, as to any proposed Subscriber or covered Member, shall constitute an intentional misrepresentation of material fact. A Member’s coverage may be rescinded retroactively to the Effective Date of coverage or terminated within three (3) years of the Member’s Effective Date, for fraud or intentional misrepresentation of material fact. Company will give the Member sixty (60) days advance written notice prior to rescinding or terminating coverage under this section. If Members are enrolled that are not eligible for coverage, it will be considered an act of fraud or intentional misrepresentation of material fact. Unless COBRA or other type of continuation of coverage is available and selected as provided in this Benefit Plan, a Member's coverage terminates as provided below: The Subscriber’s coverage and that of all his Dependents automatically, and without notice, terminates at the end of the period in which the Subscriber ceases to be eligible. The coverage of the Subscriber's Spouse will terminate automatically, and without notice, at the end of the period for which premiums have been paid at the time of the entry of a final decree of divorce or other legal termination of marriage. The coverage of a Dependent will terminate automatically, and without notice, at the end of the billing cycle in which the Dependent reaches the maximum age for coverage or otherwise ceases to be an eligible Dependent, if premiums have been paid through that period.‌‌‌ period. Upon the death of a Subscriber, the coverage of all of his surviving Dependents will terminate automatically and without notice at the end of the month that death occurred if premiums have been paid through that month. However, a surviving Spouse or Dependent may be able to elect COBRA or other type of continuation of coverage as described elsewhere in this Benefit Plan. In the event the Group cancels this Benefit Plan or Company or SHOP terminates this Benefit Plan for nonpayment of the appropriate payment when due or because the for the Group fails to perform any obligation required by this Benefit Plan, such cancellation or termination alone will operate to end all rights of the Member to Benefits under this Benefit Plan as of the Effective Date of such cancellation or termination. The Group shall have the obligation to notify its Members, participants, and beneficiaries of such cancellation or termination. Company has no such obligation to notify at the Member level. Except as otherwise provided in this Benefit Plan, no Benefits are available to a Member for Covered Services rendered after the date of cancellation or termination of a Member's coverage. coverage.‌‌‌‌ When Members on the policy change, Company reserves the right to change Subscriber’s class of coverage and bill appropriate premium to reflect the Members covered. Cancellation or termination will be effective at midnight on the last day of the billing cycle. When the Group’s coverage ends because the plan ceases to exist or COBRA is exhausted, Members may apply for individual coverage to Company or to the Exchange.