Common use of Terminations of Coverage Clause in Contracts

Terminations of Coverage. Contractor shall provide a Covered California Enrollee with notice and shall terminate coverage in a Contractor’s QDP in accordance with the requirements established by Covered California pursuant to 10 CCR § 6506 and other applicable State and Federal laws, rules and regulations. Contractor shall report information to Covered California regarding delinquent full or partial payments of premium owing by Qualified Individuals in such format and intervals as is reasonably requested by Covered California. Contractor shall notify the Agent or Agency of Record of a late payment notification at the same time the Covered California Enrollee receives notification. Covered California must send a termination transaction to Contractor within ten (10) business days of any individual Covered California Enrollee termination. Contractor must send a termination transaction to Covered California within ten (10) Days of grace period expiration. Contractor shall request termination of a Covered California Enrollee for fraud or misrepresentation through the Carrier Referral Process posted on the Contractor’s extranet website provided by Covered California (Carrier Management (External) page, Contractor’s folder, Data Integrity, Fraud Referral, folder) and provide Covered California with supporting documentation for each request to terminate. Contractor may not terminate for fraud or misrepresentation without prior approval from Covered California.

Terminations of Coverage. Contractor shall provide a Covered California Enrollee with notice and shall terminate coverage in a Contractor’s QDP QHP in accordance with the requirements established by Covered California pursuant to 10 CCR § 6506 and other applicable State and Federal laws, rules rules, and regulations. Contractor shall report information to terminate coverage for an individual Covered California regarding delinquent full or partial Enrollee’s non-payment of premium as follows: (i) effective as of the last Day of the first month of a three (3) month grace period in the event of nonpayment of premiums by individuals receiving advance payments of the premium owing tax credit or State premium assistance payments; or (ii) effective the last Day of coverage established by Qualified Individuals in such format grace periods under applicable State law, including requirements relating to Health and intervals as is reasonably requested by Covered CaliforniaSafety Code § 1365 and Insurance Code § 10273.6 for individuals not receiving advance payments of the premium tax credit or State premium assistance. Contractor shall notify the Agent or Agency of Record of a late payment notification at the same time the Covered California Enrollee receives notification. Covered California and Contractor must send a termination transaction to Contractor the other party within ten (10) business days of any individual Covered California Enrollee termination. Contractor must send a termination transaction to Covered California within ten (10) Days of grace period expiration. Contractor shall request termination of a an Covered California enrollee Enrollee for fraud or misrepresentation through the Carrier Referral Process (posted on the Contractor’s extranet website provided by Covered California (Carrier Management (External) Hub page, Contractor’s foldersubsite, Data IntegrityIntegrity Files, Fraud Referral, Fraud Referral Rev. folder)) and provide Covered California with supporting documentation for each request to terminate. Contractor may not terminate for fraud or misrepresentation without prior approval from Covered California.

Terminations of Coverage. Contractor shall provide a Covered California Enrollee with notice and shall terminate an Enrollee’s coverage in a Contractor’s QDP in accordance with the requirements established by Covered California pursuant to 10 CCR § 6506 and other applicable State and Federal laws, rules and regulations. Contractor shall report information to Covered California regarding delinquent full or partial payments of premium owing by Qualified Individuals in such format and intervals as is reasonably requested by Covered California. Contractor shall notify the Agent or Agency of Record of a late payment notification at the same time the Covered California Enrollee receives notification. Covered California and Contractor must send a termination transaction to Contractor the other party within ten (10) business days of any individual Covered California Enrollee termination. Contractor must send a termination transaction to Covered California within ten (10) Days of grace period expiration. Contractor shall request termination of a Covered California Enrollee an enrollee for fraud or misrepresentation through the Carrier Referral Process (posted on the Contractor’s extranet website provided by Covered California (Carrier Management (External) Hub page, Contractor’s subsite, Data Integrity Files, Fraud Referral, Fraud Referral Rev. folderData Home, Contractor’s folder, Data Integrity, Fraud Referral, Referral folder)) and provide Covered California with supporting documentation for each request to terminate. Contractor may not terminate for fraud or misrepresentation without prior approval from Covered California.