Common use of Third Party To Receive Premium Statement and/or Make Premium Remittance Clause in Contracts

Third Party To Receive Premium Statement and/or Make Premium Remittance. If the Group has contracted with a third party to receive the Premium Statement and/or make premium remittances to the Insurance Company, the Group understands that this does not relieve the Group from remittance of the amount due by the due date. The Group will be held responsible for the premium remittance. The Group will be responsible for any late fees or finance charges imposed for late payment. Any payment delinquency notices or coverage termination notices for non- payment of premium will be sent to the third party for notice and delivery to Group Members. The Group authorizes the Insurance Company to send such Premium Statements to and receive and accept such premium remittances from the third party. The Group shall be responsible for the validity and accuracy of the information provided to the Insurance Company and shall indemnify and hold the Insurance Company harmless from any and all liability, loss, damages, claims and expenses, including attorney’s fees, as a result of the actions or inactions of the third party, including without limitation, any incorrect information provided. If the Group assigns other functions to the third party, this Agreement shall control the performance of those functions. The Insurance Company is not a party to the agreement between the Group and the third party. The Insurance Company may refuse to accept information from the third party. The Insurance Company shall make reasonable accommodation to assist the Group in the administration of its assigned duties and responsibilities. With regard to Electronic Protected Health Information (as defined in 45 CFR Parts 160 and 162 (“Security Standards”)), the Group shall:

Third Party To Receive Premium Statement and/or Make Premium Remittance. If the Group has contracted with a third party to receive the Premium Statement and/or make premium remittances to the Insurance Company, the Group understands that this does not relieve the Group from remittance of the amount due by the due date. The Group will be held responsible for the premium remittance. The Group will be responsible for any late fees or finance charges imposed for late payment. Any payment delinquency notices or coverage termination notices for non- payment of premium will be sent to the third party for notice and delivery to Group Members. The Group authorizes the Insurance Company to send such Premium Statements to and receive and accept such premium remittances from the third party. The Group shall be responsible for the validity and accuracy of the information provided to the Insurance Company and shall indemnify and hold the Insurance Company harmless from any and all liability, loss, damages, claims and expenses, including attorney’s IURP DQ\ DQG DOO OLDELOLW\ ORVV GDPDJHV FO fees, as a result of the actions or inactions of the third party, including without limitation, any incorrect information provided. If the Group assigns other functions to the third party, this Agreement shall control the performance of those functions. The Insurance Company is not a party to the agreement between the Group and the third party. The Insurance Company may refuse to accept information from the third party. The Insurance Company shall make reasonable accommodation to assist the Group in the administration of its assigned duties and responsibilities. With regard to Electronic Protected Health Information (as defined in 45 CFR Parts 160 and 162 (“Security Standards”)), the Group shall:DQG ³6HFXULW\sh a6ll: WDQGDUGV´ WKH *URX

Third Party To Receive Premium Statement and/or Make Premium Remittance. If the Group has contracted with a third party to receive the Premium Statement and/or make premium remittances to the Insurance Company, the Group understands that this does not relieve the Group from remittance of the amount due by the due date. The Group will be held responsible for the premium remittance. The Group will be responsible for any late fees or finance charges imposed for late payment. Any payment delinquency notices or coverage termination notices for non- non-payment of premium will be sent to the third party for notice and delivery to Group Members. The Group authorizes the Insurance Company to send such Premium Statements to and receive and accept such premium remittances from the third party. The Group shall be responsible for the validity and accuracy of the information provided to the Insurance Company and shall indemnify and hold the Insurance Company harmless from any and all liability, loss, damages, claims and expenses, including attorney’s fees, as a result of the actions or inactions of the third party, including without limitation, any incorrect information provided. If the Group assigns other functions to the third party, this Agreement shall control the performance of those functions. The Insurance Company is not a party to the agreement between the Group and the third party. The Insurance Company may refuse to accept information from the third party. The Insurance Company shall make reasonable accommodation to assist the Group in the administration of its assigned duties and responsibilities. With regard to Electronic Protected Health Information (as defined in 45 CFR Parts 160 and 162 (“Security Standards”)), the Group shall: