Common use of When Coverage Ends Clause in Contracts

When Coverage Ends. ‌ As permitted by law, we may end this Policy and/or all similar policies for the reasons explained in this Policy. Your right to Benefits automatically ends on the date that coverage ends, even if you are hospitalized or are otherwise receiving medical treatment on that date, except as noted below under Extended Coverage Related to a Claim. For extended Benefits for pediatric dental and vision services, please see Section 11: Pediatric Dental Care Services and Section 12: Pediatric Vision Care Services. When your coverage ends, we will still pay claims for Covered Health Care Services that you received before the date your coverage ended. However, once your coverage ends, we will not pay claims for any health care services received after that date (even if the medical condition that is being treated occurred before the date your coverage ended). Unless otherwise stated, an Enrolled Dependent's coverage ends on the date the Policyholder's coverage ends. We will refund any Premium paid and not earned due to Policy termination. This Policy may also terminate due to changes in the actuarial value requirements under state or federal law. If this Policy terminates for this reason, a new Policy, if available, may be issued to you. You may keep coverage in force by timely payment of the required Premiums under this Policy or under any subsequent coverage you have with us. This Policy will renew on January 1 of each calendar year. However, we may refuse renewal if any of the following occur: • We refuse to renew all policies issued on this form, with the same type and level of Benefits, to residents of the state where you then live, as explained under The Entire Policy Ends below. • There is fraud or intentional misrepresentation made by you or with your knowledge in filing a claim for Benefits, as explained under Fraud or Intentional Misrepresentation below. • Your eligibility would otherwise be prohibited under applicable law. Coverage ends on the earliest of the dates specified below. When any of the following happen, we will provide written notice including the termination date and the reason for termination to the Policyholder: • The Entire Policy Ends Your coverage ends on the date this Policy ends. That date will be one of the following: ▪ The date determined by the Maryland Health Benefit Exchange that this Policy will terminate because the Policyholder no longer lives in the Service Area. ▪ The date we specify, after we give you 90 days prior written notice, that we will terminate this Policy because we will discontinue offering and refuse to renew all policies issued on this form, with the same type and level of benefits, for all residents of the state where you reside. You will be offered an option to purchase any other coverage in the individual market we offer in your state at the time of discontinuance of this Policy. This option to purchase other coverage will be on a guaranteed issue basis without regard to health status. ▪ The date we specify, after we give you and the applicable state authority at least 180 days prior written notice, that we will terminate this Policy because we will discontinue offering and refuse to renew all individual policies/certificates in the individual market in the state where you reside. • You Are No Longer Eligible Your coverage ends on the date you are no longer eligible to be a Policyholder or an Enrolled Dependent, as determined by the Maryland Health Benefit Exchange, unless you request an earlier termination date. Please refer to Section 8: Defined Terms for definitions of the terms “Eligible Person,” “Policyholder,” "Dependent" and "Enrolled Dependent." If the Maryland Health Benefit Exchange determines you are no longer eligible for coverage through the exchange, you may continue coverage with us outside of the exchange. • We Receive Notice to End Coverage Your coverage ends on the date determined by the Maryland Health Benefit Exchange rules if we receive notice from the Maryland Health Benefit Exchange instructing us to end your coverage. Your coverage ends on the date determined by the Maryland Health Benefit Exchange rules if we receive notice from you instructing us to end your coverage. The Maryland Health Benefit Exchange must permit a Covered Person to terminate his or her coverage under the Policy, including as a result of the Covered Person obtaining other minimum essential health coverage, with reasonable notice to the Maryland Health Benefit Exchange. Reasonable notice is defined as fourteen days from the requested effective date of termination. Effective date for such termination is: 1) the date specified by the Covered Person if reasonable notice was provided as described above; or 2) fourteen days after termination is requested by the Covered Person when appropriate notice is not provided; or 3) the date on which the termination is requested by the Covered Person, or on another prospective date selected by the Covered Person; or

When Coverage Ends. ‌ As permitted by law, we may end this Policy and/or all similar policies for the reasons explained in this Policy. Notice of termination of this Policy, including the reason, will be provided to you at least 90 days prior to the date of termination. Your right to Benefits automatically ends on the date that coverage ends, even if you are hospitalized or are otherwise receiving medical treatment on that date, except as noted below under Extended Coverage Related to a Claim. For extended Benefits for pediatric dental and vision services, please see Section 11: Pediatric Dental Care Services and Section 12: Pediatric Vision Care Services. When your coverage ends, we will still pay claims for Covered Health Care Services that you received before the date your coverage ended. However, once your coverage ends, we will not pay claims for any health care services received after that date (even if the medical condition that is being treated occurred before the date your coverage ended). Unless otherwise stated, an Enrolled Dependent's coverage ends on the date the Policyholder's coverage ends. We will refund any Premium paid and not earned due to Policy termination. This Policy may also terminate due to changes in the actuarial value requirements under state or federal law. If this Policy terminates for this reason, a new Policy, if available, may be issued to you. You may keep coverage in force by timely payment of the required Premiums under this Policy or under any subsequent coverage you have with us. SAMPLE This Policy will renew on January 1 of each calendar year. However, we may refuse renewal if any of the following occur: • We refuse to renew all policies issued on this form, with the same type and level of Benefits, to residents of the state where you then live, as explained under The Entire Policy Ends below. • There is fraud or intentional misrepresentation made by you or with your knowledge in filing a claim for Benefits, as explained under Fraud or Intentional Misrepresentation below. • Your eligibility would otherwise be prohibited under applicable law. Coverage ends on the earliest of the dates specified below. When any of the following happen, we will provide written notice including the termination date and the reason for termination to the Policyholder: • The Entire Policy Ends Your coverage ends on the date this Policy ends. That date will be one of the following: ▪ The date determined by the Maryland federal Health Benefit Exchange Insurance Marketplace that this Policy will terminate because the Policyholder no longer lives in the Service Area. ▪ The date we specify, after we give you 90 days prior written notice, that we will terminate this Policy because we will discontinue offering and refuse to renew all policies issued on this form, with the same type and level of benefits, for all residents of the state where you reside. You will be offered an option to purchase any other coverage in the individual market we offer in your state at the time of discontinuance of this Policy. This option to purchase other coverage will be on a guaranteed issue basis without regard to health status. ▪ The date we specify, after we give you and the applicable state authority at least 180 days prior written notice, that we will terminate this Policy because we will discontinue offering and refuse to renew all individual policies/certificates in the individual market in the state where you reside. • You Are No Longer Eligible Your coverage ends on the date you are no longer eligible to be a Policyholder or an Enrolled Dependent, as determined by the Maryland federal Health Benefit Exchange, unless you request an earlier termination dateInsurance Marketplace. Please refer to Section 8: Defined Terms for definitions of the terms “Eligible Person,” “Policyholder,” "Dependent" and "Enrolled Dependent." If the Maryland Health Benefit Exchange determines you are no longer eligible for coverage through the exchange, you may continue coverage with us outside of the exchange. • We Receive Notice to End Coverage Your coverage ends on the date determined by the Maryland federal Health Benefit Exchange Insurance Marketplace rules if we receive notice from the Maryland federal Health Benefit Exchange Insurance Marketplace instructing us to end your coverage. Your coverage ends on the date determined by the Maryland federal Health Benefit Exchange Insurance Marketplace rules if we receive notice from you instructing us to end your coverage. The Maryland Health Benefit Exchange must permit a Covered Person to terminate his or her coverage under the Policy, including as a result of the Covered Person obtaining other minimum essential health coverage, with reasonable notice to the Maryland Health Benefit Exchange. Reasonable notice is defined as fourteen days from the requested effective date of termination. Effective date for such termination is: 1) the date specified by the Covered Person if reasonable notice was provided as described above; or 2) fourteen days after termination is requested by the Covered Person when appropriate notice is not provided; or 3) the date on which the termination is requested by the Covered Person, or on another prospective date selected by the Covered Person; or.

When Coverage Ends. ‌ As permitted by law, we may end this Policy and/or all similar policies for the reasons explained in this Policy. Your right to Benefits automatically ends on the date that coverage ends, even if you are hospitalized or are otherwise receiving medical treatment on that date, except as noted below under Extended Coverage Related to a Claim. For extended Benefits for pediatric dental and vision services, please see Section 11: Pediatric Dental Care Services and Section 12: Pediatric Vision Care Services. When your coverage ends, we will still pay claims for Covered Health Care Services that you received before the date your coverage ended. However, once your coverage ends, we will not pay claims for any health care services received after that date (even if the medical condition that is being treated occurred before the date your coverage ended). Unless otherwise stated, an Enrolled Dependent's coverage ends on the date the Policyholder's coverage ends. We will refund any Premium paid and not earned due to Policy termination. This Policy may also terminate due to changes in the actuarial value requirements under state or federal law. If this Policy terminates for this reason, a new Policy, if available, may be issued to you. You may keep coverage in force by timely payment of the required Premiums under this Policy or under any subsequent coverage you have with us. SAMPLE This Policy will renew on January 1 of each calendar year. However, we may refuse renewal if any of the following occur: • We refuse to renew all policies issued on this form, with the same type and level of Benefits, to residents of the state where you then live, as explained under The Entire Policy Ends below. • There is fraud or intentional misrepresentation made by you or with your knowledge in filing a claim for Benefits, as explained under Fraud or Intentional Misrepresentation below. • Your eligibility would otherwise be prohibited under applicable law. Coverage ends on the earliest of the dates specified below. When any of the following happen, we will provide written notice including the termination date and the reason for termination to the Policyholder: • The Entire Policy Ends Your coverage ends on the date this Policy ends. That date will be one of the following: ▪ The date determined by the Maryland Health Benefit Exchange that this Policy will terminate because the Policyholder no longer lives in the Service Area. ▪ The date we specify, after we give you 90 days prior written notice, that we will terminate this Policy because we will discontinue offering and refuse to renew all policies issued on this form, with the same type and level of benefits, for all residents of the state where you reside. You will be offered an option to purchase any other coverage in the individual market we offer in your state at the time of discontinuance of this Policy. This option to purchase other coverage will be on a guaranteed issue basis without regard to health status. ▪ The date we specify, after we give you and the applicable state authority at least 180 days prior written notice, that we will terminate this Policy because we will discontinue offering and refuse to renew all individual policies/certificates in the individual market in the state where you reside. • You Are No Longer Eligible Your coverage ends on the date you are no longer eligible to be a Policyholder or an Enrolled Dependent, as determined by the Maryland Health Benefit Exchange, unless you request an earlier termination date. Please refer to Section 8: Defined Terms for definitions of the terms “Eligible Person,” “Policyholder,” "Dependent" and "Enrolled Dependent." If the Maryland Health Benefit Exchange determines you are no longer eligible for coverage through the exchange, you may continue coverage with us outside of the exchange. • We Receive Notice to End Coverage Your coverage ends on the date determined by the Maryland Health Benefit Exchange rules if we receive notice from the Maryland Health Benefit Exchange instructing us to end your coverage. Your coverage ends on the date determined by the Maryland Health Benefit Exchange rules if we receive notice from you instructing us to end your coverage. The Maryland Health Benefit Exchange must permit a Covered Person to terminate his or her coverage under the Policy, including as a result of the Covered Person obtaining other minimum essential health coverage, with reasonable notice to the Maryland Health Benefit Exchange. Reasonable notice is defined as fourteen days from the requested effective date of termination. Effective date for such termination is: 1) the date specified by the Covered Person if reasonable notice was provided as described above; or 2) fourteen days after termination is requested by the Covered Person when appropriate notice is not provided; or 3) the date on which the termination is requested by the Covered Person, or on another prospective date selected by the Covered Person; or