Common use of WHO IS COVERED Clause in Contracts

WHO IS COVERED. 1. Who is Covered Under this Contract You are covered under this Contract if you meet all of the following requirements:  You are younger than age 19.  You do not have other health care coverage.  You are not eligible for Medicaid.  You are a New York State resident and a resident of our Service Area. 2. Recertification You must periodically resubmit an application to determine whether you still meet the eligibility requirements. This process is called "recertification”. Within 60-90 days before your coverage is due to end, you will receive an email notification from NY State of Health containing your renewal options. Please log into your Marketplace account on the the NY State of Health website, read and follow the instructions carefully. To maintain your coverage, you may be required to update information on the NY State of Health website.  Complete the renewal form.  Submit the required proofs.  Sign and date the form.  Mail the form as soon as possible in the envelope provided.  If the form is not received by the date due, your coverage will end. Upon receipt of your renewal form, it will be reviewed to determine if your child's eligibility status has changed.  assist you in navigating the NY State of Health website.  schedule an appointment for you to meet with a representative.  provide a list of our locations where we can meet and assist you.  assist you in completing the forms over the telephone. 3. Change in Circumstances You must notify us of any changes to your residency or health care coverage that might make you ineligible for this contract. You must give us this notice within sixty (60) days of the change. If you fail to give us notice of a change in circumstances, you may be asked to pay back any premium that has been paid for you.

WHO IS COVERED. 1. Who is Covered Under this Contract You are covered under this Contract if you meet all of the following requirements:  • You are younger than age 19.  • You do not have other health care coverage.  • You are not eligible for Medicaid.  • You are a New York State resident and a resident of our Service Area. 2. Recertification You must periodically resubmit an application to determine whether you still meet the eligibility requirements. This process is called "recertification”. Within 60-90 days before your coverage is due to end, you will receive an email notification from NY State of Health containing your renewal options. Please log into your Marketplace account on the the NY State of Health website, read and follow the instructions carefully. To maintain your coverage, you may be required to update information on the NY State of Health website.  • Complete the renewal form.  • Submit the required proofs.  • Sign and date the form.  • Mail the form as soon as possible in the envelope provided.  • If the form is not received by the date due, your coverage will end. Upon receipt of your renewal form, it will be reviewed to determine if your child's eligibility status has changed.  • assist you in navigating the NY State of Health website.  • schedule an appointment for you to meet with a representative.  • provide a list of our locations where we can meet and assist you.  • assist you in completing the forms over the telephone. 3. Change in Circumstances You must notify us of any changes to your residency or health care coverage that might make you ineligible for this contract. You must give us this notice within sixty (60) days of the change. If you fail to give us notice of a change in circumstances, you may be asked to pay back any premium that has been paid for you.