Examples of Group Enrollment Agreement in a sentence
If the Subscriber fails to give notice which would have resulted in termination of coverage, SHL shall have the right to terminate coverage in accordance with the Group Enrollment Agreement.
In the case of conflicts between the Group Enrollment Agreement and this Combined Evidence Of Coverage and Disclosure Form, the provisions of this Combined Evidence Of Coverage and Disclosure Form shall be binding upon Health Plan notwithstanding any provisions of the Group Agreement that may be less favorable to Members.
RECOMMENDATIONS The Committee is requested to RECOMMEND that the fees and charges scheme and schedule as set out in Appendixst1 be approved to come into effect between 1stOctober 2013 and31 March 2014 and Appendix 2 be approved to come into effectstfrom 1 April 2014.
The Group Enrollment Agreement is subject to amendment and termination in accordance with its terms without the necessity of either Health Plan or the Group obtaining the consent or concurrence of any Member.
A PCP Group Enrollment Agreement with Medicaid and one agreement with an ACHN is required.
Subject to the Group’s payment of the applicable total monthly premium for each Member and subject to the Group’s submission to Health Plan prior to the first day of each month of a listing of each Member eligible to receive Covered Services, including all prospective Members, within thirty-one (31) days of the date of such Member’s first becoming eligible, coverage under the Group Enrollment Agreement will become effective for said Members on the effective date of coverage specified by the Group.
By electing coverage or accepting benefits under the Group Enrollment Agreement, all Members legally capable of contracting, and the legal representatives of all Members incapable of contracting, agree to be bound by all of the terms and conditions of the Group Enrollment Agreement.
If a Member becomes Totally Disabled while covered under the Group Enrollment Agreement, and the Group Enrollment Agreement between Health Plan and the Group is subsequently terminated, benefits for Covered Services directly relating to the disabling condition will continue for twelve (12) months following the last day of coverage for which a total monthly premium was paid to Health Plan on behalf of the Member, notwithstanding the termination of the Group Enrollment Agreement during such period.
This Section does not apply to reinstatement of the Group, but rather to reinstatement of a Member whose coverage has terminated for reasons unrelated to cancellation of the Group Enrollment Agreement for nonpayment.
Except as otherwise provided in the Group Enrollment Agreement, Health Plan will require Participating Providers to make Covered Services available to Members in the same manner, in accordance with the same standards, and with no less availability as Participating Providers provide services to their other patients.