Common use of Applying for Coverage Clause in Contracts

Applying for Coverage. This Section gives an overview of how to apply for coverage under this Contract, through the Marketplace, or directly with AvMed. Rules for enrolling during specific enrollment periods, for changing coverage, and for adding eligible dependents are described in Sections 4.3 Enrollment Periods and 4.4 Qualifying Events, SEPs and Effective Dates of Coverage. a. To apply for coverage under this Contract through the Marketplace, you must: i. Create a Marketplace account on ▇▇▇▇▇▇▇▇▇▇.▇▇▇; ii. Fill out and submit an online application or download and complete a paper application. You can also apply by phone or in-person with an assister; iii. You will receive a notice in the mail or in an email that tells you what coverage you are eligible for. Review and save this notice. iv. If you are eligible, shop for an AvMed Marketplace plan and enroll on behalf of yourself and/or your eligible dependents you want to cover; and v. Send your first Premium payment to us. b. To apply for coverage under this Contract directly through AvMed, outside of the Marketplace, you must: i. Complete an online application, or download and complete a paper application, and submit it to us on behalf of yourself and/or your eligible dependents you want to cover; ii. Provide information needed to determine eligibility, as requested; and iii. Pay the required Premium. c. By submitting an Application, you represent that you have permission from all of the people whose information is on the Application to both submit their information to us or the Marketplace and receive any communications about their eligibility and enrollment.