Common use of Clerical Errors Clause in Contracts

Clerical Errors. If a clerical or administrative error made by the Group or Health Plan results in an eligible person being incorrectly enrolled or not enrolled, then such error will be rectified by the Group and Health Plan within ninety (90) days of the error being found. If the Group’s written notice to add an eligible person is received more than ninety (90) days from the eligible person’s effective date, the Health Plan will only enroll the eligible person a maximum of ninety (90), days, retroactively from the date that the Health Plan received the written notice from the Group. Refunds or payments will be made accordingly by the Group or Health Plan, whichever is applicable. Cost Shares Members must pay or arrange for payment of amounts they owe the Health Plan, Plan Hospitals or Medical Group. The Cost Share is the amount of Allowable Charge for a covered Service and is due at the time the Member receives a Service. Limit on Cost Shares There are limits to the total amount of Cost Shares paid by a Member in a contract year for certain Services covered under this EOC. The Copayment Maximum and the Out-of-Pocket Maximum, if applicable, are provided in the Summary of Services and Cost Shares in the EOC.

Clerical Errors. If a clerical or administrative error made by the Group or Health Plan results in an eligible person being incorrectly enrolled or not enrolled, then such error will be rectified by the Group and Health Plan within ninety (90) days of the error being found. If the Group’s written notice to add an eligible person is received more than ninety (90) days from the eligible person’s effective date, the Health Plan will only enroll the eligible person a maximum of ninety (90), ) days, retroactively from the date that the Health Plan received the written notice from the Group. Refunds or payments will be made accordingly by the Group or Health Plan, whichever is applicable. Cost Shares Members must pay or arrange for payment of amounts they owe the Health Plan, Plan Hospitals or Medical Group. The Cost Share is the amount of Allowable Charge for a covered Service and is due at the time the Member receives a Service. Limit on Cost Shares There are limits to the total amount of Cost Shares paid by a Member in a contract year for certain Services covered under this EOC. The Copayment Maximum and the Out-of-Pocket Maximum, if applicable, are provided in the Summary of Services and Cost Shares in the EOC.

Clerical Errors. If a clerical or administrative error made by the Group or Health Plan results in an eligible person being incorrectly enrolled or not enrolled, then such error will be rectified by the Group and Health Plan within ninety (90) days of the error being found. If the Group’s written notice to add an eligible person is received more than ninety (90) days 90)-days from the eligible person’s effective date, the Health Plan will only enroll the eligible person a maximum of ninety (90), days, 90)-days retroactively from the date that the Health Plan received the written notice from the Group. Refunds or payments will be made accordingly by the Group or Health Plan, whichever is applicable. Cost Shares Members must pay or arrange for payment of amounts they owe the Health Plan, Plan Hospitals or Medical Group. The Cost Share is the amount of Allowable Charge for a covered Service and is due at the time the Member receives a Service. Limit on Cost Shares There are limits to the total amount of Cost Shares paid by a Member in a contract year for certain Services covered under this EOC. The Copayment Maximum and the Out-of-Pocket Maximum, if applicable, are provided in the Summary of Services and Cost Shares in the EOC.

Clerical Errors. If a clerical or administrative error made by the Group or Health Plan results in an eligible person being incorrectly enrolled or not enrolled, then such error will be rectified by the Group and Health Plan within ninety (90) days of the error being found. If the Group’s written notice to add an eligible person is received more than ninety (90) days from f rom the eligible person’s effective date, the Health Plan will only enroll the eligible person a maximum of ninety (90), days, ) days retroactively from the date that the Health Plan received the written notice from f rom the Group. Refunds or payments will be made accordingly by the Group or Health Plan, whichever is applicable. Cost Shares Members must pay or arrange for payment of amounts they owe the Health Plan, Plan Hospitals or Medical Group. The Cost Share is the amount of Allowable Charge for a covered Service and is due at the time the Member receives a Service. Limit on Cost Shares There are limits to the total amount of Cost Shares paid by a Member in a contract year for certain Services covered under this EOC. The Copayment Maximum and the Out-of-Pocket Maximum, if applicable, are provided in the Summary of Services and Cost Shares in the EOC.

Clerical Errors. If a clerical or administrative error made by the Group or Health Plan results in an eligible person being incorrectly enrolled or not enrolled, then such error will be rectified by the Group and Health Plan within ninety (90) days of the error being found. If the Group’s written notice to add an eligible person is received more than ninety (90) days from the eligible person’s effective date, the Health Plan will only enroll the eligible person a maximum of ninety (90), days, ) days retroactively from the date that the Health Plan received the written notice from the Group. Refunds or payments will be made accordingly by the Group or Health Plan, whichever is applicable. Cost Shares Members must pay or arrange for payment of amounts they owe the Health Plan, Plan Hospitals or Medical Group. The Cost Share is the amount of Allowable Charge for a covered Service and is due at the time the Member receives a Service. Limit on Cost Shares There are limits to the total amount of Cost Shares paid by a Member in a contract year for certain Services covered under this EOC. The Copayment Maximum and the Out-of-Pocket Maximum, if applicable, are provided in the Summary of Services and Cost Shares in the EOC.