Common use of Enrollee Terminations Clause in Contracts

Enrollee Terminations. In the event Contractor terminates an Enrollee’s coverage in a QHP due to non-payment of premiums, loss of eligibility, fraud or misrepresentation, change in Enrollees selection of QHP, decertification of Contractor’s QHP or as otherwise authorized under Section 2.2.4, Contractor must include the applicable regulator-approved appeals language, and any Exchange-required appeals language, in its notice of termination of coverage to the Enrollee.

Appears in 3 contracts

Samples: Qualified Health Plan Issuer Contract, Qualified Health Plan Issuer Contract, Qualified Health Plan Issuer Contract

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Enrollee Terminations. In the event Contractor terminates an Enrollee’s coverage in a QHP QDP due to non-payment of premiums, loss of eligibility, fraud or misrepresentation, change in Enrollees selection of QHPQDP, decertification of Contractor’s QHP QDP, or as otherwise authorized under Section 2.2.4Sections 2.2.4 and 2.3.4, Contractor must include the applicable regulatorState Regulator-approved appeals language, and any ExchangeCovered California-required appeals language, language in its notice of termination of coverage to the Enrollee.

Appears in 3 contracts

Samples: Qualified Dental Plan Issuer Contract, Qualified Dental Plan Issuer Contract, Qualified Dental Plan Issuer Contract

Enrollee Terminations. In the event Contractor terminates an Enrollee’s coverage in a QHP QDP due to non-payment of premiums, loss of eligibility, fraud or misrepresentation, change in Enrollees selection of QHPQDP, decertification of Contractor’s QHP or QDP and/or as otherwise authorized under Section 2.2.4Sections 2.2.4 and 2.3.4, Contractor must include the applicable regulatorRegulator-approved appeals language, and any Exchange-required appeals language, in its notice of termination of coverage to the Enrollee.

Appears in 2 contracts

Samples: Qualified Dental Plan Issuer Contract, Qualified Dental Plan Issuer Contract

Enrollee Terminations. In the event Contractor terminates an Enrollee’s Enrollee¶s coverage in a QHP QDP due to non-payment of premiums, loss of eligibility, fraud or misrepresentation, change in Enrollees selection of QHPQDP, decertification of Contractor’s QHP or Contractor¶s QDP and/or as otherwise authorized under Section 2.2.4Sections 2.2.24 and 2.3.24, Contractor must include applicable the applicable regulator-Health Insurance Regulator- approved appeals language, and any Exchange-required appeals language, in its notice of termination of coverage to the Enrollee.

Appears in 1 contract

Samples: Qualified Dental Plan Issuer Contract

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Enrollee Terminations. In the event Contractor terminates an Enrollee’s coverage in a QHP QDP due to non-payment of premiums, loss of eligibility, fraud or misrepresentation, change in Enrollees selection of QHPQDP, decertification of Contractor’s QHP or QDP and/or as otherwise authorized under Section 2.2.4Sections 2.2.24 and 2.3.24, Contractor must include the applicable regulatorHealth Insurance Regulator-approved appeals language, and any Exchange-required appeals language, language in its notice of termination of coverage to the Enrollee.

Appears in 1 contract

Samples: Covered California Qualified Dental Plan Issuer Contract

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