Common use of Enrollee Terminations Clause in Contracts

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

Appears in 4 contracts

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

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

Enrollee Terminations. In the event Contractor terminates an Enrollee’s coverage in a QDP due to non-payment of premiums, loss of eligibility, fraud or misrepresentation, change in Enrollees selection of QDP, decertification of Contractor’s QDP, or QDP and/or as otherwise authorized under Sections 2.2.4 and 2.3.4, Contractor must include applicable State Regulator-approved appeals language, and any Covered CaliforniaExchange-required appeals language 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 coverage in a QDP due to non-payment of premiums, loss of eligibility, fraud or misrepresentation, change in Enrollees selection of QDP, decertification of Contractor’s QDP, or QDP and/or as otherwise authorized under Sections 2.2.4 2.2.24 and 2.3.42.3.24, Contractor must include applicable State the Health Insurance Regulator-approved appeals language, and any Covered California-required appeals 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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Enrollee Terminations. In the event Contractor terminates an Enrollee’s Enrollee¶s coverage in a QDP due to non-payment of premiums, loss of eligibility, fraud or misrepresentation, change in Enrollees selection of QDP, decertification of Contractor’s QDP, or Contractor¶s QDP and/or as otherwise authorized under Sections 2.2.4 2.2.24 and 2.3.42.3.24, Contractor must include applicable State Regulator-the Health Insurance Regulator- approved appeals language, and any Covered CaliforniaExchange-required appeals language language, in its notice of termination of coverage to the Enrollee.

Appears in 1 contract

Samples: Qualified Dental Plan Issuer Contract

Enrollee Terminations. In the event Contractor terminates an Enrollee’s coverage in a QDP due to non-payment of premiums, loss of eligibility, fraud or misrepresentation, change in Enrollees selection of QDP, decertification of Contractor’s QDP, or QDP and/or as otherwise authorized under Sections 2.2.4 2.2.2 and 2.3.42.3.2, Contractor must include applicable State the Health Insurance Regulator-approved appeals language, and any Covered California-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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