Common use of FAILURE TO PAY PREMIUMS Clause in Contracts

FAILURE TO PAY PREMIUMS. If the Aggregate Premium is not paid by the end of the Grace Period, the Insurance Company, in its sole discretion, may: (1) notify the Group of such non- payment and termination date of the Policy and all Coverage thereunder and terminate the Policy Coverage back to the last Premium due date; or (2) work with the Group to arrange payment of the Aggregate Premium, for a period of up to 90 days. If the Group fails to pay the Premium when required, the Insurance Company will be entitled to recover Insurance Company Expenses. Insurance Company Expenses include: (1) the total outstanding Aggregate Premium; (2) the finance charge set forth below; and (3) a fee for any checks for payment of Premiums that are returned to Insurance Company for insufficient funds, closed accounts, or any other reason; and (4) any expenses reasonably incurred in recovering the amount owed to the Insurance Company including attorney’s fees. If the Insurance Company terminates the Policy back to the last Premium due date, the Insurance Company may recoup benefit payments from Members and/or Providers. The Group is still obligated to reimburse the Insurance Company for any claims or charges which the Insurance Company has to pay, as required by: (1) state or federal law; (2) pharmacy benefit management agreement; or (3) provider agreement, plus a reasonable administrative fee.

FAILURE TO PAY PREMIUMS. If the Aggregate Premium is not paid by the end of the Grace Period, the Insurance Company, in its sole discretion, may: (1) notify the Group of such non- non-payment and termination date of the Policy and all Coverage thereunder and terminate the Policy Coverage back to the last Premium due date; or (2) work with the Group to arrange payment of the Aggregate Premium, for a period of up to 90 days. If the Group fails to pay the Premium when required, the Insurance Company will be entitled to recover Insurance Company Expenses. Insurance Company Expenses include: (1) the total outstanding Aggregate Premium; (2) the finance charge set forth below; and (3) a fee for any checks for payment of Premiums that are returned to Insurance Company for insufficient funds, closed accounts, or any other reason; and (4) any expenses reasonably incurred in recovering the amount owed to the Insurance Company including attorney’s fees. If the Insurance Company terminates the Policy back to the last Premium due date, the Insurance Company may recoup benefit payments from Members and/or Providers. The Group is still obligated to reimburse the Insurance Company for any claims or charges which the Insurance Company has to pay, as required by: (1) state or federal law; (2) pharmacy benefit management agreement; or (3) provider agreement, plus a reasonable administrative fee.