Common use of Prior Coverage Clause in Contracts

Prior Coverage. If a member is confined as an inpatient in a hospital on the effective date of this agreement, and prior coverage terminating immediately before the effective date of this agreement furnishes benefits for the hospitalization after the termination of prior coverage, then services and benefits will not be covered under this agreement for that member until the member is discharged from the hospital or benefits under the prior coverage are exhausted, whichever is earlier. Out of Service Area Dependent Member Coverage A dependent member’s coverage will not cease should the dependent member live outside the service area if a court order requires the member to cover such dependent member. There will be an open enrollment period for coverage on the Health Insurance Marketplace. The open enrollment period begins November 1, 2018 and extends through December 15, 2018. Qualified individuals who enroll on or before December 15, 2018 will have an effective date of coverage on January 1, 2019. The Health Insurance Marketplace may provide a coverage effective date for a qualified individual earlier than specified in the paragraphs above, provided that either:

Prior Coverage. If a member is confined as an inpatient in a hospital on the effective date of this agreement, and prior coverage terminating immediately before the effective date of this agreement furnishes benefits for the hospitalization after the termination of prior coverage, then services and benefits will not be covered under this agreement for that member until the member is discharged from the hospital or benefits under the prior coverage are exhausted, whichever is earlier. Out of Service Area Dependent Member Coverage A dependent member’s coverage will not cease should the dependent member live outside the service area if a court order requires the member to cover such dependent member. There will be an open enrollment period for coverage on the Health Insurance Marketplace. The open enrollment period begins November 1, 2018 and extends through December 15, 2018. Qualified individuals who enroll on or before December 15, 2018 will have an effective date of coverage on January 1, 2019. The Health Insurance Marketplace may provide a coverage effective date for a qualified individual earlier than specified in the paragraphs above, provided that either: