Rapid Disenrollment Sample Clauses

Rapid Disenrollment. Medica will audit each of Agency’s new policies sold. Any policy cancelled within the first ninety (90) days of the effective date will be considered a rapid disenrollment. Medica will, pursuant to this section and CMS guidelines, collect reimbursement of all applicable Compensation from Agency where applicable, for any rapid disenrollments occurring within the 0 – 90 day time period. Since Agency is solely responsible for paying Compensation to its Individual Agents, Agency is responsible for recovering Compensation it has paid to its Individual Agents for rapid disenrollments.
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Rapid Disenrollment. Unless otherwise permitted by CMS guidance, if a Medicare Product Enrollee disenrolls or is disenrolled from a Medicare Product within 3 months of his or her enrollment in a Medicare Product (a “Rapid Disenrollment”), no compensation shall be paid by Aetna to Upline or Agents for that Sale. If compensation is paid by Aetna for a Sale, and a Rapid Disenrollment thereafter occurs, then Upline and its Agents shall refund such compensation paid by Aetna for such enrollee. Aetna may deduct any compensation amounts paid to Upline or Agents for a Rapid Disenrollment from amounts Aetna otherwise owes to Upline or Agents. In order to not be a Rapid Disenrollment, the newly enrolled Medicare beneficiary must remain enrolled with Aetna into the fourth month, i.e., if the individual enrolled with Aetna on January 1, the individual must still be enrolled with Aetna on April 1 of the same calendar year. An enrollment that occurs during the fourth quarter of a calendar year is also not considered a Rapid Disenrollment if such individual remains enrolled through the end of the same calendar year. In addition, no recoupment, chargeback, refund or deduction shall be made if CMS guidance permits payment of Commission for such Rapid Disenrollment with respect to the period that the Medicare Product Enrollee was actually enrolled. Upline Agreement 2015 18
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Rapid Disenrollment. IA shall maintain a “Rapid Disenrollment” rate of no more than ten percent (10%) for each calendar year throughout the term of this Agreement. For purposes of this provision, “Rapid Disenrollment” means the voluntary disenrollment of an Enrollee from an MA Plan on or before ninety (90) days after the Enrollee’s initial enrollment effective date. Disenrollments for all CPHL MA Plans marketed and promoted by IA are reported to CPHL by CMS on the “Monthly Membership Reconciliation” (MMR) file. If the Rapid Disenrollment rate exceeds ten percent (10%) for any calendar year, CPHL will review your agreement for potential termination.
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Rapid Disenrollment. Agent and Representatives shall maintain a “Rapid Disenrollment” rate of no more than ten percent (10%) for each calendar year throughout the term of this Agreement. For purposes of this provision, “Rapid Disenrollment” means the voluntary disenrollment of a Member from an MA Plan or PDP Plan on or before three (3) calendar months after the Member’s initial enrollment effective date; provided, however, when a Member enrolls in an MA Plan or PDP Plan effective October 1, November 1, or December 1, and subsequently changes plans effective January 1 of the following year, this is not considered a Rapid Disenrollment. Disenrollments for all MA Plans and PDP Plans marketed and promoted by Agent and Representatives are reported to the Company by CMS on the “Monthly Membership Reconciliation” (MMR) file. If the Rapid Disenrollment rate exceeds ten percent (10%) for any calendar year, Agent shall, at the request of Company, remove any Representative(s) determined by the Company or Agent to be responsible.
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Rapid Disenrollment. Consistent with CMS guidance, Producer agrees that Customer may withhold, withdraw or recoup compensation payment made to Producer if (i) a Medicare Advantage and/or Medicare Part D beneficiary disenrolls less than three (3) months after enrollment (i.e., rapid disenrollment), except as otherwise provided in CMS guidance; or (ii) any other time a beneficiary is not enrolled in a plan.
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Rapid Disenrollment. If an enrollee in a HFHP and/or FHCA Plan disenrolls or is disenrolled from a HFHP and/or FHCA Plan within three (3) months of his or her enrollment in a HFHP and/or FHCA Plan, no compensation shall be paid by HFHP and/or FHCA to Agent for such enrollee and if any compensation had already been paid by HFHP and/or FHCA then Agent shall refund such compensation received for such enrollee. In order to not be subject to a rapid disenrollment chargeback by HFHP and/or FHCA, the newly enrolled Medicare beneficiary must remain enrolled with HFHP and/or FHCA into the fourth month, i.e., if the individual enrolled with HFHP and/or FHCA on January, the individual must still be enrolled with HFHP and/or FHCA on April 1st. HFHP and/or FHCA may deduct any compensation amounts paid to Agent from amounts otherwise owed to Agent. Furthermore, such enrollee shall not count towards any enrollee production totals for Agent. HFHP and/or FHCA will follow CMS Medicare Marketing Guidelines Section 120.4.6 Recovering Compensation Payments in terms of which circumstances HFHP and/or FHCA will not recover funds for rapid disenrollment.
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Rapid Disenrollment. Agent shall maintain a “Rapid Disenrollment” rate of no more than ten percent (10%) for each calendar year throughout the term of this Agreement. For purposes of this provision, “Rapid Disenrollment” means the voluntary disenrollment of a Member from an MA Plan on or before three calendar months after the Member’s initial enrollment effective date; provided, however, when a Member enrolls in an MA Plan effective October 1, November 1, or December 1, and subsequently changes plans effective January 1 of the following year, this is not considered a Rapid Disenrollment. Disenrollments for all MA Plans marketed and promoted by Agent are reported to the Company by CMS on the “Monthly Membership Reconciliation” (MMR) file. If the Rapid Disenrollment rate exceeds ten percent (10%) for any calendar year, then Agent’s appointment shall, at the request of Company, be terminated.
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Rapid Disenrollment. Rapid Disenrollment is when a beneficiary disenrolls from a plan within the first three months of enrollment Rapid Disenrollment applies when an enrollee moves from one Parent Organization to another Parent Organization, or when an enrollee moves from one plan to another plan within the same Parent Organization.
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Rapid Disenrollment. If an Enrollee in a Plan disenrolls or is disenrolled from a Plan within three months of his or her enrollment, no Compensation or Commission shall be paid or owed by FMO or Prominence to GA or Agent. GA shall refund any amount paid by FMO related to Rapid Disenrollment. Furthermore, such a Rapid Disenrollment Enrollee shall not count towards GA’s Enrollee production totals. This policy will not apply to those Enrollees who pass away within the first three months of enrollment. Rapid Disenrollment does not include when a beneficiary enrolls in a plan effective October 1, November 1 or December 1, and then subsequently changes plans effective January 1 of the following year.
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Related to Rapid Disenrollment

  • Death After Separation from Service But Before Benefit Distributions Commence If the Executive is entitled to benefit distributions under this Agreement, but dies prior to the commencement of said benefit distributions, the Bank shall distribute to the Beneficiary the same benefits that the Executive was entitled to prior to death except that the benefit distributions shall commence within thirty (30) days following receipt by the Bank of the Executive’s death certificate.

  • Application for Employment Employee understands and agrees that, as a condition of this Agreement, Employee shall not be entitled to any employment with the Company, and Employee hereby waives any right, or alleged right, of employment or re-employment with the Company. Employee further agrees not to apply for employment with the Company and not otherwise pursue an independent contractor or vendor relationship with the Company.

  • Payment of Continued Group Health Plan Benefits If you are eligible for and timely elect continued group health plan coverage under the Consolidated Omnibus Budget Reconciliation Act of 1985 or any state law of similar effect (“COBRA”) following your Involuntary Termination, the Company will pay your COBRA group health insurance premiums for you and your eligible dependents directly to the insurer until the earliest of (A) the end of the period immediately following your Involuntary Termination that is equal to the Severance Period (the “COBRA Payment Period”), (B) the expiration of your eligibility for continuation coverage under COBRA, or (C) the date when you become eligible for substantially equivalent health insurance coverage in connection with new employment or self-employment. For purposes of this Section, references to COBRA premiums shall not include any amounts payable by you under a Section 125 health care reimbursement plan under the Code. Notwithstanding the foregoing, if at any time the Company determines, in its sole discretion, that it cannot pay the COBRA premiums without potentially incurring financial costs or penalties under applicable law (including, without limitation, Section 2716 of the Public Health Service Act), then regardless of whether you elect continued health coverage under COBRA, and in lieu of providing the COBRA premiums, the Company will instead pay you on the last day of each remaining month of the COBRA Payment Period, a fully taxable cash payment equal to the COBRA premiums for that month, subject to applicable tax withholdings (such amount, the “Special Severance Payment”), which payments shall continue until the earlier of expiration of the COBRA Payment Period or the date when you become eligible for substantially equivalent health insurance coverage in connection with new employment or self-employment. On the first payroll date following the effectiveness of the Release, the Company will make the first payment to the insurer under this clause (and, in the case of the Special Severance Payment, such payment will be to you, in a lump sum) equal to the aggregate amount of payments that the Company would have paid through such date had such payments instead commenced on the date of your Involuntary Termination, with the balance of the payments paid thereafter on the schedule described above. If you become eligible for coverage under another employer’s group health plan, you must immediately notify the Company of such event, and all payments and obligations under this subsection shall cease.

  • Compensation After Termination (i) If the Employment Period is terminated pursuant to Executive’s resignation without Good Reason, death or Incapacity, Executive shall only be entitled to receive his/her Base Salary through the date of termination and shall not be entitled to any other salary, bonus, compensation or benefits from the Company or its Subsidiaries, except as may be required by applicable law.

  • Election Period The period which begins on the first day of the Plan Year in which the Participant attains age thirty-five (35) and ends on the date of the Participant’s death. If a Participant separates from Service prior to the first day of the Plan Year in which age thirty-five (35) is attained, the Election Period shall begin on the date of separation, with respect to the account balance as of the date of separation.

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