Common use of Right of Cancellation Clause in Contracts

Right of Cancellation. If you are making any contributions toward cover- age for yourself or your Dependents, you may can- cel such coverage to be effective at the end of any period for which Dues have been paid. If your Employer does not meet the applicable xxx- gibility, participation and contribution require- ments of the group contract, Blue Shield of Cali- fornia will cancel this Plan after 30 days’ written notice to your Employer. Any Dues paid Blue Shield for a period extending beyond the cancellation date will be refunded to your Employer. Your Employer will be responsi- ble to Blue Shield for unpaid Dues prior to the date of cancellation. Blue Shield will honor all claims for Covered Ser- vices provided prior to the effective date of cancel- lation. See the Cancellation/Rescission for Fraud or Inten- tional Misrepresentations of Material Fact provi- sion for termination for fraud or intentional misrep- resentations of material fact. GROUP CONTINUATION COVERAGE AND INDIVIDUAL CONVERSION PLAN GROUP CONTINUATION COVERAGE Please examine your options carefully before declining this coverage. You should be aware that companies selling indi- vidual health insurance typically require a review of your medical history that could result in a higher premium or you could be denied coverage entirely. Applicable to Members when the Subscriber’s Employer (Contractholder) is subject to either Title X of the Xxxxxxx- dated Omnibus Budget Reconciliation Act (COBRA) as amended or the California Continuation Benefits Replace- ment Act (Cal-COBRA). The Subscriber’s Employer should be contacted for more information. In accordance with the Consolidated Omnibus Budget Rec- onciliation Act (COBRA) as amended and the California Continuation Benefits Replacement Act (Cal-COBRA), a Member will be entitled to elect to continue group coverage under this Plan if the Member would lose coverage otherwise because of a Qualifying Event that occurs while the Contractholder is subject to the continuation of group cover- age provisions of COBRA or Cal-COBRA. The Benefits under the group continuation of coverage will be identical to the Benefits that would be provided to the Member if the Qualifying Event had not occurred (including any changes in such coverage). Note: A Member will not be entitled to benefits under Cal- COBRA if at the time of the qualifying event such Member is entitled to benefits under Title XVIII of the Social Security Act (“Medicare”) or is covered under another group health plan that provides coverage without exclusions or limitations with respect to any pre-existing condition. Under COBRA, a Member is entitled to benefits if at the time of the qualifying event such Member is entitled to Medicare or has coverage under another group health plan. However, if Medicare enti- tlement or coverage under another group health plan arises after COBRA coverage begins, it will cease.

Right of Cancellation. If you are making any contributions toward cover- age cov- erage for yourself or your Dependents, you may can- cel cancel such coverage to be effective at the end of any period for which Dues have been paid. If your Employer does not meet the applicable xxx- gibilityeligibility, participation and contribution require- ments of the group contract, Blue Shield of Cali- fornia will cancel this Plan after 30 days’ written notice to your Employer. Any Dues paid Blue Shield of California for a period pe- riod extending beyond the cancellation date will be refunded to your Employer. Your Employer will be responsi- ble responsible to Blue Shield of California for unpaid Dues prior to the date of cancellation. Blue Shield of California will honor all claims for Covered Ser- vices covered Services provided prior to the effective date of cancel- lationcancellation. See the Cancellation/Cancellation and Rescission for Fraud or Inten- tional Misrepresentations of Material Fact provi- sion provision for termination for fraud misrepresentations or intentional misrep- resentations omissions. Extension of material fact. GROUP CONTINUATION COVERAGE AND INDIVIDUAL CONVERSION PLAN GROUP CONTINUATION COVERAGE Please examine your options carefully before declining this coverage. You should be aware that companies selling indi- vidual health insurance typically require a review of your medical history that could result in a higher premium or you could be denied coverage entirely. Applicable to Members when the Subscriber’s Employer (Contractholder) is subject to either Title X of the Xxxxxxx- dated Omnibus Budget Reconciliation Act (COBRA) as amended or the California Continuation Benefits Replace- ment Act (Cal-COBRA). The Subscriber’s Employer should be contacted for more information. In accordance with the Consolidated Omnibus Budget Rec- onciliation Act (COBRA) as amended and the California Continuation Benefits Replacement Act (Cal-COBRA), If a Member will be entitled to elect to continue group coverage becomes Totally Disabled while validly cov- ered under this Plan if and continues to be Totally Disabled on the Member would lose coverage otherwise because date the group contract terminates, Blue Shield of a Qualifying Event that occurs while Cali- fornia will extend the Contractholder is Benefits of this Plan, subject to the continuation of group cover- age provisions of COBRA or Cal-COBRA. The Benefits under the group continuation of coverage will be identical all limitations and restrictions, for covered Services and sup- plies directly related to the condition, illness, or injury caus- ing such Total Disability until the first to occur of the fol- lowing: (1) 12:01 a.m. on the day following a period of twelve months from the date coverage terminated; (2) the date the covered Member is no longer Totally Disabled; (3) the date on which the covered Member’s maximum Benefits that would be provided are reached; (4) the date on which a replacement carrier provides coverage to the Member if that is not subject to a Pre-existing Condition exclusion. The time the Qualifying Event had not occurred Member was covered under this Plan will apply toward the replacement plan’s pre-existing condition exclusion. No extension will be granted unless Blue Shield of Califor- nia receives written certification of such Total Disability from a licensed Doctor of Medicine (including M.D.) within 90 days of the date on which coverage was terminated, and thereaf- ter at such reasonable intervals as determined by Blue Shield of California. Coordination of Benefits When a Member who is covered under this group Plan is also covered under another group plan, or selected group, or blanket disability insurance contract, or any changes in other contrac- tual arrangement or any portion of any such coverage). Note: A arrangement whereby the members of a group are entitled to payment of or reimbursement for Hospital or medical expenses, such Member will not be permitted to make a “profit” on a dis- ability by collecting benefits in excess of actual cost during any Calendar Year. Instead, payments will be coordinated between the plans in order to provide for “allowable ex- penses” (these are the expenses that are Incurred for ser- vices and supplies covered under at least one of the plans involved) up to the maximum benefit amount payable by each plan separately. If the covered Member is also entitled to benefits under Cal- COBRA if at the time any of the qualifying event conditions as outlined under the “Limitations for Du- plicate Coverage” provision, benefits received under any such condition will not be coordinated with the benefits of this Plan. The following rules determine the order of benefit pay- ments: When the other plan does not have a coordination of benefits provision it will always provide its benefits first. Otherwise, the plan covering the Member is entitled to as an Employee will provide its benefits under Title XVIII before the plan covering the Member as a Dependent. The plan which covers the Member as a Dependent of the Social Security Act (“Medicare”) or is covered under another group health plan that provides coverage without exclusions or limitations with respect to any pre-existing condition. Under COBRA, a Member is entitled to whose date of birth, (excluding year of birth), oc- curs earlier in a Calendar Year, will determine its benefits if at before a plan which covers that Member as a Dependent of a Member whose date of birth, (excluding year of birth), occurs later in a Calendar Year. If either plan does not have the time provisions of this paragraph regarding Dependents, which results either in each plan determining its benefits before the qualifying event such Member is entitled to Medicare other or has coverage under another group health plan. Howeverin each plan determining its benefits af- ter the other, if Medicare enti- tlement or coverage under another group health the provisions of this paragraph will not apply, and the rule set forth in the plan arises after COBRA coverage begins, it which does not have the provisions of this paragraph will ceasedetermine the order of benefits.

Right of Cancellation. If you are making any contributions toward cover- age for yourself or your Dependents, you may can- cel such coverage to be effective at the end of any period for which Dues have been paid. If your Employer does not meet the applicable xxx- gibility, participation and contribution require- ments requirements of the group contract, Blue Shield of Cali- fornia California will cancel this Plan after 30 days’ written notice to your Employer. Any Dues paid Blue Shield for a period extending beyond the cancellation date will be refunded to your Employer. Your Employer will be responsi- ble to Blue Shield for unpaid Dues prior to the date of cancellation. Blue Shield will honor all claims for Covered Ser- vices provided prior to the effective date of cancel- lation. See the Cancellation/Rescission for Fraud or Inten- tional Misrepresentations of Material Fact provi- sion for termination for fraud or intentional misrep- resentations of material fact. GROUP CONTINUATION COVERAGE AND INDIVIDUAL CONVERSION PLAN GROUP CONTINUATION COVERAGE Group Continuation Coverage and Individual Conversion Plan Group Continuation Coverage Please examine your options carefully before declining this coverage. You should be aware that companies selling indi- vidual health insurance typically require a review of your medical history that could result in a higher premium or you could be denied coverage entirely. Applicable to Members when the Subscriber’s Employer (Contractholder) is subject to either Title X of the Xxxxxxx- dated Consolidat- ed Omnibus Budget Reconciliation Act (COBRA) as amended amend- ed or the California Continuation Benefits Replace- ment Replacement Act (Cal-COBRA). The Subscriber’s Employer should be contacted con- tacted for more information. In accordance with the Consolidated Omnibus Budget Rec- onciliation Recon- ciliation Act (COBRA) as amended and the California Continuation Con- tinuation Benefits Replacement Act (Cal-COBRA), a Member will be entitled to elect to continue group coverage under this Plan if the Member would lose coverage otherwise because of a Qualifying Event that occurs while the Contractholder is subject to the continuation of group cover- age coverage provisions of COBRA or Cal-COBRA. The Benefits under the group continuation of coverage will be identical to the Benefits that would be provided to the Member Mem- ber if the Qualifying Event had not occurred (including any changes in such coverage). Note: A Member will not be entitled to benefits under Cal- COBRA if at the time of the qualifying event such Member is entitled to benefits under Title XVIII of the Social Security Act (“Medicare”) or is covered under another group health plan that provides coverage without exclusions or limitations with respect to any pre-existing condition. Under COBRA, a Member is entitled to benefits if at the time of the qualifying event such Member is entitled to Medicare or has coverage under another group health plan. However, if Medicare enti- tlement or coverage under another group health plan arises after COBRA coverage begins, it will cease.

Right of Cancellation. If you are making any contributions toward cover- age for yourself or your Dependents, you may can- cel such coverage to be effective at the end of any period for which Dues have been paid. If your Employer the Trust does not meet the applicable xxx- gibilityeligibility, participation and contribution require- ments requirements of the group contract, Blue Shield of Cali- fornia California will cancel can- cel this Plan after 30 days’ written notice to your Employerthe Trust. Any Dues paid Blue Shield for a period extending beyond the cancellation date will be refunded to your Employerthe Trust. Your Employer The Trust will be responsi- ble responsible to Blue Shield for unpaid Dues prior to the date of cancellationcancel- lation. Blue Shield will honor all claims for Covered Ser- vices provided prior to the effective date of cancel- lation. See the Cancellation/Rescission for Fraud or Inten- tional Misrepresentations of Material Fact provi- sion for termination for fraud or intentional misrep- resentations of material fact. GROUP CONTINUATION COVERAGE AND INDIVIDUAL CONVERSION PLAN GROUP CONTINUATION COVERAGE Please examine your options carefully before declining this coverage. You should be aware that companies selling indi- vidual health insurance typically require a review of your medical history that could result in a higher premium or you could be denied coverage entirely. Applicable to Members when the Subscriber’s Employer Trust (Contractholder) is subject to either Title X of the Xxxxxxx- dated Omnibus Budget Reconciliation Act (COBRA) as amended or the California Continuation Benefits Replace- ment Act (Cal-COBRA). The Subscriber’s Employer Trust should be contacted for more information. In accordance with the Consolidated Omnibus Budget Rec- onciliation Act (COBRA) as amended and the California Continuation Benefits Replacement Act (Cal-COBRA), a Member will be entitled to elect to continue group coverage under this Plan if the Member would lose coverage otherwise because of a Qualifying Event that occurs while the Contractholder is subject to the continuation of group cover- age provisions of COBRA or Cal-COBRA. The Benefits under the group continuation of coverage will be identical to the Benefits that would be provided to the Member if the Qualifying Event had not occurred (including any changes in such coverage). Note: A Member will not be entitled to benefits under Cal- COBRA if at the time of the qualifying event such Member is entitled to benefits under Title XVIII of the Social Security Act (“Medicare”) or is covered under another group health plan that provides coverage without exclusions or limitations with respect to any pre-existing condition. Under COBRA, a Member is entitled to benefits if at the time of the qualifying event such Member is entitled to Medicare or has coverage under another group health plan. However, if Medicare enti- tlement or coverage under another group health plan arises after COBRA coverage begins, it will cease.

Right of Cancellation. If you are making any contributions toward cover- age for yourself or your Dependents, you may can- cel such coverage to be effective at the end of any period for which Dues have been paid. If your Employer does not meet the applicable xxx- gibility, participation and contribution require- ments requirements of the group contract, Blue Shield of Cali- fornia California will cancel this Plan after 30 days’ written notice to your Employer. Any Dues paid Blue Shield for a period extending beyond the cancellation date will be refunded to your Employer. Your Employer will be responsi- ble to Blue Shield for unpaid Dues prior to the date of cancellation. Blue Shield will honor all claims for Covered Ser- vices provided prior to the effective date of cancel- lation. See the Cancellation/Rescission for Fraud or Inten- tional Misrepresentations of Material Fact provi- sion for termination for fraud or intentional misrep- resentations of material fact. GROUP CONTINUATION COVERAGE AND INDIVIDUAL CONVERSION PLAN GROUP CONTINUATION COVERAGE Please examine your options carefully before declining this coverage. You should be aware that companies selling indi- vidual health insurance typically require a review of your medical history that could result in a higher premium or you could be denied coverage entirely. Applicable to Members when the Subscriber’s Employer (Contractholder) is subject to either Title X of the Xxxxxxx- dated Consolidat- ed Omnibus Budget Reconciliation Act (COBRA) as amended amend- ed or the California Continuation Benefits Replace- ment Replacement Act (Cal-COBRA). The Subscriber’s Employer should be contacted con- tacted for more information. In accordance with the Consolidated Omnibus Budget Rec- onciliation Recon- ciliation Act (COBRA) as amended and the California Continuation Con- tinuation Benefits Replacement Act (Cal-COBRA), a Member will be entitled to elect to continue group coverage under this Plan if the Member would lose coverage otherwise because of a Qualifying Event that occurs while the Contractholder is subject to the continuation of group cover- age coverage provisions of COBRA or Cal-COBRA. The Benefits under the group continuation of coverage will be identical to the Benefits that would be provided to the Member Mem- ber if the Qualifying Event had not occurred (including any changes in such coverage). Note: A Member will not be entitled to benefits under Cal- COBRA if at the time of the qualifying event such Member is entitled to benefits under Title XVIII of the Social Security Act (“Medicare”) or is covered under another group health plan that provides coverage without exclusions or limitations with respect to any pre-existing condition. Under COBRA, a Member is entitled to benefits if at the time of the qualifying event such Member is entitled to Medicare or has coverage under another group health plan. However, if Medicare enti- tlement or coverage under another group health plan arises after COBRA coverage begins, it will cease.