SHOP. In the event that Contractor continues to offer small group coverage in the State following the Notice of Non-Recertification Election, Contractor shall comply with applicable laws, rules and regulations relating to the discontinuation of a benefit package, including those set forth at Section 1365 of the Health and Safety Code and Section 10713 of the Insurance Code. The termination of the Agreement shall occur upon the termination of coverage which shall be determined as follows:
SHOP. With respect to SHOP, Contractor acknowledges that (i) the Exchange is responsible for collecting premiums from Employers and Employees, and (ii) the Exchange will remit applicable Employer and Employee premiums collected by the Exchange to Contractor, net of (1) Participation Fees computed in accordance with the Participation Methodology - SHOP, and (2) agent commissions determined in accordance with the terms set forth at Section 3.29. The Exchange shall transfer funds to Contractor on a monthly basis or such other intervals as mutually agreed upon by the Exchange and Contractor and shall establish a process to resolve any disagreements on premium amounts due in a timely manner and prior to transfer of funds to Contractor as required under this Section.
SHOP. The Participation Fee payable to the Exchange during each month of this Agreement shall be equal to a per member per month (“PMPM”) rate of $18.90 multiplied by the number of Enrollees in Contractor’s QHPs for such month plus additional fees as necessary to pay agent commissions. This Participation fee is based on the Exchange’s estimates of the revenue required to support the transition of the Exchange to being self-sufficient beginning in 2015. This Participation fee is based on a rate equivalent to approximately four percent (4%) of the estimated aggregate premiums relating to all QHP products and policies sold through SHOP. The Participation Fee will be assessed by the Exchange and payable monthly by Contractor based on enrollment in Contractor's QHPs sold through the SHOP Exchange in 2014.
SHOP. (i) SHOP will be responsible for collection of premiums, including delinquent payments. Premium charged in SHOP includes the assessment of the participation fee, agent and general agent commissions (see Section 5.03 Participation Fee).
SHOP. AHCD has facilitated numerous stakeholder forums and targeted workgroups aimed at fostering discussion and gathering information from the individuals and groups who will be most impacted by the development of the Marketplace. Based on expressed concern that employers would drop coverage after Marketplaces are introduced, ACHI prepared a policy brief in August, 2011, titled, “Will Employers Drop, Keep, or Add Health Insurance in 2014 xxxx://xxx.xxxx.xxx/HCR%20Docs/110808%20ISSUE%20BRIEF%20EMPLOYER%20RESPONSE.pdf.The brief reviewed factors that suggest employers will drop, keep, or add coverage and reviewed five national studies (Mercer, McKinsey, Congressional Budget Office, RAND, and Urban Institute). The report concluded that the overall availability of employer-sponsored insurance is not likely to change much after 2014. Since hiring the Plan Management Specialist, AHCD has been actively engaged with CCIIO and CMS to ensure a successful implementation of the SHOP program with the federal government. The individual and SHOP markets will be separate as part of the SPM model. As the result of federal changes, employers in 2014 will choose one plan for their employees as they do now. AHCD has contracted with the University of Arkansas at Little Rock Arkansas Small Business and Technology Development Center (ASBTDC) for outreach to the small business community, with emphasis on SHOP. ASBTDC will work closely with the Small Business Administration regional office and the state and local xxxxxxxx of commerce. PROPOSAL TO MEET PROGRAM REQUIREMENTS Building on the work of the last two-plus years funded by our Planning Grant (awarded September 2010 with Administrative Supplement awarded March 2012), Level One A grant (awarded February 2012), Level One B grant (awarded September 2012), and Level One C grant (awarded April 2013), ACHD is making systematic, steady progress toward implementing the State Partnership Marketplace (SPM) model for Arkansas. Early and on-going research coupled with guidance from CMS and our CCIIO state officer has supported our efforts as well as helped us plan for the future. Arkansas chose the SPM model because it allows local development and oversight of the functions that most directly interact with Arkansans, and the insurance issuers and producers who do business in our state. From the onset of our planning efforts, we devoted much of our energy and resources to interaction with a wide-range of stakeholders and consumer groups. As we ...
SHOP. The Small Business Health Options Program described in Government Code 100502(m).
SHOP. All those employees who are presently members of the Union or who are eligible for membership in the Union shall, as a condition of continued employment, maintain such membership or become a member of the Union immediately upon the signing of this agreement. All employees hired on or after the date of signing this agreement shall, as a condition of employment, become members of the Union and maintain such membership.
SHOP. For the use of the offered SHOP you must accept the terms of the third-party supplier. The servers for the service SHOP are located abroad, and you declare yourself to be in agreement with the corresponding export of data. Duties of the customer relating to the services WEB and MAIL It is your obligation to load your data onto the Swizzonic Ltd. server for the purposes of the services WEB and MAIL. You must produce your own security copies of any data that you transmit to the Swizzonic Ltd. servers or the servers of a third-party supplier in relation to services WEB and MAIL. If Swizzonic Ltd. has to recover secured data for you, you will be charged the associated costs at the rate published on the website of Swizzonic Ltd. You shall be personally responsible for updating your system (including third party software with the exception of clause 5.2.4.) and must install all updates, in particular security-related updates. You will be responsible for examining the compatibility of any adaptations associated with updating the system and are obliged to undertake these. You shall also be obliged to delete from the server any software that you no longer require and use. You agree to take all necessary actions to ensure that third-party systems cannot be accessed, or programs manipulated, and that they cannot be infiltrated by computer viruses or malware via your website or your e- mail account. In addition, you also confirm that your computer and the server cannot be misused, especially by the fact that no or only simple passwords are used which allow penetration into the shared WEB. You shall be fully liable to Swizzonic Ltd. for all losses that caused through the misuse of your website or your e-mail account (such as hacking via defective or out-of-date scripts, the use of the same access data in FTP and databases, spam attacks through your e-mail account, malware distribution etc.). You undertake to ensure fulfilment of regulatory requirements and for obtaining official approvals, if this is necessary at present or in future in order for you to use Swizzonic Ltd. services. Duties of the customer relating to the service TOOL Premium, TOOL Basic It shall be your obligation to load your data onto the Swizzonic Ltd. server for the purposes of the services TOOL Premium and TOOL Basic. You must produce your own security copies of any data that you transmit to the Swizzonic Ltd. servers or the servers of a third-party supplier in relation to services TOOL Premium and...
SHOP. In accordance with 45 CFR § 156.286, Carrier agrees to accept payment from a qualified employer or an enrollee, or a SHOP on behalf of a qualified employer or enrollee, in accordance with applicable SHOP requirements. The MHBE shall establish policies and procedures as to nonpayment grace periods and associated effective termination dates; the Carrier shall be responsible for terminating employers for nonpayment of premium.