Common use of Termination for Non-Payment of Premium Clause in Contracts

Termination for Non-Payment of Premium. When Group fails to pay Premium on or before the Premium Due Date, Group shall have a period of at least thirty-one (31) days to pay all Premiums owed (“Grace Period”). The Grace Period shall begin the day after the Premium Due Date. This Agreement will remain in full force and effect throughout the Grace Period and Group will remain responsible for payment of Premiums during the Grace Period (and any additional period prior to termination, if that occurs). If the Health Plan receives full payment of Premiums on or before the last day of the Grace Period, this Agreement will remain in effect according to its terms and conditions. If Group fails to pay all Premiums owed (including those owed for the Grace Period) on or before the last day of the Grace Period, then the Health Plan may, at its option and in lieu of any other remedy, terminate this Agreement without further extension or consideration. The Health Plan will notify Group of the past-due amount and the effective date of termination. Such notice shall be sent at least fifteen (15) days prior to the effective date of termination. If Premiums are paid after the Grace Period ends, the Health Plan may charge interest on the overdue Premiums Interest shall not accrue during the Grace Period, and the interest rate shall be six (6) percent per year or the maximum amount permitted by applicable law, whichever is less. If any renewal Premium is not paid in full within the time granted for payment, a later acceptance of Premium in full by us or by any agent authorized by us to accept the Premium, without requiring a reinstatement application in connection with the acceptance of the Premium in full, shall reinstate the Agreement. However, if we or the agent requires an application for reinstatement and issues a conditional receipt for the premium tendered, the Agreement will be reinstated upon approval of the application by us or, lacking approval, upon the 45th day following the date of its conditional receipt. Termination for Fraud, Intentionally Furnishing Incorrect or Incomplete Information and/or Violation of Contribution or Participation Requirements If the Group fails to (a) adhere to the Health Plan’s contribution or participation requirements, including those listed in the Eligibility and Enrollment section below, or (b) performs an act that constitutes fraud or intentional misrepresentation of material information to the Health Plan under the terms of coverage, the Health Plan will terminate this Agreement with thirty-one (31) days’ prior written notice to the Group.

Termination for Non-Payment of Premium. When Group fails to pay Premium on or before the Premium Due Date, Group shall have a period of at least thirty-one (31) days to pay all Premiums owed (“Grace Period”). The Grace Period shall begin the day after the Premium Due Date. This Agreement will remain in full force and effect throughout the Grace Period and Group will remain responsible for payment of Premiums during the Grace Period (and any additional period prior to termination, if that occurs). If the Health Plan receives full payment of Premiums on or before the last day of the Grace Period, this Agreement will remain in effect according to its terms and conditions. If Group fails to pay all Premiums owed (including those owed for the Grace Period) on or before the last day of the Grace Period, then the Health Plan may, at its option and in lieu of any other remedy, may terminate this Agreement without further extension or considerationfor non-payment of Premium. The Upon non-payment of Premium, the Health Plan will notify the Group of the past-due amount and the effective date of termination. Such notice shall , which will be sent at least fifteen (15) days prior from the date of the written notice. The fifteen (15) days from the written notice by the Health Plan to the effective termination date will constitute a grace period. This Agreement will remain in full force and effect throughout the grace period. If the Health Plan receives full payment within the grace period, this Agreement remain in effect according to the terms and conditions in the Agreement. If the Health Plan does not receive full payment by the end of the grace period, this Agreement will be terminated without further extension or consideration. The Group will be liable for all unpaid amounts due through the date of termination. If Premiums are paid after the Grace Period ends, the Health Plan may charge interest on the overdue Premiums Interest shall not accrue during the Grace Period, and the interest rate shall be six (6) percent per year or the maximum amount permitted by applicable law, whichever is less. If any renewal Premium is not paid in full within the time granted for payment, a later acceptance of Premium in full by us or by any agent authorized by us to accept the Premium, without requiring a reinstatement application in connection with the acceptance of the Premium in full, shall reinstate the Agreement. However, if we or the agent requires an application for reinstatement and issues a conditional receipt for the premium tendered, the Agreement will be reinstated upon approval of the application by us or, lacking approval, upon the 45th day following the date of its conditional receipt. Termination for Fraud, Intentionally Furnishing Incorrect or Incomplete Information Information, and/or Violation of Contribution or Participation Requirements If the Group fails to (a) adhere to the Health Plan’s contribution or participation requirements, including those listed in the “Eligibility and Enrollment Enrollment” section below, or (b) performs an act that constitutes fraud or intentional misrepresentation of material information to the Health Plan under the terms of coverage, the Health Plan will terminate this Agreement with thirty-one (31) days’ days prior written notice to the Group. Termination for Movement Outside of the Service Area The Health Plan may terminate this Agreement upon thirty-one (31)-days prior written notice to Group if no eligible person lives, resides, or works in Health Plan’s Service Area as described in the EOC. Discontinuance of Product or All Products within a Market The Health Plan may terminate a particular product or all products offered in a small or large group market, as permitted by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). If the Health Plan discontinues offering a particular product, Health Plan may terminate this Agreement upon ninety (90) days written notice prior to the date of nonrenewal to each affected Subscriber, plan sponsor, participant and beneficiary. The Health Plan shall then offer the Group another product available at that time to groups in its respective market. The Health Plan shall act uniformly without regard to the claims experience of any affected plan sponsor, or any health status-related factor of any affected individual. Health status-related factor means a factor related to (a) health status; (b) medical condition; (c) claims experience; (d) receipt of health care, (e) medical history, (f) genetic information, (g) evidence of insurability including conditions arising out of acts of domestic violence, or (h) disability. If the Health Plan discontinues offering all products to small and/or large group markets, the Health Plan may terminate this Agreement upon one-hundred eighty (180) days written notice to the Group. And, upon at least thirty (30) working days before that notice shall give notice, to the Commissioner, and, may not write new business for groups in the state for a five (5)-year period beginning on the date of notice to the commissioner. No other product will be offered to the Group. For purposes of this Section, a “product” is a combination of benefits and Services provided to Members, each such product being defined by a distinct disclosure form or EOC.

Termination for Non-Payment of Premium. When Group fails to pay Premium on or before the Premium Due Date, Group shall have a period of at least thirty-one (31) days to pay all Premiums owed (“Grace Period”). The Grace Period shall begin the day after the Premium Due Date. This Agreement will remain in full force and effect throughout the Grace Period and Group will remain responsible for payment of Premiums during the Grace Period (and any additional period prior to termination, if that occurs). If the Health Plan receives full payment of Premiums on or before the last day of the Grace Period, this Agreement will remain in effect according to its terms and conditions. If Group fails to pay all Premiums owed (including those owed for the Grace Period) on or before the last day of the Grace Period, then the Health Plan may, at its option and in lieu of any other remedy, terminate this Agreement without further extension or consideration. The Health Plan will notify Group of the past-due amount and the effective date of termination. Such notice shall be sent at least fifteen (15) days prior to the effective date of termination. If Premiums are paid after the Grace Period ends, the Health Plan may charge interest on the overdue Premiums Interest shall not accrue during the Grace Period, and the interest rate shall be six (6) percent per year or the maximum amount permitted by applicable law, whichever is less. If any renewal Premium is not paid in full within the time granted for payment, a later acceptance of Premium in full by us or by any agent authorized by us to accept the Premium, without requiring a reinstatement application in connection with the acceptance of the Premium in full, shall reinstate the Agreement. However, if we or the agent requires an application for reinstatement and issues a conditional receipt for the premium tendered, the Agreement will be reinstated upon approval of the application by us or, will be reinstated lacking such approval, upon the 45th 45TH day following the date of conditional receipt unless the insurer has previously notified the insured in writing of its conditional receiptdisapproval of the application. Termination for Fraud, Intentionally Furnishing Incorrect or Incomplete Information and/or Violation of Contribution or Participation Requirements If the Group fails to (a) adhere to the Health Plan’s contribution or participation requirements, including those listed in the Eligibility and Enrollment section below, or (b) performs an act that constitutes fraud or intentional misrepresentation of material information to the Health Plan under the terms of coverage, the Health Plan will terminate this Agreement with thirty-one (31) days’ prior written notice to the Group.