Terms Different than Requested Clause Samples

Terms Different than Requested. If the RO offers a WA to the producer, and the WA offer provides terms and conditions that are different from those requested on the Request for Actuarial Change form (including renewal requests), the producer must be given the opportunity to request an administrative review. The RO will issue a letter for the producer via cover letter attached to the RO issued WA offer, which provides that the producer has a right to request an administrative review in accordance with 7 CFR Part 400, Subpart J. The AIP should provide the letter and WA offer to the producer expeditiously to allow the producer adequate time to request administrative review. (1) Requests for a WA that just contain general requests (such as, the best available rates, requesting lower rates, or a request for a change that does not specifically state what is being requested), or the WA offer provides what is requested, there is no right to administrative review, mediation, or appeal. (2) For those WA offers where administrative review rights have been provided, the RO will also notify the producer that:

Terms Different than Requested. If the RO offers a WA to the producer, and the WA offer provides terms and conditions that are different from those requested on the Request for Actuarial Change form (including renewal requests), the producer must be given the opportunity to request an administrative review. The RO will issue a letter for the producer via cover letter attached to the RO issued WA offer, which provides that the producer has a right to request an administrative review in accordance with 7 CFR Part 400, Subpart J. The AIP should provide the letter and WA offer to the producer expeditiously to allow the producer adequate time to request administrative review. (1) Requests for a WA that just contain general requests (such as, the “best available rates,” “requesting lower rates,” or a request for a change that does not specifically state what is being requested), or the WA offer provides what is requested, there is no right to administrative review, mediation, or appeal. (2) For those WA offers where administrative review rights have been provided, the RO will also notify the producer that: (a) a request for administrative review does not affect the producer’s responsibility to accept or reject the WA offer on or before the expiration date; A. Terms Different Than Requested (continued) (b) if the producer rejects or fails to sign the WA offer by the expiration date, the producer will not be able to receive insurance under the terms of the WA if the producer does not prevail on the request for administrative review, mediation, or any subsequent appeal request; and (c) if the producer accepts the offer by the expiration date, the producer will receive insurance under the terms of the WA unless the producer prevails on the request for administrative review, mediation, or any subsequent appeal. (3) If the producer seeks administrative review and does not receive what was requested, the RO must provide notice to the producer of the right to mediation and appeal. (4) If the producer seeks administrative review, subsequently appeals in accordance with 7 CFR Part 11, and later drops the appeal, the RO does not have to provide notice of the right to administrative review, mediation, or appeal for any subsequently filed request for a WA that requests the same terms and conditions that were the subject of the appeal, unless additional information is submitted in support of the request. (5) The RO does not have to provide notice of the right to administrative review, mediation, or appeal f...