SADP definition

SADP means a Health Plan that has have been approved by OID as meeting the requirements of the Insurance Code, that complies with the Benefit Design Standards of Cover Oregon, and that is currently certified by Cover Oregon.
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Examples of SADP in a sentence

  • Each Stand Alone Dental Plan (SADP) offered by Contractor under the terms of this Agreement shall provide dental benefits in accordance with the Benefit Plan Design requirements as required under this Agreement, and as applicable, any other laws, rules and regulations, including California Health and Safety Code § 1367.005, California Insurance Code § 10112.27, California Government Code § 100503(e), 45 C.F.R. § 155.1065, 45 C.F.R § 156.150, and as applicable, 45 C.F.R. § 156.200(b).

  • At the request of Carrier, the Marketplace will certify an Individual Dental Plan as an SADP if Carrier obtains approval from DFR of the rates, forms, and binder and will certify a Small Employer Dental Plan as an SADP if Carrier obtains approval from DFR of the forms and binders.

  • Carrier shall follow the SADP Submission Process described in Section 4.1 for all SADPs for which it seeks Recertification.

  • The Marketplace may at any time decertify an SADP if the Marketplace determines that Carrier or SADP is no longer in compliance with the Marketplace’s Certification criteria.

  • Contractor shall ensure a coverage effective date for the Enrollee as of (1) the first day of the next subsequent month for a SADP selection notice received by the Exchange between the first day and fifteenth (15) day of the month, or (2) the first day of the second following month for SADP selections received by the Exchange from the sixteenth day through the last day of a month, or (3) such other applicable dates specified in 45 C.F.R. 155.

  • Contractor shall provide information describing Participating Providers in its SADP networks in a format prescribed by the Exchange on a quarterly basis to support the Exchange’s centralized provider directory containing every SADP’s network providers.

  • Upon verification of eligibility and selection of Contractor’s SADP, the Exchange shall (1) process enrollment of Employees into Contractor’s SADPs, (2) establish effective dates of Employee coverage, and (3) transmit enrollment information for Employees to Contractor and Contractor shall notify Employee of the effective date of coverage.

  • Notwithstanding any other language set forth in this Section 7.07, the Agreement shall expire on the Expiration Date set forth in Section 7.01 in the event that the Exchange elects to decertify Contractor’s SADP based on the Exchange’s evaluation of Contractor’s SADP during the recertification process that shall be conducted by Exchange pursuant to Section 7.02 above.

  • This notice obligation only attaches to network providers who have submitted claims to the SADP within the previous two months and any provider who is an assigned dental care provider for that enrollee.

  • Election Contractor shall provide the Exchange with notice on or before July 1 during any Contract Year regarding Contractor’s election to not seek re-certification of Contractor’s SADP as of the expiration of the Agreement (‘Non-Recertification Election”).