Third Party Plan definition
Examples of Third Party Plan in a sentence
The Services are not reimbursable by any federal, state, or private health care benefit program or insurance plan (each a “Third- Party Plan”), and each Party agrees that it will not submit claims to or seek reimbursement from any Third- Party Plan for any portion of the Services.
Actual services to be provided by the Third Party Plan Administrator to the MEUHP and the Member Districts is set forth in a written agreement between the Third Party Plan Administrator and the MEUHP.
The Member District agrees and acknowledges that all funds in the MEUHP accounts belong to the MEUHP, and that the MEUHP has authorized the Third Party Plan Administrator access to MEUHP accounts for payment of claim expenses, administrative service fees, stop loss policy premiums, and other plan expenses per written Plan documents, administrative agreements and policies in effect with the MEUHP.
A percentage of premiums will be utilized to pay Third Party Plan Administrator fees.
Upon notification to the Third Party Plan Administrator of any termination information, the Third Party Plan Administrator will provide the Member District’s terminating enrollees with all necessary public sector COBRA notifications.
Premiums are due by the Member District to the Third Party Plan Administrator on the first day of each month during the Plan Year.
The MEUHP will obtain appropriate business associate agreements between the MEUHP and the Claims Administrator, between MEUHP and the Stop Loss Reinsurer and between the MEUHP and the Third Party Plan Administrator.
The Member District will gather all necessary information related to the termination of enrollment of any enrollee or the continuation of coverage by an enrollee under the Public Health Service Act (i.e., the “public sector COBRA” law) and will promptly provide the information to the Third Party Plan Administrator.
The Member District will gather all necessary enrollment information from the Member District’s eligible employees, spouses, dependents and retirees who elect to enroll in an MEUHP health care plan offered by the Member District and will provide the enrollment information to the Third Party Plan Administrator by the deadline established by the Third Party Plan Administrator.
The Member District also agrees to forward customer care questions to the Third Party Plan Administrator.