Rescissions of coverage Sample Clauses

Rescissions of coverage. After exhausting the internal review process, the claimant can make a written request to the Appeals & Grievance Department for external review after the date of receipt of our internal response. We will send your request to the IRO. You must contact the IRO or us within 120 calendar days (4 months) of the date of your appeal resolution letter. If you do not file your appeal for an external independent review within 120 days, it cannot be reviewed. If you are not sure whether your appeal is eligible, or if you want more information, please contact Ambetter from Sunshine Health.
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Related to Rescissions of coverage

  • Limitations of Coverage For the repair or replacement of the outside line, we will pay a maximum of $2,000 in the aggregate per Agreement term. After the outside gas service line is repaired or replaced, our independent service provider will provide basic site restoration to the affected area, limited to backfill of excavated soil, raking and reseeding.

  • Terms of Coverage The plan takes effect upon check-in on the booked arrival date to an iTrip unit. All coverage shall terminate upon normal check-out time of the iTrip unit or the departure of the Covered Guest, whichever occurs first.

  • Types of Coverage We offer the following types of coverage:

  • Waiver of Coverage Any bargaining unit member covered under family coverage of the school district’s health insurance who is eligible for family coverage or any bargaining unit member who subsequently becomes eligible for family coverage because of a change in marital status, who declares in writing to the District Treasurer before September 15 that he/she does not elect to be covered under one of the District’s insurance options under Section A and E for the entire school year may opt out of the District Plan, if he/she is covered by another plan outside the District. Said election shall be effective at the 1st day of the month following election and shall continue until a new election is made pursuant to the provisions of this section. Additionally, employees hired after September 1 and employees who first become eligible for benefits after September 1 may declare in writing to the District Treasurer that he/she does not elect to be covered under Section A and E or the remainder of the period from the date of hire through the subsequent August 31 may opt out of the District Plan, if he/she is covered by another plan outside the District. If an employee opts out of the medical plan coverage of the District, that employee may only be permitted to change his/her election and to reenroll under the health plan prior to the following August 31 if (1) there has been a change in status that would permit the employee to change his/her election under the applicable rules and regulations of the IRS under Section 125 of the Federal tax law, and (2) such change would be a qualifying event defined by the health plan of the school district. If the employee’s election of no coverage remains in effect until the following August 31, said bargaining unit member shall be paid $1,000 for the 12-month period from the effective date of his/her election [or number of months employed or eligible for benefits to August 31 if a new employee or first time eligible employee or to the end of the month for which coverage has not been received if the election is changed as permitted in this paragraph] (prorated for persons who have prorated insurance to the same percentage as paid by the Board for prorated insurance). The payment provided in this section shall be paid in a lump sum no later than June 30 in that school year that coverage was waived. Any bargaining unit member under single coverage of the school district’s health insurance plan who declares in writing to the District Treasurer before September 15 that he/she does not elect to be covered under one of the District’s insurance options under Section A and E for the entire school year may opt out of the District Plan, if he/she is covered by another plan outside the District. Said election shall be effective at the first day of the month following election and shall continue until a new election is made pursuant to the provisions of this section. Additionally, employees hired after September 1 and employees who first become eligible for benefits after September 1 may declare in writing to the District Treasurer that he/she does not elect to be covered under section A and E for the remainder of the period from the date of hire through the subsequent August 31 may opt out of the District Plan, if he/she is covered by another plan outside the District. If an employee opts out of the medical plan coverage of the District, that employee may only be permitted to change his/her election and to reenroll under the health plan prior to the following August 31 if (1) there has been a change in status that would permit the employee to change his/her election under the applicable rules and regulations of the IRS and under Section 125 of the Federal tax law, and (2) such change would be a qualifying event defined by the health plan of the school district. If the employee’s election of no coverage remains in effect until the following August 31, said bargaining unit member shall be paid $500 for the 12-month period from the effective date of his/her election [or number of months employed or eligible for benefits to August 31 if a new employee or first time eligible employee or to the end of the month for which coverage has not been received if the election is changed as permitted in this paragraph] (prorated for persons who have prorated insurance to the same percentage as paid by the Board for prorated insurance). The payment provided in this section shall be paid in a lump sum no later than June 30th in that school year that coverage was waived.

  • Obligations of Covered Entity (1) Covered Entity shall notify Business Associate of any limitations in its notice of privacy practices of Covered Entity, in accordance with 45 C.F.R. § 164.520, or to the extent that such limitation may affect Business Associate’s use or disclosure of PHI.

  • Modifications and Rectifications to Coverage 1. A Party may make rectifications of a purely formal nature to its coverage under this Chapter, or minor amendments to its Schedules in Annex XVI, provided that it notifies the other Parties in writing and no Party objects in writing within 45 days from the receipt of the notification. A Party that makes such a rectification or minor amendment need not provide compensatory adjustments to the other Parties.

  • Special Claims Made Policy Form Provisions CONTRACTOR shall not provide a Commercial General Liability (Claims Made) policy without the express prior written consent of COUNTY, which consent, if given, shall be subject to the following conditions:

  • Types and Amounts of Coverage Without limiting Grantee's liability pursuant to Article 9, Grantee shall maintain in force, during the full term of this Agreement, insurance in the following amounts and coverages:

  • TYPES OF CONTRACT MODIFICATIONS In order to expedite processing of a contract modification, where proposed changes involve more than one category below, each change should be submitted to OGS as a separate request.

  • Agreement of Coverage  The Eligible Person and/or Dependent loses eligibility under Medicaid or Children's Health Insurance Program (CHIP). Coverage will begin only if SHL receives the completed enrollment form and any required Premium within 60 days of the date coverage ended.  Any other event which affects a Dependent’s eligibility. If the Subscriber fails to give notice which would have resulted in termination of coverage, SHL shall have the right to terminate coverage. A Dependent’s coverage terminates on the same day as the Subscriber.

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