Social Security and Tax Identification Numbers. Within 60 days after Health Plan sends Group a written request, Group will send Health Plan a list of all Members covered under this Agreement, along with the following: • The Social Security number of the Member • The tax identification number of the employer of the Subscriber in the Member's Family • Any other information that Health Plan is required by law to collect Premiums Only Members for whom Health Plan (or its designee) has received the Full Premium payment as described below are entitled to coverage under this Agreement, and then only for the period for which Health Plan (or its designee) has received required Premium payment. Group is responsible for paying Premiums, except that Members who have Cal-COBRA coverage under an EOC that is included in this Agreement are responsible for paying Premiums for Cal-COBRA coverage.
Social Security and Tax Identification Numbers. Within 60 days after Health Plan sends Group a written request, Group will send Health Plan a list of all Members covered under this Agreement, along with the following: • The Social Security number of the Member • The tax identification number of the employer of the Subscriber in the Member's Family • Any other information that Health Plan is required by law to collect Premiums Only Members for whom Health Plan (or its designee) has received the appropriate Premium payment listed on the Face Sheet are entitled to coverage under this Agreement, and then only for the period for which Health Plan (or its designee) has received appropriate payment.
Social Security and Tax Identification Numbers. Within 60 calendar days after Health Plan sends Group a written request, Group will send us a list of all Members covered under this EOC, along with the following: · The Member’s Social Security number. · The tax identification number of the employer of the Subscriber in the Member’s Family. · Any other information that Health Plan is required by law to collect. Summaries of Benefits and Coverage Group will provide electronic or paper summaries of benefits and coverage (SBCs) to participants and beneficiaries to the extent required by the Patient Protection and Affordable Care Act, except that Health Plan will provide SBCs to Members who make a request to us. Group Riders/Amendments Member Riders/Amendments Prescription Drug Rider $3/$15/$50/$200 Hearing Aid 60% Infertility Treatment Rider Primary Care Office Visits for Children Fit Rewards $200 (Active & Fit) Group Domestic Partner Amendment Applicable to Groups with Sr. Advantage Members Xxxxxx Permanente Senior Advantage (HMO) offered by Xxxxxx Foundation Health Plan Inc., Hawaii Region This section is only applicable to employer groups with Senior Advantage members. If you want a copy of your group's Senior Advantage Benefit Summary, please contact your group's account manager. 2021 Annual Notice of Changes for Contract Renewals for Xxxxxx Permanente Senior Advantage Group Members This summary only applies to Senior Advantage members. This summary does not fully describe your coverage. For details on your coverage, please refer to your employer’s Group Agreement, Senior Advantage Employer Benefits information, Senior Advantage Evidence of Coverage, and Riders if any (collectively known as “Commercial Evidence of Coverage”). The Commercial Evidence of Coverage is the legally binding document between Health Plan and its members. In the event of ambiguity, or a conflict between this summary and the Commercial Evidence of Coverage, the Commercial Evidence of Coverage shall control. 2021 changes We're sending you this Annual Notice of Changes to tell you about the changes our plan is making effective January 1, 2021 or your employer's contract renewal date (unless otherwise noted), for all Xxxxxx Permanente Senior Advantage group members, in accord with the Centers for Medicare & Medicaid Services (CMS) requirements. This notice only describes changes required by our plan (or Medicare for Part D prescription drug plans). This notice doesn't describe any other changes; for example, changes made at the reques...
