Common use of Termination by Us Clause in Contracts

Termination by Us. This Group Agreement will terminate as of the last day of the Grace Period if the Premium remains unpaid at the end of the Grace Period. This Group Agreement may also be terminated by Us as follows: • Immediately upon notice to Contract Holder if Contract Holder has performed any act or practice that constitutes fraud or made any intentional misrepresentation of a material fact relevant to the coverage provided under this Group Agreement; • Immediately upon notice to Contract Holder if Contract Holder no longer has any enrollee under the Plan who resides or works in the Service Area; • Upon 30 days written notice to Contract Holder if Contract Holder (i) breaches a provision of this Group Agreement and such breach remains uncured at the end of the day notice period; (ii) ceases to meet Our requirements for an employer group[ or association]; (iii) fails to meet Our contribution or participation requirements applicable to this Group Agreement (which contribution and participation requirements are available upon request); (iv) fails to provide the certification required by Section 5.4 within a reasonable period of time specified by Us; or (v) changes its eligibility or participation requirements without Our consent; • Upon 90 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer the product to which the Group Agreement relates; • Upon 180 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer coverage in a market in which Members covered under this Group Agreement reside; Upon 30 days written notice to Contract Holder for any other reason which is acceptable to the Department of Insurance and consistent with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) or by applicable federal rules and regulations, as amended.

Termination by Us. This Group Agreement will terminate as of the last day of the Grace Period if the Premium remains unpaid at the end of the Grace Period. This Group Agreement may also be terminated by Us as follows: • Immediately upon notice to Contract Holder if Contract Holder has performed any act or practice that constitutes fraud or made any intentional misrepresentation of a material fact relevant to the coverage provided under this Group Agreement; • Immediately upon notice to Contract Holder if Contract Holder no longer has any enrollee under the Plan who resides or works in the Service Area; • Upon 30 days written notice to Contract Holder if Contract Holder (i) breaches a provision of this Group Agreement and such breach remains uncured at the end of the day notice period; (ii) ceases to meet Our requirements for an employer group[ group or association]; (iii) fails to meet Our contribution or participation requirements applicable to this Group Agreement (which contribution and participation requirements are available upon request); (iv) fails to provide the certification required by Section 5.4 within a reasonable period of time specified by Us; or (v) changes its eligibility or participation requirements without Our consent; • Upon 90 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer the product to which the Group Agreement relates; • Upon 180 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer coverage in a market in which Members covered under this Group Agreement reside; • Upon 30 days written notice to Contract Holder for any other reason which is acceptable to the Department of Insurance and consistent with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) or by applicable federal rules and regulations, as amended.

Termination by Us. This Group Agreement will terminate as of the last day of the Grace Period if the Premium remains unpaid at the end of the Grace Period. This Group Agreement may also be terminated by Us as follows: • Immediately upon notice to Contract Holder if Contract Holder has performed any act or practice that constitutes fraud or made any intentional misrepresentation of a material fact relevant to the coverage provided under this Group Agreement; • Immediately upon notice to Contract Holder if Contract Holder no longer has any enrollee under the Plan who resides or works in the Service Area; • Upon 30 days written notice to Contract Holder if Contract Holder (i) breaches a provision of this Group Agreement and such breach remains uncured at the end of the day notice period; (ii) ceases to meet Our requirements for an employer group[ group or association]; (iii) fails to meet Our contribution or participation requirements applicable to this Group Agreement (which contribution and participation requirements are available upon request); (iv) fails to provide the certification required by Section 5.4 within a reasonable period of time specified by Us; or (v) changes its eligibility or participation requirements without Our consent; • Upon 90 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer the product to which the Group Agreement relates; • Upon 180 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer coverage in a market in which Members covered under this Group Agreement reside; • Upon 30 days written notice to Contract Holder for any other reason which is acceptable to the Department of Insurance Managed Health Care and consistent with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) or by applicable federal rules and regulations, as amended.

Termination by Us. This Group Agreement will terminate as of the last day of the Grace Period if the Premium remains unpaid at the end of the Grace Period. We will provide written notification to Contract Holder and Members 10 days prior to cancellation of the Group Agreement. This notification is not required when We have received written notice from the Contract Holder that replacement coverage has been obtained. This Group Agreement may also be terminated by Us as follows: • Immediately upon notice to Contract Holder if Contract Holder has performed any act or practice that constitutes fraud or made any intentional misrepresentation of a material fact relevant to the coverage provided under this Group Agreement; • Immediately upon notice to Contract Holder if Contract Holder no longer has any enrollee under the Plan who resides or works in the Service Area; • Upon 30 days written notice to Contract Holder if Contract Holder (i) breaches a provision of this Group Agreement and such breach remains uncured at the end of the day notice period; (ii) ceases to meet Our requirements for an employer group[ group or association]; (iii) at Renewal, fails to meet Our contribution or participation requirements applicable to this Group Agreement (which contribution and participation requirements are available upon request); (iv) fails to provide the certification required by Section 5.4 within a reasonable period of time specified by Us; or (v) changes its eligibility or participation requirements without Our consent; • Upon 90 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer the product to which the Group Agreement relates; • Upon 180 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer coverage in a market in which Members covered under this Group Agreement reside; • Upon 30 days written notice to Contract Holder for any other reason which is acceptable to the Department of Insurance and consistent with the Health Insurance Portability and Accountability Act of 1996 (“"HIPAA”") or by applicable federal rules and regulations, as amended.

Termination by Us. This Group Agreement will terminate as of the last day of the Grace Period if the Premium remains unpaid at the end of the Grace Period. This Group Agreement may also be terminated by Us as follows: • Immediately upon  Upon 45 days written notice to Contract Holder if Contract Holder has performed any act or practice that constitutes fraud or made any intentional misrepresentation of a material fact relevant to the coverage provided under this Group Agreement; • Immediately upon  Upon 45 days written notice to Contract Holder if Contract Holder no longer has any enrollee under the Plan who resides or works in the Service Area; •  Upon 30 45 days written notice to Contract Holder if Contract Holder (i) breaches a provision of this Group Agreement and such breach remains uncured at the end of the day notice period; (ii) ceases to meet Our requirements for an employer group[ group or association]; (iii) fails to meet Our contribution or participation requirements applicable to this Group Agreement (which contribution and participation requirements are available upon request); (iv) fails to provide the certification required by Section 5.4 within a reasonable period of time specified by Us; or (v) changes its eligibility or participation requirements without Our consent; •  Upon 90 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer the product to which the Group Agreement relates; •  Upon 180 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer coverage in a market in which Members covered under this Group Agreement reside;  Upon 30 days written notice to Contract Holder for any other reason which is acceptable to the Department of Insurance and consistent with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) or by applicable federal rules and regulations, as amended; or  Upon 45 days written notice to Contract Holder if a member of an association group, the Contract Holder’s membership in the association ceases.

Termination by Us. This Group Agreement will terminate as of the last day of the Grace Period if the Premium remains unpaid at the end of the Grace Period. This Group Agreement may also be terminated by Us as follows: • Immediately upon notice to Contract Holder if Contract Holder has performed any act or practice that constitutes fraud or made any intentional misrepresentation of a material fact relevant to the coverage provided under this Group Agreement; • Immediately upon notice to Contract Holder if Contract Holder no longer has any enrollee under the Plan who resides or works in the Service Area; • Upon 30 days days' written notice to Contract Holder if Contract Holder (i) breaches a provision of this Group Agreement and such breach remains uncured at the end of the day notice period; (ii) ceases to meet Our requirements for an employer group[ group or association]; (iii) fails to meet Our contribution or participation requirements applicable to this Group Agreement (which contribution and participation requirements are available upon request); (iv) fails to provide the certification required by Section 5.4 within a reasonable period of time specified by Us; or (v) changes its eligibility or participation requirements without Our consent; • Upon 90 days days' written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) and Members if We cease to offer the product to which the Group Agreement relates; • Upon 180 days days' written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) and Members if We cease to offer coverage in a market in which Members covered under this Group Agreement reside; • Upon 30 days days' written notice to Contract Holder for any other reason which is acceptable to the Department of Insurance and consistent with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) or by applicable federal rules and regulations, as amended.

Termination by Us. This Group Agreement will terminate as of the last day of the Grace Period if the Premium remains unpaid at the end of the Grace Period. This Group Agreement may also be terminated by Us as follows: • Immediately upon notice to Contract Holder if Contract Holder has performed any act or practice that constitutes fraud or made any intentional misrepresentation of a material fact relevant to the coverage provided under this Group Agreement; • Immediately upon notice to Contract Holder if Contract Holder no longer has any enrollee under the Plan who resides or works in the Service Area; • Upon 30 60 days written notice to Contract Holder if Contract Holder (i) breaches a provision of this Group Agreement and such breach remains uncured at the end of the day notice period; (ii) ceases to meet Our requirements for an employer group[ or association]; (iiiii) fails to meet a material plan provision related to Our contribution or participation requirements applicable to this Group Agreement (which contribution and participation requirements are available upon request); (iv) fails to provide the certification required by Section 5.4 within a reasonable period of time specified by Us; or (v) changes its eligibility or participation requirements without Our consent; . • Upon 90 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer the product to which the Group Agreement relates; • Upon 180 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer coverage in a market in which Members covered under this Group Agreement reside; • Upon 30 days written notice to Contract Holder for any other reason which is acceptable to the Department of Insurance and consistent with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) or by applicable federal rules and regulations, as amended.

Termination by Us. This Group Agreement will terminate as of the last day of the Grace Period may be terminated by Aetna by providing Contract Holder with 30 days' prior written notice if the Premium remains Member Premiums owed by ten percent (10%) or more of Members remain unpaid at the end of the applicable Grace Period. The notice of termination shall specify the effective date of such termination. This Group Agreement may also be terminated by Us as follows: • Immediately upon notice to Contract Holder if Contract Holder has performed any act or practice that constitutes fraud or made any intentional misrepresentation of a material fact relevant to the coverage provided under this Group Agreement; • Immediately upon notice to Contract Holder if Contract Holder no longer has any enrollee under the Plan who resides or works in the Service Area; • Upon 30 days written notice to Contract Holder if Contract Holder (i) breaches a provision of this Group Agreement and such breach remains uncured at the end of the day notice period; (ii) ceases to meet Our requirements for an employer group[ group or association]; (iii) fails to meet Our contribution or participation requirements applicable to this Group Agreement (which contribution and participation requirements are available upon request); (iv) fails to provide the certification required by Section 5.4 the Policies and Procedures; Compliance Verification section within a reasonable period of time specified by Us; (v) provides written notice to Members stating that coverage under this Group Agreement will no longer be provided to Members; or (vvi) changes its eligibility or participation requirements without Our consent; • Upon 90 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer the product to which the Group Agreement relates; • Upon 180 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer a product or coverage in a any market in which Members covered under this Group Agreement reside; • Upon 30 days written notice to Contract Holder for any other reason which is acceptable to the Department of Insurance Centers for Medicare and Medicaid Services and consistent with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) or by applicable federal rules and regulations, as amended; or • Immediately upon notice to Contract Holder if Contract Holder is a member of an employer-based association group, and the Contract Holder’s membership in the association ceases.

Termination by Us. This Group Agreement will terminate immediately upon notice to Contract Holder as of the last day of the Grace Period if the Premium remains unpaid at the end of the Grace Period. This Group Agreement may also be terminated by Us as follows: • Immediately upon notice to Contract Holder if Contract Holder has performed any act or practice that constitutes fraud or made any intentional misrepresentation of a material fact relevant to the coverage provided under this Group Agreement; • Immediately upon notice to Contract Holder if Contract Holder no longer has any enrollee under the Plan who resides or works in the Service Area; • Effective upon any anniversary of the Effective Date if Aetna will no longer offer any of the products most recently offered to Contract Holder in any Service Areas covered under this Group Agreement, because: (1) CMS terminates or otherwise non-renews the Aetna’s CMS Contract, or (2) Aetna terminates its CMS Contract or reduce the Service Areas referenced in Aetna’s CMS Contract; • Upon 30 days written notice to Contract Holder if Contract Holder (i) breaches a provision of this Group Agreement and such breach remains uncured at the end of the day notice period; (ii) ceases to meet Our requirements for an employer group[ group or association]; (iii) fails to meet Our contribution or participation requirements applicable to this Group Agreement (which contribution and participation requirements are available upon request); (iv) fails to provide the certification required by the Policies and Procedures; Compliance Verification Section 5.4 within a reasonable period of time specified by Us; or (v) provides written notice to Members stating that coverage under this Group Agreement will no longer be provided to Members; (vi) changes its eligibility or participation requirements without Our consent; • Upon 90 days written notice consent or (vii) ceases to meet any Mandates applicable to offering the Plan to Contract Holder (or such shorter notice as may be permitted by applicable lawHolder, but including those Mandates described in no event less than 30 days) if We cease to offer the product to which the Section 9.21 of this Group Agreement relatesAgreement; • Upon 180 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 30-120 days) if We cease to offer a product or coverage in a any market in which Members covered under this Group Agreement reside; • Upon 30 days written notice to Contract Holder for any other reason which is acceptable to the Department of Insurance CMS and consistent with the Health Insurance Portability and Accountability Act of 1996 (“"HIPAA”") or by applicable federal rules and regulationsother Mandates; or • Immediately upon notice to Contract Holder if Contract Holder is a member of an employer-based association group, as amendedthe Contract Holder's membership in the association ceases.

Termination by Us. This Group Agreement will terminate as of the last day of the Grace Period if the Premium remains unpaid at the end of the Grace Period. This Group Agreement may also be terminated by Us as follows: • Immediately upon notice to Contract Holder if Contract Holder has performed any act or practice that constitutes fraud or made any intentional misrepresentation of a material fact relevant to the coverage provided under this Group Agreement; • Immediately upon notice to Contract Holder if Contract Holder no longer has any enrollee under the Plan who resides or works in the Service Area; • Upon 30 31 days written notice to Contract Holder if Contract Holder (i) breaches a provision of this Group Agreement and such breach remains uncured at the end of the day notice period; (ii) ceases to meet Our requirements for an employer group[ group or association]; (iii) fails to meet Our contribution or participation requirements applicable to this Group Agreement (which contribution and participation requirements are available upon request); (iv) fails to provide the certification required by Section 5.4 within a reasonable period of time specified by Us; or (v) changes its eligibility or participation requirements without Our consent; • Upon On the Contract Holder’s Renewal Date upon 90 days prior written notice to Contract Holder (or such shorter notice as may be permitted by applicable lawand Subscriber, but in no event less than 30 days) if We cease to offer the product to which the Group Agreement relates; • Upon On the Contract Holder’s Renewal Date upon 180 days prior written notice to Contract Holder (or such shorter notice as may be permitted by applicable lawXxxxxx and Subscriber, but in no event less than 30 days) if We cease to offer coverage in a market in which Members covered under this Group Agreement reside; • Upon 30 days written notice to Contract Holder for any other reason which is acceptable to the Department of Insurance and consistent with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) or by applicable federal rules and regulations, as amended; or • Immediately upon notice to Contract Holder if Contract Holder’s membership in the association ceases. AETNA HEALTH INC. (ILLINOIS) GROUP AGREEMENT AMENDMENT Contract Holder Group Agreement Effective Date: January 1, 2013 The Aetna Health Inc. (HMO) Group Agreement issued to the Contract Holder is hereby amended as follows: Section 5., RESPONSIBILITIES OF THE CONTRACT HOLDER, is hereby amended to include the following:

Termination by Us. This Group Agreement will terminate as of the last day of the Grace Period if the Premium remains unpaid at the end of the Grace Period. This Group Agreement may also be terminated by Us as follows: • Immediately upon  Upon 15 days' notice to Contract Holder if Contract Holder has performed any act or practice that constitutes fraud or made any intentional misrepresentation of a material fact relevant to the coverage provided under this Group Agreement; • Immediately upon  Upon 30 days' notice to Contract Holder if Contract Holder no longer has any enrollee under the Plan who resides or works in the Service Area; •  Upon 30 days days' written notice to Contract Holder if Contract Holder (i) breaches a provision of this Group Agreement and such breach remains uncured at the end of the day notice period; (ii) ceases to meet Our requirements for an employer group[ group or association]; (iii) fails to provide the certification required by Section 5.4 within a reasonable period of time specified by Us; or (iv) changes its eligibility or participation requirements without Our consent;  Upon the first Renewal Date following 6 consecutive months of failure by Contract Holder to meet Our contribution or participation requirements applicable to this Group Agreement (which contribution and participation requirements are available upon request); (iv) fails to provide the certification required by Section 5.4 within a reasonable period of time specified by Us; or (v) changes its eligibility or participation requirements without Our consent; •  Upon 90 days days' written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer the product to which the Group Agreement relates; •  Upon 180 days days' written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer coverage in a market in which Members covered under this Group Agreement reside;  Upon 30 days 60 days' written notice to Contract Holder for any other reason which is acceptable to the Department of Insurance and consistent with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) or by applicable federal rules and regulations, as amended; or  Upon 30 days' notice to Contract Holder if an association group, the Contract Holder’s membership in the association ceases.

Termination by Us. This Group Agreement will terminate as of the last day of the Grace Period if the Premium remains unpaid at the end of the Grace Period. This Group Agreement may also be terminated by Us as follows: • Immediately upon notice to Contract Holder if Contract Holder has performed any act or practice that constitutes fraud or made any intentional misrepresentation of a material fact relevant to the coverage provided under this Group Agreement; • Immediately upon notice to Contract Holder if Contract Holder no longer has any enrollee under the Plan who resides or works in the Service Area; • Upon 30 days written notice to Contract Holder if Contract Holder (i) breaches a provision of this Group Agreement and such breach remains uncured at the end of the day notice period; (ii) ceases to meet Our requirements for an employer group[ or association].; (iii) fails to meet Our contribution or participation requirements applicable to this Group Agreement (which contribution and participation requirements are available upon request); (iv) fails to provide the certification required by Section 5.4 within a reasonable period of time specified by Us; or (v) changes its eligibility or participation requirements without Our consent; • Upon 90 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer the product to which the Group Agreement relates; • Upon 180 days written notice to Contract Holder (or such shorter notice as may be permitted by applicable law, but in no event less than 30 days) if We cease to offer coverage in a market in which Members covered under this Group Agreement reside; • Upon 30 days written notice to Contract Holder for any other reason which is acceptable to the Department of Insurance and consistent with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) or by applicable federal rules and regulations, as amended.