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2020/12/16 Council Agenda Packet
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2020/12/16 Council Agenda Packet
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Council Agenda Packet
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12/16/2020
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Section 3 Premium Provisions <br />3.1 Payment of Premium. The Premium for each Enrollee is due on the Premium due date, which is <br />the first day of each month. The payment of the Premium for all Enrollees must be submitted to <br />the Company in a single lump sum. A 30-day grace period is granted for payment of the Premium <br />If the Premium is unpaid at the end of the grace period, the Company will be released from all <br />further obligations under this Contract. Only Enrollees for whom the Company has received the <br />Premium payment are entitled to Covered Services. <br />3.2 Premium and Contract Revisions. Payment of the Premium after the notice period set forth <br />below constitutes the Policyholder's acceptance of the revision. The Company may revise the <br />Premium rates and provisions of this Contract as follows: <br />3.2.1 At any time with 90 days' prior written notice, based on any change in the characteristics <br />of the Policyholder. <br />3.2.2 On the anniversary date of this Contract with 90 days' prior written notice. If for any reason <br />the annual renewal of this Contract is delayed beyond the anniversary date, the Company <br />retains the right to revise the Premium and provisions of this Contract, effective on the first <br />day of the month following 30 days' prior written notice. <br />3.2.3 At any time a statutory or regulatory change occurs that affects the terms of this Contract, <br />whereby Company may on 30 days' prior written notice revise this Contract provisions as <br />necessary to bring this Contract into compliance with such statutory or regulatory change; <br />or at any time a governmental unit imposes any new tax or assessment or increases the <br />rate of any current tax or assessment used to determine the Premium rate, whereby <br />Company may revise the Premium rate by the amount of such new tax or assessment <br />increase. <br />3.3 Payment of Premium when Coverage is Continued. If the Enrollee is eligible for continuation <br />rights and elects to continue coverage, the Enrollee must submit timely payment of the Premium <br />through the Policyholder. <br />3.4 Return of Advance Payment of Premium. If the Policyholder submits early payment of the <br />Premium prior to the termination of this Contract, the Company will return the unearned Premium <br />to the Policyholder. Prior written notice of the intent to terminate in accordance with this Contract <br />must be provided. The Policyholder must promptly notify all Enrollees of the termination of this <br />Contract. If an Enrollee receives Covered Services after termination or during any period for which <br />the Premium is unpaid, the Participating Provider is entitled to recover the Reasonable Cash Value <br />of the services provided <br />001 L-WA811(5/20) 6 <br />
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