Laserfiche WebLink
Section 6 Termination Provisions <br />6.1 Termination of Contract. The Policyholder shall promptly notify all Enrollees of the termination of <br />this Contract. This Contract will terminate on the earliest of the following: <br />6.1.1 On this Contract's anniversary date if the Policyholder or the Company provides the other <br />party with 90 days' prior written notice. <br />6.1.2 On the last day of any month if the Policyholder provides the Company with 90 days' prior <br />written notice and remits the entire Premium amount due for the time period prior to the <br />termination date. <br />6.1.3 On the last day of the last month for which the Premium is paid and accepted by the <br />Company, if the payment of the Premium is not received by the end of the grace period <br />specified in Section 3. <br />6.1.4 On the last day of the last month following the date the Policyholder ceases to meet the <br />eligibility, participation, group size, contribution, and other terms of agreement between the <br />Company and the Policyholder. <br />6.1.5 On the date of written notice if there is legal cause for termination. <br />6.2 Termination of Coverage. Coverage for Enrollees will terminate on the earliest of the following: <br />6.2.1 On the date this Contract is terminated. <br />6.2.2 On the last day of the month for which the Premium is paid, if the Premium is not received <br />at the end of the grace period as specified in Section 3. <br />6.2.3 On the last day of the month during which eligibility ends or continuation rights expire. <br />6.2.4 On the last day of the month with 30 days' prior written notice to the Enrollee of good cause <br />for termination. Good cause includes, but is not limited to, a documented inability to <br />establish or maintain an appropriate provider -patient relationship with the Participating <br />Provider, threats or abuse towards the Participating Provider, office staff, or other patients <br />or nonpayment of Copayments. <br />6.2.5 If coverage terminates for the Member, it will terminate for the Dependents covered under <br />the Member. <br />6.3 False Statements False statements or withholding information, with intent to affect eligibility or <br />enrollment, affect the risks assumed by the Company, or mislead the Company into providing <br />Covered Services it would not have otherwise provided, is a material breach of this Contract. Any <br />ineligible person mistakenly enrolled will not be entitled to Covered Services. The Company is <br />entitled to repayment for the Reasonable Cash Value of the Covered Services provided during the <br />period of ineligibility from the ineligible person and any person responsible for making false <br />statements. <br />001 L-WA811(5/20) 16 <br />