Common use of Agent Actions Clause in Contracts

Agent Actions. (a) Upon notice from Aetna, Upline shall promptly prohibit Agent from Selling or Referring, if Aetna determines: (i) Agent is or has been charged with criminal conduct; (ii) Agent is excluded from the Medicare Program or any other federal or state health benefit program; (iii) Agent violated a law, regulation or CMS guidance regarding the marketing, offering or sale or distribution of Medicare plans or products; (iv) Agent intentionally misrepresented the provisions, benefits or premiums of any Medicare plan or product; (v) Agent acted in a manner that is materially detrimental to Aetna; (vi) Agent caused an unacceptable number of CTMs as determined by Aetna, in Aetna’s sole discretion; (vii) Agent has an unacceptable number of Rapid Disenrollments, applicant cancellations of enrollments in Medicare Products prior to the effective date of coverage, and/or disenrollments in Medicare Products by the Medicare Product Enrollee, as determined by Aetna, in Aetna’s sole discretion; (viii) Agent failed to cooperate, as determined solely by Aetna, in an investigation of a complaint involving Agent; or (ix) Agent appeared on the Specially Designation Nationals or Blocked Persons List published by the Office of Foreign Assets Control of the Department of Treasury. (b) In addition, Upline shall promptly notify Aetna if Upline becomes aware of or receives any information about an Agent as to items (i), (ii), (iii), (iv), (v), (viii) and (ix), above. If an LOA commits any of the foregoing actions, Aetna shall have the right to terminate payment of Commissions to Upline in respect of any Sales or Renewals for which that LOA is the agent of record. No action Upline may take pursuant to this Section 3.20, shall affect any rights Aetna may have under Section 8.3 or 8.4. (c) If Aetna terminates with cause an Independent Agent’s Agent Contract, Upline will cease receiving all Commissions in respect of Sales and Renewals of such Independent Agent.