Right to Recalculate Clause Samples

Right to Recalculate. CICI has the right to recalculate premium rates and stop loss factors for each Policy Renewal Date. CICI also reserves the right to change the premium rate or any Aggregate Stop Loss Factor as of the date of any change to the underlying assumptions or information that impacts the risk assumed for the insurance we are providing under the Policy or if the change affects the initial underlying assumptions made, as of the Effective Date of coverage. Changes include, but are not limited to: • Any change of +/- [10%] in Employees or Covered Units. • Any change to the Plan document(s) that will change the risk assumed under this Policy. • Any change to this Policy. • Any addition or deletion of a unit, division, subsidiary, affiliated or associated company from this Policy. • Any change in federal or state law or regulation that impacts this Policy or the coverage provided. • Any change impacting the risk we have assumed, including but not limited to: age, gender, geography, occupation, incorrect or incomplete information provided in the Disclosure Statement, etc., that we determine impacts the nature of the risk by more than 10%. • Any change in Claims Administrator, provider network or cost containment vendor, provided we have consented to the change in writing. • Any change in the Claims Administrator’s claim payment system or payment practices that causes a variation of +/- 5% versus the most recent 12-month average of claims processing time. Any failure by CICI to adjust any premium rate or stop loss factor during a Policy Period will not prohibit us from making an adjustment during any subsequent Policy Period. Changes To The Plan This section is applicable if CICI is not your Claims Administrator, network provider, or cost containment vendor for any Covered Benefit. CICI has the right to approve any change to the Plan if the change impacts the Eligible Claim Expenses or assumptions under this Policy. You must notify us promptly, in writing, at least 30 days before the Effective Date of any plan change or change in Claims Administrator, provider network, or cost containment vendor. CICI’s prior written agreement is required before the coverage under the Policy will apply to the changes. Otherwise, benefits under the Policy will be paid based on the Plan as it existed when last approved by CICI, and CICI reserves the right to terminate the Policy upon discovery of such change. Fraud, Deception, Or Misrepresentation CICI pursues all appropriate and available ...