Loss of Minimum Essential Coverage definition

Loss of Minimum Essential Coverage means in the case of a Member who has coverage that is not COBRA continuation coverage, the conditions are satisfied at the time the coverage is terminated as a result of loss of eligibility (regardless of whether the individual is eligible for or elects COBRA continuation coverage). Loss of eligibility does not include a loss due to the failure to pay premiums on a timely basis or termination of coverage for cause (such as making a fraudulent Claim or an intentional misrepresentation of a material fact in connection with the Plan). Loss of eligibility for coverage includes, but is not limited to:
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Loss of Minimum Essential Coverage includes loss of eligibility for coverage as a result of any of the following: (i) Legal separation or divorce. (ii) Cessation of dependent status (such as reaching the maximum age to be eligible as a Dependent under this Contract). (iii) Death of an employee; termination of employment; reduction in the number of hours of employment; or any loss of eligibility for coverage after a period that is measured by any of the foregoing. (iv) Individual who no longer resides, lives or works in the service area. (v) A situation in which a health benefit plan no longer offers any benefits to the class of similarly situated individuals that includes the individual. (vi) Termination of employer contributions. (vii) Exhaustion of COBRA continuation of coverage.
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Examples of Loss of Minimum Essential Coverage in a sentence

  • An individual may enroll in HPN outside of the annual open enrollment period under the following circumstances; pre-enrollment verification may apply:  Loss of Minimum Essential Coverage (MEC): An applicant may enroll sixty (60) days before and after loss of MEC; the effective date of coverage will be the first (1st) day the month following loss of MEC.

  • An individual may enroll in HPN outside of the annual open enrollment period under the following circumstances; pre-enrollment verification may apply:  Loss of Minimum Essential Coverage (MEC): An applicant may enroll sixty (60) days before and after loss of MEC.

  • An individual may enroll in SHL outside of the annual open enrollment period under the following circumstances; pre-enrollment verification may apply:  Loss of Minimum Essential Coverage (MEC): An applicant may enroll sixty (60) days before and after loss of MEC; the effective date of coverage will be the first (1st) day the month following loss of MEC.

  • An individual may enroll in SHL outside of the annual open enrollment period under the following circumstances; pre-enrollment verification may apply:  Loss of Minimum Essential Coverage (MEC): An applicant may enroll sixty (60) days before and after loss of MEC.

Related to Loss of Minimum Essential Coverage

  • Minimum Essential Coverage has the meaning given in the Affordable Care Act, 26 U.S.C. §5000A(f).

  • Defects Liability Period (Warranty Period) means the period stated in the Schedule A Special Stipulations, following the taking over, during which the Contractor is responsible for making good defects and damage in accordance with Clause 15.

  • Minimum Extended Summer Resource Requirement means, for Delivery Years through May 31, 2017, the minimum amount of capacity that PJM will seek to procure from Extended Summer Demand Resources and Annual Resources for the PJM Region and for each Locational Deliverability Area for which the Office of the Interconnection is required under Tariff, Attachment DD, section 5.10(a) to establish a separate VRR Curve for such Delivery Year. For the PJM Region, the Minimum Extended Summer Resource Requirement shall be equal to the RTO Reliability Requirement minus [the Limited Demand Resource Reliability Target for the PJM Region in Unforced Capacity]. For an LDA, the Minimum Extended Summer Resource Requirement shall be equal to the LDA Reliability Requirement minus [the LDA CETL] minus [the Limited Demand Resource Reliability Target for such LDA in Unforced Capacity]. The LDA CETL may be adjusted pro rata for the amount of load served under the FRR Alternative.

  • General Conditions Cost means costs incurred and minor work performed by Contractor without the need for competitive bids/proposals. The allowable General Conditions items are limited in Paragraph 11.1 and are further described on Exhibit “D”. The maximum allowable General Conditions Cost payable to Contractor during the Construction Phase of the Project is set out in Exhibit “A” attached to this Agreement.

  • Direct Damage has the meaning given in clause 24.2; "Dispute" has the meaning given in clause 23.1;