AMERICAN SPECIALTY HEALTH PLANS GROUP SUBSCRIBER AGMT 1998

~~ 10. TERMINATION OF MEMBERSHIP. 10.01 Termination. The rights of Members under this Agreement shall terminate upon occurrence of any of the following: 10.01.01 Nonpayment of Health Plan Premiums, copayments or Fees for Non-covered Services. Any Member for whom applicable Health Plan Premium payments or copayments are not paid may be disenrolled from this Health Plan by ASHP within fifteen (15) days after mailing written notice of termination for nonpayment to such Member. Such notice shall state that the receipt by ASHP of the applicable Health Plan Premium or copayments within fifteen (15) days shall cause ASHP to revoke the notice. The notice of termination shall be revoked and membership in this Health Plan shall continue without interruption upon the receipt of the applicable Health Plan Premium. The failure of any Member to reimburse ASHP for payments made in error by ASHP within fifteen (15) days after the mailing of written notice of termination for nonpayment by ASHP or to reach reasonable accommodations with ASHP regarding repayment shall result in the termination of Member's membership in this Health Plan. To reinstate coverage, Member must submit a new application for membership and comply with all applicable eligibility requirements. 10.01.02 Termination of Agreement by Group. In the event Group voluntarily terminates this Agreement pursuant to Subparagraph 9.01 of this Agreement, Member's membership in this Health Plan shall terminate at the end of the month for which the last Health Plan Premium is received by ASHP from Group on Member's behalf. _ 10.01.03 Member Permanently Moves Out of Service Area. Member's membership in this Health Plan shall terminate in the event either: (1) Member is absent from the Service Area for 90 consecutive days, or (2) Member moves from the Service Area without the intent to return. Member shall notify ASHP of his or her permanent move from the Service Area as soon as possible. Termination shall be effective the last day of the month in which Member receives notice of termination from ASHP. Notice sent to Member's last-known address shall be deemed effective notice for purposes of this Section 10.01.03. 10.01.04 Member's Loss of Eligibility. Member's Membership in this Health Plan shall terminate on the last day of the month in which Member's eligibility ceases. Member shall be eligible for continuing benefits as set forth in Section 11. a. Dissolution of Subscriber's Marriage. Dependent Eligibility. A Dependent's spouse's membership as a Dependent of Subscriber shall terminate on the first day of the month following the month in which a fmal judgment or decree of dissolution of marriage is entered. A Dependent child's membership in this Health Plan shall continue notwithstanding dissolution of Subscriber's marriage for as long as Dependent child remains eligible and Health Plan Premiums are received by ASHP. 10.01.05 Member Fraud or Deception. A Member's membership in this Health Plan shall immediately terminate if such Member knowingly provides ASHP with fraudulent information upon which ASHP relies and which materially affects Member's eligibility for Enrollment or benefits under this Health Plan. In such instances, ASHP shall send a written notice of termination to Member. 10.01.06 Member Assist Another to Improperly Obtain Benefits. A Member's membership in this Health Plan shall immediately terminate if such Member assists a person who is not a Member to obtain benefits under this Health Plan. In such instances, ASHP shall mail all written notice of termination to the Member.