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SECTION 5: PAYMENT PROVISIONS <br />A. Monthly Invoice <br />We will prepare a monthly invoice of the Premium due on or before the due date. This monthly invoice <br />will also reflect any prorated charges and credits resulting from changes in the number of Covered <br />Persons and changes in the types of coverage that took place in the previous or current month. <br />If you become aware that a Covered Person will become ineligible, you must provide us with written <br />notice of such ineligibility as described in Section 3 of this Agreement. You shall be liable to us for the <br />Premium due for each individual enrolled in a Medicare Plan under this Agreement until the effective <br />date of disenrollment, which is set by CMS Requirements. <br />You must pay the total amount of the invoice. Do not add names to an invoice, change coverage or pay <br />for a retiree or dependent whose name does not appear on the invoice. No changes can be made to a <br />Group invoice unless a signed application form is on file and submitted to Florida Blue. Payment shall <br />be for the total amount of the Group invoice. <br />B. Payment Due Date <br />The first Premium payment is due before the Effective Date of the Agreement. Each following payment <br />is due monthly unless you agree with us in writing on some other method and/or frequency of payment. <br />The Premium is due and payable on or before the first day of each succeeding calendar month to which <br />such payments apply. <br />C. Grace Period <br />This Agreement has a sixty (60) calendar day Premium payment Grace Period, which begins on the date <br />the Premium payment is due. if we do not receive the required Premium payment on or before the date it <br />is due, it may be paid during this Grace Period. Coverage will stay in force during the Grace Period. If <br />Premium payments are not received by the end of the Grace Period, we will terminate this Agreement <br />and proceed with the disenrollment of Covered Persons as described in Section 3 of this Agreement. <br />D. Changes in Premium <br />Premium rates may be changed on your Anniversary Date as described in Section 4.A above regarding <br />renewal. <br />E. Other Rules Regarding the Payment of Premiums <br />CMS rules govern the effective date of any disenrollment of a Covered Person under this <br />Agreement, and we are not required to retroactively terminate this Agreement or coverage for <br />any Covered Person. <br />If full payment of the Premium is not paid when due, this Agreement may be terminated as <br />described in Section 4 of this Agreement. <br />6 164 <br />