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TERMINATION DATE

TAX PAYER IDENTIFICATION NUMBER (TIN)
March 22, 2018
TPA (THIRD PARTY ADMINISTRATOR)
March 22, 2018
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THE DATE THAT SPECIFIES THE END OF A PRIMARY PAYER’S RESPONSIBILITY FOR CLAIMS.FOR GROUP HEALTH PLAN – THE TERMINATION DATE SPECIFIES THE END OF GROUP HEALTH PLAN COVERAGE FOR LIABILITY & WORKER’S COMPENSATION CASES – THE TERMINATION DATE SPECIFIES THE END OF THE LIABLE PARTY’S RESPONSIBILITY FOR CLAIMS (TYPICALLY THE DATE OF SETTLEMENT FOR THE LIABILITY OR WORKER’S COMPENSATION CASE)

FOR NO-FAULT CASES – THE TERMINATION DATE SPECIFIES THE END OF THE LIABLE INSURER’S RESPONSIBILITY FOR CLAIMS (TYPICALLY DUE TO BENEFITS BEING EXHAUSTED OR THE CLOSURE OF THE NO-FAULT CASE WHEN THE BENEFICIARY HAS COMPLETED TREATMENT FOR THEIR ACCIDENT RELATED INJURIES