Enrollment and Disenrollment Sample Clauses

Enrollment and Disenrollment. ‌ The Division or its Agent shall send written notification to the Member to inform the Member of Enrollment into the MississippiCAN Program and to select a CCO and PCP.

Enrollment and Disenrollment. ‌ The Division or its Agent shall send written and electronic (if available) notification to the Member to inform the Member of the Member’s Enrollment into MississippiCAN or CHIP and to select a Contractor and PCP. The Division and its Agent will be responsible for Choice Counseling for the Member. Upon enrollment, a Member must either choose a Contractor in which to enroll or be passively auto enrolled to a Contractor by the Division. Regardless of whether the Member chooses a Contractor or is passively auto enrolled, the Member may change Contractor membership within ninety (90) calendar days from the date of enrollment if desired. The Member will remain a Member of the Contractor in which the Member is enrolled on the 90th day after the date of enrollment until the next open enrollment period unless the Member becomes ineligible for the program or is otherwise disenrolled. Passive auto enrollment rules will include provisions to determine the following: 1. Prior Enrollment: The Division will determine whether the Member was enrolled with a Contractor within the previous sixty (60) calendar days and assign the Member to that Contractor.

Enrollment and Disenrollment. In accordance with A.R.S. §8-512, CMDP provides comprehensive medical and dental care for each child who is: a) placed in a ▇▇▇▇▇▇ home; b) in the custody of DES and placed with a relative, in a certified adoptive home prior to the final order of adoption, or in an independent living program as provided in A.R.S. §8-512; and c) in the custody of the Arizona Department of Juvenile Corrections (ADJC) or the Administrative Office of the Courts/Juvenile Probation Office (AOC/JPO) and placed in ▇▇▇▇▇▇ care. Children who are enrolled with CMDP when placed temporarily in detention may remain Title XIX or Title XXI eligible. When it is determined that the child does not meet the “inmate of a public institution” status as determined by the Children in Detention Policy, AHCCCS enrollment will remain with CMDP. The Division of Children, Youth and Families (DCYF) is responsible for determining Title XIX eligibility for the children entitled to CMDP coverage. Upon notification from DCYF that a CMDP covered child qualifies for Title XIX, AHCCCS, will enroll the child with CMDP as the Title XIX health plan. AHCCCS shall in turn notify CMDP of the child’s AHCCCS enrollment, and CMDP shall ensure that the member is enrolled in CMDP’s Title XIX line of business. DCYF is responsible for timely notification to AHCCCS that a member is no longer eligible for Title XIX or that member no longer meets the criteria for CMDP coverage as set forth in A.R.S. §8-512. As a result of the DCYF notification that a member no longer qualifies for CMDP, AHCCCS shall notify CMDP of a member’s termination from CMDP. CMDP shall timely disenroll the member from CMDP’s Title XIX line of business. AHCCCS is responsible for determining Title XXI eligibility. AHCCCS shall notify CMDP when a child qualifies for Title XXI and CMDP coverage. CMDP shall ensure that the member is enrolled in CMDP’s Title XXI line of business. AHCCCS shall notify CMDP if a Title XXI child no longer meets the criteria for Title XXI eligibility, and CMDP shall disenroll such child from the Title XXI line of business. If a Title XXI eligible child no longer meets the criteria for CMDP coverage as set forth in A.R.S. §8.512, CMDP shall notify AHCCCS, and the child shall be disenrolled from CMDP, by AHCCCS and CMDP. CMDP may not disenroll because of an adverse change in the member’s health status, or because of the member’s utilization of medical services, diminished mental capacity, or uncooperative or disruptive behavior resu...

Enrollment and Disenrollment. ‌ DOM or its Agent shall send written notification to the Member to inform the Member of Enrollment into CHIP and to select a CCO and Primary Care Provider (PCP).

Enrollment and Disenrollment. 1.5.1 Non-Discrimination

Enrollment and Disenrollment. When the Safety Net Benefit Program enrollee becomes ineligible (either because of non-payment of premium, income, or other factors including that the employer ceases to qualify as a participating employer), then coverage will end on the last day of the month in which the premiums have been paid. Affected employees must be notified promptly of their ineligibility. If the enrollee, before the later of that date or 15 days following notification, corrects any deficiency (either though payment of the premium or other means), or demonstrates an error in the notification, the enrollee will be retroactively reinstated.

Enrollment and Disenrollment. Procedures i) Where appropriate, explanation of Lock-In requirements, and initial grace period when person may change plans, or return to fee-for-service in voluntary areas. ii) Choice of PCP (each person can have his/her own PCP and can change thirty (30) days after the initial appointment with their PCP, and once every six months thereafter). iii) Procedures for disenrollment. iv) Opportunities for change v) LDSS/or enrollment broker phone number for information on enrollment and disenrollment.

Enrollment and Disenrollment. 2.1.1.1 Enrollment Procedures (1) The Contractor will receive a complete referral package from CARES.

Enrollment and Disenrollment. A. Enrollment Services Contractor MDHHS contracts with an Enrollment Services Contractor to act as its Agent to contact and educate Medicaid beneficiaries regarding dental plan choice and assist beneficiaries to enroll, disenroll, and change enrollment with their dental plan. Contractor must work with the Enrollment Services Contractor as directed by MDHHS. B. Enrollment Discrimination Prohibited 1. Contractor must not discriminate against individuals eligible to enroll on the basis of: a. Health status or the need for health and/or Dental Services b. Race, color, national origin, age, disability, sex, or other factors identified in 42 CFR 438.3(d) and will not use any policy or practice that has the effect of discriminating as such 2. Contractor must accept all MDHHS assigned Enrollees without restriction. C. Initial Enrollment and Automatic Reenrollment 1. Contractor must accept as enrolled all beneficiaries listed on monthly HIPAA-compliant enrollment files/reports. 2. Enrollees disenrolled from the Contractor due to loss of Medicaid eligibility or other action will be retroactively reenrolled to the same Contractor automatically, provided eligibility is regained within two months. D. Auto-assignment of Beneficiaries 1. MDHHS will initially automatically assign beneficiaries to the Contractor. If there are multiple dental plans assigned to a service area, MDHHS will alternatively assign beneficiaries to a Contractor. Members of a family unit will be assigned together whenever possible.