Common use of Enrollment and Disenrollment Processes Clause in Contracts

Enrollment and Disenrollment Processes. When no active choice has been made, enrollment for eligible beneficiaries (as described above in Section III.C.1) may be conducted using a seamless passive enrollment process that provides the opportunity for Enrollees to make a voluntary choice to enroll or disenroll from the CICO on a monthly basis. Under passive enrollment, eligible individuals will be notified of plan selection and of their right to select among other contracted CICOs no fewer than sixty (60) days prior to the effective date of enrollment, and will have the opportunity to opt out until the last day of the month prior to the effective date of enrollment, as further detailed in Appendix 7. Disenrollment from CICOs and enrollment from one CICO to a different CICO shall be allowed on a month- to-month basis any time during the year; however, coverage for these individuals will continue through the end of the month. CMS and the State will monitor enrollments and disenrollments for both evaluation purposes and for compliance with applicable marketing and enrollment laws, regulations and CMS policies, and for the purposes of identifying any inappropriate or illegal marketing practices. As part of this analysis, CMS and the State will monitor any unusual shifts in enrollment by individuals identified for Passive Enrollment into a particular CICO to a Medicare Advantage plan operated by the same parent organization. If those shifts appear to be due to inappropriate or illegal marketing practices, CMS and the State may issue corrective action. Any illegal marketing practices will be referred to appropriate agencies for investigation. As mutually agreed upon, and as discussed further in Appendix 7 and the Three-Way Contract, CMS and the State will utilize an independent third party entityto facilitate all enrollments into the CICOs. CICO enrollments, including enrollment from one CICO to a different CICO, and opt-outs shall become effective on the same day for both Medicare and Medicaid (the first day of the following month). For those who lose Medicaid eligibility during the month, coverage and Federal financial participation will continue through the end of that month.

Enrollment and Disenrollment Processes. When no active choice has been made, The Demonstration will begin with an opt- in period during which the enrollment for eligible beneficiaries (as described above in Section III.C.1) may will only be conducted using a seamless passive enrollment process that provides the opportunity for Enrollees among those individuals who choose to make a voluntary choice to enroll or disenroll from the CICO on a monthly basisparticipate. Under passive enrollment, eligible Eligible individuals will be notified of plan selection and of their right to select among other contracted CICOs ICOs no fewer than sixty thirty (6030) days prior to the first effective date of enrollment. For eligible individuals who do not participate in the opt-in period – either by choosing an ICO or expressing a preference not to participate in the Demonstration – enrollment into an ICO may be conducted using a seamless, and passive enrollment process. Individuals eligible for passive enrollment will be notified no fewer than 60 days prior to the enrollment effective date of plan assignment, the opportunity to choose among ICOs, choose not to participate in the Demonstration, or choose to disenroll from an ICO at any time after enrollment. Prior to the effective date of their enrollment, beneficiaries who would be passively enrolled will have the opportunity to opt out until the last day of the month prior month, and will receive sufficient notice and information with which to the effective date of enrollmentdo so, as further detailed in Appendix 7. Disenrollment from CICOs ICOs and enrollment from one CICO ICO to a different CICO ICO shall be allowed on a month- month-to-month basis any time during the year; however, coverage for these individuals will continue through the end of the month. CMS and the State MDCH will monitor enrollments and disenrollments for both evaluation purposes and for compliance with applicable marketing and enrollment laws, regulations regulations, and CMS policies, and for the purposes of identifying any inappropriate or illegal marketing practices. As part of this analysis, CMS and the State MDCH will monitor any unusual shifts in enrollment by individuals identified for Passive Enrollment passive enrollment into a particular CICO ICO to a Medicare Advantage plan operated by the same parent organization. If those shifts appear to be due to inappropriate or illegal marketing practices, CMS and the State MDCH may issue corrective actiondiscontinue further passive enrollment into an ICO. Any illegal marketing practices will be referred to appropriate agencies for investigation. As mutually agreed upon, and as discussed further in Appendix 7 and the Threethree-Way Contractway contract, CMS and the State MDCH will utilize an independent third party entityto entity to facilitate all enrollments into the CICOsICOs. CICO enrollments, including enrollment from one CICO to a different CICO, and opt-outs shall become effective on the same day for both Medicare and Medicaid (the first day of the following month). For those who lose Medicaid eligibility during the month, coverage and Federal financial participation will continue through the end of that month.ICO

Enrollment and Disenrollment Processes. When no active choice has been madeUnder this Demonstration, enrollment for eligible beneficiaries (as described above in Section III.C.1) into a MMIP may be conducted – when no active choice has otherwise been made – using a seamless seamless, passive enrollment process that provides the opportunity for Enrollees beneficiaries to make a voluntary choice to enroll or disenroll from the CICO on a monthly basisMMIP at any time. Under passive enrollment, eligible individuals will be notified of plan selection and of their right to select among other contracted CICOs MMIPs no fewer than sixty (60) days prior to the effective date of enrollment, and will have the opportunity to opt out until the last day of the month prior to the effective date of enrollment, as further detailed in Appendix 7. If a choice to enroll in a MMIP is made by the second to the last business day of the month, enrollment will be effective the first calendar day of the following month. Disenrollment from CICOs MMIPs and enrollment from one CICO MMIP to a different CICO MMIP shall be allowed on a month- month-to-month basis any time during the year; however. All disenrollments will be effective the first day of the month after the choice is made. MMIP enrollments, including enrollment from one MMIP to a different MMIP, and opt-outs shall become effective on the same day for both Medicare and Medicaid (the first day of the following month). For those who lose Medicaid eligibility during the month, coverage for these individuals and FFP will continue through the end of the that month. See Appendix 7 for a more detailed discussion on timing of enrollments and disenrollments. CMS and the State will monitor enrollments and disenrollments for both evaluation purposes and for compliance with applicable marketing and enrollment laws, regulations and CMS policies, and for the purposes purpose of identifying any inappropriate or illegal marketing practices. As part of this analysis, CMS and the State will monitor any unusual shifts in enrollment by individuals identified for Passive Enrollment passive enrollment into a particular CICO MMIP to a Medicare Advantage plan Plan operated by the same parent organization. If those shifts appear to be due to inappropriate or illegal marketing practices, CMS and the State may issue corrective action. Any illegal marketing practices will be referred to appropriate agencies for investigation. As mutually agreed upon, and as discussed further in Appendix 7 and the Three-Way Contract, CMS and the State will utilize an independent third party entityto facilitate all enrollments into the CICOs. CICO enrollments, including enrollment from one CICO to a different CICO, and opt-outs shall become effective on the same day for both Medicare and Medicaid (the first day of the following month). For those who lose Medicaid eligibility during the month, coverage and Federal financial participation will continue through the end of that month.

Enrollment and Disenrollment Processes. When no active choice has been made, enrollment for eligible beneficiaries (as described above in Section III.C.1) may be conducted using a seamless passive enrollment process that provides the opportunity for Enrollees to make a voluntary choice to enroll or disenroll from the CICO on a monthly basis. Under passive enrollment, eligible Eligible individuals will be notified of plan selection and of their right to select among other contracted CICOs ICDS Plans no fewer than sixty (60) days prior to the effective date of enrollment. When no active choice has been made, and enrollment into an ICDS Plan may be conducted using a seamless, passive enrollment process that provides the opportunity for beneficiaries to make a voluntary choice to enroll or disenroll from the ICDS Plan at any time. Prior to the effective date of their enrollment, individuals who would be passively enrolled will have the opportunity to opt opt-out until the last day of the month prior and will receive sufficient notice and information with which to the effective date of enrollmentdo so, as further detailed in Appendix 7. Disenrollment from CICOs ICDS Plans and enrollment from one CICO to a different CICO transfers between ICDS Plans shall be allowed on a month- month-to-month basis any time during the year; however, coverage for these individuals will continue through the end of the month. CMS and the State will monitor enrollments and disenrollments for both evaluation purposes and for compliance with applicable marketing and enrollment laws, laws regulations and CMS policies, and for the purposes of identifying any inappropriate or illegal marketing practices. As part of this analysis, CMS and the State will monitor any unusual shifts in enrollment by individuals identified for Passive Enrollment passive enrollment into a particular CICO ICDS plan to a Medicare Advantage plan operated by the same parent organization. If those shifts appear to be due to inappropriate or illegal marketing practices, CMS and the State may issue corrective actiondiscontinue further passive enrollment into an ICDS plan. Any illegal marketing practices will be referred to appropriate agencies for investigation. As mutually agreed upon, and as discussed further in Appendix 7 and the Threethree-Way Contractway contract, CMS and the State will utilize an independent third party entityto entity to facilitate all enrollments enrollment into the CICOsICDS Plans. CICO ICDS Plan enrollments, including enrollment from one CICO to a different CICO, transfers and opt-outs shall become effective on the same day for both Medicare and Medicaid (the first day of the following month). For those who lose Medicaid eligibility during the month, coverage and Federal financial participation will continue through the end of that month.

Enrollment and Disenrollment Processes. When no active choice has been made, enrollment for eligible beneficiaries (as described above in Section III.C.1) may be conducted using a seamless passive enrollment process that provides the opportunity for Enrollees to make a voluntary choice to enroll or disenroll from the CICO on a monthly basis. Under passive enrollment, eligible individuals will be notified of plan selection and of their right to select among other contracted CICOs Participating Plans no fewer than sixty (60) days prior to the effective date of enrollment, and will have the opportunity to opt out until the last day of the month prior to the effective date of enrollment. When no active choice has been made, enrollment into a Participating Plan may be conducted using a seamless, passive enrollment process that provides the opportunity for beneficiaries to make a voluntary choice to enroll or disenroll from the Participating Plan at any time. Prior to the effective date of their enrollment, individuals who would be passively enrolled will have the opportunity to opt out and will receive sufficient notice and information with which to do so, as further detailed in Appendix 7. Disenrollment from CICOs Participating Plans and enrollment from one CICO to a different CICO transfers between Participating Plans shall be allowed on a month- month-to-month basis any time during the year; however, coverage for these individuals will continue through the end of the month. CMS and the State DMAS will monitor enrollments and disenrollments for both evaluation purposes and for compliance with applicable marketing and enrollment laws, regulations and CMS policies, and for the purposes of identifying any inappropriate or illegal marketing practices. As part of this analysis, CMS and the State DMAS will monitor any unusual shifts in enrollment by individuals identified for Passive Enrollment passive enrollment into a particular CICO Participating Plan to a Medicare Advantage plan operated by the same parent organization. If those shifts appear to be due to inappropriate or illegal marketing practices, CMS and the State DMAS may issue corrective action. Any illegal marketing practices will be referred to appropriate agencies for investigation. As mutually agreed upon, and as discussed further in Appendix 7 and the Threethree-Way Contractway contract, CMS and the State DMAS will utilize an independent third party entityto entity to facilitate all enrollments into the CICOsParticipating Plans. CICO Participating Plan enrollments, including enrollment from one CICO to a different CICOtransfers, and opt-outs shall become effective on the same day for both Medicare and Medicaid (the first day of the following month). For those who lose Medicaid eligibility during the month, coverage and Federal financial participation will continue through the end of that month.