Common use of Enrollment Information Clause in Contracts

Enrollment Information. Complete the following table that outlines all enrollment activity under the demonstration. Indicate “N/A” where appropriate. If there was no activity under a particular enrollment category, the state should indicate that by placing “0” in the appropriate cell. Budget Population 1: ABD no TPL Budget Population 2: ABD TPL Budget Population 3: RIte Care Budget Population 4: CSHCN Budget Population 5: EFP Budget Population 6: Pregnant Expansion Budget Population 7: CHIP Children Budget Population 8: Substitute care Budget Population 9: CSHCN Alt Budget Population 10: Elders 65 and over Budget Population 11: 217-like group Budget Population 12: 217-like group Budget Population 13: 217-like group Budget Population 14: BCCTP Budget Population 15: AD Risk for LTC Budget Population 16: Adult Mental Unins Budget Population 17: Youth Risk Medic Budget Population 18: HIV Budget Population 19: AD Non-working Budget Population 20: Alzheimer adults Budget Population 21: ▇▇▇▇▇▇▇ aged out Cumulative Number of Voluntary Disenrollments Within Current Demonstration Year: Reasons for Voluntary Disenrollments. Cumulative Number of Involuntary Disenrollments Within Current Demonstration Year: Reasons for Involuntary Disenrollments: