Member Disenrollment Initiated by HSD Sample Clauses

The 'Member Disenrollment Initiated by HSD' clause defines the circumstances and procedures under which the Health Services Department (HSD) can remove a member from a health plan or program. Typically, this clause outlines specific reasons for disenrollment, such as ineligibility, non-compliance with program requirements, or fraudulent activity, and details the notification process and any rights to appeal. Its core function is to provide a clear and standardized process for involuntary disenrollment, ensuring both administrative efficiency and fairness to members while protecting the integrity of the program.
Member Disenrollment Initiated by HSD. 4.3.3.1 HSD may disenroll a Member if: 4.3.3.1.1 The Members loses Medicaid eligibility; or 4.3.3.1.2 At any point in the Fair Hearing process when it is determined that such removal is in the best interest of the Member and/or HSD.
View SourceView Similar (17)

Related to Member Disenrollment Initiated by HSD

  • Enrollment You are responsible for i) having all of the required information in this Agreement completed and

  • Plan Design The flexible benefits plan is a cafeteria-style benefits program wherein the County makes a contribution toward the Flexible Benefits Plan for each eligible employee to be allocated during the employee's active employment. The County contribution is distributed by the employee among the menu of benefit options listed below, the specific details and administration of which are set forth in the plan brochures: • Health insurance • County basic life and AD&D insurance • Dental insurance • Vision insurance • Supplemental life insurance • Supplemental accidental death and dismemberment insurance (AD&D) • Flexible spending accounts for pre-tax reimbursement of qualified medical and/or dependent day care expenses. Account credits must be used during the plan year in which they are earned for expenses incurred during the same plan year. • The plan may be modified upon written notice by the County. This plan includes for eligible employees pre-tax contributions for all monies paid toward health, dental, vision and/or voluntary AD&D plans.

  • SALARY DETERMINATION FOR EMPLOYEES IN ADULT EDUCATION PCA Article B.3 does not apply in School District No. 59 (Peace River South).