Covered California Enrollee Materials. Basic Requirements
a) Contractor shall provide or make available to Covered California Enrollees Plan materials required under the terms of the Agreement and applicable laws, rules and regulations. Such materials shall be available in languages as required by Federal and State law and receive any necessary regulatory approvals from the relevant State Regulators, be provided to Covered California as directed by Covered California, and shall include information brochures, a summary of the Plan that accurately reflects the coverage available under the Plan (a Summary of Benefits and Coverage), and related communication materials. Contractor shall, upon request by Covered California, provide copies of Covered California Enrollee communications and give Covered California the opportunity to comment and suggest changes in such material.
b) Covered California Enrollee materials shall be available in English, Spanish and other languages as required by applicable laws, rules and regulations. Contractor shall comply with Federal and State laws, rules and regulations regarding language access. To the extent possible, Covered California Enrollee materials shall be written in plain language, as that term is defined in applicable laws, rules and regulations. Plan materials that require Covered California notification before usage are those that communicate specific eligibility and enrollment and other key information to Covered California Enrollees. Such materials may include:
i. Welcome letters;
ii. Covered California Enrollee ID card;
iii. Billing notices and statements;
iv. Notices of actions to be taken by QHP Issuer that may impact coverage or benefit letters;
v. Termination Grievance process materials;
vi. Drug formulary information;
vii. Uniform Summary of Benefits and Coverage; and viii.Other materials required by Covered California.
