Common use of Disenrollment Guidelines Clause in Contracts

Disenrollment Guidelines. a) Disenrollment of an Enrollee from the Contractor's Plan may be initiated by the Enrollee, LDSS or the Contractor under the conditions specified in Sections 8.4, 8.7, 8.8 and 8.9 and as detailed in Appendix H, Section E and F of this Agreement. b) The LDSS and the Contractor agree to conduct disenrollment in accordance with the guidelines set forth in Appendix H, Section E and F of this Agreement. c) The SDOH and LDSS, upon mutual agreement, may modify Appendix H of this Agreement upon sixty (60) days prior written notice to the Contractor and such modifications shall become binding and incorporated into this Agreement without further action by the parties. d) LDSS shall make the final determination concerning disenrollment.

Appears in 6 contracts

Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.), Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)

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Disenrollment Guidelines. a) Disenrollment of an Enrollee from the Contractor's Plan may be initiated by the Enrollee, LDSS an LDSS, or the Contractor under the conditions specified in Sections 8.4, 8.7, 8.8 and 8.9 and as detailed in Appendix H, Section Sections D and E and F of this Agreement. b) The LDSS LDSSs and the Contractor agree to will conduct disenrollment disenrollments in accordance with the guidelines set forth in Appendix H, Section Sections D and E and F of this Agreement. c) The SDOH and LDSS, upon mutual agreement, may modify Appendix H of this Agreement upon sixty (60) days prior written notice to the Contractor and such modifications shall become binding and incorporated into this Agreement without further action by the partiesaction. d) LDSS LDSSs shall make the final determination concerning disenrollmentdisenrollments, except for Contractor-initiated disenrollments and expedited disenrollments, which may be subject to SDOH approval as specified elsewhere in this Agreement.

Appears in 1 contract

Samples: Consultant Services Agreement (Wellcare Health Plans, Inc.)

Disenrollment Guidelines. a) Disenrollment of an Enrollee from the Contractor's Plan may be initiated by the Enrollee, LDSS or LDSS, and/or the Contractor under the conditions specified in Sections 8.4, 8.7, 8.8 and 8.9 and as detailed in Appendix H, Section E and F of this Agreement. b) The LDSS and the Contractor agree to conduct disenrollment in accordance with the guidelines set forth in Appendix H, Section E and F of this Agreement.E. c) The SDOH and LDSS, upon mutual agreement, may modify Appendix H of this Agreement upon sixty (60) days prior written notice to the Contractor and such modifications shall become binding and incorporated into this Agreement without further action by the parties. d) LDSS shall make the final determination concerning disenrollment, except for Contractor initiated disenrollments and expedited disenrollments, which ma y be subject to SDOH approval as specified elsewhere in this Agreement.

Appears in 1 contract

Samples: Contractor Agreement (Americhoice Corp)

Disenrollment Guidelines. a) Disenrollment of an Enrollee from the Contractor's Plan may be initiated by the Enrollee, LDSS or the Contractor under the conditions specified in Sections 8.4, 8.7, 8.8 and 8.9 and as detailed in Appendix H, Section E and F of this Agreement. b) The LDSS and the Contractor agree to conduct disenrollment in accordance with the guidelines set forth in Appendix H, Section E and F of this Agreement. c) The SDOH and LDSS, upon Upon mutual agreement, may modify Appendix H of this Agreement upon sixty (60) days prior written notice to the Contractor and such modifications shall become binding and incorporated into this Agreement without further action by the parties. d) LDSS shall make the final determination concerning disenrollment.

Appears in 1 contract

Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)

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Disenrollment Guidelines. a) Disenrollment of an Enrollee from the Contractor's Plan may be initiated by the Enrollee, LDSS or on the Contractor under the conditions specified in Sections 8.4, 8.7, 8.8 and 8.9 and as detailed in Appendix H, Section E and F of this Agreement. b) The LDSS and the Contractor agree to conduct disenrollment in accordance with the guidelines set forth in Appendix H, Section E and F of this Agreement. c) The SDOH and LDSS, upon mutual agreement, may modify Appendix H of this Agreement upon sixty (60) days prior written notice to the Contractor and such modifications shall become binding and incorporated into this Agreement without further action by the parties. d) LDSS shall make the final determination concerning disenrollment.

Appears in 1 contract

Samples: Medicaid Managed Care Model Contract (Wellcare Health Plans, Inc.)

Disenrollment Guidelines. a) Disenrollment of an Enrollee from the Contractor's Plan may be initiated by the Enrollee, LDSS or the Contractor under the conditions specified in Sections 8.4, 8.7, 8.8 and 8.9 and as detailed in Appendix H, Section E and F of this Agreement. b) The LDSS and the Contractor agree to conduct disenrollment in accordance with the guidelines set forth in Appendix H, Section E and F of this Agreement. c) The SDOH and LDSS, upon mutual agreement, may modify Appendix H of this Agreement upon sixty UPON SIXTY- (60) days prior written notice to the Contractor and such modifications shall become binding and incorporated into this Agreement without further action by by, the parties. d) LDSS shall make the final determination concerning __________ disenrollment.

Appears in 1 contract

Samples: Medicaid Managed Care Model Contract (Amerigroup Corp)

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