Disenrollment Summary Report Clause Samples

Disenrollment Summary Report. This report provides a uniform means of reporting each contractor's monthly disenrollments. The report is required to assess the reasons for each disenrollment and to ensure that disenrollments are in compliance with contract guidelines. This report must be provided as a Microsoft Excel spreadsheet in the format specified in Exhibit B of this contract. Disenrollments shall be numbered, and information shall be listed in alphabetized ascending order by enrollee last name, then by enrollee first name. Information shall pertain only to disenrollments that are effective for the month being reported. A report will be required if there are no disenrollments filed during the given month. For example, the November 2002 report of disenrollments would include information on an enrollee that expired on October 28, 2002. October 28, 2002, would be provided as the Disenrollment Reason Occurrence Date for that enrollee in the Disenrollment Summary Report.