Eligibility File. The compilation of all Eligibility Data for an Enrollee or group of Enrollees into a single electronic format used to store or transmit the data.
Eligibility File. From time to time, Employer will (directly or through an agent) either send an electronic file or upload to HQY’s website (each, an “Eligibility File”) information pertaining to: (i) employees who have submitted HSA applications through Employer’s benefits enrollment system and instructed Employer to open HSAs on their behalf, or (ii) employees for whom Employer is requesting that HSAs be opened without the employees’ affirmative consent.
Eligibility File. The compilation of all Eligibility Information for an Enrollee or group of Enrollees into a single electronic format used to store or transmit the data. Employee – A “qualified Employee,” as defined in 45 C.F.R. 155.20. Employer – A “qualified Employer,” as defined in § 1312(f)(2) of the Act. Encounter – Any dental service or bundle of related dental services provided to one Enrollee by one Health Care Professional within one time period. Any dental services provided must be recorded in the Enrollee’s health record. Encounter Data – Encounter information Contractor can use to demonstrate the provision of dental services to Enrollees. Enrollee – Enrollee means each and every individual or an Employee and each of their Family Members enrolled in a QDP offered through the Exchange for the purpose of receiving health benefits. An Enrollee may be referred to as a member of a QDP who is entitled to receive covered services. Evidence of Coverage (EOC) and Disclosure Form – The booklet(s) which describe(s) the benefits, exclusions, limitations, conditions, and the benefit levels of the applicable Plan(s). The Exchange – The California Health Benefit Exchange, doing business as Covered California and an independent entity within the State of California. Explanation of Benefits (EOB) – A statement sent from the Contractor to an Enrollee listing services provided, amount billed, eligible expenses and payment made by the Plan. Explanation of Payment (EOP) – A statement sent from the Contractor to Providers detailing payments made for Health Care Services. Family Dental Plan – A plan certified by the Exchange that provides the pediatric dental benefits required in Health and Safety Code 1367.005(a)(5) and Insurance Code 10122.27(a)(5), and also includes coverage for certain benefits for adult Enrollees. Family Member – An individual who is within an Enrollee’s or Employee’s family, as defined in 26 U.S.C. 36B (d)(1). General Agent – A licensed insurance brokerage firm, qualified and operating under the laws of the state of California, with a network of affiliated Agents in the state of California, that is contracted with the Exchange. Grace Period – A specified time following the premium due date during which coverage remains in force and an Enrollee or Employer or other authorized person or entity may pay the premium without penalty. Health Care Professional – An individual with current and appropriate licensure, certification, or accreditation in a medical, dental or...
Eligibility File. The CONTRACTOR must accept an eligibility file update on a schedule agreed upon by the DEPARTMENT’S IAS vendor, and the CONTRACTOR, and accurately process the enrollment file additions, changes, deletions, and discrepancies within three (3) BUSINESS DAYS of receipt of the file. Delays in processing the eligibility file must be communicated to the DEPARTMENT Program Manager or designee within one (1)
Eligibility File. DHS will provide Maximus a daily Eligibility File that includes records for all newly eligible Participants. Xxxxxxx shall use the Daily Eligibility File to confirm the Participant's program enrollment, update Maximus' system with any Participant demographic changes and Disenrollments, and for such other purposes as may be designated by the Department. In addition, for CHC Participants, Xxxxxxx shall use the auto-assignment indicator from the Eligibility File to determine outreach, CHC MCO selections, and the mailing of appropriate notices and packets. Xxxxxxx must reconcile any CHC Participant CHC-MCO selections in the Eligibility File that differ from the CHC Participants' advanced plan selections. The Department will treat any Depattment requested changes to required uses of the file as a change under Section IV-3.D.
Eligibility File. The compilation of all Eligibility Information for an Enrollee or group of Enrollees into a single electronic format used to store or transmit the data. Employee – A “qualified Employee,” as defined in 45 C.F.R. § 155.20. Employer – A “qualified Employer,” as defined in § 1312(f)(2) of the Affordable Care Act. Encounter – Any dental service or bundle of related dental services provided to one Enrollee by one Health Care Professional within one time period. Any dental services provided must be recorded in the Enrollee’s health record. Encounter Data – Encounter information Contractor can use to demonstrate the provision of dental services to Enrollees. Enrollee – Enrollee means each and every individual enrolled in a QDP offered through the Exchange for the purpose of receiving dental benefits. An Enrollee may be referred to as a member of a QDP who is entitled to receive covered services. Evidence of Coverage (EOC) and Disclosure Form – The booklet(s) which describe(s) the benefits, exclusions, limitations, conditions, and the benefit levels of the applicable Plan(s). The Exchange – The California Health Benefit Exchange, doing business as Covered California and an independent entity within the State of California. Explanation of Benefits (EOB) – A statement sent from the Contractor to an Enrollee listing services provided, amount billed, eligible expenses and payment made by the Plan. Explanation of Payment (EOP) – A statement sent from the Contractor to Providers detailing payments made for Health Care Services. Family Dental Plan – A plan certified by the Exchange that provides the pediatric dental benefits required in Health and Safety Code § 1367.005(a)(5) and Insurance Code § 10122.27(a)(5), and also includes coverage for certain benefits for adult Enrollees. Family Member – An individual who is within an Enrollee’s or Employee’s family, as defined in 26 U.S.C.
Eligibility File. The compilation of all Eligibility Information for an Enrollee or group of Enrollees into a single electronic format used to store or transmit the data. Employee – A “qualified Employee,” as defined in 45 C.F.R. § 155.20. Employer – A “qualified Employer,” as defined in § 1312(f)(2) of the Affordable Care Act. Encounter – Any dental service or bundle of related dental services provided to one Enrollee by one Health Care Professional within one time period. Any dental services provided must be recorded in the Enrollee’s health record. Encounter Data – Encounter information Contractor can use to demonstrate the provision of dental services to Enrollees. Enrollee – Enrollee means each and every individual or an Employee and each of their Family Members enrolled in a QDP offered through the Exchange for the purpose of receiving health benefits. An Enrollee may be referred to as a member of a QDP who is entitled to receive covered services. Evidence of Coverage (EOC) and Disclosure Form – The booklet(s) which describe(s) the benefits, exclusions, limitations, conditions, and the benefit levels of the applicable Plan(s). The Exchange – The California Health Benefit Exchange, doing business as Covered California and an independent entity within the State of California.
Eligibility File. The compilation of all Eligibility Information for an Enrollee or group of Enrollees into a single electronic format used to store or transmit the data. Employee – A “qualified employee,” as defined in 45 C.F.R. 155.20. Employer – A “qualified employer,” as defined in §Section 1312(f)(2) of the Act. Encounter – Any dental service or bundle of related dental services provided to one Enrollee by one Health Care Professional within one time period. Any dental services provided must be recorded in the Enrollee’s health record. Encounter Data – Encounter information Contractor can use to demonstrate the provision of dental services to Enrollees. Enrollee – Enrollee means each and every individual or an Employee and each of their Family Members enrolled in a QDP offered through the Exchange for the purpose of receiving health benefits. An Enrollee may be referred to as a member of a QDP who is entitled to receive covered services. Evidence of Coverage (EOC) and Disclosure Form – The booklet(s) which describe(s) the benefits, exclusions, limitations, conditions, and the benefit levels of the applicable Plan(s). The Exchange – The California Health Benefit Exchange, doing business as Covered California and an independent entity within the State of California.
