Common use of Eligibility List and Modifications Clause in Contracts

Eligibility List and Modifications. (a) Blue Shield shall provide to Group on a monthly basis within ten days of the start of the month, a member eligibility report and a member eligibility change report, as further described in the Provider Manual. These reports shall be submitted to the Group electronically, unless both Blue Shield and the Group agree that it may be submitted in writing. Blue Shield shall attempt to discourage retroactive cancellation or retroactive addition of Members. However, Blue Shield may make exceptions as may be necessary for administrative or business reasons. Subsequent Capitation to Group will be adjusted to reflect the retroactive addition or deletion of Members. With the exception of retroactive changes for Members enrolled in Blue Shield 65 Plus and those Members enrolled through CalPERS and FEHBP, retroactive additions or deletions shall not exceed ninety (90) days.

Eligibility List and Modifications. (a) Blue Shield shall provide to Group on a monthly basis within ten days of the start of the month, a member eligibility report and a member eligibility change report, as further described in the Provider Manual. These reports shall be submitted to the Group electronically, unless both Blue Shield and the Group agree that it may be submitted in writing. Blue Shield shall attempt to discourage retroactive cancellation or retroactive addition of Members. However, Blue Shield may make exceptions as may be necessary for administrative or business reasons. Subsequent Capitation to Group will be adjusted to reflect the retroactive addition or deletion of Members. With the exception of retroactive changes for Members enrolled in Blue Shield 65 Plus and those Members enrolled through CalPERS and FEHBP, retroactive additions or deletions shall not exceed ninety (90) days.