Common use of Enrollment and Disenrollment Procedures Clause in Contracts

Enrollment and Disenrollment Procedures. i) Where appropriate, explanation of Lock-In requirements, and initial grace period when person may change plans, or return to fee-for-service in voluntary areas. ii) Choice of PCP (each person can have his/her own PCP and can change thirty (30) days after the initial appointment with their PCP, and once every six months thereafter). iii) Procedures for disenrollment. iv) Opportunities for change v) LDSS/or enrollment broker phone number for information on enrollment and disenrollment. 1) Rights and Responsibilities of Enrollees i) Explanation of what an Enrollee has the right to expect from the Contractor in the way of medical care and treatment of the Enrollee. ii) Responsibilities of the Enrollee (general). iii) Enrollee's financial responsibility for payment when services are furnished by a provider who is not part of the Contractor's network or by any provider without required authorization or when a procedure, treatment, or service is not a covered benefit; also note exceptions such as family planning and HIV counseling/testing. iv) Enrollee's rights under State law to formulate advance directives. v) The manner in which Enrollees may participate in the development of plan policies.

Enrollment and Disenrollment Procedures. i) Where appropriate, explanation of Lock-In requirements, and initial grace period when person may change plans, plans or return to fee-for-service in voluntary areas., ii) Choice of PCP (each person can have his/her own PCP and can change thirty (30) days after the initial appointment with their PCP, and once every six months thereafter). iii) Procedures for disenrollment. iv) Opportunities for change v) LDSS/or enrollment broker phone number for information on enrollment and disenrollment. 1) Rights and Responsibilities of Enrollees i) Explanation of what an Enrollee has the right to expect from the Contractor in the way of medical care and treatment of the Enrollee. ii) Responsibilities of the Enrollee (general). iii) Enrollee's financial responsibility for payment when services are furnished by a provider who is not part of the Contractor's network or by any provider without required authorization or when a procedure, treatment, or service is not a covered benefit; also note exceptions such as family planning and HIV counseling/testing. iv) Enrollee's rights under State law to formulate advance directives. v) The manner in which Enrollees may participate in the development of plan policies.