Common use of Enrollment and Disenrollment Processes Clause in Contracts

Enrollment and Disenrollment Processes. Enrollment into a Participating Plan may be conducted using a seamless, passive enrollment process that provides the opportunity for beneficiaries to make a voluntary choice to enroll or disenroll from the Participating Plan at any time. Prior to the effective date of their enrollment, individuals who would be passively enrolled will have the opportunity to opt-out and will receive sufficient notice and information with which to do so, as further detailed in Appendix 7. Disenrollment from Participating Plans and transfers between Participating Plans shall be allowed on a month-to- month basis any time during the year; however, coverage for these individuals will continue through the end of the month. CMS and the Commonwealth will monitor enrollments and disenrollments for both evaluation purposes and for compliance with applicable marketing laws, for the purposes of identifying any inappropriate or illegal marketing practices. Any illegal marketing practices will be referred to appropriate agencies for investigation. As mutually agreed upon, and as discussed further in Appendix 7 and the three-way contract, CMS and the Commonwealth will utilize an independent third party entity to facilitate all enrollment into the Participating Plans. Participating Plan enrollments and disenrollments shall become effective on the same day for both Medicare and Medicaid (the first of the month). For those who lose Medicaid eligibility during the month, coverage and Federal financial participation will continue through the end of that month.

Enrollment and Disenrollment Processes. Enrollment into a Participating Plan may be conducted using a seamless, passive enrollment process that provides the opportunity for beneficiaries to make a voluntary choice to enroll or disenroll from the Participating Plan at any time. Prior to the effective date of their enrollment, individuals who would be passively enrolled will have the opportunity to opt-out and will receive sufficient notice and information with which to do so, as further detailed in Appendix 7. Disenrollment from Participating Plans and transfers between Participating Plans shall be allowed on a month-to- to-month basis any time during the year; however, coverage for these individuals will continue through the end of the month. CMS and the Commonwealth will monitor enrollments and disenrollments for both evaluation purposes and for compliance with applicable marketing laws, for the purposes of identifying any inappropriate or illegal marketing practices. Any illegal marketing practices will be referred to appropriate agencies for investigation. As mutually agreed upon, and as discussed further in Appendix 7 and the three-way contract, CMS and the Commonwealth will utilize an independent third party entity to facilitate all enrollment into the Participating Plans. Participating Plan enrollments and disenrollments shall become effective on the same day for both Medicare and Medicaid (the first of the month). For those who lose Medicaid eligibility during the month, coverage and Federal financial participation will continue through the end of that month.

Enrollment and Disenrollment Processes. Enrollment into a Participating Plan may be conducted using a seamless, passive enrollment process that provides the opportunity for beneficiaries to make a voluntary choice to enroll or disenroll from the Participating Plan at any time. Prior to the effective date of their enrollment, individuals who would be passively enrolled will have the opportunity to opt-out and will receive sufficient notice and information with which to do so, as further detailed in Appendix 7. Disenrollment from Participating Plans and transfers between Participating Plans shall be allowed on a month-to- month basis any time during the year; however, coverage for these individuals will continue through the end of the month. CMS and the Commonwealth State will monitor enrollments and disenrollments for both evaluation purposes and for compliance with applicable marketing laws, for the purposes of identifying any inappropriate or illegal marketing practices. Any illegal marketing practices will be referred to appropriate agencies for investigation. As mutually agreed upon, and as discussed further in Appendix 7 and the three-way contract, CMS and the Commonwealth State will utilize an the Medicaid fiscal agent or another independent third party entity to facilitate all enrollment into the Participating Plans. Participating Plan enrollments and disenrollments shall become effective on the same day for both Medicare and Medicaid (the first of the month), except that when a beneficiary dies, disenrollment shall be effective on the date of death. For those who lose Medicaid eligibility during the month, except for when the beneficiary dies, coverage and Federal financial participation will continue through the end of that month.