Enrollment of Members with a CCO Sample Clauses

Enrollment of Members with a CCO. ‌ A Member shall have thirty (30) Calendar Days to select a CCO and a PCP. Members who fail to make a voluntary Contractor selection within thirty (30) calendar days of their Enrollment will be auto enrolled to a Contractor by the Division. Auto-assignment rules will include provisions to: 1. Determine whether the Member was previously enrolled within a CCO with the previous sixty (60) calendar days; and assign member to that CCO; 2. Determine whether an immediate family member is assigned to a CCO and assign the Member to that CCO; 3. Review paid claims data within the past six (6) months and assign Member to the CCO that has a contract with a PCP with whom the Member has a history in the last six (6) months; and 4. If no previous assignment within sixty (60) days; and no immediate family members already enrolled, of if the Member does not have a prior history with a PCP, then assign the Member to Contractor with a PCP closest to Member’s home address. 5. If multiple Contractors meet this standard, then assignment will occur using a random process. The Division reserves the right to modify the Enrollment and Auto Enrollment rules at its discretion. The Division may, at its discretion, set and make subsequent changes to a threshold for the percentage of Members who can be enrolled with a single CCO. Members will not be auto enrolled to a CCO that exceeds this threshold unless a family member is enrolled in the CCO or a historical Provider relationship exists with a Provider that does not participate in any other CCO. The Division will provide the CCOs with a minimum of fourteen (14) days advance notice in writing when changing the threshold percentage. The Division will notify Members and the Contractor within five (5) business days of the selection or Auto Enrollment. The Division’s notice to the Member will be made in writing and sent via surface mail. Notice to the Contractor will be made via the Member Listing Report.
Sample 1Sample 2
AutoNDA by SimpleDocs
Enrollment of Members with a CCO. ‌ As part of the application process for coverage under CHIP, a Member shall select a CCO. DOM will send Members identified through the Federal Facilitated Marketplace an Enrollment form. Members will have thirty (30) calendar days to select a CCO. Members who fail to make a voluntary CCO selection will be subject to Auto Enrollment with a Contractor by DOM. Auto Enrollment rules will include provisions to consider the following in the order listed below. For initial Enrollment on January 1, 2015, family history and prior Enrollment in CHIP will not apply. 1. Family History and Prior Enrollment in CHIP: DOM will assign the CHIP Member to a CCO if the Member and/or individuals in the Member’s Case Identification Number are or were enrolled with a particular CCO as part of CHIP within the past two (2) months. If DOM does not identify that the Member and/or individuals in the Member’s Case Identification Number were enrolled in a CCO under CHIP, DOM will check if the Member was enrolled previously in the MississippiCAN Program with a particular CCO. 2. Prior Enrollment in the MississippiCAN Program: DOM will assign a Member to a CCO if the Member was enrolled with a particular MississippiCAN CCO within the past two (2) months. If DOM does not identify prior MississippiCAN Enrollment, DOM will review the Member’s prior claims history.
Sample 1

Related to Enrollment of Members with a CCO

  • Action by Members Without a Meeting Action required or permitted to be taken at a meeting of Members may be taken without a meeting if the action is evidenced by one or more written consents describing the action taken, signed by all Members and delivered to the Secretary or any Assistant Secretary of the Company for inclusion in the minutes or for filing with the Company records. Action taken under this Section is effective when all Members have signed the consent, unless the consent specifies a different effective date.

  • Additional Members One or more additional members may be admitted to the Company with the consent of the Member. Prior to the admission of any such additional members to the Company, the Member shall amend this Agreement to make such changes as the Member shall determine to reflect the fact that the Company shall have such additional members. Each additional member shall execute and deliver a supplement or counterpart to this Agreement, as necessary.

  • Approval by Limited Partners of Merger or Consolidation (a) Except as provided in Section 14.3(d), the General Partner, upon its approval of the Merger Agreement, shall direct that the Merger Agreement be submitted to a vote of Limited Partners, whether at a special meeting or by written consent, in either case in accordance with the requirements of Article XIII. A copy or a summary of the Merger Agreement shall be included in or enclosed with the notice of a special meeting or the written consent. (b) Except as provided in Section 14.3(d), the Merger Agreement shall be approved upon receiving the affirmative vote or consent of the holders of a Unit Majority unless the Merger Agreement contains any provision that, if contained in an amendment to this Agreement, the provisions of this Agreement or the Delaware Act would require for its approval the vote or consent of a greater percentage of the Outstanding Units or of any class of Limited Partners, in which case such greater percentage vote or consent shall be required for approval of the Merger Agreement. (c) Except as provided in Section 14.3(d), after such approval by vote or consent of the Limited Partners, and at any time prior to the filing of the certificate of merger pursuant to Section 14.4, the merger or consolidation may be abandoned pursuant to provisions therefor, if any, set forth in the Merger Agreement. (d) Notwithstanding anything else contained in this Article XIV or in this Agreement, the General Partner is permitted, in its discretion, without Limited Partner approval, to merge the Partnership or any Group Member into, or convey all of the Partnership’s assets to, another limited liability entity which shall be newly formed and shall have no assets, liabilities or operations at the time of such Merger other than those it receives from the Partnership or other Group Member if (i) the General Partner has received an Opinion of Counsel that the merger or conveyance, as the case may be, would not result in the loss of the limited liability of any Limited Partner or any Group Member or cause the Partnership or any Group Member to be treated as an association taxable as a corporation or otherwise to be taxed as an entity for federal income tax purposes (to the extent not previously treated as such), (ii) the sole purpose of such merger or conveyance is to effect a mere change in the legal form of the Partnership into another limited liability entity and (iii) the governing instruments of the new entity provide the Limited Partners and the General Partner with the same rights and obligations as are herein contained.

  • Appointment to Fill a Vacancy in Office of Trustee The Issuer, whenever necessary to avoid or fill a vacancy in the office of Trustee, will appoint, in the manner provided in Section 6.10, a Trustee, so that there shall at all times be a Trustee with respect to each series of Securities hereunder.

  • Communications by Holders with Other Holders Holders may communicate pursuant to TIA § 312(b) with other Holders with respect to their rights under this Indenture or the Notes. The Issuer, the Guarantors, the Trustee, the Registrar and anyone else shall have the protection of TIA § 312(c).

  • Communication by Holders with Other Holders Holders may communicate pursuant to TIA Section 312(b) with other Holders with respect to their rights under this Indenture or the Securities. The Company, the Trustee, the Registrar and anyone else shall have the protection of TIA Section 312(c).

  • Time Off for Meetings Any representative of the Union on this Committee, or their alternate, who is in the employ of the Employer, shall have the privilege of attending meetings of the Committee held within working hours without loss of remuneration, provided that the Senior Administrator has prior notice.

  • Appointment to Fill a Vacancy in the Office of Trustee The Issuers, whenever necessary to avoid or fill a vacancy in the office of Trustee, will appoint, in the manner provided in Section 7.08, a Trustee, so that there shall at all times be a Trustee hereunder with respect to each series of Debt Securities.

  • Professional Meetings Employees should be encouraged to and may, with the approval of the supervisor, attend professional meetings, conferences, and activities. Subject to the availability of funds, the employee's expenses in connection with such meetings, conferences, or activities shall be reimbursed in accordance with the applicable provisions of State law and university rules.

  • Consent of Members Each Member hereby expressly consents and agrees that, whenever in this Agreement it is specified that an action may be taken upon the affirmative vote or consent of less than all of the Members, such action may be so taken upon the concurrence of less than all of the Members and each Member shall be bound by the results of such action.

Draft better contracts in just 5 minutes Get the weekly Law Insider newsletter packed with expert videos, webinars, ebooks, and more!