Common use of Exchange Responsibilities Clause in Contracts

Exchange Responsibilities. a) The Exchange shall be solely responsible for the determination of eligibility and enrollment of individuals in the Exchange in accordance with applicable Federal and State laws, rules and regulations. b) The Exchange shall determine eligibility and enroll eligible individuals in the Exchange pursuant to its management and participation in CalHEERS, a project jointly sponsored by the Exchange and DHCS with the assistance of the Office of Systems Integration. The Exchange and CalHEERS shall develop, implement, and maintain processes to make the eligibility and enrollment decisions regarding the Exchange and other California health care programs and submit that information to Contractor in a timely manner in accordance with Federal and State laws, rules and regulations, and the terms set forth in this Agreement. c) The Exchange shall notify Contractor regarding each eligible applicant who has completed an application for enrollment and selected Contractor as the QHP Issuer. The Exchange shall transmit information required for Contractor to enroll the applicant within five (5) business days of receipt of verification of eligibility and selection of Contractor’s QHP. d) The Exchange shall send enrollment information to Contractor on a daily basis and Contractor shall reconcile specified enrollment information received from the Exchange with Contractor’s enrollment data on a monthly basis through the Reconciliation Process. e) The Exchange shall utilize the Dispute Process pursuant to Section 2.1.2 d) to resolve issues related to the Reconciliation Process.

Exchange Responsibilities. a) The Exchange shall be solely responsible for the determination of eligibility and enrollment of individuals in the Exchange in accordance with applicable Federal and State laws, rules and regulations. b) The Exchange shall determine eligibility and enroll eligible individuals in the Exchange pursuant to its management and participation in CalHEERS, a project jointly sponsored by the Exchange and DHCS with the assistance of the Office of Systems Integration. The Exchange and CalHEERS shall develop, implement, implement and maintain processes to make the eligibility and enrollment decisions regarding the Exchange and other California health care programs and submit that information to Contractor in a timely manner in accordance with Federal and State laws, rules and regulations, regulations and the terms set forth in this Agreement. c) The Exchange shall notify Contractor regarding each eligible applicant who has completed an application for enrollment and selected Contractor as the QHP Issuer. The Exchange shall transmit information required for Contractor to enroll the applicant within five (5) business days of receipt of verification of eligibility and selection of Contractor’s QHP. d) The Exchange shall send enrollment information to Contractor on a daily basis and Contractor shall reconcile specified enrollment information received from the Exchange with Contractor’s enrollment data on a monthly basis through the Reconciliation Processbasis. e) The In addition, the Exchange shall utilize issue certifications of individual exemption in a timely manner consistent with the Dispute Process pursuant to Section 2.1.2 d) to resolve issues related to the Reconciliation ProcessAffordable Care Act standards.

Exchange Responsibilities. a) The Exchange shall be solely responsible for the determination of eligibility and enrollment of individuals in the Exchange in accordance with applicable Federal and State laws, rules and regulations. b) The Exchange shall determine eligibility and enroll eligible individuals in the Exchange pursuant to its management and participation in CalHEERS, a project jointly sponsored by the Exchange and DHCS with the assistance of the Office of Systems Integration. The Exchange and CalHEERS shall develop, implement, implement and maintain processes to make the eligibility and enrollment decisions regarding the Exchange and other California health care programs and submit that information to Contractor in a timely manner in accordance with Federal and State laws, rules and regulations, regulations and the terms set forth in this Agreement. c) The Exchange shall notify Contractor regarding each eligible applicant who has completed an application for enrollment and selected Contractor as the QHP Issuer. The Exchange shall transmit information required for Contractor to enroll the applicant within five (5) business days of receipt of verification of eligibility and selection of Contractor’s QHP. d) The Exchange shall send enrollment information to Contractor on a daily basis and Contractor shall reconcile specified enrollment information received from the Exchange with Contractor’s enrollment data on a monthly basis through the Reconciliation Processbasis. e) The Exchange shall utilize the Dispute Process pursuant to Section 2.1.2 d) to resolve issues related to the Reconciliation Process.