Common use of Member 12 Month Eligibility Period Clause in Contracts

Member 12 Month Eligibility Period. Members must have their eligibility redetermined by the State every 12 months. Member eligibility redetermination occurs 12 months from the member’s HIP start date. The Contractor will receive the member’s eligibility redetermination date from the State. The Contractor is responsible for reaching out to members prior to their redetermination to encourage them to complete required redetermination paperwork. 2.1. The assignment of Potential Plus will provide members with the opportunity to move from HIP Basic to HIP Plus by making their POWER Account contribution or fast track payment. If a member is determined to remain eligible for HIP at the end of an eligibility period, the member’s POWER Account contribution will need to be verified. The State will update the member’s POWER Account contribution as necessary based on any changes in the member’s income recognized during redetermination. POWER Accounts follow the calendar year benefit period (January through December) and do not mirror the eligibility period. Members that do not complete their annual 12-month eligibility redetermination will be subject to a six (6) month lockout. For the initial three (3) months following the termination of coverage these members may reenter HIP by providing the required information. For the subsequent three (3) months, members that fail to complete a redetermination are locked out of HIP participation.

Member 12 Month Eligibility Period. Members must have their eligibility redetermined by the State every 12 months. Member eligibility redetermination occurs 12 months from the member’s HIP start date. The Contractor will receive the member’s eligibility redetermination date from the State. The Contractor is responsible for reaching out to members prior to their redetermination to encourage them to complete required redetermination paperwork. 2.1. The assignment of Potential Plus will provide members with the opportunity to move from HIP Basic to HIP Plus by making their POWER Account contribution or fast track payment. If a member is determined to remain eligible for HIP at the end of an eligibility period, the member’s POWER Account contribution will need to be verified. The State will update the member’s POWER Account contribution as necessary based on any changes in the member’s income recognized during redetermination. POWER Accounts follow the calendar year benefit period (January through December) and do not mirror the eligibility period. Members that do not complete their annual 12-12 month eligibility redetermination will be subject to a six (6) month lockout. For the initial three (3) months following the termination of coverage these members may reenter HIP by providing the required information. For the subsequent three (3) months, members that fail to complete a redetermination are locked out of HIP participation.