Member Enrollment. Indiana Health Coverage Program applicants have an opportunity to select an MCE on their application. MCEs are expected to conduct marketing and outreach efforts to raise awareness of the Hoosier Healthwise program and their product. The Enrollment Broker is available to assist members in choosing an MCE. Applicants who do not select an MCE on their application will be auto-assigned to an MCE according to the State’s auto- assignment methodology. The State reserves the right to amend the auto-assignment logic and may incorporate HEDIS or other quality indicators into the auto-assignment logic at a future date. Default auto-assignment will not be available to any MCE who does not successfully complete readiness review. In accordance with 42 CFR 438.10(e), the State shall provide to potential members general information about the basic features of managed care and information specific to each MCE operating in the potential member’s service area. At minimum, this information will include factors such as Contractor service area, benefits covered, cost- sharing and network provider information. The State shall provide information on program MCEs in a comparative chart-like format. Once available, the State also intends to include Contractor quality and performance indicators on materials distributed to facilitate MCE selection. The State reserves the right to develop a rating system advertising Contractor performance on areas such as consumer satisfaction, network access and quality improvement. To facilitate State development of these materials, the Contractor shall comply with State requests for information needed to develop informational materials for potential members. Per 42 CFR 438.3(d), the Contractor shall accept individuals eligible for enrollment in the order in which they apply without restriction. The Contractor shall not, on the basis of health status or need for health care services, discriminate against individuals eligible to enroll. Additionally, the Contractor shall not discriminate against individuals eligible to enroll on the basis of race, color, national origin, sex, sexual orientation, gender identity or disability and will not use any policy or practice that has the effect of discriminating in such manner. Contractor shall also adhere to Section 1557 of the Affordable Care Act / 45 CFR 92.1.
Member Enrollment. The Department is solely responsible for the Enrollment of Medicaid Beneficiaries and Managed Care Members into the Healthy Connections Program. The Department will use its best efforts to ensure that the CONTRACTOR receives timely and accurate Enrollment and Disenrollment information. In the event of discrepancies or unresolvable differences between the Department and the CONTRACTOR regarding Enrollment, Disenrollment and/or termination, the Department will be responsible for taking the appropriate action for resolution.
Member Enrollment. The host site understands that the Program will reduce or renegotiate the awarded member slots at any time if the host site is unable to fill the host site’s AmeriCorps slots.
Member Enrollment. Indiana Health Coverage Program applicants have an opportunity to select an MCE on their application. MCEs are expected to conduct marketing and outreach efforts to raise awareness of both the program and their product. The Enrollment Broker is available to assist members in choosing an MCE. Applicants who do not select an MCE on their application will be auto- assigned to an MCE according to the State’s auto-assignment methodology. The State reserves the right to amend the auto-assignment logic and may incorporate HEDIS or other quality indicators into the auto-assignment logic at a future date. Default auto-assignment will not be available to any MCE who does not successfully complete readiness review
Member Enrollment. Velovita provides to its Member (i) a personalized marketing website that includes web hosting and (ii) the V-Cloud administrative tools that enable the Member to manage his/ her business, view online tools, review the calculation and payment of commissions, and access previous records of Member purchases. When a Member elects to enroll with the Velovita V-Cloud at an annual cost of forty- nine dollars and ninety-five cents ($49.95 USD), such Member will have unlimited access to his/her V-Cloud management software for one year from the date of purchase. This amount will be refunded only if the Member resigns within the first 30 (thirty) days after the registration purchase.
Member Enrollment. (A) Maximum Medicaid Enrollment
(B) Enrollment Requirements
(1) without restriction, and pursuant to waiver authority, unless authorized by CMS Regional Administrator;
(2) up to the limits established pursuant to this Agreement;
(3) the CONTRACTOR shall not discriminate against eligible individuals on the basis of health status, need for health services, disability, race, color, national origin, sexual orientation, religion, and gender, and will not use any policy or practice that has the effect of discriminating on the basis of race, color, or national origin;
(4) the CONTRACTOR shall assume responsibility for all covered medical conditions of each Member inclusive of pre-existing conditions as of the effective date of enrollment; and
(5) the enrollment file received from HSD shall be the file of record regarding plan and service eligibility. If the enrollment file and the Omnicaid system are in conflict as to a Member’s plan eligibility and/or service eligibility, the CONTRACTOR shall work to resolve the conflict as soon as possible with HSD to facilitate an updated enrollment, quarterly cohort adjustment report or other agreed upon communication among the CONTRACTOR, TPA and HSD.
Member Enrollment. Employer shall distribute information about the Program to its eligible employees, their spouses, or domestic partners and/or their dependents as well as assisting CHN in communicating with those who are interested in the Program on how to access Practice’s online onboarding platform so that Patient may auto-enroll into the Program and complete the Membership Agreement.
Member Enrollment. The State will monitor the MCO’s member enrollment in the mandatory RBMC counties and may limit the MCO’s member enrollment in a particular county (or counties), as described in Attachment F. Any member enrollment limitations that the State applies to the MCO is in the interest of protecting the mandatory status of the county by ensuring adequate member choice of health plans and will not limit or impede a member’s choice in PMP selection. The State requires the MCO to accept as enrolled all individuals appearing on the enrollment rosters or enrollees for whom the MCO receives capitation payment. The MCO and rendering provider are responsible for verifying the member’s eligibility. If an MCO receives either enrollment information or capitation for a member, the MCO is financially responsible for the member. Hoosier Healthwise members selecting a PMP contracted with the MCO will become enrolled members with the same MCO until that PMP no longer contracts with the MCO or the member changes his/her PMP. In accordance with 42 CFR 438.56, Sections (c), (d) and (e), the MCO must have policies and procedures that allow members to change their PMPs.
Member Enrollment. Manager shall be responsible for implementation and maintenance of such systems and procedures as directed by Physicians Care to enroll and disenroll new employer groups and individuals in a prompt manner, and to maintain a continuous record of enrollment. Such systems and procedures shall be installed and be operational no later than the earliest effective date of any Physicians Care Subscriber Agreement. Such system must permit Physician Care providers to confirm enrollee eligibility and products status electronically.
Member Enrollment. The Enrollment Date shall be the date that Employer submits the Enrollment Roster to MASA. The Parties agree that the method for enrollment shall be as follows: Membership Fees & Payment. MASA MTS agrees to provide the Emergent Plus Membership at a rate of one hundred and sixty dollars ($160.00) per employee per year. The total cost of the initial one (1) year term is calculated by taking the current headcount times the rate of $160.00.