Common use of Member Enrollment and Contractor Selection Clause in Contracts

Member Enrollment and Contractor Selection. Hoosier Care Connect applicants shall have the opportunity to select a MCE at the time of Medicaid application. The State’s Enrollment Broker will provide information and assistance with MCE selection to applicants. In accordance with 42 CFR 438.10(e), the State must provide potential members with 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 MCE service area, benefits covered, cost-sharing and network provider information. The State shall provide information on Hoosier Care Connect 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 must comply with State, or its designee, requests for information needed to develop informational materials for potential members. Members who do not select an MCE at the time of application, and Supplemental Security Income (SSI) recipients who are not required to submit a Medicaid application, shall receive information from the State or its designee describing the process to select an MCE. Individuals who do not select a Contractor within sixty (60) calendar days of the enrollment mailing will be auto-assigned to a Contractor in accordance with an auto-enrollment algorithm to be designed by the State. The State reserves the right to revise the timing and strategies employed to facilitate member selection. Additional information on the auto-assignment process can be found in Contract Exhibit 4.

Member Enrollment and Contractor Selection. Hoosier Care Connect applicants shall have the opportunity to select a an MCE at the time of Medicaid application. The State’s Enrollment Broker will provide information and assistance with MCE selection to applicants. In accordance with 42 CFR 438.10(e), the State must provide potential members with 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 MCE service area, benefits covered, cost-sharing and network provider information. The State shall provide information on Hoosier Care Connect 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 must comply with State, or its designee, requests for information needed to develop informational materials for potential members. Members who do not select an MCE at the time of application, and Supplemental Security Income (SSI) recipients who are not required to submit a Medicaid application, shall receive information from the State or its designee describing the process to select an MCE. Individuals who do not select a Contractor within sixty (60) calendar days of the enrollment mailing will be auto-assigned to a Contractor in accordance with an auto-enrollment algorithm to be designed by the State. The State reserves the right to revise the timing and strategies employed to facilitate member selection. Additional information on the auto-assignment process can be found in Contract Exhibit 44 Responsibilities of the State.

Member Enrollment and Contractor Selection. Hoosier Care Connect applicants shall have the opportunity to select a an MCE at the time of Medicaid application. The State’s Enrollment Broker will provide information and assistance with MCE selection to applicants. In accordance with 42 CFR 438.10(e), the State must provide potential members with 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 MCE service area, benefits covered, cost-sharing and network provider information. The State shall provide information on Hoosier Care Connect 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 must comply with State, or its designee, requests for information needed to develop informational materials for potential members. Members who do not select an MCE at the time of application, and Supplemental Security Income (SSI) recipients who are not required to submit a Medicaid application, shall receive information from the State or its designee describing the process to select an MCE. Individuals who do not select a Contractor within sixty (60) calendar days of the enrollment mailing will be auto-assigned to a Contractor in accordance with an auto-enrollment algorithm to be designed by the State. The State reserves the right to revise the timing and strategies s trategies employed to facilitate member selection. Additional information on the auto-assignment process can be found in Contract Exhibit 44 Responsibilities of the State.