New Enrollee Procedures and Materials Sample Clauses

New Enrollee Procedures and Materials a. Within five (5) days following receipt of the X12-834 enrollment file from the Agency or its fiscal agent, the Managed Care Plan shall furnish to the new enrollee: (1) An enrollee identification (ID) card; (2) An enrollee handbook; (3) A provider directory; (4) For MMA Managed Care Plans and Comprehensive LTC Managed Care Plans, the following information: (a) Name, telephone number and address of the MMA enrollee’s PCP assignment; (b) An explanation that enrollees may choose to have all family members served by the same PCP or may choose different PCPs; and (c) A postage-paid, pre-addressed return envelope. b. New enrollee materials are not required for a former enrollee who was disenrolled because of the loss of Medicaid eligibility and who regains eligibility within their temporary loss period, as specified in Section III.B.1.h., and is automatically reinstated in the Managed Care Plan, unless there was change in enrollee materials or the provider directory during the timeframe in which the recipient was disenrolled. c. A notation of the effective date of the reinstatement is to be made on the most recent application or conspicuously identified in the enrollee’s administrative file. d. Enrollees who were previously enrolled in the Managed Care Plan, and who lose and regain eligibility in a number of days in excess of the temporary loss period, as specified in Section III.B.1.h., will be treated as new enrollees. e. The Managed Care Plan may furnish new enrollment material in separate distributions. Each distribution/provision of materials shall be documented in the Managed Care Plan’s records.