Notice to Enrollees Sample Clauses

Notice to Enrollees. If the STATE determines there is a Material Modification, the MCO shall provide prior written notification to Enrollees who will be affected by such a Material Modification. The MCO shall submit such notice to the STATE for prior approval. The notice must inform each affected Enrollee that:  One of the Primary Care Providers they have used in the past is no longer available and the Enrollee must choose a new Primary Care Provider from the MCO’s remaining choices; or that the Enrollee has been reassigned from a terminated sole source Provider; or  One of the major Subcontractors providing a network of Providers, including but not limited to the behavioral health network, pharmacy benefit manager, care system, care coordination/case management entity or dental network will no longer be available in the MCO’s network and that access to these services may require that the Enrollee choose a different provider for these services or be assigned a different care coordinator/case manager. This section does not apply to county Subcontractors providing only care coordination/case management, if the county is choosing to no longer contract with any MCO and the loss of the county as a Subcontractor does not result in a change in any other providers.‌‌  The notice shall also inform the Enrollee that the Enrollee has the opportunity to disenroll and change MCOs up to one hundred and twenty (120) days from the date of notification, unless open enrollment occurs within one hundred and twenty (120) days of the date of notification. The MCO shall fully cooperate with the STATE and Local Agency to facilitate a change of MCO for Enrollees affected by the Provider termination. See also section 6.13, Transition Services.‌‌‌‌

Notice to Enrollees. The MCO shall provide prior written notification to Enrollees that will be affected by such a Material Modification. The MCO shall submit such notice to STATE for prior approval. The notice must inform each affected Enrollee that: (a) One of the Primary Care Providers they have used in the past is no longer available and they must choose a new Primary Care Provider from the MCO’s remaining choices, or that the Enrollee has been reassigned from a terminated sole source Provider; and (b) In either case, the Enrollee has the opportunity to disenroll or change MCOs up to one hundred and twenty (120) days from the date of notification, unless open enrollment occurs within one hundred and twenty (120) days of the date of notification. The MCO shall fully cooperate with the STATE and Local Agency to facilitate a change of MCO for Enrollees affected by the Provider termination.

Notice to Enrollees. If the STATE determines there is a Material Modification, the MCO shall provide prior written notification to Enrollees who will be affected by such a Material Modification. The MCO shall submit such notice to the STATE for prior approval. The notice must inform each affected Enrollee that:  One of the Primary Care Providers they have used in the past is no longer available, and the Enrollee must choose a new Primary Care Provider from the MCO’s remaining choices; or that the Enrollee has been reassigned from a terminated sole source Provider; or  One of the major Subcontractors providing a network of Providers, including but not limited to the behavioral health network, pharmacy benefit manager, or dental network will no longer be available in the MCO’s network and that access to these services may require that the Enrollee choose a different provider for these services.  The notice shall also inform the Enrollee that the Enrollee has the opportunity to disenroll at any time. The MCO shall fully cooperate with the STATE and Local Agency to facilitate a change of MCO for Enrollees affected by the Provider termination.

Notice to Enrollees. The MCO shall provide prior written notification to Enrollees that will be affected by such a Material Modification. Such prior written notice shall be approved by the STATE. The notice must inform each affected Enrollee that one of the Primary Care Providers they have used in the past is no longer available, and: 1) the Enrollee must choose a new Primary Care Provider from the MCOs remaining choices; or 2) the Enrollee has been reassigned from a terminated sole source Provider. The notice shall also inform the Enrollee that, in either case, the Enrollee has the opportunity to disenroll at any time. The MCO shall fully cooperate with the STATE and Local Agency to facilitate a change of MCO for Enrollees affected by the Provider termination.

Notice to Enrollees. If the STATE determines there is a Material Modification, the MCO shall provide prior written notification to Enrollees who will be affected by such a Material Modification. The MCO shall submit such notice to the STATE for prior approval. The notice must inform each affected Enrollee that: (a) One of the Primary Care Providers they have used in the past is no longer available and the Enrollee must choose a new Primary Care Provider from the MCO’s remaining choices; or that the Enrollee has been reassigned from a terminated sole source Provider; or (b) One of the major subcontractors providing a network of Providers, including but not limited to the behavioral health network, pharmacy benefit manager, or dental network will no longer be available in the MCO’s network and that access to these services may require that the Enrollee choose a different provider for these services. (c) The notice shall also inform the Enrollee that the Enrollee has the opportunity to disenroll and change MCOs up to one hundred and twenty (120) days from the date of notification, unless open enrollment occurs within one hundred and twenty (120) days of the date of notification. The MCO shall fully cooperate with the STATE and Local Agency to facilitate a change of MCO for Enrollees affected by the Provider termination.

Notice to Enrollees. Seller shall, or shall cause its Affiliates to, take such action as may be necessary to disseminate and mail such notices to Enrollees relating to the transactions contemplated by this Agreement as CMS requires (in a form mutually acceptable to Seller and Purchaser and in accordance with CMS requirements), and Seller shall, or shall cause its Affiliates to, promptly provide CMS with such certifications concerning the discharge of such obligation as may reasonably be requested by CMS.

Notice to Enrollees. The HEALTH PLAN shall provide prior written notification to Enrollees who will be affected by a Material Modification. Such prior written notice shall be approved by the STATE. The notice must inform each affected Enrollee that: one of the Primary Care Providers they have used in the past are no longer available and that they must choose a new Primary Care Provider from the HEALTH PLAN’s remaining choices OR that the Enrollee has been reassigned from a terminated sole source provider, AND in either case the Enrollee has the opportunity to disenroll and change health plans up to 120 days from the date of notification, unless open enrollment occurs within 120 days of the date of notification. The HEALTH PLAN shall fully cooperate with the STATE and Local Agency to facilitate a change of health plan for Enrollees affected by the provider termination.

Notice to Enrollees. The parties may agree in writing that certain notices required from Delta Dental to any Enrollee may be given to the County, who shall disseminate such notice to Enrollee by the next regular communication but in no event later than thirty (30) days after receipt thereof.