Outreach and Enrollment. The goal of Project D is to design, implement, and document enrollment, outreach and health care access projects for individuals who may be eligible for public subsidized and non-subsidized health insurance programs and who may require individualized support due to geography, ethnicity, race, culture, immigration, disability, or disease status. Funding for this project will support outreach and marketing, information and education, and screening and enrolling or referring patients to appropriate programs, and assisting applicants and current enrollees to gather and submit all necessary verifications or requests for information during the application and annual review/annual open enrollment processes.
Outreach and Enrollment. 4.1 Outreach, Marketing, and Information for Participants
A. The Contractor shall:
1. In conjunction with the Department, promote ACAP to Medical Assistance recipients in the Service Area and, when appropriate, in the regional offices of the Department.
2. Obtain approval from BSASP of its plan for outreach, marketing, and enrollment on an annual basis or when changes occur. The plan shall include: how outreach to potential Applicants will be made; how ACAP will be promoted; a schedule for the sequence and timing of promotional and enrollment activities in the Service Area; development and procurement of resources needed for implementation; and how the Contractor will ensure that marketing, including plans and materials, is accurate and does not mislead, confuse, or defraud potential Applicants or the Department.
3. Obtain approval from BSASP prior to use of all outreach and marketing materials which are produced in any medium by or on behalf of the Contractor and can reasonably be interpreted as intended to influence a person to enroll in Contractor's Plan.
4. Inform potential Applicants of the basic features of the Plan, which populations are eligible and ineligible for ACAP, and the Plan's responsibilities for coordinating care.
5. Provide a summary, and make available more detailed information upon request, of the services provided; the Service Area; benefits that are available under the Medical Assistance Program, but are not Covered Services, including how and where the Participant may obtain those benefits; any cost sharing; how transportation is provided; which benefits are provided by the Contractor and which benefits are provided by the Department; the requirements for the Contractor to provide adequate access to services consistent with this Agreement; the Contractor’s responsibility for coordination of Participant care; and the Contractor’s quality and performance indicators, including Participant satisfaction.
6. Inform potential Applicants of their ability to terminate enrollment voluntarily at any time.
7. Ensure that all staff and Network Providers who have contact with potential Applicants are fully informed of and understand the Contractor's policies for outreach, enrollment, and disenrollment.
8. Distribute its outreach and marketing materials in the entire Service Area.
9. Develop and publish outreach and marketing materials for potential Applicants in English and in the prevalent non- English languages spoken in the Service Area in a f...
Outreach and Enrollment
