Period of Enrollment. (A) An Enrollee shall be considered enrolled in the Contractor’s PMHP during the months in which the Contractor receives a Capitation Payment from the Department.
(B) Until the Department notifies the Contractor that an Enrollee is no longer Medicaid eligible, the Contractor may assume that the Enrollee continues to be eligible. The Contractor is responsible for verifying enrollment using the most current information available from the Department.
(C) The Contractor shall be responsible for payment of all Clean Claims for Covered Services rendered to an Enrollee for whom the Contractor has received a Capitation Payment. The Contractor is responsible for payment even where an Enrollee changes their county of residence during the month that the Contractor received a Capitation Payment.
Period of Enrollment. (A) Each Enrollee will be enrolled for either the period of this Contract, the period of Medicaid eligibility, or until such person disenrolls or is disenrolled, whichever is earlier.
(B) Until the Department notifies the Contractor that an Enrollee is no longer Medicaid eligible, the Contractor may assume that the Enrollee continues to be eligible. The Contractor is responsible for verifying enrollment using the most current information available from the Department.
(C) Each enrollee shall be automatically re-enrolled at the end of each month unless the Enrollee notifies the Department’s Health Program Representatives of an intent not to re-enroll in the Health Plan prior to the benefit issuance date and the reason for not re-enrolling meets the Department’s criteria found in Article 3.7 of this Contract.
Period of Enrollment. Each Beneficiary enrolled in the MCO pursuant to this Contract shall be enrolled for twelve (12) months following the effective date of coverage, subject to the exceptions in this section.
Period of Enrollment.
(1) Each MSC+ Enrollee shall be enrolled for twelve (12) months following the effective date of coverage, subject to the exceptions in this section.
(2) For MSHO, each Enrollee may choose to disenroll at the end of any month consistent with paragraph 3.2.10 below. The MCO agrees to retain Medicare eligible Enrollees for up to three months after losing their Medicaid eligibility in the MCO, including Enrollees who no longer meet the requirements for managed care enrollment as part of the MCO’s Medicare Special Needs Plan enrollment.
Period of Enrollment. The MCO agrees to retain Medicare eligible Enrollees for three months after losing their Medicaid eligibility in the MCO, including Enrollees who no longer meet the requirements for managed care enrollment as part of the MCO’s Medicare Special Needs Plan enrollment. The MCO shall accept enrollment of any eligible Beneficiaries during any annual health-plan selection period required by the STATE or CMS.
Period of Enrollment. (A) Each Enrollee shall be enrolled for either the period of this Contract, the period of Medicaid eligibility, or until such person disenrolls or is disenrolled, whichever is earlier.
(B) Until the Department notifies the Contractor that an Enrollee is no longer enrolled with the Contractor, the Contractor shall assume that the Enrollee continues to be enrolled. The Contractor is responsible for verifying enrollment using the most current information available from the Department.
(C) Each Enrollee shall be automatically re-enrolled at the end of each month unless the Enrollee notifies the Department’s Health Program Representatives of an intent not to re-enroll in the Integrated Care Plan prior to the benefit issuance date and the reason for not re-enrolling meets the Department’s criteria found in Article 3.7 of this attachment.
Period of Enrollment. I understand and agree that the period of enrollment shall be for the entire 2022- 2023 school year (September 2022 through August 2023) or, in the case of a Student entering after the school year has begun, from the date of enrollment through August 2023.
Period of Enrollment. (A) An Enrollee shall be considered enrolled in the Contractor’s Dental Plan beginning on the effective date show on the Eligibility Transmission.
(B) An Enrollee shall be enrolled in the Contractor’s Dental Plan until the earliest of the following:
(1) the end of the Contract;
(2) the end of the period of CHIP eligibility;
(3) the date the Enrollee has changed Dental Plans; or
(4) the date the Enrollee is disenrolled.
(C) Until the Department notifies the Contractor that an Enrollee is no longer CHIP eligible or is no longer enrolled with the Contractor’s Dental Plan, the Contractor may assume that the Enrollee continues to be enrolled. The Contractor is responsible for verifying enrollment using the most current information available from the Department.
(D) Generally, the enrollment period is for one year from the time of enrollment.
Period of Enrollment. Every Enrollee shall remain enrolled until the Enrollee's coverage is ended pursuant to Article IV, Section 4.4.
Period of Enrollment. I/we understand and agree that the period of enrollment shall be for the beginning and ending dates set by the Polk County School Board for the 2017-2018 school year, subject to any changes and/or emergency closings approved by the School’s Board of Directors.
