Common use of Recalculation of Enrollee POWER Account Contribution Amount Clause in Contracts

Recalculation of Enrollee POWER Account Contribution Amount. At the end of each coverage term and after the enrollee has been determined eligible for another coverage term, the enrollee’s POWER Account contribution may need to be recalculated for the new coverage term, based on changes in the enrollee’s annual household income identified at the time of redetermination. The State will notify the MCO or ESP of the enrollee’s POWER Account contribution for the new coverage term, and within 60 days, the MCO or ESP will: i. Reduce the enrollee’s POWER Account contribution for the new coverage term by the amount of the enrollee’s POWER Account balance that was carried forward as calculated in paragraph 46(c); ii. Notify the enrollee of this roll-over amount, as well as the new amount to be billed to the enrollee in equal monthly installments in the new coverage term; and iii. Reconcile any overpayments or underpayments made by the enrollee as a result of the overlapping timeframes of monthly payments and recalculation of new contribution amounts for the new coverage term.

Appears in 2 contracts

Samples: Special Terms and Conditions, Special Terms and Conditions

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Recalculation of Enrollee POWER Account Contribution Amount. At the end of each coverage term and after the enrollee has been determined eligible for another coverage term, the enrollee’s POWER Account contribution may need to be recalculated for the new coverage term, based on changes in the enrollee’s annual household income identified at the time of redetermination. The State state will notify the MCO or ESP of the enrollee’s POWER Account contribution for the new coverage term, and within 60 days, the MCO or ESP will: i. Reduce the enrollee’s POWER Account contribution for the new coverage term by the amount of the enrollee’s POWER Account balance that was carried forward as calculated in paragraph 46(c42(c); ii. Notify the enrollee of this roll-over amount, as well as the new amount to be billed to the enrollee in equal monthly installments in the new coverage term; and iii. Reconcile any overpayments or underpayments made by the enrollee as a result of the overlapping timeframes of monthly payments and recalculation of new contribution amounts for the new coverage term.

Appears in 2 contracts

Samples: Special Terms and Conditions, Special Terms and Conditions

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Recalculation of Enrollee POWER Account Contribution Amount. At the end of each coverage term and after the enrollee has been determined eligible for another coverage term, the enrollee’s POWER Account contribution may need to be recalculated for the new coverage term, based on changes in the enrollee’s annual household income identified at the time of redetermination. The State state will notify the MCO or ESP of the enrollee’s POWER Account contribution for the new coverage term, and within 60 days, the MCO or ESP will: i. Reduce the enrollee’s POWER Account contribution for the new coverage term by the amount of the enrollee’s POWER Account balance that was carried forward as calculated in paragraph 46(c41(c); ii. Notify the enrollee of this roll-over amount, as well as the new amount to be billed to the enrollee in equal monthly installments in the new coverage term; and iii. Reconcile any overpayments or underpayments made by the enrollee as a result of the overlapping timeframes of monthly payments and recalculation of new contribution amounts for the new coverage term.

Appears in 1 contract

Samples: Special Terms and Conditions

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