Recalculation of Member Contributions. The State fiscal agent will notify the Contractor of the member’s POWER Account contribution for the new benefit period. After the 12 month calendar year reconciliation period, the Contractor shall report any applicable POWER Account rollover amounts determined in accordance with Section 5.8.2.1 or any discounts determined in accordance with Section 5.8.2.2 to the State fiscal agent on the POWER Account Reconciliation file (PRF), as set forth in Sections 5.8.2 and 5.8.3 below. The Contractor shall notify members of any roll over amounts, as well as any changes in their monthly POWER Account contribution due to roll over amounts or discounts applied. If a HIP Basic or HIP State Plan Basic member is eligible for a discount for participation in HIP Plus, the Contractor shall notify the member of the opportunity to transfer to HIP Plus benefits or HIP State Plan Plus at the discounted rate. Due to the fact that the first POWER Account installment in the new calendar year benefit period may become due before the member’s individual contribution has been recalculated by the State, the member may be billed by the Contractor according to the required contribution schedule. However, the Contractor will be required to reconcile any overpayments or underpayments made by the member after being notified by the State of the member’s rollover amount or discount for the new benefit period.
Appears in 7 contracts
Samples: Contract, Contract for Providing Risk Based Managed Care Services, Contract
Recalculation of Member Contributions. The State fiscal agent will notify the Contractor of the member’s POWER Account contribution for the new benefit period. After the 12 12-month calendar year reconciliation period, the Contractor shall report any applicable POWER Account rollover amounts determined in accordance with Section 5.8.2.1 or any discounts determined in accordance with Section 5.8.2.2 to the State fiscal agent on the POWER Account Reconciliation file (PRF), as set forth in Sections 5.8.2 and 5.8.3 below. The Contractor shall notify members of any roll over amounts, as well as any changes in their monthly POWER Account Ac count contribution due to roll over amounts or discounts applied. If a HIP Basic or HIP State Plan Basic member is eligible for a discount for participation in HIP Plus, the Contractor shall notify the member of the opportunity to transfer to HIP Plus benefits or HIP State Plan Plus at the discounted rate. Due to the fact that the first POWER Account installment in the new calendar year benefit period may become due before the member’s individual contribution has been recalculated by the State, the member may be billed by the Contractor according to the required contribution schedule. However, the Contractor will be required to reconcile any overpayments or underpayments made by the member after being notified by the State of the member’s rollover amount or discount for the new benefit period.
Appears in 2 contracts
Samples: Contract Amendment, Contract
Recalculation of Member Contributions. The State fiscal agent will notify the Contractor of the member’s POWER Account contribution for the new benefit period. After the 12 12-month calendar year reconciliation period, the Contractor shall report any applicable POWER Account rollover amounts determined in accordance with Section 5.8.2.1 or any discounts determined in accordance with Section 5.8.2.2 to the State fiscal agent on the POWER Account Reconciliation file (PRF), as set forth in Sections 5.8.2 and 5.8.3 below. The Contractor shall notify members of any roll over amounts, as well as any changes in their monthly POWER Account contribution due to roll over amounts or discounts applied. If a HIP Basic or HIP State Plan Basic member is eligible for a discount for participation in HIP Plus, the Contractor shall notify the member of the opportunity to transfer to HIP Plus benefits or HIP State Plan Plus at the discounted rate. Due to the fact that the first POWER Account installment in the new calendar year benefit period may become due before the member’s individual contribution has been recalculated by the State, the member may be billed by the Contractor according to the required contribution schedule. However, the Contractor will be required to reconcile any overpayments or underpayments made by the member after being notified by the State of the member’s rollover amount or discount for the new benefit period.
Appears in 1 contract
Samples: Contract Amendment