Reporting Membership Changes and Retroactivity. Group must report membership changes (including sending appropriate membership forms) within the time limit for retroactive changes and in accord with any applicable "rescission" provisions of the Patient Protection and Affordable Care Act and regulations. The time limit for retroactive membership changes, except retroactive membership additions, is the calendar month when Health Plan's California Service Center receives Group's notification of the change. For example, if Group wants June 1 to be the first day that the Member is not covered, Health Plan's California Service Center must receive Group's notification no later than the end of June. The time limit for retroactive membership additions is the calendar month when Health Plan's California Service Center receives Group's notification of the change plus the previous two months. For example, if Group wants June 1 to be the first day that the member is to be covered, Health Plan's California Service Center must receive Group's notification no later than the end of August. Group must send membership changes to the following address: Xxxxxx Permanente California Service Center X.X. Xxx 00000 Xxx Xxxxx, XX 00000-0000 • Electronic data submissions regarding enrollment and eligibility • Health Plan approved online tool for submission of data • Paper enrollments submitted through postal mail or fax Health Plan's Administrative Handbook includes the details about how to report membership changes. Group's Xxxxxx Permanente representative can provide Group with an Administrative Handbook if Group does not have one.
Reporting Membership Changes and Retroactivity. Group must report membership changes (including sending appropriate membership forms) within the time limit for retroactive changes and in accord with any applicable "rescission" provisions of the Patient Protection and Affordable Care Act and regulations. Except for Senior Advantage membership terminations discussed below, the time limit for retroactive membership changes is the calendar month when Health Plan's California Service Center receives Group's notification of the change plus the previous 2 months. • Electronic data submissions regarding enrollment and eligibility • Health Plan approved online tool for submission of data • Paper enrollments submitted through postal mail or fax Health Plan's Administrative Handbook includes the details about how to report membership changes. Group's Health Plan account manager can provide Group with an Administrative Handbook if Group does not have one. Group must give Health Plan's California Service Center 30 days' prior written notice of Senior Advantage involuntary membership terminations. An involuntary membership termination is a termination that is not in response to a disenrollment notice issued by CMS to Health Plan or received by Health Plan directly from a Member (these events are usually in response to a Member's request for disenrollment to CMS because the Member has enrolled in another Medicare health plan or wants Original Medicare coverage or has lost Medicare eligibility). The membership termination date is the first of the month following 30 days after the date when Health Plan's California Service Center receives a Senior Advantage membership termination notice unless Group specifies a later termination date. For example, if Health Plan's California Service Center receives a termination notice on March 5 for a Senior Advantage Member, the earliest termination date is May 1 and Group is required to pay applicable Premiums for the months of March and April.
