Required Involuntary Disenrollments Sample Clauses

Required Involuntary Disenrollments. Texas and CMS shall terminate an Enrollee’s Enrollment in the STAR+PLUS MMP upon the occurrence of any of the conditions enumerated in Section 40.2 of the most current Medicare-Medicaid Plan Enrollment and Disenrollment Guidance or upon the occurrence of any of the conditions described in this Section. Except for the CMT’s role in reviewing documentation related to an Enrollee’s residence outside the Service Area or alleged material misrepresentation of information regarding third-party reimbursement coverage, as described in this Section, the CMT shall not be responsible for processing disenrollments under this Section. Further, nothing in this Section alters the obligations of the Parties for administering disenrollment transactions described elsewhere in this Contract. 288 2.3.5.6.1. If the STAR+PLUS MMP becomes aware of any conditions enumerated in Section 40.2 of the most current Medicare-Medicaid Plan Enrollment and Disenrollment Guidance or upon the occurrence of any of the conditions described in this Section that would prompt termination of coverage, the STAR+PLUS MMP shall notify the HHSC Administrative Services Contractor of any individual who is no longer eligible to remain enrolled in the Demonstration per CMS Medicare-Medicaid Plan Enrollment and Disenrollment Guidance, in order for them to disenroll the Enrollee. 289 2.3.5.6.2. The STAR+PLUS MMP shall notify HHSC when an Enrollee has private or Third Part Health Insurance coverage with the STAR+PLUS MMP or any other carrier: 289 2.3.5.6.2.1. Within fifteen (15) Business Days when an Enrollee is verified as having Third Party Health Insurance with the STAR+PLUS MMP, as defined herein. 289 2.3.5.6.2.2. Within fifteen (15) Business Days of the date when the STAR+PLUS MMP becomes aware that an Enrollee has any health care insurance coverage with any other insurance carrier. The STAR+PLUS MMP is not responsible for the determination of Third-Party Health Insurance. 289 2.3.5.6.3. Any Enrollee with Third Party Health Insurance will be disenrolled from the STAR+PLUS MMP. 289 2.3.5.6.4. The Enrollment of any Enrollee under this Contract shall be terminated if the Enrollee becomes ineligible for Enrollment due to a change in eligibility status. When an Enrollee’s Enrollment is terminated for eligibility, the termination shall be effective: 289 2.3.5.6.4.1. The first day of the month following the month in which the eligibility is lost or person determined to be out of the Service Area. 289 2.3.5.6.5....
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Required Involuntary Disenrollments. MDCH and CMS shall terminate an Enrollee’s coverage upon the occurrence of any of the conditions enumerated in Section 40.2 of the 2013 Medicare-Medicaid Plan Enrollment and Disenrollment Guidance or upon the occurrence of any of the conditions described in this section. Except for the CMT’s role in reviewing documentation related to an Enrollee’s alleged material misrepresentation of information regarding third-party reimbursement coverage, as described in this section, the CMT shall not be responsible for processing disenrollments under this section. Further, nothing in this section alters the obligations of the parties for administering disenrollment transactions described elsewhere in this Contract.
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Required Involuntary Disenrollments. 2.3.6.3.1. RI EOHHS and CMS shall terminate an Enrollee’s coverage upon the occurrence of any of the conditions enumerated in Section 40.2 of the Medicare-Medicaid Plan Enrollment and Disenrollment Guidance, State- specific Enrollment and Disenrollment Guidance, or upon the occurrence of any of the conditions described in this Section 2.3.
Sample 1Sample 2
Required Involuntary Disenrollments. Texas and CMS shall terminate an Enrollee’s Enrollment in the STAR+PLUS MMP upon the occurrence of any of the conditions enumerated in Section 40.2 of the most current Medicare-Medicaid Plan Enrollment and Disenrollment Guidance or upon the occurrence of any of the conditions described in this section. Except for the CMT’s role in reviewing documentation related to an Enrollee’s residence outside the Service Area or alleged material misrepresentation of information regarding third-party reimbursement coverage, as described in this section, the CMT shall not be responsible for processing Disenrollments under this section. Further, nothing in this section alters the obligations of the parties for administering Disenrollment transactions described elsewhere in this Contract.
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Related to Required Involuntary Disenrollments

  • Involuntary Demotion An employee assigned to a lower rated position shall continue to be paid at the employee's current rate of pay until the rate of pay in the new position equals or exceeds it.

  • Voluntary Demotion An employee requesting a voluntary demotion from a higher-rated position and who is subsequently demoted to the lower-rated position, shall be paid on the increment step appropriate to the employee’s continuous service with the Employer. A voluntary demotion shall not change an employee’s anniversary date.

  • Death During Distribution of a Benefit If the Executive dies after any benefit distributions have commenced under this Agreement but before receiving all such distributions, the Bank shall distribute to the Beneficiary the remaining benefits at the same time and in the same amounts they would have been distributed to the Executive had the Executive survived.

  • Unforeseeable Emergency In the event of a Participant’s Unforeseeable Emergency, such Participant may request an emergency withdrawal from his or her Account. Any such request shall be subject to the approval of the Administrator, which approval shall not be granted to the extent that such need may be relieved (i) through reimbursement or compensation by insurance or otherwise or (ii) by liquidation of the Participant’s assets (to the extent the liquidation of such assets would not itself cause severe financial hardship). A Participant may withdraw all or a portion of his or her Account due to an Unforeseeable Emergency; provided, however, that the withdrawal shall not exceed the amount reasonably needed to satisfy the need created by the Unforeseeable Emergency.

  • Involuntary Withdrawal Involuntary withdrawal of a Partner shall include, but not be limited to, the following: a.) Death of a Partner; b.) Partner that becomes incapacitated or not able to make decisions on their own as determined by a licensed physician; c.) A handicap of a Partner that prevents the individual from carrying out their Partnership duties and obligations; d.) Incompetence or negligence of a Partner; e.) A Partner’s breach of fiduciary duties;

  • How Do I Correct an Excess Contribution? If you make a contribution in excess of your allowable maximum, you may correct the excess contribution and avoid the 6% penalty tax under Section 4973 of the Internal Revenue Code for that year by withdrawing the excess contribution and its earnings on or before the due date, including extensions, of the tax return for the tax year for which the contribution was made (generally October 15th). Any earnings on the withdrawn excess contribution may be subject to a 10% early distribution penalty tax if you are under age 59½. In addition, in certain cases an excess contribution may be withdrawn after the time for filing your tax return. Finally, excess contributions for one year may be carried forward and applied against the contribution limitation in succeeding years.

  • Contribution Formula Dental Coverage Faculty Member Coverage. For faculty member dental coverage, the Employer contributes an amount equal to the lesser of ninety percent (90%) of the faculty member premium of the State Dental Plan, or the actual faculty member premium of the dental plan chosen by the faculty member. However, for calendar years beginning January 1, 2006, and January 1, 2007, the minimum employee contribution shall be five dollars ($5.00) per month.

  • Termination of Service for Cause Upon a termination of the Participant’s Service by the Company for Cause the Option, including the Vested Portion, shall immediately terminate and be forfeited without consideration.

  • Verification of Employment Eligibility By executing this Agreement, Consultant verifies that it fully complies with all requirements and restrictions of state and federal law respecting the employment of undocumented aliens, including, but not limited to, the Immigration Reform and Control Act of 1986, as may be amended from time to time, and shall require all subconsultants and sub-subconsultants to comply with the same.

  • Voluntary Deductions A. The Employer agrees to deduct from the wages of any employee who is a member of the Union a PEOPLE deduction as provided for in a written authorization. Such authorization must be executed by the employee and may be revoked by the employee at any time by giving written notice to both the Employer and the Union. The Employer agrees to electronically remit any deductions made pursuant to this provision to the Union together with an electronic report showing: 1. Employee name;

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