Requirements for Written Material a. The Managed Care Plan shall provide enrollee information in accordance with 42 CFR 438.10, which addresses information requirements related to written and oral information provided to enrollees, including: languages; format; Managed Care Plan features, such as benefits, cost sharing, provider network and physician incentive plans; enrollment and disenrollment rights and responsibilities; grievance and appeal system; and advance directives. The Managed Care Plan shall notify enrollees, on at least an annual basis, of their right to request and obtain information in accordance with the above requirements.
b. All enrollee communications, including written materials, spoken scripts and websites shall be at or near the fourth (4th) grade comprehension level. Readability test to determine whether the written materials meet this requirement are:
(1) Fry Readability Index;
(2) PROSE The Readability Analyst (software developed by Education Activities, Inc.);
(3) Gunning FOG Index;
(4) XxXxxxxxxx SMOG Index;
(5) The Xxxxxx-Xxxxxxx Index; and/or
(6) Other readability test approved by the Agency.
c. The Managed Care Plan shall make all written material available in English, Spanish and all other appropriate foreign languages. The appropriate foreign languages comprise all languages in the Managed Care Plan Contract region(s) spoken by approximately five percent (5%) or more of the total population. Upon request, the Managed Care Plan shall provide, free of charge, interpreters for potential enrollees or enrollees whose primary language is not English. (See 42 CFR 438.10(c)(3).)
d. The Managed Care Plan shall make all written materials available in alternative formats and in a manner that takes into consideration the enrollee’s special needs, including those who are visually impaired or have limited reading proficiency. The Managed Care Plan shall notify all enrollees and, upon request, potential enrollees that information is available in alternative formats and how to access those formats.
Requirements for Written Material a. The Health Plan shall make all written materials available in alternative formats and in a manner that takes into consideration the enrollee’s special needs, including those who are visually impaired or have limited reading proficiency. The Health Plan shall notify all enrollees and, upon request, potential enrollees that information is available in alternative formats and how to access those formats.
b. The Health Plan shall make all written material available in English, Spanish, and all other appropriate foreign languages. The appropriate foreign languages comprise all languages in the Health Plan service area spoken by approximately five percent (5%) or more of the total population. Upon request, the Health Plan shall provide, free of charge, interpreters for potential enrollees or enrollees whose primary language is not English.
c. The Health Plan shall provide enrollee information in accordance with 42 CFR 438.10, which addresses information requirements related to written and oral information provided to enrollees, including: languages; format; Health Plan features, such as benefits, cost sharing, service area, provider network and physician incentive plans; enrollment and disenrollment rights and responsibilities; grievance system; and advance directives. The Health Plan shall notify enrollees on at least an annual basis of their right to request and obtain information in accordance with the above requirements.
d. All written materials and web sites shall be at or near the fourth (4th) grade comprehension level. Suggested reference materials to determine whether the written materials meet this requirement are:
(1) Fry Readability Index;
(2) PROSE The Readability Analyst (software developed by Education Activities, Inc.);
(3) Gunning FOG Index;
(4) MxXxxxxxxx SMOG Index;
(5) The Fxxxxx-Xxxxxxx Index; and/or
(6) Other software approved by the Agency. WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract
