Common use of Retroactive Disenrollment of Medicare Advantage Group Members Clause in Contracts

Retroactive Disenrollment of Medicare Advantage Group Members. Disenrollments may be retroactive under very limited circumstances. The reason for retroactive disenrollment must be explained in writing by the Group or Member (or Member’s authorized representative). KFHPWA must receive supporting documentation to show that timely information was received by the Group and the Group failed to inform KFHPWA of the termination prior to the effective date. CMS must approve retroactive disenrollments and this process may take up to 90 days. Premiums are due until the effective date of the disenrollment.