Eligible Enrollee definition

Eligible Enrollee means any individual that meets all premium assistance eligibility requirements established in section 4 of this policy.

Eligible Enrollee means an enrollee who meets the criteria outlined in the NCQA survey specifications.

Eligible Enrollee means an enrollee who:

Examples of Eligible Enrollee in a sentence

• Valid claims received after the 180-day period will be reviewed if the Eligible Enrollee can show that it was not reasonably possible to submit the claim within that time.

• No Claims Administrator, or employee or agent of any Claims Administrator, shall be liable to any Claimant, Eligible Enrollee, Program Participant, or their respective counsel for his acts or omissions, or those of any agent or employee of any Claims Administrator, in connection with the Program except, with respect to each such Person, for such Person’s own willful misconduct.

• Nothing in this Section confers on any Claimant, Eligible Enrollee, Program Participant, or their respective counsel any privity of contract with, or other right to institute any action against, any Claims Administrator.

• The Contractor will receive two monthly capitation payments for each Dual Eligible Enrollee: one amount from Medicare and a second amount from MassHealth.

• If, in an extenuating circumstance, a Medicaid or CHIP Eligible Enrollee incurs out-of-pocket expenses for Emergency Services provided in the United States, ASES shall reimburse the Enrollee for such expenses within thirty (30) days of receipt of such expenses, and the reimbursement shall be considered a Covered Service.

More Definitions of Eligible Enrollee

Eligible Enrollee has the meaning ascribed thereto in Section 1.01. “Eligible Claim” has the meaning set forth in Section 2.01. “Execution Date” has the meaning ascribed thereto in the Preamble. “Expenses Report” has the meaning ascribed thereto in Section 6.04.

Eligible Enrollee means a person who:

Eligible Enrollee means all Claimants (including Representative Claimants) who:

Eligible Enrollee has the meaning ascribed thereto in Section 2.01. “Eligible Injury” has the meaning ascribed thereto in Section 2.01.

Eligible Enrollee means a person who is determined to be eligible for coverage under this policy by the policyholder, consistent with guidelines set by Anthem. Unless otherwise agreed in writing by Anthem, a person may not be an eligible enrollee unless he or she:

Eligible Enrollee means an enrollee

Eligible Enrollee means an eligible senior and/or eligible disabled person. "Eligible Senior" means a resident of Illinois who is 65 years of age or older.