Enrollment Application definition

Enrollment Application means the information submitted by or on behalf of an individual to the Exchange in connection with a request to enroll as either a Subscriber or Dependent. Exchange means the District of Columbia Health Benefit Exchange (DC HBX).

Enrollment Application means the form approved by the Plan by which an individual seeks to enroll one or more Members in the Plan.

Enrollment Application means the form or forms prescribed by RCI from time to time for enrollment of Members in the RCI Weeks Exchange Program.

Examples of Enrollment Application in a sentence

• A complete application consists of responses to all required forms and information listed on FORM B, Open Enrollment Application Checklist.

• Place the Application Face Page (FORM A) at the front of the application packet followed by Open Enrollment Application Checklist (FORM B).

• If Medicare has issued a new Medicare number, the provider must complete and submit a Texas Medicaid Provider Enrollment Application in order to enroll with the new information.

• If the provider is joining a new group practice has changed from a group practice to an individual enrollment or vice versa, the provider must complete and submit a new Texas Medicaid Provider Enrollment Application to request enrollment with the new status information.

• Providers may download the Texas Medicaid Provider Enrollment Application at www.tmhp.com or request a paper application form by contacting TMHP directly at 1-800-925-9126.

More Definitions of Enrollment Application

Enrollment Application means the form approved by the Plan which the Subscriber fills out to enroll one or more Members in the Plan. Members must select an Affiliated Physician/PCP on this application.

Enrollment Application means any enrollment forms or procedures, including payroll deduction authorizations, effectuated by any means prescribed by the Plan Administrator or its designee, including by means of internet or telephone-based communications.

Enrollment Application means the agreement executed by the Employee, establishing the Employee’s participation under this Agreement.

Enrollment Application means the information submitted by or on behalf of an individual to the Exchange in connection with a request to enroll under this Agreement as either a Subscriber or Dependent.

Enrollment Application means the form to be accurately completed by prospective Enrollees when they apply for enrollment under the Plan.

Enrollment Application means the information submitted by or on behalf of an individual to the Exchange in connection with a request to enroll as either a Subscriber or Dependent. Exchange means the District of Columbia Health Benefit Exchange (DC HBX). Exclusive Specialty Pharmacy Network means a pharmacy network that is limited to certain specialty Pharmacies that have been designated as “Exclusive” by CareFirst. Members may contact CareFirst for a list of Pharmacies in the Exclusive Specialty Pharmacy Network. Experimental/Investigational means a service or supply in the developmental stage and in the process of human or animal testing excluding patient costs for clinical trials as stated in the Description of Covered Services. Services or supplies that do not meet all five of the criteria listed below are deemed to be Experimental/Investigational:

Enrollment Application. The form of application from time to time prescribed by RCI for the enrollment of Purchasers in the RCI Exchange Program.