Late Enrollees definition

Late Enrollees means individuals who fail to enroll with the Plan Sponsor for coverage under the Plan during the required thirty-one (31) day period when they first become eligible for coverage. This term does not include Special Enrollees.

Late Enrollees means Applicant or Dependents who request enrollment in a health benefit plan after the initial open enrollment period. An individual will not be considered a Late Enrollee if: (a) the person enrolls during his/her initial enrollment period under the Contract:

Late Enrollees means Applicant or Dependents who request enrollment in a health benefit plan after the initial open enrollment period. An individual will not be considered a Late Enrollee if: (a) the person enrolls during his/her initial enrollment period under the Contract: (b) the person enrolls during a special enrollment period; or (c) a court orders that coverage be provided for a minor Covered Dependent under a Member’s Contract, but only as long as the Member requests enrollment for such Dependent within sixty (60) days after the court order is issued. Late Enrollees are those who declined coverage during the initial open enrollment period and did not submit a certification to us that coverage was declined because other coverage existed. Clear plastic single vision, bifocal or trifocal corrective materials which are ground as prescribed by a licensed Provider.

Examples of Late Enrollees in a sentence

• If you ask that your Dependent be insured after having canceled his or her coverage while your Dependent was still entitled to coverage, your Dependent's coverage will become effective in accordance with the provisions for Late Enrollees.

• If a new Employee and/or his Dependent(s) do not enroll within 31 days of becoming eligible, then that Employee and/or his Dependent(s) will be considered a Late Enrollee(s).

• In addition, an Employee [and any Dependents] will not be considered [a] Late Enrollee[s] if the Employee is employed by an employer which offers multiple Health Benefits Plans and the Employee elects a different plan during the open enrollment period.

• If the Subscriber submits the application or change form after the applicable 90-day time period, coverage for the Subscriber’s newborn Child will become effective in accordance with the provisions for Late Enrollees.

• If application is not made within the initial 31 days, then your Dependent’s coverage will become effective on the Contract Anniversary following the Employer’s Open Enrollment Period.If you ask that your Dependent be insured after having canceled his or her coverage while your Dependent was still entitled to coverage, your Dependent’s coverage will become effective in accordance with the provisions for Late Enrollees.

• If the Subscriber submits the application or change form after such 60-day period, coverage for the adopted Child will become effective in accordance with the provisions for Late Enrollees.

• If a Subscriber submits the application or change form after the 30-day period, coverage for the Spouse will become effective in accordance with the provisions for Late Enrollees.

• Xxxxxx Title: Chairman of the Board and Chief Executive Officer XXXXXXXXXXX IMAGING CENTER, L.P. By: /s/ Xxxxxx X.

• If a new Employee and/or his Dependent(s) does not enroll within 31 days of becoming eligible, the Employee and/or his Dependent(s) will be considered a Late Enrollee(s).

• Late Enrollees have a 12-month waiting period for orthodontic services.

More Definitions of Late Enrollees

Late Enrollees means Applicant or Dependents who request enrollment in a health benefit plan after the initial open enrollment period. An individual will not be considered a Late Enrollee if: (a) the person enrolls during his/her initial enrollment period under the Contract: (b) the person enrolls during a special enrollment period; or (c) a court orders that coverage be provided for a minor Covered Dependent under a Member’s Contract, but only as long as the Member requests enrollment for such Dependent within sixty (60) days after the court order is issued. Late Enrollees are those who declined coverage during the initial open enrollment period and did not submit a certification to us that coverage was declined because other coverage existed. Clear plastic single vision, bifocal or trifocal corrective materials which are ground as prescribed by a licensed Provider. Long Term Acute Care requires a Hospital environment which provides the patient with daily Physician visits, a critical care and medical/surgical experienced nursing staff, a complete respiratory department (24 hours a day, 7 Maternity Care Maximum Allowed Cost or Maximum Allowable Charge (MAC) Maximum Allowed Cost and/or Maximum Allowable Charge shall mean the maximum amount payable for a Covered Service under the Contract and meeting Medical Necessity and Prior Authorization requirements. The MAC will not include any identifiable billing mistakes including, but not limited to, up-coding, unbundled services/charges, duplicate charges, and charges for services not performed. An MCSO is any court judgment, decree or order (including a court’s approval of a domestic relations settlement agreement) that: • Provides for child support payment related to health benefits with respect to the child of a health plan participant or requires health benefit coverage of such child in such plan, and is ordered under state domestic relations law; or • Enforces a state law relating to medical child support payment with respect to a health plan. Medical Facility Any Hospital, ambulatory care facility, Chemical Dependency Treatment Facility, Skilled Nursing facility, Home Health Care Agency or mental health facility, as defined in this Certificate. The facility must be licensed, registered or approved by the Joint Commission on Accreditation of Hospitals or meet specific requirements established by us. We reserve the right to determine whether a health care service or supply is Medically Necessary. The fact that a Physician ha...

Late Enrollees means Applicant or Dependents who request enrollment in a health benefit plan after the initial open enrollment period. An individual will not be considered a Late Enrollee if: (a) the person enrolls during his/her initial enrollment period under the Contract: (b) the person enrolls during a special enrollment period; or (c) a court orders that coverage be provided fora minor Covered Dependent under a Member’s Contract, but only as long as the Member requests enrollment for such Dependent within sixty (60) days after the court order is issued. Late Enrollees are those who declined coverage during the initial open enrollment period and did not submit a certification to Us that coverage was declined because other coverage existed. Long Term Acute Care Long Term Acute Care requires a Hospital environment which provides the patient with daily Physician visits, a critical care and medical/surgical experienced nursing staff, a complete respiratory department (24 hours a day, 7 days a week), an in-house rehab department, case management, social services, an in-house pharmacy, radiology and a complete health care system designed to meet the needs of highly acute patients. This acute care environment promotes timely and effective responses to maximize the recovery potential of the patient and prevents the need for discharge when complications arise. Such care differs from skilled nursing facility/subacute facility care because that care is limited in the range and frequency of services provided and does not offer a complete health care delivery system.

Late Enrollees means Employees or Dependents who request enrollment in a health benefit plan after the initial open enrollment period. An individual will not be considered a Late Enrollee if: (a) the person enrolls during his/her initial enrollment period under the Contract: (b) the person enrolls during a special enrollment period; or (c) a court orders that coverage be provided for a minor Covered Dependent under a Member’s Contract, but only as long as the Member requests enrollment for such Dependent within sixty (60) days after the court order is so issued. Late Enrollees are those who declined coverage during the initial open enrollment period and did not submit a certification to us that coverage was declined because other coverage existed. Clear plastic single vision, bifocal or trifocal corrective materials which are ground as prescribed by a licensed Provider. Long Term Acute Care requires a Hospital Environment which provides the patient with daily Physician visits, a critical care and medical/surgical experienced nursing staff, a complete respiratory department (24 hours a day, 7 days a week), an in-house rehab department, case management, social services, an in-house pharmacy, radiology, an operating room, an ICU, and a complete health care system designed to meet the needs of highly acute patients. This acute care environment promotes timely and effective responses to maximize the recovery potential of the patient, and prevents the need for discharge when complications arise. Such care differs from skilled nursing facility/subacute facility care because that care is limited in the range and frequency of services provided and does not offer a complete health care delivery system.