Plan enrollee definition
Examples of Plan enrollee in a sentence
In addition, unless requested by the enrollee, new enrollee materials are not required for a former enrollee subject to open enrollment who was disenrolled because of the loss of Medicaid eligibility, regains eligibility within the time specified in this paragraph and is reinstated as a Health Plan enrollee.
In addition, hospital provider contracts shall require that the hospitals notify the Health Plan of enrollee pregnancies and births where the mother is a Health Plan enrollee.
Medicaid HMO Non-Reform Contract births where the mother is a Health Plan enrollee.
The report shall list each Health Plan enrollee enrolled in the Child Welfare PMHP, as applicable, who has had a pharmacy claim paid within the month.
Critical Incident — Critical events that negatively impact the health, safety, or welfare of a Long-term Care Plan enrollee, including death by suicide, homicide, abuse/neglect or that is otherwise unexpected; adverse incident or major illness; sexual battery; medication errors; suicide attempts; altercations requiring medical intervention; or elopement.
As such, whenever benefits are to be coordinated with some other payor for Health Services provided to a Medi-Cal Managed Care Plan enrollee, Anthem shall be the secondary payor for all treatment and care provided to the Covered Individual.
In the event that a HFHP and/or FHCA Plan enrollee switches from one HFHP and/or FHCA Plan to another HFHP and/or FHCA Plan without a break in coverage, such switch by the enrollee shall not be considered a new sale and shall not be subject to first year commission rates; rather, Agents shall only earn renewal Commissions with respect to such enrollee.