Rapid Disenrollment definition

Rapid Disenrollment means an individual who disenrolls from Molina Healthcare or changes plans within Molina Healthcare during the first three (3) months of enrollment.
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Rapid Disenrollment applies when an enrollee makes any plan change (regardless of whether the plan change is with the current carrier or to a different carrier) within the first three (3) months enrollment.
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Rapid Disenrollment. As defined by CMS within Chapter 2 of the MMCM, when a beneficiary disenrolls from a plan within the first three months from the effective date of enrollment. Rapid Disenrollment does not apply if death occurs in the first 3 months.
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Examples of Rapid Disenrollment in a sentence

  • For purposes of this provision, “Rapid Disenrollment” means the voluntary disenrollment of a Member from an MA Plan or PDP Plan on or before three (3) calendar months after the Member’s initial enrollment effective date; provided, however, when a Member enrolls in an MA Plan or PDP Plan effective October 1, November 1, or December 1, and subsequently changes plans effective January 1 of the following year, this is not considered a Rapid Disenrollment.

  • If the Rapid Disenrollment rate exceeds ten percent (10%) for any calendar year, Agent shall, at the request of Company, remove any Representative(s) determined by the Company or Agent to be responsible.

  • A Rapid Disenrollment will result in Humana recovering from the Producer any commission paid to Producer related to the Medicare Product.

  • Molina Healthcare will charge back or recoup the full amount of compensation when there is a Rapid Disenrollment and such Rapid Disenrollment does not meet one of the exceptions listed in Chapter 3, Section 120.4.3, or applicable section of the Medicare Managed Care Manual.

  • General Agent agrees to ensure that the Rapid Disenrollment rate for Medicare Advantage enrollments for each General Agent and each of its Participating Producers as measured each calendar month, does not exceed five percent (5%).

  • An enrollment that occurs during the fourth quarter of a calendar year is also not considered a Rapid Disenrollment if such individual remains enrolled through the end of the same calendar year.

  • For any disenrollment or retro- disenrollment that is not a Rapid Disenrollment, Molina Healthcare will charge back or recoup commissions if compensation has already been paid after the beneficiary’s disenrollment date.

  • In addition, no recoupment, chargeback, refund or deduction shall be made if CMS guidance permits payment of Commission for such Rapid Disenrollment with respect to the period that the Medicare Product Enrollee was actually enrolled.

  • In order to not be a Rapid Disenrollment, the newly enrolled Medicare beneficiary must remain enrolled with Aetna into the fourth month, i.e., if the individual enrolled with Aetna on January 1, the individual must still be enrolled with Aetna on April 1 of the same calendar year.

  • If the Rapid Disenrollment rate exceeds ten percent (10%) for any calendar year, CPHL will review your agreement for potential termination.


More Definitions of Rapid Disenrollment

Rapid Disenrollment means the voluntary disenrollment of a Member from an MA Plan on or before three calendar months after the Member’s initial enrollment effective date; provided, however, when a Member enrolls in an MA Plan effective October 1, November 1, or December 1, and subsequently changes plans effective January 1 of the following year, this is not considered a Rapid Disenrollment. Disenrollments for all MA Plans marketed and promoted by Agent are reported to the Company by CMS on the “Monthly Membership Reconciliation” (MMR) file. If the Rapid Disenrollment rate exceeds ten percent (10%) for any calendar year, then Agent’s appointment shall, at the request of Company, be terminated.
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Related to Rapid Disenrollment

  • Disenrollment means either voluntary or involuntary termination of a participant from the Independent Choices Program.

  • Declining enrollment means any significant decrease in the school district’s enrollment which may affect the school district’s allocation of funds in future years and/or the necessity of maintaining certain class sections or offerings.

  • Enrollment means the number of students who are enrolled in a school operated by the district on October 1. A student shall be counted as one whether the student is enrolled as a full-time or part-time student. Students enrolled in prekindergarten programs shall not be counted.

  • Special Enrollment Period means a period of time allowed under this Plan, other than the eligible person’s Initial Enrollment Period or an Open Enrollment Period, during which an eligible person can request coverage under this Plan as a result of certain events that create special enrollment rights.

  • Annual Enrollment Period or "Enrollment Period" means the period before each policy anniversary so designated by the Sponsor and Lincoln during which you may enroll for coverage under this policy.

  • payment initiation service means a service to initiate a payment order at the request of the payment service user with respect to a payment account held at another payment service provider;

  • Open Enrollment Period means an enrollment period during which time any Eligible Employee and/or Dependent may apply to become a Subscriber and/or Covered Dependent, and existing Subscribers may apply to change to another provider network or coverage option, if available, or elect to terminate coverage.

  • Enrollment Period means that period of time prescribed by the Administrator, which period shall conclude prior to the Offering Date, during which Eligible Employees may elect to participate in an Offering Period. The duration and timing of Enrollment Periods may be changed or modified by the Administrator from time to time.

  • Initial Enrollment Period means one of the following periods during which you may first enroll for coverage under this plan:

  • Enrollee means any person entitled to health care services from a carrier.

  • Open enrollment means a period of time as defined in rule

  • ODJFS means the Ohio Department of Job and Family Services.

  • Dual enrollment means the enrollment of a 3- or 4-year-old student who is eligible for special education services in both a public school district, through which the student receives special education services, and a private or home school.

  • Statewide popular election means a general election in which votes are cast for

  • MCP means a Material Change Proposal for the Station issued on [ ];

  • Potential Enrollee means a Medical Assistance Recipient who may voluntarily elect to enroll in a given managed care program, but is not yet an Enrollee of an MCO.

  • Newborn means a baby less than nine days old.

  • Mail ballot election means any election that is conducted under Title 13, chapter 19, by mailing

  • Self-service display means the open display or storage of Tobacco Products or Tobacco Paraphernalia in a manner that is physically accessible in any way to the general public without the assistance of the retailer or employee of the retailer and a direct person-to-person transfer between the purchaser and the retailer or employee of the retailer. A vending machine is a form of Self-Service Display.

  • PCP means Primary Care Provider.

  • Prepaid wireless calling service means a telecommunications service that provides the right to utilize mobile wireless service as well as other non-telecommunications services, including the download of digital products delivered electronically, content and ancillary services, which must be paid for in advance that is sold in predetermined units or dollars of which the number declines with use in a known amount.

  • Public benefit means making capital available, or facilitating the availability of capital, to businesses in this state that have 750 or fewer employees, the intent of which is to create or retain employment opportunities for residents of this state, stabilize or increase the tax base of this state, or support the redevelopment of facilities for use by small businesses.

  • Concurrent enrollment means the simultaneous enrollment of a qualified student in a district high school and in one or more postsecondary courses at an institution of higher education. Concurrent enrollment does not include a student’s simultaneous enrollment in: a district high school and in one or more secondary career and technical education courses, advanced placement courses, or international baccalaureate courses; an early college course and a postsecondary course; a p-tech school and a postsecondary course; or a district high school and a postsecondary course that does not fall within the definition of concurrent enrollment.

  • Voice Initiated Election means any election concerning dividend options available to Investment Company shareholders or subscribers which is requested by voice over the telephone.

  • Enrollment Date means the first day of each Offering Period.

  • Enrolled Nurse means an employee: