Beneficiary Protections. The New Section 1860D-1 would establish guaranteed issue and community-rating requirements. The provision would specify that individuals electing qualified prescription drug coverage under a PDP plan or MA Rx or EFFS Rx plan could not be denied enrollment based on health status or other factors. MA provisions relating to priority enrollment (where capacity limits have been reached) and limitations on terminations of elections would apply to PDP sponsors. The provision would require PDP sponsors to make drug coverage available to all eligible individuals residing in the area without regard to their health or economic status or their place of residence in the area. The New Section 1860D-3 would specify required beneficiary protections. Plans would have to comply with guaranteed issue and community-rated premium requirements specified in the new Section 1860D-1, access to negotiated prices as specified in the new Section 1860D-2, and the non-discrimination provisions specified in the new Section 1860D-6. PDP plan sponsors would be required to disclose, to each enrolling beneficiary, information about the plan’s benefit structure. The plan would have to disclose information on:
Appears in 4 contracts
Samples: Conference Agreement, Conference Agreement, Conference Agreement
