Common use of Member Enrollment Clause in Contracts

Member Enrollment. Indiana Health Coverage Program applicants have an opportunity to select an MCE on their application. MCEs are expected to conduct marketing and outreach efforts to raise awareness of the Hoosier Healthwise program and their product. The Enrollment Broker is available to assist members in choosing an MCE. Applicants who do not select an MCE on their application will be auto-assigned to an MCE according to the State’s auto- assignment methodology. The State reserves the right to amend the auto-assignment logic and may incorporate HEDIS or other quality indicators into the auto-assignment logic at a future date. Default auto-assignment will not be available to any MCE who does not successfully complete readiness review. In accordance with 42 CFR 438.10(e), the State shall provide to potential members general information about the basic features of managed care and information specific to each MCE operating in the potential member’s service area. At minimum, this information will include factors such as Contractor service area, benefits covered, cost- sharing and network provider information. The State shall provide information on program MCEs in a comparative chart-like format. Once available, the State also intends to include Contractor quality and performance indicators on materials distributed to facilitate MCE selection. The State reserves the right to develop a rating system advertising Contractor performance on areas such as consumer satisfaction, network access and quality improvement. To facilitate State development of these materials, the Contractor shall comply with State requests for information needed to develop informational materials for potential members. Per 42 CFR 438.3(d), the Contractor shall accept individuals eligible for enrollment in the order in which they apply without restriction. The Contractor shall not, on the basis of health status or need for health care services, discriminate against individuals eligible to enroll. Additionally, the Contractor shall not discriminate against individuals eligible to enroll on the basis of race, color, national origin, sex, sexual orientation, gender identity or disability and will not use any policy or practice that has the effect of discriminating in such manner. Contractor shall also adhere to Section 1557 of the Affordable Care Act / 45 CFR 92.1.

Member Enrollment. Indiana Health Coverage Program applicants have an opportunity to select an MCE on their application. MCEs are expected to conduct marketing and outreach efforts to raise awareness of the Hoosier Healthwise program and their product. The Enrollment Broker is available to assist members in choosing an MCE. Applicants who do not select an MCE on their application will be auto-assigned to an MCE according to the State’s auto- auto-assignment methodology. The State reserves the right to amend the auto-assignment logic and may incorporate HEDIS or other quality indicators into the auto-assignment logic at a future date. Default auto-assignment will not be available to any MCE who does not successfully complete readiness review. In accordance with 42 CFR 438.10(e), the State shall provide to potential members general information about the basic features of managed care and information specific to each MCE operating in the potential member’s service area. At minimum, this information will include factors such as Contractor service area, benefits covered, cost- cost-sharing and network provider information. The State shall provide information on program MCEs in a comparative chart-like format. Once available, the State also intends to include Contractor quality and performance indicators on materials distributed to facilitate MCE selection. The State reserves the right to develop a rating EXHIBIT 1.E SCOPE OF WORK – HOOSIER HEALTHWISE system advertising Contractor performance on areas such as consumer satisfaction, network access and quality improvement. To facilitate State development of these materials, the Contractor shall comply with State requests for information needed to develop informational materials for potential members. Per 42 CFR 438.3(d), the Contractor shall accept individuals eligible for enrollment in the order in which they apply without restriction. The Contractor shall not, on the basis of health status or need for health care services, discriminate against individuals eligible to enroll. Additionally, the Contractor shall not discriminate against individuals eligible to enroll on the basis of race, color, national origin, sex, sexual orientation, gender identity or disability and will not use any policy or practice that has the effect of discriminating in such manner. Contractor shall also adhere to Section 1557 of the Affordable Care Act / 45 CFR 92.1.

Member Enrollment. Indiana Health Coverage Program applicants have an opportunity to select an MCE on their application. MCEs are expected to conduct marketing and outreach efforts to raise awareness of the Hoosier Healthwise program and their product. The Enrollment Broker is available to assist members in choosing an MCE. Applicants who do not select an MCE on their application will be auto-assigned to an MCE according to the State’s auto- auto-assignment methodology. The State reserves the right to amend the auto-assignment logic and may incorporate HEDIS or other quality indicators into the auto-assignment logic at a future date. Default auto-assignment will not be available to any MCE who does not successfully complete readiness review. In accordance with 42 CFR 438.10(e), the State shall provide to potential members general information about the basic features of managed care and information specific to each MCE operating in the potential member’s service area. At minimum, this information will include factors such as Contractor service area, benefits covered, cost- cost-sharing and network provider information. The State shall provide information on program MCEs in a comparative chart-chart- like format. Once available, the State also intends to include Contractor quality and performance indicators on materials distributed to facilitate MCE selection. The State reserves the right to develop a rating system advertising Contractor performance on areas such as consumer satisfaction, network access and quality improvement. To facilitate State development of these materials, the Contractor shall comply with State requests for information needed to develop informational materials for potential members. Per 42 CFR 438.3(d), the Contractor shall accept individuals eligible for enrollment in the order in which they apply without restriction. The Contractor shall not, on the basis of health status or need for health care services, discriminate against individuals eligible to enroll. Additionally, the Contractor shall not discriminate against individuals eligible to enroll on the basis of race, color, national origin, sex, sexual orientation, gender identity or disability and will not use any policy or practice that has the effect of discriminating in such manner. Contractor shall also adhere to Section 1557 of the Affordable Care Act / 45 CFR 92.1.

Member Enrollment. Indiana Health Coverage Program applicants have an opportunity to select an MCE on their application. MCEs are expected to conduct marketing and outreach efforts to raise awareness of the Hoosier Healthwise program and their product. The Enrollment Broker is available to assist members in choosing an MCE. Applicants who do not select an MCE on their application will be auto-assigned to an MCE according to the State’s auto- auto-assignment methodology. The State reserves the right to amend the auto-assignment logic and may incorporate HEDIS or other quality indicators into the auto-assignment logic at a future date. Default auto-assignment will not be available to any MCE who does not successfully complete readiness review. In accordance with 42 CFR 438.10(e), the State shall provide to potential members general information about the basic features of managed care and information specific to each MCE operating in the potential member’s service area. At minimum, this information will include factors such as Contractor service area, benefits covered, cost- cost-sharing and network provider information. The State shall provide information on program MCEs in a comparative chart-like format. Once available, the State also intends to include Contractor quality and performance indicators on materials distributed to facilitate MCE selection. The State reserves the right to develop a rating system advertising Contractor performance on areas such as consumer satisfaction, network access and quality improvement. To facilitate State development of these materials, the Contractor shall comply with State requests for information needed to develop informational materials for potential members. Per 42 CFR 438.3(d), the Contractor shall accept individuals eligible for enrollment in the order in which they apply without restriction. The Contractor shall not, on the basis of health status or need for health care services, discriminate against individuals eligible to enroll. Additionally, the Contractor shall not discriminate against individuals eligible to enroll on the basis of race, color, national origin, sex, sexual orientation, gender identity or disability and will not use any policy or practice that has the effect of discriminating in such manner. Contractor shall also adhere to Section 1557 of the Affordable Care Act / 45 CFR 92.1.

Member Enrollment. Indiana Health Coverage Program applicants have an opportunity to select an MCE on their application. MCEs are expected to conduct marketing and outreach efforts to raise awareness of both the Hoosier Healthwise program and their product. The Enrollment Broker is available to assist members in choosing an MCE. Applicants who do not select an MCE on their application will be auto-auto- assigned to an MCE according to the State’s auto- auto-assignment methodology. The State reserves the right to amend the auto-assignment logic and may incorporate HEDIS or other quality indicators into the auto-assignment logic at a future date. Default auto-assignment will not be available to any MCE who does not successfully complete readiness review. review In accordance with 42 CFR 438.10(e), the State shall provide to potential members general information about the basic features of managed care and information specific to each MCE operating in the potential member’s service area. At minimum, this information will include factors such as Contractor service area, benefits covered, cost- cost-sharing and network provider information. The State shall provide information on program MCEs in a comparative chart-like format. Once available, the State also intends to include Contractor quality and performance indicators on materials distributed to facilitate MCE selection. The State reserves the right to develop a rating system advertising Contractor performance on areas such as consumer satisfaction, network access and quality improvement. To facilitate State development of these materials, the Contractor shall comply with State requests for information needed to develop informational materials for potential members. Per 42 CFR 438.3(d), the Contractor shall accept individuals eligible for enrollment in the order in EXHIBIT 2.I SCOPE OF WORK – HEALTHY INDIANA PLAN which they apply without restriction. The Contractor shall not, on the basis of health status or need for health care services, discriminate against individuals eligible to enroll. Additionally, the Contractor shall not discriminate against individuals eligible to enroll on the basis of race, color, national origin, sex, sexual orientation, gender identity or disability and will not use any policy or practice that has the effect of discriminating in such manner. Contractor shall also adhere to Section 1557 of the Affordable Care Act / 45 CFR 92.1. Member enrollment with the Contractor will be for the full 12-month calendar year benefit period once the member makes an initial POWER Account contribution. Members will have the opportunity to select a new MCE every year between November 1st to December 15th as part of the open enrollment period.

Member Enrollment. Indiana Health Coverage Program applicants have an opportunity to select an MCE on their application. MCEs are expected to conduct marketing and outreach efforts to raise awareness of both the Hoosier Healthwise program and their product. The Enrollment Broker is available to assist members in choosing an MCE. Applicants who do not select an MCE on their application will be auto-auto- assigned to an MCE according to the State’s auto- auto-assignment methodology. The State reserves the right to amend the auto-assignment logic and may incorporate HEDIS or other quality indicators into the auto-assignment logic at a future date. Default auto-assignment will not be available to any MCE who does not successfully complete readiness review. review In accordance with 42 CFR 438.10(e), the State shall provide to potential members general information about the basic features of managed care and information specific to each MCE operating in the potential member’s service area. At minimum, this information will include factors such as Contractor service area, benefits covered, cost- cost-sharing and network provider information. The State shall provide information on program MCEs in a comparative chart-like format. Once available, the State also intends to include Contractor quality and performance indicators on materials distributed to facilitate MCE selection. The State reserves the right to develop a rating system advertising Contractor performance on areas such as consumer satisfaction, network access and quality improvement. To facilitate State development of these materials, the Contractor shall comply with State requests for information needed to develop informational materials for potential members. Per 42 CFR 438.3(d), the Contractor shall accept individuals eligible for enrollment in the order in which they apply without restriction. The Contractor shall not, on the basis of health status or need for health care services, discriminate against individuals eligible to enroll. Additionally, the Contractor shall not discriminate against individuals eligible to enroll on the basis of race, color, national origin, sex, sexual orientation, gender identity or disability and will not use any policy or practice that has the effect of discriminating in such manner. Contractor shall also adhere to Section 1557 of the Affordable Care Act / 45 CFR 92.1. Member enrollment with the Contractor will be for the full 12-month calendar year benefit period once the member makes an initial POWER Account contribution. Members will have the opportunity to select a new MCE every year between November 1st to December 15th as part of the open enrollment period.

Member Enrollment. Indiana Health Coverage Program applicants have an opportunity to select an MCE on their application. MCEs are expected to conduct marketing and outreach efforts to raise awareness of both the Hoosier Healthwise program and their product. The Enrollment Broker is available to assist members in choosing an MCE. Applicants who do not select an MCE on their application will be auto-auto- assigned to an MCE according to the State’s auto- auto-assignment methodology. The State reserves the right to amend the auto-assignment logic and may incorporate HEDIS or other quality indicators into the auto-assignment logic at a future date. Default auto-assignment will not be available to any MCE who does not successfully complete readiness review. review In accordance with 42 CFR 438.10(e), the State shall provide to potential members general information about the basic features of managed care and information specific to each MCE operating in the potential member’s service area. At minimum, this information will include factors such as Contractor service area, benefits covered, cost- cost-sharing and network provider information. The Per 42 CFR 438.10(f), the State shall provide information on program MCEs in a comparative chart-like format. Once available, the State also intends to include Contractor quality and performance indicators on materials distributed to facilitate MCE selection. The State reserves the right to develop a rating system advertising Contractor performance on areas such as consumer satisfaction, network access and quality improvement. To facilitate State development of these materials, the Contractor shall comply with State requests for information needed to develop informational materials for potential members. Per 42 CFR 438.3(d438.6(d), the Contractor shall accept individuals eligible for enrollment in the order in which they apply without restriction. The Contractor shall not, on the basis of health status or need for health care services, discriminate against individuals eligible to enroll. Additionally, the Contractor shall not discriminate against individuals eligible to enroll on the basis of race, color, national origin, sex, sexual orientation, gender identity or disability and will not use any policy or practice that has the effect of discriminating in such manner. Contractor shall also adhere to Section 1557 of the Affordable Care Act / 45 CFR 92.1.

Member Enrollment. Indiana Health Coverage Program applicants have an opportunity to select an MCE on their application. MCEs are expected to conduct marketing and outreach efforts to raise awareness of the Hoosier Healthwise program and their product. The Enrollment Broker is available to assist members in choosing an MCE. Applicants who do not select an MCE on their application will be auto-assigned to an MCE according to the State’s auto- auto-assignment methodology. The State reserves the right to amend the auto-assignment logic and may incorporate HEDIS or other quality indicators into the auto-assignment logic at a future date. Default auto-assignment will not be available to any MCE who does not successfully complete readiness review. In accordance with 42 CFR 438.10(e), the State shall provide to potential members general information about the basic features of managed care and information specific to each MCE operating in the potential member’s service area. At minimum, this information will include factors such as Contractor service area, benefits covered, cost- cost-sharing and network provider information. The State shall provide information on program MCEs in a comparative chart-like format. Once available, the State also intends to include Contractor quality and performance indicators on materials distributed to facilitate MCE selection. The State reserves the right to develop a rating EXHIBIT 1.E SCOPE OF WORK – HOOSIER HEALTHWISE system advertising Contractor performance on areas such as consumer satisfaction, network access and quality improvement. To facilitate State development of these materials, the Contractor shall comply with State requests for information needed to develop informational materials for potential members. Per 42 CFR 438.3(d), the Contractor shall accept individuals eligible for enrollment in the order in which they apply without restriction. The Contractor shall not, on the basis of health status or need for health care services, discriminate against individuals eligible to enroll. Additionally, the Contractor shall not discriminate against individuals eligible to enroll on the basis of race, color, national origin, sex, sexual orientation, gender identity or disability and will not use us e any policy or practice that has the effect of discriminating in such manner. Contractor shall also adhere to Section 1557 of the Affordable Care Act / 45 CFR 92.1.

Member Enrollment. Indiana Health Coverage Program applicants have an opportunity to select an MCE on their application. MCEs are expected to conduct marketing and outreach efforts to raise awareness of the Hoosier Healthwise program and their product. The Enrollment Broker is available to assist members in choosing an MCE. Applicants who do not select an MCE on their application will be auto-assigned to an MCE according to the State’s auto- auto-assignment methodology. The State reserves the right to amend the auto-assignment logic and may incorporate HEDIS or other quality indicators into the auto-assignment logic at a future date. Default auto-assignment will not be available to any MCE who does not successfully complete readiness review. In accordance with 42 CFR 438.10(e), the State shall provide to potential members general information about the basic features of managed care and information specific to each MCE operating in the potential member’s service area. At minimum, this information will include factors such as Contractor service area, benefits covered, cost- cost-sharing and network provider information. The Per 42 CFR 438.10(f), the State shall provide information on program MCEs in a comparative chart-like format. Once available, the State also intends to include Contractor quality and performance indicators on materials distributed to facilitate MCE selection. The State reserves the right to develop a rating system advertising Contractor performance on areas such as consumer satisfaction, network access and quality improvement. To facilitate State development of these materials, the Contractor shall comply with State requests for information needed to develop informational materials for potential members. Per 42 CFR 438.3(d438.6(d), the Contractor shall accept individuals eligible for enrollment in the order in which they apply without restriction. The Contractor shall not, on the basis of health status or need for health care services, discriminate against individuals eligible to enroll. Additionally, the Contractor shall not discriminate against individuals eligible to enroll on the basis of race, color, national origin, sex, sexual orientation, gender identity or disability and will not use any policy or practice that has the effect of discriminating in such manner. Contractor shall also adhere to Section 1557 of the Affordable Care Act / 45 CFR 92.1.

Member Enrollment. Indiana Health Coverage Program applicants have an opportunity to select an MCE on their application. MCEs are expected to conduct marketing and outreach efforts to raise awareness of the Hoosier Healthwise program and their product. The Enrollment Broker is available to assist members in choosing an MCE. Applicants who do not select an MCE on their application will be auto-assigned to an MCE according to the State’s auto- --assignment methodology. The State reserves the right to amend the auto-assignment logic and may incorporate HEDIS or other quality indicators into the auto-assignment logic at a future date. Default auto-assignment will not be available to any MCE who does not successfully complete readiness review. In accordance with 42 CFR 438.10(e), the State shall provide to potential members general information about the basic features of managed care and information specific to each MCE operating in the potential member’s service area. At minimum, this information will include factors such as Contractor service area, benefits covered, cost- cost-sharing and network provider information. The State shall provide information on program MCEs in a comparative chart-chart- like format. Once available, the State also intends to include Contractor quality and performance indicators on materials distributed to facilitate MCE selection. The State reserves the right to develop a rating system advertising Contractor performance on areas such as consumer satisfaction, network access and quality improvement. To facilitate State development of these materials, the Contractor shall comply with State requests for information needed to develop informational materials for potential members. Per 42 CFR 438.3(d), the Contractor shall accept individuals eligible for enrollment in the order in which they apply without restriction. The Contractor shall not, on the basis of health status or need for health care services, discriminate against individuals eligible to enroll. Additionally, the Contractor shall not discriminate against individuals eligible to enroll on the basis of race, color, national origin, sex, sexual orientation, gender identity or disability and will not use any policy or practice that has the effect of discriminating in such manner. Contractor shall also adhere to Section 1557 of the Affordable Care Act / 45 CFR 92.1.

Member Enrollment. Indiana Health Coverage Program applicants have an opportunity to select an MCE on their application. MCEs are expected to conduct marketing and outreach efforts to raise awareness of both the Hoosier Healthwise program and their product. The Enrollment Broker is available to assist members in choosing an MCE. Applicants who do not select an MCE on their application will be auto-auto- assigned to an MCE according to the State’s auto- auto-assignment methodology. The State reserves the right to amend the auto-assignment logic and may incorporate HEDIS or other quality indicators into the auto-assignment logic at a future date. Default auto-assignment will not be available to any MCE who does not successfully complete readiness review. review In accordance with 42 CFR 438.10(e), the State shall provide to potential members general information about the basic features of managed care and information specific to each MCE operating in the potential member’s service area. At minimum, this information will include factors such as Contractor service area, benefits covered, cost- cost-sharing and network provider information. The State shall provide information on program MCEs in a comparative chart-like format. Once available, the State also intends to include Contractor quality and performance indicators on materials distributed to facilitate MCE selection. The State reserves the right to develop a rating system advertising Contractor performance on areas such as consumer satisfaction, network access and quality improvement. To facilitate State development of these materials, the Contractor shall comply with State requests for information needed to develop informational materials for potential members. Per 42 CFR 438.3(d), the Contractor shall accept individuals eligible for enrollment in the order in EXHIBIT 2.I SCOPE OF WORK – HEALHTY INDIANA PLAN which they apply without restriction. The Contractor shall not, on the basis of health status or need for health care services, discriminate against individuals eligible to enroll. Additionally, the Contractor shall not discriminate against individuals eligible to enroll on the basis of race, color, national origin, sex, sexual orientation, gender identity or disability and will not use any policy or practice that has the effect of discriminating in such manner. Contractor shall also adhere to Section 1557 of the Affordable Care Act / 45 CFR 92.1. Member enrollment with the Contractor will be for the full 12-month calendar year benefit period once the member makes an initial POWER Account contribution. Members will have the opportunity to select a new MCE every year between November 1st to December 15th as part of the open enrollment period.