Direct Enrollment definition

Direct Enrollment means the process by which a Web-broker or QHP Issuer may enroll an Applicant in a QHP in a manner that is considered through the Exchange consistent with 45 C.F.R. §§ 155.220(c), 155.221, 156.265, and 156.1230.
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Examples of Direct Enrollment in a sentence

  • The Enhanced Direct Enrollment (EDE) pathway will replace the proxy DE pathway that CMS allowed DE entities to use for PY 2018.

  • Beginning with the Open Enrollment Period for plan year (PY) 2019, CMS is implementing a program to allow Direct Enrollment (DE) entities (qualified health plan (QHP) issuers and web- brokers) in the Federally-facilitated Exchanges (FFE) and State-based Exchanges on the Federal Platform (SBE-FPs) to integrate an application for Marketplace coverage through the FFE with the standalone eligibility service (SES) to host application and enrollment services on their own website.

  • In general, a qualified individual has 60 days to report certain life changes, known as “qualifying events” to the plan or by using ▇▇▇▇▇▇▇▇’s Enhanced Direct Enrollment tool.

  • As defined for the purposes of this Agreement, CMS systems that agents and brokers access when assisting Consumers, including but not limited to ▇▇▇▇▇▇▇▇▇▇.▇▇▇, the CMS Enterprise Portal, and (if applicable) the Direct Enrollment Pathways.

  • This shift will instead allow awardees to utilize less 9 See Proxy Direct Enrollment Pathway for 2018 Individual Market Open Enrollment Period, CMS Health Insurance Exchange Guidance, May 17, 2017, ▇▇▇▇▇://▇▇▇.▇▇▇.▇▇▇/CCIIO/Resources/Regulations-and- Guidance/Downloads/Guidance-for-the-Proxy-Direct-Enrollment-Pathway-for-2018-Individual-Market-Open- Enrollment-Period.pdf.

  • EDE Entity must not take any actions that impair 11 The table in Appendix C is an updated version of Exhibit 2 in the “Third-party Auditor Operational Readiness Reviews for the Enhanced Direct Enrollment Pathway and Related Oversight Requirements.” the independence and objectivity of EDE Entity’s Auditor.

  • Web-broker, including Agent or Broker Direct Enrollment Technology Provider, must provide this information to CMS to connect to the DE or EDE web services in production.

  • Web-broker understands and agrees that in such circumstances CMS may immediately terminate this Agreement for cause, or the Agent or Broker Direct Enrollment Technology Provider may provide advance notice to CMS to terminate this agreement without cause per Section VIII.a of this Agreement.

  • Scripting and other automation of interactions with CMS Systems or the Direct Enrollment Pathways are strictly prohibited, unless approved in advance in writing by CMS.

  • The funding available to Navigator awardees is reflective of a maturing Exchange and is intended to align with ongoing operational changes to the enrollment process—such as the launch of the proxy Direct Enrollment (DE) pathway for plan year (PY) 20189 and the forthcoming Enhanced Direct Enrollment (EDE) pathway for PY 201910, both of which aim to further improve the consumer enrollment experience by providing multiple avenues through which a consumer can apply for coverage.