Plan enrollee definition

Plan enrollee means an employee or annuitant who is enrolled in the plan established under this subchapter.
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Plan enrollee means any individual described in rule 3307:1-11-02 of the Administrative Code who participates in the medical plans offered by the retirement system.
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Plan enrollee. ’ means an eligible individual or eligible employee
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Examples of Plan enrollee in a sentence

  • All Managed Care Plan enrollee placements into participating or non-participating residential facilities shall be appropriate to the enrollees’ needs.

  • The newborn will not automatically become a Health Plan enrollee upon birth.

  • 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.

  • Medicare Prescription Drug CoverageIf you or a covered dependent is eligible for Medicare-primary coverage and have enrolled in a Medicare Part D prescription drug plan, read the following information about how to use your Empire Plan benefits for secondary coverage.A Medicare-primary Empire Plan enrollee or dependent enrolled in a Medicare Part D drug plan must use his or her Medicare Part D prescription drug program first.

  • The newborn will automatically become a Managed Care Plan enrollee retroactive to birth.

  • 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 Managed Care Plan enrollee, unless there was change in enrollee materials or provider directory during the timeframe in which the recipient was disenrolled.

  • In comparing Wellness Plan per member per month (PMPM) cost and use to State Plan enrollee PMPM cost and use, the ED and prescription medicine PMPM cost and use are all significantly less.

  • PDO Services – These are the services a Managed Care Plan enrollee may self-direct.

  • 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.

  • Choosing a PCPEach enrolled UnitedHealthcare Community Plan enrollee either chooses or is assigned a PCP.


More Definitions of Plan enrollee

Plan enrollee means an eligible individual or eligible employee who enrolls in the HIFA health insurance program.
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Plan enrollee means an eligible individual or eligible employee who enrolls in VolunteerCare Health Insurance through VolunteerCare Health. "Plan enrollee" includes an eligible employee who is eligible to enroll in TennCare.
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Related to Plan enrollee

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

  • 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.

  • Pharmacy benefits management means the administration or management of prescription drug

  • Pharmacy benefits manager means a person that performs pharmacy benefits management.

  • Retiree Health Plan means an "employee welfare benefit plan" within the meaning of Section 3(1) of ERISA that provides benefits to individuals after termination of their employment, other than as required by Section 601 of ERISA.

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

  • Health plan or "health benefit plan" means any policy,

  • Managed care plan means a health benefit plan that either requires a covered person to use, or creates incentives, including financial incentives, for a covered person to use health care providers managed, owned, under contract with or employed by the health carrier.

  • New employee orientation means the onboarding process of a newly hired public employee, whether in person, online, or through other means or mediums, in which employees are advised of their employment status, rights, benefits, duties and responsibilities, or any other employment-related matters.

  • Declining enrollment means a decrease in the School District’s total enrollment or enrollment in a particular program or curriculum offering which in the sole judgement of the board of education may adversely affect the School District’s current or future allocation of funds and/or the necessity of maintaining certain current class sections or curriculum offerings.

  • Medicare Advantage plan means a plan of coverage for health benefits under Medicare Part C as defined in 42 U.S.C. 1395w-28(b)(1), and includes:

  • Pharmacy benefit manager means a person, business or other

  • School employer means a board of school directors, the

  • School employee means (1) a teacher, substitute teacher, school administrator, school superintendent, guidance counselor, psychologist, social worker, nurse, physician, school paraprofessional or coach employed by a local or regional board of education or working in a public elementary, middle or high school; or (2) any other individual who, in the performance of his or her duties, has regular contact with students and who provides services to or on behalf of students enrolled in a public elementary, middle or high school, pursuant to a contract with the local or regional board of education.

  • Qualifying Educational Program means a program at a post-secondary school level of not less than three consecutive weeks duration that requires each student taking the program to spend not less than 10 hours per week on courses or work in that program.

  • Basic health plan means the plan described under chapter

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

  • Academic employee Academic employee shall mean an employee in the Professional Services Negotiating Unit with academic or qualified academic rank.

  • Adult education means all education or instruction,

  • HMO means any health maintenance organization, managed care organization, any Person doing business as a health maintenance organization or managed care organization, or any Person required to qualify or be licensed as a health maintenance organization or managed care organization under applicable federal or state law (including, without limitation, HMO Regulations).

  • Basic health plan model plan means a health plan as required in RCW 70.47.060(2)(e).

  • Newborn means a baby less than nine days old.

  • Medical Benefits means the monthly fair market value of benefits provided to the Employee and the Employee’s dependents under the major medical, dental and vision benefit plans sponsored and maintained by the Company, at the level of coverage in effect for such persons immediately prior to the Employee’s termination of employment date. The “monthly fair market value” of such benefits shall be equal to the monthly cost as if such persons elected COBRA continuation coverage at such time at their own expense.

  • MCO means an organization having a certificate of authority or certificate of registration from the 11 Washington State Office of Insurance Commissioner that contracts with HCA under a comprehensive 12 risk contract to provide prepaid health care services to eligible HCA Enrollees under HCA managed 13 care programs.

  • Enrolled Nurse means an employee:

  • Registered Health Practitioner means a health practitioner registered, or licensed, as a health practitioner (or as a health practitioner of a particular type) under a law of a State or Territory that provides for the registration or licensing of health practitioners (or health practitioners of that type).