Default Enrollment definition

Default Enrollment means the process established by HHSC to assign a mandatory STAR, STAR+PLUS, or CHIP Perinate enrollee who has not selected an MCO to an MCO. Deliverable means a written or recorded work product or data prepared, developed, or procured by HMO as part of the Services under the Contract for the use or benefit of HHSC or the State of Texas.
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Default Enrollment means the process established by HHSC to assign a mandatory STAR, STAR+PLUS, or CHIP Perinate enrollee who has not selected an MCO to an MCO. Deliverable means a written or recorded work product or data prepared, developed, or procured by MCO as part of the Services under the Contract for the use or benefit of HHSC or the State of Texas. Delivery Supplemental Payment means a one-time per pregnancy supplemental payment for STAR, CHIP and CHIP Perinatal MCOs. Designated Provider means a physician, clinical practice or clinical group practice, rural clinic, community heath center, community mental health center, home health agency, or any other entity or provider (including pediatricians, gynecologists, and obstetricians) that are determined by the State and approved by the U.S. Secretary of Health and Human Services to be qualified to be a Health Home for Members with chronic conditions on the basis of documentation that the physician practice or clinic (A) has the systems and infrastructure in place to provide Health Home services and (B) satisfies the qualification standards established by the U.S. Secretary of Health and Human Services. Diagnostic means assessment that may include gathering of information through interview, observation, examination, and use of specific tests that allows a provider to diagnose existing conditions. Disabled Person or Person with Disability means a person under 65 years of age, including a child, who qualifies for Medicaid services because of a disability. Disability means a physical or mental impairment that substantially limits one (1) or more of an individual’s major life activities, such as caring for oneself, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and/or working. Disability-related Access means that facilities are readily accessible to and usable by individuals with disabilities, and that auxiliary aids and services are provided to ensure effective communication, in compliance with Title III of the Americans with Disabilities Act.
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Default Enrollment means the processes established by HHSC to assign an enrollee, who has not selected a Dental Contractor or Main Dentist, to a Dental Contractor or Main Dentist. See 1 Tex. Admin. Code § 353.403 for Medicaid default enrollment processes, and 1 Tex. Admin. Code § 370.303 for CHIP default enrollment processes.
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Examples of Default Enrollment in a sentence

  • On an informational basis only, MAO shall report quarterly, by month, to AHCCCS of its default enrollment process activities and results, as specified in Attachment 1: Chart of Deliverables and Attachment 5: Default Enrollment Process Reporting Requirements.

  • Default Enrollment (Assignment) – a process established by the Department through the CMS waiver authority to assign an enrollee who has not selected an MCO to an MCO.

  • Once HHSC has updated the State’s eligibility system to identify the CHIP or CHIP Perinatal Program Member as TP13, following standard eligibility cut-off rules,HHSC will allow the Member to prospectively move to Medicaid FFS.HHSC will not retroactively disenroll a Member from the CHIP or CHIP Perinatal Programs.Section 5.06 Modified Default Enrollment ProcessUnder the circumstances described in HHSC’s administrative rules at 1 Tex.

  • It would have been possible, however, to use the freeware tool TAGS to create the same collection of tweets, as both tools utilize the Search API and allow users to download the corpus in CSV format, which can then be imported into and modi- fied in by spreadsheet programs such as Mi- crosoft Excel.

  • All such external vendors must contract with the State and obtain eligibility information from the State.Section 5.08 Modified Default Enrollment Process‌ Section 5.08 is modified by Version2.1 and 2.6Section 5.09 is deleted and replaced with Section5.08 by Version 2.6Section 5.10 is deleted and replaced with Section5.08 by Version 2.6Section 5.11 deleted in its entirety by Version 2.3Under the circumstances described in HHSC’s administrative rules at 1 Tex.

  • The capture of public policy-making institutions can thus thwart economic structures in the di- rection of entrenching the position of incumbents and so- lidify entry barriers.

  • Notwithstanding anything to the contrary contained in this IIFCL Guarantee, (i) if the Guarantee does not become effective on or prior to the date on which the period of [•] from the Signing Date expires, or (ii) if the Debentures are not issued on or prior to the date on which the period of [•] from the Signing Date expires, then it shall not thereafter become effective as against the Guarantor (unless the Guarantor agree in writing to extend such date).

  • On an informational basis only, MAO shall report monthly to AHCCCS of its default enrollment process activities and results, as specified in Attachment 1: Chart of Deliverables and Attachment 5: Default Enrollment Process Reporting Requirements.

  • Additionally, HHSC Enrollment Broker will not allow CHIP Members who have exhausted their annual benefit limits to change dental plans.Section 5.05 Default Enrollment.The following special Default Enrollment process will apply to and be calculated separately for Medicaid and CHIP program recipients.(a) Special Default Enrollment Process.

  • For Participants with an Employment Commencement Date, Reemployment Commencement Date, or a transfer from ineligible to Eligible Employee status, on or after July 1, 2016, the Default Enrollment Percentage shall be 6% of Eligible Compensation.


More Definitions of Default Enrollment

Default Enrollment means a process approved by the State and CMS that allows the Contractor to offer enrollment to a Member of an affiliated Medicaid Managed Care Organization (MCO) to its Medicare Dual Eligible Special Needs Plan (D-SNP) when that member becomes newly eligible for Medicare. (42 CFR 422.66)
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Related to Default Enrollment

  • Provider Enrollment means an agreement between the Department and a Medicaid provider to provide room and board and deliver care and services to a Medicaid eligible individual in an adult foster home for compensation.

  • 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.

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

  • 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.

  • 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;

  • 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.

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

  • Declining enrollment means a decrease in the District's total enrollment or enrollment in a particular program or curricular / instructional offering which in the sole judgment of the board of education may adversely affect the District's current or future funding and/or the necessity of maintaining certain current or future class sections or curricular / instructional offerings.

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

  • 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.

  • 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.

  • Continuous enrollment means enrollment in a state- supported postsecondary education institution at the same degree level for consecutive terms, excluding summer term, since the beginning of the period for which continuous enrollment is claimed unless a sequence of continuous enrollment is broken due to extenuating circumstances beyond the student’s control, including serious personal illness or injury, or illness or death of a parent.

  • Enrollment Period means the period agreed upon by the Policyholder and Us when an Eligible Person may enroll for coverage or an Insured may change benefit elections under the Policy.

  • Distribution Election With respect to any Series, as specified in the related Supplement.

  • Statewide popular election means a general election in which

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

  • Enrollment Agreement means an agreement between the Company and an employee, in such form as may be established by the Company from time to time, pursuant to which the employee elects to participate in this Plan, or elects changes with respect to such participation as permitted under the Plan.

  • Payment Election means an election pursuant to Section 5.1.

  • Retirement Eligibility means attainment of age 60 and completion of at least five (5) years of continuous service with the Company.

  • Distribution Election Form means the form established from time to time by the Plan Administrator that the Director completes, signs and returns to the Plan Administrator to designate the time and form of distribution.

  • Eligibility Service of an employee means the period or periods of service credited to him under the provisions of Article II for purposes of determining his eligibility to participate in the Plan as may be required under Article III or Article VI.

  • Qualified Election Period means the six Plan Year period beginning with the Plan Year in which the Participant first becomes a Qualified Participant.

  • 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.

  • Primary election means any regular primary election held under the election

  • Optional Deferral Provision means, as to any Qualifying Capital Securities, a provision in the terms thereof or of the related transaction agreements to the effect that: