My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2022-149A
CBCC
>
Official Documents
>
2020's
>
2022
>
2022-149A
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
5/26/2023 10:33:49 AM
Creation date
5/26/2023 10:32:28 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
08/16/2022
Control Number
2022-149A
Agenda Item Number
8.Z.
Entity Name
Blue Cross Blue Shield of Florida, Inc.
Subject
BlueMedicare Group Master Agreement Renewal
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
12
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
SECTION 3 ELIGIBILITY, ENROLLMENT, AND DISENROLLMENT <br />A. Eligibility Determination <br />Determination of whether an individual is an Eligible Retiree or Eligible Dependent wil I be a two-step <br />process: <br />1. You will determine whether the individual is eligible to participate in the retiree group health <br />benefit plan that you sponsor. For individuals meeting your eligibility criteria, you will promptly <br />forward completed applications to us. You are responsible for complying with all applicable laws <br />and regulations, including but not limited to the Employee Retirement Income Security Act <br />(ERISA) and the Internal Revenue Code, in making this eligibility determination. You must also <br />comply with all eligibility guidelines included in the benefit administrative guide and Evidence <br />of Coverage. <br />2. After receiving a complete application, we will process the application in accordance with CMS <br />Requirements. An application must be approved by us and accepted by CMS for an individual to <br />be enrolled in a Medicare Plan. <br />B. Distribution of Enrollment Materials <br />You may only distribute materials describing the Medicare Plan that we have provided to you or that we <br />have approved in writing. You will distribute any pre -enrollment materials that we provide to you to each <br />potential enrollee before collecting enrollment applications. Nothing in this Section will preclude you <br />from making additional disclosures about your group health benefit plan as applicable to comply with <br />ERISA, such as a wrap-around summary plan description or other plan document. If applicable, you are <br />solely responsible for compliance with ERISA disclosure requirements in connection with the Medicare <br />Plan(s). <br />C. Group Disenrollment <br />If you decide to disenroll all Covered Persons from a Medicare Plan, you must: <br />1. Notify all beneficiaries that you intend to disenroll them from the Medicare Plan. You will provide <br />this notice at least twenty one (2 1) calendar days before the disenroltment. This notice will explain <br />how to contact Medicare for information about other plan options that may be available. You will <br />include language provided by Florida Blue in this notice to meet specific CMS Requirements for <br />notice contents. <br />2. Provide us with all information necessary to submit a complete disenrolhnent request;transaction <br />to CMS in accordance with CMS Requirements. <br />3. In the event of termination of this Agreement, provide advanced notice in accordance with Section <br />4 of this Agreement. <br />D. Individual Covered Person Disenrollment <br />Covered Persons may be disenrolled from a Medicare Plan by Florida Blue if they bq'come jneligible for <br />continued enrollment. Covered Persons may also be disenrolled if this Agreement terminates or if you <br />
The URL can be used to link to this page
Your browser does not support the video tag.