| 1. |
DEFINITIONS
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| 1.1 |
"Emergency Medical Group ("EMG")
A category of Enrollees qualified for GHP under a temporary expansion
of Medicaid coverage eligibility requirements during the COVID-19 pandemic.
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| 1.2 |
Emergency Medical Group Enrollees
From November 15, 2020 to September 30, 202J, Potential Enrollees who
qualify for the Emergency Medical Group ("EMG") are eligible to participate under the Medicaid and CHIP programs under the GHP. During this time, EMG Enrollees shall receive the same benefits as the eligible populations as defined in Section 1.3.1.
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| 2. |
ELIGIBILITY
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|
2.1
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EMG potential enrollees shall comply with eligibility requirements as set forth by the Medicaid Program for the establishment of the poverty level for eligibility certification. EMG enrollees may be considered Medicaid, CHIP or State Population according to Medicaid Program's eligibility certification.
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| 3. |
ENROLLMENT
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| 3.1 |
Effective Date of Enrollment for EMG.
The effective Date of Enrollment for all Emergency Medical Group Enrollees shall begin no earlier than November 15, 2020. All other Enrollment processes
and procedures under Section 5.2 of this Contract shall apply, including those applicable provisions governing notification to Enrollees and Providers on Enrollment and changes in Enrollment status.
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| 3.2 |
Disenrollment.
EMG Enrollees shall have a Term of Enrollment that expires on
September 30, 2021. Upon expiration of this term, EMG Enrollees shall undergo the same Disenrollment procedures set forth under Section 5.3 as applicable to Enrollees who are no longer eligible for the GH P.
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| 4. |
ATTACHMENT APPLICABILITY
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