Toll-free telephone lines, usually staffed by the State or enrollment broker, that beneficiaries may call when they encounter a problem with their managed care organization. The people who staff hotlines are knowledgeable about program policies and may plan an “intake and triage” role or may assist in resolving the problem.
Insurance Encyclopedia
Enrolling unit (Health Insurance)
The company or group that has signed up for membership in a health insurance plan.
Enrollment
1. Total number of members or subscribers in a managed care plan at a given time. 2. Conversion of an eligible group into managed care plan membership. Some group plans have conditions of the minimum size or minimum percentage of a group that must enroll before insurance coverage is available. See also open enrollment period . 3. Process by which an individual becomes a subscriber for coverage in a health plan. 4. Process by which a Medicaid-eligible person becomes a member of a managed care plan. Enrollment data refer to the managed care plan’s information on Medicaid-eligible individuals who are plan members. The managed care plan gets its enrollment data from the Medicaid program’s eligibility system. 5. Information confirming that an individual is enrolled in a health insurance plan.
Enrollment (Health Insurance)
The act of signing people up for participation in a health insurance plan. This term may also mean the total number of participants in a health care plan.
Enrollment area
Geographical area in which subscribers must reside to be eligible for enrollment in a managed care plan.
Enrollment card
1. Signed document by an employee that indicates his or her desire in becoming a member of a group insurance plan. 2. In contributory insurance plans, enrollment cards authorize an employer to deduct the employee’s contributions from his or her wages.
Enrollment date
Month, day, and year on which a group’s or individual’s health insurance coverage starts. Also called coverage effective date .
Enrollment fee
Amount the beneficiary must pay every year to get a Medicare-approved drug discount card.
Enrollment period
1. Time in which individuals may apply for life insurance or health insurance. 2. Time in which individuals may choose either to re-enroll in an existing managed care plan or change to a competitor’s plan. See also open enrollment period, federal open enrollment , and group enrollment period . 3. Specified time when an individual can sign up for Medicare benefits. The period for general enrollment is January 1 through March 31 of each year for Medicare supplementary insurance. 4. Certain period of time when an individual can join a Medicare health plan if it is open and accepting new Medicare members. If a health plan chooses to be open, it must allow all eligible people with Medicare to join.
Enrollment period (Health Insurance)
The time frame during which employees can sign up for participation in a health care plan.