Enrollment and Eligibility (ENR) FAQ
Guidance for FAQ regarding Notices and Other
Program Area: Enrollment and Eligibility (ENR)
Question: In reference to Appendix C (nonpayment letter) of the Enrollment Operational Policy and Guidance module, does the member need to pay the September premium by September 1 to avoid termination?
Answer: To avoid termination, enrollees must pay the full portion of the premium for which they are responsible prior to the end of the applicable grace period. In this example, if the enrollee paid the entire outstanding premium for which he or she is responsible on August 31 (premiums for June, July, August), the enrollee is no longer in the grace period. However, If the enrollee does not pay the entire outstanding amount on August 31st, the enrollee will be terminated.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 27, 2014
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