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MEMBER DECIDES TO LEAVE PLAN / DISENROLL
CANCELLATION
- coverage is being ended or stopped, before the plan's start date.
- customers cancel before plans effective date
- mistaken or duplicate enrollment
DISENROLL
- ends coverage after it has started
- only allowed during APE (oct 15-dec 07) or SEP
- requires CMS approval > Healthspring process
DISENROLLMENT / CANCELLATION SUB TYPE
incarcerated - member who have been imprisoned
cost - issue with the amount of premium
customer service - decides to cancel because unsatisfied
formulary - the medication is too high
Other coverage - decides to cancel because they found a better drug plan
pharmacy - pharmacy is no longer in network
star rating - they see low star rating
switch to MAPD - they choose Medicare advantage plan
unaware enrollment - they are not aware
deceased - the member has passed away
eligibility status - when they start the effective date or start with us Missing via fax - enrollment status - wants to check the status of application retro disenrollment - member who already left prison Transferred to CIGNA telesale OOA PLAN - if the member will change address that is OOA in our ends