Election Periods
Systems
Pend Reasons
True or False
100

The number of days Enrollment will allow an app to pend without a valid Election Period.

What is 7?

100

This is the system that houses enrollment applications and supporting documents such as Chronic Verification forms and Medicaid Award Letters submitted to UHC. 

What is VIEW?

100

This is the document that provides the meaning of pend reasons and how to resolve them.

What is the MA/MAPD/PDP Pre-Enrollment Support Generalist doc?

100

PHD needs verbal permission from the client to update an address on a pending app.

What is false? The agent can attest to receiving permission from the client to update and the date permission was received.

200

True or False: Member permission is needed to update an Election Period.

What is False?

200

This is the name of UHC's online enrollment system.

What is JarvisEnroll?

200

These are the pend reasons you will see if Medicaid needs to be verified for a DSNP app. 

What is DSNP plan requires verification, No Matching Beneficiary, and/or Matching Rules Ineligible?

200

If you can update an app with the needed missing information, and it was the only reason the app was pending, you can process the app directly to CMS by pressing "Save".

What is true?

300

The number of times the SEP Integrated Care can be used.

What is once per month?

300

This is where we document calls and escalate service requests.

What is PCL?

300

The amount of time an app will pend for while waiting for additional information?

21 days or to the end of the Election Period, whichever is longer. 30 days for Employer Group Subsidy.

300

Verbal permission is needed directly from the enrollee to change the Effective Date on an app.

What is true?

400

The number of times the OEP election can be used.

What is one?

400

The 3 systems we can use to confirm if chronic verifications have been received.

What is GPS, VIEW, Maestro/MIIM?

400

These are the ways you can find the amount owed when an app is pending for Special Handling Exists.

What are in the Application History Notes and/or viewing the AIL letter in Doc360?

400

Members can get as many IDs as they need, anytime while on the plan, by contacting PHD.

What is false? 

As a one-time courtesy, and within 90 days from the effective date, PES can generate a replacement ID card.

Members can log on to their account via the plan website and view their member ID.

500

The number of times the AEP election can be used.

What is N/A? This election can be used more than once with the last app in and approved being the one that will take effect.

500
This is how you ensure you are using the most up to date version of our guides and documents. 

What is pulling them from Knowledge Central daily instead of opening from a bookmark?

500

This is the only time you should check Medicaid on an app pending for Medicaid verification.

What is if you see notes from Enrollment that Medicaid cannot be verified and an AIL letter has been sent?

500

When providing the agent with the AIL date (last date missing information can be received), we provide the Withdrawal Date listed in GPS. 

What is false? The AIL date is 2 days before the Withdrawal date. Confirm by pulling the AIL letter in Doc360.

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