Web Content Launch: The web content dedicated to the September 30, 2017 PHARMACY BENEFIT PLAN and upcoming IT’S YOUR CHOICE OPEN ENROLLMENT period is completed, as determined by the DEPARTMENT Program Manager or designee, and launched. Informational Mailing: The CONTRACTOR shall send an October 2017 informational mailing with materials approved by the DEPARTMENT (Date TBD) Program Manager or designee to eligible program households one (1) week prior to the start of the OPEN IT’S YOUR CHOICE ENROLLMENT period. Employer Health Fairs: The CONTRACTOR shall participate in October November IT’S – YOUR CHOICE OPEN ENROLLMENT health fairs sponsored by 2017 EMPLOYERS in their service area. Enrollment File: The daily and full file compare of the November 16, 2017 DEPARTMENT HIPAA 834 enrollment files have been fully tested and are ready for program operation. Financial Administration: Financial administration requirements November 30, 2017 are operational, including but not limited to: Establishment of bank account(s) for funds for claims payments, and determine bank account(s) ownership. Establishment of mutually agreed upon written procedures related to managing the bank account(s) and invoicing (including data fields to be included). ACH mechanism for EFT of claims payments and fees. Grievance Procedure: The CONTRACTOR must submit its November 30, 2017 grievance procedure, including the DEPARTMENT administrative and independent review rights and sample grievance decision letters, for the and approval. DEPARTMENT’S review ID CARDS: The CONTRACTOR issues welcome packets that December 15, 2017 contain ID CARDS for SUBSCRIBERS with coverage effective January 1, 2018. Claims Administrative Services: All claims administrative services January 1, 2018 for the PHARMACY BENEFIT PLAN are fully operational. Accumulator File Data: The medical and pharmacy data transfer January 1, 2018 processes for accumulating PARTICIPANT out-of-pocket costs for deductibles and out-of-pocket limits is established, tested and working correctly. Web-Portal: The web-portal tracking January 1, 2018 CONTRACTOR’S PARTICIPANT level information is launched. Medical and Dental Data: The medical and dental data transfer January 15, 2018 process is established, tested, and working correctly. Wellness and Disease Management Data: The wellness and January 31, 2018 disease management data transfer process is established, tested, and working correctly.
Web Content Launch: The web content dedicated to the PHARMACY BENEFIT PLAN and upcoming IT’S YOUR CHOICE OPEN ENROLLMENT period is completed, as determined by the DEPARTMENT Program Manager or designee, and launched. September 30, 2017 Informational Mailing: The CONTRACTOR shall send an informational mailing with materials approved by the DEPARTMENT Program Manager or designee to eligible program households one (1) week prior to the start of the IT’S YOUR CHOICE OPEN ENROLLMENT period. October 2017 (Date TBD) Employer Health Fairs: The CONTRACTOR shall participate in IT’S YOUR CHOICE OPEN ENROLLMENT health fairs sponsored by EMPLOYERS in their service area. October – November 2017 Enrollment File: The daily and full file compare of the DEPARTMENT HIPAA 834 enrollment files have been fully tested and are ready for program operation. November 16, 2017 Financial Administration: Financial administration requirements are operational, including but not limited to: Establishment of bank account(s) for funds for claims payments, and determine bank account(s) ownership. Establishment of mutually agreed upon written procedures related to managing the bank account(s) and invoicing (including data fields to be included). ACH mechanism for EFT of claims payments and fees. November 30, 2017 Grievance Procedure: The CONTRACTOR must submit its grievance procedure, including the DEPARTMENT administrative and independent review rights and sample grievance decision letters, for the DEPARTMENT’S review and approval. November 30, 2017 ID CARDS: The CONTRACTOR issues welcome packets that contain ID CARDS for SUBSCRIBERS with coverage effective January 1, 2018. December 15, 2017 Claims Administrative Services: All claims administrative services for the PHARMACY BENEFIT PLAN are fully operational. January 1, 2018 Accumulator File Data: The medical and pharmacy data transfer processes for accumulating PARTICIPANT out-of-pocket costs for deductibles and out-of-pocket limits is established, tested and working correctly. January 1, 2018 Web-Portal: The CONTRACTOR’S web-portal tracking PARTICIPANT level information is launched. January 1, 2018 Medical and Dental Data: The medical and dental data transfer process is established, tested, and working correctly. January 15, 2018 Wellness and Disease Management Data: The wellness and disease management data transfer process is established, tested, and working correctly. January 31, 2018