Contract may include provisions that inform enrollees that, as Contract Discretionary WAC part of its routine operations, the carrier applies the terms of its Examination Clauses contracts for making decisions, including determinations and Prohibited regarding eligibility, receipt of benefits and claims, or Standards explaining its policies, procedures, and processes. (Cont’d) Discretionary Clauses Prohibited (Cont’d)
Contract Examination and Standards (Cont’d) Discretionary Clauses Prohibited Discretionary Clauses Prohibited (Cont’d) WAC Contract may include provisions that inform enrollees that, as part of its routine operations, the carrier applies the terms of its contracts for making decisions, including determinations regarding eligibility, receipt of benefits and claims, or explaining its policies, procedures, and processes.
cklist-forms-18-hcsc-ind-stand-alone-dental-w-pediatric-ehbs.docx