New Policies from Carewell Health Systems, Inc.

Post date: 2021 Aug 20 11:35 AM by KAJJ1 (Public)

NOTICE MEMORANDUM

 

To: ALL MEMBERS

From: THE MANAGEMENT
Subject: NEW POLICIES FROM CAREWELL HEALTH SYSTEMS, INC.

Date: AUG-20-2021

 

 


Dear Valued Member,

 

We would like to bring to your notice the recent changes made by Carewell Health Systems, Inc. in policies related with late and delinquent payments. These changes will come in effect immediately.

 

§  All payments should be endorsed directly to KAJJ HSI on or before the due date. Coverage of members whose payments were endorsed to KAJJ HSI after the due date will not be active for the whole applicable month. Payments made on or before the due date but were not endorsed directly to KAJJ HSI on or before the due date will not be active for the whole applicable month.

 

Example:

April coverage

paid and endorsed on time

May coverage

late endorsement

June coverage

paid and endorsed on time

continuous coverage

ACTIVE

NOT ACTIVE

ACTIVE

 

April coverage

paid and endorsed on time

May coverage

late endorsement

June coverage

late endorsement

apply for new coverage

ACTIVE

NOT ACTIVE

NOT ACTIVE

 

 

April coverage should be paid on March 25.

May coverage should be paid on April 25. If payment is endorsed after April 25 for May coverage, member’s coverage will not be active for the whole month of May. Member has to pay for June coverage not later than May 25 for coverage to be active.

 

§  Only a one-month arrear is allowed from the current month for HMO to be continuous of coverage, otherwise member shall have to apply for a NEW coverage. The one-month arrear shall be paid together with the next month membership for HMO to be active and continuous.

 

Example:

April coverage

paid and endorsed on time

May coverage

not paid

June coverage

paid and endorsed on time including payment for arrear

continuous coverage

April coverage

paid and endorsed on time

May coverage

not paid

June coverage

not paid

apply for new coverage

April coverage

paid and endorsed on time

May coverage

not paid

June coverage

late endorsement

apply for new coverage

                               

§  If arrears are more than one month already and member wishes to have coverage, member may APPLY for NEW COVERAGE in the condition that mode of payment will be SEMI-ANNUAL throughout the membership.

 

§  Members with discontinued coverage and wish to apply for new coverage may do so in the condition that mode of payment will be SEMI-ANNUAL throughout the membership.

 

§  Cut-off schedule for new application of members:

 

Endorsement Date

Start of Coverage

1st to 27th of the month

1st of the following month

28th to the end of the month

1st of the month after the following month

                       

Example:

Endorsement Date

Start of Coverage

March 27th

April 1

March 28th

May 1

 

Members shall endorse payment on time for coverage to be active. Late endorsement of payments will make coverage inactive for the whole applicable month. Only a one-month arrear is allowed for coverage to be continuous. All members who will re-apply for new coverage will only be accepted under semi-annual mode of payment throughout membership.

 

These changes have been made because our HMO provider, Carewell Health Systems, Inc., has noticed the practice of a large number of delinquent members where they only update their payments when in need to avail of the HMO services, which they brought to our attention. For the past years, our HMO provider has been lenient and accommodating. These policies have been made in order for Carewell Health Systems, Inc. to provide continuous coverage to our members.

 

These changes shall supersede all affected prior policies. This is for strict compliance.

 

Looking forward to the cooperation of all members.

 

 

 

The Management



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