PARKLAND HEALTHfirst - Parkland Community Health Plan, Inc.
PARKLAND HEALTHfirst - Parkland Community Health Plan, Inc.
PARKLAND HEALTHfirst - Parkland Community Health Plan, Inc.
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• In order to synchronize all CHIP and CHIP Perinatal members in a household, all members will remain<br />
in the MCO providing CHIP Perinatal coverage until the CHIP Perinate Newborn completes its 12-<br />
month eligibility. After the CHIP Perinate Newborn’s coverage period is completed, the child will be<br />
added to the existing CHIP case. The coverage period for the newly enrolled child will be the remaining<br />
period of coverage of the siblings already enrolled in CHIP.<br />
Disenrollment<br />
HHSC must approve and will make the final decision on any request for disenrollment of a member for<br />
cause.<br />
A provider cannot take retaliatory action against a member who is disenrolled from <strong>Parkland</strong> CHIP Perinate<br />
or <strong>Parkland</strong> CHIP Perinate Newborn.<br />
<strong>Plan</strong> Changes<br />
92<br />
• Once the mother of the CHIP Perinate picks an MCO, the CHIP Perinate must remain in this MCO until<br />
the end of the CHIP Perinatal continuous eligibility period.<br />
• If the mother of the CHIP Perinate does not pick an MCO within 15 calendar days of receiving the<br />
enrollment packet, the CHIP Perinate is defaulted into an MCO and the mother is notified of the plan<br />
choice. When this happens, the mother has 30 days to pick another MCO.<br />
• All CHIP and CHIP Perinatal members must remain in the same MCO until the end of the CHIP<br />
Perinatal continuous eligibility period. After the CHIP Perinate Newborn’s coverage period is<br />
completed, the child will be added to the existing CHIP case. The coverage period for the newly<br />
enrolled child will be the remaining period of coverage of the siblings already enrolled in CHIP. At the<br />
first CHIP renewal after the CHIP Perinatal eligibility ends, the family can pick a new MCO. Note:<br />
The switch of the CHIP members from their MCO to the MCO providing the CHIP Perinatal coverage<br />
does not count as their one MCO change per year.<br />
• Members can ask to change MCOs for exceptional reasons or good cause.<br />
Provider Marketing Guidelines<br />
The following CHIP provider marketing policy is consistent with HHSC Marketing Policies and Texas<br />
Department of Insurance standards.<br />
CHIP Provider Marketing Policy<br />
• <strong>Health</strong> care providers can undertake a variety of activities designed to urge families to apply for CHIP.<br />
Examples include, but are not limited to:<br />
• Displaying posters, brochures, or other written material<br />
• Distributing application booklets to families with uninsured children<br />
• Playing a video that promotes CHIP<br />
• Informing their patients of the toll-free CHIP Help Line<br />
• Providers can educate their patients about CHIP specifically.<br />
• Providers can not promote the selection of specific health plans within the context of the CHIP enrollment<br />
process.<br />
• Providers can not help families in filling out the health plan selection form.<br />
• Providers can not distribute health plan marketing materials in their offices.