For example, a plan could allow beneficiaries to pay the lesser of a plan coinsurance amount or copayment amount for a particular plan benefit. Since changes in benefits are considered a change in plan rules, organizations are required to notify plan members of approved benefit enhancements at least 30 days prior to the effective date. Important Dates Several important dates regarding the CY 2000 benefit enhancement process are noted below. Organizations can, however, request that a benefit enhancement be effective at some later date 4 . For example, organizations may not revise cost estimates for plan benefits when proposing to reduce the plan premium.
Documentation is needed ONLY to support the proposed enhancements.
HCFA may not begin reviewing proposals until all information noted above is received. In addition, organizations should submit a cover letter describing the proposed enhancements. In addition, organizations should submit a copy of the member notification, amendment to the SB, and amendment to the EOC to the HCFA RO for review and approval. To increase the probability of a February 1 effective date and to ensure that benefit information is updated in MCC on February 5, electronic submissions should be sent no later than January 1, 2000. A copy of that letter will be distributed to appropriate HCFA staff in the central office and ROs.