Final answer:
When a member leaves the plan and then a few months later returns to the plan, this is referred to as Reenrollment.
Step-by-step explanation:
Reenrollment is the process of a member returning to a plan after previously leaving it. This can occur for various reasons such as a change in coverage needs or a lapse in coverage. When a member leaves a plan and then returns a few months later, they are considered a reenrollee.
When a member leaves a plan and then returns, there are a few steps that need to be taken in order to properly reenroll them. Firstly, the member must submit a new application for enrollment, which includes providing updated personal and demographic information. This is important to ensure that the member's information is current and accurate in the plan's records.
Next, the plan must determine if the member is eligible for reenrollment. This may involve verifying their previous enrollment and coverage status, as well as any changes in their eligibility for the plan. For example, if the member had previously aged out of the plan but is now eligible again due to a change in age requirements, they may be able to reenroll.
Once eligibility is established, the plan must also determine if there are any waiting periods or restrictions for reenrollment. This may depend on the reason for the member's previous departure from the plan. For instance, if the member voluntarily terminated their coverage, there may be a waiting period before they can reenroll. However, if the member's coverage was terminated due to non-payment of premiums, they may be able to reenroll immediately upon payment of any outstanding premiums.
In addition to these steps, the plan must also consider any financial implications of reenrollment. For example, if the member had previously reached their maximum benefit limit, reenrollment may require a recalculation of benefits and cost-sharing amounts.
Overall, reenrollment is a key process in ensuring that members have access to the coverage they need and that their information is accurate and up-to-date. It allows for flexibility in coverage options and helps to maintain continuity of care for members who may have had a temporary lapse in coverage.