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2) Inform the individual in writing or by telephone (contact must be documented and retained with the individual’s enrollment request) that they have 30 calendar days to confirm their intent to enroll in the plan.

3) Ensure plan benefits are available to the individual as of the effective date of the initial enrollment request and that the provision of plan benefits is not delayed in anticipation of the applicant’s confirmation of intent to enroll.

If the individual indicates that they are fully aware of any consequence to their employer or union coverage brought about by enrolling in the Part D Plan, and confirms the intent to enroll, the plan must update the transaction with the appropriate “flag” (detailed instructions for this activity are included with CMS systems guidance) and resubmit it for enrollment. The effective date of enrollment will be based upon the individual's initial enrollment request.

If the individual does not respond in 30 days, or responds and declines the enrollment, the enrollment must be denied. A denial notice must be provided (see MA Exhibit 7 or Part D Exhibit 6).

50.8 – Transmission of Enrollment to CMS 42 CFR §§ 422.60(e)(5) and 423.32(c)

Plans are required to submit the information necessary for CMS to add the individual to its records as an enrollee of the MA or Part D organization within seven calendar days of receipt of the completed enrollment request. CMS system “down” days are included in the calculation of the seven calendar days (refer to https://www.cms.gov/research-statistics-data-and-systems/cms- information-technology/mapdhelpdesk/mapd-marx-calendars-and-schedules). To assess plan compliance, CMS will count the enrollment request receipt date as “day zero” and the following day as “day one.”

When submitting enrollment transactions to CMS, the plan should use the application date that is appropriate for each enrollment request mechanism outlined in the chart below.

Enrollment Request Mechanism Application Date Special Notes Paper Enrollment Forms § 40.1.1 The date the paper request is initially received Paper requests submitted to or collected by sales agents or brokers are considered received by the MA or Part D organization on the date the agent or broker receives the request from the individual Fax § 40.1.1 The date the fax is received on the plan’s fax machine