Medicare Advantage and Prescription Drug Plans December 28 ...

Plan Communications User Guide Appendices, Version 6.3
Code Type Title Short Definition Definition
104
Con’t
R
Rejected;
Invalid or
Missing
Election Type
BAD ELECT TYPE
Z - SEP for:
Auto-Enrollment (Enrollment Source Code = A)
Facilitated Enrollment (Enrollment Source Code = C)
Plan-Submitted Auto-Enrollment (Enrollment Source Code = E) and Transaction
Type 61 (PBP Change) and MA or Cost Plan (all conditions must be met)
POS Enrollment (Enrollment Source Code = G)
S - Special Enrollment Period (SEP)
The value expected in Election Type depends on the Plan and transaction type, as well as on when
the beneficiary gains entitlement. Each Election Type Code can be used only during the election
period associated with that election type. Additionally, there are limits on the number of times each
election type may be used by the beneficiary.
105 R Rejected;
Invalid
Effective
Date for
Election Type
BAD ELECT
DATE
Plan Action: Review the detailed information on Election Periods in Chapter 2 of the MMCM or
the PDP Guidance on Eligibility, Enrollment and Disenrollment. Determine the appropriate
Election Type value and resubmit, if appropriate.
An enrollment or disenrollment transaction (Transaction Types 61, 51) was rejected because the
effective date was not appropriate for the election type or for the submitted application date.
Examples of inappropriate effective dates:
Date is outside of the election period defined by the submitted election type.
(ex: Election Type = A and Effective Date = 2/1/2007)
Date is not appropriate for the application date
(ex: App date = 6/10/2007 & Eff Date =11/01/2007)
Plan Action: Correct the Effective Date or Election Type and resubmit if appropriate. Review
Chapter 2 of the MMCMor the PDP Guidance on Eligibility, Enrollment and Disenrollment for
detailed descriptions of the Election Periods and corresponding effective dates.
December 28, 2012 I-25 Transaction Reply Codes (TRCs)