Medicare Advantage and Prescription Drug Plans December 28 ...

Plan Communications User Guide Appendices, Version 6.3
M: Valid Election Types for Plan-Submitted Transactions
Table M-1 shows the valid election types for Plan-submitted enrollment and disenrollment
transactions. Plans must ensure the requirements in the CMS Enrollment and Disenrollment
guidance applicable to the Plan type are followed to properly determine and report the election
type.
Table M-1:Valid Election Types for Plans
Election Types
PLANS
AEP (A) OEPI (T) SEP (Note 2) IEP (E/F) MADP ICEP (I)
MA Y Y Y N Y Y
MA-PD Y Y Y Y Y Y
PDP
Y
N
(Use coordinating
SEP where
appropriate per
CMS guidance)
Y Y N
(Use
coordinating
SEP where
appropriate
per CMS
guidance)
N
SHMO I Y Y Y Y
SHMO II Y Y Y Y
Cost with Part D
Y
N
(Use coordinating
SEP where
appropriate per
CMS guidance)
Y
Y
Use
coordinating
SEP where
appropriate
per CMS
guidance)
Cost without
Part D
None required; however, if the beneficiary is currently enrolled in an MA Plan, a valid
MA election period is required to leave that program and enroll in the cost Plan.
WPP Y Y Y Y Y
ESRD I
ESRD II
PACE National
CCIP / FFS
Demos
MDHO Demo
MSHO Demo
Y
Y
None Required
None Required
None Required
None Required
December 28, 2012 M-1 Valid Election Types for
Plan-Submitted