Introduction

10 – Introduction (Rev. 111, 05-03-13, Effective: 05-03-13, Implementation: 05-03-13) A list of waivers or modifications approved for MAOs offering employer/union-sponsored group health plans is set forth in this chapter. As noted in §10.1, as a condition of CMS granting the particular waiver or modification, MAOs must demonstrate that they meet the criteria established by CMS as outlined in the specific waiver. For each waiver, CMS has noted whether the waiver/modification applies to “800 Series” MA plans, Direct Contract MA plans, or employer/union-sponsored group health plan enrollments in individual MA plans. Each of these waivers/modifications will automatically apply to those MAOs approved to offer EGWPs or individual plans that satisfy the applicable criteria; thus, they do not need to be granted on an individual basis. However, some waivers may be restricted to particular kinds of entities and/or a particular set of circumstances as noted. A complete list of currently-approved waivers can be found in Appendix II.