Michigan Get Covered Connector Organization
Agreement
This Organization Agreement is between the Michigan Primary Care Association, hereafter referred to
as “MPCA”, and Click here to enter text., hereafter referred to as “Organization.” This Organization
Agreement has been developed to outline the mutual understandings and obligations to support both
parties in helping to provide Michigan’s uninsured residents with access to an on-line scheduling tool
that connects people in need of assistance with trained and certified individuals who can help with
applying and enrolling in health coverage offered through Health Insurance Marketplace and the Michigan
Department of Health and Human Services.
This on-line tool, Get Covered Connector, is owned by Enroll America and administered for Michigan
Hospitals and Health Centers by the MPCA through an agreement with Enroll America. This
Organization Agreement (“Agreement”) is between MPCA operating as an Administrator for the Get
Covered Connector (“Connector”), and the Organization. MPCA may require that this Agreement be
renewed at regular intervals or when the contents of the Agreement are altered or changed. Failure to
submit renewal Agreements may result in disabling of this Organization and associated Users in the
Connector. Additionally, failure to abide by the terms set forth in this agreement may result in disabling
of this Organization and associated Users without notice and at the sole discretion of MPCA staff.
The Entity agrees to the following standards of operating and Organization as described above:
1. The Organization agrees that there is never a fee charged for consumers using the Connector.
2. The Organization agrees that the organization and/or individuals associated with the
Organization may not reap financial benefit from the use of the Connector.
3. The Organization agrees that it will not solicit or accept donations from consumers for use of
the Connector.
4. The Organization agrees to promptly provide MPCA with any changes of contact information as
listed in the Organization’s profile.
5. The Organization agrees that Users are prohibited from sharing their login names and
passwords, and from using another User’s login name and password to access the Connector.
6. The Organization agrees to clearly explain to consumers how their Personally Identifiable
Information (“PII”) will be collected, used, stored and distributed by the Connector, Enroll
America, and other third-parties including the Organization.
7. The Organization agrees that certain logos and html code may be used to promote Connector
services and/or embed the consumer interface on Organization websites, social media, and/or
other advertising only after obtaining prior written approval from MPCA staff.
8. The Organization understands that complaints received by MPCA regarding the Organization’s
use of the Connector will be investigated by MPCA staff and that complaints may lead to
disabling of the Organization and associated User accounts.
9. The Organization agrees to request User accounts only for volunteers and/or staff that are
associated with their Organization.
10. The Organization agrees to obtain consent from locations where appointments will be offered
to the public in order to list their address and location name on the Connector.
1
connector@mpca.net
11. The Organization agrees that consumers using the Connector may not be solicited to
contribute money, sign petitions, or be forced to engage with persons conducting activities
unrelated to the Connector.
12. The Organization agrees that all associated Users operate within the boundaries set by federal
rules and regulations governing their organization and individual certifications.
13. The Organization agrees that associated Users may only use PII provided by the Connector for
the purposes of scheduling, confirming, cancelling, rescheduling, and/or updating appointment
outcomes. Other use of PII by the Organization, or distribution to third-parties including Enroll
America, is prohibited unless separate written consent is obtained by the Organization and
maintained for a period of no less than six years.
14. The Organization agrees that all Users will complete required training provided in a time and
manner to be determined by MPCA staff prior to accessing the system.
15. The Organization agrees to attend update or refresher trainings provided by MPCA or Enroll
America.
16. The Organization agrees to provide MPCA with contact information for the following individuals
designated to manage the operations of the Connector at the Organization. The Organization
must designate at least one individual for each of the roles defined below:
a) Signing Official– The official of the Organization who is authorized to represent and bind
the Organization for the purposes of this Organization Agreement. This person will be
contacted if this agreement needs to be altered, suspended, or revoked, and will have
access to view, but not change Organization information in the Connector.
b) Organization Administrator – Organization staff who is primarily responsible for
operations and management of the Connector at the Organization (may also be a User,
but may not be the same as Signing Official). Person will be able to view, add, and
change all information related to the Organization in the Connector.
c) User – Person who will be providing assister services at your organization. The User
may be responsible for posting their schedules, managing their own appointments,
pulling their own reports, etc. The Organization Administrator may take on the
responsibility of posting User schedules, managing User appointments, pulling User
reports, etc.
X
X
Signing Official Signature
MPCA Director of Enabling Servces Signature
Print Name:_____________________
Print Name:______________________
Date:______________________
Date:______________________
2
connector@mpca.net