California Code of Regulations
Title 10 - Investment
Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program
Article 2 - Eligibility, Application, and Enrollment
Section 2699.6604 - Waiting List for Children

Universal Citation: 10 CA Code of Regs 2699.6604

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

(a) If the program has established and is operating a waiting list pursuant to Section 2699.6603, children for whom the program has received applications or Add-A-Person forms shall be placed on the waiting list in the order their applications or Add-A-Person forms were received. A child's effective date on the waiting list shall be the date on which the program received the child's application. An eligibility determination shall not be made until the Executive Director has made a determination pursuant to Section 2699.6603(d) and the applicant provides all supporting documentation pursuant to subsection (d)(2) of this section.

(b) If the Board makes a finding pursuant to Section 2699.6603(b), each subscriber child disenrolled at Annual Eligibility Review pursuant to Section 2699.6603(b) shall be placed on the waiting list and the subscriber child's effective date on the waiting list shall be his or her disenrollment date.

(c) When the program places a child on the waiting list pursuant to subsections (a) or (b) of this section, the program shall provide the applicant with written notification of the child's placement on the waiting list.

(d) When the Executive Director determines, pursuant to Section 2699.6603(d), that sufficient funds are available to cover some or all eligible children who are not currently enrolled, the program shall enroll the number of eligible wait-listed children for whom sufficient funds are available, as follows:

(1)
(A) The program shall first enroll those children who are on the waiting list because they were disenrolled at Annual Eligibility Review pursuant to Section 2699.6603(b). The program shall enroll these children in the order of their effective dates on the waiting list, starting with those who have the earliest effective date.

(B) If and when there are no remaining children who are on the waiting list because they were disenrolled at Annual Eligibility Review pursuant to Section 2699.6603(b), the program shall, to the extent that sufficient funds are available, enroll additional wait-listed children in the order of their effective dates on the waiting list, starting with those who have the earliest effective date.

(2) When sufficient funds are available to enroll a child based on that child's placement on the waiting list, the program shall provide the applicant with written notification. In that notice, the program shall request any necessary information pursuant to Sections 2699.6600 and 2699.6606 and any updates to information that no longer is current, pursuant to Section 2699.6600. The program shall then make an eligibility determination in accordance with Sections 2699.6606 and 2699.6607 and shall enroll the child if he or she is eligible.

1. New section filed 11-30-2007 as an emergency; operative 11-30-2007 (Register 2007, No. 48). A Certificate of Compliance must be transmitted to OAL by 5-28-2008 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance as to 11-30-2007 order transmitted to OAL 5-28-2008 and filed 7-7-2008 (Register 2008, No. 28).

Note: Authority cited: Section 12693.21, Insurance Code. Reference: Sections 12693.21 and 12693.96, Insurance Code

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