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 2699.6608 - Enrollment of Aim Infants

Universal Citation: 10 CA Code of Regs 2699.6608

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

(a) An AIM infant, who is born prior to July 1, 2007, shall be enrolled without application when the program receives the required family child contribution beginning with the first full month of coverage pursuant to Section 2699.6613(g), and the following information about the infant from the AIM infant's mother at any time through the end of the eleventh month following the month of birth:

(1) Name; and

(2) Date of birth; and

(3) Sex.

(b) An AIM infant, who is born on or after July 1, 2007, shall be enrolled without application provided the infant is not enrolled in no-cost full scope Medi-Cal, meets the eligibility requirements pursuant to Section 2699.6607(d), and the following information about the infant from the AIM infant's mother is provided at any time through the end of the eleventh month following the month of birth. Coverage shall begin pursuant to Subsection 2699.6613(h).

(1) Name; and

(2) Date of birth; and

(3) Sex; and

(4) Information on whether or not the infant currently is enrolled in employer sponsored health coverage and the date coverage began; and

(5) Information on whether or not the infant was previously enrolled in employer sponsored health coverage, the date coverage began, the date in which coverage terminated, and the reasons for termination.

(c) The program shall request information from the AIM infant's mother, on the AIM infant's weight at birth and primary care provider.

(d) In lieu of reporting by the AIM infant's mother, the program must also accept the information specified in subsections (a) and (c) from the AIM infant's mother's health plan or a health care provider that provided services to the AIM infant's mother or the AIM infant.

(e) Upon receipt of the family child contribution and the information specified in subsection (a), or the information as specified in subsection (b), the program shall automatically enroll the eligible infant in the same health plan within the Healthy Families Program that the AIM infant's mother is enrolled in through the AIM program.

(f) Automatic enrollment of AIM infants (born before July 1, 2007) is subject to payment of family child contributions and timely notification of the infant's birth as provided in (a).

(g) Enrollment of eligible AIM infants (born on or after July 1, 2007) is subject to timely notification of the infant's borth as provided in (b).

(h) Notwithstanding subsection (a) or (b) of this section, infants in need of immediate health care services will be immediately enrolled in the program if:

(1) the AIM infant's mother's health plan notifies the program in writing of the need for services and provides the information specified in subsection (a) or (b) of this section; and

(2) this written notification occurs no later than the 10th day of the second full calendar month of the infant's life. For infants enrolled pursuant to this subsection (h), the required family child contribution shall be billed to the AIM mother. If the required family child contribution is not paid, the provisions of this article concerning disenrollment for failure to pay the required family child contribution shall govern.

1. New section filed 7-1-2004 as an emergency; operative 7-1-2004 (Register 2004, No. 27). Pursuant to Section 80, A.B. 1762 (Chapter 230, Stats. 2003) a Certificate of Compliance must be transmitted to OAL by 12-28-2004 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance as to 7-1-2004 order transmitted to OAL 11-24-2004 and filed 1-7-2005 (Register 2005, No. 1).
3. Amendment deemed an emergency and exempt from OAL review pursuant to Section 75 of Chapter 74, Statutes of 2006, filed 7-31-2007; operative 7-31-2007 (Register 2007, No. 31). A Certificate of Compliance must be transmitted to OAL by 1-28-2008 or emergency language will be repealed by operation of law on the following day.
4. Amendment of subsections (a) and (b) 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.
5. Certificate of Compliance as to 7-31-2007 order transmitted to OAL 1-28-2008 and filed 3-12-2008 (Register 2008, No. 11).
6. 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: Sections 12693.21 and 12693.755, Insurance Code. Reference: Sections 12693.21, 12693.70, 12693.71, 12693.73, 12693.755 and 12693.756, Insurance Code.

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