Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1720.1 - FREEDOM OF CHOICE, ENROLLMENT AND DISENROLLMENT
Subchapter 3 - ENROLLMENT
Section 17-1720.1-17 - Assignment to a health plan for a newly eligible individual
Universal Citation: HI Admin Rules 17-1720.1-17
Current through November, 2024
(a) An individual meeting one of the following conditions will be auto-assigned to a health plan at the time of determination of eligibility.
(1) A newborn
of an enrolled individual shall be enrolled into the health plan of the mother,
retroactive to the date of birth. The newborn auto-assignment shall be
effective for at least the first (1st) thirty (30)
calendar days following the birth;
(2) An individual who lost eligibility for a
period of six (6) months or less shall be re-enrolled into their previous
health plan;
(3) An enrolled
individual who enters into the child welfare system shall remain in their
current health plan;
(b) Following the enrollment of a newly eligible individual into an auto-assigned health plan by the department, the individual shall be sent an enrollment notice that identifies the auto-assigned health plan and provides the individual the opportunity to select a different health plan, which is available in the service area in which the individual resides and open to new members, within the fifteen (15) calendar days grace period from the date of enrollment into an auto-assigned health plan.
(1) If an individual does not select a
different health plan within the fifteen (15) calendar days grace period,
enrollment shall continue in the health plan to which auto-assigned, and the
individual will be informed of the sixty (60) calendar days grace period from
the date of initial enrollment to change health plans.
(2) If the individual selects a different
health plan during the fifteen (15) calendar days grace period, the date of
enrollment into the selected health plan shall be the first of the next month
following the month in which the selection occurred, and the department shall
send an enrollment notice identifying the selected health plan and inform the
individual of the sixty (60) calendar days grace period from the date of
enrollment to select a different health plan available in the service area in
which the individual resides open to new members.
(3) If during the sixty (60) calendar days
grace period an individual selects to change health plans, the date of
enrollment into the selected health plan shall be the first
(1st) of the next month following the month in which
the selection occurred, and the department shall send a new enrollment notice
identifying the selected health plan.
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