Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 370 - STATE CHILDREN'S HEALTH INSURANCE PROGRAM
Subchapter C - ENROLLMENT, RENEWAL, DISENROLLMENT, AND COST SHARING
Division 1 - ENROLLMENT AND DISENROLLMENT
Section 370.301 - CHIP Enrollment Packet

Universal Citation: 1 TX Admin Code § 370.301

Current through Reg. 49, No. 38; September 20, 2024

(a) HHSC or its designee will conduct enrollment and disenrollment activities.

(b) Within 5 business days of determining a child is CHIP eligible, HHSC's designee must send the applicant a CHIP enrollment packet containing:

(1) an explanation of CHIP benefits;

(2) information about the value-added services provided by MCOs;

(3) an enrollment form and instructions for completing the form;

(4) information on how to obtain a provider directory for each MCO available in the applicant's service area;

(5) a CHIP member guide;

(6) cost-sharing information specific to the household's percentage of the Federal Poverty Level (FPL) income, which includes:

(A) the enrollment fee, if any;

(B) a schedule of co-payments, if any; and

(7) the process for requesting review of an action;

(8) information specifying the earliest date coverage can begin and the latest date the completed enrollment form must be received by HHSC or its designee to ensure enrollment on the first day of the appropriate month; and

(9) information summarizing the importance of appropriate MCO, primary care provider (PCP), and dental home choices.

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