(1) The HMK coverage group eligibility terminates immediately upon:

(a) death of the enrollee; or

(b) incarceration of the enrollee.

(2) The HMK coverage group eligibility terminates at the end of the month the department becomes aware:

(a) the enrollee attains the age of 19 years;

(b) the enrollee is a beneficiary of other creditable health insurance;

(c) the enrollee is determined eligible for HMK Plus;

(d) the enrollee wishes to disenroll;

(e) the enrollee moves out of Montana;

(f) the enrollee has moved without providing a new address and the department is unable to locate the enrollee; or

(g) information requested by the department to redetermine eligibility has not been received.

(3) Termination of eligibility, based on insufficient funding at the department may not be effective earlier than the end of the month notice of termination is given to the enrollee or the enrollee's parent or guardian. Disenrollment for provisions of (2), except for (2)(a), will be effective subject to ten-day notification per ARM 37.79.505.

(4) A parent or guardian is liable to the department and the department may collect from the parent or guardian the amount of actual payments to the TPA contractor or to providers for any benefits furnished to the enrollee because of an intentional misrepresentation or a failure to give notice of changes as required by this subchapter.

History: 53-4-1004, 53-4-1009, 53-4-1105, MCA; IMP, 53-4-1003, 53-4-1004, 53-4-1009, 53-4-1104, 53-4-1105, MCA; NEW, 2000 MAR p. 1221, Eff. 5/12/00; AMD, 2004 MAR p. 330, Eff. 2/13/04; AMD, 2008 MAR p. 49, Eff. 1/18/08; AMD, 2009 MAR p. 1673, Eff. 10/1/09; AMD, 2010 MAR p. 2217, Eff. 10/1/10; AMD, 2013 MAR p. 214, Eff. 2/15/13.