37.79.503    ENROLLMENT

(1) The HMK coverage group will accept without restriction eligible applicants in the order in which they are received for enrollment until the maximum enrollment, at which time eligible applicants will be put on a waiting list and will be enrolled when spaces become available. Applicants come off the waiting list and are enrolled based on the date they were determined eligible.

(2) Except for a newborn child, a child's HMK enrollment begins the later of:

(a) the first day of the month an application is received so long as the child is determined to meet all eligibility criteria;

(b) the first day of the month the family reports a new child, who meets all HMK eligibility criteria, joined the family;

(c) the first day of the month after an insurance delay period has ended; or

(d) the month funding is sufficient to enroll the applicant from the waiting list.

(3) A newborn will be enrolled effective:

(a) the date of birth when the child's birth is reported during the birth month;

(b) the date of birth when the birth is reported the following month, but within ten days of birth;

(c) if not reported within ten days, the first of the month the child's birth is reported; or

(d) the month funding is sufficient to enroll the applicant from the waiting list.

(4) The HMK coverage group will:

(a) provide each enrollee with a handbook of information about the program including a summary of benefits; and

(b) issue an appropriate identification card to each enrollee.

(5) For presumptively eligible children, enrollment begins the date the qualified entity (QE) determines eligibility and may not exceed two consecutive calendar months in a 12-month period.

(a) The QE will give the enrollee a copy of the signed presumptive eligibility (PE) determination to verify PE for service providers during the enrollment period.

History: 53-4-1004, 53-4-1009, 53-4-1105, MCA; IMP, 53-4-1003, 53-4-1004, 53-4-1007, 53-4-1009, 53-4-1103, 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, 2011 MAR p. 70, Eff. 1/1/11; AMD, 2013 MAR p. 214, Eff. 2/15/13.