| (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
(C) information about the cost-sharing cap;
(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.
|
| Source Note: The provisions of this §370.301 adopted to be effective September 1, 2003, 28 TexReg 7337; amended to be effective January 1, 2006, 30 TexReg 8666; amended to be effective March 1, 2012, 37 TexReg 1301; amended to be effective July 8, 2012, 37 TexReg 4854; amended to be effective January 1, 2014, 38 TexReg 9477 |
