Sec. R9-22-1705 - Guaranteed Enrollment Period

ยง R9-22-1705. Guaranteed Enrollment Period

A. General. Except for members enrolled with IHS or CMDP, the Administration shall provide a guaranteed enrollment period for a one-time period that begins on the effective date of the member's initial enrollment with a contractor and ends on the last day of the fifth full calendar month after the date of the member's initial enrollment.

B. Exceptions to guaranteed period. The Administration shall not grant a guaranteed enrollment period or shall terminate a guaranteed enrollment period as provided in subsection (C), if the member:

1. Did not meet the conditions of eligibility when initially enrolled with the contractor;

2. Except as provided in 9 A.A.C. 22, Article 12, is an inmate of a public institution as defined in 42 CFR 435.1010;

3. Dies;

4. Moves out-of-state;

5. Voluntarily withdraws from the AHCCCS program;

6. Is adopted; or

7. Has whereabouts that are unknown.

C. Disenrollment effective date. The Administration shall terminate any guaranteed enrollment period to which the member is not entitled effective on:

1. The date the member is admitted to a public institution under subsection (B);

2. The member's date of death;

3. The last day of the month in which the Administration receives notification that a member moved out-of-state;

4. The date the Administration receives written notification of the member's voluntary withdrawal from the AHCCCS program;

5. The last day of the month in which the Administration receives notification that a member's adoption proceedings are finalized; or

6. The last day of the month in which the Administration receives notification that a member's whereabouts are unknown.

D. Retroactive adjustments. The Administration shall adjust the member's eligibility and enrollment retroactively under subsection (C).

(New Section made by final rulemaking at 14 A.A.R. 1598, effective May 31, 2008 (Supp. 08-2).)

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