California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 2 - Eligibility, Application, and Enrollment › Section 2699.6611 - Disenrollment

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A subscriber
				shall be disenrolled from participation in the program if any of the following
				occur:
(1) The subscriber is found by the
				program to no longer be eligible during the annual eligibility review
				period.
(2) The Board has made a
				finding pursuant to Section
				2699.6603(b) and
				subscriber children are disenrolled from the program at Annual Eligibility
				Review. Each subscriber child disenrolled pursuant to Section
				2699.6603(b)
				shall be placed on the waiting list and the subscriber child's effective date
				on the waiting list shall be his or her disenrollment date.
(3) The subscriber child attains the age of
				19. A subscriber child who attains the age of 19 will not be disenrolled from
				the program if he or she applies to the program pursuant to Section
				2699.6600 and is determined to be
				eligible for the program as a subscriber parent pursuant to Section
				2699.6607 before his or her
				effective date of disenrollment.
(4) A subscriber is determined by the program
				to not be a citizen, non-citizen national, or a qualified alien eligible to
				participate in the program or fails to provide documentation required pursuant
				to Subsection
				2699.6600(c)(1)(T)
				within the required time period.
(5) The applicant fails to pay the required
				family contribution for the subscriber for two (2) consecutive calendar
				months.
(6) The applicant so
				requests in writing on behalf of himself or herself or on behalf of another
				subscriber for whom he or she applied.
(7) The applicant has intentionally made
				false declarations in order to establish program eligibility for any
				person.
(8) The applicant fails to
				provide the necessary information for the subscriber to be
				requalified.
(9) Death of a
				subscriber.
(10) The child through
				whom the subscriber parent became eligible as a child-linked adult as defined
				in Section
				2699.6500 is no longer enrolled in
				no-cost Medi-Cal and has not enrolled in the program.
(11) The child through whom the subscriber
				parent became eligible as a child-linked adult as defined in Section
				2699.6500 did not enroll in
				no-cost Medi-Cal, or the program, and the subscriber parent has no other
				children enrolled in the program or no-cost Medi-Cal.
(12) The child through whom the subscriber
				parent became eligible as a child-linked adult as defined in Section
				2699.6500 attains the age of 19
				and the subscriber parent has no other children enrolled in the program or no
				cost Medi-Cal.
(13) The child
				through whom the subscriber parent became eligible as a child-linked adult as
				defined in Section
				2699.6500 no longer lives with the
				subscriber parent and another adult with whom the child now lives applies and
				is found eligible for enrollment as a child-linked adult through the same
				child.
(14) The child through whom
				the subscriber parent became eligible as a child-linked adult as defined in
				Section 2699.6500 is no longer enrolled in
				the program, and the subscriber parent has no other children enrolled in the
				program or no-cost Medi-Cal.