410 SELECTION OF A MANAGED CARE ORGANIZATION

410.1 A. Once eligibility has been determined, an eligible person shall have the opportunity to select a participating MCO in the county of the eligible person’s residence. If there is only one participating MCO available in the county of the eligible person’s residence, the eligible person shall be enrolled in that MCO. B. In the event the Department contracts with an MCO to provide dental services to Children’s Basic Health Plan enrollees, an enrollee automatically will be enrolled with such MCO. No separate MCO election will be required. 410.2 MCO SELECTION A. Upon determination of eligibility for the Children’s Basic Health Plan program, if the eligible person has notified the Department or its designee of his/her chosen MCO prior to the last business day of the month in which eligibility was determined, the Department or its designee shall enroll the eligible person in that MCO. B. Upon determination of eligibility for the Children’s Basic Health Plan program, if the eligible person has not chosen an MCO, the Department or its designee shall enroll the eligible person in an MCO selected by the Department or its designee. In areas of the state where there is only one participating MCO available, the Department or its designee shall select that MCO and enroll the eligible person. C. The Department or its designee shall notify the enrollee of the MCO selected. If the enrollee wants to change MCOs, the enrollee shall contact the Department or its designee within 90 days from the effective date of the MCO enrollment. An enrollee may also change a pending MCO enrollment before the effective date. D. For renewal applications, the Department or its designee shall reassign the eligible person to the participating MCO the applicant approved for the previous enrollment period. If the eligible person wishes to change MCO enrollment, he/she shall notify the Department or its designee within his/her re-enrollment period. 410.3 In counties in which a participating MCO as defined in section 50.14.A is not available, the eligible person shall be enrolled in an MCO as defined in section 50.14.B. 410.4 Once an enrollee has selected an MCO or upon expiration of the timeframe to change, the enrollee shall remain enrolled in that MCO for the remainder of his/her eligibility period, unless the eligible person meets any of the disenrollment criteria set forth in section 440. 410.5 An eligible person shall have an opportunity to change to a different MCO serving the eligible person’s geographic region, if one is available, during the applicant’s annual redetermination period.