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UNOFFICIAL 1720.1-7 §17-1720.1-18 Change of a health plan for an individual prior to the annual plan change period. (a) Except for changes made by a newly eligible individual during the fifteen (15) or sixty (60) calendar days grace periods, an enrolled individual shall only be allowed to change enrollment from one health plan to another during the annual plan change period. (b) Exceptions to (a) can occur for cause, which include the following circumstances: (1) A decision from an administrative appeals office allowing participating health plan change; (2) A court order allowing participating health plan change; (3) Provisions in federal or State statutes or administrative rules; (4) A non-returning plan or termination of the individual’s health plan’s contract or the start of a new contract; (5) Mutual agreement by the participating health plans involved, the enrolled individual and the department; (6) Violations by a participating health plan specified in chapter 17-1735.2; (7) Change in foster placement if necessary for the best interest of the child; (8) The individual’s PCP or long-term care residential facility is not in the health plan’s provider network and is in the provider network of a different participating health plan provided the health plan is not at its maximum enrollment; (9) The individual is eligible to receive HCBS or personal assistance services level I and is enrolled in a health plan with a waiting list for HCBS or personal assistance services level I and another health plan does not have a waiting list for the necessary service(s);