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Title 5: Centrally Administered Programs Page 74 Iowa Department of Human Services Employees’ Manual Chapter E: Healthy and Well Kids in Iowa (hawk-i) Approval of hawk-i Coverage Revised July 3, 2009 Enrollment Enrollment Legal reference: 441 IAC 86.13(9) Send a file of new hawk-i enrollees to the health and dental plans on a daily basis once the following occurs: ♦ The family makes its health and dental plan choices, or ♦ The family is randomly auto-enrolled in health and dental plans because the family failed to make a choice, or ♦ The family is automatically enrolled in a health and dental plan because only one health or dental plan covers the county where the family resides. Information Provided to Enrollees by Participating Plans Legal reference: 441 IAC 86.15(6)“c” The health and dental plans issue medical identification cards to the enrollees for use in securing covered services. The health plan also provides to each enrollee a current handbook that fully explains the services available, how and when to obtain them, and special factors applicable to the hawk-i enrollees. The handbook includes covered services, network providers, exclusions, emergency services procedures, a 24-hour toll free number for certification of services, a daytime number to call for assistance, appeal procedures, enrollee rights and responsibilities, and definitions of terms. Notice Requirements Legal reference: 441 IAC 86.11, Iowa Code 514I Provide the applicant an adequate written notice of the decision regarding the applicant’s eligibility for the hawk-i program. Notify the enrollee in writing of any decision that adversely affects the enrollee’s eligibility or the amount of benefits. The notice shall clearly explain the action being taken in regard to an application or an existing enrollment. Denial notices and cancellation notices shall clearly explain the appeal rights of the applicant or enrollee. All notices are available in English and Spanish.