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Title 5: Centrally Administered Programs Page 81 Iowa Department of Human Services Employees’ Manual Chapter E: Healthy and Well Kids in Iowa (hawk-i) Case Maintenance July 3, 2009 Change in Health and Dental Plan Change in Health and Dental Plan If more than one plan is available in the county in which the child resides at the time of the annual review of eligibility, the child may be enrolled in another plan. The plan choice may be designated verbally or in writing. Form 470-3574, Selection of Plan, may be used for this purpose. The child remains enrolled in the current plan if the family does not notify the third-party administrator, either verbally or in writing, of a new plan choice by the end of the current 12-month enrollment period. hawk-i Enrollee Appears Eligible for Medicaid At the time of the annual review, if it appears the child may be eligible for Medicaid with the exception of meeting a spenddown under the Medically Needy program, make a referral to the Department for a determination of Medicaid eligibility. However, the child remains eligible for the hawk-i program pending the Medicaid eligibility determination unless the 12-month certification period expires first. Disenrollment Legal reference: 441 IAC 86.7, Iowa Code 514I A child may be disenrolled from the selected plan before the end of the 12-month enrollment period for any of the following reasons: ♦ Child moves from the service area ♦ Child turns age 19 ♦ Nonpayment of premiums ♦ Moving out of the state ♦ Eligible for Medicaid ♦ Enrolled in other health insurance coverage ♦ Admission to a nonmedical public institution ♦ Admission to an institution for mental disease ♦ Employment with the state of Iowa