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3.1.8 Notice of Determination of Eligibility A. Once an application is completed and the required verifications are performed, eligibility for Medicaid and other forms of affordable coverage is made for each member of the household. (For information on other forms of affordable coverage, see www.HealthSourceRI.com or call HSRI at 1-855-840-4774). B. Household members determined Medicaid-eligible may enroll immediately in the health plan of choice. A formal notice will be generated after the determination indicating which household members are eligible for Medicaid or other forms of affordable coverage, the legal basis for the determination of eligibility, and the plan in which each household member is enrolled, if applicable. The notice will be sent via the applicant’s secure online account if opting to receive agency communications in such a manner or by mail in a reasonable time period. A “reasonable time” period usually will not exceed ten (10) business days, but in no instance will it extend beyond the thirty (30) day application period. C. The notice must also advise the applicant of the right to appeal and request a hearing, in accordance with Part 10-05-2 of this Title. 3.1.9 Agency and Applicant Roles and Responsibilities A. The State and applicants have shared and distinct responsibilities in the application process. 1. Medicaid agency – Under current State and Federal laws, the Medicaid State Agency is required to: a. Assist applicants in completing all necessary forms. b. Provide applicants with an interpreter or translator services upon request. c. Assure all information applicants provide is kept confidential unless otherwise authorized to share with other State and Federal agencies for the purposes of verification and enrollment. d. Make timely determinations of eligibility in accordance with applicable laws and Regulations. e. Accept appeals and hold hearings on agency actions related to eligibility decisions in accordance with Part 10-05-2 of this Title. f. Provide a mechanism for beneficiaries to voluntarily withdraw eligibility for Medicaid health coverage at any time by submitting a written request via the U.S. Mail or fax to the EOHHS or DHS agency or an HSRI representative.