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request, even if the individual is not lawfully present at the time the plan receives the enrollment request.

CMS uses its systems of records, which include data from SSA systems, as the primary resource for determining lawful presence status. • If an individual provides evidence of their lawful presence status to the plan, it may not consider it when determining eligibility for enrollment. • If an individual has evidence of their lawful presence status and there is a dispute over their status, the plan should refer the individual to SSA to have their status reviewed and adjusted by: o Calling SSA’s toll-free number, 1-800-772-1213. TTY users should call 1-800- 325-0778 weekdays from 8:00 a.m. to 7:00 p.m. local time. o Going to their local SSA field office. A beneficiary can get addresses and directions to SSA field offices from the Social Security Office Locator which is available at: http://www.ssa.gov/locator/. • The plan may not request any documentation of U.S. citizenship or alien status.

20.5 – Completion of Enrollment Request 42 CFR §§ 422.50(a)(5) and 423.32

An individual (or their authorized representative, as described in § 50.1) must complete an enrollment request to enroll in a plan, even if switching among plans offered by the same organization. To make an election, the individual must: • Complete an enrollment request; • Provide required information to the organization within the required time frames; • Submit the completed request to the organization during a valid enrollment period.

This is required for all enrollments, unless otherwise specified in regulation or in this guidance. CMS considers an enrollment request to have been completed by the individual if they accept the offer of an enrollment initiated by CMS, the state, the employer, or the MAO, as outlined in § 40.

Individuals may use any of the enrollment mechanisms offered by the organization to make their enrollment request. See § 40.1 for more information on the types of enrollment mechanisms allowed.

20.6 – Agreeing to Abide by Plan Rules 42 CFR § 422.50(a)(6)

To be eligible to enroll in a plan, it is our expectation that an individual would be fully informed of the plan’s rules and agree to abide by them. This agreement would occur during the enrollment process and is made through the completion of the enrollment request. “Fully informed” means that the plan provides the individual with the applicable rules of the plan, as described in § 50.9 and any requirements outlined in 42 CFR §§ 422 and 423, Subpart V. It is our expectation that a plan would deny enrollment to any individual who does not agree to abide by the rules of the organization.