Iowa Admin. Code r. 441-86.7

Current through Register Vol. 47, No. 11, December 11, 2024

Rule 441-86.7 - Cancellation

The child's eligibility for the hawki program shall be canceled before the end of the 12-month enrollment period for any of the following:

(1)Child moves from the service area. Rescinded lAB 1/13/10, effective 3/1/10.

(2)Age. The child shall be canceled from the hawki program as of the first day of the month following the month in which the child attained the age of 19.

(3)Nonpayment of premiums. The child shall be canceled from the program as of the first day of the month in which premiums are not paid in accordance with the provisions of subrules 86.8(3) and 86.8(5), unless premiums are subsequently received in accordance with the grace period provisions of subrule 86.8(4).

(4)Iowa residence abandoned. The child shall be canceled from the program as of the first day of the month following the month in which the child relocated to another state. Eligibility shall not be canceled when the child is temporarily absent from the state in accordance with the provisions of 441-subrule 75.10(2).

(5)Eligible for Medicaid. The child shall be canceled from the program as of the first day of the month following the month in which Medicaid eligibility is obtained. If there are months during which the child is covered by both the Medicaid and hawki programs, the hawki program shall be the primary payor and Medicaid shall be the payor of last resort.

(6)Enrolled in other health insurance coverage. The child shall be canceled from the program as of the first day of the month following the month in which the department is notified that the child has other health insurance coverage. If there are months during which the child is covered by both another insurance plan and the hawki program, the other insurance plan shall be the primary payor and hawki shall be the payor of last resort.

(7)Admission to a public institution. The child shall be canceled from the program if the child is in a public institution at the time of the annual review.

(8)Admission to an institution for mental disease. The child shall be canceled from the program if the child is a patient in an institution for mental disease at the time of annual review.

(9)Employment with the state of Iowa. The child shall be canceled from the hawki program as of the first day of the month in which the child's parent became eligible to participate in a health or dental plan available to state of Iowa employees.

Iowa Admin. Code r. 441-86.7

ARC 8478B, IAB 1/13/10, effective 3/1/10; ARC 9083B, IAB 9/22/10, effective 9/1/10; ARC 0837C, IAB 7/24/2013, effective 10/1/2013

Amended by IAB November 20, 2019/Volume XLII, Number 11, effective 12/25/2019

Amended by IAB August 12, 2020/Volume XLIII, Number 4, effective 12/1/2020