Section 53924 - Enrollment/Disenrollment Form(a) The department shall develop a combined enrollment/disenrollment form and shall provide it to GMC plans and the GMC enrollment contractor.(b) Each GMC plan shall send an enrollment/disenrollment form to each member, as specified in Section 53926.5.(c) Each GMC plan shall make enrollment/disenrollment forms available during business hours: (1) At each service site. In the case of a GMC plan in which all primary care providers are the exclusive providers of that plan and are contiguously located, enrollment/disenrollment forms shall be available, at a minimum, in the member services department of the plan.(2) At each member services department.(d) Each GMC plan shall provide an enrollment/disenrollment form to a member immediately if requested in person, or by mail if requested by telephone or in writing. The GMC plan shall mail the form within three working days of receiving the request.(e) The GMC enrollment contractor shall make enrollment/disenrollment forms available at the GMC options presentation. The GMC enrollment contractor shall mail a form to a member within three working days of receiving a telephone or written request for a form.Cal. Code Regs. Tit. 22, § 53924
1. New section filed 3-11-94; operative 3-11-94; Submitted to OAL for printing only pursuant to section 147, SB 485 (Chapter 722, Statutes of 1992) (Register 94, No. 15). Note: Authority cited: Sections 10725, 14089.7, 14105, 14124.5, 14203 and 14312, Welfare and Institutions Code. Reference: Section 14089, Welfare and Institutions Code.
1. New section filed 3-11-94; operative 3-11-94; Submitted to OAL for printing only pursuant to section 147, SB 485 (Chapter 722, Statutes of 1992) (Register 94, No. 15).