Section 53926.5 - Information to New Members(a) Each eligible beneficiary, prior to or upon either signing an enrollment application or being assigned to GMC plans in accordance with Section 53921.5, shall be informed in writing by the department or the GMC enrollment contractor of at least the following:(1) There will be a 15 to 45 day processing time between the date of application and the effective date of enrollment in GMC plans.(2) Until GMC plan enrollment is effective, the beneficiary may receive Medi-Cal covered health care services from any Medi-Cal provider licensed to provide the services.(3) An alternative to GMC plan enrollment exists.(4) Disenrollment from certain GMC plans, specified in Section 53925.5, is restricted during the second through sixth month of enrollment.(b) Each GMC plan shall provide in writing, in addition to those items of information required by Section 14406, Welfare and Institutions Code, the following to each member within seven days after the effective date of enrollment in the plan: (1) The effective date of enrollment.(2) A description of all available services and an explanation of any service limitations, exclusions from coverage or charges for services, when applicable.(3) The name, telephone number and service site address of the primary care provider selected by the member or instructions to select a primary care provider within thirty days or be assigned to one, in accordance with Section 53925.(4) An enrollment/disenrollment form and an explanation that it must be used to disenroll from the GMC plan, in the event disenrollment is requested by the member.(5) Information concerning non-medical transportation available to them under the Medi-Cal program, or offered by the GMC plan, if applicable, and how to receive it.Cal. Code Regs. Tit. 22, § 53926.5
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: Sections 14089, 14406 and 14407.6, 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).