10 Colo. Code Regs. § 2505-3-410
Current through Register Vol. 47, No. 18, September 25, 2024
Section 10 CCR 2505-3-410 - SELECTION OF A MANAGED CARE ORGANIZATION410.1A. Once eligibility has been determined, an eligible person shall have the opportunity to select a participating MCO in the county of the eligible person's residence. If there is only one participating MCO available in the county of the eligible person's residence, the eligible person shall be enrolled in that MCO.B. In the event the Department contracts with an MCO to provide dental services to Children's Basic Health Plan enrollees, an enrollee automatically will be enrolled with such MCO. No separate MCO election will be required.410.2 MCO SELECTION A. Upon determination of eligibility for the Children's Basic Health Plan program, if the eligible person has notified the Department or its designee of his/her chosen MCO prior to the last business day of the month in which eligibility was determined, the Department or its designee shall enroll the eligible person in that MCO.B. Upon determination of eligibility for the Children's Basic Health Plan program, if the eligible person has not chosen an MCO, the Department or its designee shall enroll the eligible person in an MCO selected by the Department or its designee. In areas of the state where there is only one participating MCO available, the Department or its designee shall select that MCO and enroll the eligible person.C. The Department or its designee shall notify the enrollee of the MCO selected. If the enrollee wants to change MCOs, the enrollee shall contact the Department or its designee within 90 days from the effective date of the MCO enrollment. An enrollee may also change a pending MCO enrollment before the effective date.D. For renewal applications, the Department or its designee shall reassign the eligible person to the participating MCO the applicant approved for the previous enrollment period. If the eligible person wishes to change MCO enrollment, he/she shall notify the Department or its designee within his/her re-enrollment period.410.3 In counties in which a participating MCO as defined in section 50.14.A is not available, the eligible person shall be enrolled in an MCO as defined in section 50.14.B.410.4 Once an enrollee has selected an MCO or upon expiration of the timeframe to change, the enrollee shall remain enrolled in that MCO for the remainder of his/her eligibility period, unless the eligible person meets any of the disenrollment criteria set forth in section 440.410.5 An eligible person shall have an opportunity to change to a different MCO serving the eligible person's geographic region, if one is available, during the applicant's annual redetermination period.38 CR 11, June 10, 2015, effective 7/1/201540 CR 03, February 10, 2017, effective 3/2/201740 CR 17, September 10, 2017, effective 9/30/201740 CR 19, October 10, 2017, effective 10/30/201741 CR 19, October 10, 2018, effective 10/30/201842 CR 18, October 10, 2019, effective 10/1/201942 CR 23, December 10, 2019, effective 12/30/201943 CR 11, June 10, 2020, effective 5/8/202043 CR 17, September 10, 2020, effective 9/4/202044 CR 01, January 10, 2021, effective 12/11/202044 CR 17, September 10, 2021, effective 8/9/202144 CR 23, December 10, 2021, effective 11/12/202145 CR 03, February 10, 2022, effective 3/10/202245 CR 07, April 10, 2022, effective 3/11/202245 CR 11, June 10, 2022, effective 6/30/202245 CR 15, August 10, 2022, effective 7/8/202245 CR 22, November 25, 2022, effective 10/14/202245 CR 19, October 10, 2022, effective 10/30/202246 CR 06, March 25, 2023, effective 2/10/202346 CR 07, April 10, 2023, effective 4/30/202346 CR 11, June 10, 2023, effective 5/12/202346 CR 19, October 10, 2023, effective 10/30/2023