Authority: IC 12-15-44.5-9

Affected: IC 12-15-44.5

Sec. 1. (a) An applicant seeking coverage under the plan shall submit an application on the form approved or accepted by the office.

(b) An application may be submitted through:

1. (1) the division;
2. (2) a designated enrollment center;
3. (3) an online method determined by the division; or
4. (4) the federal marketplace.

(c) The following individuals may sign an application:

1. (1) The applicant.
2. (2) The applicant's next of kin.
3. (3) The applicant's authorized representative.

(d) An enrollment broker may assist plan applicants in choosing a managed care organization.

(e) The office shall assign an applicant to a managed care organization if:

1. (1) such applicant does not choose a managed care organization on the application; or
2. (2) the applicant is within his or her current benefit period and not otherwise eligible to change managed care organizations in accordance with 405 IAC 10-8-2.

(f) A designated enrollment center that completes initial intake processing for an applicant shall forward the completed application and all required documentation materials to the division.

(g) The date of application shall be determined as follows:

1. (1) In the case of an application filed with the division, the date a signed application is received by the division.
2. (2) In the case of an application filed at a designated enrollment center, the date a signed application is received by the designated enrollment center.
3. (3) In the case of an application filed via the federal marketplace, the date provided to the state by the federal marketplace.

(h) If an applicant fails or refuses to provide information or verification of information required to determine the applicant's eligibility for the plan, the applicant shall be ineligible and the division shall deny the application. Prior to denying an application under this section, the division shall provide the applicant written notice of the specific information or verification needed to determine eligibility. The division shall deny an application if the information or verification is not received by the division within thirteen (13) calendar days of the date of the notice. If a deadline falls on a weekend or holiday, the deadline for receiving the information shall be the next business day.

(i) The division shall send an eligibility determination notice to the applicant within forty-five (45) days of the date of the application.

(Office of the Secretary of Family and Social Services; 405 IAC 10-3-1; filed May 18, 2015, 12:34 p.m.: 20150617-IR-405140339FRA; filed Jan 19, 2018, 8:42 a.m.: 20180214-IR-405170484FRA; filed Mar 18, 2019, 2:27 p.m.: 20190417-IR-405180371FRA; readopted filed Oct 16, 2024, 11:20 a.m.: 20241113-IR-405230817RFA)