While You Are in AIM

How You May Be Disenrolled

You will be disenrolled for the below reasons:

1. You write to the AIM Program and ask that your coverage be cancelled. If you ask on or after the first day you are enrolled in AIM, you will still have to pay the 1.5% cost.
2. You no longer live in California. You must write to the AIM Program within 30 days to notify AIM of this move.
3. You commit fraud against the AIM Program. This would also include giving false information on your application
4. You are no longer pregnant on your effective date of coverage. In this case, your AIM coverage will not begin. You must notify AIM within 30 days of the end of your pregnancy. If notification to the program is received after the effective date of coverage, documentation by a licensed or certified health care professional showing the end date of your pregnancy must be submitted. You may use the Early End of Pregnancy Form here or you may send a letter as long as it contains the same information.
5. You will be disenrolled 60 days after the end of your pregnancy. You need to notify the AIM Program within 30 days from the end of your pregnancy. The AIM Program cannot cover any medical services you receive after the 60^th day from the end of your pregnancy.

The AIM Program will inform you of the disenrollment and the reason. If you are disenrolled for reasons 1-3 above, your AIM coverage will end at the end of the calendar month in which the request was received or at the end of a future calendar month as requested. You are still responsible for paying all of your subscriber contribution if you are disenrolled for reasons 1, 2, 3, and 5 above. Once you are disenrolled from the AIM Program, you cannot re-enroll for the same pregnancy.

Eligibility Appeals

If you disagree with a decision that the AIM Program has made regarding your eligibility, disenrollment or transfer you may appeal to the Executive Director. Your appeal must be in writing and submitted to the address provided below within sixty (60) calendar days following your receipt of a denial letter. An appeal shall include all of the following:

1. A statement specifically describing the issues which are disputed.
2. A statement of the resolution requested.
3. Any other relevant information. This includes copies of the denial letter and all the documentation submitted with the AIM application (except for the payment).

Mail your appeal to:

Executive Director
AIM Program
P.O. Box 15559
Sacramento, CA 95852-0559

Disability Access

Physical Access
Applying for AIM is done through the mail with follow up by phone. However, our office in Folsom is fully accessible to our disabled clients to pick up applications or drop off completed applications only.

Access for the Hearing-Impaired
The hearing-impaired may contact one of our AIM
eligibility specialists by calling our TTY number:
1-800-735-2929.

Access for the Vision-Impaired
This application will be made available in alternate formats for the vision-impaired. Large print formats are available. Our AIM eligibility specialists are available by phone to explain all aspects of AIM eligibility and enrollment to the visually impaired.

Americans with Disabilities Act
Section 504 of the Rehabilitation Act of 1973 states that no qualified disabled person shall, on the basis of disability, be excluded from participation in, be denied the benefits of, or otherwise be subjected to discrimination under any program or activity which receives or benefits from Federal financial assistance.

The Americans with Disabilities Act of 1990 prohibits the Managed Risk Medical Insurance Board and its contractors from discriminating on the basis of disability, protects its applicants and enrollees with disabilities in program services, and requires the Board to make reasonable accommodations to applicants and enrollees.

Disability Access Grievances
If you believe the AIM Program has failed to respond to your disability access needs, you may file a complaint or grievance with the ADA Coordinator at the Managed Risk Medical Insurance Board at the following address:

ADA Coordinator
Managed Risk Medical Insurance Board
P.O. Box 2769
Sacramento, CA 95812-2769
(916) 324-4695 (Voice)
1-800-735-2929 (California Relay Service for the hearing-impaired)

NOTE: to employers, insurance agents, brokers and potential subscribers regarding employer-based health insurance and the AIM Program:

It is against the law for an employer to take away a pregnant woman’s maternity insurance and offer her AIM health coverage instead. It is also illegal for an employer to charge an employee more money or make changes to the woman’s maternity insurance, so that the woman enrolls into AIM.

California law states that it is an unfair labor practice for an employer to refer or arrange for an individual employee or their dependent to apply for the AIM Program for the purpose of separating that employee or their dependent from employer-based group health coverage. This provision is enforceable under Section 95 of the California Labor Code and will result in employer penalties.

California law further states that it is an unfair labor practice for any employer to change the employee-employer share-of-cost ratio or to make any other modification of maternity care coverage for employees or employees’ dependents that results in the enrollment of the employees or employees’ dependents in the AIM Program. This provision is enforceable under Section 95 of the California Labor Code and will result in employer penalties.

California law also states that it is unfair competition for an insurance agent or broker or administrator to refer or arrange an individual employee or their dependent to apply for the AIM Program for the purpose of separating that employee or their dependent from employer-based group health coverage. California state law states that an employee shall have a personal right of action to enforce this provision.