Health Care Renewal Notice Page 9
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46Bulletin #14-21-05
December 23, 2014
Page 9
B. Pre-populated Renewal Forms
Eligibility workers should see the ONEsource procedure “Process MA and
MinnesotaCare Renewals in the New Eligibility System” for more information and
instructions for processing pre-populated renewal forms. For enrollees who switch
programs at renewal, MA and MinnesotaCare managed care enrollment follows the
current procedures.
V. Legal Authorities
Code of Federal Regulations, title 42, chapter IV, subchapter C, part 435, subpart D,
section 340
Code of Federal Regulations, title 42, chapter IV, subchapter C, part 435, subpart J, section
916
Minnesota Statutes, section 256B.056
Minnesota Statutes, section 256L.05, subdivision 3(a)
VI. Attachments
Attachment A: Health Care Renewal Notice with Information Summary
Attachment B: Health Care Renewal Notice with Renewal Form
Attachment C: Manual Notice: Processed and Program Continuation
Attachment D: Manual Notice: Renewal Change Notice—Medical Assistance
Attachment E: Manual Notice: Renewal Change Notice—MinnesotaCare
Attachment F: Manual Notice: Processed and Program Closing
VII. Americans with Disabilities Act (ADA) Advisory
This information is available in accessible formats for people with disabilities by calling
(651) 431-2283 (voice) or toll free at (888) 938-3224 or by using your preferred relay
service. For other information on disability rights and protections, contact the agency’s ADA
coordinator.
Minnesota Department of Human Services · PO Box 64238 · St. Paul, MN 55164-0238
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