An individual who is competent and physically able to transact business must file the individual's own request for enrollment. The enrollment request must be filed during a prescribed enrollment period. See HI 00805.060.

An individual who is incompetent, or is competent but physically unable to apply for enrollment, may be enrolled by a legal guardian or representative payee, if the individual has one.

If there is no representative payee (e.g., the individual is a non-beneficiary), the person providing care and/or support may enroll the individual. If such person is unwilling or uninterested, some other relative or friend willing to assume responsibility for premium payments may file an enrollment request on behalf of the individual.

SMI premium notices are sent to the person who filed on behalf of the incompetent individual as long as the person has such individual in care or assumes responsibility for premium payment. When the person no longer has the SMI enrollee in care, the notices will be sent directly to the enrollee, unless another person applies to receive them.