Section 522.001 - Massachusetts Insurance Connection for Individuals with AIDS or HIV (Closed to New Applicants)(A)Introduction. The Massachusetts Insurance Connection (MIC) is a health insurance buy-in program administered by the MassHealth agency for individuals with Acquired Immune Deficiency Syndrome (AIDS) or human immunodeficiency virus (HIV). MIC is closed to new applicants effective January 1, 2020. Program participants may continue to receive benefits through MIC for as long as they meet the requirements of 130 CMR 522.001(B).(B)Eligibility Requirements. The MassHealth agency may pay the monthly private and group health insurance premiums of a program participant (and his or her spouse and dependent children, provided that the program participant (1) was enrolled in the MIC program as of December 31, 2019, and remains continuously enrolled in the MIC program (continuous enrollment ends when a program participant has not been enrolled in the MIC program for six months);(2) had a health insurance policy (group or private) before becoming eligible for the MIC program (individuals who elect to continue employer-based group health insurance are subject to the provisions of the Omnibus Budget Reconciliation Act of 1990 (OBRA) and the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), P.L. 99-272) that (a) has comprehensive coverage, as determined by the MassHealth agency on an individual basis; and(b) requires premium payments that do not exceed the average monthly cost incurred by the MassHealth agency for the care of an individual with AIDS or HIV;(3) has a diagnosis of AIDS or HIV;(4) applies for and meets the Social Security Administration's definition of disability for AIDS or HIV;(5) is a resident of Massachusetts;(6) in conjunction with his or her spouse and dependent children, has a gross annual income that does not exceed 300% of the annualized federal poverty level income standard for a household of that size; and(7) is not eligible for a MassHealth coverage type that provides or pays for comprehensive benefits.(C)Verifications. Applicants must have submitted the following verifications to the MIC program coordinator within 45 days of the receipt of the application by the MassHealth agency: (1) a written statement of a diagnosis of AIDS or HIV by the examining licensed physician;(2) documentation of receipt of social security disability benefits or SSI; and(3) documentation of gross annual income.(D)Redetermination of Eligibility. The MassHealth agency completes a redetermination of eligibility for each program participant on an annual basis, or as needed.(E)Termination of Benefits. (1) When a program participant no longer meets one or more of the conditions in 130 CMR 522.001(B), the MassHealth agency terminates premium payments for that program participant effective on the next premium payment due date. However, the following exceptions apply: (a) in the event of the death of a qualified individual who has coverage under a family plan, payment for the continuation of the existing plan will not exceed a period of three months following his or her death; and(b) if a qualified individual relocates to another state, he or she will be afforded one additional premium payment after relocation to cover the transition period.(2) The MassHealth agency sends written notice to program participants of the termination of premium payments, the reason for the termination, and the individual's right to appeal such termination in accordance with the provisions of 130 CMR 610.000: MassHealth: Fair Hearing Rules.Amended by Mass Register Issue 1352, eff. 11/17/2017.Amended by Mass Register Issue 1407, eff. 1/1/2020.