10- 144 C.M.R. ch. 103, § V-5.2

Current through 2024-51, December 18, 2024
Section 144-103-V-5.2 - Changes In Circumstances That Affect Payment Of Premiums

Recipients are required to report changes in circumstances that may affect payment of a premium. If changes in circumstances that would have resulted in payment of a premium are not reported timely, past due premiums must be paid in order for coverage to continue or be reinstated.

Example: The income of a recipient increases from <100% of the poverty guidelines to 135% of the guideline. The increase is received on August 25th but the information is not reported to the Department. The Department learns of the increase in income and notifies the individual of fee requirements with a 12 day notice ending October 18th. The recipient is eligible for "transition" Program coverage in November only if s/he pays a premium for October that would have been required if the change hand been reported timely. Since the change was not reported timely, the first month in which the premium is due is determined by allowing for the 12 day notice from the date the change occurred (increased income was received).

10- 144 C.M.R. ch. 103, § V-5.2