Section 210-RICR-30-05-3.22 - Cooperation RequirementsA. All Medicaid applicants and beneficiaries must cooperate with the non-financial requirements for eligibility as follows: 1. Information - All individuals and families are required to provide information about other health coverage (TPL) and/or access to ESI when applying for initial or continuing eligibility. The required information relating specifically to access to ESI includes, but is not limited to: a. The names of any family members in the household currently covered by, or with access to, ESI;b. The name of the policy holder and the employer offering the ESI; andc. Verification of monthly enrollment costs via a paycheck stub if the policy holder is currently enrolled or, if available, enrollment information provided by the employer indicating the policy holder's monthly premium for the appropriate family composition.2. RIte Share participation - Medicaid beneficiaries required to enroll in the ESI must cooperate as follows: a. Enroll in the ESI in the manner, and within the timelines, established by EOHHS. Failure to do so will result in the termination of Medicaid for any eligible parents/caretaker age nineteen (19) and older in the family. The eligibility of any other Medicaid beneficiaries in a family must not be terminated as the result of the refusal of an otherwise ineligible policy holder to enroll in the ESI. See § 3.20 of this Part.b. Submit verification of enrollment in accordance with § 3.19 of this Part when the employer does not participate in RIte Share.c. Provide reports to EOHHS indicating any changes in enrollment status of Medicaid-eligible family members, enrollment costs, household composition, employment, income, residence, and access to ESI within ten (10) days from the date the change occurs.d. Pay buy-in amounts - Individuals subject to the buy-in requirements must cooperate in making monthly buy-in payments in accordance with § 3.7 of this Part to remain enrolled in ESI. Failure to make a required premium payment, without good cause, as specified in § 3.23 of this Part, results in disenrollment from the RIte Share Premium Assistance Program and loss of ESI premium coverage.210 R.I. Code R. 210-RICR-30-05-3.22
Amended effective 8/6/2019