Section 182-558-0060 - PPP for a client with a qualified employer-sponsored group health insurance plan(1)General rule. Under section 1906A of the Social Security Act, the agency pays an eligible person's premium assistance subsidy and other cost-sharing obligations when the agency determines it is cost-effective as defined in WAC 182-558-0020.(2)Eligible persons. An eligible person is: (a) A client under age nineteen who is: (i) Covered under a qualified employer-sponsored group health insurance plan as defined in WAC 182-558-0020;(ii) Receiving benefits under: (A) Alternative benefits plan coverage;(B) Categorically needy coverage; or(C) Medically needy coverage.(b) The parent of the client in (a) of this subsection, if: (i) Enrollment in the health plan depends on a parent's enrollment; and(ii) The client is a dependent of the parents.(3)Cost-sharing benefit. The premium payment program (PPP) may provide cost-sharing reimbursement to nonmedicaid-eligible parents for medicaid-covered services under this section.Wash. Admin. Code § 182-558-0060
Adopted by WSR 17-03-014, Filed 1/5/2017, effective 3/1/2017Amended by WSR 19-11-129, Filed 5/22/2019, effective 6/22/2019Amended by WSR 24-02-019, Filed 12/21/2023, effective 3/1/2024