R382-10-19. Quarterly Premiums

  (1) Each family with children enrolled in the CHIP program must pay a quarterly premium based on the countable income of the family during the first month of the quarter.

  (a) The eligibility agency may not charge a premium to a child who is American Indian or Alaska Native.

  (b) A family with countable income up to 150% of the federal poverty level must pay a quarterly premium of $30.

  (c) A family with countable income greater than 150% and up to 200% of the federal poverty level must pay a quarterly premium of $75.

  (d) The agency shall charge the family the lowest premium amount when the family has two or more children, and those children qualify for different quarterly premium amounts.

  (2) The eligibility agency shall end CHIP coverage and assess a $15 late fee to a family who does not pay its quarterly premium by the premium due date.

  (3) The agency may reinstate coverage if the family pays the premium and the late fee by the last day of the month immediately following the termination.

  (4) A child is ineligible for CHIP for three months if CHIP is terminated for failure to pay the quarterly premium. The child must reapply at the end of the three months. If eligible, the agency shall approve eligibility without payment of the past due premiums or late fee.

  (5) The eligibility agency may not charge the household a premium during a due process month associated with the periodic eligibility review.

  (6) The eligibility agency shall assess premiums that are payable each quarter for each month of eligibility.