R414-320-16. Benefits

  (1) The UPP program shall provide cash reimbursement to enrollees.

  (2) The reimbursement may not exceed the amount that the enrollee pays toward the cost of the employer-sponsored health plan, employer-sponsored plans selected through UHE, or COBRA continuation coverage.

  (3) The UPP program may reimburse an adult up to $150 each month.

  (4) The UPP program may reimburse a child up to $120 each month for medical coverage. The UPP program will pay the child an additional $20 if the child elects to enroll in employer-sponsored dental coverage.

  (a) When the employer-sponsored insurance does not include dental benefits, a child may receive cash reimbursement up to $120 for the medical insurance cost and may receive dental-only benefits through CHIP.

  (b) When the employer also offers employer-sponsored dental coverage, the applicant may choose to enroll a child in the employer-sponsored dental coverage, in which case, the UPP program will pay the child an additional $20. The enrollee may also choose to only enroll the child in the employer-sponsored health insurance and UPP, and not enroll the child in the employer-sponsored dental coverage, in which case the child may receive dental-only benefits through CHIP.