Connector releases extensive Administrative Bulletin

Submitted by Meg at CP on June 14, 2007 - 12:56pm.

Procedures for obtaining waivers, making appeals and changing plans have been established in a May 31st Administrative Bulletin released by the Connector. Enrollment and eligibility information for Commonwealth Care members and other important details have been clarified. This post addresses the hardship waiver process.

A premium hardship waiver is available to current and former Commonwealth Care members, as well as to new applicants whose premiums cause "extreme financial hardship" as defined by the Connector.

  • Waiver requests must be made first to the Connector call center
  • The call center will send out a waiver request form
  • Premium waivers or reductions may last for up to six months
  • Premium waivers or reductions may be applied to past due accounts
  • If an applicant pays the premium to enroll in a plan, and is later determined to meet waiver criteria, the premium will be refunded.

A co-pay hardship waiver is available to Commonwealth Care members enrolled in plans without premiums (for those under 150% of the federal poverty level). The process is the same as above, except that waivers or reductions will not be applied to past due co-pay costs.

Click here for the affordability schedule (PDF)
Click here for the premium waiver application (PDF)
Click here for the co-pay waiver application (PDF)

Does the 'affordability

Does the 'affordability schedule' mean that if a person cannot afford their employer-sponsored health plan because the premium is more than $35 per month (with an income between $15,316 and $20,420 for instance), they will not be subject to the tax penalties, and able to remain on UCP? If so, what is the mechanism for documenting this?

Documenting unaffordable

Thanks for your question. I'm checking into this, and will post information here when I learn the answer.

Meg

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