Page 159

CODE OF COLORADO REGULATIONS 10 CCR 2505-10 8.100 Medical Services Board

159 i) The amount of premiums cannot exceed 7.5% of the individual’s income. ii) Premiums are charged beginning the month after determination of eligibility. Any premiums for the months prior to the determination of eligibility will be waived. iii) Premium amounts are as follows: 1) There is no monthly premium for individuals with income at or below 40% FPL. 2) A monthly premium of $25 is applied to individuals with income above 40% of FPL but at or below 133% of FPL. 3) A monthly premium of $90 is applied to individuals with income above 133% of FPL but at or below 200% of FPL. 4) A monthly premium of $130 is applied to individuals with income above 200% of FPL but at or below 300% of FPL. 5) A monthly premium of $200 is applied to individuals with income above 300% of FPL but at or below 450% of FPL. iv) The premium amounts will be updated at the beginning of each State fiscal year based on the annually revised FPL if the revised FPL would cause the premium amount (based on percentage of income) to increase by $10 or more. v) A change in a member’s net income may impact the monthly premium amount due. Failure to pay premium payments in full within 60 days from the premium due date will result in the member’s assistance being terminated prospectively. The effective date of the termination will be the last day of the month following the 60 days from the date on which the premium became past due. The Department will waive premiums for the Medicaid Buy-In for Working Adults with Disability Program for member’s who are within their 12 months postpartum period.

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Page 159

Official source

CODE OF COLORADO REGULATIONS 10 CCR 2505-10 8.100 Medical Services Board

159 i) The amount of premiums cannot exceed 7.5% of the individual’s income. ii) Premiums are charged beginning the month after determination of eligibility. Any premiums for the months prior to the determination of eligibility will be waived. iii) Premium amounts are as follows: 1) There is no monthly premium for individuals with income at or below 40% FPL. 2) A monthly premium of $25 is applied to individuals with income above 40% of FPL but at or below 133% of FPL. 3) A monthly premium of $90 is applied to individuals with income above 133% of FPL but at or below 200% of FPL. 4) A monthly premium of $130 is applied to individuals with income above 200% of FPL but at or below 300% of FPL. 5) A monthly premium of $200 is applied to individuals with income above 300% of FPL but at or below 450% of FPL. iv) The premium amounts will be updated at the beginning of each State fiscal year based on the annually revised FPL if the revised FPL would cause the premium amount (based on percentage of income) to increase by $10 or more. v) A change in a member’s net income may impact the monthly premium amount due. Failure to pay premium payments in full within 60 days from the premium due date will result in the member’s assistance being terminated prospectively. The effective date of the termination will be the last day of the month following the 60 days from the date on which the premium became past due. The Department will waive premiums for the Medicaid Buy-In for Working Adults with Disability Program for member’s who are within their 12 months postpartum period.