Page 85

Title 5: Centrally Administered Programs Page 76 Iowa Department of Human Services Employees’ Manual Chapter E: Healthy and Well Kids in Iowa (hawk-i) Premiums and Copayments July 3, 2009 Premiums The third-party administrator is responsible for: ♦ Calculating premiums, ♦ Issuing premium payment coupons or monthly billing statements to the family, ♦ Tracking the status of the premium payments, and ♦ Mailing a reminder notice to the family if the premium is not received by the due date. Premiums may be submitted in the form of cash, personal checks, or money orders. All premium payments are deposited into an interest-bearing account maintained by the Department for periodic transmission of the funds and any accrued interest to the hawk-i trust fund in accordance with state accounting procedures. Premiums on Initial Applications When an initial application is approved and the family will owe a premium, the first month for which a premium will be due is the third month following the month in which the approval letter is dated. An “initial application” is defined as any application that is not considered an annual renewal. Notify the health and dental plan of the enrollment upon approval.

Mrs. T applies for hawk-i for her two children. The application is received on April 12. The children are not currently covered by hawk-i. Mrs. T’s application is approved with a premium on May 2. Coverage for the children begins May 1, the first day following the month in which the application was received. The first month for which Mrs. T will owe a premium is August. The premium will be due on July 10. Premium Due Dates All premiums must be postmarked no later than the last day of the month before the month of coverage. Failure to pay the premium by the last day of the month before the month of coverage shall result in disenrollment.