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Title 5: Centrally Administered Programs Page 77 Iowa Department of Human Services Employees’ Manual Chapter E: Healthy and Well Kids in Iowa (hawk-i) Premiums and Copayments July 3, 2009 Premium Due Dates Families may choose to pay premiums in advance (e.g., on a quarterly or semiannual basis) rather than a monthly basis. Any premium balance will be refunded to the family if the case is closed before all premiums paid in advance being used. Also, refund any premium submitted on a closed case to the family. Failure to Pay Failure to pay a premium shall result in disenrollment from the health and dental plan and cancellation from the program unless the reinstatement provisions apply. Once a child is disenrolled and canceled from the program due to nonpayment of premiums, the family must reapply for coverage unless they are eligible for a grace period. Reinstatement A child may be reinstated once in a 12-month period when the family fails to pay a premium by the last day of the month before the month of coverage. The premium must be postmarked within the calendar month following the month of nonpayment and the premium must be paid in full before reinstatement.
1. The four children of Mr. and Mrs. B are enrolled in hawk-i. The Bs pay a monthly premium of $20. The Bs’ February premium, which is due January 10, is not postmarked by January 31. The children are disenrolled effective February 1. However, the premium is received on February 5. Since the enrollment for the Bs’ children has not previously been reinstated for a late premium during the current enrollment period, hawk-i coverage for the children is reinstated effective February 1. 2. Mrs. D’s child is enrolled in hawk-i. Mrs. D pays a monthly premium of $10. The May premium, which is due April 10, is not received by April 30. Mrs. D’s child is disenrolled effective May 1. However, the premium is received on June 2 showing a postmark of May 29. Since the premium payment is postmarked during the calendar month following the month of nonpayment, hawk-i coverage for Mrs. D’s child can be reinstated. This action is not counted towards the one- time grace period.