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2. Recertifications and Change of Circumstances ongoing cases:

When DHB notifies the local agency caseworker that the HCWD premium has been received:

a. Refer to NC FAST Job Aid: Forced Eligibility for Income Support Medical Assistance, Special Assistance & Cash Assistance.

b. Authorize eligibility for the month or months covered by the premium.

c. For ongoing cases, apply premium payments to the oldest unpaid month in the current certification period.

E. When The Premium Is Not Paid 1. Applications:

Upon receipt of notification from DHB that the a/b refused to pay the premium or failed to pay the premium:

a. Deny the application for failure to pay the premium and send the DHB-5147, HCWD Denial for Non-Payment of Premiums form.

b. Provide the coverage period and amount due for each month owed in the appropriate section of the DHB-5147 form.

c. Provide the caseworker’s name and contact information in the appropriate section of the DHB-5147 form.

d. If the enrollment fee has been paid, refund it.

2. Recertifications and Change of Circumstances for Ongoing Cases:

Upon receipt of notification from DHB that the a/b refused to pay the premium or failed to pay the premium:

a. Do not send a termination notice prior to the day after the payment is due.

b. Mail the DHB-5148, HCWD Termination for Non-Payment of Premium form, follow timely notice procedures found in MA-2420, Notice and Hearings policy. (1) Provide the coverage period and amount due for each month owed in the appropriate section of the termination Docusign Envelope ID: B8C63DC7-7367-4210-853E-B7B004802EE4