Page 225

28.7 Reserved

This page last updated in Release Number: 23-02 Release Date: 04/17/2023 Effective Date: 04/1/2023 28.8 Reserved

This page last updated in Release Number: 22-01 Release Date: 04/04/2022 Effective Date: 04/04/2022 28.9 Reserved

This page last updated in Release Number: 22-01 Release Date: 04/04/2022 Effective Date: 04/04/2022 29.1 Notices A notice must be either mailed or sent electronically at least 10 days prior to the effective date of an adverse action, such as a termination of benefits or an increase in premium. 29.1.1 Notice Requirements Applicants and members must receive written notice of: • The decision on an application or renewal • Any action to extend current benefits • Any action to discontinue or suspend a member’s benefits • Any action that changes the form or amount of benefits 29.1.2 Notice of Approval Any notice of approval of eligibility must include: • The basis and effective date of eligibility and which individuals are eligible • The circumstances under which the individual must report and procedures for reporting any changes that may affect the individual's eligibility • If applicable, the amount of medical expenses that must be incurred to meet a deductible • If applicable, basic information on the level of benefits and services available based on the individual's eligibility, including: ◦ A description of any premiums and cost sharing required ◦ An explanation of how to receive additional detailed information on benefits and financial responsibilities ◦ An explanation of any right to appeal the eligibility status or level of benefits and services approved