Page 2127

West Virginia Income Maintenance Manual Chapter 26

West Virginia Income Maintenance Manual Page 3 Chapter 26 Medicaid Work Incentive (M-WIN)

outside the sheltered workshop setting. Individuals employed through a sheltered workshop contract working on an outside contract are paid at or above the federal minimum wage and are engaged in competitive employment alongside others without disabilities. 26.2.5 ENROLLMENT FEE AND PREMIUM PAYMENT Each eligible applicant must pay a $50 enrollment fee. Once the assistance group (AG) is approved, an ongoing monthly premium payment will be required. Upon payment of the enrollment fee, the first month’s premium is waived. In the following months, the client must make the premium payment by the premium due date for continued enrollment. Except in the case of agency error, the enrollment fee must be paid each time the client loses coverage under this program for any reason. This includes, but is not limited to, non-payment of the monthly premium, failure to complete a redetermination of eligibility, or voluntary disenrollment. When an enrollment fee payment is returned for insufficient funds, this is considered as non-payment. 26.2.5.A Enrollment Fee 26.2.5.A.1 Notification After eligibility is established, the applicant is notified that he meets all program requirements, except payment of the enrollment fee. The notice includes the following information: • The amount of the enrollment fee • The requirement that the enrollment fee must be received within 60 days of the date of the notice or the application will be denied • The amount of the ongoing monthly premium • Instructions to mail a check or money order for the enrollment fee made payable to the State of West Virginia with the enclosed enrollment fee payment stub to: West Virginia Department of Human Services (DOHS)