12VAC30-130-760: Notices

An adequate notice consistent with 42 CFR 431.210 shall be provided to the recipient, person carrying the group health plan policy or responsible person in the case under the following circumstances:

1. To inform the household of the decision on cost effectiveness and premium payment.

2. To inform the household that premium payments are being discontinued because Medicaid eligibility has been lost by all persons covered under the group health plan.

3. To inform the household that premium payments are being discontinued because the group health plan is no longer available to the family (e.g., the employer drops insurance coverage or the plan is terminated by the insurance company).

4. To inform the household that premium payments are being discontinued because DMAS has determined it is no longer cost effective to pay the premiums.