5101.5213 Monthly premium for buy-in program - default.
(A) An individual participating in the children’s buy-in program shall be charged a monthly premium established by rules adopted under section 5101.5215 of the Revised Code. The amount of the monthly premium shall not be less than the following:
(1) In the case of an individual with countable family income exceeding three hundred per cent but not exceeding four hundred per cent of the federal poverty guidelines, the following amount:
(a) If no other member of the individual’s family receives medical assistance under the program with the individual, one hundred dollars;
(b) If one or more members of the individual’s family receive medical assistance under the program with the individual, one hundred fifty dollars.
(2) In the case of an individual with countable family income exceeding four hundred per cent but not exceeding five hundred per cent of the federal poverty guidelines, the following amount:
(a) If no other member of the individual’s family receives medical assistance under the program with the individual, one hundred twenty-five dollars;
(b) If one or more members of the individual’s family receive medical assistance under the program with the individual, one hundred seventy-five dollars.
(3) In the case of an individual with countable family income exceeding five hundred per cent of the federal poverty guidelines, the full amount of the actuarially determined cost of the premium.
(B) If the premium for the children’s buy-in program is not paid for two consecutive months, the individual shall lose eligibility for the program. The individual may not resume participation in the program until the unpaid premiums that accrued before the individual lost eligibility are paid.
Amended by 128th General Assembly File No. 9, HB 1, § 101.01, eff. 10/16/2009.
5101.5213 Monthly premium for buy-in program - default.
(A) An individual participating in the children’s buy-in program shall be charged a monthly premium established by rules adopted under section 5101.5215 of the Revised Code. The amount of the monthly premium shall not be less than the following:
(1) In the case of an individual with countable family income exceeding three hundred per cent but not exceeding four hundred per cent of the federal poverty guidelines, the following amount:
(a) If no other member of the individual’s family receives medical assistance under the program with the individual, one hundred dollars;
(b) If one or more members of the individual’s family receive medical assistance under the program with the individual, one hundred fifty dollars.
(2) In the case of an individual with countable family income exceeding four hundred per cent but not exceeding five hundred per cent of the federal poverty guidelines, the following amount:
(a) If no other member of the individual’s family receives medical assistance under the program with the individual, one hundred twenty-five dollars;
(b) If one or more members of the individual’s family receive medical assistance under the program with the individual, one hundred seventy-five dollars.
(3) In the case of an individual with countable family income exceeding five hundred per cent of the federal poverty guidelines, the full amount of the actuarially determined cost of the premium.
(B) If the premium for the children’s buy-in program is not paid for two consecutive months, the individual shall lose eligibility for the program. The individual may not resume participation in the program until the unpaid premiums that accrued before the individual lost eligibility are paid.
Amended by 128th General Assembly File No. 9, HB 1, § 101.01, eff. 10/16/2009.
5101.5213 Monthly premium for buy-in program - default.
(A) An individual participating in the children’s buy-in program shall be charged a monthly premium established by rules adopted under section 5101.5215 of the Revised Code. The amount of the monthly premium shall not be less than the following:
(1) In the case of an individual with countable family income exceeding three hundred per cent but not exceeding four hundred per cent of the federal poverty guidelines, the following amount:
(a) If no other member of the individual’s family receives medical assistance under the program with the individual, one hundred dollars;
(b) If one or more members of the individual’s family receive medical assistance under the program with the individual, one hundred fifty dollars.
(2) In the case of an individual with countable family income exceeding four hundred per cent but not exceeding five hundred per cent of the federal poverty guidelines, the following amount:
(a) If no other member of the individual’s family receives medical assistance under the program with the individual, one hundred twenty-five dollars;
(b) If one or more members of the individual’s family receive medical assistance under the program with the individual, one hundred seventy-five dollars.
(3) In the case of an individual with countable family income exceeding five hundred per cent of the federal poverty guidelines, the full amount of the actuarially determined cost of the premium.
(B) If the premium for the children’s buy-in program is not paid for two consecutive months, the individual shall lose eligibility for the program. The individual may not resume participation in the program until the unpaid premiums that accrued before the individual lost eligibility are paid.
Amended by 128th General Assembly File No. 9, HB 1, § 101.01, eff. 10/16/2009.
