1. (a) Each Issuer shall send a Medi-Cal Property Exemption Report (rev. 12/93) at least Quarterly to each Policy or Certificate holder for whom any benefit payments were made since the last Medi-Cal Property Exemption report. Each Medi-Cal Property Exemption report shall include the dollar amounts of benefits paid by the Policy or Certificate for the Policy or Certificate holder in the following order and for the periods specified:

   1. (1) the cumulative amount of benefits paid prior to the current reporting period that counted towards the Medi-Cal Property Exemption;
   2. (2) the amount paid during the current reporting period regardless of qualification for the Medi-Cal Property Exemption;
   3. (3) the amount paid during the current reporting period that counts towards the Medi-Cal Property Exemption; and
   4. (4) the total cumulative amount paid to date that counts towards the Medi-Cal Property Exemption (i.e., the amounts reported in (1)+(3)). This amount should be clearly indicated with a label “Medi-Cal Property Exemption To Date”.
   5. (5) the remaining benefit amount.

2. (b) The Medi-Cal Property Exemption report shall also include the following statement in bold type:

   “This report provides you with a total amount of insurance payments, to date, which count towards the Medi-Cal Property Exemption for purposes of being eligible for the State of California's Medicaid (Medi-Cal) program. Please examine this report and carefully compare your current asset total with the amount indicated in this report with the label “Medi-Cal Property Exemption To Date.” If your Property Exemption level is close to the amount of the assets you currently have, you may be eligible for the Medi-Cal program. It is your responsibility to make application to the County (usually the Department of Social Services); at the time of your application, a determination will be made whether and when you are eligible. (Please note: contact the appropriate County department regarding other exemptions of assets in addition to the Property level listed above.)”

Note: Authority cited: Section 22009(a), Welfare and Institutions Code. Reference: Sections 22004, 22005, and 22006, Welfare and Institutions Code.

History

1. New section filed 8-30-93 as an emergency; operative 8-30-93 (Register 93, No. 36). Submitted for printing only pursuant to section 22009, Welfare and Institutions Code.

2. Certificate of Compliance as to 8-30-93 order, including amendment of subsection (a), transmitted to OAL 12-30-93 and filed 1-28-94 (Register 94, No. 4).

3. New subsection (a)(5) filed 10-1-98 as an emergency; operative 10-1-98. Submitted to OAL for printing only pursuant to Welfare and Institutions Code section 22009(d) (Register 98, No. 41). A Certificate of Compliance must be transmitted to OAL by 1-29-99 or emergency language will be repealed by operation of law on the following day.

4. Certificate of Compliance as to 10-1-98 order transmitted to OAL 1-28-99 and filed 3-15-99 (Register 99, No. 12).