Authority: IC 12-15-44.5-9

Affected: IC 12-15-44.5

Sec. 7. (a) For purposes of this section, "debt" means amounts that accrue as a result of:

1. (1) a managed care organization's advance payment of the member's portion of the deductible as provided under 405 IAC 10-9-5(a)(1) that has not been repaid through the member's POWER account contributions; or
2. (2) any nonsufficient funds check charges resulting from a member's payments to a managed care organization as a result of payment processing.

(b) A member's debt under subsection (a)(1) shall be calculated as follows:

1. (1) Divide the member's annual POWER account contribution amount by two thousand five hundred dollars ($2,500).
2. (2) Multiply the amount of claims paid up to two thousand five hundred dollars ($2,500) during the benefit period by the amount determined in subdivision (1).
3. (3) Subtract the total monthly individual contributions paid by the member during the benefit period by the amount determined under subdivision (2).

(c) A member's debt under this section shall not exceed the sum of the unpaid monthly contributions that accrued during the months in which the member received HIP Plus coverage.

(d) If a member has debt, the managed care organization may collect from the individual.

(Office of the Secretary of Family and Social Services; 405 IAC 10-10-7; filed May 18, 2015, 12:34 p.m.: 20150617-IR-405140339FRA; filed Jan 19, 2018, 8:42 a.m.: 20180214-IR-405170484FRA; filed Mar 18, 2019, 2:27 p.m.: 20190417-IR-405180371FRA; readopted filed Oct 16, 2024, 11:20 a.m.: 20241113-IR-405230817RFA)