Changes in Your Income or Household Size. If You Enrolled in Child Health Plus Coverage through NY State of Health (Marketplace) website: You may request that we review your family premium contribution whenever your income or household size changes. You may request a review by logging into your NY State of Health account or by calling the NY State of Health help line at 0-000-000-0000. If your child has been continuously enrolled with Fidelis prior to the NY State of Health Marketplace (2013): You may request that we review your family premium contribution whenever your income or household size changes. You may request a review by calling us at 0-000-XXXXXXX (1-888- 000-0000) or by calling the Child Health Plus Hotline at 0-000-000-0000. At that time, we will provide you with the form and documentation necessary to conduct the review. We will re- evaluate your family premium contribution and notify you of the results within ten (10) business days of receipt of the request and documentation necessary to conduct the review. If the review results in a change in your family premium contribution, we will apply that change no later than forty (40) days from receipt of the review request and supporting documentation.
Appears in 4 contracts
Samples: Health Plus Subscriber Contract, Health Plus Subscriber Contract, Health Plus Subscriber Contract
