Enrollment of Uninsured Children up to Age Eighteen Above 250 Percent of the FPL (Related Group. The Contractor agrees to make coverage available to uninsured children under eighteen years of age with income above 250 percent of the Federal poverty level, at a monthly premium rate (payable by the family) not to exceed the full community rated non-group premium for the defined benefit package, as described later in this chapter. The Contractor may not require evidence of insurability; however, it may restrict enrollment to: • The open enrollment period; and • Households that have not voluntarily dropped insurance coverage within the previous twelve (12) months, or voluntarily declined coverage through their employer within the previous twelve (12) months, and who sign a sworn affidavit to that effect .and provide supporting documentation as specified by EOHHS.
Enrollment of Uninsured Children up to Age Eighteen Above 250 Percent of the FPL (Related Group. The Contractor agrees to make coverage available to uninsured children under eighteen years of age with income above 250 percent of the Federal poverty level, at a monthly premium rate (payable by the family) not to exceed the full community rated non-group premium for the defined benefit package, as described later in this chapter. The Contractor may not require evidence of insurability; however, it may restrict enrollment to: • The open enrollment period; and • Households that have not voluntarily dropped insurance coverage within the previous twelve (12) months, or voluntarily declined coverage through their employer within the previous twelve (12) months, and who sign a sworn affidavit to that effect .and provide supporting documentation as specified by EOHHS. The Contractor agrees to offer a conversion option (payable by the member) to members who lose their eligibility. The Contractor will have written policies and procedures for enrolling all members covered under this Agreement, that are consistent with the procedures used for enrolling its commercial and employer-sponsored enrollees. The Contractor may restrict enrollment to all affected individuals within a family, if more than one person is losing eligibility including family members in a Related Group.
