§ 40-8.7-7. Premiums.
(a) The department of human services is authorized and directed to promulgate such rules
to establish the monthly premium payments for employed individuals with disabilities
who opt to participate directly in the Medicaid buy-in program. To participate in
the Medicaid buy-in program, the employed individual with disabilities shall be required
to make payment for coverage in accordance with a monthly payment or payment formula
to be established by the department that shall count a portion of the individual's
or couple's earned income on a sliding-scale basis, in accordance with rules to be
established by the d
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§ 40-8.7-7. Premiums.
(a) The department of human services is authorized and directed to promulgate such rules
to establish the monthly premium payments for employed individuals with disabilities
who opt to participate directly in the Medicaid buy-in program. To participate in
the Medicaid buy-in program, the employed individual with disabilities shall be required
to make payment for coverage in accordance with a monthly payment or payment formula
to be established by the department that shall count a portion of the individual's
or couple's earned income on a sliding-scale basis, in accordance with rules to be
established by the department.
(b) The department is further authorized and directed to promulgate such rules to encourage
businesses to hire individuals with disabilities, and to allow employed individuals
with disabilities who have access to employer-based health insurance and who are determined
eligible by the department pursuant to this chapter to coordinate health insurance
coverage options.
(c) The department of human services, in consultation with the health insurance commissioner,
employer and disability advocacy organizations, shall, by June 30, 2012, investigate,
develop, and promulgate rules that may:
(1) Require enrollment in the employer-based health insurance plan as a condition of participation
in the Medicaid buy-in program under this chapter, provided that enrollment in the
employer-based health insurance plan is cost-effective and its benefits are comparable
to the benefits provided by the Medicaid program. Enrollment of the individual and/or
the family in the employer-based health insurance plan without regard to any enrollment
season restrictions, subject to Centers for Medicare and Medicaid Services approval;
or
(2) Provide opportunities for employers to buy into the Medicaid Buy-in program, at the
employer's expense, where the employer's premium contribution shall be no greater
than the employer's premiums in the existing employer-based health insurance or before
September 30, 2012.