Tennessee § 71-5-708 Premium payments - Billing and payment of premiums

Tennessee Statutes

§ 71-5-708 — Premium payments - Billing and payment of premiums

(a)The director shall ensure, when determining the premium amount a person must pay for participation in the buy-in program, that:

(1)The bureau counts only the income of the person approved for the program, and does not count the income of another household member;

(2)For purposes of determining countable income to be used in the premium calculation, the bureau applies the following rules:

(A)Income is considered available and owned when it is:

(i)Received; and (ii) Can be used to meet the person's needs for food, clothing, and shelter; and (B) Certain receipts are not income as described in 20 C.F.R. § 416.1103 ;

(3)The buy-in program premium amount equals, rounded down to the nearest whole dollar, five percent (5%) of countable income described in subdivision (a)(2), including bot

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(a) The director shall ensure, when determining the premium amount a person must pay for participation in the buy-in program, that: (1) The bureau counts only the income of the person approved for the program, and does not count the income of another household member; (2) For purposes of determining countable income to be used in the premium calculation, the bureau applies the following rules: (A) Income is considered available and owned when it is: (i) Received; and (ii) Can be used to meet the person's needs for food, clothing, and shelter; and (B) Certain receipts are not income as described in 20 C.F.R. § 416.1103 ; (3) The buy-in program premium amount equals, rounded down to the nearest whole dollar, five percent (5%) of countable income described in subdivision (a)(2), including both earned and unearned income; (4) When determining the premium amount, the bureau uses the verified income amount until a change in income is reported and processed, unless good cause for delay in verifying changes exists; and (5) A change in the premium amount is effective the month after the change in income is reported to and processed by the bureau. (b) The director shall ensure, when billing for and processing payments of buy-in program premiums, that: (1) For current and ongoing coverage, the bureau bills for program premiums during the month following the benefit month; (2) The first monthly premium begins the first full month of coverage; (3) Pursuant to § 71-5-706(3) , the bureau may terminate program coverage if premiums are not paid in full for four (4) consecutive months; (4) The person must pay the monthly premium in full to avoid losing program coverage and, if a person makes a partial payment, the payment does not count as a full payment toward the premium; (5) Payments received are applied to premiums owed in the following order: (A) Past due months, beginning with the most delinquent month; and (B) The current coverage month that has been invoiced; and (6) A person must pay a premium for any month that program coverage is provided, including months when a redetermination of coverage is made, months when continued coverage is requested, and during the period of an aid-pending eligibility appeal.

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