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Effective: December 1, 2006 |
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25.10.25ar1 - MA-EPD Good Cause for Nonpayment (Archive) |
Archived: March 2007 |
The Special Recovery Unit (SRU) at DHS is responsible for good cause determinations involving MA-EPD premium non-payments or late payments. The good cause decision is based on the guidelines listed in Four-Month Penalty.
Refer clients who are unable to pay the premium by the due date or wish to claim good cause to DHS SRU. SRU may be contacted either:
l By phone at 1-800-657-3762 or (651) 296-6607.
l The client or financial worker may submit a written request to:
DHS Special Recovery Unit,
444 Lafayette Road,
St. Paul, MN 55155-3863.
l Fax to (651) 282-6744.
The written request should include:
l The client’s legal name.
l PMI number.
l Mailing address.
l Phone number.
l Reason for requesting good cause.
l Supporting documentation.
SRU will provide the client with written notice of the decision within 30 days. Clients may appeal a finding that good cause does not exist.
SRU contacts the worker by sending either or both of the following:
l A copy of the approval letter.
l A MAXIS email.
SRU will notify the worker of whether the premium payment is made or not.
Enrollees who have been granted good cause and set up a payment plan will continue to appear on the MA-EPD Overdue Premiums Report.
l A finding of good cause does not relieve the client’s obligation to pay the premium.
l Do not close these enrollees for late payment unless instructed to do so by DHS.
l If the client later pays the premium in full, reinstate coverage back to the date of closure.