Ariz. Admin. Code § R9-31-1419 - Premium Payment during the Appeal and Request for Hearing Process
A. Discontinuance
of eligibility. To receive coverage from the time an appeal and request for
hearing is filed for a discontinuance of eligibility until a Director's
decision is made.
1. A member shall:
a. File an appeal and request for hearing
prior to the effective date of the discontinuance.
b. Submit the full monthly premium amount to
the Administration prior to the date of the discontinuance, and
c. Continue to pay the full monthly premium
amount each month during the hearing process.
2. Failure of the member to pay the full
premium shall result in the loss of eligibility effective the first of the next
month.
3. If the decision is
upheld, the Administration shall not refund any premium amounts that have been
paid during the hearing process.
B. Increase in premium amount. To stop the
Administration from increasing the premium amount from the time an appeal and
request for hearing is filed until a Director's decision is made.
1. A member shall file an appeal and request
for hearing prior to the effective date of the action. The member shall pay the
lower premium amount until the decision is made.
2. If the decision to increase the premium is
upheld, the member shall be responsible for paying the higher premium
retroactively from the proposed effective date of the increase in the premium
amount that is being appealed.
C. Imposition of a premium. To receive
coverage from the time an appeal and request for hearing is filed for an
imposition of a premium until a Director's decision is made.
1. A member shall file an appeal and request
for hearing in accordance with the time-frame as specified in
R9-34-107.
2. A member shall pay
the premium as billed by the Administration.
3. If the decision determines the imposition
of the premium is incorrect then the premium will be refunded to the
member.
D. Method of
payment. To continue coverage a member shall pay the premium by:
1. Cashier's check,
2. Money order, or
3. Other form approved by the Administration.
Notes
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