§17-1731-4 - Benefits.

§17-1731-4 Benefits.

         (a) The department shall, upon presentation of an invoice by a qualified health plan to the department, pay the share of premium that the eligible individual is required to pay to the qualified health plan to receive coverage.

         (b) Benefit limitations:

(1) The department shall pay an eligible individual's share of premium to the qualified health plan only upon receipt of an invoice submitted by the qualified health plan to the department;
(2) The department shall not make any payments directly to eligible individuals; and
(3) The department shall not pay and the eligible individual shall be responsible for, any cost-sharing including, but not limited to, deductibles, co-payments or coinsurance.

         (c) The department is not responsible for ensuring that the qualified health plan timely submits an invoice for an eligible individual's share of premium to the department.

        [Eff 02/27/15 ] (Auth: HRS §346-14) (Imp: HRS §346-14)

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