N.J. Admin. Code 155 app I

Current through Register Vol. 54, No. 7, April 4, 2022

Examples of Catastrophic Illness in Children Relief Fund Program +
The examples below illustrate the extent to which the Fund would assist three
families with different income levels.
FAMILY #1 (with income of $ 30,000)
Family income:................................................... $ 30,000
Eligibility Standard (Exceeding 10% of income): ................. 3,000
Amount of Eligible Medical Expenses not Covered by Insurance:.... 15,000
Family Responsibility (Exceeding 10% of Eligibility Standard):... 300
Amount of Fund's Financial Assistance to Family: ................ 14,700
Amount for which Family remains responsible: .................... 300
FAMILY #2 (with income of $ 80,000)
Family income:................................................... $ 80,000
Eligibility Standard (Exceeding 10% of income): ................. 8,000
Amount of Eligible Medical Expenses not Covered by Insurance:.... 15,000
Family Responsibility (Exceeding 10% of Eligibility Standard):... 800
Amount of Fund's Financial Assistance to Family: ................ 14,200
Amount for which Family remains responsible: .................... 800
FAMILY #3 (with income of $ 120,000)
Family income:................................................... $ 120,000
Eligibility Standard:............................................ 13,000
Exceeding 10% of the first $ 100,000 or 10,000
Exceeding 15% of the excess over $ 100,000 or 3,000
Amount of Eligible Medical Expenses not Covered by Insurance:.... 15,000
Family Responsibility (Exceeding 10% of Eligibility Standard):... 1,300
Amount of Fund's Financial Assistance to Family: ................ 13,700
Amount for which Family remains responsible: .................... 1,300
+ Assuming: an annual $ 100,000 cap; adequate monies available in Fund
obviating need for additional restrictions and cost-sharing; and none of the
cases are in the "special" category.

Notes

N.J. Admin. Code 155 app I
Amended by R.1990 d.619, effective 12/17/1990.
See: 22 New Jersey Register 2669(b), 22 New Jersey Register 3754(a).
All examples deleted; new examples added.
Amended by R.1993 d.438, effective 9/7/1993.
See: 25 New Jersey Register 2169(a), 25 New Jersey Register 4128(a).
Amended by R.1998 d.504, effective 10/19/1998.
See: 30 New Jersey Register 2562(a), 30 New Jersey Register 3837(a).
Substituted references to Eligibility Standards for references to Family Income and changed dollar amounts throughout.
Amended by R.1999 d.354, effective 10/18/1999.
See: 31 New Jersey Register 2164(a), 31 New Jersey Register 3090(a).
Rewrote the appendix.

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