Indiana Code 12-15-44.5-4.9. Eligibility period; renewal; unused share of health care account distribution
(b) If an individual chooses to renew participation in the plan, the individual is subject to an annual renewal process at the end of the benefit period to determine continued eligibility for participating in the plan. If the individual does not complete the renewal process, the individual may not reenroll in the plan for at least six (6) months.
Terms Used In Indiana Code 12-15-44.5-4.9
- Month: means a calendar month, unless otherwise expressed. See Indiana Code 1-1-4-5
- plan: refers to the healthy Indiana plan established by section 3 of this chapter. See Indiana Code 12-15-44.5-2
- preventative care services: means care that is provided to an individual to prevent disease, diagnose disease, or promote good health. See Indiana Code 12-15-44.5-2.3
- Year: means a calendar year, unless otherwise expressed. See Indiana Code 1-1-4-5
(d) For individuals participating in the plan who, in the past, did not make consistent payments into the individual’s health care account while participating in the plan, but:
(1) had a balance remaining in the individual’s health care account; and
(2) received all of the required preventative care services;
the office may elect to offer a discount on the individual’s required payments to the individual’s health care account for the subsequent benefit year. The amount of the discount under this subsection must be related to the percentage of the health care account balance at the end of the plan year but not to exceed a fifty percent (50%) discount of the required contribution.
(e) If an individual is no longer eligible for the plan, does not renew participation in the plan at the end of the plan period, or is terminated from the plan for nonpayment of a required payment, the office shall, not more than one hundred twenty (120) days after the last date of the plan benefit period, refund to the individual the amount determined under subsection (f) of any funds remaining in the individual’s health care account as follows:
(1) An individual who is no longer eligible for the plan or does not renew participation in the plan at the end of the plan period shall receive the amount determined under STEP FOUR of subsection (f).
(2) An individual who is terminated from the plan due to nonpayment of a required payment shall receive the amount determined under STEP SIX of subsection (f).
The office may charge a penalty for any voluntary withdrawals from the health care account by the individual before the end of the plan benefit year. The individual may receive the amount determined under STEP SIX of subsection (f).
(f) The office shall determine the amount payable to an individual described in subsection (e) as follows:
STEP ONE: Determine the total amount paid into the individual’s health care account under this chapter.
STEP TWO: Determine the total amount paid into the individual’s health care account from all sources.
STEP THREE: Divide STEP ONE by STEP TWO.
STEP FOUR: Multiply the ratio determined in STEP THREE by the total amount remaining in the individual’s health care account.
STEP FIVE: Subtract any nonpayments of a required payment.
STEP SIX: Multiply the amount determined under STEP FIVE by at least seventy-five hundredths (0.75).
As added by P.L.30-2016, SEC.32. Amended by P.L.114-2018, SEC.6.