211.15 Good Cause for Non-Payment of MEAD Premiums SR 13-35 Dated 10/13

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Good cause for non-payment of premiums, as determined by OMBP, exists when an individual has exhausted all available resources with which to pay his or her premium because the individual:

. experiences a temporary or unexpected loss of income for at least 3 months;

. incurs an unexpected out-of-pocket medical expense; or

. experiences a hardship due to:

- the loss of the home;

- costs associated with a fire or flood;

- unexpected high heating bills that result in a 25% increase over the annual cost;

- significant car repairs totaling 25% of the individual's gross monthly income; or

- the need to replace a refrigerator or stove.

References: He-C 5003, He-W 841.03, RSA 167:3-i, RSA 167:3-c,XII, RSA 167:6,IX, 42 CFR 435.914, 42 USC 1396a(a)(10)(A)(ii)(XV)