For Premium-HI, the grace period for paying premiums extends to the end of the third
month in which premiums have not been paid.
When an enrollee is billed monthly, the premium should be paid by the due date shown
on the initial billing notice (the 25th of the month). If the payment is not received
by that date, a second notice will be sent to the enrollee. This notice will include
two months of premiums, (the current premium liability and the liability from last
month"s billing notice). If 60 days has elapsed and a payment has not been received,
a delinquent notice will be sent. This notice will include three months" premiums,
the premium liability for the current month"s billing notice and the amount due from
the last billing notice. This notice will not include a termination date at this time.
If after 90 days, the initial premium liability has not been paid, the enrollee will
receive a second delinquent notice. This notice will now include the premium liability
for the current month, the amount due from the last billing notice, and a termination
date.
It is important to note that when a billing notice is sent to an enrollee, a receivable
balance is established by the direct billing system. When the receivable balance is
90 days old, the direct billing system triggers a termination. The aging of the receivable
balance is the key factor to the termination of the grace period. To avoid termination,
at least one month"s liability or that portion of the premium liability that is 90
days old must be paid.
Example:
Mr. Jones was sent a delinquent notice early in 12/98 for $1418.00. The termination
date field indicated that the hospital and medical insurance would end on 12/31/98.
To protect Mr. Jones' Part A and B coverage for one month, Mr. Jones would have to
pay at least $354.50. This would reduce the Part A to 927.00 and the Part B to 136.50.
Another delinquent notice would be sent to Mr. Jones in January, 1999 reflecting a
termination date of 01/31/99.