ACWDL 14-29: Interim Non-Payment of Premium (NPP) Processes for the Optional Targeted Low-Income Children Program (August 8, 2014)
DHCS issued guidelines for counties to proceed on discontinuing Optional Targeted Low-Income Children Program cases on the basis of non-payment of premiums (NPP). The counties have experienced a backlog of NPPs that should have been terminated. DHCS has determined that premium payment status is an eligibility condition, so there are no redetermination requirements unless there’s a reported change in circumstances.
For those on aid codes H3 and H5, NPPs will be sent a timely NOA and terminated accordingly. Beneficiaries must pay past-due premiums before termination to preserve eligibility. If a beneficiary pays past-due premiums after discontinuance but within 30 days, coverage can be reinstated without a break in coverage. After 30 days, the beneficiary will need to reapply. Those on aid code 5D will proceed similarly.
The letter includes sample discontinuance language for NOAs.