Current through September, 2024
Section 17-1731-4 - Benefits(a) The department shall, upon presentation of an invoice by a qualified health plan to the department, pay the share of premium that the eligible individual is required to pay to the qualified health plan to receive coverage.(b) Benefit limitations: (1) The department shall pay an eligible individual's share of premium to the qualified health plan only upon receipt of an invoice submitted by the qualified health plan to the department;(2) The department shall not make any payments directly to eligible individuals; and(3) The department shall not pay and the eligible individual shall be responsible for, any cost-sharing including, but not limited to, deductibles, co-payments or coinsurance.(c) The department is not responsible for ensuring that the qualified health plan timely submits an invoice for an eligible individual's share of premium to the department. [2/27/2015] (Auth: HRS § 346-14) (Imp: HRS § 346-14)