reglab/statecodes huggingface dataset:
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1706 - INCOME TAX SETOFF PROGRAM › Section 17-1706-9 - Action on request for an administrative hearing

Current through June, 2024
(a) A
				request for an administrative hearing after an adverse informal review decision
				shall be received by the department within fourteen calendar days of the date
				of the written adverse informal decision. When an administrative hearing is
				requested due to an adverse informal review decision on a pretax setoff notice,
				the department shall not refer the name of the individual to DAGS as a debtor.
				The individual's name shall be referred to DAGS as a debtor only if the
				administrative appeals office renders a decision in favor of the department. A
				circuit court appeal shall not stay the referral.
(b) A request for an administrative hearing
				after a tax setoff notice shall be received by the department within thirty
				calendar days of the date of the tax setoff notice. When an administrative
				hearing is requested at the time of the tax setoff, the individual will receive
				that portion of their state tax refund that was setoff only after a decision
				favorable to the claimant has been rendered by the administrative appeals
				office.
(c) When an administrative
				hearing request is received by a unit other than ASO-recovery, the unit shall
				stamp the request with the date of receipt and immediately forward the hearing
				request to ASO-recovery.
(d) When
				an administrative hearing request is received by ASO-recovery, ASO-recovery
				shall:
(1) Stamp the request with the date of
				receipt if the request is initially received by ASO-recovery;
(2) Make one copy of the request and send the
				original request to the administrative appeals office if the request is
				initially received by ASO-recovery;
(3) Make copies of the account ledgers of all
				debts (to include financial, medical, and food stamp claims) for the identified
				debtor; and
(4) Forward the copy of
				the administrative hearing request and copies of the account ledgers to the
				respective division.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1706 - INCOME TAX SETOFF PROGRAM › Section 17-1706-10 - Department's responsibility

Current through June, 2024
(a) The Policy and
				Program Development Office (PPDO) of the Med-QUEST Division shall review all
				requests for fair hearing to assure that all facts are properly considered. If
				any basis for the grievance is found prior to the hearing, the PPDO office
				shall promptly take necessary corrective action.
(b) The PPDO office shall complete the branch
				report.
(c) The PPDO office shall
				remain in touch with the claimant and shall immediately notify the hearing
				officer of any change in address or circumstances which may affect the need for
				the hearing.
(d) The PPDO office
				shall represent the department in tax setoff hearings on Oahu branch. In all
				other branches, the supervisors of the unit in the geographic area nearest the
				debtor's residence shall be the department's representative at the tax setoff
				hearing, if a PPDO representative is not requested.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1706 - INCOME TAX SETOFF PROGRAM › Section 17-1706-11 - Responsibility of the administrative appeals office

Current through June, 2024
(a) The
				administrative appeals office shall accept:
(1) Any request directly at the
				administrative appeals office; and
(2) All requests cleared through the
				department.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1706 - INCOME TAX SETOFF PROGRAM › Section 17-1706-12 - Denial of request for administrative hearing

Current through June, 2024
(a) An
				administrative hearing shall not be granted by the department when the claimant
				has withdrawn the request in writing. Where the claimant verbally reports a
				desire to withdraw the administrative hearing request, the claimant shall be
				advised that the withdrawal shall be submitted in writing. If the claimant
				prefers, the department shall confirm the claimant's request to withdraw in
				writing to the claimant.
(b) An
				administrative hearing shall not be granted by the department when the
				department decides not to complete a tax setoff or refunds the tax setoff
				before a hearing is scheduled.
(c)
				An administrative hearing shall not be granted by the hearing officer when the
				claimant has abandoned the request. Abandonment occurs when the claimant or the
				authorized representative, without good cause, fails to appear at the
				administrative hearing scheduled for the claimant.
(1) The hearing officer shall send the
				claimant a letter stating that the appeal is considered abandoned unless there
				was good cause for the claimant's failure to appear. The claimant shall be
				notified that the request shall continue only if the claimant presents good
				cause for the failure to appear and contacts the agency within ten calendar
				days of the notice. If no reply is received within the ten calendar days, the
				administrative hearing request shall be considered abandoned. If the tenth day
				falls on a weekend or holiday, the tenth day shall then be the working day
				after the weekend or the holiday.
(2) Good cause may be established on the
				basis of one of the following factors:
(A)
				Death in the family;
(B) Personal
				injury or illness which reasonably prohibits the claimant from attending the
				administrative hearing; or
(C)
				Sudden and unexpected emergencies.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1706 - INCOME TAX SETOFF PROGRAM › Section 17-1706-13 - The administrative hearing

Current through June, 2024
(a) The
				administrative hearing shall include consideration of:
(1) Evidence received, including oral
				testimony and exhibits; and
(2)
				Proposed findings and exceptions.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1706 - INCOME TAX SETOFF PROGRAM › Section 17-1706-14 - Administrative hearing decision

Current through June, 2024
(a) All matters
				relating to the administrative hearing shall be heard and disposed of within
				one hundred twenty calendar days from the date of request for an administrative
				hearing except when the hearing is continued or the record is held open as
				specified in section 17-1706-13(f). The time limit shall be extended only for
				the period of the continuance.
(b)
				Unless the record is held open for additional documentary evidence, after
				closing the administrative hearing, the hearing officer shall prepare the
				decision in writing. The decision shall contain a statement concerning the
				claimant's right to judicial review, the reasons for the decision, the
				evidence, and the rules supporting the decision. A copy of the written decision
				shall be provided the claimant or the authorized representative and the
				department.
(c) The transcript,
				recording, or an official record containing the substance of the administrative
				hearing proceedings, together with all papers filed in the proceeding and the
				hearing officer's decision shall constitute the exclusive record and shall be
				maintained in the administrative appeals office. The record shall be made
				available to the claimant or the authorized representative during normal
				business hours through the administrative appeals office.
(d) The department shall comply with the
				administrative hearing decision immediately upon receipt of the decision.
(1) When the pretax setoff administrative
				hearing is favorable to the department, the department shall refer the
				claimant's name to the comptroller, department of accounting and general
				services, as a debtor. A circuit court appeal shall not stay the
				referral.
(2) When the tax setoff
				administrative hearing is in favor of the claimant, the claimant shall receive
				that portion of the claimant's state income tax refund that was
				setoff.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1706 - INCOME TAX SETOFF PROGRAM › Section 17-1706-15 - Appeal rights of the claimant

Current through June, 2024
The claimant may appeal an adverse administrative hearing
				  decision to the state circuit court. At the time of the hearing decision which
				  upholds the department's action, the claimant shall be notified of the right to
				  pursue judicial review with the circuit court.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.2 - STATE FUNDED HAWAII PREMIUM PLUS › Subchapter 1 - GENERAL PROVISIONS › Section 17-1709.2-1 - Purpose

Current through June, 2024
This chapter is established to authorize, subject to the
					 availability of state funding, a temporary state funded program to prevent,
					 shorten, or eliminate the need for medical assistance administered by the
					 department. Hawaii premium plus provides employers an incentive to increase
					 employment by providing a monthly premium subsidy for providing health coverage
					 to qualified employees for one year from the date of hire. At a minimum, the
					 health coverage shall be the prevailing benefits as required by the Hawaii
					 Prepaid Health Care Act.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.2 - STATE FUNDED HAWAII PREMIUM PLUS › Subchapter 1 - GENERAL PROVISIONS › Section 17-1709.2-2 - Definitions

Current through June, 2024
As used in this chapter:
"Department" means the department of human services of the
					 State of Hawaii or its designee.
"Eligible employer" means an employer who meets the
					 requirements of an eligible employer as described in §
										17-1709.2-7.
"Full-time" means an individual working a minimum of
					 thirty-two hours per week.
"Hawaii premium plus" means the temporary State funded
					 premium subsidy program described in this chapter.
"Hawaii Prepaid Health Care Act" means Hawaii Revised
					 Statutes, Chapter
					 393.
"Health plan" means an insurance company or other
					 organization, which provides different health care benefit packages to one or
					 more groups of enrollees.
"Premium subsidy" means a payment amount up to $140 not to
					 exceed fifty percent of the employer's monthly payment for a health insurance
					 policy that covers the qualified employee and any others on that policy.
"Qualified employee" means an individual who meets the
					 requirements of a qualified employee as described in §
										17-1709.2-8.
"Unemployment insurance benefits" means temporary
					 financial assistance to workers who are unemployed through no fault of their
					 own and who meet the requirements of the Hawaii Employment Security Law, Hawaii
					 Revised Statutes, Chapter
					 383.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.2 - STATE FUNDED HAWAII PREMIUM PLUS › Subchapter 1 - GENERAL PROVISIONS › Section 17-1709.2-3 - General provisions

Current through June, 2024
The following provisions are specific to this
					 chapter:
(1) This program, which is
				  unlike the medical assistance programs administered by the department of human
				  services, shall not be subject to the rules of this subtitle, except as
				  specifically set forth in this chapter.
(2) The provisions of chapter 1704 addressing
				  fraud shall apply to this program. However, in applying chapter 1704 to this
				  program, the terms "medical assistance" and "Medicaid" in chapter 1704 shall be
				  replaced by the term "Hawaii premium plus program."
(3) The provisions of subchapter 7 of chapter
				  1705 addressing recipient recovery shall apply to this program. However, in
				  applying subchapter 7 to this program, the terms "medical assistance" and
				  "recipient" in subchapter 7 of chapter 1705 shall be replaced by the terms
				  "Hawaii premium plus program" and "eligible employer," respectively.
(4) The department or its designee shall
				  administer this program.
(5) This
				  program shall be subject to the availability of State funds.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.2 - STATE FUNDED HAWAII PREMIUM PLUS › Subchapter 2 - HAWAII PREMIUM PLUS › Section 17-1709.2-7 - Requirements for an eligible employer

Current through June, 2024
An eligible employer shall:
(1) Have had no more than fifty employees on
				  January 1, 2 010 employed in the State.
(2) Meet all the requirements of the Hawaii
				  Prepaid Health Care Act.
(3) Have
				  the appropriate licensure to operate in the State.
(4) Provide their taxpayer identification
				  number.
(5) Employ the qualified
				  employee for full-time employment.
(6) Intend to employ a qualified employee
				  full-time for a minimum of twenty-four consecutive months.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.2 - STATE FUNDED HAWAII PREMIUM PLUS › Subchapter 2 - HAWAII PREMIUM PLUS › Section 17-1709.2-8 - General requirements for a qualified employee

Current through June, 2024
A qualified employee is an individual who:
(1) Is legally residing in Hawaii;
(2) Is age eighteen years old or
				  older;
(3) Meets the financial
				  requirements for a qualified employee as described in section
				  17-1709.2-10;
(4) Has been
				  unemployed for a minimum of six consecutive weeks immediately prior to applying
				  for Hawaii premium plus;
(5) Is
				  employed by an eligible employer for a full-time position commencing on or
				  after May 1, 2010, up to a date determined by the department that is no later
				  than April 30, 2011;
(6) Is
				  enrolled in a health plan, offered by the eligible employer that meets all the
				  requirements of the Hawaii Prepaid Health Care Act;
(7) Is not an independent contractor;
				  and
(8) Is not eligible for
				  participation in Hawaii premium plus as described in chapter 17-1709.3 or was
				  transitioned by the department from Hawaii premium plus as described in chapter
				  17-1709.3 to Hawaii premium plus as described in this chapter.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.2 - STATE FUNDED HAWAII PREMIUM PLUS › Subchapter 2 - HAWAII PREMIUM PLUS › Section 17-1709.2-10 - Financial requirements for a qualified employee

Current through June, 2024
(a) A
				  qualified employee's countable family income shall not exceed four hundred and
				  fifty per cent of the federal poverty level for Hawaii for a family of
				  applicable size.
(b) Countable
				  family income shall be determined by adding the monthly gross earned and any
				  unearned income for each household member of the employee as described in
				  chapter 17-1724.
(c) Income from
				  the employment by an eligible employer shall be reported and considered as
				  earned income in the application for Hawaii premium plus.
(d) An individual may not be a qualified
				  employee if the individual has substantial assets as determined by the
				  department.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.2 - STATE FUNDED HAWAII PREMIUM PLUS › Subchapter 2 - HAWAII PREMIUM PLUS › Section 17-1709.2-11 - Application for Hawaii premium plus

Current through June, 2024
(a) The statewide
				  maximum number of individuals determined to be qualified employees shall be
				  6,450.
(b) After the cumulative
				  statewide number of individuals determined to be qualified individuals reaches
				  6,450, the department may determine an individual to be a qualified employee
				  if:
(1) The number of participating qualified
				  employees on the date of determination is less than 6,450; and
(2) There is available funding which meets
				  the amount equal to twelve months of premium subsidy to be paid to the employer
				  for the individual.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.2 - STATE FUNDED HAWAII PREMIUM PLUS › Subchapter 2 - HAWAII PREMIUM PLUS › Section 17-1709.2-12 - Effective date of participation

Current through June, 2024
The provisions for effective date of participation as
					 described in chapter 17-1709.3 shall apply.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.2 - STATE FUNDED HAWAII PREMIUM PLUS › Subchapter 2 - HAWAII PREMIUM PLUS › Section 17-1709.2-13 - Termination from participation

Current through June, 2024
The provisions for termination from participation as
					 described in chapter 17-1709.3 shall apply.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.2 - STATE FUNDED HAWAII PREMIUM PLUS › Subchapter 3 - SPECIAL PROVISIONS › Section 17-1709.2-18 - Reporting requirements for the eligible employer

Current through June, 2024
The provisions for reporting requirements for an eligible
					 employer as described in chapter 17-1709.3 shall apply.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.2 - STATE FUNDED HAWAII PREMIUM PLUS › Subchapter 3 - SPECIAL PROVISIONS › Section 17-1709.2-20 - Payment of premium subsidy to an eligible employer

Current through June, 2024
The provisions for payment of premium subsidy to an
					 eligible employer as described in chapter 17-1709.3 shall apply.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.2 - STATE FUNDED HAWAII PREMIUM PLUS › Subchapter 3 - SPECIAL PROVISIONS › Section 17-1709.2-21 - Hawaii premium plus program termination

Current through June, 2024
The provisions for Hawaii premium plus program termination
					 as described in chapter 17-1709.3 shall apply.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.2 - STATE FUNDED HAWAII PREMIUM PLUS › Subchapter 3 - SPECIAL PROVISIONS › Section 17-1709.2-22 - Recoupment

Current through June, 2024
The provisions for recoupment as described in chapter
					 17-1709.3 shall apply.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 1 - GENERAL PROVISIONS › Section 17-1709.3-1 - Purpose

Current through June, 2024
This chapter is established to authorize, subject to the
					 availability of state funding, a temporary state with federal match funded
					 program to prevent, shorten, or eliminate the need for medical or other public
					 assistance administered by the department. Hawaii premium plus provides
					 employers an incentive to increase employment by providing a monthly premium
					 subsidy for health insurance to qualified employees for one year. At a minimum,
					 the health insurance shall meet the requirements of the Hawaii Prepaid Health
					 Care Act.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 1 - GENERAL PROVISIONS › Section 17-1709.3-2 - Definitions

Current through June, 2024
As used in this chapter:
"Department" means the department of human services of the
					 State of Hawaii or its designee.
"Eligible employer" means an employer who meets the
					 requirements of an eligible employer as described in §
										17-1709.3-7.
"full-time" means an individual working a minimum of
					 thirty-two hours per week.
"Hawaii premium plus" means the temporary state with
					 federal match funded premium subsidy program described in this chapter.
"Hawaii Prepaid Health Care Act" means Hawaii Revised
					 Statutes, chapter
					 393.
"Health plan" means an insurance company or other
					 organization, which provides different health care benefit packages to one or
					 more groups of enrollees.
"Maintenance period" means the twelve consecutive month
					 period immediately following the reimbursement period during which the employer
					 maintains the employee on its payroll without receiving any additional premium
					 subsidy from the department.
"Premium subsidy" means a payment amount up to $140 not to
					 exceed fifty percent of the employer's monthly payment for a health insurance
					 policy that covers the qualified employee and any others on that policy.
"Qualified employee" means an individual who meets the
					 requirements of a qualified employee as described in section
					 17-1709.3-8.
"Reimbursement period" means the twelve consecutive month
					 period that the qualified employee is employed by the eligible employer,
					 beginning with the effective date of participation as described in section
					 17-1709.3-11, for which an
					 eligible employer may receive a premium subsidy.
"Unemployment insurance benefits" means temporary
					 financial assistance to workers who are unemployed through no fault of their
					 own and who meet the requirements of the Hawaii Employment Security Law, Hawaii
					 Revised Statutes, chapter
					 383.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 1 - GENERAL PROVISIONS › Section 17-1709.3-3 - General provisions

Current through June, 2024
The following provisions are specific to this
					 chapter:
(1) This program, which is
				  unlike the medical assistance programs administered by the department of human
				  services, shall not be subject to the rules of this subtitle, except as
				  specifically set forth in this chapter;
(2) The provisions of chapter 17-1704
				  addressing fraud shall apply to this program. However, in applying chapter
				  17-1704 to this program, the terms "medical assistance" and "Medicaid" in
				  chapter 17-1704 shall be replaced by the term "Hawaii premium plus
				  program";
(3) The provisions of
				  subchapter 7 of chapter 17-1705 addressing recipient recovery shall apply to
				  this program. However, in applying subchapter 7 of chapter 17-1705 to this
				  program, the terms "medical assistance" and "recipient" in subchapter 7 of
				  chapter 17-1705 shall be replaced by the terms "Hawaii premium plus program"
				  and "eligible employer," respectively;
(4) The department shall administer this
				  program; and
(5) This program shall
				  be subject to the availability of state funds.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 2 - HAWAII PREMIUM PLUS › Section 17-1709.3-6 - Purpose

Current through June, 2024
This subchapter describes who may participate in Hawaii
					 premium plus and the requirements for participation.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 2 - HAWAII PREMIUM PLUS › Section 17-1709.3-7 - Requirements for an eligible employer

Current through June, 2024
An eligible employer shall:
(1) Not be a city, county, state or other
				  government entity;
(2) Meet all of
				  the requirements of the Hawaii Prepaid Health Care Act;
(3) Have the appropriate licensure to operate
				  in the State;
(4) Provide their
				  state and federal taxpayer identification numbers; and
(5) Intend to employ a qualified employee
				  full-time for a minimum of twenty-four consecutive months.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 2 - HAWAII PREMIUM PLUS › Section 17-1709.3-8 - General requirements for a qualified employee

Current through June, 2024
A qualified employee is an individual who:
(1) Meets the citizenship requirements as
				  described in section 17-1714-28;
(2) Is legally residing in Hawaii;
(3) Is age eighteen years old or
				  older;
(4) Meets the financial
				  requirements for a qualified employee as described in section
				  17-1709.3-9;
(5) Has been
				  unemployed for a minimum of six consecutive weeks immediately prior to
				  employment by the eligible employer, and who during this period either was
				  receiving unemployment insurance benefits or had exhausted their unemployment
				  insurance benefits;
(6) Is employed
				  by an eligible employer for a full-time position commencing on or after May 1,
				  2010, up to a date determined by the department that is no later than April 30,
				  2011;
(7) Is enrolled in a health
				  plan offered by the eligible employer that meets all the requirements of the
				  Hawaii Prepaid Health Care Act; and
(8) Is not an independent
				  contractor.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 2 - HAWAII PREMIUM PLUS › Section 17-1709.3-9 - Financial requirements for a qualified employee

Current through June, 2024
(a) A
				  qualified employee's countable family income shall not exceed four hundred per
				  cent of the federal poverty level for Hawaii for a family of applicable
				  size.
(b) Countable family income
				  shall be determined by adding the monthly gross earned and any unearned income
				  for each household member of the employee as described in chapter
				  17-1724.
(c) Income from the
				  employment by an eligible employer shall be reported and considered as earned
				  income in the application for Hawaii premium plus.
(d) An individual may not be a qualified
				  employee if the individual has substantial assets as determined by the
				  department.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 2 - HAWAII PREMIUM PLUS › Section 17-1709.3-10 - Application for Hawaii premium plus

Current through June, 2024
(a) The maximum
				  cumulative statewide number of individuals determined to be qualified employees
				  for Hawaii premium plus program under this chapter and Hawaii premium plus
				  under chapter 17-1709.2 shall be 6,450.
(b) After the cumulative statewide number of
				  individuals determined to be qualified individuals reaches 6,450, the
				  department may determine an individual to be a qualified employee if:
(1) The number of participating qualified
				  employees on the date of determination is less than 6,450; and
(2) There is available funding which meets
				  the amount equal to twelve months of premium subsidy to be paid to the employer
				  for the individual.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 2 - HAWAII PREMIUM PLUS › Section 17-1709.3-11 - Effective date of participation

Current through June, 2024
The effective date of an eligible employer's participation
					 in Hawaii premium plus for a qualified employee shall be:
(1) The first day of the month in which a
				  full month's health insurance is provided for that employee through the
				  eligible employer;
(2) No earlier
				  than May 1, 2010; and
(3) No
				  earlier than the day on which the qualified employee started
				  employment.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 2 - HAWAII PREMIUM PLUS › Section 17-1709.3-12 - Termination from participation

Current through June, 2024
An eligible employer's participation in Hawaii premium
					 plus:
(a) Shall be terminated for any
				  of the following reasons:
(1) Fails to meet
				  any one of the requirements described in section 17-1709.3-7;
(2) Voluntarily terminates participation;
				  or
(3) Business is
				  dissolved.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 3 - SPECIAL PROVISIONS › Section 17-1709.3-18 - Reporting requirements for the eligible employer

Current through June, 2024
(a)
				  The eligible employer shall submit a completed report in a format prescribed by
				  the department. The report shall be due to the department by the fifteenth of
				  the month following the conclusion of the reporting period, as determined by
				  the department.
(b) The eligible
				  employer shall attest that the information provided under subsection (a) is
				  true and accurate. Any intentional false statements may be prosecuted under
				  Hawaii Revised Statutes section
				  710-1063.
(c) The eligible employer shall notify the
				  department, in a format prescribed by the department, when a qualified employee
				  is no longer employed by the eligible employer by the end of the month in which
				  the employment ends.
(d) Failure to
				  comply with the reporting requirements may result in withholding of payment,
				  recoupment, and termination from participation in Hawaii premium
				  plus.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 3 - SPECIAL PROVISIONS › Section 17-1709.3-19 - Appeals

Current through June, 2024
An eligible employer may request a review by the
					 department if unsatisfied with a decision made by the department. Requests for
					 review shall be submitted in writing within ten days from the date the decision
					 is rendered. If the request is untimely, it shall be denied. A decision under
					 this subsection shall be final and conclusive.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 3 - SPECIAL PROVISIONS › Section 17-1709.3-20 - Payment of premium subsidy to an eligible employer

Current through June, 2024
(a)
				  The department shall pay the eligible employer or its designee premium
				  subsidies for the reimbursement period for each qualified employee.
(b) The amount of the monthly premium subsidy
				  shall be up to $140 and not exceed fifty percent of the employer's monthly
				  payment for a health insurance policy that covers the qualified employee and
				  any others on that policy.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 3 - SPECIAL PROVISIONS › Section 17-1709.3-21 - Hawaii premium plus program termination

Current through June, 2024
The Hawaii premium plus program shall terminate:
(1) On May 1, 2013;
(2) Due to a lack of state funds;
				  or
(3) When the program is
				  terminated or repealed.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1709.3 - STATE WITH FEDERAL MATCH FUNDED HAWAII PREMIUM PLUS › Subchapter 3 - SPECIAL PROVISIONS › Section 17-1709.3-22 - Recoupment

Current through June, 2024
(a) An eligible employer shall face a penalty
				  if the eligible employer:
(1) Released a
				  qualified employee before the end of the reimbursement period;
(2) Released a qualified employee before the
				  end of the maintenance period; or
(3) Intentionally provided false information
				  about the qualified employee or eligible employer, or both.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 1 - GENERAL PROVISIONS › Section 17-1711.1-2 - Availability of program information

Current through June, 2024
(a) The department
				  must provide the following information to any individual who requests it:
(1) Eligibility requirements;
(2) Available medical assistance Services;
				  and
(3) Rights and responsibilities
				  of an individual with respect to the State's medical assistance
				  programs.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 2 - APPLICANTS › Section 17-1711.1-8 - Purpose

Current through June, 2024
This subchapter describes the rights and responsibilities
					 of an individual applying for participation in a medical assistance
					 program.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 2 - APPLICANTS › Section 17-1711.1-9 - Who may apply

Current through June, 2024
The department must accept an application for medical
					 assistance and any documentation required to establish eligibility from an
					 applicant, an adult who is in the applicant's household or family, an
					 authorized representative, or if the applicant is a minor or incapacitated,
					 someone acting responsibly for the applicant.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 2 - APPLICANTS › Section 17-1711.1-10 - Individuals who are not required to apply

Current through June, 2024
The following individuals shall be automaticully
					 determined eligible for Medicaid:
(1)
				  A newborn up to one year of age born to a Medicaid beneficiary mother,
				  including a mother receiving only emergency medical services under chapter
				  17-1723.1;
(2) An individual
				  receiving Title IV-E foster care or kinship guardianship payments who is:
(A) Under twenty-one years of age;
(B) Certified by a social worker of the
				  department to be eligible for Title IV-E foster care maintenance or kinship
				  guardianship payments; and
(C)
				  Placed in a licensed or authorized foster home or child caring institution that
				  is appropriately supervised by a licensed child placement agency or the State
				  family court; or
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 2 - APPLICANTS › Section 17-1711.1-11 - Application counselors

Current through June, 2024
(a) The department
				  shall provide assistance to any individual seeking help with the medical
				  assistance application or annual redetermination process in person, over the
				  telephone, and online, in a manner that is accessible to individuals with
				  disabilities and those who are limited English proficient, consistent with
				  subsections 17-1711.1-2(b),(c) and (d).
(b) The department may choose to designate
				  organizations, subject to certification by the department or designee to
				  provide assistance to an individual with the application or redetermination
				  process, to include but not be limited to:
(1)
				  Completion or submission of an application or redetermination form for medical
				  assistance;
(2) Interaction with
				  the department on the status of the application or redetermination;
(3) Assistance with responses to the
				  department; and
(4) Case management
				  following the initial approval and subsequent redeterminations in compliance
				  with all federal requirements.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 2 - APPLICANTS › Section 17-1711.1-12 - Authorized representatives

Current through June, 2024
(a) An individual
				  applying for medical assistance may designate an individual or organization to
				  be an authorized representative to act on their behalf to assist with an
				  application, a redetermination of eligibility, and other on-going
				  communications with the department.
(b) The designation of an authorized
				  representative must be in writing and signed by the individual. Legal
				  documentation of authority to act on behalf of an individual under State law,
				  to include a court order establishing legal guardianship, or power of attorney,
				  shall serve in the place of a written authorization.
(c) The authority of an authorized
				  representative is valid until:
(1) The
				  applicant or beneficiary withdraws the authorization by notifying the
				  department that the representative is no longer authorized to act on the
				  applicant's or beneficiary's behalf;
(2) There is a change in the legal document
				  of authority to act on the applicant's or beneficiary's behalf; or
(3) The authorized representative informs the
				  department that he is no longer acting as the individual's authorized
				  representative.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 2 - APPLICANTS › Section 17-1711.1-13 - Applicant rights

Current through June, 2024
(a) The department
				  must provide an individual the opportunity to apply for Medicaid without
				  delay.
(b) The department shall
				  inform the individual of their right to language access services, and auxiliary
				  aids and services for individuals with disabilities, and how to access those
				  services.
(c) The department shall
				  not require an inperson interview as part of the application process for a
				  determination of eligibility using MAGI-based income methodology.
(d) An individual may withdraw, modify or
				  terminate a submitted application as described in section
				  17-1711.1-22.
(e) An individual
				  eligible under more than one medical assistance program shall be afforded the
				  opportunity to select the program of the individual's choice.
(f) A request for an administrative hearing
				  may be submitted by the individual or the individual's authorized
				  representative when the individual is not satisfied with the department's
				  eligibility determination, under the provisions of chapter 171703.1.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 2 - APPLICANTS › Section 17-1711.1-14 - Applicant responsibilities

Current through June, 2024
(a) The individual
				  shall:
(1) Complete the application form(s)
				  as prescribed by the department for medical assistance;
(2) Provide all information requested by the
				  department to establish eligibility and submit required documents as
				  appropriate within the time period specified by the department;
(3) Apply for and develop potential sources
				  of income and assets as applicable; and
(4) Assign any benefits due to a possible
				  third party liability, including referral for child support and initiation of a
				  referral to establish paternity as required under the provisions of chapter
				  17-1705.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 3 - APPLICATION PROCESS › Section 17-1711.1-20 - Purpose

Current through June, 2024
This subchapter describes the application process to
					 determine eligibility for participation in a medical assistance
					 program.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 3 - APPLICATION PROCESS › Section 17-1711.1-21 - Filing an application for medical assistance

Current through June, 2024
(a) The
				  application process shall begin when a completed application for medical
				  assistance is received by the department or designee and ends with the
				  department's issuing an eligibility determination to the applicant.
(b) The application shall be used for all
				  insurance affordability programs and may be submitted according to the
				  applicant's preference by one of the following methods:
(1) Via the department's designated internet
				  web site(s);
(2) By
				  telephone;
(3) Via the United
				  States Postal Service;
(4) In
				  person; and
(5) Through other
				  commonly available electronic means.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 3 - APPLICATION PROCESS › Section 17-1711.1-22 - Application withdrawn or discontinued

Current through June, 2024
(a) An individual
				  may withdraw or discontinue an application in writing, verbally by telephone,
				  in person or through other commonly available electronic means.
(b) Requests for application withdrawal shall
				  be documented in the individual's record and a confirmation notice of
				  withdrawal sent in accordance with chapter 17-1713.1.
(c) The department may discontinue an
				  application for medical assistance prior to an eligibility determination for
				  any of the following reasons:
(1) Death of
				  the applicant, and:
(A) Information provided
				  at the point of application is insufficient to determine eligibility;
				  or
(B) No other individual is
				  designated or able to continue the application process on behalf of the
				  deceased;
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 3 - APPLICATION PROCESS › Section 17-1711.1-23 - Verification prior to approval

Current through June, 2024
(a) The department
				  shall inform the individual of its intent to obtain and use information from
				  other federal and State programs, as applicable and available, to verify
				  information required to make an eligibility determination for Medicaid and
				  other insurance affordability programs, including, but not limited to:
(1) U.S. citizenship or non-citizen status
				  and identity as required by chapter 17-1714.1;
(2) Assignment of possible third party
				  liability, including referral for child support and initiation of a referral to
				  establish paternity as required by chapter 17-1705;
(3) Date of birth and gender;
(4) Social security number as required by
				  chapter 17-1714.1;
(5) Gross
				  non-exempt income of the household as required by chapter 17-1724.1;
(6) Non-exempt resources of the household as
				  required by chapter 17-1725.1;
(7)
				  Blindness or disability as determined in accordance with the provisions of
				  chapter 17-1719;
(8) Prior
				  determination of blindness or disability verified by the:
(A) Social Security Administration
				  (SSA);
(B) Department's Aid to
				  Disabled Review Committee (ADRC); or
(C) Department's consultant ophthalmologist
				  with the vocational rehabilitation and services for the blind division at
				  Ho'opono.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 4 - ELIGIBILITY DETERMINATION PROCESS › Section 17-1711.1-29 - Purpose

Current through June, 2024
This subchapter describes the process to determine
					 eligibility for an individual who is applying for participation in a medical
					 assistance program.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 4 - ELIGIBILITY DETERMINATION PROCESS › Section 17-1711.1-30 - Presumptive eligibility submitted by a qualified hospital

Current through June, 2024
(a)
				  The department shall provide Medicaid to certain individuals who are determined
				  presumptively eligible by a qualified hospital.
(b) Approval for presumptive eligibility
				  shall be limited to the coverage groups as determined by the
				  department.
(c) The department
				  shall establish standards, policies, and measures of quality outcomes to
				  qualify, and as appropriate disqualify, hospitals approved to determine
				  presumptive eligibility.
(d) The
				  applicant shall be subject to departmental fraud penalties or recovery
				  requirements for false or withheld information.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 4 - ELIGIBILITY DETERMINATION PROCESS › Section 17-1711.1-31 - Expedited processing for emergency medical services

Current through June, 2024
(a)
				  An application shall be processed within two working days when:
(1) The applicant is suffering from an
				  emergency medical condition for which covered medical services are available;
				  and
(2) Failure to receive
				  immediate treatment would result in any of the following consequences;
(A) Serious risk of disease;
(B) Threat to life or vital
				  function;
(C) Serious health
				  complication; or
(D) Serious
				  irreparable harm.
Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1711.1 - PROCESSING OF APPLICATIONS FOR MEDICAL ASSISTANCE › Subchapter 4 - ELIGIBILITY DETERMINATION PROCESS › Section 17-1711.1-32 - Determination of eligibility for Medicaid

Current through June, 2024
(a) The department
				  shall determine eligibility according to federal and State regulations and
				  policies. The decision regarding eligibility or ineligibility shall be
				  supported by facts in the applicant's record. Each application shall be
				  determined as eligible or ineligible unless the application is withdrawn or
				  discontinued under section 17-1711.1-22.
(b) Timely dispositions of eligibility or
				  ineligibility shall be made within:
(1)
				  Ninety days from the date of application for an applicant applying for medical
				  assistance on the basis of disability including applications for long-term
				  care; or
(2) Forty-five days from
				  the date of application for all other applicants.