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Revision 11-3; Effective September 1, 2011
A hardship exemption may be granted for loss of income if the loss of income is due to:
- termination of employment because of layoff or business closing;
- involuntary reduction in work hours;
- a parent leaving the household because of divorce or separation; or
- a parent's death (the parent had to be previously residing in the same household as the MBIC applicant/recipient).
No hardship exemption is allowed to waive prior months premium(s).
Hardship exemption is only allowed once per household every 12 calendar months (regardless of how many MBIC recipients are in the household).
A hardship must be requested within 10 days from the date on Form H0065-MBIC, Hardship Form. A hardship request must be in writing; however, a verbal request is acceptable to meet the 10-day deadline. Written follow-up is required.
Example: First missed payment is May 5, 2011. On June 5, 2011, the May payment is missed a second time. On June 7, 2011, Form H0062-MBIC, Late Payment Notice, and Form H0065-MBIC, Hardship Form, are sent to the client/authorized representative. Due date for premium payment is July 6, 2011. Due date for a hardship to be claimed is June 17, 2011 (10 days from date of Form H0065-MBIC). Payment must be received by two days before cut-off in July 2011 or hardship claimed by June 17, 2011. If no payment is received or hardship claimed, denial is effective July 31, 2011. TIERS will auto terminate the MBIC EDG(s) effective the end of that month.
N-7510 Hardship Approval
Revision 11-3; Effective September 1, 2011
Approve a hardship request if one of the valid reasons is met. Do not require verification of hardship reasons. Use client's statement and signature on Form H0065-MBIC, Hardship Form, as proof of the hardship; however, if the reason is something that would potentially impact benefits (such as loss of job), verify the change for potential eligibility changes to ongoing benefits. This does not have to be done before the hardship can be approved. Notify a client/authorized representative of the hardship approval on Form TF0001-MBIC, Hardship Waiver Approved.
If approved, the hardship exemption begins on the first of the month for which a premium payment was not received and is granted for three consecutive months.
Example: Premiums were missed in May and again in June. Hardship was claimed on Form H0065-MBIC, and hardship was approved in July. Premiums are waived for May, June and July.
N-7511 Hardship Approval Reasons
Revision 11-3; Effective September 1, 2011
Form TF0001-MBIC, Hardship Waiver Approved, will be pre-populated with one of the following reasons.
- Someone living with you was laid off their job. – OR – The place where they work closed.
- Someone living with you has less income because they work fewer hours.
- A parent left the house because of a divorce or separation.
- A parent died. (This is an approval reason but this actual verbiage will not print on the TF0001.)
N-7520 Hardship Denial
Revision 11-3; Effective September 1, 2011
Deny a hardship request if:
- none of the valid reasons are met; or
- Form H0065-MBIC, Hardship Form, or a verbal request was not received by the due date; or
- a hardship has been granted within the past 12 calendar months. TIERS will track the12-month period.
Notify a client/authorized representative of the hardship denial via Form TF0001-MBIC, Hardship Waiver Denied.
N-7521 Hardship Denial Reasons
Revision 11-3; Effective September 1, 2011
Form TF0001-MBIC, Hardship Waiver Denied, will be pre-populated with one of the following reasons.
- We didn't get your "Hardship Form" (H0065-MBIC) by the due date.
- It hasn't been 12 months since we last stopped your payments. Your payments can be stopped for three months only once in 12 months.
- You didn't lose money from a job (income) for reasons that allow us to stop your payments.