With the move to an enterprise-wide modern membership system, we’re implementing and standardizing premium payment-related policies for KPIF health plan members to better align the administrative experience. Policy updates will not be proactively communicated to members since policies are captured in Evidence of Coverage (EOC) documents and other communications based on their membership experience. However, we want to make you aware of these updates.
We’re implementing a non-sufficient funds fee for returned checks or insufficient funds on electronic payments. KPIF health plan members will be sent a notification when the fee is incurred and reflected as an adjustment in their next premium billing statement. The new $20 fee applies to KPIF On and Off Exchange members in Oregon: The fee does not currently apply to members in Washington.
We’re aligning the termination for non-payment policy. Members who do not pay their current and past due premiums by the end of their grace period will be terminated retroactively to their paid-through date. This applies to KPIF On and Off Exchange members in Oregon and Washington who do not receive federal premium subsidies (APTC). Note: This is a change for KPIF On Exchange members who currently are terminated at the end of their grace period.
We’re aligning our binder premium payment due date for newly enrolled members. The binder premium due date in our new membership system is the later of (1) the enrollment effective date, or (2) the date we receive the enrollment + 30 calendar days. This applies to KPIF On and Off Exchange members in Washington. Note: This is a change for KPIF Off Exchange members.
Example: For an enrollment received on 2/16/2024 with an effective date of 3/1/2024, the binder due date is 3/17/2024 (enrollment received date + 30 calendar days).
Already in place in our systems, Oregon’s binder payment due date is defined by State regulations and will not be changed. The due date is the later of (1) the enrollment effective date + 14 calendar days, or (2) the date we receive the enrollment + 30 calendar days.
