Click here to see the MAWD Initial Premium Statement (PA 1755).
If the applicant requests and is authorized retroactive MAWD benefits, the initial premium statement issued by the CAO must include the premium amount for each Retroactive month.
Reminder: Data entry of retroactive MAWD eligibility period cannot be completed until Central Office notifies the CAO by Alert #182 that the Retroactive premium(s) has been paid. If the CAO is waiting for notification of payment of the premium for Retroactive months, do not delay authorization of ongoing MAWD benefits.
If the data entry (for ongoing benefits) is completed after the eligibility begin date, include the monthly premium for each ongoing month beginning with the first month of ongoing eligibility and ending with the current month on the initial premium statement.
Retroactive and ongoing monthly premiums are included on the same initial premium statement.
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Do not send the initial premium statement until the PW budget is authorized. |
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EXAMPLES: |
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MAWD On-going Eligibility Begin Date |
Data Entry Completion Date |
Initial Premium Statement Issued by CAO |
Central Office Statement System Generated |
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April 1st |
Before 3/31 |
No (CAO does not issue) (System generated by Central Office) |
April |
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March 1st |
3/1 – 3/31 |
Yes |
April |
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February 1st |
3/1 – 3/31 |
Yes |
April |
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January 1st |
3/1 – 3/31 |
Yes |
April |
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Premium Statements issued by Central Office |
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All MAWD budgets authorized by the last day of the month with a begin date of the first day of the next month will have a Premium Statement issued by Central Office. |
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CAOs must not issue an initial premium statement in this situation. |
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Example: |
Date of Application is 4/22/2010. |
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Retroactive benefits requested for 1/2010, 2/2010 and 3/2010. (Each month requires separate eligibility determination and premium calculation). |
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Applicant can request authorization of on-going MAWD benefits for 4/1/2010 or 5/1/2010. |
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1. |
Data entry is completed on or before 4/30/2010. MAWD eligibility begin date is 4/1/2010. Determined eligible for retroactive benefits. |
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Initial premium statement would include: |
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Retroactive months of 1/2010, 2/2010 and 3/2010. |
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On-going month of 4/2010. |
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2. |
Data entry is completed after 4/30/2010 but before 5/31/2010. MAWD eligibility begin date is 4/1/2010. Determined eligible for Retroactive benefits. |
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Initial premium statement would include: |
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Retroactive months of 1/2010, 2/2010 and 3/2010. |
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On-going months of 4/2010 and 5/2010. |
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3. |
Data entry is completed before or on 4/30/2010. MAWD begin date is 5/1/2010. Determined eligible for Retroactive benefits. |
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Initial premium statement would include: |
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Retroactive months of 1/2010, 2/2010 and 3/2010. |
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Central Office will issue the Premium Statement for May. |
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If the applicant was not eligible for Retroactive benefits or did not request retroactive benefits, the CAO does not issue an initial premium statement.
If the initial premium statement includes premium billing for more than one month and the recipient does not submit payment for all of the months (on initial statement), payment is applied to the earliest months.
Example: If the individual is initially billed for 4 months of premiums (2 retroactive and 2 ongoing months), but only pays 2 months, the payment is applied to the retroactive months.
Updated February 14, 2012, Replacing October 17, 2008