BLUE CROSS AGREEMENT REGULATION

Transcription

1 Province of Alberta ALBERTA HEALTH CARE INSURANCE ACT BLUE CROSS AGREEMENT REGULATION Alberta Regulation 77/2006 With amendments up to and including Alberta Regulation 4/2016 Office Consolidation Published by Alberta Queen s Printer Alberta Queen s Printer 7 th Floor, Park Plaza Avenue Edmonton, AB T5K 2P7 Phone: Fax: qp@gov.ab.ca Shop on-line at

2 Copyright and Permission Statement Alberta Queen's Printer holds copyright on behalf of the Government of Alberta in right of Her Majesty the Queen for all Government of Alberta legislation. Alberta Queen's Printer permits any person to reproduce Alberta s statutes and regulations without seeking permission and without charge, provided due diligence is exercised to ensure the accuracy of the materials produced, and Crown copyright is acknowledged in the following format: Alberta Queen's Printer, 20.* *The year of first publication of the legal materials is to be completed. Note All persons making use of this consolidation are reminded that it has no legislative sanction, that amendments have been embodied for convenience of reference only. The official Statutes and Regulations should be consulted for all purposes of interpreting and applying the law.

3 (Consolidated up to 4/2016) ALBERTA REGULATION 77/2006 Alberta Health Care Insurance Act BLUE CROSS AGREEMENT REGULATION Table of Contents 1 Definitions Part 1 Applicants for Enrolment 2 Enrolment as non-group member 3 New residents 4 Person who ceases to be a dependant 5 Transfer from group member 6 Transfer from other group insurance plan 7 Cancellation by resident 8 Cancellation by Minister Part 2 Enrolment by Minister 9 Application of Part 1 10 Enrolment of seniors 11 Enrolment of widow s pension recipients Definitions 1 In this Regulation, (a) Act means the Alberta Health Care Insurance Act; (b) Alberta Blue Cross Plan means the Alberta Blue Cross Plan operated by the ABC Benefits Corporation under the ABC Benefits Corporation Act and the regulations under that Act; (c) date of receipt means the date the applicant s application under section 2 was received by the Minister; (d) date of residency means the date the applicant became a resident of Alberta;

4 Section 2 BLUE CROSS AGREEMENT REGULATION AR 77/2006 (e) dependant, except in section 4, means dependant as defined in the Alberta Health Care Insurance Regulation. Part 1 Applicants for Enrolment Enrolment as non-group member 2(1) A resident of Alberta who is not in arrears in the payment of premiums under the Health Insurance Premiums Act may apply to the Minister in the form established by the Minister to be enrolled, with the resident s dependants, as a non-group member of the Alberta Blue Cross Plan. (2) The effective date of membership of an applicant under subsection (1) is the first day of the 4th month following the date of receipt, unless section 3, 4, 5 or 6 applies. (3) The effective date of membership of an applicant s dependants is the same as the effective date of membership of the applicant. New residents 3 The effective date of membership of an applicant under section 2 is the first day of the 3rd month following the date of receipt if the applicant moved to Alberta (a) from another jurisdiction in Canada and the date of receipt falls before the first day of the 4th month following the date of residency, or (b) from a jurisdiction outside Canada and the date of receipt is not later than 3 months following the date of residency. Person who ceases to be a dependant 4 The effective date of membership of an applicant under section 2 is the date on which the applicant s registration under the Health Insurance Premiums Act is effective if all of the following apply: (a) the applicant ceased to be a dependant under the Health Insurance Premiums Act and applied for registration under that Act; (b) the applicant requested an application form referred to in section 2 within one month after the date shown in the Minister s records as the date that the applicant ceased to be a dependant under the Health Insurance Premiums Act; 2

5 Section 5 BLUE CROSS AGREEMENT REGULATION AR 77/2006 (c) the date of receipt is not more than one month after the date the application form was given or mailed to the applicant; (d) the applicant s eligibility for receipt of benefits under the Alberta Health Care Insurance Plan has not ceased since the date the applicant ceased to be a dependant under the Health Insurance Premiums Act. Transfer from group member 5(1) Subject to subsection (2), the effective date of membership of an applicant under section 2 who wishes to transfer from enrolment as a group member of the Alberta Blue Cross Plan to enrolment as a non-group member of the Alberta Blue Cross Plan is (a) the date on which the termination of the applicant s enrolment as a group member is effective, or (b) if the applicant is notified of the termination of the applicant s enrolment as a group member after the date on which the termination is effective, (i) the date on which the termination of the applicant s enrolment as a group member was effective, or (ii) the first day of the 4th month following the date of receipt, whichever the applicant chooses. (2) Subsection (1) applies only if the date of receipt is not more than 30 days after the applicant is notified of the termination of the applicant s enrolment as a group member. Transfer from other group insurance plan 6(1) Subject to subsection (2), the effective date of membership of an applicant under section 2 who wishes to transfer from enrolment under a group insurance plan that in the Minister s opinion is similar to the Alberta Blue Cross Plan to enrolment as a non-group member of the Alberta Blue Cross Plan is the date on which the termination of the applicant s coverage under the group insurance plan is effective. (2) Subsection (1) applies only if the date of receipt is not more than 30 days after the date on which the termination of the applicant s coverage under the group insurance plan is effective. 3

6 Section 7 BLUE CROSS AGREEMENT REGULATION AR 77/2006 Cancellation by resident 7 A resident enrolled as a non-group member of the Alberta Blue Cross Plan may notify the Minister to cancel the resident s membership and the cancellation of the membership is effective on the last day of the month in which the Minister receives the notification. Cancellation by Minister 8 If a resident enrolled as a non-group member of the Alberta Blue Cross Plan is in arrears in the payment of premiums under the Health Insurance Premiums Act or the regulations under that Act for a period longer than 3 months, the Minister shall cancel the resident s membership as a non-group member of the Alberta Blue Cross Plan. Part 2 Enrolment by Minister Application of Part 1 9 Part 1 does not apply to a resident enrolled as a non-group member of the Alberta Blue Cross Plan in accordance with this Part. Enrolment of seniors 10(1) If a resident or the resident s spouse or adult interdependent partner is 65 years of age or older, the Minister shall enrol the resident and the resident s dependants as non-group members of the Alberta Blue Cross Plan. (2) The effective date of membership of a person enrolled under subsection (1) is (a) the date on which the registration for basic health services under the Health Insurance Premiums Act becomes effective, where the resident, spouse or adult interdependent partner is 65 years of age or older at the time of registration, (b) the first day of the first month following the 65th birthday of the resident, spouse or adult interdependent partner, where that birthday occurs after the date on which the registration for basic health services becomes effective, or (c) the date of the 65th birthday of the resident, spouse or adult interdependent partner, where that birthday falls on the first day of the month and occurs after the date on 4

7 Section 11 BLUE CROSS AGREEMENT REGULATION AR 77/2006 which the registration for basic health services becomes effective. (3) Entitlement to enrolment under subsection (1) ceases at the end of the 2nd month following the month in which the death of the resident, spouse or adult interdependent partner who is 65 years of age or older occurs. Enrolment of widow s pension recipients 11(1) If a resident is in receipt of a widow s pension the Minister shall enrol the resident and the resident s dependants as non-group members of the Alberta Blue Cross Plan. (2) The effective date of membership of a person enrolled under subsection (1) is the date on which (a) the registration for basic health services under the Health Insurance Premiums Act becomes effective, where the resident is in receipt of the widow s pension at the time of registration, or (b) entitlement to the widow s pension occurs, where entitlement occurs after the date on which the registration for basic health services becomes effective. (3) Entitlement to enrolment under subsection (1) ceases (a) at the end of the 2nd month following the month in which the resident who was receiving the widow s pension dies, or (b) at the end of the 2nd month following the month in which the resident becomes ineligible for the widow s pension, whichever occurs first. Part 3 Repealed AR 4/2016 s2. 5

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